肝硬化上消化道出血的输血治疗进展

Progress in Transfusion Therapy for Upper Gastrointestinal Hemorrhage

肝硬化患者常见并发症有上消化道出血,因凝血功能障碍、血小板数量减少及功能异常而易致止血困难,引起失血性休克,甚至死亡。临床医师可通过输注新鲜冰冻血浆、冷沉淀及血小板改善凝血功能、促进止血,并输注红细胞悬液提高携氧能力。合理输血可以提高治疗效果,缩短住院时间,减少不良反应发生率及死亡率。目前国内外对肝硬化上消化道出血的输血启动阈值、输血剂量尚存争议,近年仍在不断研究和探讨,本文现对近年相关研究进行综述,以制定科学的输血治疗方案。

Common complications of patients with cirrhosis include upper gastrointestinal bleeding,due to coagulopathy,decreased platelet count and dysfunction,which may cause hemostasis,hemorrhagic shock,and even death.Clinicians can improve blood coagulation by infusion of fresh frozen plasma,cryoprecipitate and platelets,promote hemostasis,and infuse red blood cell suspension to increase oxygen carrying capacity.Reasonable blood transfusion can improve the treatment effect,shorten the hospital stay,reduce the incidence of adverse reactions and mortality.At present,there are still controversies about the threshold of blood transfusion initiation and blood transfusion of upper gastrointestinal hemorrhage in liver cirrhosis.In recent years,research and discussion are still ongoing.This paper reviews the related research in recent years to develop a scientific blood transfusion treatment plan.