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目的 :肝硬化门脉压力波动失去了正常的生理节律 ,在夜间逐渐增高并于 2 4 :0 0达到最高 ,该研究探讨门脉高压所致的食管胃底曲张静脉破裂与门脉高压性胃病出血的时间分布特点及其与肝功能的关系。方法 :对该院 1998～ 2 0 0 1年肝硬化上消化道出血的 136例住院病例进行回顾性分析 ,统计内镜确诊食管胃底曲张静脉破裂和门脉高压性胃病所致出血的次数 ,分析不同病因和Child -Pugh分级与不同的时段B1(19:0 0～ 2 4 :0 0 ) ,B2 (2 4 :0 0～ 9:0 0 )和B3(9:0 0～ 19:0 0 )出血的次数的关系 ,出血时间定义为出现呕血或黑便的时间 ,不同时段率的比较采用 χ2 检验。结果 :共有 198次上消化道出血胃镜证实因食管胃底曲张静脉破裂或门脉高压性胃病引起 ,其中 135 (6 8.2 % )次表现为呕血 ,6 3(31.8% )次表现为黑便 ,两者有显著性差异 (P <0 .0 1)。其中B1时段为 110 (5 5 .6 % )次 ,B2时段为 5 2 (2 6 .3% )次 ,B3时段为 36 (18.2 % )次 ,B1时段出血次数显著多于B2和B3时段 (P <0 .0 1) ,31(2 2 .8% )例ChildA级患者出血 4 0 (2 0 .2 % )次 ,5 2 (38.2 % )例ChildB级患者出血 6 6 (33.3% )次 ,5 3(39.0 % )例ChildC级患者出血 92 (46 .5 % )次 ,B1时段ChildC级出血 6 0 (5 4 .5 % )次 ,与ChildA ,ChildB级相比 ,
Objective: Cirrhotic portal pressure fluctuations lose normal circadian rhythms, gradually increasing at night and reaching the highest at 24: 0 0. This study explored the relationship between portal hypertension and portal hypertensive gastropathy Time distribution of bleeding and its relationship with liver function. Methods: A retrospective analysis was performed on 136 inpatients with cirrhosis and upper gastrointestinal bleeding during 1998-2001. The number of bleeding caused by rupture of esophageal and gastric varices and portal hypertensive gastropathy was analyzed by endoscopy. Analysis of different etiologies and Child-Pugh classification with different periods B1 (19: 0 0 ~ 2 4: 0 0), B2 (2 4 0 0 ~ 9 0 0) and B3 (9 0 0 ~ 19 0 0) the relationship between the number of bleeding, bleeding time is defined as the time to vomiting or melena, the different time rate comparison using χ2 test. Results: A total of 198 upper gastrointestinal gastroscopy proved to be caused by rupture of esophageal varices or portal hypertensive gastropathy, 135 (6 8.2%) showed hematemesis, 63 (31.8%) showed melena, There was a significant difference between the two (P <0.01). Among them, 110 (55.6%) were in B1, 52 (26.3%) in B2 and 36 (18.2%) in B3, with significantly more bleeding in B1 than in B2 and B3 P <0.01), 31 (22.8%) cases of ChildA grade bleeding 40 (20.2%), 52 (38.2%) cases of ChildB class bleeding 6 6 (33.3%) times , 93 (39.0%) cases of ChildC grade bleeding in 92 (46.5%) times and B1 (66.5%) ChildC grade, compared with ChildA and ChildB class,