KẾT QUẢ ĐIỀU TRỊ SỐC GIẢM THỂ TÍCH Ở NGƯỜI BỆNH XUẤT HUYẾT TIÊU HOÁ CAO TẠI BỆNH VIỆN ĐẠI HỌC Y HÀ NỘI

Abstract

Background: Hypovolemic shock due to upper gastrointestinal bleeding (UGIB) is a critical emergency requiring intensive resuscitation with blood transfusion, intravenous fluids, and vasopressors to stabilize hemodynamics, along with urgent hemostatic interventions such as endoscopy, interventional radiology, or surgery. Objective: To evaluate the treatment outcomes of patients with grade III or higher hypovolemic shock caused by UGIB at Hanoi Medical University Hospital. Methods: A retrospective descriptive study was conducted on 36 patients with grade III or higher hypovolemic shock due to UGIB, treated between January 2022 and January 2025. Results: The mean age was 53.3 ± 16.4 years (range 19–91), with males accounting for 86.1%. All patients were admitted in shock with lactate 4.4 ± 3.7 mmol/L and hemoglobin 78.6 ± 22.9 g/L; 27.8% required vasopressors (mainly noradrenaline). All underwent endoscopy within 6 hours of admission, 47.2% within the first 3 hours. Hemostatic procedures included hemoclip application (10 cases), APC (2 cases), hemostatic spray (4 cases), and rubber band ligation for esophageal varices (11 cases). The overall rate of successful hemostasis with discharge/transfer was 91.7%. Conclusion: Intensive resuscitation combined with early endoscopy is highly effective in managing UGIB with hypovolemic shock, minimizing the need for interventional radiology or surgery.