限制输血对急性上消化道出血患者止血率及再出血发生风险的影响

Impact of limited blood transfusion on hemostasis rate and risk of recurrence of hemorrhage in patients with acute upper gastrointestinal hemorrhage

目的探讨限制输血对急性上消化道出血患者止血率及再出血发生风险的影响。方法选取2018年5月至2020年4月入住我院的急性上消化道出血患者124例,应用随机数字表法分为两组,每组各62例。对照组应用积极输血干预,研究组采用限制输血干预。对比两组患者的止血率、不良事件发生率及再出血发生情况。结果研究组再出血危险性Blatchford水平为(2.623±0.615)分,低于对照组的(3.724±0.501)分,两组比较,差异有统计学意义(P<0.05),研究组不良事件发生率为8.065%,低于对照组的20.968%,两组比较,差异有统计学意义(P<0.05);研究组输血24 h止血率为29.032%,高于对照组的11.290%,两组比较,差异有统计学意义(P<0.05),两组输血48 h、72 h后比较,差异无统计学意义(P>0.05)。结论应用限制输血对急性上消化道出血患者实施干预,早期治疗止血效果较为显著,再出血风险较低,不良事件的发生获得较好控制,具有极高的应用安全性,可推广应用。

Objective To explore the impact of limited blood transfusion on hemostasis rate and risk of recurrence of hemorrhage in patients with acute upper gastrointestinal hemorrhage.Methods A total of 124 patients with acute upper gastrointestinal hemorrhage admitted to our hospital from May 2018 to April 2020 were divided into the study group(n=62)and the control group(n=62)according to the random number table method.The control group was treated with active blood transfusion intervention,while the study group was treated with limited blood transfusion intervention.The hemostatic rate,incidence of adverse events and recurrence of hemorrhage were compared between the two groups of patients.Results The Blatchford level of recurrence risk of hemorrhage in the study group was(2.623±0.615)points,lower than(3.724±0.501)points in the control group,with significant difference between the two groups(P<0.05).The incidence of adverse events in the study group was 8.065%,lower than 20.968%in the control group,with significant difference between the two groups(P<0.05).The hemostatic rate of 24 hours after blood transfusion in the study group was 29.032%,higher than 11.290%in the control group,with significant difference between the two groups(P<0.05).There were no significant differences between the two groups after 48 and 72 hours of blood transfusion(P>0.05).Conclusion The application of limited blood transfusion in patients with acute upper gastrointestinal hemorrhage has obvious hemostatic efficacy in early treatment,lower recurrence risk of hemorrhage,better control of adverse events and high application safety,which can be promoted and applied.