CAJ | 학술논문

目的：观察参附注射液对失血性休克患者减少红细胞（RBC）输注量以及输血相关并发症的影响。方法选取APACHEⅡ评分≥15分并且≤25分的急性失血性休克患者60例，随机分为治疗组与对照1组、对照2组，每组20例。三组均予常规止血早期液体复苏等治疗，对照1组设定血红蛋白（Hb）<60g/L为输血指征；对照2组Hb<80g/L为输血指征；治疗组应用参附注射液，同时设定以Hb<60g/L为输血指征。观察各组血管活性药物维持时间、ICU治疗天数、RBC输注量，6、24h动脉血乳酸清除率，24、72h凝血酶原时间（PT）。结果治疗组血管活性药物维持时间、ICU治疗时间、RBC输注量，6、24h乳酸清除率及24、72h PT指标均明显优于对照1组（P<0.05或P<0.01）；治疗组血管活性药物维持时间、6h乳酸清除率与对照2组比较，差异无统计学意义（P>0.05），ICU治疗天数、RBC输注量、24h乳酸清除率、24、72h PT等指标明显优于对照2组（P<0.05或P<0.01）。结论参附注射液能显著改善失血性休克患者的血流动力学状态，增加组织氧供，有效改善细胞氧代谢，从而减少失血性休克患者RBC输注量，改善凝血功能。
목적：관찰삼부주사액대실혈성휴극환자감소홍세포（RBC）수주량이급수혈상관병발증적영향。방법선취APACHEⅡ평분≥15분병차≤25분적급성실혈성휴극환자60례，수궤분위치료조여대조1조、대조2조，매조20례。삼조균여상규지혈조기액체복소등치료，대조1조설정혈홍단백（Hb）<60g/L위수혈지정；대조2조Hb<80g/L위수혈지정；치료조응용삼부주사액，동시설정이Hb<60g/L위수혈지정。관찰각조혈관활성약물유지시간、ICU치료천수、RBC수주량，6、24h동맥혈유산청제솔，24、72h응혈매원시간（PT）。결과치료조혈관활성약물유지시간、ICU치료시간、RBC수주량，6、24h유산청제솔급24、72h PT지표균명현우우대조1조（P<0.05혹P<0.01）；치료조혈관활성약물유지시간、6h유산청제솔여대조2조비교，차이무통계학의의（P>0.05），ICU치료천수、RBC수주량、24h유산청제솔、24、72h PT등지표명현우우대조2조（P<0.05혹P<0.01）。결론삼부주사액능현저개선실혈성휴극환자적혈류동역학상태，증가조직양공，유효개선세포양대사，종이감소실혈성휴극환자RBC수주량，개선응혈공능。
To investigate the effects of Shenfu injection on red blood cell (RBC) transfusion and transfusion related complications in patients with hemorrhagic shock. Methods Sixty hemorrhagic shock patients with APACHEIIscore of 15-25 were randomly assigned to treatment group(n=20),control group 1(n=20) and con-trol group 2 (n=20). All patients in 3 groups received conventional hemostatic treatment and early fluid resuscita-tion. The indications of blood transfusion were Hb<60g/L and Hb<80g/L in control group 1 and 2,respectively. Shenfu injection was added to treatment group and the indication of blood transfusion was Hb<60g/L. The duration of vasoactive drugs,ICU stay,volume of RBC transfusion,6-h and 24-h lactate clearance rate,and 24-h and 72-h prothrombin time(PT) were observed in 3 groups. Results Compared with control group 1,the duration of vasoac-tive drugs,ICU stay,volume of RBC transfusion, and 24-h and 72-h PT were decreased, and 6-h and 24-h lac-tate clearance rate was increased in treatment group(P<0.05 or P<0.01). Compared with control group 2,no signifi-cant difference was found in the duration of vasoactive drugs and 6-h lactate clearance rate in treatment group(P>0.05),but ICU stay,volume of RBC transfusion,and 24-h and 72-h PT were decreased and 24-h lactate clearance rate was increased in treatment group (P<0.05 or P<0.01). Conclusion Shenfu injection can significantly improve the hemodynamic status of patients with hemorrhagic shock by increasing tissue oxygen supply and effectively im-proving cellular oxygen metabolism to reduce volume of RBC transfusion and ameliorated coagulation.