限制性输血治疗对肝硬化急性上消化道出血患者凝血因子及凝血功能的影响  

Restrictive Transfusion Treatment for Liver Cirrhosis Patients with Acute Upper Gastrointestinal Bleeding and Clotting Factor and the Influence of the Blood Coagulation Function

作　　者：王东阳 牛志莹[1] 贾伟 WANG Dong-yang;NIU Zhi-ying;JIA Wei(Department of Blood Transfusion,First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳医学高等专科学校第一附属医院输血科,河南南阳473000

出　　处：《罕少疾病杂志》2025年第4期81-83,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探究在肝硬化急性上消化道出血患者中予以限制性输血治疗对凝血因子、凝血功能影响。方法回顾性分析2021年10月至2024年2月南阳医专第一附属医院收治的94例肝硬化急性上消化道出血患者,按输血方式的不同分组,其中接受开放性输血治疗的45例患者为对照组,接受限制性输血治疗的49例患者为观察组。比较两组临床疗效、凝血因子、凝血功能、预后情况、不良事件。结果较对照组的(80.00%),观察组治疗总有效率(95.92%)高,差异有统计学意义(P<0.05);对比两组治疗前凝血因子水平、凝血功能、GIasgow-Blatchford评分系统(GBS)评分,差异无统计学意义(P>0.05);观察组治疗后凝血因子IX(FIX)(77.59±6.25)%、凝血因子VⅢ(FVⅢ)(91.47±8.23)%均较对照组高,凝血酶原时间(PT)(10.36±1.33)s、活化部分凝血活酶时间(APTT)(35.62±1.86)s均较对照组短,GBS评分(6.12±0.95)分较对照组低,差异有统计学意义(P<0.05);较对照组的(17.78%),观察组不良事件发生率(2.04%)低,差异有统计学意义(P<0.05)。结论相较于开放性输血,限制性输血治疗肝硬化急性上消化道出血患者效果更为显著,可进一步调节凝血因子水平,改善凝血功能及预后,减少不良事件的发生。Objective To explore the effect of restrictive blood transfusion on coagulation factors and coagulation function in liver cirrhosis patients with acute upper gastrointestinal bleeding.Methods a retrospective analysis from October 2021 to February 2024 nanyang medical college in the first affiliated hospital treated 94 cases of liver cirrhosis patients with acute upper gastrointestinal bleeding,according to the different group of blood transfusion,which transfusions of 45 patients undergoing open as the control group,the 49 cases treated with restrictive transfusion treatment for observe group.Compare two groups of clinical curative effect,clotting factors,blood coagulation function,prognosis,and adverse events.Results in the control group(80.00%),to observe treatment group total effectiveness(95.92%)is high,the difference was statistically significant(P<0.05).There were no statistically significant differences in the levels of coagulation factors,coagulation function,and GIasgow-Blatchford scoring system(GBS)score between the two groups before treatment(P>0.05).After treatment,coagulation factor IX(FIX)(77.59±6.25)%and coagulation factor VⅢ(FVⅢ)(91.47±8.23)%in the observation group were higher than those in the control group.The prothrombin time(PT)(10.36±1.33)s and activated partial thromboplastin time(APTT)(35.62±1.86)s in the observation group were shorter than those in the control group,and the GBS score(6.12±0.95)was lower than that in the control group,and the differences were statistically significant(P<0.05).Than the control group(17.78%),the observation group(2.04%),low incidence of adverse events,the difference was statistically significant(P<0.05).Conclusion compared with open transfusion,restrictive transfusion treatment more significant effect of liver cirrhosis patients with acute upper gastrointestinal bleeding,can further adjust the clotting factor level,improve the function of blood coagulation and prognosis,and reduce the occurrence of adverse events.

关 键 词：肝硬化 急性上消化道出血 限制性输血 凝血因子 凝血功能 预后 不良事件 

分 类 号：R657.31[医药卫生—外科学]