Report of 2 cases of hemorrhagic shock caused by explicit small intestinal bleeding treated with norepinephrine in the emergency department
急诊科内去甲肾上腺素治疗显性小肠出血致失血性休克2例报道

摘要

目的 分析去甲肾上腺素使用后再次显性出血频率的相关性。方法 选择2019年10月到2023年10月武汉协和医院重症监护病房已确诊为显性小肠出血，并失血性休克时应用去甲肾上腺素维持压的患者共2例做为回顾性研究对象。分析应用去甲肾上腺素维持血压前后患者显性出血的频率、输血量及血红蛋白的变化。结果 静脉应用去甲肾上腺素维持血压后可减少患者再次显性出血的频率，减少输血量，维持生命体征。结论 在急诊科内首诊疑似显性小肠出血患者可在失血性休克代偿期应用PPI及止血药物基础上积极应用去甲肾上腺素减少出血量，维持体征，为患者转运、手术治疗争取时间。

Abstract

Objective: To analyze the correlation between the frequency of recurrent bleeding after the use of norepinephrine. Method: Two patients diagnosed with overt small intestinal bleeding in the intensive care unit of Wuhan Union Medical College Hospital from October 2019 to October 2023, who were treated with norepinephrine to maintain blood pressure during hemorrhagic shock, were selected as the retrospective study subjects. The frequency of overt bleeding, transfusion volume, and hemoglobin changes in patients before and after using norepinephrine to maintain blood pressure were analyzed. Result: Intravenous application of norepinephrine to maintain blood pressure can reduce the frequency of recurrent bleeding, decrease blood transfusion volume, and maintain vital signs in patients.
Conclusion  : Patients with suspected overt small intestinal bleeding in the emergency department can actively use norepinephrine in addition to PPI and hemostatic drugs during the compensatory period of hemorrhagic shock to reduce bleeding volume, maintain physical signs, and buy time for patient transportation and surgical treatment.