肝硬化食管静脉曲张破裂出血急诊治疗后早期再出血的影响因素分析.docVIP

肝硬化食管静脉曲张破裂出血急诊治疗后早期再出血的影响因素分析 ［ ］目的探讨肝硬化食管静脉曲张破裂出血急 诊治疗后早期再出血的影响因素。方法选择本院消化内科 2013年5月?2014年5月收治并给予内镜下治疗的肝硬化 食管静脉曲张破裂出血患者90例，根据出血控制后72 h?6 周内有无再出血分为再出血组（28例）和未出血组（62例）。 比较两组患者的曲张静脉程度和肝功能Child-Pugh分级、 腹水程度、出血程度，并分析两组患者的相关凝血指标（PT、 PTA、PLT）和生化指标（Na+、ALT、AST、TBil、Alb）,分 析各因素对早期再出血的影响。结果再出血组静脉曲张III 级12例（42.86%）、肝功能Child-Pugh分级C级10例 （35.71%）、大量腹水15例（53.57%）、重度出血10例 （35.71%）均明显多于未出血组的7例（11.29%）、8例 （12. 90%）、6 例（9.68%）、7 例（11.29%），差异有统计学 意义（P0.05）。结论静脉曲张程度、肝功能Child-Pugh 分级、腹水程度、出血程度、凝血功能及血生化（Na+、TBil、 Alb）均对早期再出血有影响，改善这些因素对预防肝硬化 食管静脉曲张破裂出血患者发生早期再出血可能有一定的 帮助。 ［关键词］肝硬化；静脉曲张；再出血 ［ ］R575.2 ［ ］A ［ ］ 1674-4721 (2015) 06 (a) -0037-04 Study on the impact of emergency treatment after liver cirrhosis esophagus varicosity burst hemorrhage on the early rebleeding YE Xiang-dong Department of Surgery ， Shenwan Hospital in Zhongshan City of Guangdong Province, Zhongshan 528462, China [Abstract] Objective To explore the influence factors of early bleeding again after emergency treatment for Liver cirrhosis esophagus varicosity burst hemorrhage. Method 90 cases of patients with liver cirrhosis esophagus varicosity burst hemorrhage who were analyzed and accepted endoscopic treatment in our digestive internal medicine from May 2013 to May 2014 were selected. According to whether to bleed again or not in the 72 h to 6 weeks after control bleeding, they were divided into further hemorrhage group (28 cases) and no bleeding group (62 cases) .The degree of varicose vein, Child-Pugh class of liver function, and the degree of ascites and bleeding between two groups of patients was compared respectively. Blood coagulation indexes (PT，PTA，PLT) and biochemical indicators (Na+, ALT，AST, TBil，Alb) between two groups of patients was analyzed respectively and the effect of various factors on the early bleeding again was analyzed. Results Rebleeding group varices stage III in 12 cases (42.86%)， Child-Pugh classification of liver function grade C in 10 cases (35.71%)， a large number of ascites in 15 cases (