肝硬化食管静脉曲张破裂出血危险因素的预测

Cirrhosis Ruptured Esophageal Varices Bleeding Risk Factors Forecasts

目的:通过对肝硬化食管静脉曲张破裂出血(EVB)危险因素的分析,探讨EVB高危病例筛选标准,以期得到有效的预防和治疗。方法:选取92例EVB患者以及106例肝硬化非出血患者,对照观察其肝硬化病因,ALT水平,腹水情况,凝血酶原活动度,Child-Pugh分级,血常规,门、脾静脉宽度,胃镜检查食管静脉曲张部位、形态、直径和红色征,进行grade G分级,判定与EVB的关系。结果:两组在病因、腹水情况、血清ALTChild-Pugh分级差异均无显著意义(P>0.05)。而在白细胞计数、外周血小板计数、凝血酶原活动度食管静脉曲张分级(grade G)标准差异有显著意义(P<0.01)。B超检查门静脉直径、脾静脉直径两组间差异有显著意义(P<0.05)。结论:与EVB有关的因素包括重度食管静脉曲张(GⅢ)门静脉增宽脾静脉增宽、外周血小板、白细胞减少、凝血酶原活动度明显下降。重视对上述指标的随访和对高危者的预防性治疗,对防止EVB的发生有积极的意义。

Objective：Tthrough to cirrhosis ruptured esophageal varices hemorrhage （EVB） risk factor analysis,the discussion EVB high-risk cases screening standards, in order to get effective prevention and treatment.Methods：Select 92 cases of 106 patients EVB patients and bleeding patients.compared with liver cirrhosis not observe its cirrhosis ascites ALT,etiology, prothrombin aetivity, Child- Pugh grading,blood tests,door, spleen vein width,gastroscope inspection esophageal varices parts and form,diameter and red levy,grade G judgement and grading EVB relationship.Results：Two groups in etiology, asoites,ALT, Pugh classification Child-there are no significant difference （P〉0.05）.And in white htood count and peripheral blood platelet count. Prethrombin activity, esophageal varices classification （grade G） standards have significant difference （P〈0.01）;B ultrasonic examination portal,diameter, spleen vein diameter difference between the two groups have significant （P〈0.05） Conclusion;Conclusion and EVB relevant factors include severe esophageal varices （GIII） portal widened, Spleen vein Widened and periphetal blood piatlet;leukopenia,prothmbin activity decreased obviously.Attach importance to the above indexes of the follow-up and high-risk to prevent the prventative treatment ,EVB occurs with positive significance.