内镜治疗肝硬化食管静脉曲张后近期再出血的危险因素分析  

Risk factors for recent rebleeding after endoscopic therapy for cirrhotic esophageal varice

作　　者：黎庆宁[1] 聂玉强[1] 

机构地区：[1]广州市第一人民医院消化内科,510180

出　　处：《现代消化及介入诊疗》2009年第4期207-209,共3页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的探讨内镜止血治疗后与肝硬化食管静脉曲张近期再出血有关的危险因素。方法回顾性分析食管静脉曲张出血内镜下治疗后30d内的近期再出血率及其相关的危险因素。结果312例近期再出血74例(23.7%),合并肝癌者(40.0%)高于单纯肝硬化者(17.6%)(P<0.05)。与合并肝癌的近期再出血有关因素有:以往多次出血,转氨酶、AFP和血小板高,未服心得安。与单纯肝硬化的近期再出血有关因素是:与以往首次出血间隔时间短,过去多次硬化剂治疗,高转氨酶和心率快。结论肝硬化合并肝癌、转氨酶增高、心率未受控制等因素与内镜治疗后食管静脉曲张近期再出血有关。Objective To investigate the risk factors related with the recent rebleeding after endoscopic therapy for cirrhotic esophageal varices. Methods Retrospective analysis was made from the data including the rebleeding rate within 30 days after endoscopic sclerotherapy or ligation for esophageal variceal bleeding and risk factors. Results Endoscopic therapy for esophageal variceal bleeding was performed in 312 cirrhotic pa- tients, in which 74 cases （23.7%） suffered from rebleeding episodes. The rebleeding rate was higher in the patients with hepatocellular carcinoma（HCC） than that without HCC（40.0% vs 17.6%, P 〈 0.05）. More bleeding episodes in the past, higher level of transaminase and alpha-fetoprotein, increased amount of platelet, and without propranolol oral intake presented in the rebleeding cases with HCC. Shorter period from the first bleeding episode, more times of sclerotherapy, higher level of transaminase, and faster heart rate presented in the rebleeding cases without HCC. Conclusion Several clinical conditions in cirrhosis, such as HCC, higher level of transaminase, and inefficient controll of heart rate were related with the recent rebleeding after endoscopic therapy for esophageal varices.

关 键 词：食管静脉曲张 内镜 再出血 

分 类 号：R572.205[医药卫生—消化系统] R571.3[医药卫生—内科学]