Restellini Sophie, Kherad Omar, Martel Myriam, Barkun Alan
Service de Gastroentérologie et Hépatologie, Département des Spécialitésde Médecine, HUG, Genève.
Rev Med Suisse. 2013 Apr 10;9(381):750-3.
Upper gastrointestinal bleeding is a major digestive emergency. The compensation of hypovolemia represents the cornerstone of the initial treatment, according to international recommendations. In contrast, use of red blood cells transfusion and target hemoglobin vary considerably across different centers. The real impact of blood transfusions on the rate of rebleeding and mortality is still unknown. However, several studies suggest that transfusion may have a deleterious effect in patients with hemodynamically stable condition during upper gastrointestinal bleeding, promoting recurrent bleeding.
上消化道出血是一种严重的消化系统急症。根据国际指南,低血容量的代偿是初始治疗的基石。相比之下,不同中心红细胞输注的使用情况和目标血红蛋白水平差异很大。输血对再出血率和死亡率的实际影响尚不清楚。然而,多项研究表明,在上消化道出血期间,对于血流动力学稳定的患者,输血可能产生有害影响,会促使再次出血。