少量多次输血对肝硬化并上消化道出血患者血液流变学的影响及临床疗效评价

Effect of Small Blood Transfusion on Hemorheology in Patients with Cirrhosis and Upper Gastrointestinal Hemorrhage and Evaluation of Clinical Efficacy

目的探究少量多次输血肝硬化并上消化道出血患者血液流变学的影响及治疗效果。方法方便选取2018年1—12月该院收治的43例肝硬化合并上消化道出血患者为研究对象,出血控制后给予每次2U红细胞悬液,分别在患者输血前和3次输血后对其各项血液流变学指标进行检测。结果患者治疗后的血浆比粘度、全血比粘度、红细胞压积、白蛋白均分别为(1.78±0.19)、(4.62±0.84)、(48.97±8.32)%、(34.75±6.21)g/L,明显高于治疗前的(1.61±0.13)、(3.81±0.65)、(37.21±10.36)%、(29.65±5.42)g/L,差异有统计学意义(t=4.8422、5.0009、5.8037、4.0573,P<0.05);患者治疗后的总胆红素、血沉分别为(248.67±62.37)μmol/L、(17.65±23.13)mm/h,明显低于治疗前的(289.35±57.64)μmol/L、(38.17±21.34)mm/h,差异有统计学意义(P<0.05);患者治疗后的AST、ALT分别为(352±96)U/L、(226±106)U/L,明显低于治疗前的(604±114)U/L、(477±88)U/L,差异有统计学意义(t=11.0877、11.947,P<0.05)。结论少量多次输血治疗肝硬化并上消化道出血会对血液流变学和肝脏功能产生一定影响,缩短患者再次出血时间,临床上应当推广少输血,限制性输血。

Objective To investigate the effects of hemorheology and therapeutic effects in patients with multiple transfusion cirrhosis and upper gastrointestinal hemorrhage. Methods Forty-three patients with cirrhosis and upper gastrointestinal hemorrhage admitted to our hospital from January to December 2018 were convenient selected and enrolled in the study. After the bleeding control, 2 U of red blood cell suspension was administered, respectively, before transfusion and 3 transfusions. After that, various blood rheology indicators were tested. Results Plasma specific viscosity, whole blood specific viscosity, hematocrit, and albumin were (1.78±0.19),(4.62±0.84),(48.97±8.32)%, and (34.75±6.21)g/L was significantly higher than (1.61±0.13),(3.81±0.65),(37.21±10.36)%, and (29.65±5.42) g/L before treatment, and the difference was statistically significant (t=4.842 2, 5.00 9, 5.803 7, 4.057 3, P<0.05);total bilirubin and erythrocyte sedimentation rate after treatment were (248.67±62.37)μmol/L,(17.65±23.13) mm/h, which was significantly lower than that before treatment(289.35±57.64)μmol/L,(38.17±21.34) mm/h, the difference was statistically significant (P<0.05);AST and ALT after treatment were (352±96)U/L,(226±106)U/L, significantly lower than (604±114)U/L,(477±88)U/L before treatment, the difference was statistically significant (t=11.087 7, 11.947, P<0.05). Conclusion A small number of multiple blood transfusions for cirrhosis and upper gastrointestinal hemorrhage will have certain effects on hemorheology and liver function, shorten the time of re-bleeding of patients, and clinically should promote less blood transfusion and restrictive blood transfusion.