發(fā)布時間：2019-03-16 15:25

【摘要】：目的探討肝硬化合并上消化道出血的危險因素,分析出血患者影響預(yù)后的相關(guān)因素,為臨床治療提供參考。方法選取2008年6月-2014年8月566例肝硬化患者按照是否合并出血分為出血組320例和未出血組246例,分析兩組患者凝血功能、幽門螺桿菌感染、肝功能評分等指標(biāo)得出危險因素;將出血組再分為死亡組48例和生存組272例,對比兩組患者出血次數(shù)、合并癥等指標(biāo),研究影響預(yù)后的相關(guān)因素。結(jié)果單因素、多因素分析表明,胃左靜脈內(nèi)徑、食管靜脈曲張、腹水、PT16s是上消化道出血的危險因素;肝硬化并上消化道出血預(yù)后獨立危險因素為失血性休克(OR=3.652,95%CI=1.12~3.13,P=0.022)、胃底靜脈曲張破裂(OR=7.744,95%CI=4.43~11.53,P=0.008)、合并癥(OR=4.872,95%CI=2.64~7.57,P=0.010)。結(jié)論胃左靜脈內(nèi)徑、腹水、食管胃靜脈曲張、PT16s是上消化道出血的危險因素;出血量、反復(fù)出血、合并肝性疾病、肝功能Child C級均是預(yù)后的影響因素。
[Abstract]:Objective to explore the risk factors of liver cirrhosis complicated with upper digestive tract hemorrhage, and to analyze the related factors affecting the prognosis of patients with hemorrhage, so as to provide reference for clinical treatment. Methods from June 2008 to August 2014, 566 patients with liver cirrhosis were divided into bleeding group (320 cases) and non-bleeding group (246 cases). The risk factors such as coagulation function, Helicobacter pylori infection and liver function score were analyzed. The bleeding group was divided into the death group (48 cases) and the survival group (272 cases). The bleeding times and complications were compared between the two groups to study the related factors affecting the prognosis. Results univariate and multivariate analysis showed that left gastric vein diameter, esophageal varices, ascites and PT16s were risk factors for upper gastrointestinal bleeding. The independent prognostic risk factors for cirrhosis with upper gastrointestinal bleeding were hemorrhagic shock (OR=3.652,95%CI=1.12~3.13,P=0.022), gastric variceal rupture (OR=7.744,95%CI=4.43~11.53,P=0.008). Complications (OR=4.872,95%CI=2.64~7.57,P=0.010). Conclusion left gastric vein diameter, ascites, esophageal gastric varicose vein and PT16s are risk factors for upper gastrointestinal bleeding, bleeding volume, recurrent bleeding, combined with hepatic diseases and liver function Child grade C are prognostic factors.
【作者單位】： 浙江省平陽縣人民醫(yī)院外科;
【基金】：浙江省衛(wèi)生廳基金資助項目(2013KYA121)
【分類號】：R575.2

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本文編號：2441635