肝炎肝硬化合并鼻出血的影响因素分析  

Risk Factors for Epistaxis in Patients with Hepatitis Cirrhosis

作　　者：邵姗[1] 鲍诗平[1] 刘勇刚[1] 焦楠[1] 赵晶[1] 花卉[1] 张淼[1] 魏春丽[1] 

机构地区：[1]首都医科大学附属北京佑安医院耳鼻咽喉头颈外科,北京市100069

出　　处：《中国全科医学》2013年第30期3544-3546,共3页Chinese General Practice

摘　　要：目的探讨肝炎肝硬化合并鼻出血的影响因素,以便于临床早期干预,减少鼻出血的发生。方法收集2010年4月—2012年12月在首都医科大学附属北京佑安医院就诊的48例肝炎肝硬化合并鼻出血患者为鼻出血组,48例肝炎肝硬化无鼻出血患者为对照组,采用单因素和多因素Logistic回归分析性别、年龄、肝硬化分期、高血压、鼻中隔偏曲、干燥性鼻炎、血小板计数、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(FIB)水平与鼻出血发生的相关性。结果肝炎肝硬化病因:对照组患者乙型肝炎38例、丙型肝炎10例,鼻出血组乙型肝炎39例、丙型肝炎7例、乙型肝炎+丙型肝炎2例,差异无统计学意义(χ2=2.542,P=0.280)。对照组与鼻出血组性别、肝硬化分期及有无干燥性鼻炎比较,差异有统计学意义(P<0.05);两组年龄、有无高血压及鼻中隔偏曲、血小板计数、PT、APTT、FIB水平比较,差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,男性、失代偿期肝硬化、干燥性鼻炎与鼻出血发生有回归关系(P<0.05)。结论男性、失代偿期肝硬化及合并干燥性鼻炎是引发肝炎肝硬化患者发生鼻出血的重要危险因素。早期对这些因素进行干预,对于减少肝硬化患者发生鼻出血有重要意义。Objective To investigate the risk factors of epistaxis in patients with hepatitis cirrhosis. Methods 48 hepatitis cirrhosis patients with epistaxis and 48 hepatitis cirrhosis patients without epistaxis admitted to Beijing You＇an Hospital from April 2010 to December 2012 were retrospectively analyzed. Univariate and multivariate analysis were used to screen the risk fac- tors including gender, age, classification of liver cirrhosis, history of high blood pressure, deviation of nasal septum, rhinitis sicca, blood platelet count, prothrombin time （PT）, activated partial thromboplastin time （APTT） and fibrinogen （FIB） for epistaxis in patients with hepatitis -related cirrhosis. Results Etiology of hepatitis cirrhosis： in the control group there were 38 cases of hepatitis B and 10 cases of hepatitis C, while in the epistaxis group there were 39 cases of hepatitis B, 7 cases of hepati- tis C and 2 cases of hepatitis B combined with hepatitis C, and the difference was not statistically significant （X2 = 2. 542, P = 0. 280） . The gender composition, classification of liver cirrhosis and rhinitis sicca between two groups showed statistically signif- icant differences （P 〈 O. 05） . The age, history of high blood pressure, deviation of nasal septum, blood platelet count, PT, APTY and FIB showed no statistically significant difference （ P 〉 0.05 ） . Multiple Logistic regression analysis indicated that male, decompensated hepatitis cirrhosis and rhinitis sicca were closely related with epistaxis （P 〈 0. 05） . Conclusion Male, decom- pensated hepatitis cirrhosis and rhinitis sicca are the risk factors for the occurrence of epistaxis in patients with hepatitis cirrhosis. Early intervention of these factors is of great importance for the prevention of epistaxis in patients with hepatitis cirrhosis.

关 键 词：肝硬化 鼻出血 危险因素 

分 类 号：R657.31[医药卫生—外科学]