45例肝硬化并上消化道出血临床分析

The 45 Cases Clinical Analysis of Liver Cirrhosis with Upper Gastrointestinal Bleeding

目的探讨肝硬化并上消化道出血患者的可能诱因和病因,指导临床的治疗。方法收集整理45例肝硬化并上消化道出血患者的临床资料,通过其胃镜检查结论及其他可能的诱因和病因进行回顾性分析。结果肝硬化上消化道出血男性占较高的比例,与女性之比为2∶1;其中有饮酒史患者21例,占患者总数的46.67%,HP感染患者12例(26.67%),服用NSAID患者23例(51.11%),无明显的其他诱发因素的有3例,占6.67%。胃镜下表现45例患者均有不同程度食管、胃底静脉曲张。其中,食管胃底静脉曲张破裂出血(GEVB)29例,占64.44%;门脉高压性胃病(PHG)出血9例,占20%,消化性溃疡出血14例,占31.11%,其他未发现明显原因的2例,占4.44%。结论临床上应根据其较高的诱发因素进行有效的预防,针对临床病因的确诊进行一系列对因治疗,尤其是应对临床常见的原因如静脉曲张性破裂、门脉高压、HP感染、消化性溃疡进行有效的控制,改善肝功能对减少肝硬化患者发生上消化道出血等等都具有重要意义。

Objective To study the causes of the possible incentives in patients with liver cirrhosis combine with upper gastrointestinal bleeding to guide the clinical treatment. Methods Collected 45 cases clinical data of liver cirrhosis combine with upper gastrointestinal bleeding, through endoscopy conclusions and other possible incentives and causes were analyzed retrospectively. Results The results of upper gastrointestinal bleeding in liver cirrhosis accounted for a higher proportion of men, with female ratio of 2 ： 1; including drinking history of 21 patients, accounting for the total number of patients 46.67%, HP infection in 12 cases （26.67%）, taking NSAID in patients with 23 cases （51.11%）, no obvious trigger factors of the other 3 cases, accounting for 6.67%. Endoscopic performance of 45 patients have varying degrees of esophageal varices. Among them, esophageal variceal bleeding （GEVB） 29 cases, accounting for 64.44%; portal hypertensive gastropathy （PHG） bleeding in 9 cases, accounting for 20%, peptic ulcer bleeding in 14 cases, accounting for 31.11%; others are found in significant cause of two cases, accounting for 4.44%. Conclusion Should be based on its high clinical predisposing factors and effective prevention, diagnosis for the clinical cause of some columns due to treatment, especially for dealing with common clinical reasons, such as variceal rupture, portal hypertension, HP infection, peptic ulcer exercise effective control, improve liver function in reducing upper gastrointestinal bleeding in patients with cirrhosis, and so are all of great significance.