中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
29期
151-153,154
,共4页
肝硬化%胃食管%静脉曲张%出血%预后
肝硬化%胃食管%靜脈麯張%齣血%預後
간경화%위식관%정맥곡장%출혈%예후
Liver cirrhosis%Stomach esophagus%Varicose veins%Bleeding%Prognosis
目的：探析肝硬化胃食管静脉曲张破裂出血预后。方法：选取本院150例肝硬化胃食管静脉曲张破裂出血患者，对其临床资料进行全面研究，采用单因素分析和多元Logistic回归分析探讨预后指标。结果：轻度出血42例（28.0%），中度出血90例（60.0%），重度出血18例（12.0%）；药物治疗组、内镜治疗组、三腔二囊管组和联合组患者急诊止血成功率分别为90.8%、93.5%、85.7%、85.7%，各组间比较差异无统计学意义（P>0.05）；17例死亡病例，其中13例（76.4%）死于失血性休克，1例（5.9%）死于肝性脑病，1例（5.9%）死于肝功能衰竭，2例（11.8%）死于多器官功能衰竭；对肝硬化胃食管静脉曲张破裂出血患者死亡风险有较大影响的独立预后指标为门冬氨酸氨基转移酶、总胆红素、胃镜检查和出血程度，其中胃镜检查是病死的保护因素。结论：肝硬化胃食管静脉曲张破裂出血患者的严重程度一般为中重度，多死于出血性休克，通过早期胃镜检查能够有效地改善预后。
目的：探析肝硬化胃食管靜脈麯張破裂齣血預後。方法：選取本院150例肝硬化胃食管靜脈麯張破裂齣血患者，對其臨床資料進行全麵研究，採用單因素分析和多元Logistic迴歸分析探討預後指標。結果：輕度齣血42例（28.0%），中度齣血90例（60.0%），重度齣血18例（12.0%）；藥物治療組、內鏡治療組、三腔二囊管組和聯閤組患者急診止血成功率分彆為90.8%、93.5%、85.7%、85.7%，各組間比較差異無統計學意義（P>0.05）；17例死亡病例，其中13例（76.4%）死于失血性休剋，1例（5.9%）死于肝性腦病，1例（5.9%）死于肝功能衰竭，2例（11.8%）死于多器官功能衰竭；對肝硬化胃食管靜脈麯張破裂齣血患者死亡風險有較大影響的獨立預後指標為門鼕氨痠氨基轉移酶、總膽紅素、胃鏡檢查和齣血程度，其中胃鏡檢查是病死的保護因素。結論：肝硬化胃食管靜脈麯張破裂齣血患者的嚴重程度一般為中重度，多死于齣血性休剋，通過早期胃鏡檢查能夠有效地改善預後。
목적：탐석간경화위식관정맥곡장파렬출혈예후。방법：선취본원150례간경화위식관정맥곡장파렬출혈환자，대기림상자료진행전면연구，채용단인소분석화다원Logistic회귀분석탐토예후지표。결과：경도출혈42례（28.0%），중도출혈90례（60.0%），중도출혈18례（12.0%）；약물치료조、내경치료조、삼강이낭관조화연합조환자급진지혈성공솔분별위90.8%、93.5%、85.7%、85.7%，각조간비교차이무통계학의의（P>0.05）；17례사망병례，기중13례（76.4%）사우실혈성휴극，1례（5.9%）사우간성뇌병，1례（5.9%）사우간공능쇠갈，2례（11.8%）사우다기관공능쇠갈；대간경화위식관정맥곡장파렬출혈환자사망풍험유교대영향적독립예후지표위문동안산안기전이매、총담홍소、위경검사화출혈정도，기중위경검사시병사적보호인소。결론：간경화위식관정맥곡장파렬출혈환자적엄중정도일반위중중도，다사우출혈성휴극，통과조기위경검사능구유효지개선예후。
Objective:To analyze the prognosis of cirrhosis of the liver stomach esophagus varicosity burst hemorrhage. Method:150 patients with cirrhosis of the liver stomach esophagus varicosity burst hemorrhage were chosen from our hospital. A comprehensive study on the clinical data was conducted with the single factor analysis and multivariate Logistic regression analysis of prognostic index. Result:The mild hemorrhage had 42 cases(28.0%),moderate hemorrhage 90 cases(60.0%),and severe hemorrhage 18 cases(12.0%). The emergency hemostatic success rate was 90.8%in drug therapy group,93.5%in endoscopic treatment group,85.7%in three cavity two capsule group and 85.7%in combined group,there was no significant difference(P>0.05). 17 cases were died,including 13 cases(76.4%)died of bleeding,1 case(5.9%)died of hepatic encephalopathy,1 case(5.9%)died of liver failure,2 cases(11.8%)died of multiple factors. Death in patients with cirrhosis of the liver stomach esophagus varicosity burst hemorrhage risk had a great influence on independent prognostic indicators for aspartic acid transaminase,total bilirubin,gastroscopy and bleeding, and the gastroscopy was illness protection factors. Conclusion:Patients with cirrhosis of the liver stomach esophagus varicosity burst hemorrhage is usually moderate,and the severity of the many die of hemorrhagic shock,and the early gastroscopy can effectively improve the prognosis.
