CAJ | 학술논문

目的：探讨肝硬化并上消化道出血（ UGH ）患者预后的相关因素。方法：回顾性分析2010年3月至2014年2月收治的149例肝硬化并UGH患者的临床资料，其中死亡27例（死亡组），经治疗后存活122例（生存组），比较两组年龄、既往出血史、并发症、呕血量、24h内再出血、Hb水平、出血病因以及肝功能Child－Pugh分级等因素的差异，分析肝硬化并UGH预后的相关因素。结果：多因素Logistic回归显示出血病因、年龄、呕血量、Hb水平、24h内再出血、Child－Pugh 分级、并发症是影响肝硬化并UGH患者预后的独立危险。结论：UGH仍是肝硬化并UGH患者临床死亡的一项重要原因，病人年龄大、呕血量＞500mL、Hb水平＜90g／L、恶性肿瘤、Child－Pugh分级为C级、食管胃底静脉曲张（ EGV）、24h内再出血、合并症等均影响患者转归，是其独立危险因素。
목적：탐토간경화병상소화도출혈（ UGH ）환자예후적상관인소。방법：회고성분석2010년3월지2014년2월수치적149례간경화병UGH환자적림상자료，기중사망27례（사망조），경치료후존활122례（생존조），비교량조년령、기왕출혈사、병발증、구혈량、24h내재출혈、Hb수평、출혈병인이급간공능Child－Pugh분급등인소적차이，분석간경화병UGH예후적상관인소。결과：다인소Logistic회귀현시출혈병인、년령、구혈량、Hb수평、24h내재출혈、Child－Pugh 분급、병발증시영향간경화병UGH환자예후적독립위험。결론：UGH잉시간경화병UGH환자림상사망적일항중요원인，병인년령대、구혈량＞500mL、Hb수평＜90g／L、악성종류、Child－Pugh분급위C급、식관위저정맥곡장（ EGV）、24h내재출혈、합병증등균영향환자전귀，시기독립위험인소。
Objective:To study the prognosis related factors of liver cirrhosis patients with upper gastro-intestinal hemorrhage ( UGH) .Method:A retrospective analysis of patients with cirrhosis and UGH in Mar . 2010 to Feb.2014 were performed, including 27 patients died (death group), 122 cases survived (survival group), Differences between the two groups in age , previous history of bleeding, complication, hemateme-sis, 24 hours rebleeding, Hb level, the cause of hemorrhage and the Child-Pugh classification of liver func-tion and other factors were compared .Related factors and prognosis of UGH in liver cirrhosis were analyzed . Result:Multivariate Logistic regression showed that age , amount of bleeding , hematemesis, the level of Hb, 24h, Child-Pugh grading of rebleeding , complications were independent risk factors of the prognosis of pa-tients with liver cirrhosis and UGH .Conclusion:UGH is an important reason of death of patients with liver cirrhosis and clinical UGH, patient age, hematemesis, Hb <90g/L and malignant tumor, Child-Pugh class C, esophageal and gastric varices ( EGV) , 24h bleeding ( with HRs, ascites, hepatic encephalopathy ) af-fect patient outcomes , they are independent risk factors .