食管静脉曲张套扎术后早期再出血的危险因素探讨  

Risk factors of predicting early variceal rebleeding after endoscopic variceal ligation

作　　者：季峰[1] 徐勤伟[1] 张咩庆[1] 

机构地区：[1]浙江大学医学院附属第一医院消化内科,浙江杭州310003

出　　处：《中国内镜杂志》2010年第4期344-347,共4页China Journal of Endoscopy

摘　　要：目的探讨肝硬化食管静脉曲张内镜下套扎术(EVL)后早期再出血的危险因素。方法回顾性分析259例接受EVL术肝硬化患者的一般情况、病因、手术史、临床表现、胃镜检查、饮食及运动负荷、药物治疗及实验室检查等情况,寻找独立危险因素。结果 EVL术后早期再出血率为8.49%,再出血死亡率为31.8%。摄入硬食、腹水量、凝血酶原时间、门静脉血栓及血红蛋白为EVL术后早期再出血的独立危险因素。结论 EVL术前纠正严重受损的肝功能、大量腹水、凝血功能异常及术后避免硬食可减少术后早期再出血的发生。【Objective】To analyze the clinical risk factors of early variceal rebleeding after endoscopic variceal ligation （EVL）.【Methods】A total of 259 cirrhotic patients with esophageal varices who received regular or emergent EVL procedure were retrospectively analyzed. The risk factors for analysis included the sex,age,etiology of cirrhosis,existence of hepatocellular carcinoma （HCC）,portal vein thrombosis,Child-Pugh status,diet,exercise load and basic laboratory data. 【Results】The incidence of early rebleeding after EVL is 8.49% and the morbidity of rebleeding is 31.8%. Patients with portal vein thrombosis,prolonged prothrombin time,lower hemoglobin,hard diet and mass ascites were independent risk factors of early rebleeding after EVL. 【Conclusions】The early rebleeding rate after EVL is affected by the portal vein thrombosis,prolonged prothrombin time,lower hemoglobin,hard diet and mass ascites,effective measures for prevention and treatment should be adopted before and after EVL.

关 键 词：食管静脉曲张破裂出血 套扎术 早期再出血 危险因素 

分 类 号：R655.4[医药卫生—外科学]