摘要
目的:比较急性上消化道出血患者采用积极输血与限制输血策略对止血效果及凝血功能的影响。方法:选取2017年4月-2020年4月于中国人民解放军联勤保障部队第九八八医院就诊的146例急性上消化道出血患者,采用随机数表法分为两组。对照组73例患者实施积极输血,观察组73例患者实施限制输血。比较两组患者止血效果、凝血功能[凝血酶时间(TT)、凝血原时间(PT)和活化部分凝血活酶时间(APTT)]、血液流变学以及再出血风险。结果:观察组输血后24 h止血率高于对照组,差异有统计学意义(χ^(2)=7.243,P<0.05);两组患者输血后48 h、72 h止血率比较,差异无统计学意义(χ^(2)=2.204、1.895,P>0.05)。观察组输血后TT (15.24±4.20) s、PT (15.39±1.89) s、APTT (27.38±9.51) s,短于对照组的(20.72±5.31) s、(18.41±2.36) s、(38.55±11.62) s,红细胞比容(49.91±7.21)%、血浆黏度(2.64±0.35) mPa·s、全血黏度(4.52±0.27) mPa·s,高于对照组的(42.58±5.66)%、(2.08±0.26) mPa·s、(4.07±0.25) m Pa·s,再出血风险评分(2.48±0.71)分,低于对照组的(3.51±0.69)分,差异有统计学意义(t=0.091、6.916、0.289、8.534、0.007、6.356,P<0.05)。结论:与积极输血相比,限制输血策略治疗急性上消化道出血患者止血效果较佳,对改善凝血功能、血液流变学,降低再出血风险具有积极的作用,利于患者预后。
Objective:To compare the effects of aggressive blood transfusion and restricted blood transfusion strategies on hemostasis and coagulation function in patients with acute upper gastrointestinal bleeding.Methods:A total of 146 patients with acute upper gastrointestinal bleeding who visited the hospital from April 2017 to April 2020 were selected and divided into two groups by random number table method.73 patients in the control group received active blood transfusion,and 73 patients in the observation group received restricted blood transfusion.The hemostatic effect,coagulation function(thrombin time[TT],prothrombin time[PT]and activated partial thromboplastin time[APTT]),hemorheology and rebleeding risk were compared between the two groups.Results:The hemostasis rate at 24 h after blood transfusion in the observation group was higher than that in the control group,and the difference was statistically significant(χ^(2)=7.243,P<0.05).There was no statistically significant difference in the hemostasis rate between the two groups at 48 h and 72 h after blood transfusion(χ^(2)=2.204,1.895,P>0.05).After blood transfusion the TT in the observation group was(15.24±4.20)s,the PT was(15.39±1.89)s,and the APTT was(27.38±9.51)s,which were shorter than(20.72±5.31)s,(18.41±2.36)s,and(18.41±2.36)s in the control group.(38.55±11.62)s,the hematocrit was(49.91±7.21)%,the plasma viscosity was(2.64±0.35)mPa·s,and the whole blood viscosity was(4.52±0.27)mPa·s,which were higher than(42.58±5.66)%,(2.08±0.26)mPa·s,(4.07±0.25)mPa·s in the control group,the rebleeding risk score was(2.48±0.71)which was lower than(3.51±0.69)of the control group,and the difference was statistically significant(t=0.091,6.916,0.289,8.5340.007,6.356,P<0.05).Conclusion:Compared with active blood transfusion,the limited blood transfusion strategy in the treatment of patients with acute upper gastrointestinal bleeding has better hemostatic effect,and has a positive effect on improving coagulation function,hemorheology,and reducing the risk of rebleeding,which is beneficial to the prognosis of patients.
作者
赵自勇
孙振威
尚伟
乔素冬
ZHAO Zi-yong;SUN Zhen-wei;SHANG Wei(Department of Laboratory and Blood Transfusion,The 988th Hospital of the Chinese People’s Liberation Army Joint Logistics Support Force,Zhengzhou,Henan,450000,China)
出处
《黑龙江医学》
2022年第7期847-849,共3页
Heilongjiang Medical Journal
关键词
急性上消化道出血
积极输血
限制输血
止血效果
凝血功能
再出血风险
Acute upper gastrointestinal bleeding
Active blood transfusion
Restrict blood transfusion
Hemostatic effect
Coagulation function
Risk of rebleeding
