肝硬化合并上消化道出血42例临床诊治分析

Analysis of Clinical Diagnosis and Treatment for the Cirrhosis and Upper Gastrointestinal Bleeding of 42 Cases

目的:分析肝硬化合并上消化道出血原因和临床诊治效果。方法:对于我院3年来救治的42例肝硬化合并上消化道出血患者的临床资料进行回顾性分析。结果:纤维胃镜显示出现食管静脉曲张破裂出血的患者24例,占出血总数人数54.8%;出现门脉高压性胃病出血的患者13例,占出血总数人数28.6%;出现消化性溃疡出血3例,占出血总数人数7.1%;出现急性胃黏膜病变3例,占出血总数人数7.1%;胃癌患者1例,占出血总数人数2.4%。42例患者治疗后止血成功38例,成功率90.5%;剩下4例,1例死亡,3例再次有效止血。结论:肝硬化合并上消化道出血病中,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 three years to 42 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 54.8%; portal hypertension sex stomach bleeding 12 cases,accounting for bleeding total 28.6%,peptic ulcer hemorrhage in 3 cases,total of bleeding 7.1%,acute gastric mucosa in 3 cases,accounting for bleeding total 7.1%,gastric carcinoma in 1 case,total of bleeding 2.4%.42 patients after treatment,38 patients with bleeding success rate 90.5%,rest in 4 cases,1 case death,3 cases effective homeostasis again.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.