不同输血方式治疗消化道出血的疗效及对疾病转归的影响

Effect of different blood transfusion methods on gastrointestinal bleeding and its effect on disease outcome

目的:探讨不同输血方式治疗消化道出血的疗效及对疾病转归的影响。方法:选取2020年1月~2023年12月厦门医学院附属第二医院收治的118例消化道出血患者,采用随机数字表法分为常规组、观察组,各59例,常规组采用积极输血治疗,观察组采用限制性输血治疗。比较两组治疗前后凝血功能指标凝血酶原时间(PT)、红细胞比积(HCT)及血液流变学全血黏度、血浆黏度(PV)的变化,统计两组疗效及再出血、头晕等并发症发生情况。结果:治疗前两组PT、HCT差异无统计学意义(P>0.05);与治疗前比,治疗后两组PT、HCT水平均降低,差异有统计学意义(P<0.05);治疗后观察组PT、HCT均低于常规组,差异有统计学意义(P<0.05)。治疗前两组全血黏度、PV对比差异均无统计学意义(P>0.05);与治疗前比,治疗后两组全血黏度、PV均提高,差异有统计学意义(P<0.05);且观察组上述指标均高于常规组,差异有统计学意义(P<0.05)。观察组总有效率高于常规组,差异有统计学意义(P<0.05)。与常规组相比,观察组并发症发生率较低,差异无统计学意义(P>0.05)。结论:限制性输血治疗消化道出血患者,有利于提高治疗效果,促进凝血功能、血液流变学的恢复,可降低并发症发生率。

Objective To investigate the efficacy of different blood transfusion methods in the treatment of gastrointestinal bleeding and its effect on the prognosis of the disease.Method 118 patients with gastrointestinal bleeding treated in our hospital from January 2020 to December 2023 were selected and randomly divided into routine group(59 cases)and observation group(59 cases).The routine group was treated with active blood transfusion and the observation group was treated with restrictive blood transfusion.The changes of prothrombin time(PT),hematocrit(HCT),hemorheology,whole blood viscosity and plasma viscosity(PV)of the two groups were compared before and after treatment,and the hemostasis,rebleeding,death and complications of the two groups were counted.Results No difference between PT and HCT in the two groups before treatment(P>0.05),compared with the pre-treatment ratio,the PT and HCT levels in the two groups after treatment were lower(P<0.05),and the PT and HCT in the observation group after treatment were lower than those in the conventional group(P<0.05).No difference in whole blood viscosity and PV before treatment(P>0.05),and the pre-treatment group increased whole blood viscosity and PV after treatment(P<0.05),and the above indicators were higher than those of the conventional group(P<0.05).The total response rate in the observation group was higher than that of the conventional group,significant(P<0.05).The observation group had a lower complication rate compared to the conventional group(P>0.05).Conclusion Restricted blood transfusion is beneficial to improve the therapeutic effect,promote the recovery of coagulation function and hemorheology,and reduce the incidence of complications.