48例肝硬化并上消化道出血临床诊治分析探讨

目的分析肝硬化并上消化道出血原因和临床诊治效果。方法回顾性分析近4a来收治的48例肝硬化并上消化道出血患者的临床资料。结果胃镜检查:表现为食管静脉曲张破裂出血征象者24例,占出血总数50%;门脉高压性胃病出血13例,占出血总数27%;消化性溃疡出血8例,占出血总数16.6%;急性胃黏膜病变2例,占出血总数4.1%;胃癌1例,占出血总数2%。48例患者治疗后止血成功42例,成功率87.5%;剩下6例,1例死亡,5例继发感染。结论肝硬化并上消化道出血病因中,食管静脉曲张破裂出血征象、门脉高压性胃病出血和消化性溃疡出血占据很高的比例,临床治疗中应以胃镜检查,查找出血原因及部位,进行密切观察、抢救,以针对性措施进行诊治。

Objective To analyze the liver cirrhosis and upper gastrointestinal bleeding reason and clinical treatment effect. Methods A retrospective analysis of nearly four years to our 57.0% 48 cases cirrhosis and upper gastrointestinal bleeding in patients with clinical data. Results Gastro scope inspection, for the performance of the esophagus varicosity burst bleeds 24 cases, accounting for signs of bleeding amount 50%; portal hypertension sex stomach bleeding 13 cases, accounting for bleeding total 27%, peptic ulcer hemorrhage in 8 cases, total of bleeding 16.6%, acute gastric mucosa in 2 cases, accounting for bleeding total 4.1 per cent, gastric carcinoma, 1 case with 2%. 48 patients after treatment, 42 patients with bleeding success rate 87.5%, rest in 6 cases, 1 case death, 5 cases renewal infections. Conclusion Liver cirrhosis and upper gastrointestinal bleeding etiology, esophagus varicosity burst bleeds signs, portal hypertension sex stomach bleeding and high rate of, peptic ulcer bleeding occupy clinical treatment should emphasize the gastro scope inspection, the search bleeding reasons and parts, close observation, rescue, with corresponding measures for treatment.