血浆与红细胞不同的输注比例对急性上消化道出血患者预后的影响

doi:10.3969/j.issn.1671-7171.2018.06.008

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Abstract 【Objective】To explore optimal proportion of plasma (FFP) and red blood cell (RBC) in patients with acute upper gastrointestinal bleeding and to evaluate the prognosis.【Methods】The clinical data of 120 patients with acute upper gastrointestinal bleeding in our hospital from June 2014 to June 2017 were retrospectively analyzed. According to the proportion of blood transfusion in FFP and RBC, 37 cases of FFP:RBC > 1:1 were recorded as group A, 45 cases of FFP:RBC more than or equal to 1:2, and less than or equal to 1:1 were recorded as B group, and the other 38 cases of FFP:RBC < 1:2 were recorded as group C. The use of FFP and RBC, blood routine, blood coagulation, changes in electrolyte indicators, adverse effects of blood transfusion and prognosis were compared. 【Results】The differences of the use of FFP and RBC in the 3 groups was statistically significant (P< 0.05), which were also statistically significant between each two groups (P<0.05). The use of FFP in the group A was the highest, the B group was a little lower and the C group was the lowest. The use of RBC in the group B was the highest, the A group was a little lower, and the C group was the lowest. The differences of blood routine, blood coagulation function index and Ca²⁺ levels among the 3 groups after blood transfusion were statistically significant (P<0.05). Compared among the groups, Hb, PLT and INR in group C were significantly higher than those in the group A and the group B (P<0.05), and the PT and APTT were significantly longer than those of the group A and B (P<0.05), and the INR in the group A was significantly higher than that in the group B (P<0.05), and the levels of PT and APTT were significantly longer than those in the group B (P<0.05). The level of Ca²⁺ in the group B was significantly lower than those of the group A and C group (P<0.05). After transfusion, the levels of Hb and Ca²⁺ in the 3 groups were all decreased (P<0.05), and the levels of PLT in the group A and C decreased (P<0.05), the levels of PT and APTT were prolonged (P<0.05), INR increased (P<0.05). The incidences of total adverse reactions of blood transfusion in the group A, the group B and the C group were 5.41%, 0.00%, 2.63%, respectively, without statistically significant differences (P> 0.05). The incidences of total poor prognosis in the 3 groups was 21.62%, 2.22%, 15.79%, respectively, of which the group B was significantly lower than that of the group A and C (P<0.05). 【Conclusion】Patients with different FFP and RBC ratios can affect the function of blood clotting and electrolyte of acute upper gastrointestinal bleeding, and it is recommended to maintain FFP:RBC more than or equal to 1:2 and less than or equal to 1:1, which can significantly reduce adverse events and improve the prognosis.

Key words： GastrointestinalHemorrhage/TH BloodComponentTransfusion/MT BloodCoagulation Electrolytes

Received: 28 March 2018

PACS:

R573.2

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	HUANG Ya
	WU Yue-qing
	WANG Hai-bao

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HUANG Ya,WU Yue-qing,WANG Hai-bao. Comparison of the Effect of bBood Transfusion of the Different Ratio of Plasma and Red Blood Cells on the Prognosis of Patients with Acute Upper Gastrointestinal Bleeding[J]. JOURNAL OF CLINICAL RESEARCH, 2018, 35(6): 1062-1065.

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http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2018.06.008 OR http://www.jcr.net.cn/EN/Y2018/V35/I6/1062

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