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目的探讨肝硬化食管胃底静脉曲张破裂出血的高危因素。方法选取2010年至2013年食管胃底静脉曲张破裂出血的肝硬化患者100例为观察组,另选同期无食管胃底静脉曲张破裂出血的肝硬化患者100例为对照组。比较两组病因、肝功能,对临床指标行多因素Logistic分析。结果两组患者肝功能分级情况、血清白蛋白、门静脉内径、脾脏厚度和凝血酶原时间等比较差异有统计学意义(P<0.05);门静脉内径、脾脏厚度及白蛋白患者出血独立高危因素。结论影响食管胃静脉曲张肝硬化患者发生破裂出血的因素有许多,对于存在高危因素的患者应该注意临床保护措施,其中改善白蛋白对降低发生出血的风险有重要意义。
Objective To investigate the risk factors of esophageal and gastric variceal bleeding in patients with cirrhosis. Methods One hundred patients with cirrhosis who underwent esophageal and gastric variceal bleeding from 2010 to 2013 were selected as the observation group. Another 100 patients with cirrhosis who had esophagogastric variceal bleeding during the same period were selected as the control group. The etiology and liver function of the two groups were compared, and the multivariate Logistic analysis was performed on the clinical data. Results The grading of liver function, serum albumin, diameter of portal vein, spleen thickness and prothrombin time in two groups were statistically significant (P <0.05). The portal vein diameter, spleen thickness and bleeding were independent high risk factors. Conclusion There are many factors that affect the occurrence of rupture and hemorrhage in patients with esophagogastric varices cirrhosis. Patients with high risk factors should pay attention to clinical protection measures, and improving albumin is important to reduce the risk of bleeding.