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目的探讨血浆输注对非甾体抗炎药(NSAIDs)相关性消化性溃疡并出血的临床转归影响。方法收集本院NSAIDs相关性消化性溃疡并出血病例97例,根据是否曾输注血浆分为实验组:56例输注红细胞和血浆;对照组:41例仅输注红细胞;分析2组病例的一般临床资料、输血量、输血后疗效、临床转归相关指标。结果实验组与对照组比较:1)2组的性别、年龄、休克发生率、溃疡大小、溃疡Forrest分级、合并症、输血后Hb等无明显差异(P>0.05);2)PT、APTT(s)在输血前分别为20.30±2.65 vs 19.76±2.07(P>0.05)、49.70±2.93 vs 46.93±5.10(P>0.05),在输血后分别为13.12±1.68 vs 18.13±1.80(P<0.05)、31.67±5.06 vs 40.41±2.64(P<0.05);实验组输血前、后凝血功能差异明显(P<0.05),而对照组变化基数(P>0.05);3)平均红细胞输注量(m L)分别为420±63.75 vs 673±55.62(P<0.05),好转率分别为91.0%(51/56)vs 73.2%(30/41)(P<0.05),平均住院时间(d)分别为6.37±2.15 vs11.21±3.07(P<0.05),再出血率分别为5.4%vs 19.5%(P<0.05)。结论早期输注血浆既可及时纠正NSAIDs相关性消化性溃疡并出血患者凝血功能,又能有效减少患者红细胞输注用量,缩短患者平均住院时间,有助于更好的临床转归预后。
Objective To investigate the clinical effects of plasma transfusion on peptic ulcer associated with non-steroidal anti-inflammatory drugs (NSAIDs) and bleeding. Methods Ninety-seven patients with peptic ulcer associated with peptic ulcer in our hospital were collected. According to whether they had been transfused into the experimental group, 56 cases were transfused with erythrocytes and plasma. In control group, only 41 cases were transfused with erythrocytes. General clinical data, blood transfusion, efficacy after transfusion, clinical outcome index. Results There was no significant difference between the experimental group and the control group (P> 0.05); 2) There was no significant difference in gender, age, shock incidence, ulcer size, Forrest classification of ulcer, Hb after transfusion, s were significantly lower than those before transfusion (20.30 ± 2.65 vs 19.76 ± 2.07, P> 0.05), 49.70 ± 2.93 vs 46.93 ± 5.10 (P> 0.05) , 31.67 ± 5.06 vs 40.41 ± 2.64 (P <0.05). The blood coagulation function of the experimental group before and after blood transfusion was significantly different (P <0.05), while that of the control group (P> 0.05) (P <0.05). The improvement rates were 91.0% (51/56) vs 73.2% (30/41) (P <0.05), and the average length of stay (d) were 6.37 ± 2.15 vs11.21 ± 3.07 (P <0.05). The rates of rebleeding were 5.4% vs 19.5% (P <0.05), respectively. Conclusion The early infusion of plasma can not only correct the NSAIDs-related peptic ulcer bleeding in patients with coagulation, but also effectively reduce the amount of red blood cells transfused patients, shorten the average length of stay in patients, contribute to a better clinical prognosis.