摘要
目的探讨内镜下硬化剂联合组织胶治疗食管胃底静脉曲张破裂出血(EGVB)患者后早期再出血的危险因素。方法回顾性分析2014年1月至2016年12月在重庆市第六人民医院因EGVB而行内镜下硬化剂联合组织胶治疗的213例患者,按是否发生早期再出血分为再出血组和未出血组,对两组的年龄、性别、肝硬化原因、是否合并原发性肝癌、Child-Pugh分级、腹水量、门静脉直径、血常规、肝功能、凝血功能、红色征以及静脉曲张程度等临床资料进行对比分析,采用SPSS 19.0统计学软件进行早期再出血相关因素的单因素和多因素Logistic回归分析。结果内镜下硬化剂联合组织胶治疗EGVB后早期再出血发生率为25.35%,多因素Logistic回归分析显示早期再出血的OR值及95%CI分别为:合并原发性肝癌2.130(1.731～3.726)、Child-Pugh C级7.115(4.544～9.230)、中大量腹水2.250(1.326～4.413)、门静脉直径3.027(1.661～6.102)、静脉曲张程度2.754(1.304～4.074)、凝血酶原时间1.762(1.132～2.864)和红色征3.133(2.066～5.216)。结论合并原发性肝癌、Child-Pugh C级、中大量腹水、门静脉直径、静脉曲张程度、凝血酶原时间以及红色征是EGVB患者内镜下硬化联合组织胶治疗后早期再出血的独立危险因素。
Objective This paper aims to explore the risk factors of early rebleeding after endoscopic sclerotherapy combined with tissue adhesive agent in the treatment of esophagogastric variceal bleeding(EGVB).Methods A retrospective analysis was conducted of 213 patients treated with endoscopic sclerotherapy combined with tissue adhesive agent for EGVB in Chongqing Sixth People′s Hospital from January 2014 to December 2016.The patients were divided into the rebleeding group and the non-bleeding group according to the occurrence or not of early rebleeding.To identify probable risk factors for rebleeding after treatment,various factors were collected and analyzed,including age,gender,types of cirrhosis,combined primary liver carcinoma,Child-Pugh classification,presence of ascites,diameter of portal vein,routine blood tests,liver function tests,coagulation function tests,red-color sign,and degree of varicose veins.The univariate and multivariate logistic regression analysis of factors associated with early rebleeding were performed using the SPSS 19.0 statistical software.Results The rate of rebleeding was found to be 25.35%after the treatment.The multivariate logistic regression analysis showed that the OR value of early rebleeding and 95%CI were:combined primary liver carcinoma 2.130(1.731~3.726),Child-Pugh C 7.115(4.544~9.230),large amount of ascites 2.250(1.326~4.413),diameter of portal vein 3.027(1.661~6.102),degree of varicose veins 2.754(1.304~4.074),prothrombin time 1.762(1.132~2.864),and red-color sign 3.133(2.066~5.216).Conclusions Combined primary liver carcinoma,Child-Pugh C,large amount of ascites,diameter of portal vein,degree of varicose veins,prothrombin time,and red-color sign are independent risk factors for early rebleeding after endoscopic sclerotherapy combined with tissue adhesive agent in patients with EGVB.
作者
陈彩霞
胡藻
CHEN Caixia;HU Zao(Department of Gastroenterology,Chongqing Sixth People′s Hospital,Chongqing 400060,China)
出处
《国际消化病杂志》
CAS
2018年第6期397-401,共5页
International Journal of Digestive Diseases
关键词
食管胃底静脉曲张
出血
内镜治疗
危险因素
Eesophageal gastric varices
Bleeding
Endoscopic treatment
Risk factors
