急性上消化道出血输血治疗血浆与浓缩红细胞输注比例的探究  

Study on the Proportion of Plasma Transfusion and Concentrated Red Blood Cell Transfusion in the Treatment of Acute Upper Gastrointestinal Hemorrhage

作　　者：潘云振 PAN Yunzhen(Department of Laboratory,Putian Hanjiang Hospital,Putian Fujian 351111,China)

机构地区：[1]莆田涵江医院检验科,福建莆田351111

出　　处：《中国卫生标准管理》2022年第3期135-137,共3页China Health Standard Management

摘　　要：目的探究急性上消化道出血患者输血治疗时不同新鲜冷冻血浆(fresh frozen plasma,FFP)与浓缩红细胞(concentrate red blood cells,cRBC)比例对临床效果的影响。方法回顾性选取莆田市涵江医院2019年3月—2020年3月收治急性上消化道出血且接受输血治疗60例患者的临床资料,依据FFP、cRBC输注比例将其分为甲组32例、乙组28例,甲组输注比例为FFP∶cRBC=1∶1,乙组输注比例为FFP∶cRBC=1∶2,比较两组FFP、cRBC、血小板(platelet,PLT)、冷却沉淀输注量、住院时间,比较两组输血前后凝血功能、血常规变化情况和不良反应发生率。结果甲组FFP输注量高于乙组,cRBC输注量低于乙组,住院时间短于乙组,差异有统计学意义(P<0.05),但两组PLT、冷却沉淀输注量比较,差异无统计学意义(P>0.05);输血前两组血常规和凝血功能比较,差异无统计学意义(P>0.05);输血后两组血清血红蛋白(hemoglobin,Hb)水平升高,且甲组高于乙组,差异有统计学意义(P<0.05);两组活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)均高于输血前,但纤维蛋白原(fibrinogen,FIB)、PLT水平低于输血前,且甲组上调(或下降)程度均低于乙组,差异有统计学意义(P<0.05);甲组输血后不良反应发生率(6.25%)与乙组输血后不良反应发生率(10.71%)比较,差异无统计学意义(P>0.05)。结论对急性上消化道出血需输血治疗患者而言,输血时FFP与cRBC输注比例为1∶1可有效改善患者凝血功能及Hb水平,输血效果佳。Objective To investigate the effect of different fresh frozen plasma(FFP)to erythrocyte concentrate red blood cells(cRBC)ratios on clinical outcomes in patients with acute upper gastrointestinal hemorrhage undergoing transfusion therapy.Methods A total of sixty patients with acute upper gastrointestinal hemorrhage admitted to our hospital from March 2019 to March 2020 were selected and divided into group A(32 cases)and group B(28 cases)according to the transfusion ratio of FFP and cRBC.The transfusion ratio of group A was FFP:cRBC=1:1,and that of group B was FFP:cRBC=1:2.FFP,cRBC,platelet(PLT),cooling precipitation transfusion volume and hospitalization time were compared between the two groups,and the blood coagulation function before and after transfusion,and changes in blood routine and incidence of adverse reactions were compared between the two groups.Results The infusion volume of FFP in group A was higher than that in group B,the infusion volume of cRBC was lower than that in group B,and the hospitalization time was shorter than that in group B,and the differences were statistically significant(P<0.05).However,there was no significant difference in the infusion volume of PLT and cryoprecipitate between the two groups(P>0.05);before blood transfusion,there was no significant difference in blood routine and coagulation function between the two groups(P>0.05).After blood transfusion,serum hemoglobin(Hb)levels in two groups increased,and group A was higher than group B,the difference was statistically significant(P<0.05).Activated partial thromboplastin time(APTT),prothrombin time(PT)in both groups were higher than those before blood transfusion,but fibrinogen(FIB)and PLT levels were lower than those before blood transfusion.The degree of up-regulation(or decrease)in group A was lower than that in group B,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions after blood transfusion in group A(6.25%)and group B(10.71%)(P>0.05).Conclusi

关 键 词：急性上消化道出血 输血治疗 新鲜冰冻血浆 浓缩红细胞 比例 凝血功能 

分 类 号：R457[医药卫生—治疗学]