摘要
目的:探讨肝硬化并发首次上消化道出血致命的危险因素,为临床防治提供参考。方法:选取在华北理工大学附属医院和唐山市传染病医院收住院的肝硬化患者572例,依据是否并发上消化道出血,分为出血组163例和非出血组409例。再将出血组患者依据是否并发首次上消化道出血死亡,分为病例组(并发首次上消化道出血死亡)65例和对照组(并发非首次上消化道出血死亡)98例。分析患者的一般临床资料及实验室、影像学检查等资料,分析肝硬化并发上消化道出血的危险因素以及肝硬化并发首次上消化道出血致命的独立危险因素。结果:(1)单因素分析显示:出血组和非出血组Hb、PLT、CHE、ALB、TBIL、PT、胃左静脉内径、门静脉内径、肝硬化病程、肝硬化家族史、肝功能Child分级、食管胃底静脉曲张、腹水、肝性脑病、门静脉血栓等方面比较,差异均有统计学意义(P<0.05)。(2)多因素Logistic回归分析显示:胃左静脉内径、食管胃底静脉曲张、腹水、肝功能Child C级、门静脉血栓是肝硬化患者并发上消化道出血的危险因素;胃左静脉内径、食管胃底静脉曲张、门静脉血栓是肝硬化并发首次上消化道出血致命的独立危险因素。结论:更宽的胃左静脉内径、重度食管胃底静脉曲张、门静脉血栓形成是肝硬化并发首次上消化道出血致命的独立危险因素。
Objective: To explore the fatal risk factors of liver cirrhosis complicated with the first upper gastrointestinal bleeding, so as to provide reference for clinical prevention and treatment. Methods:572 patients with cirrhosis admitted to North China University of Science and Technology and Tangshan Infectious Diseases Hospital from January 2014 to January 2018 were selected. According to whether there is concurrent upper gastrointestinal bleeding, it is divided into 163 cases of hemorrhage group and 409 cases of non bleeding group. The patients in the hemorrhagic group were divided into case group(65 cases died of first upper gastrointestinal bleeding) and control group(98 cases died of non-first upper gastrointestinal bleeding). The general clinical data, laboratory and imaging data of the patients were analyzed. The risk factors of upper gastrointestinal bleeding in cirrhosis and the independent risk factors of the first upper gastrointestinal bleeding in cirrhosis were analyzed. Results:(1) Univariate analysis showed that: there were significant differences in Hb, PLT, CHE, ALB, TBIL, PT, left gastric vein diameter, portal vein diameter, course of cirrhosis, family history of cirrhosis, Child classification of liver function, esophagogastric varices, ascites, hepatic encephalopathy and portal vein thrombosis between hemorrhagic and non-hemorrhagic groups(P<0.05). The difference was statistically significant.(2) Multivariate logistic regression analysis showed that the diameter of left gastric vein, esophageal varices, ascites, Child C grade of liver function and portal vein thrombosis were risk factors for upper gastrointestinal bleeding in patients with cirrhosis. Left gastric vein diameter, esophagogastric varices and portal vein thrombosis are independent risk factors for first upper gastrointestinal bleeding in cirrhosis. Conclusion:Wider internal diameter of left gastric vein, severe esophagogastric varices and portal vein thrombosis are independent risk factors for fatal upper gastrointestinal bleeding i
作者
王柳青
李盛楠
张国顺
WANG Liu-qing;LI Sheng-nan;ZHANG Guo-shun(Department of Gastroenterology,North China University of Science and Technology,Tangshan,063000,China)
出处
《海南医学院学报》
CAS
2019年第6期451-454,458,共5页
Journal of Hainan Medical University
基金
中国肝炎防治基金会资助项目(TQGB20170015)
河北省医学科学研究重点课题计划(20170933)~~
关键词
肝硬化
上消化道出血
危险因素
Liver cirrhosis
Upper gastrointestinal bleeding
Risk factors
