肝硬化并上消化道出血的死亡危险因素分析

Death Risk Analysis of Upper Gastrointestinal Bleeding in Hepatic Cirrhosis

目的观察肝硬化GEV住院患者影响死亡的危险因素。方法回顾性分析2000—01～2007—10之间住院的127例肝硬化GEV患者的临床和实验室指标与死亡率的关系。临床指标包括：Child—Pugh分级，腹水，肝性脑病，内窥镜检查24h的再出血；实验室指标包括：血红素浓度，凝血酶原时间，血清胆红素，血清肌酐，血清白蛋白。结论血清肌酐水平〉135μmol／L，血清胆红素水平〉51μmol／L，肝性脑病的出现和内窥镜检查24h内的再出血是肝硬化和胃肠道出血死亡的独立危险因素。

Objective To identify mortality factors in patients with gastro- esophageal variceal hemorrhage. Methods Retrospectively analyzed 127 patients admitted with gastro - esophageal variceal hemorrhage between January 2000 and October 2007. Relevant clinical and laboratory parameters and their relationship to mortality, were studied. Clinical parameters assessed included Child- Pugh class, ascites, portosystemic encephalopathy （PSE） and occurrence of rebleed within 24 hours of esophago - gastroduodenoscopy. The laboratory parameters assessed were： hemoglobin, prothrombin time, serum bilirubin, creatinine and albumin. Results serum creatinine and bilirubin levels, presence of PSE and re -bleeding within 24 hours of initial endoscopy are independent predictors of mortality in patients with gastro - esophageal variceal bleeding.