不同输血方式辅助常见用药方案治疗肝硬化上消化道出血患者的效果对比  

Comparison of the Effects of Different Blood Transfusion Methods Assisted with Common Medication Regimens in the Treatment of Patients with Liver Cirrhosis and Upper Gastrointestinal Bleeding

作　　者：杨曼 王潇翊 李静[1] 蔡莉莉[1] YANG Man;WANG Xiaoyi;LI Jing;CAI Lili(Department of Blood Transfusion,the First People's Hospital of Shangqiu,Shangqiu 476000,Henan,China)

机构地区：[1]商丘市第一人民医院输血科,河南商丘476000

出　　处：《中国药物滥用防治杂志》2025年第2期258-261,共4页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：河南省高等学校重点科研项目计划(编号:17A320023)。

摘　　要：目的:对比不同输血方式辅助常见用药方案治疗肝硬化(HC)上消化道出血(UGIB)患者的效果。方法:回顾性分析2022年1月—2023年8月医院收治的128例HC并发UGIB患者的临床资料,依据不同治疗方案分为对照组[64例,采用开放性输血策略(LTS)+药物治疗]与研究组[64例,采用限制性输血(RTS)+药物治疗],对比两组治疗前、治疗后血管活性物质(VS)水平、凝血功能,统计两组治疗后不同时点止血率、再出血率及不良事件发生率。结果:两组治疗后血管紧张素Ⅱ(AT-Ⅱ)、一氧化氮(NO)、肿瘤坏死因子-α(TNF-α)、血管紧张素转化酶(ACE)、D-二聚体(D-D)、凝血酶原时间(PT)水平均较治疗前降低,内皮素(ET-1)、凝血因子Ⅸ(FⅨ)水平较治疗前升高,且研究组治疗后AT-Ⅱ、NO、TNF-α、ACE、D-D、PT水平低于对照组,ET-1、FⅨ水平高于对照组(P<0.05);研究组治疗24h后止血率、再出血率及不良事件发生率低于对照组(P<0.05)。结论:RTS联合药物治疗HC并发UGIB可改善患者VS水平及凝血功能,提高治疗后24 h内止血率,降低或避免患者治疗后再出血及不良事件发生风险。Objective:To compare the effects of different blood transfusion methods in the treatment of patients with liver cirrhosis(HC)and upper gastrointestinal bleeding(UGIB).Methods:The clinical data of 128 patients with HC complicated with UGIB admitted to our hospital from January 2022to August 2023 were retrospectively analyzed.According to different treatment schemes,they were divided into control group[64 patients,using open blood transfusion strategy(LTS)+drug treatment]and study group[64 patients,using restrictive blood transfusion(RTS)+drug treatment].The vasoactive substance(VS)level and coagulation function before and after treatment were compared between the two groups.The hemostasis rate,rebleeding rate and incidence of adverse events at different time points after treatment were counted.Results:After treatment,the levels of angiotensinⅡ(AT-Ⅱ),nitric oxide(NO),tumor necrosis factor-α(TNF-α),angiotensin converting enzyme(ACE),D-dimer(D-D)and prothrombin time(PT)in the two groups were lower than those before treatment,the levels of endothelin(ET-1)and coagulation factor IX(FIX)were higher than those before treatment,while the levels of AT-II,NO,TNF-α,ACE,D-D and PT in the study group were lower than those in the control group,and the levels of ET-1 and FIX were higher than those in the control group(P<0.05).The hemostasis rate,rebleeding rate and incidence of adverse events in the study group were lower than those in the control group after 24 hours of treatment(P<0.05).Conclusion:RTS combined with drugs in the treatment of HC complicated with UGIB can improve the VS level and coagulation function of patients,improve the hemostasis rate within 24 h after treatment,and reduce or avoid the risk of rebleeding and adverse events after treatment.

关 键 词：肝硬化 上消化道出血 限制性输血 药物治疗 血管活性物质 凝血功能 

分 类 号：R575.2[医药卫生—消化系统]