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目的 研究不同因素对门脉高压食管胃静脉曲张出血转归的影响。方法 对北京地区16家医院 82 6例门脉高压食管胃静脉曲张出血住院患者病例资料进行分析 ,包括 :年龄、性别、肝硬化病因、肝硬化病程、出血病程 ,出血次数 ,出血程度、肝功能Child分级、降门脉压药物使用、三腔两囊管、内镜下食管静脉套扎术 (EVL)、内镜下食管静脉硬化术 (EVS)、外科治疗等因素对门脉高压食管胃静脉曲张出血转归的影响进行分析 ;对影响转归的各种因素进行多因素逐步Logistic回归分析 ;并对各种止血方法疗效进行比较。结果 本组资料门脉高压食管胃静脉曲张破裂出血转归与患者年龄 ,出血病程 ,出血程度 ,肝功能分级 ,胆红素 ,白蛋白 ,凝血酶原时间 ,奥曲肽 ,凝血酶 ,巴曲酶 ,三腔两囊管 ,EVL及EVS等多因素相关 ;目前门脉高压食管胃静脉曲张出血以内科治疗为主 ,总止血成功率为 90 .90 % ;死亡 97例 ,死亡率为 11.74%。EVS能改善门脉高压食管胃静脉曲张出血转归 ,止血成功率达 98.88% ,为门脉高压食管胃静脉破裂中重度出血治疗首选方法。
Objective To study the influence of different factors on the outcome of portal hypertension with esophagogastric variceal bleeding. Methods A total of 826 inpatients with portal hypertension gastroesophageal variceal bleeding were analyzed in 16 hospitals in Beijing. The data included age, gender, cirrhosis, cirrhosis, duration of bleeding, frequency of bleeding, degree of bleeding, liver function Child grading, use of antihypertensive drugs, triple-lumen bifurcation, endoscopic esophageal varicose vein ligation (EVL), endoscopic esophageal venous sclerosis (EVS) and surgical treatment of portal hypertension Variceal hemorrhage outcome of the impact of the analysis; the factors that affect the prognosis of multi-factor Logistic regression analysis; and a variety of hemostatic efficacy comparison. Results The data of patients with portal hypertension and esophageal variceal bleeding in patients with age, bleeding course, degree of bleeding, liver function grading, bilirubin, albumin, prothrombin time, octreotide, thrombin, batroxobin, Three-chamber two-capsular tube, EVL and EVS and other factors; the current portal hypertension gastroesophageal varices bleeding mainly medical treatment, the total success rate of hemostasis was 90.90%; 97 deaths, the mortality rate was 11.74%. EVS can improve the outcome of portal hypertensive esophagogastric variceal hemorrhage, hemostasis success rate of 98.88%, the portal vein for the treatment of severe bleeding in esophageal and gastric venous rupture method of choice.