限制性输血与开放性输血对消化道出血患者凝血功能、电解质平衡的影响

Effects of restrictive blood transfusion and open blood transfusion on coagulation function and electrolyte balance in patients with gastrointestinal bleeding

目的 探讨限制性输血与开放性输血对消化道出血患者凝血功能、电解质平衡的影响。方法 选取郑州市第一人民医院2019年1月—2021年12月收治的急性上消化道出血患者102例作为研究对象,根据输血方式的不同将患者分为开放输血组(开放性输血,n=58)及限制输血组(限制性输血,n=44)。对比分析2组患者输血治疗前后凝血功能以及电解质的变化。结果 治疗前,2组患者凝血功能指标[凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)以及纤维蛋白原(FIB)]及Ca^(2+)、K^(+)及Na^(+)水平对比,差异均无统计学意义(P>0.05)。治疗后,2组患者的PT、APPT、TT等指标水平均有所升高,且限制输血组高于同期开放输血组(P<0.05);2组患者FIB水平均有所降低,且限制输血组低于同期开放输血组(P<0.05);2组患者的Ca^(2+)与Na^(+)水平均显著下降,且开放输血组低于同期限制输血组(P<0.05);2组患者K^(+)水平显著上升,且开放输血组高于同期限制输血组(P<0.05)。此外,开放输血组患者治疗有效率为70.69%,低于限制输血组的75.00%,但差异无统计学意义(P>0.05)。结论 开放性输血与限制性输血2种输血方法的止血效果良好,疗效无显著差异,但是限制性输血在稳定患者电解质平衡以及防止凝血功能紊乱等方面更具优势。

Objective This study aimed to explore the effects of restrictive blood transfusion and open blood transfusion on coagulation function and electrolyte balance in patients with gastrointestinal bleeding.Methods A total of 102 patients with acute upper gastrointestinal bleeding admitted to the First People's Hospital of Zhengzhou from January 2019 to December 2021 were selected as the study participants.The patients were assigned to two groups following different transfusion methods,the open blood transfusion group(n=58)and the restrictive blood transfusion group(n=44).The changes in coagulation function and electrolyte balance before and after transfusion therapy were compared and analyzed between the two groups.Results Before treatment,there was no statistically significant difference in coagulation function indicators[prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)]and the levels of Ca^(2+),K^(+),and Na^(+)between the two groups(P>0.05).After treatment,the levels of PT,APPT,and TT in both groups increased,and the restrictive blood transfusion group was significantly higher than the open blood transfusion group during the same period(P<0.05).The FIB levels in both groups decreased,and the restrictive blood transfusion group was significantly lower than the open blood transfusion group during the same period(P<0.05).The levels of Ca^(2+)and Na^(+)in both groups significantly decreased,and the open blood transfusion group was significantly lower than the restrictive blood transfusion group during the same period(P<0.05).The level of K^(+)in both groups significantly increased,and the open blood transfusion group was higher than the blood restrictive transfusion group during the same period(P<0.05).In addition,the response rate of treatment in the open blood transfusion group was 70.69%,which was lower than that in the restrictive blood transfusion group(75.00%),but the difference was not statistically significant(P>0.05).Conclusion Both open and restrictive blood transfusion methods have good hemostatic effects,and their therapeutic effects are not significantly different.However,restrictive blood transfusion has the advantages of stabilizing the patient's electrolyte balance and preventing coagulation dysfunction.