急性上消化道出血患者输血策略的研究进展

Research progress on transfusion strategies for acute upper gastrointestinal bleeding

急性上消化道出血是一种常见的医疗急症,患者以呕血和黑便为主要临床表现,是红细胞输注最常见指征之一。但从早期开始,消化道出血患者的输血阈值就一直未被确定,最佳输注阈值存在争议。近年来,随着医学的发展与进步,人们对输血的认知程度不断加深,输血方式、输血策略及输血观点都在随着时间的推移而不断优化和改变。越来越多的研究结果表明,在很多情况下,限制性输血与开放性输血相比,患者有相似的,甚至更好的转归和预后。目前主流观点认为消化道出血患者更适合采取限制性输血策略,该输血策略在节约血液资源、降低输血不良反应发生风险的同时又不会对患者产生不利影响,甚至有利于患者预后。本文就急性上消化道出血患者输血策略的相关研究进展作一综述。

Acute upper gastrointestinal bleeding is a common medical emergency whose main clinical manifestations are hematemesis and melena. It is a leading indication for red blood cell transfusion worldwide, although optimal thresholds for transfusion are debated. In recent years, with the development and progress of medicine, people′s understanding of blood transfusion has been deepened and the transfusion methods/strategies have been continuously optimized over time. More and more studies have shown that restrictive transfusion method has similar, even better effect than open transfusion method in many cases. At present, the mainstream view is that patients with acute gastrointestinal bleeding are more suitable for restrictive transfusion strategy, which can save blood resources, reduce the risk of adverse transfusion reactions and even be conducive to the patients′ prognosis in some extent. This article will provide a brief overview on transfusion strategy for acute upper gastrointestinal bleeding.