参附注射液对急性失血性休克患者红细胞输注量及凝血功能的影响

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。

Effects of Shenfu Injection on Blood Cell Transfusion and Transfusion Related Complications in Patients with Hemorrhagic Shock

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.