本文選題：肝硬化 + 并發(fā)癥��； 參考：《寧夏醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的研究影響肝硬化患者住院期間死亡的相關(guān)危險(xiǎn)因素。方法收集2001年12月到2015年4月寧夏醫(yī)科大學(xué)總醫(yī)院收住入院的肝硬化患者共7287例,將好轉(zhuǎn)出院的6981例定義為存活組,院內(nèi)死亡的306例定義為死亡組。收集兩組患者的病例資料:一般資料、常見并發(fā)癥、是否出現(xiàn)肝衰竭及合并疾病。兩組間單因素分析采用卡方檢驗(yàn);將有統(tǒng)計(jì)學(xué)意義的指標(biāo)納入多因素Logistic回歸模型分析肝硬化患者住院期間死亡的相關(guān)危險(xiǎn)因素;P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果1、一般資料死亡組中,男性239例(78.10%),女性67例(21.90%);漢族262例(85.62%),回族36例(11.76%),蒙古族6例(1.96%),滿族2例(0.65%);最小年齡0.42歲(5個(gè)月),最大年齡88歲,平均年齡為(54.57±13.23)歲;其中51.63%為46歲~65歲的中年患者。2、并發(fā)癥死亡組中各并發(fā)癥的發(fā)生率均高于存活組,兩組間比較有統(tǒng)計(jì)學(xué)差異(P0.05)。死亡組中前三位的并發(fā)癥依次為上消化道出血61.76%、感染57.52%、肝性腦病37.91%。3、肝衰竭死亡組中出現(xiàn)肝衰竭的患者占15.03%,高于存活組1.83%,兩組間比較有統(tǒng)計(jì)學(xué)差異(P0.05)。4、合并疾病死亡組患者合并心臟病、高血壓病、腦血管病及糖尿病的比例高于存活組,兩組間比較有統(tǒng)計(jì)學(xué)差異(P0.05)。死亡組中前三位的合并疾病依次為糖尿病16.67%,高血壓病9.15%,心臟病5.56%。5、多因素分析將單因素分析中有統(tǒng)計(jì)學(xué)意義的指標(biāo)進(jìn)行多因素Logistic回歸,結(jié)果表示年齡(OR=1.020)、上消化道出血(OR=6.734)、感染(OR=2.462)、肝性腦病(OR=3.316)、肝腎綜合征(OR=2.672)、原發(fā)性肝癌(OR=1.754)、電解質(zhì)平衡紊亂(OR=1.886)、肝衰竭(OR=2.485)及心臟病(OR=2.258)為肝硬化患者住院期間死亡的相關(guān)危險(xiǎn)因素。結(jié)論1、本研究肝硬化死亡組患者多為中年,男性多于女性。2、本研究肝硬化死亡組患者發(fā)生率前三位的并發(fā)癥是上消化道出血、感染、肝性腦病。3、年齡、多數(shù)并發(fā)癥(上消化道出血、感染等)、出現(xiàn)肝衰竭及合并心臟病為肝硬化患者住院期間死亡的相關(guān)危險(xiǎn)因素。
[Abstract]:Objective to study the risk factors of death in patients with liver cirrhosis during hospitalization. Methods A total of 7287 patients with liver cirrhosis admitted to the General Hospital of Ningxia Medical University from December 2001 to April 2015 were collected. 6981 patients who recovered and discharged from hospital were defined as survival group and 306 patients who died in hospital were defined as death group. Collect the case data of the two groups: general data, common complications, liver failure and associated diseases. Univariate analysis between the two groups using chi-square test; the statistical significance of the indicators into the multivariate logistic regression model to analyze the risk factors related to death in patients with liver cirrhosis during hospitalization P0.05 for the difference was statistically significant. Results 1 in the general data death group, 239 males (78.10m) and 67 females (21.90), 262 Han (85.62), 36 Hui (11.76), 6 Mongolian (1.96), 2 Manchu (0.65), 0.42 (5 months, 88 years old, mean 54.57 鹵13.23) years of age; 51.63% of them were middle aged patients aged 46 to 65 years old. The incidence of complications in the death group was higher than that in the survival group, and there was significant difference between the two groups (P 0.05). The first three complications in the death group were upper gastrointestinal hemorrhage 61.76g, infection 57.52, hepatic encephalopathy 37.91.3The proportion of patients with liver failure in the death group was 15.03, higher than that in the survival group 1.833.There was a statistical difference between the two groups (P0.05.4). Group B patients with heart disease, The proportion of hypertension, cerebrovascular disease and diabetes mellitus was higher than that of survival group, and there was significant difference between the two groups (P 0.05). In the death group, the first three diseases were diabetes 16.67, hypertension 9.15, heart disease 5.56, multivariate analysis and multivariate logistic regression. The results showed that the related risk factors of death in patients with liver cirrhosis were the age of OR1. 020, the upper gastrointestinal hemorrhage of 6. 734, the infection of OR2. 462, the hepatic encephalopathy 3. 316, the hepatorenal syndrome of 2. 672, the primary liver cancer of 1. 754, the electrolyte imbalance of OR1. 886, the liver failure OR2. 485) and the heart disease OR2. 258). Conclusion 1, the mortality group of cirrhosis in this study is mostly middle-aged, male is more than female. The first three complications in the death group of liver cirrhosis are upper gastrointestinal hemorrhage, infection, hepatic encephalopathy and age. Most complications (upper gastrointestinal bleeding, infection, etc.), liver failure and heart disease were risk factors for death in patients with liver cirrhosis.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R575.2

