摘要
目的:探析肝硬化胃食管静脉曲张破裂出血预后。方法:选取本院150例肝硬化胃食管静脉曲张破裂出血患者,对其临床资料进行全面研究,采用单因素分析和多元Logistic回归分析探讨预后指标。结果:轻度出血42例(28.0%),中度出血90例(60.0%),重度出血18例(12.0%);药物治疗组、内镜治疗组、三腔二囊管组和联合组患者急诊止血成功率分别为90.8%、93.5%、85.7%、85.7%,各组间比较差异无统计学意义(P>0.05);17例死亡病例,其中13例(76.4%)死于失血性休克,1例(5.9%)死于肝性脑病,1例(5.9%)死于肝功能衰竭,2例(11.8%)死于多器官功能衰竭;对肝硬化胃食管静脉曲张破裂出血患者死亡风险有较大影响的独立预后指标为门冬氨酸氨基转移酶、总胆红素、胃镜检查和出血程度,其中胃镜检查是病死的保护因素。结论:肝硬化胃食管静脉曲张破裂出血患者的严重程度一般为中重度,多死于出血性休克,通过早期胃镜检查能够有效地改善预后。
Objective：To analyze the prognosis of cirrhosis of the liver stomach esophagus varicosity burst hemorrhage. Method：150 patients with cirrhosis of the liver stomach esophagus varicosity burst hemorrhage were chosen from our hospital. A comprehensive study on the clinical data was conducted with the single factor analysis and multivariate Logistic regression analysis of prognostic index. Result：The mild hemorrhage had 42 cases（28.0%）,moderate hemorrhage 90 cases（60.0%）,and severe hemorrhage 18 cases（12.0%）. The emergency hemostatic success rate was 90.8%in drug therapy group,93.5%in endoscopic treatment group,85.7%in three cavity two capsule group and 85.7%in combined group,there was no significant difference（P〉0.05）. 17 cases were died,including 13 cases（76.4%）died of bleeding,1 case（5.9%）died of hepatic encephalopathy,1 case（5.9%）died of liver failure,2 cases（11.8%）died of multiple factors. Death in patients with cirrhosis of the liver stomach esophagus varicosity burst hemorrhage risk had a great influence on independent prognostic indicators for aspartic acid transaminase,total bilirubin,gastroscopy and bleeding, and the gastroscopy was illness protection factors. Conclusion：Patients with cirrhosis of the liver stomach esophagus varicosity burst hemorrhage is usually moderate,and the severity of the many die of hemorrhagic shock,and the early gastroscopy can effectively improve the prognosis.
出处
《中国医学创新》
CAS
2014年第29期151-154,共4页
Medical Innovation of China
关键词
肝硬化
胃食管
静脉曲张
出血
预后
Liver cirrhosis
Stomach esophagus
Varicose veins
Bleeding
Prognosis
