摘要
目的探讨限制性输血在急性上消化道大出血救治过程中的效果。方法选取2014年1月~2016年10月我科收治的78例急性上消化道大出血患者作为研究对象,按照随机原则分为对照组和观察组,每组各39例。对照组采用常规的开放性积极输血,观察组采取限制性输血,对比两组患者在24、48、72 h的止血率和输血后不良反应的发生率,同时应用Blatchford评分系统评估两组患者的再出血风险。结果在24 h内,观察组患者的止血率为28.21%,明显高于对照组的10.26%,差异有统计学意义(P<0.05);而在48 h及72 h,观察组患者的止血率分别为48.72%、84.62%,对照组的止血率分别为41.03%、79.49%,差异无统计学意义(P>0.05);观察组患者的总不良反应发生率(33.33%)明显低于对照组(53.85%),差异有统计学意义(P<0.05);观察组患者的Blatchford评分为(2.89±0.75)分,明显低于对照组的(3.69±0.81)分,差异有统计学意义(P<0.05)。结论在急性上消化道大出血患者采取输血治疗时,可以选择限制性输血方式,不仅可以提高止血率,同时降低再出血的风险,也能够降低输血不良事件的发生率,减少临床输血量,值得临床推广。
Objective To investigate the effect of restrictive transfusion in the treatment of acute upper gastrointestinal bleeding.Methods 78 patients with acute upper gastrointestinal bleeding treated in our department from January 2014 to October 2016 were selected as the subjects,and divided into control group and observation group,39 cases in each group according to the random principle.In the control group,conventional open positive blood transfusion was used, while in the observation group,restrictive transfusion was adopted.The rate of hemostasis at 24,48 and 72 h,and incidence of adverse reactions after transfusion were compared between the two groups.At the same time,the risk of rebleeding was assessed by Blatchford scoring system.Results Within 24 hours,the rate of hemostasis in the observation group was 28.21%,much higher than that in the control group accounting for 10.26%,and the difference was statistically significant （P〈O.OS）.The rates of hemostasis at 48 h and 72 h were 48.72% and 84.62% in the observation group,while in the control group,they were 41.03% and 79.49% respectively,without statistical difference （P〉O.05）.In comparison of adverse reaction,the total incidence of adverse reactions in the observation group （33.33%） was much lower than that in the control group （53.85%）,the difference was statistically significant （P〈0.05）.In the Blatchford scoring,the score in the observation group was （2.89±0.75） points,significantly lower than that in the control group for （3.69±0.81） points,the difference was statistically significant （P〈0.05）.Conclusion In patients with acute upper gastrointestinal hemorrhage for transfusion,restrictive mode can be selected.It can not only increase the hemostatic rate but also reduce the risk of rebleeding.Besides,it can also reduce the incidence of adverse reactions during blood transfusion as well as the amount of blood transfusion in clinic,which is worthy of promotion.
出处
《中国当代医药》
2018年第4期35-37,共3页
China Modern Medicine
关键词
限制性
输血
急性上消化道大出血
失血性休克
止血
Restrictive
Bloodtransfusion
Acute upper gastrointestinal bleeding
Hemorrhagicshock
Hemostasis
