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.
Abstract
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 pa-tients treated at the First Hospital of Lanzhou University from May 2020 to May 2023 were divided into the bleed-ing 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 gastro-intestinal 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 paid-to prevention and timely management.
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