【摘要】：目的:探討首次擇期食管靜脈曲張硬化劑治療后胸腔積液的危險(xiǎn)因素。方法:回顧性分析2013年12月至2016年12月在廣西醫(yī)科大學(xué)一附院首次接受擇期食管靜脈曲張硬化劑治療的肝硬化患者的臨床資料,收集可能與首次擇期食管靜脈曲張硬化劑治療后胸腔積液的危險(xiǎn)因素,按術(shù)后有無胸腔積液進(jìn)行分組,進(jìn)行危險(xiǎn)因素分析,尋找首次擇期硬化劑治療后胸腔積液的獨(dú)立危險(xiǎn)因素。結(jié)果:收集首次行食管靜脈曲張硬化劑治療患者119例,排除46例(14例急診手術(shù),14例合并肺部感染,4例合并術(shù)前胸腔積液,2例并發(fā)術(shù)后近期出血,2例合并心功能不全,2例為原發(fā)性肝癌,2例同時(shí)行套扎術(shù),6例資料不全),納入分析73例病例,男性65例,女性8例,平均年齡52.35歲。其中硬化劑后無胸腔積液者52例,出現(xiàn)胸腔積液21例(28.76%),術(shù)后出現(xiàn)胸腔積液患者治療有效20例,死亡1例。兩組進(jìn)行單因素分析提示曲張靜脈直徑(χ~2=10.77,P=0.008),肝功能Child-Pugh分級(χ~2=7.70,P=0.019)、腹水量(χ~2=13.07,P=0.001)、血清白蛋白[P=0.000,95%CI(-9.30~-4.28)]、凝血酶原時(shí)間[P=0.038,95%CI(0.08~2.98)]、血白細(xì)胞計(jì)數(shù)[P=0.005,95%CI(1.26~6.22)]、硬化劑劑量[P=0.013,95%CI(1.21~9.73)]為首次擇期食管靜脈曲張硬化劑治療后胸腔積液的危險(xiǎn)因素。logistic回歸分析結(jié)果顯示腹水量[B=1.551,OR=5.61,95%CI(1.30~24.13),P=0.031]、血清白蛋白[B=-0.230,OR=0.69,95%CI(0.54~0.87),P=0.011],術(shù)后白細(xì)胞計(jì)數(shù)[B=1.877,OR=1.333,95%CI(1.01~1.76),P=0.044]是首次擇期食管靜脈曲張硬化劑治療后胸腔積液的獨(dú)立危險(xiǎn)因素。結(jié)論:1、首次擇期食管靜脈曲張EIS后胸腔積液發(fā)生率為28.8%;2、曲張靜脈直徑、肝功能分級、凝血酶原時(shí)間、硬化劑劑量與首次擇期食管靜脈曲張EIS后胸腔積液的有關(guān);3、腹水量、術(shù)后血白細(xì)胞計(jì)數(shù)與首次擇期食管靜脈曲張EIS后胸腔積液發(fā)生率呈正相關(guān),而血清白蛋白與首次擇期食管靜脈曲張EIS后胸腔積液的發(fā)生率成負(fù)相關(guān)。
[Abstract]:Objective: to investigate the risk factors of pleural effusion after the first selective treatment of esophageal varices with sclerosing agent. Methods: the clinical data of cirrhotic patients who were treated with selective esophageal variceal sclerosing agent for the first time from December 2013 to December 2016 in the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed. To collect the risk factors of pleural effusion after the first selective esophageal variceal sclerotherapy, and to analyze the risk factors according to whether there is pleural effusion after operation. To find out the independent risk factors of pleural effusion after the first selective sclerotherapy. Results: 119 patients were treated with esophageal varices sclerosing agent for the first time. 46 cases were excluded (14 cases of emergency operation, 14 cases of pulmonary infection, 4 cases of preoperative pleural effusion, 2 cases of postoperative hemorrhage, 2 cases of cardiac insufficiency, 2 cases of primary hepatocellular carcinoma, 2 cases of primary liver cancer, 2 cases of primary hepatic carcinoma and 6 cases of incomplete data). 73 cases were analyzed, There were 65 males and 8 females with an average age of 52.35 years. There were 52 cases without pleural effusion after sclerosing agent, 21 cases (28.76%) with pleural effusion, 20 cases with postoperative pleural effusion and 1 case died. 涓ょ粍榪涜鍗曞洜绱犲垎鏋愭彁紺烘洸寮犻潤鑴夌洿寰，

本文編號：2209736