限制性输血治疗对消化道出血患者APTT、Hb水平及TEG参数的影响  

Effect of restrictive transfusion therapy on APTT,Hb levels and TEG parameters in pa⁃tients with gastrointestinal bleeding

作　　者：李毅 陈雪梅 杨芳 欧莉 赵云 LI Yi;CHEN Xuemei;YANG Fang;OU Li;ZHAO Yun(Department of Blood Transfusion,Jinniu District People's Hospital,Chengdu,Sichuan,China,610036;Department of Gastroenterology,Jinniu District People's Hospital,Chengdu,Sichuan,China,610036)

机构地区：[1]成都市金牛区人民医院输血科,四川成都610036 [2]成都市金牛区人民医院消化内科,四川成都610036

出　　处：《分子诊断与治疗杂志》2025年第1期46-49,共4页Journal of Molecular Diagnostics and Therapy

基　　金：四川省卫生健康科研课题普及项目(23PJ181)。

摘　　要：目的探究限制性输血治疗对消化道出血患者活化部分凝血活酶时间(APTT)、血红蛋白(Hb)水平及血栓弹力图(TEG)参数的影响。方法选取2022年1月至2024年1月成都市金牛区人民医院收治的122例消化道出血患者作为研究对象,根据输血方法的差异将其分为对照组(予以开放性输血治疗,n=60例)与观察组(予以限制性输血治疗,n=62例)。对比两组临床疗效、临床指标、APTT、Hb水平、TEG参数[反应时间(R)、血凝块形成时间(KT)、凝固角(α)、最大振辐(MA)、血凝块强度(G)]以及不良反应发生情况。结果观察组的总有效率为85.48%,对照组的总有效率为85.00%,两组总有效率比较,差异无统计学意义(P>0.05);观察组输血量少于对照组,止血时间、出院时间短于对照组,差异有统计学意义(P<0.05);治疗后,两组APTT、Hb水平均上升,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组R、α、MA、G参数上升,KT参数下降,且观察组R、α、MA、G参数高于对照组,KT参数低于对照组对照组,差异有统计学意义(P<0.05);观察组(3.22%)的不良反应发生率低于对照组(13.33%),差异有统计学意义(P<0.05)。结论相较于开放性输血,限制性输血可明显改善消化道出血患者APTT、Hb水平、TEG参数,降低不良反应发生率,且治疗疗效更佳。Objective To investigate the effect of restrictive transfusion therapy on activated partial thromboplastin time(APTT),hemoglobin(Hb)levels and thombelastogaphy(TEG)parameters in patients with gastrointestinal bleeding.Methods One hundred and twenty⁃two patients with gastrointestinal hemorrhage were admitted to Jinniu District People's Hospital of Chengdu from January 2022 to January 2024 and were selected for the study.They were divided into the control group(treated with open transfusion,n=60 cases)and the observation group(treated with restrictive transfusion,n=62 cases)based on the differences in the methods of blood transfusion.The two groups were compared in terms of clinical efficacy,clinical in⁃dexes,APTT,Hb level,TEG parameters(reaction time(R),clot formation time(KT),coagulation angle(Alpha angle,α),maximal amplitude(MA),blood clot strength(G)and the occurrence of adverse reactions.Results The total effective rate was 85.48%in the observation group and 85.00%in the control group,the dif⁃ference was not statistically significant(P>0.05).The amount of blood transfusion in the observation group was lower than that in the control group,and the time of hemostasis and discharge was shorter in the observation group,with a statistically significant difference(P<0.05).After treatment,the APTT and Hb levels in both groups increased,with the observation group showing higher levels than the control group,a statistically significant difference(P<0.05).Additionally,the R,α,MA,and G parameters in both groups increased,while the KT parameters decreased.The observation group had higher R,α,MA,and G parameters compared to the control group,with a statistically significant difference(P<0.05).The incidence of adverse reactions in the observation group(3.22%)was significant lower than that in the control group(13.33%),with a statistically signifi⁃cant difference(P<0.05).Conclusion Compared to open transfusion,restrictive transfusion can significantly improve APTT,Hb levels,TEG parameters,and reduce the incidence o

关 键 词：限制性输血治疗 消化道出血 APTT HB TEG 

分 类 号：R573.2[医药卫生—消化系统] R457.1[医药卫生—内科学]