限制输血与积极输血治疗急性上消化道出血的效果观察

Effects of restrictive transfusion and positive transfusion on acute upper gastrointestinal hemorrhage

目的 研究并比较限制输血与积极输血治疗急性上消化道出血的临床效果.方法 选择102例急性上消化道出血患者,按随机数字表法分为对照组与观察组,每组51例.对照组采用积极输血策略,观察组采用限制输血,且两组均接受常规止血治疗.比较两组的总有效率、止血时间、退热时间、止血率、凝血功能指标、再出血风险评分.结果 观察组痊愈率高于对照组（P〈0.05）,两组总有效率比较差异未见统计学意义（P〉0.05）.观察组止血时间、退热时间均短于对照组（P〈0.05）.治疗后24 h,观察组止血率高于对照组（P〈0.05）;而治疗后48、72 h,两组止血率比较差异未见统计学意义（P〉0.05）.两组患者输血后凝血酶原时间（PT）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）均较输血前缩短（P〈0.05）;而在输血后,观察组PT、TT、APTT均短于对照组（P均〈0.05）.观察组再出血风险评分（2.57±0.78）低于对照组（3.42±0.86,P〈0.05）.结论 对急性上消化道出血患者采取限制输血策略可加快患者止血,促进其症状缓解,降低再出血风险,有利于改善凝血功能.

Objective To study and compare transfusion on acute upper gastrointestinal hemorrhage. the effects of restrictive transfusion and positive Methods A total of 102 patients with acute up-per gastrointestinal hemorrhage were enrolled and were divided into observation group and control group, according to random number table method, with 51 cases in each group. The control group was treated by positive transfusion strategies, and the observation group was treated by restrictive transfusion strategy; at the same time, the two groups underwent the routine hemostatic treatment. The total effective rate, bleed-ing time, antifebrile time, hemostasis rate, blood coagulation function index, risk score of recurrence of hemorrhage were compared between the two groups. Results Cure rate of observation group was higher than that of control group （P 〈 0. 05) ; there was no significant difference in the total effective rate be-tween observation group and control group （P 〉 0. 05). The bleeding time, antifebrile time in observa-tion group were shorter than those in control group (P 〈 0.05). The bleeding rate of observation group was obviously higher than that of control group at 24 h after treatment （P 〈 0. 05） ; there was no signifi-cant difference in hemostasis rate between the two groups at 48 h and 72 h after treatment (P 〉 0. 05). Prothrombin time （PT）, thrombin time （TT）, activated partial thrombin time （APTY） after blood trans-fusion were significantly reduced in the two groups (P 〈 0. 05) ; while after blood transfusion, PT, TT and APTT in observation group were significantly shorter than those in control group (P 〈 0. 05). Risk score of recurrence of bleeding in observation group （2.57 ± 0. 78) was significantly lower than that in control group （3.42 ± 0. 86） , P 〈 0. 05. Conclusions Restrictive transfusion in the treatment of pa-tients with symptoms, agulation. acute upper gastrointestinal bleeding coul and reduce risk of recurrence of bleeding, d expedite hemostasis, be conductive to alleviate and be helpful to improve the function of blood coagulation.