高海拔地区食管静脉曲张套扎术后再出血情况及危险因素分析  

Analysis of Rebleeding and Risk Factors After Esophageal Varices Ligation in High Altitude Area

作　　者：刘明成 王倩林 刁永智 尹若楠 宋秋花 Liu Mingcheng;Wang Qianlin;Diao Yongzhi(First People's Hospital of Xining City,Xining,Qinghai 810000,China)

机构地区：[1]西宁市第一人民医院,青海西宁810000

出　　处：《四川医学》2025年第2期132-136,共5页Sichuan Medical Journal

基　　金：西宁市科技计划项目(编号:2020-M-24)。

摘　　要：目的 探讨高海拔地区食管静脉曲张套扎术(EVL)后再出血情况及危险因素分析。方法 将2020年1月至2023年1月于我院完成EVL的患者90例作为研究对象。收集患者相关临床资料,计算EVL术后再出血情况,经单因素及多因素Logistic回归分析探讨EVL术后再出血的危险因素。结果 90例高海拔地区行EVL的患者中,31例患者发生了再出血,占34.44%,59例未发生再出血,占65.56%。根据高海拔地区患者EVL术后是否再出血,将患者分为出血组(31例)及未出血组(59例),单因素分析显示,两组患者的年龄、性别、BMI、基础疾病(高血压、糖尿病、高血脂)史、吸烟史、饮酒史、WBC、FBG、Hb、Alb、UN、Cr、ALT、AST比较,差异无统计学意义(均P>0.05),静脉曲张类型、肝功能Child-Pugh分级、进食硬质食物史、Alb与患者再出血发生相关(P<0.05);多因素Logistic回归分析显示,静脉曲张类型大型(OR=2.349,95%CI 1.328~4.155)、肝功能Child-Pugh分级C级(OR=2.614,95%CI 1.564~4.369)、有进食硬质食物史(OR=2.115,95%CI 1.303~3.432)、Alb≤29.89 g/L(OR=3.056,95%CI 1.616~5.778)是高海拔地区EVL术后再出血的危险因素(P<0.05)。结论 高海拔地区EVL术后再出血发生率较高,再出血与多种因素有关,需重视引起再出血的相关危险因素,采取有效的预防及治疗措施。Objective To investigate the rebleeding and risk factors after esophageal varices ligation(EVL)in high altitude area.Methods 90 patients who underwent EVL in our hospital from January 2020 to January 2023 were selected as the research objects.The relevant clinical data of patients were collected,and the rebleeding after EVL was calculated.The risk factors of rebleeding after EVL were explored by univariate and multivariate Logistic regression analysis.Results Among 90 patients with EVL in high altitude area,31 patients had rebleeding,accounting for 34.44%,and 59 patients did not have rebleeding,accounting for 65.56%.According to whether there was rebleeding after EVL in high altitude area,the patients were divided into bleeding group(31 cases)and non-bleeding group(59 cases).Univariate analysis showed that there was no significant difference in age,gender,BMI,history of basic diseases(hypertension,diabetes,hyperlipidemia),smoking history,drinking history,WBC,FBG,Hb,Alb,UN,Cr,ALT and AST between the two groups(all P>0.05).Varicose type,Child-Pugh classification of liver function,history of eating hard food,and Alb were related to the occurrence of rebleeding(P<0.05).Large varices(OR=2.349,95%CI 1.328~4.155),Child-Pugh grade C(OR=2.614,95%CI 1.564~4.369),history of eating hard food(OR=2.115,95%CI 1.303~3.432),and Alb≤29.89 g/L(OR=3.056,95%CI 1.616~5.778)were risk factors for rebleeding after EVL in high altitude area(P<0.05).Conclusion The incidence of rebleeding after EVL in high altitude area is high,and rebleeding is related to many factors.We should pay attention to the risk factors of rebleeding and take effective preventive and treatment measures.

关 键 词：食管静脉曲张 套扎术 高海拔地区 再出血 危险因素 

分 类 号：R571.3[医药卫生—消化系统]