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乳酸清除预测大量输血在上部胃肠道出血:一个单中心的回顾性研究
Betül Çiğdem Yortanlı1, Korhan Kollu2, Ahmet Sami Varol1
1Department of Internal Medicine, University of Health Sciences Turkey, Konya City Hospital, Konya, Turkey.
BMC gastroenterology
|January 27, 2026
概括
上部胃肠道出血 (UGIB) 患者的乳酸清除率 (LC) 降低表明对大量输血 (MT) 的需求更高. 将LC与格拉斯哥-布拉奇福得分 (GBS) 结合起来,有助于在UGIB中早期对MT的风险分层.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 紧急医疗 紧急医疗
背景情况:
- 乳酸清除率 (LC) 是重症患者的预后标志物.
- 在上部胃肠道出血 (UGIB) 中大规模输血 (MT) 的LC的预测值尚未得到充分确立.
研究的目的:
- 为了评估LC对UGIB患者的MT要求的预测值.
- 评估 LC 和 UGIB 中 MT 的格拉斯哥-布拉奇福德得分 (GBS) 的联合预测值.
主要方法:
- 452名UGIB患者的回顾性研究 (2021年9月至2023年9月).
- MT定义为24小时内≥10个单位RBC或1小时内≥4个单位.
- LC计算为[[初始乳酸-1小时乳酸]/初始乳酸] × 100.
主要成果:
- 33名患者 (7.3%) 需要手术.
- 较低的LC与MT显著相关 (p < 0.001).
- LC显示AUC为0.840用于预测MT;与GBS相结合,AUC改善到0.880.
结论:
- 减少LC预测UGIB患者的MT可能性更高.
- 与GBS结合的LC可能会改善MT的早期风险分层.
- 由于追溯设计,研究结果需要在前性多中心研究中进行验证.
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