摘要
目的:探讨肝硬化合并食管胃静脉曲张患者内镜下序贯治疗后早期再出血的危险因素,为临床内镜治疗再出血提供准确预测.方法:抽取我院消化内科 2020 年 3 月至 2022 年 3 月住院治疗的386 例肝硬化食管胃静脉曲张的患者进行回顾性分析,将其 80 例术后早期再出血的患者作为观察组,同期住院治疗未出血接受内镜治疗的306 例患者作为对照组,比较两组患者临床各项指标.结果:386 例肝硬化食管胃静脉曲张的患者,其中术后早期再出血者为80 例,占20.73%,未发生出血者为306例,占79.27%;早期再出血患者单因素分析可见,Child-Pugh 分级、白蛋白、血钠、脾脏厚度、是否首次套扎与肝硬化食管静脉曲张患者有相关性,经统计学分析有统计学意义(P<0.05);单因素分析筛选出有统计学差异的指标进行二元次Logistic回归因素分析,结果显示Child-Pugh 分级、白蛋白、血钠、脾脏厚度、是否首次套扎均为静脉曲张再出血的独立危险因素(P<0.05).结论:Child-Pugh 分级、白蛋白、血钠、脾脏厚度、是否首次套扎均为静脉曲张再出血的独立影响因素,对病情可作出早期预测,值得临床重视.
Abstract
Objective:To investigate the risk factors of early rebleeding in patients with cirrhosis com-bined with esophagogastric varices after endoscopic treatment,and to provide accurate prediction for clinical endoscopic treatment of rebleeding.Methods:A total of 386 patients with cirrhosis combined with esopha-gogastric varices who were hospitalized in the Department of Gastroenterology in our hospital from March 2020 to March 2022 were selected for retrospective analysis,and 80 patients with early postoperative rebleeding were selected as the observation group.306 patients who received endoscopic treatment without bleeding in hospital were selected as the control group.The clinical indicators of the two groups were compared.Results:Among 386 patients with cirrhosis combined with esophagogastric varices,80 had early postoperative rebleed-ing,accounting for 20.73%,and 306 had no bleeding,accounting for 79.27%.Univariate analysis showed that Child-Pugh grade,albumin,serum sodium,spleen thickness,and whether the first band ligation was associated with patients with liver cirrhosis and esophageal varices,which were statistically significant(P<0.05);univariate analysis screened out statistically significant The difference indexes were analyzed by binary logistic regression,and the results showed that Child-Pugh grade,albumin,serum sodium,spleen thickness,and whether or not the first ligation was the independent risk factor for variceal rebleeding(P<0.05).Con-clusion:Child-Pugh grade,albumin,serum sodium,spleen thickness,and whether or not the first ligation is an independent risk factor for variceal rebleeding can be used to predict the disease early,and it is worthy of clinical attention.
基金项目
河北省医学科学研究项目(2022)(20220405)
维普
万方数据