冷沉淀治疗肝硬化合并消化道出血

Cryoprecipitate Treatment for Cirrhosis Complicated with Gastrointestinal Bleeding

目的研究冷沉淀用于肝硬化合并消化道出血的临床效果。方法选取于2014年2月至2016年3月期间,我院收治的肝硬化合并消化道出血患者32例,随机分为治疗组和对照组,每组16例,治疗组患者给予适量的冷沉淀,根据患者凝血四项及D-D二聚体水平检测结果,进行适当调整;对照组患者给予灭活冰冻血浆,去白悬浮红细胞等成分血。对比两组患者治疗前后的PT、aPTT、TT、Fbg指标,D-二聚体水平,实验结束后,对比两组患者的成分血用量及治愈率。结果治疗组患者的PT、aPTT、TT水平显著低于治疗前,且显著低于对照组(P<0.05),Fbg水平显著高于治疗前及对照组(P<0.05),治疗组患者的灭活冰冻血浆,去白悬浮红细胞的输注量显著低于对照组(P<0.05),治疗组共治愈患者15例(93.75),对照组共治愈11例(68.75%),治疗组的治愈率显著高于对照组(P<0.05)。结论在肝硬化合并消化道出血患者中输入冷沉淀,具有提高患者血液循环中凝血酶因子及纤维蛋白原等凝血物质的水平,治愈率高。

Objective To study the clinical effect of cryoprecipitate for the treatment of liver cirrhosis complicated with gastrointestinal hemorrhage. Methods 32 patients of liver cirrhosis complicated with gastrointestinal hemorrhage were divided into treatment group and control group randomly, 16 patients each group. The patients in treatment group were infused with appropriate amount of cryoprecipitate and the amount was adjusted according to results of eoagulation and D-dimer concentration. The patients in control group were infused with blood components of inactivated frozen plasma, suspended red blood cells without blood cells and some other components. The values of PT、aPTT、TT、Fbg and D-dimer were examinated and compared between the two groups before and after the treatment,tile blood components used and the recoery rate between two groups were compared at the end of the experiment. Results The values of PT,aPTT,TT were significantly lower（P 〈 0.05） and the level of Fbg was significantly higher than that of the control group （P 〈 0.05 ）. The volume of inaetivated frozen plasma and suspended red blood without bold was significantly lower than that of the control group（P 〈 0. 05 ）. 15 patients（93.75% ）were cured of the treatment group, and was significantly higher than the 11 patients （68.75%） of the control group （P 〈 0.05）. Conclusion Inthsion with eryopreeipitate for patients with liver cirrhosis complicated with gastrointestinal hemorrhage can increase the level of thrombin and fibrinogen. The cure rate is high.