肝硬化门静脉血栓患者并发上消化道出血危险因素与预后的影响因素分析(1)
【摘要】 目的：探讨肝硬化门静脉血栓患者并发上消化道出血危险因素，并分析出血患者影响其预后的相关因素。方法：选取2014年1月-2018年12月肝硬化门静脉血栓患者216例病例资料进行回顾性分析，依据是否并发上消化道出血，分为病例组(并发出血，n=152)和对照组(没有并发出血，n=64)。比较两组一般临床资料与实验室检查等资料，分析并发上消化道出血危险因素。再依据其预后，将病例组分为生存组(n=124)和死亡组(n=28)，分析影响预后的相关因素。结果：病例组与对照组的肝功能分级、食管胃底静脉曲张、腹水、出血病史、血红蛋白(Hb)、血小板(PLT)、白蛋白(ALB)、凝血酶原时间(PT)、胃左静脉内径比较，差异均有统计学意义(P<0.05);生存组与死亡组在失血性休克、反复出血>2次、重度食管胃底静脉曲张、合并症、肝功能Child C级方面比较，差异均有统计学意义(P<0.05);胃左静脉内径增大、重度食管胃底静脉曲张、腹水与肝功能Child C级是肝硬化门静脉血栓患者并发上消化道出血的独立危险因素(P<0.05);失血性休克与重度食管胃底静脉曲张是影响预后的独立危险因素(P<0.05)。结论：定期监测胃左静脉内径、食管胃底静脉曲张、腹水及肝功能分级情况，进行早期预防干预，可降低肝硬化门静脉血栓患者并发上消化道出血的危险，改善其预后，提高生活質量。
【关键词】 肝硬化 门静脉血栓 上消化道出血 危险因素 预后
[Abstract] Objective： To explore the risk factors of upper gastrointestinal bleeding in patients with cirrhosis and portal vein thrombosis， and analyze the related factors that affect the prognosis of patients with bleeding. Method： Data of 216 patients with cirrhosis and portal vein thrombosis from January 2014 to December 2018 were retrospectively analyzed. According to whether complicated with upper gastrointestinal bleeding， they were divided into case group (complicated bleeding， n=152) and control group (without complicated bleeding， n=64). The risk factors of upper gastrointestinal hemorrhage were analyzed by comparing the general clinical data and laboratory examination data of the two groups. Then according to the prognosis， the case group was divided into survival group (n=124) and death group (n=28). The related factors affecting prognosis were analyzed. Result： There were statistically significant differences between the case group and the control group in liver function grading， esophageal and gastric varices， ascites， history of bleeding， hemoglobin (Hb)， platelet (PLT)， albumin (ALB)， prothrombin time (PT)， and left gastric vein diameter (P<0.05). There were statistically significant differences between the survival group and the death group in hemorrhagic shock， repeated bleeding >2 times， severe esophageal and gastric varices， presence of complications and liver function Child C (P<0.05). The internal diameter of the left gastric vein enlargement， severe esophageal and gastric varices， the ascites and the liver function Child C were the independent risk factors of upper gastrointestinal bleeding in patients with cirrhosis and portal vein thrombosis (P<0.05). The hemorrhagic shock and severe esophageal and gastric varices were independent risk factor for the prognosis (P<0.05). Conclusion： Regular monitoring of left gastric vein diameter， esophageal and gastric varices， ascites and liver function grading， early prevention and intervention can reduce the risk of upper gastrointestinal bleeding in patients with with cirrhosis and portal vein thrombosis， improve their prognosis and quality of life., http://www.100md.com(李志英)
【关键词】 肝硬化 门静脉血栓 上消化道出血 危险因素 预后
[Abstract] Objective： To explore the risk factors of upper gastrointestinal bleeding in patients with cirrhosis and portal vein thrombosis， and analyze the related factors that affect the prognosis of patients with bleeding. Method： Data of 216 patients with cirrhosis and portal vein thrombosis from January 2014 to December 2018 were retrospectively analyzed. According to whether complicated with upper gastrointestinal bleeding， they were divided into case group (complicated bleeding， n=152) and control group (without complicated bleeding， n=64). The risk factors of upper gastrointestinal hemorrhage were analyzed by comparing the general clinical data and laboratory examination data of the two groups. Then according to the prognosis， the case group was divided into survival group (n=124) and death group (n=28). The related factors affecting prognosis were analyzed. Result： There were statistically significant differences between the case group and the control group in liver function grading， esophageal and gastric varices， ascites， history of bleeding， hemoglobin (Hb)， platelet (PLT)， albumin (ALB)， prothrombin time (PT)， and left gastric vein diameter (P<0.05). There were statistically significant differences between the survival group and the death group in hemorrhagic shock， repeated bleeding >2 times， severe esophageal and gastric varices， presence of complications and liver function Child C (P<0.05). The internal diameter of the left gastric vein enlargement， severe esophageal and gastric varices， the ascites and the liver function Child C were the independent risk factors of upper gastrointestinal bleeding in patients with cirrhosis and portal vein thrombosis (P<0.05). The hemorrhagic shock and severe esophageal and gastric varices were independent risk factor for the prognosis (P<0.05). Conclusion： Regular monitoring of left gastric vein diameter， esophageal and gastric varices， ascites and liver function grading， early prevention and intervention can reduce the risk of upper gastrointestinal bleeding in patients with with cirrhosis and portal vein thrombosis， improve their prognosis and quality of life., http://www.100md.com(李志英)