肝硬化患者消化道出血的影响因素分析
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摘要
目的探讨肝硬化患者消化道出血的影响因素。方法选取潢川县人民医院2012年8月—2018年5月收治的720例肝硬化患者作为研究对象,其中发生消化道出血的患者为观察组,无消化道出血的患者为对照组,对两组患者的临床资料进行比较分析。结果 720例肝硬化患者中发生消化道出血179例,发生率为24.86%。经单因素分析显示两组患者在出血前合并有肝性脑病、门静脉血栓、CTP分级、消化道出血史、血清肌酐、凝血酶原时间、血红蛋白、血小板计数水平、MELD评分以及MELD-Na评分方面差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示肝性脑病、门静脉血栓、凝血酶原时间以及MELD-NA评分>15分是影响肝硬化患者消化道出血的独立危险因素(P<0.05)。结论肝硬化合并肝性脑病、门静脉血栓以及凝血酶原时间延长可增加肝硬化患者发生消化道出血的风险。
Objective To investigate the influencing factors of gastrointestinal bleeding in patients with liver cirrhosis.Methods Totally 720 cases of liver cirrhosis admitted to our hospital from August 2012 to May 2018 were selected as the research objects, among which the patients with gastrointestinal bleeding were the observation group and the patients without gastrointestinal bleeding were the control group, and the clinical data of the two groups were compared and analyzed.Results In 720 cases of cirrhosis, 179 cases of gastrointestinal bleeding occurred, with an incidence of 24.86%. Univariate analysis showed that patients in the two groups had hepatic encephalopathy, portal vein thrombosis, CTP grading, history of gastrointestinal bleeding, serum creatinine, prothrombin time, hemoglobin, platelet count level, MELD score and meld-na score before bleeding, and the differences were statistically significant(P<0.05). Multivariate Logistic regression analysis showed that hepatic encephalopathy, portal vein thrombosis, prothrombin time and meld-na score > 15 were independent risk factors for gastrointestinal bleeding in patients with liver cirrhosis(P<0.05).Conclusion Prolonged liver cirrhosis with hepatic encephalopathy, portal vein thrombosis and prothrombin can increase the risk of gastrointestinal bleeding in patients with liver cirrhosis.
Objective To investigate the influencing factors of gastrointestinal bleeding in patients with liver cirrhosis.Methods Totally 720 cases of liver cirrhosis admitted to our hospital from August 2012 to May 2018 were selected as the research objects, among which the patients with gastrointestinal bleeding were the observation group and the patients without gastrointestinal bleeding were the control group, and the clinical data of the two groups were compared and analyzed.Results In 720 cases of cirrhosis, 179 cases of gastrointestinal bleeding occurred, with an incidence of 24.86%. Univariate analysis showed that patients in the two groups had hepatic encephalopathy, portal vein thrombosis, CTP grading, history of gastrointestinal bleeding, serum creatinine, prothrombin time, hemoglobin, platelet count level, MELD score and meld-na score before bleeding, and the differences were statistically significant(P<0.05). Multivariate Logistic regression analysis showed that hepatic encephalopathy, portal vein thrombosis, prothrombin time and meld-na score > 15 were independent risk factors for gastrointestinal bleeding in patients with liver cirrhosis(P<0.05).Conclusion Prolonged liver cirrhosis with hepatic encephalopathy, portal vein thrombosis and prothrombin can increase the risk of gastrointestinal bleeding in patients with liver cirrhosis.
引文
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[7] 崔燕平,刘凤华,石庆凤,等.106例慢加急性肝衰竭合并肝性脑病患者预后影响因素的Logistic回归分析[J].临床肝胆病杂志,2014,30(10):992-995.
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[9] 侯会香.肝硬化患者凝血酶原时间与血小板检验的临床价值[J].临床合理用药杂志,2015,8(26):86-87.
[10] 施伦波.肝硬化患者肝功能Child-Pugh分级与血小板参数及凝血指标变化的临床相关性探究[J].中华全科医学,2015,13(6):941-943.
[2] 汪徐林,邵建国,朱永昌,等.江苏省南通地区2005年至2014年慢加急性肝功能衰竭流行病学调查分析[J].中华传染病杂志,2016,34(9):530-535.
[3] 贺加星,阴继凯,刘凡,等.肝硬化门静脉高压并发上消化道出血的相关危险因素分析[J].中国普通外科杂志,2015,24(1):127-129,130.
[4] 杨美荣,张国顺,刘斌,等.肝硬化患者并发上消化道出血的影响因素分析[J].中国综合临床,2016,32(3):235-238.
[5] 李阳,何德宏,刘威,等.彩色多谱勒超声在门脉高压食道胃底静脉曲张的临床应用[J].中国医药导报,2014,11(5):93-95,98.
[6] 高长泰,郭应兴,杨含腾,等.乙肝后肝硬化食道胃底静脉曲张出血组与未出血组门静脉压力的对照研究[C].2014甘肃省中医药学会学术年会论文集.2014:214-217.
[7] 崔燕平,刘凤华,石庆凤,等.106例慢加急性肝衰竭合并肝性脑病患者预后影响因素的Logistic回归分析[J].临床肝胆病杂志,2014,30(10):992-995.
[8] 阮承兰,张骏飞,宋海燕,等.肝衰竭预后影响因素的Logistic回归分析[J].中华疾病控制杂志,2014,18(6):537-540.
[9] 侯会香.肝硬化患者凝血酶原时间与血小板检验的临床价值[J].临床合理用药杂志,2015,8(26):86-87.
[10] 施伦波.肝硬化患者肝功能Child-Pugh分级与血小板参数及凝血指标变化的临床相关性探究[J].中华全科医学,2015,13(6):941-943.