肝硬化患者鼻出血的临床特征及危险因素分析  

Clinical characteristics and risk factors of epistaxis in patients with liver cirrhosis

作　　者：鲍诗平[1] 刘勇刚[1] 邵珊[1] 杨琳[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,100069

出　　处：《北京医学》2015年第9期850-853,共4页Beijing Medical Journal

摘　　要：目的探讨肝硬化患者鼻出血的临床特征及相关危险因素。方法收集143例肝硬化患者的临床资料，其中鼻出血组75例，无鼻出血组（对照组）68例。分析指标包括性别、年龄、肝硬化病因学诊断、肝硬化分期、既往高血压史、鼻中隔偏曲、鼻腔干燥、血小板计数、活化部分凝血活酶时间、凝血酶原时间、纤维蛋白原，总胆红素。结果慢性乙型肝炎肝硬化最常见，鼻出血组占57．3％，对照组占52．9％。logistic回归分析结果显示，肝硬化分级（OR=6．272，95％CI1．453～27．083，P=0．014）及鼻腔干燥（OR=4．286，95％CI1．964—9．354，P〈0．001）是导致肝硬化患者鼻出血发生的最主要因素。结论失代偿期肝硬化和鼻腔干燥是引发肝硬化患者发生鼻出血的重要危险因素。延缓肝硬化进程，保持鼻腔湿润状态，对减少肝硬化患者发生鼻出血具有重要意义。Objective To investigate the clinical characteristics and risk factors of epistaxis in patients with liver cirrhosis. Methods The clinical data of 143 patients with liver cirrhosis were retrospectively analyzed. Patients were di- vided into 2 groups, the epistaxis group （n=75） and the control group （n=68）. Main outcome measures included gender, age, etiology of liver cirrhosis, classification of liver cirrhosis, history of hypertension, deviation of nasal septum, nasal dryness, PLT count, APTT, PT, FIB, T-BIL. Results Chronic hepatitis B （CHB） was the main cause of liver cirrhosis in the 2 groups. There were 57.3% CHB patients in the epistaxis group and 52,9% in the control group. Logistic regression analysis indicated that classification of liver cirrhosis （OR = 6.272, 95%CI 1.453-27.083, P = 0.014）, nasal dryness （OR = 4.286, 95%CI 1.964-9.354, P 〈 0.001 ）were closely related to epistaxis. Conclusion Decompensated liver cirrhosis and nasal dryness are the risk factors for the occurrence of epistaxis in liver cirrhosis patients. Delaying the process of liver cir- rhosis and keeping the nasal moisture are very important for reducing the occurrence of nasal bleeding in cirrhosis patients.

关 键 词：肝硬化 鼻出血 回归分析 

分 类 号：R575.2[医药卫生—消化系统]