Loperfido S, Nieri A
Minerva Chir. 1989 Oct 15;44(19):2073-6.
On the basis of data published, at least three quarters of patients with acute haemorrhage of the upper digestive tract (AHUDT) undergo blood transfusions. An epidemiologic survey carried out over a period of more than two years, showed that only 322 subjects out of 587 (54.8%) with AHUDT received blood transfusions, the mean need being 3.6 +/- 6.1 units of packed erythrocytes. Our series included a relevant percentage (29%) of hepatocirrhotics, whose transfusion need was, as expected, markedly higher in comparison with the others (71% transfused versus 47.9%, and a mean of 5.3 units versus 2.9). Persistent bleeding, rebleeding rate, operation and mortality rate in our study were, respectively, 4.1%, 28.4%, 10.2% and 15.5%. Mortality among subjects non transfused was 3.4%. The adoption of restrictive criteria made it possible to avoid unnecessary blood transfusions. Patients who were hemodynamically stable with haemoglobin greater than 8 g/dl were not transfused. Our experience has shown that about fifty per cent of patients with AHUDT can be preserved from the risks connected with blood transfusions.
根据已发表的数据，至少四分之三的上消化道急性出血（AHUDT）患者接受输血治疗。一项持续两年多的流行病学调查显示，587例AHUDT患者中只有322例（54.8%）接受了输血治疗，平均需要3.6±6.1单位的浓缩红细胞。我们的研究系列中包括相当比例（29%）的肝硬化患者，正如预期的那样，他们的输血需求明显高于其他患者（71%接受输血，而其他患者为47.9%；平均输血5.3单位，而其他患者为2.9单位）。我们研究中的持续出血、再出血率、手术率和死亡率分别为4.1%、28.4%、10.2%和15.5%。未输血患者的死亡率为3.4%。采用限制性标准可以避免不必要的输血。血红蛋白大于8g/dl且血流动力学稳定的患者不进行输血。我们的经验表明，约50%的AHUDT患者可以避免与输血相关的风险。
