限制性输血、开放性输血对急性上消化道出血患者输血价值及凝血功能指标的影响比较

Comparison of the Effects of Restrictive Blood Transfusion and Open Blood Transfusion in Patients with Acute Upper Gastrointestinal Bleeding on Transfusion Value and Coagulation Function Indexes

目的:分析并比较限制性输血、开放性输血对急性上消化道出血患者的输血价值及对凝血功能指标的影响。方法:回顾性分析2017年6月-2019年6月在大连市第五人民医院接受治疗的144例急性上消化道出血患者的临床资料。依据输血治疗方法的不同,将所选144例急性上消化道出血患者分成两组:观察组(72例,限制性输血)、对照组(72例,开放性输血)。对两组治疗效果,凝血指标及不良反应发生情况进行比较。结果:观察组总有效率为88.9%,明显高于对照组的69.4%(χ^(2)=8.253,P=0.004)。观察组症状消失时间、治疗时间均明显短于对照组(t=11.879、7.758,P<0.001)。治疗后,两组PT、APTT水平较治疗前均降低,且观察组均低于对照组,差异均有统计学意义(P<0.05)。观察组不良反应发生率明显低于对照组(χ^(2)=5.807,P=0.016)。结论:相较于开放性输血,急性上消化道出血患者应用限制性输血能获得更好的治疗效果,更低的不良反应发生率。

Objective:To analyze and compare the effects of restrictive blood transfusion and open blood transfusion in patients with acute upper gastrointestinal bleeding on transfusion value and coagulation function indexes.Method:The clinical data of 144 patients with acute upper gastrointestinal bleeding who treated in Dalian Fifth People’s Hospital from June 2017 to June 2019 were retrospective analyzed.According to the different methods of blood transfusion,144 patients with acute upper gastrointestinal bleeding were divided into two groups:the observation group(n=72,restrictive blood transfusion)and the control group(n=72,open blood transfusion).The treatment effects,coagulation parameters and adverse reactions between two groups were compared.Result:The total effective rate of the observation group was 88.9%,which was significantly higher than 69.4%of the control group(χ^(2)=8.253,P=0.004).The disappearance time and treatment time in the observation group were significantly shorter than those in the control group(t=11.879,7.758,P<0.001).After treatment,the levels of PT and APTT in two groups were lower than those before treatment,and the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(χ^(2)=5.807,P=0.016).Conclusion:Compared with open blood transfusion,patients with acute upper gastrointestinal bleeding by using restrictive blood transfusion therapy can achieve better therapeutic effect,lower incidence of adverse reactions.