肝硬化并上消化道出血急救预后危险因素研究  

Study on Risk Factors Affecting the Prognosis of Emergency Treatment for Cirrhosis Complicated by Upper Gastrointestinal Bleeding

作　　者：元媛 毛永武 张雪梅 田爱平[1] 王晓锋 YUAN Yuan;MAO Yongwu;ZHANG Xuemei;TIAN Aiping;WANG Xiaofeng(Lanzhou University First Hospital Infectious Diseases Department,Lanzhou 730030,China.2.Gansu Maternal and Child Health Hospital(Gansu Provincial Central Hospital),Lanzhou 730050,China)

机构地区：[1]兰州大学第一医院感染科,甘肃兰州730030 [2]甘肃省妇幼保健医院(甘肃省中心医院)急诊科,甘肃兰州730050

出　　处：《中华灾害救援医学》2024年第6期690-692,共3页Chinese Journal of Disaster Medicine

摘　　要：目的初步评估肝硬化并上消化道出血的风险和预后相关因素。方法回顾性分析2020年5月至2023年5月到兰州大学第一医院就诊的150例肝硬化患者资料,分为出血组(n=66例)和非出血组(n=84例);出血组再分为生存组(n=36例)和死亡组(n=30例)。分析肝硬化并上消化道出血的危险因素及预后因素。结果发现上消化道出血史、肝功能分级、血肌酐、凝血酶原时间、血红蛋白、胃底静脉曲张程度、红色征、门静脉内径及腹水等因素与出血有关(P<0.05);Logistic分析示胃底静脉曲张、凝血酶原时间、门静脉内径及腹水是出血的独立危险因素。休克指数、并发症、凝血酶原时间、血红蛋白、血清胆红素与预后有关(P<0.05);Logistic分析示休克指数、血清胆红素水平及肝性脑病是预后的独立危险因素。结论肝硬化上消化道出血及预后相关因素较多,临床应注意预防,并及时处理。Objective To preliminarily evaluate the risk and prognostic factors associated with cirrhosis complicated by upper gastrointestinal bleeding.Methods Retrospective analysis of data from 150 cirrhosis patients treated at the First Hospital of Lanzhou University from May 2020 to May 2023 were divided into the bleeding group(n=66)and the non-bleeding group(n=84).The bleeding group was further subdivided into the survival group(n=36)and the death group(n=33).The risk and prognostic factors of cirrhosis complicated by upper gastrointestinal bleeding were analyzed.Results History of upper gastrointestinal bleeding,liver function grade,blood creatinine,prothrombin time,hemoglobin,degree of fundic varices,red signs,portal vein diameter,and ascites were related to bleeding(P<0.05).Logistic analysis indicated that fundic varices,prothrombin time,portal vein diameter,and ascites were independent risk factors for bleeding.Shock index,complications,prothrombin time,hemoglobin,and serum bilirubin were related to prognosis(P<0.05).Logistic analysis showed that shock index,serum bilirubin levels,and hepatic encephalopathy were independent prognostic factors.Conclusion There are multiple factors associated with upper gastrointestinal bleeding and prognosis in cirrhosis patients.Clinical attention should be paidto prevention and timely management.

关 键 词：肝硬化 预后 出血 门静脉 

分 类 号：R575[医药卫生—消化系统]