摘要
目的:探讨限制性输血与开放性输血对肝硬化上消化道出血患者血清凝血因子及预后等指标的影响。方法:选取2020年4月至2021年7月收治的肝硬化上消化道出血患者75例,将其按就诊顺序分为两组,开放组患者38例,在常规治疗基础上施行开放性输血;限制组患者37例,在常规治疗基础上施行限制性输血。对两组患者疗效、临床指标、血清凝血因子及血管活性物质水平、预后等情况进行比较分析。结果:与开放组相比较,限制组患者疗效较好,输血量较少,止血所需时间较短,患者住院时间短,不良反应发生率低(P<0.05)。输血治疗前,两组患者凝血因子IX(FIX)、纤维蛋白原(FIB)、凝血因子VⅢ(FVⅢ)、内皮素-1(ET-1)、一氧化氮(NO)水平比较无统计学差异(P>0.05),FIX、FIB、FVⅢ、ET-1水平于治疗后高于治疗前,NO水平于治疗后低于治疗前,限制组患者FIX、FIB、FVⅢET-1水平于治疗后高于开放组,NO水平于治疗后低于开放组(P<0.05)。治疗前,两组患者Glasgow-Blatchford评分系统(GBS)评分比较差异无统计学意义(P>0.05),两组患者GBS评分于治疗后低于治疗前,限制组患者GBS评分低于开放组(P<0.05)。结论:对肝硬化上消化道出血患者实施限制性输血效果显著,患者疗效得到提升,同时能在短时间内止血,减少输血量,对患者凝血功能及血管功能均有较好改善作用。
Objective:To explore the impacts of restrictive blood transfusion and open blood transfusion on serum coagulation factors and prognosis in patients with upper gastrointestinal bleeding in cirrhosis.Methods:Seventy-five patients with upper gastrointestinal bleeding in liver cirrhosis who were accepted by our hospital from April 2020 to July 2021 were gathered,and they were separated into two groups according to the order of treatment.The group was given restrictive blood transfusion based on conventional treatment.The curative effect,clinical indicators,serum coagulation factor,and vasoactive substance levels,and prognosis of the two groups were compared and analyzed.Results:Compared with the open group,the restrictive group had a higher curative effect,less blood transfusion,shorter time required for hemostasis,shorter hospital stay,and lower incidence of adverse reactions(P<0.05).The rebleeding rate and mortality were not greatly different between the two groups(P>0.05).Before blood transfusion,there were no obvious differences in the levels of coagulation factor IX(FIX),fibrinogen(FIB),coagulation factor VⅢ(FVⅢ),endothelin-1(ET-1),and nitric oxide(NO)between the two groups(P>0.05),the levels of FIX,FIB,FVⅢ,and ET-1 after treatment were higher,and the levels of NO were lower,the levels of FIX,FIB,FVⅢand ET-1 in the restrictive group were higher than the open group after treatment,and the level of NO was lower than that in the open group after treatment(P<0.05).Before treatment,the Glasgow-Blatchford scoring system(GBS)score was not greatly different between the two groups(P>0.05).Conclusion:Restrictive blood transfusion in patients with upper gastrointestinal bleeding in liver cirrhosis has an obvious effect,and the curative effect of the patients is improved.At the same time,it can stop bleeding in a short time,reduce the amount of blood transfusion,and improve the coagulation function and vascular function of the patients.
作者
李英
张琳
于欣
陈婧宇
李双
刘宇
苑建磊
LI Ying;ZHANG Lin;YU Xin(Cangzhou Central Blood Station Blood Donation Service Department,Cangzhou Hebei,061000,China;不详)
出处
《中西医结合肝病杂志》
CAS
2023年第7期603-605,共3页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
河北省医学科学研究课题计划项目(No.20200300)。
关键词
肝硬化
上消化道出血
限制性输血
凝血功能
预后
liver cirrhosis
upper gastrointestinal bleeding
restrictive blood transfusion
coagulation function
prognosis
