摘要
目的探讨肝硬化合并食管胃静脉曲张破裂出血(EGVB)患者的血流动力学特点及不良结局影响因素。方法选定本院2016年4月至2019年4月收诊的90例肝硬化合并EGVB患者,按照预后不同分为死亡组(16例)与生存组(74例)2组。了解90例肝硬化合并EGVB患者的门静脉充血指数(CI)、门静脉血流速度(Vpv)、门静脉直径(Dpv)水平。调查分析两组的年龄、性别、1年内再出血,以及肝硬化病因、合并肝性脑病、消化道出血史、Child-Pugh分级情况,并比较其血钠、中性粒细胞、白细胞计数(WBC)、终末期肝病模型(MELD)总分及血流动力学指标。随后采用logistic回归模式探寻其中的影响因素。结果⑴90例肝硬化合并EGVB患者中包括40例轻度、32例中度、18例重度,随着该病患者的食管静脉曲张程度变化,其血流动力学会相应改变。⑵经多因素分析发现,肝硬化合并EGVB患者生存与1年内再出血、Child-Pugh分级、Vpv、WBC、MELD总分等因素存在相关性(P<0.05)。结论肝硬化合并EGVB患者可基于1年内再出血、Child-Pugh分级、Vpv、WBC、MELD总分等影响因素做好相关防治工作,尽可能降低患者的死亡风险。
Objective To investigate the hemodynamic characteristics and influencing factors of adverse outcomes in patients with liver cirrhosis complicated with esophageal and gastric variceal bleeding(EGVB).Methods A total of 90 patients with liver cirrhosis and EGVB admitted to the hospital were selected between April 2016 and April 2019,and they were divided into the death group(16 cases)and the survival group(74 cases)according to different prognosis.The portal vein congestion index(CI),portal vein peak velocity(Vpv)and diameter of portal vein(Dpv)were understood among 90 patients with liver cirrhosis and EGVB.The age,gender,rebleeding within 1 year,etiology of liver cirrhosis,combined hepatic encephalopathy,history of gastrointestinal bleeding and Child-Pugh classification were investigated and analyzed,and the blood sodium,neutrophils,white blood cell count(WBC),total score of Model for End-Stage Liver Disease(MELD)and hemodynamic indicators were compared.Logistic regression model was used to explore the influencing factors.Results(1)Among 90 patients with liver cirrhosis complicated with EGVB,there were 40 mild cases,32 moderate cases and 18 severe cases.As the changes in degree of esophageal varices in patients with this disease,the hemodynamics would change accordingly.(2)Multivariate analysis found that the survival of patients with liver cirrhosis and EGVB was correlated with factors such as rebleeding within 1 year,Child-Pugh classification,Vpv,WBC,and MELD total score(P<0.05).Conclusion It is necessary for patients with liver cirrhosis and EGVB to perform relevant prevention and control work based on influencing factors such as rebleeding within 1 year,Child-Pugh classification,Vpv,WBC and MELD total score,so as to reduce the death risk as much as possible.
作者
马丽娜
MA Li-na(Gastroenterology Second Ward,Zhengzhou Second People's Hospital,Zhengzhou 450000,Henan Province,China)
出处
《罕少疾病杂志》
2022年第4期73-75,共3页
Journal of Rare and Uncommon Diseases
关键词
食管胃静脉曲张破裂出血
肝硬化
血流动力学特点
Esophageal and Gastric Variceal Bleeding
Liver Cirrhosis
Hemodynamic Characteristics
作者简介
第一作者/通讯作者:马丽娜,女,主治医师,主要研究方向:消化内科。E-mail:malina7758@sina.com。
