肝硬化食管胃静脉曲张内镜下治疗后近期再出血的危险因素分析  

Risk factors for near-term rebleeding after endoscopic treatment of esophageal and gastric varices in cirrhosis

作　　者：方倩倩[1] 宋莎莎[1] 章礼久[1] FANG Qianqian;SONG Shasha;ZHANG Lijiu(Department of Gastroenterology,The Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230601,China)

机构地区：[1]安徽医科大学第二附属医院消化内科,安徽合肥230601

出　　处：《医药前沿》2021年第12期3-5,共3页Journal of Frontiers of Medicine

摘　　要：目的:分析肝硬化伴食管胃静脉曲张内镜下治疗后近期再出血的危险因素。方法:收集2017年1月—2019年12月因肝硬化食管胃静脉曲张破裂出血或为预防再出血行内镜下治疗而入院患者202例,根据患者术后6个月内是否再出血,分为再出血组和未出血组,通过单因素及多因素回归分析,探究肝硬化食管胃静脉曲张内镜下治疗后近期再出血的可能危险因素。结果:再出血组37例,未出血组165例,内镜下治疗后近期再出血发生率为18.3%。结果单因素分析显示,两组在年龄、既往脾切除史、合并门脉血栓、红色征阳性、内镜治疗后服用非选择性β受体阻滞剂等差异存在统计学意义(P<0.05);多因素Logistic回归分析显示,既往脾切除史、门静脉血栓、红色征阳性、内镜治疗后服用非选择性β受体阻滞剂是食管胃镜静脉曲张内镜下治疗后近期再出血的影响因素(P<0.05)。结论:门静脉血栓、红色征阳性是肝硬化食管胃静脉曲张内镜治疗后再出血的独立危险因素;既往脾切除史、术后服用非选择性β受体阻滞剂的患者,术后再发出血的概率降低。Objective To investigate the risk factors of near-term rebleeding after endoscopic treatment of cirrhosis with esophageal and gastric varices.Methods A total of 202 patients,including 141 males and 61 females,with an average age of 53.7 years,who were admitted to the hospital due to bleeding from ruptured esophageal and gastric varices of cirrhosis or underwent endoscopic therapy to prevent rebleeding from January 2017 to December 2019 were collected.Patients were divided into two groups according to whether they had rebleeding within 6 months after surgery.The clinical data characteristics of the two groups were analyzed.Univariate and multivariate regression analysis was conducted to study the possible risk factors for recent rebleeding after endoscopic treatment of esophageal and gastric varices in cirrhosis.Results There were 37 cases in the rebleeding group and 165 cases in the non-bleeding group.The recent rebleeding rate after endoscopic treatment was 18.3%.Results univariate analysis showed that there were statistically significant differences between the two groups in age,previous splenectomy history,portal thrombosis,positive red sign,and the use of non-selectiveβ-blockers after endoscopic therapy.Multivariate Logistic regression analysis showed that history of splenectomy,portal vein thrombosis,positive red sign,and non-selectiveβ-blocker after endoscopic treatment were independent factors affecting short-term rebleeding after endoscopic varicose veins.Conclusion Portal vein thrombosis and positive red sign are independent risk factors for rebleeding after endoscopic treatment of esophageal and gastric varices in cirrhosis.Patients who had previously had splenectomy and who had taken nonselective beta blockers were less likely to reproduce blood after surgery.

关 键 词：肝硬化 食管胃静脉曲张 再出血 危险因素 

分 类 号：R657.3[医药卫生—外科学]