肝硬化食管静脉曲张破裂出血的危险因素分析  

Risk factors analysis and intervention study of esophageal varices hemorrhage in liver cirrhosis

作　　者：陈菲菲[1] 薛峰[1] 冯静云[1] 徐尧[1] 张俊 CHEN Fei-fei;XUE Feng;FENG Jing-yun;XU Yao;ZHANG Jun(Department of Intensive Care Unit,Changzhou Third People's Hospital,213000Changzhou,Jiangsu,China;Department of Intensive Care Unit,Yangzhou University Affiliated Hospital,225001Yangzhou,Jiangsu,China)

机构地区：[1]常州市第三人民医院重症医学科,江苏常州213000 [2]扬州大学附属医院重症医学科,江苏扬州225001

出　　处：《临床消化病杂志》2022年第5期371-374,共4页Chinese Journal of Clinical Gastroenterology

基　　金：江苏省高校优势学科建设工程项目(No:YSHL0104-04)。

摘　　要：[目的]分析肝硬化食管静脉曲张破裂出血的相关因素分析,为临床诊治提供参考。[方法]回顾性分析742例肝硬化食管静脉曲张患者的临床资料。单因素分析破裂出血组与未破裂出血组患者的病情资料的差异,并采用多因素Logistic分析对上述有差异的统计学资料进行进一步回归分析,最终探讨影响肝硬化食管静脉曲张破裂出血的影响因素。[结果]在所有患者中,出现破裂出血的共计212例,发生率达到28.57%。通过单因素分析发现,破裂出血组与未破裂出血组性别、年龄、PT、APTT、肝功能分级、肝性脑病、肝肾综合征上比较差异无统计学意义(P>0.05);2组在血小板数量,脾静脉以及门静脉内径、腹水发生率、食管静脉曲张程度上差异有统计学意义(P<0.05)。将上述结果进一步纳入多因素分析得出主要影响因素为血小板、门静脉内径、食管静脉曲张程度。[结论]肝硬化食管静脉曲张破裂出血发生率较高,且血小板、门静脉内径、食管静脉曲张程度为其高危因素,临床上应进行针对性预防。[Objective]To analyze the related factors of esophageal varices hemorrhage in liver cirrhosis, to provide reference for clinical diagnosis and treatment.[Methods]The clinical data of 742 liver cirrhosis patients with esophageal varices were retrospectively analyzed.Univariate analysis was used to analyze the differences in demographic and disease data between the patients with or without hemorrhage, and multivariate Logistic analysis was used to conduct further regression analysis.Finally the influencing factors of esophageal varices hemorrhage were explored.[Results]In all patients, esophageal varices hemorrhage occurred in 212 cases, the incidence rate was 28.57%.Univariate analysis showed that there were no significant differences in gender, age, PT, APTT,liver function classification, hepatic encephalopathy and hepatorenal syndrome between the two groups(P>0.05).There were significant differences between the two groups in platelets count, inner diameters of splenic vein and portal vein, incidence of ascites and degree of esophageal varices(P<0.05).The multivariate analysis was performed after further enrolled the data and showed that the main influencing factors were platelets count, portal vein diameter and degree of esophageal varices.[Conclusion]The incidence of esophageal varices hemorrhage in liver cirrhosis is high, and platelet count, portal vein diameter and esophageal varices degree are the high risk factors.Therefore, target on the prevention should be carried out in clinical practice.

关 键 词：肝硬化 食管静脉曲张 相关因素 干预对策 

分 类 号：R575.2[医药卫生—消化系统]