肝硬化食管静脉曲张内镜下套扎治疗术后早期再出血临床分析.docVIP

肝硬化食管静脉曲张内镜下套扎治疗术后早期再出血临床分析 　　[摘要] 目的 肝硬化食管静脉曲张内镜下套扎（EVL）治疗术后早期再出血的临床分析。方法 整群选取该院2009年5月―2015年5月收治的95例肝硬化行EVL患者为研究对象，17例发生术后早期再出血事件，纳入早期再出血组，其余78例为对照组，比较两组性别、合并疾病、Grade分级、Child-Pugh分级等一般临床资料，血红蛋白、血清白蛋白、总胆红素、凝血酶原时间等生化指标。 结果 两组Grade分级、Child-Pugh分级比较有统计学意义（P0.05）。早期再出血组总胆红素（40.69±25.68）μmol/L、凝血酶原时间（21.63±3.68）s高于对照组（26.35±18.56）μmol/L、（16.75±4.52）s，差异有统计学意义（P0.05）。 结论 Child-Pugh分级与Grade分级是影响EVL术后早期再出血的危险因素。总胆红素水平升高、凝血酶原时间延长可提示术后发生早期再出血，可为临床提供一定的指导意义。 　　[关键词] 肝硬化；食管静脉曲张；EVL 术后；早期再出血 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2016）06（a）-0061-03 　　[Abstract] Objective To analyze early rebleeding after endoscopic esophageal variceal ligation （EVL） in the treatment of liver cirrhosis with esophageal varices. Methods Group selection 95 cases of patients with liver cirrhosis who underwent EVL in our hospital between May 2009 and May 2015 were selected as the study subjects. 17 cases with early postoperative rebleeding were included into early rebleeding group. The other 78 cases were included in the control group. The general clinical data such as gender， complicated diseases， Grade grading and Child-Pugh grading and biochemical indexes such as hemoglobin， serum albumin， total bilirubin and prothrombin time were compared between the two groups. Results There were significant differences in Grade grading and Child-Pugh grading between the two groups （P 0.05）. The total bilirubin level （40.69±25.68） μmol/L and prothrombin time （21.63±3.68） s in the early rebleeding group were higher than those in the control group [（26.35±18.56） μmol/L， （16.75±4.52） s] （P 0.05）. Conclusion Child-Pugh grading and Grade grading are the risk factors influencing early rebleeding after EVL. The increase of total bilirubin and prolongation of prothrombin time may indicate that there is early rebleeding after operation， which can provide some guidance for clinical treatment. 　　[Key words] Liver cirrhosis； Esophageal varices； After EVL； Early rebleeding 　　肝硬化失代偿期最常见最严重的并发症之一为食管静脉曲张破裂出血，其是晚期肝硬化患者