不同输血方法对急性上消化道非大量出血患者预后的影响

Effect of Different Blood Transfusion Methods on Prognosis in Patients with Acute Upper Gastrointestinal Non Massive Bleeding

目的:探讨不同输血方法对急性上消化道非大量出血患者预后的影响。方法:选取本院2016年1月-2018年1月收治的急性上消化道非大量出血患者86例,所有患者均给予抑酸、抑酶、止血等常规药物加输血治疗。依据输血方式的不同,将行限制性输血治疗者设为限制组(n=56),行积极行输血治疗者设为积极组(n=30),记录患者的输液量、住院时间、输血情况(输血次数、输血量、输血前及出院时血红蛋白水平)、住院期间不良事件情况(再出血、死亡、并发症)等。结果:两组患者每日输液量、输血次数、输血量比较差异无统计学意义(t=1.059、1.227、1.579,P>0.05);限制组输血前血红蛋白水平(59.37±10.08)g/L,低于积极组的(81.44±11.46)g/L(t=4.094,P<0.05),但出院时两组患者的血红蛋白水平(98.64±12.06)g/L vs(104.94±13.07)g/L比较差异无统计学意义(t=1.941,P>0.05);限制组患者的死亡率为5.36%,与积极组的6.67%比较差异无统计学意义(χ^(2)=1.157,P>0.05);限制组患者的住院时间(8.06±0.35)d,短于积极组的(11.64±0.69)d(t=6.087,P<0.05);限制组和积极组患者的再出血发生率(8.93% vs 13.33%)、并发症发生率(17.88% vs 26.67%)比较,差异均有统计学意义(χ^(2)=8.357、7.034,P<0.05)。结论:限制性输血和积极性输血均是急性上消化道非大量出血的有效治疗方法,但限制性输血可缩短住院时间,减少再出血和并发症的发生,可考虑推广使用。

Objective:To investigate the effects of different methods of blood transfusion on the prognosis in patients with acute upper gastrointestinal non massive bleeding.Method:A total of 86 patients with acute upper gastrointestinal non massive hemorrhage in our hospital from January 2016 to January 2018 were selected.All patients were given acid suppression,aprotinin,bleeding and other conventional drugs plus blood transfusions.According to the different ways of blood transfusion,the patients with restrictive blood transfusion were set as the restrictive group (n=56),and the patients with active blood transfusion were set as the active group (n=30).The patients’ fluid volume,length of stay,blood transfusion (blood transfusions,blood transfusion,blood transfusion and before hospital discharge when hemoglobin levels) during hospitalization adverse events (rebleeding,death,complications) were recorded.Result:There were no significant differences in fluid volume,number of blood transfusions,transfusion volume between the two groups (t=1.059,1.227,1.579,P>0.05).The hemoglobin levels before transfusion of the restrictive group was (59.37±10.08) g/L,which was lower than (81.44±11.46) g/L of the active group (t=4.094,P<0.05),but there was no significant difference in the discharge hemoglobin levels of (98.64±12.06) g/L vs (104.94±13.07) g/L between the two groups (t=1.941,P>0.05).The restrictive group of patients had a mortality rate of 5.36%,and which was 6.67% in the active group,there was no significant differences (χ^(2)=1.157,P>0.05).The length of stay was (8.06±0.35) d in the restrictive group,which was shorter than (11.64±0.69) d in the active group (t=6.087,P<0.05).The rebleeding rate (8.93% vs 13.33%) and the complication rates (17.88% vs 26.67%) were compared between the two groups,and the differences were statistically significant (χ^(2)=8.357,7.034,P<0.05).Conclusion:Both limited blood transfusion and active blood transfusion are effective treatments for acute upper gastrointestinal non massive hemorrhage,but restrictive transfusion can shorten hospital stays,reduce rebleeding and complications,may be considered to promote the use.