Immediate hemostasis combined with mucosal regeneration using PRP: a novel multidisciplinary management strategy for refractory hemorrhage in critically ill patients with gastric ulcers
10.13303/j.cjbt.issn.1004-549x.2026.04.019
- VernacularTitle:富血小板血浆即刻止血联合黏膜再生：危重症胃溃疡难治性出血的多学科救治新策略
- Author:
Qiuju MOU
1
;
Zixin ZHU
1
;
Lili ZHU
1
Author Information
1. Department of Blood Transfusion, Guizhou Medical University Hospital, Guiyang 550004, China
- Publication Type:Journal Article
- Keywords:
platelet-rich plasma (PRP);
gastric ulcer bleeding;
critical illness;
multidisciplinary collaboration;
endoscopic therapy
- From:
Chinese Journal of Blood Transfusion
2026;39(4):547-551
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the clinical efficacy of autologous platelet-rich plasma (PRP) combined with endoscopy and interventional embolization in treating refractory gastric ulcer hemorrhage in critically ill patients with systemic diseases (sepsis, uremia), and to provide a novel therapeutic option for cases failing conventional treatments. Methods: A case of a 60-year-old male patient with sepsis and uremia complicated by gastric antral ulcer (Forrest Ib) with active bleeding was reported. Autologous venous blood was collected, and PRP was prepared via a two-step centrifugation method. PRP was sprayed endoscopically followed by local injection, and then covered with a thrombin-calcium ion activator to form a gel layer. Initial treatment was performed, followed by consolidation therapy seven days later, along with selective gastroduodenal artery embolization. Results: Hemorrhage was controlled within 24 hours after the initial PRP treatment. Hemoglobin (Hb) increased from 49 g/L to 56 g/L, and coagulation function improved [activated partial thromboplastin time (APTT) decreased from>170 s to 85 s]. A stable coagulum formed on the ulcer surface after the second PRP treatment on day 7. At the 4-week follow-up endoscopic assessment, the ulcer had shrunk to approximately 0.8×1.0 cm, Hb had risen to 92 g/L, and no rebleeding occurred. Conclusion: PRP, acting through mechanical tamponade by a physical barrier and sustained release of growth factors, serves as an effective supplementary treatment for refractory gastric ulcer bleeding, offering dual mechanisms of immediate hemostasis and promotion of mucosal repair. Combining PRP with interventional embolization and multidisciplinary collaboration can further enhance efficacy and may have potential for broader application.