【相似文獻(xiàn)】

相關(guān)期刊論文 前3條

1 徐菁;張志勇;;自體外周血干細(xì)胞移植治療乙型肝炎肝硬化臨床觀察[J];檢驗(yàn)醫(yī)學(xué)與臨床;2014年10期

2 袁芳岑;汪志兵;張振玉;;肝硬化并創(chuàng)傷弧菌感染1例報(bào)告[J];山東醫(yī)藥;2014年10期

3 李正民;方盼盼;宮璀璀;王文麗;;糖類抗原125在非婦科疾病診治中的研究現(xiàn)狀[J];實(shí)用醫(yī)藥雜志;2014年04期

相關(guān)博士學(xué)位論文 前1條

1 焦國慧;PD-1調(diào)節(jié)自身免疫性肝炎肝硬化患者脾切除后免疫耐受功能的研究[D];天津醫(yī)科大學(xué);2017年

相關(guān)碩士學(xué)位論文 前10條

1 孫昊;肝硬化患者死亡相關(guān)危險(xiǎn)因素分析[D];寧夏醫(yī)科大學(xué);2017年

2 夏丁昌;焦慮抑郁狀態(tài)與肝硬化進(jìn)展關(guān)系研究[D];山西醫(yī)科大學(xué);2017年

3 李文靜;無創(chuàng)評(píng)估病毒性肝炎后肝硬化食管靜脈曲張及出血的臨床價(jià)值[D];鄭州大學(xué);2017年

4 牛亞慧;肝硬化合并門靜脈血栓形成抗凝治療的有效性及安全性的薈萃分析[D];山西醫(yī)科大學(xué);2017年

5 趙明遠(yuǎn);肝硬化合并不同程度的食管靜脈曲張患者血清25OHD_3的水平及臨床意義[D];山西醫(yī)科大學(xué);2017年

6 張妮娜;丙型肝炎后肝硬化的影響因素分析[D];山西醫(yī)科大學(xué);2017年

7 凌新建;腹腔鏡脾切除術(shù)治療肝硬化所致脾功能亢進(jìn)的臨床研究[D];安徽醫(yī)科大學(xué);2017年

8 丁鵬鵬;AFP、AFP-L3%、GP73及IL-6在肝硬化人群中診斷肝癌的價(jià)值和cGAMP檢測(cè)方法初探[D];中國人民解放軍軍事醫(yī)學(xué)科學(xué)院;2017年

9 張文祥;肝硬化合并門靜脈血栓形成危險(xiǎn)因素的Meta分析[D];山西醫(yī)科大學(xué);2017年

10 左穎婷;遺傳算法BP神經(jīng)網(wǎng)絡(luò)在肝硬化分期診斷中的應(yīng)用[D];山西醫(yī)科大學(xué);2017年

，

本文編號(hào)：1993476