唐山地区肝硬化并发上消化道出血的病因及临床特点分析  

Causes and clinical features of liver cirrhosis complicated by upper gastrointestinal bleeding in Tangshan,China

作　　者：杨美荣 刘斌 张国顺 尚华[3] 吴贵恺[4] 高宝霞[5] YANG Meirong LIU Bin ZHANG Guoshun et al(Department of Hematology, The Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei 063000, Chin)

机构地区：[1]华北理工大学附属医院血液内科,河北唐山063000 [2]华北理工大学附属医院消化内科,河北唐山063000 [3]唐山市传染病医院,河北唐山063000 [4]唐山市工人医院,河北唐山063000 [5]开滦集团有限责任公司医院,河北唐山063000

出　　处：《临床肝胆病杂志》2017年第3期476-478,共3页Journal of Clinical Hepatology

基　　金：国家自然科学基金项目(81370477)

摘　　要：目的分析唐山地区近5年来肝硬化并发上消化道出血(UGH)的病因及临床特点,为临床治疗提供参考。方法抽取2011年1月-2016年1月于华北理工大学附属医院、唐山市传染病医院、唐山市工人医院和开滦集团有限责任公司医院住院的肝硬化并发UGH患者共计462例,所有患者均行胃镜检查明确出血病因。研究出血病因与肝功能Child-Pugh分级之间的关系。计数资料组间比较用χ~2检验。结果肝硬化并发UGH的病因中,食管胃底静脉曲张破裂出血占52.16%;门静脉高压性胃病占27.71%;肝源性溃疡占11.04%;急性胃黏膜病变占4.11%;混合型占3.25%;其他占1.73%。不同病因患者之间,肝功能ChildPugh B级、C级和A级相比较,差异有统计学意义(χ~2=30.12,P=0.007)。结论肝硬化并发UGH的病因中,食管胃底静脉曲张破裂出血所占的比例最高,其次为门静脉高压性胃病。出血病因与肝功能Child-Pugh分级具有一定关系。Objective To investigate the causes and clinical features of liver cirrhosis complicated by upper gastrointestinal bleeding in Tangshan,China in the past 5 years,and to provide a reference for clinical treatment.Methods A total of 462 patients with liver cirrhosis complicated by upper gastrointestinal bleeding who were hospitalized in The Affiliated Hospital of North China University of Science and Technology,Tangshan Municipal Hospital of Infectious Diseases,Tangshan Workers＇ Hospital,and The Affiliated Hospital of Kailuan Group Limited Liability Corporation were enrolled,and all the patients underwent gastroscopy to clarify the cause of bleeding.The association between the cause of bleeding and Child-Pugh class was analyzed.The chi-square test was used for comparison of categorical data.Results Among the causes of liver cirrhosis complicated by upper gastrointestinal bleeding,esophagogastric variceal bleeding,portal hypertensive gastropathy,hepatogenic ulcer,acute gastric mucosal lesion,and mixed type accounted for 52.16%,27.71%,11.04%,4.11%,and 3.25%,respectively,and other causes accounted for 1.73%.There were significant differences in Child-Pugh class between the patients with different causes（χ^2=30.12,P=0.007）.Conclusion Among the causes of liver cirrhosis complicated by upper gastrointestinal bleeding,esophagogastric variceal bleeding is the most common one,followed by portal hypertensive gastropathy.The cause of bleeding is associated with Child-Pugh class.

关 键 词：肝硬化 胃肠出血 临床特点 

分 类 号：R575.2[医药卫生—消化系统]