实用肝脏病杂志
實用肝髒病雜誌
실용간장병잡지
JOURNAL OF CLINICAL HEPATOLOGY
2014年
3期
279-282
,共4页
食管静脉曲张%内镜根除治疗%复发%危险因素
食管靜脈麯張%內鏡根除治療%複髮%危險因素
식관정맥곡장%내경근제치료%복발%위험인소
Esophageal varices%Endoscopic eradication therapy%Relapse%Risk factors
目的：探讨食管静脉曲张（EV）经内镜下套扎序贯硬化（EVLS）根除治疗后影响复发的因素。方法对61例食管静脉曲张患者行 EVLS 治疗达到根除标准后随访2年，依据复发时间分为高危组（24月内复发）与低危组（24月内未复发），收集食管静脉曲张经内镜治疗达到根除标准时患者的生化及随访期间的临床资料进行统计学分析。结果2年内食管静脉曲张复发24例（39.3％），未复发37例（60.7％）；高危组与低危组在出血、脾功能亢进、糖尿病和中/重度腹水的发生率以及 Child-Pugh 评分、血清白蛋白、血小板计数、凝血酶原时间和超声测量门静脉直径等方面差异有统计学意义（P 均<0.05）；进一步行非条件 Logistic 回归分析显示出血史、中/重度腹水和糖尿病病史（OR 值分别为9.7，6.5和10.8）是食管静脉曲张复发的独立危险因素。结论出血、中/重度腹水、糖尿病是食管静脉曲张复发的独立危险因素，对该类患者应积极随访和再治疗。
目的：探討食管靜脈麯張（EV）經內鏡下套扎序貫硬化（EVLS）根除治療後影響複髮的因素。方法對61例食管靜脈麯張患者行 EVLS 治療達到根除標準後隨訪2年，依據複髮時間分為高危組（24月內複髮）與低危組（24月內未複髮），收集食管靜脈麯張經內鏡治療達到根除標準時患者的生化及隨訪期間的臨床資料進行統計學分析。結果2年內食管靜脈麯張複髮24例（39.3％），未複髮37例（60.7％）；高危組與低危組在齣血、脾功能亢進、糖尿病和中/重度腹水的髮生率以及 Child-Pugh 評分、血清白蛋白、血小闆計數、凝血酶原時間和超聲測量門靜脈直徑等方麵差異有統計學意義（P 均<0.05）；進一步行非條件 Logistic 迴歸分析顯示齣血史、中/重度腹水和糖尿病病史（OR 值分彆為9.7，6.5和10.8）是食管靜脈麯張複髮的獨立危險因素。結論齣血、中/重度腹水、糖尿病是食管靜脈麯張複髮的獨立危險因素，對該類患者應積極隨訪和再治療。
목적：탐토식관정맥곡장（EV）경내경하투찰서관경화（EVLS）근제치료후영향복발적인소。방법대61례식관정맥곡장환자행 EVLS 치료체도근제표준후수방2년，의거복발시간분위고위조（24월내복발）여저위조（24월내미복발），수집식관정맥곡장경내경치료체도근제표준시환자적생화급수방기간적림상자료진행통계학분석。결과2년내식관정맥곡장복발24례（39.3％），미복발37례（60.7％）；고위조여저위조재출혈、비공능항진、당뇨병화중/중도복수적발생솔이급 Child-Pugh 평분、혈청백단백、혈소판계수、응혈매원시간화초성측량문정맥직경등방면차이유통계학의의（P 균<0.05）；진일보행비조건 Logistic 회귀분석현시출혈사、중/중도복수화당뇨병병사（OR 치분별위9.7，6.5화10.8）시식관정맥곡장복발적독립위험인소。결론출혈、중/중도복수、당뇨병시식관정맥곡장복발적독립위험인소，대해류환자응적겁수방화재치료。
Objective To investigate the recurrence factors for esophageal varices after endoscopic eradication therapy of endoscopic sequential variceal ligation plus sclerotherapy (EVLS). Methods Sixty-one patients with esophageal varices achieved eradication standards after EVLS therapy were followed up for 2 years. The patients were divided into high recurrence risk group (relapse within 24 months) and low recurrence risk group (without recurrence within 24 months) according to the recurrence time,and the biochemical and clinical data of the two groups were collected and analyzed statistically. Results There were 24 (39.3%) cases of patients diagnosed with esophageal variceal recurrence within two years,and 37(60.7%)without recurrence. There were significant differences between the two groups as respect to bleeding history,spleen hyperthyroidism,diabetes,moderate/severe ascites, Child-Push scores,serum albumin,platelet counts,prothrombin time and portal vein diameters measured by ultra-sound(P<0.05);Furthermore,non-conditional logistic regression analysis showed that bleeding history,moderate/severe ascites and diabetes history were independent risk factors for esophageal varices recurrence (OR value 9.7,6.5 and 10.8,respectively). Conclusions Bleeding history,moderate/severe ascites and diabetes history are independent risk factors for esophageal varices recurrence and these patients should be actively followed up and retreated in time.
