双管双输法在AUGB患者中补充血容量的临床疗效观察

Observation on Clinical Effect of Double Tube and Double Transfusion Method in Supplementing Blood Volume in AUGB Patients

目的:探讨双管双输法补充血容量对急性上消化道出血(AUGB)患者输血效果、钙离子量、凝血功能、输血反应的影响。方法:将上海中治医院2019年11月-2021年11月收治的66例AUGB患者,按计算机分组法分为对照组和观察组,各33例。两组均建立静脉通路用以补充血容量(输注液体为血浆和红细胞悬液),其中对照组用单通道法补充,观察组用双管双输法补充。输血后第2天,观察两组输血效果、钙离子量、凝血功能、输血反应。结果:输血前,两组心率、平均动脉压、血氧含量比较差异无统计学意义(P>0.05),输血后,两组心率低于输血前,平均动脉压、血氧含量高于输血前(P<0.05),且观察组心率低于对照组,平均动脉压、血氧含量高于对照组(P<0.05),观察组止血率36.36%,高于对照组的15.15%(P<0.05);输血前,两组钙离子水平、活化部分凝血活酶时间(APTT)、凝血原酶时间(PT)比较差异无统计学意义(P>0.05),输血后,两组钙离子水平低于输血前,APTT和PT长于输血前(P<0.05),但观察组钙离子水平、ATPP、PT与对照组比较差异无统计学意义(P>0.05);观察组输血反应发生率15.15%,与对照组的9.09%比较差异无统计学意义(P>0.05)。结论:AUGB患者采用双管双输法输血可稳定心率、血压,提高血氧含量和止血率,且不会影响钙离子变化和凝血功能,也不增加输血反应。

Objective:To explore the effect of double tube and double transfusion method for supplement blood volume on the effect of patients with acute upper gastrointestinal bleeding(AUGB)about blood transfusion,calcium ion,coagulation function,and transfusion reaction.Method:A total of 66 AUGB patients admitted to Shanghai MCC Hospital from November 2019 to November 2021 were included in the control group and the observation group according to the computerized grouping method,with 33 cases in each.In both groups,venous access was established to supplement blood volume(the infusion fluid was plasma and red blood cell suspension).The control group was supplemented by a single channel method,and the observation group was supplemented by a double tube and double infusion method.On the second day after blood transfusion,the blood transfusion effect,calcium ion amount,blood coagulation function,blood transfusion reaction of the two groups were observed.Result:Before blood transfusion,there were no significant differences in heart rate,mean arterial pressure and blood oxygen content between the two groups(P>0.05).After blood transfusion,the heart rate of the two groups was lower than that before blood transfusion,the average arterial pressure and blood oxygen content were higher than those before blood transfusion(P<0.05),and the heart rate of the observation group was lower than the control group,and the average arterial pressure and blood oxygen content were higher than those of the control group(P<0.05),the hemostatic rate of the observation group was 36.36%,which was higher than 15.15%of the control group(P<0.05).Before blood transfusion,there were no significant differences in calcium ion level,activated partial thromboplastin time(APTT)and thromboplastin time(PT)between the two groups(P>0.05).After blood transfusion,the calcium ion levels of the two groups were lower than those before blood transfusion,and the APTT and PT were longer than those before blood transfusion(P<0.05),but there were no statistically significant differences in the calcium ion level,ATPP,PT between the observation group and the control group(P>0.05).There was no significant difference in the incidence of transfusion reaction between the observation group and the control group at 15.15%and 9.09%(P>0.05).Conclusion:AUGB patients using double tube and double transfusion method can stabilize heart rate and blood pressure,increase blood oxygen content and hemostasis rate,and do not affect calcium ion changes and blood coagulation function,and do not increase adverse reactions.