CAJ | 학술논문

目的：比较肝硬化食管静脉曲张破裂出血和肝硬化非食管静脉曲张破裂出血患者的临床特征。方法选择2007年1月至2014年8月接受治疗的肝硬化合并上消化道出血患者300例。根据患者的出血原因，分为食管静脉曲张破裂出血（ EVB）组182例，非静脉曲张破裂出血（ NEVB）组118例。比较两组患者的临床表现、并发症情况和Child-Pugh肝功能分级。结果 EVB组患者呕血、呕吐咖啡样物的比率明显低于NEVB组，差异具有统计学意义（ P >0.05）。EVB组患者失血性休克、便血的比率低于NEVB组，但差异无统计学意义（ P <0.05）。EVB组患者出现肝癌、肝性脑病并发症的发病率低于 NVEB组，门静脉血栓的发病率高于 NEVB组，但差异无统计学意义（ P >0.05）。EVB组患者Child-Pugh分级为A、B级的患者比率高于NEVB组，C级患者比率低于NEVB组，但差异无统计学意义（ P >0.05）。结论肝硬化非静脉曲张破裂出血在肝硬化合并上消化道出血中并非罕见，EVB和NEVB患者的临床表现相似，但NEVB患者更易呕吐咖啡样胃内容物，可根据临床表现区分。
목적：비교간경화식관정맥곡장파렬출혈화간경화비식관정맥곡장파렬출혈환자적림상특정。방법선택2007년1월지2014년8월접수치료적간경화합병상소화도출혈환자300례。근거환자적출혈원인，분위식관정맥곡장파렬출혈（ EVB）조182례，비정맥곡장파렬출혈（ NEVB）조118례。비교량조환자적림상표현、병발증정황화Child-Pugh간공능분급。결과 EVB조환자구혈、구토가배양물적비솔명현저우NEVB조，차이구유통계학의의（ P >0.05）。EVB조환자실혈성휴극、편혈적비솔저우NEVB조，단차이무통계학의의（ P <0.05）。EVB조환자출현간암、간성뇌병병발증적발병솔저우 NVEB조，문정맥혈전적발병솔고우 NEVB조，단차이무통계학의의（ P >0.05）。EVB조환자Child-Pugh분급위A、B급적환자비솔고우NEVB조，C급환자비솔저우NEVB조，단차이무통계학의의（ P >0.05）。결론간경화비정맥곡장파렬출혈재간경화합병상소화도출혈중병비한견，EVB화NEVB환자적림상표현상사，단NEVB환자경역구토가배양위내용물，가근거림상표현구분。
Objective To compare the clinical features of liver cirrhosis patients with esophageal variceal bleeding( EVB)with liver cir-rhosis patients without EVB( non-EVB,NENB). Methods Three hundred liver cirrhosis patients with upper gastrointestinal hemorrhage trea-ted in our hospital between January 2007 and August 2014 were selected. The patients were divided into EVB group(n=182)and NEVB group (n=118). Clinical manifestations,complications,and the Child-Pugh classification of liver function were compared between two groups. Re-sults The incidences of hematemesis and coffee-ground vomitus in EVB group were significantly lower than NEVB group( P <0. 05). The in-cidences of hemorrhagic shock,bloody stool,liver cancer,and hepatic encephalopathy were lower,and portal vein thrombosis incidence was high-er in EVB group,but no significant differences were found between two groups( P >0. 05). Child-Pugh classification of the patients showed that higher percentage of Child-Pugh class A and B,and lower percentage of Child-Pugh class C in EVB group than NEVB group,but the differences were not statistically significant between two groups( P >0. 05). Conclusion Clinical manifestations especially coffee-ground vom-itus may be used for the differentiation of EVB and NEVB.