CAJ | 학술논문

目的初步探讨食管胃底静脉曲张患者行内镜下静脉曲张套扎术(EVL)及内镜下组织胶注射术后早期再出血的独立危险因素.方法回顾性总结370例396例次肝硬化食管胃底静脉曲张出血或曾经出血为预防再出血而行EVL和(或)内镜下组织胶注射术治疗患者的临床资料,分析术后早期再出血患者群与未出血患者群间的差异性因素,并引入Logistic回归分析以寻找独立危险因素.结果是否有合并症、腹水、门静脉宽度、Child-Pugh分值、蓝色曲张静脉、胆碱酯酶、白蛋白水平在术后早期再出血患者和未出血患者群中分布差异明显(P均＜0.05)；Logistic回归分析发现腹水、门静脉宽度、Child-Pugh分值、白蛋白水平为EVL及内镜下组织胶注射术后早期再出血的独立危险因素(P值分别为0.011、0.008、0.009和0.005),进一步进行分层分析得出随着腹水量增多、门静脉宽度增加、白蛋白减少、Child-Pugh分值大于10分后,EVL及内镜下组织胶注射术后发生早期再出血的危险性明显增加.结论腹水量、门静脉宽度、Child-Pugh分值及白蛋白水平可明显影响食管胃底静脉曲张患者行EVL及组织胶注射术后早期再出血的发生.
목적 초보탐토식관위저정맥곡장환자행내경하정맥곡장투찰술(EVL)급내경하조직효주사술후조기재출혈적독립위험인소.방법 회고성총결370례396례차간경화식관위저정맥곡장출혈혹증경출혈위예방재출혈이행EVL화(혹)내경하조직효주사술치료환자적림상자료,분석술후조기재출혈환자군여미출혈환자군간적차이성인소,병인입Logistic회귀분석이심조독립위험인소.결과 시부유합병증、복수、문정맥관도、Child-Pugh분치、람색곡장정맥、담감지매、백단백수평재술후조기재출혈환자화미출혈환자군중분포차이명현(P균＜0.05)；Logistic회귀분석발현복수、문정맥관도、Child-Pugh분치、백단백수평위EVL급내경하조직효주사술후조기재출혈적독립위험인소(P치분별위0.011、0.008、0.009화0.005),진일보진행분층분석득출수착복수량증다、문정맥관도증가、백단백감소、Child-Pugh분치대우10분후,EVL급내경하조직효주사술후발생조기재출혈적위험성명현증가.결론 복수량、문정맥관도、Child-Pugh분치급백단백수평가명현영향식관위저정맥곡장환자행EVL급조직효주사술후조기재출혈적발생.
Objective To study the independent risk factors of early rebleeding after endoscopic variceal ligation (EVL) and/or endoscopic injection of fibrin tissue adhesive.Methods Data of 370 patients who had cirrhosis and accepted 396 procedures of EVL and/or endoscopic injection of fibrin tissue adhesive were retrospectively studied.Independent risk factors for early rebleeding were determined by Logistic regression analysis.Results Results of all the factors that were significantly different between the re-bleeding and non-rebleeding patients,the portal vein diameter,ascites volume,Child-Pugh score and serum albumin were independent ones of early rebleeding after EVL and/or endoscopic injection of fibrin tissue adhesive ( P ＜ 0.05).Larger volume of ascites,wider portal vein diameter,reduced albumin,Child-Pugh score greater than 10 were indicative factors of rebleeding.Conclusion The early rebleeding rate after EVL and/or endoscopic injection of fibrin tissue adhesive is determined by portal vein diameter,ascites volume,ChildPugh score,and serum albumin.