食管静脉曲张套扎术后再出血的危险因素分析

Risk factors of bleeding for the patients with esohageal variceal hemorrhage by endoscopic variceal ligation

目的评估肝硬化门静脉高压食管静脉曲张破裂出血,采用食管静脉曲张套扎治疗术后再出血的危险因素并提出防治预案。方法对118例肝硬化门静脉高压食管静脉曲张破裂出血患者进行流行病学调查,采用COX模型分析治疗后出血的危险因素。结果出血程度、脾大程度、术后有无坚持治疗和出血后采用何种方法治疗是影响术后再出血的危险因素。结论食管静脉曲张套扎治疗是肝硬化门静脉高压食管静脉曲张破裂出血的重要手段,为降低术后再出血率,应当慎重选择患者,避免术前有出血病史和脾脏明显增大者,术后应积极给予有效的降低门静脉压力治疗。

Objective The purpose to estimate the risk factors of bleeding for the hepatocirrhosis portalhypertension patients with Esohageal variceal hemorrhage by Endoscopic variceal hgation and to provide prevention and treatment plan. Methods 118 cases with Esohageal variceal hemorrhang were chozen and make the epidemiologic study analysis the bleeding risk factor after treatment with the COX mode. Results The risk factors of bleeding after operation（VEL） were the degree of bleeding and splenomegaly, whether keeping on treatment after operation, and which method to treat the bleeding.Conclusions VEL was an important method to treat Esohageal variceal hemorrhage. In order to reduce the risk of bleeding again, we must choose the patient carefully, avoid to choose the patient with the bleeding history, obvious splenomegaly, and reduce portalhypertension actively for preventing esophageal variceal hemorrhage after operation.