胃静脉曲张出血死亡因素分析.docVIP

胃静脉曲张出血死亡因素分析[摘要] 目的：探讨与胃静脉曲张出血死亡相关的危险因素。方法：回顾性分析肝硬化胃静脉曲张临床资料72例，生存组53例，死亡组19例，基于相关影响因素的单因素Logistic分析，有意义者纳入多元Logistic回归模型分析。结果：单因素Logistic分析显示，肝功能、血小板在两组间有显著性差异（P＜0.01）；多元Logistic分析结果显示，以上二者是死亡的独立危险因素。结论：肝功能水平和血小板含量是胃静脉曲张出血死亡相关的独立危险因素，积极予以处理能干预死亡的发生，提高临床疗效。 [关键词] 胃静脉曲张；死亡；危险因素；Logistic模型 [中图分类号] R575.2[文献标识码] C[文章编号] 1673-7210（2010）11（c）-108-03 Analysis on reasons for death of patients of gastric variceal hemorrhage LI Xiaoping1, SHEN Xiaoli2 (1.Gas Company Staff Hospital of Changzhi City, Shanxi Province, Changzhi 046000, China; 2.The Second Hospital of Shaanxi Province, Xi′an 710005) [Abstract] Objective: To investigate the prognostic variables predicting mortality for gastric variceal hemorrhage. Methods: 72 patiens with gastric varices bleeding caused by cirrhosis were retrospectively analysed. 53 in the survival group and 19 in the death group. Based on the results by univariate analysis, the data were processed by Logistic multiple regression model. Results: Univariate analysis revealed that liver function and platelets had a significant diference between two groups. Logistic multiple regression model analysis showed that above two factors were independent death risks of gastric variceal hemorrhage (P＜0.05). Conclusion: Liver function and platelets are independent death risks factors of gastric variceal hemorrhage. Dealing with these risk factors actively may play an important role in prognosis for patients with gastric variceal hemorrhage. [Key words] Gastric varices; Death; Risk factors; Logistic models 肝硬化胃静脉曲张多与食管静脉曲张并存，其破裂出血发生率为10%～36%，随着现代医学发展该病的治疗方法增多，但再次出血死亡的发生率仍极高[1]，故研究其死亡的相关因素，有助于把握本病的发展和预后，以进一步指导临床诊治。本文回顾2004～2009年72例肝硬化胃静脉曲张出血患者的临床资料，应用多元统计学方法，分析了病史、肝功能状况、合并症及治疗等方面的因素与死亡的相关关系，现报道如下： 1 资料与方法 1.1 一般资料 经临床结合胃镜诊断为肝硬化胃静脉曲张出血患者72例。肝功能Child-pugh分级多为B、C级。其中重症患者47例。 1.2 方法 大致有两种方法，以药物治疗44例，用药同时接受镜下栓塞曲张静脉（三明治夹心法）28例。药物组以生长抑素制剂常规用法；栓塞治疗组用药同时给予组织胶栓塞。 1.3统计学分析 根据临床知识和文献资料，选取可能影响肝硬化胃静脉出血患者病死率的危险因素：肝功能（Child-pugh A、B