【摘要】：目的通過對(duì)310例肝硬化食管胃靜脈曲張出血并行內(nèi)鏡治療患者進(jìn)行臨床病例回顧性分析，初步探尋經(jīng)Qg鏡治療后早期再出血危險(xiǎn)因素，為臨床工作提供一定的參考。 方法回顧性分析寧夏醫(yī)科大學(xué)總醫(yī)院2009年1月至2012年12月收治的伴有食管胃靜脈曲張破裂出血行內(nèi)鏡下治療的肝硬化患者的臨床資料，，按6周內(nèi)是否發(fā)生再出血分為再出血組和對(duì)照組,應(yīng)用SPSS17.0統(tǒng)計(jì)軟件分析,將差異有顯著性的指標(biāo)運(yùn)用二元非條件Logistic回歸模型進(jìn)行分析。分析各因素對(duì)早期再出血的影響,進(jìn)一步找出獨(dú)立的危險(xiǎn)因素。P值小于0.05，認(rèn)為差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果分析310例患者中，34例(10.9%)發(fā)生再出血,276例未再出血患者為對(duì)照組。兩組在Na+、ALB、PTA、INR、門靜脈內(nèi)徑、脾臟厚度、腹水程度、Child-Pugh分級(jí)、靜脈曲張程度的差異有統(tǒng)計(jì)學(xué)意義。對(duì)上述觀察指標(biāo)進(jìn)行二元非條件Logistic回歸分析，肝功能Child-Pugh分級(jí)、血清Na+、血漿白蛋白ALB、脾臟厚度、中-大量腹水、重度靜脈曲張是早期再出血的獨(dú)立危險(xiǎn)因素。 結(jié)論1、肝功能Child-Pugh分級(jí)、血清Na+、血漿白蛋白ALB、脾臟厚度、中-大量腹水、重度靜脈曲張是早期再出血的獨(dú)立危險(xiǎn)因素。 2、肝功能Child-Pugh分級(jí)為C級(jí)，且大量腹水的EGVB患者更易發(fā)生早期再出血。
[Abstract]:Objective to explore the risk factors of early rebleeding after QG therapy in 310 patients with esophageal and gastric variceal bleeding combined with endoscopic therapy in order to provide some reference for clinical work. Methods the clinical data of patients with esophageal and gastric variceal bleeding treated by endoscope in Ningxia Medical University General Hospital from January 2009 to December 2012 were analyzed retrospectively. According to whether rebleeding occurred within 6 weeks, the patients were divided into two groups: rebleeding group and control group. The statistical software SPSS17.0 was used to analyze the significant difference between the two groups, and the binary non-conditional Logistic regression model was used to analyze the difference. The influence of various factors on early rebleeding was analyzed and the independent risk factor. P value was found to be less than 0. 05. The difference was statistically significant. Results 34 cases (10.9%) of 310 patients with recurrent hemorrhage were analyzed as control group. There were significant differences in the diameter of portal vein, the thickness of spleen, the degree of ascites and Child-Pugh grade and the degree of varicose vein between the two groups. The risk factors of early rebleeding were analyzed by binary non-conditional Logistic regression analysis, liver function Child-Pugh grade, serum Na, plasma albumin, spleen thickness, moderate to massive ascites and severe varicose veins. Conclusion 1. Child-Pugh grade of liver function, serum Na, plasma albumin, thickness of spleen, medium to large ascites, severe varicose veins are independent risk factors for early rebleeding. 2. Child-Pugh grade of liver function is C grade. EGVB patients with a large amount of ascites are more prone to early rebleeding.
【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】：2014
【分類號(hào)】：R575.2

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