限制输血与积极输血治疗急性上消化道出血的效果分析

Curative effect of restrictions blood transfusion compared with active blood transfusion in patients with acute upper gastrointestinal bleeding

目的：比较限制输血与积极输血治疗急性上消化道出血（ AUGB）的疗效，为AUGB的抢救提供参考。方法将96例AUGB患者随机分为两组，每组48例，两组均进行常规止血治疗，积极组给予无限制积极输血治疗，限制组根据血红蛋白水平控制输血量，分析两组患者24、48、72 h内止血率，采用Blatchford评分系统评估两组再出血危险性，观察不良事件发生率。结果限制组24 h止血率高于积极组（29?17％与12?50％）（χ2＝4?04，P＜0?05），两组患者48、72 h止血率比较差异均无统计学意义（ P均＞0?05）；限制组Blatchford评分低于积极组[（2?98±0?63）分与（3?47±0?72）分]（t＝3?20，P＜0?05）；两组患者不良事件发生率比较差异无统计学意义（ P＞0?05）。结论限制输血早期止血率高于积极输血，且再出血危险性低于积极输血，临床在AUGB患者抢救中可根据实际情况适当限制输血时机及输血量。

Objective To compare the curative effect of restrictions blood transfusion with active blood transfusion in patients with acute upper gastrointestinal bleeding( AUGB) ,so as to provide reference for AUGB′s rescue?Methods Ninety?six cases patients with AUGB were randomly divided into two groups, 48 cases in each group?Routine hemostasis was performed in the two groups,the active group was given unlimited transfu?sion,while the restriction group controlled the amount of blood transfusion according to hemoglobin level?The curative rate within 24 h,48 h,72 h were analyzed in two groups?Blatchford grading system was used to evaluate the risk of re?bleeding,and the incidence of adverse events was observed?Results The hemostasis rate within 24 h in the restriction group was higher than that in the active group( 29?17% vs?12?50%,χ2=4?04,P<0?05) , the hemostasis rate within 48 h,72 h between two groups had no statistical significance( P>0?05)?Blatchford score in the restriction group was lower than that in the active group((2?98±0?63) points vs?(3?47±0?72) points,t=3?20,P<0?05)?There was no significant difference on the incidence of adverse events between two groups( P>0?05)?Conclusion The early hemostasis rate of restricted blood transfusion is higher than that of active blood transfusion,and the risk of bleeding is lower than that of active blood transfusion?According to the actual situation,the timing of blood transfusion and the amount of blood transfusion can be restricted according to the actual situation in the rescue of patients with AUGB.