临床医药实践
臨床醫藥實踐
림상의약실천
PROCEEDING OF CLINICAL MEDICINE
2015年
8期
586-588,589
,共4页
许飞%胡江玲%姜曼蕾%梁斌
許飛%鬍江玲%薑曼蕾%樑斌
허비%호강령%강만뢰%량빈
食管%胃底%静脉曲张%破裂出血%再出血%危险因素
食管%胃底%靜脈麯張%破裂齣血%再齣血%危險因素
식관%위저%정맥곡장%파렬출혈%재출혈%위험인소
esophagealgastricfundusvarices%varicoseveins%rehaemorrhagia%riskfactors
目的：探讨食管胃底静脉曲张破裂出血患者再出血的危险因素。方法：选取126例食管胃底静脉曲张破裂出血（EGVB）患者为研究对象，根据其再出血情况分成再出血组（A组，n=57）和对照组（B组，n=69）两组。回顾性分析其临床病历资料，比对两组患者在年龄、性别、血清总胆红素水平、凝血酶原时间、血小板计数、红色征、门静脉内径、食管静脉曲张程度等因素上的差异，并针对差异显著指标行非条件Logistic回归分析，记录其相关危险因素。结果：两组患者性别、年龄、肝功能分级等一般临床资料及血清总胆红素水平、凝血酶时间等指标对比，差异无统计学意义（P>0.05）；EGVB患者再出血的发生同血小板计数呈负相关性，同食管静脉曲张程度、红色征、门静脉内径、凝血酶原时间等呈正相关性。结论：凝血酶原时间过长、重度食管静脉曲张、门静脉内径增加及血小板计数减少等均为导致EGVB患者再次出血的危险因素，以红色征最为突出，医师需对此类患者重点留意。
目的：探討食管胃底靜脈麯張破裂齣血患者再齣血的危險因素。方法：選取126例食管胃底靜脈麯張破裂齣血（EGVB）患者為研究對象，根據其再齣血情況分成再齣血組（A組，n=57）和對照組（B組，n=69）兩組。迴顧性分析其臨床病歷資料，比對兩組患者在年齡、性彆、血清總膽紅素水平、凝血酶原時間、血小闆計數、紅色徵、門靜脈內徑、食管靜脈麯張程度等因素上的差異，併針對差異顯著指標行非條件Logistic迴歸分析，記錄其相關危險因素。結果：兩組患者性彆、年齡、肝功能分級等一般臨床資料及血清總膽紅素水平、凝血酶時間等指標對比，差異無統計學意義（P>0.05）；EGVB患者再齣血的髮生同血小闆計數呈負相關性，同食管靜脈麯張程度、紅色徵、門靜脈內徑、凝血酶原時間等呈正相關性。結論：凝血酶原時間過長、重度食管靜脈麯張、門靜脈內徑增加及血小闆計數減少等均為導緻EGVB患者再次齣血的危險因素，以紅色徵最為突齣，醫師需對此類患者重點留意。
목적：탐토식관위저정맥곡장파렬출혈환자재출혈적위험인소。방법：선취126례식관위저정맥곡장파렬출혈（EGVB）환자위연구대상，근거기재출혈정황분성재출혈조（A조，n=57）화대조조（B조，n=69）량조。회고성분석기림상병력자료，비대량조환자재년령、성별、혈청총담홍소수평、응혈매원시간、혈소판계수、홍색정、문정맥내경、식관정맥곡장정도등인소상적차이，병침대차이현저지표행비조건Logistic회귀분석，기록기상관위험인소。결과：량조환자성별、년령、간공능분급등일반림상자료급혈청총담홍소수평、응혈매시간등지표대비，차이무통계학의의（P>0.05）；EGVB환자재출혈적발생동혈소판계수정부상관성，동식관정맥곡장정도、홍색정、문정맥내경、응혈매원시간등정정상관성。결론：응혈매원시간과장、중도식관정맥곡장、문정맥내경증가급혈소판계수감소등균위도치EGVB환자재차출혈적위험인소，이홍색정최위돌출，의사수대차류환자중점류의。
Objective:Tostudytheesophagealgastricvaricesbleedinginpatientswithriskfactorsofrebleeding.Methods:All 126 cases of esophageal gastric varices bleeding( EGVB)patients as the research object,according to rebleeding rate were divided into bleeding group(group A,n=57)and control group(group B,n=69). Retrospective analysis of the clinical data, compared the differences in factors of age,sex,serum total bilirubin,prothrombin time,platelet count,red color sign,portal vein diameter,esophageal varices and so on of patients in two groups,and for non conditional Logistic regression analysis of signifi-cant index difference line,recorded related risk factors. Results:No significant difference between two groups in gender,age, grade of liver function with such general clinical data and serum total bilirubin levels,thrombin time index(P>0. 05). The in-cidence of recurrent bleeding and platelet count in EGVB patients was negatively correlated,was positive correlation between the degree of esophageal varices,red color sign,portal vein diameter,prothrombin time. Conclusion:The prothrombin time too long,severe esophageal varices,portal vein diameter increased and reduced platelet counts are the risk factors contributing to rehaemorrhagia of EGVB patients,with a red sign is the most prominent,physicians should pay attention to.
