输血治疗对消化道出血HB、HCT、止血效果与再出血的影响分析

Analysis of the impact of blood transfusion therapy on HB,HCT,hemostatic effect and rebleeding in gastrointestinal bleeding

目的探究输血治疗对消化道出血患者血红蛋白(HB)、血细胞比容(HCT)、止血效果的影响,并分析治疗后再出血的影响因素。方法选取2019年2月至2023年3在芜湖市第一人民医院进行治疗的消化道出血患者130例为研究对象。根据不同治疗方法将患者分为两组,研究组(80例)给予常规治疗+输血治疗,对照组(50例)仅给予常规治疗。比较两组患者消化道治疗情况、治疗前后HB、HCT水平变化和治疗后止血效果;分析研究组输血治疗后再出血的影响因素。结果研究组住院时间、治疗总有效率高于对照组(53.75%vs 36.00%),差异均有统计学意义(t=3.562,χ^(2)=3.892,P<0.05)。治疗前,两组患者HB、HCT差异均无统计学意义(t=1.898、1.888,P>0.05);治疗后,两组患者HB、HCT均有不同程度的升高,研究组患者HB、HCT均高于对照组,差异均有统计学意义(t=2.483、2.228,P<0.05)。研究组治疗24 h止血率、72 h止血率均高于对照组,差异有统计学意义(χ^(2)=3.864、4.588,P<0.05)。研究组输血后再次出血患者18例(22.5%)。二元Logistic回归分析显示72 h早期止血(OR=0.217),合理输血(OR=0.262)是异体输血后再出血的保护因素(P<0.05)。结论输血治疗对消化道出血早期止血效果显著。加强对老龄、女性患者的护理、合理输血、早期止血可预防再出血的发生,并提高临床治疗效果。

Objective To explore the influence of allogeneic blood transfusion therapy on HB,HCT and hemostatic effect of gastrointestinal bleeding,and analyze the influencing factors of rebleeding after treatment.Methods A total of 130 patients with gastrointestinal bleeding who were treated in Wuhu First People's Hospital from February 2019 to March 2023 were selected as the study subjects.The patients were divided into two groups according to different treatment methods.The study group(80 cases)was given routine treatment plus blood transfusion,and the control group(50 cases)was only given routine treatment.The treatment of digestive tract,the changes of HB and HCT levels before and after treatment and the hemostatic effect after treatment were compared between the two groups.The influencing factors of rebleeding after blood transfusion treatment in the study group were analyzed.Results The hospitalization time and total effective rate of treatment in the study group were higher than those in the control group(53.75%vs 36.00%),the differences were statistically significant(t=3.562,χ^(2)=3.892,P<0.05).After treatment,the levels of HB and HCT in the two groups increased to varying degrees,while HB and HCT in the study group were higher than those in the control group,the differences were statistically significant(t=2.483,2.228,P<0.05).The hemostasis rate at 24 h and 72 h in the study group were higher than those in the control group,and the differences were statistically significant(χ^(2)=3.864,4.588,P<0.05).In the study group,18 patients(22.5%)had rebleeding after blood transfusion,and 62 patients(77.5%)had no rebleeding.Binary Logistic regression analysis showed that early hemostasis at 72 h(OR=0.217)and reasonable blood transfusion(OR=0.262)were protective factors for rebleeding after allogeneic blood transfusion(P<0.05).Conclusion Blood transfusion therapy has a significant effect on early hemostasis of gastrointestinal bleeding.Strengthening nursing care of elderly and female patients,reasonable blood transfusion and early hemostasis can prevent further bleeding and improve clinical treatment effects.