饮食干预对肝硬化合并食管胃底静脉曲张出血患者的影响

Impact of dietary intervention on esophageal and variceal bleeding patients with cirrhosis

目的 探讨饮食干预对肝硬化合并食管胃底静脉曲张消化道出血的影响。方法 选择2011年1月~2013年6月我科收治的肝硬化合并食管胃底静脉曲张出血患者90例,按住院时间先后分为对照组45例和干预组45例。对照组按常规方法护理;干预组在积极治疗原发病基础上,从入院评估、一对一指导、饮食干预、自我管理、随访制度化等方面进行饮食干预。比较两组患者的初次出血率、再次出血率、死亡率。结果 干预组患者初次出血率为28.9%,低于对照组的33.3%,差异无统计学意义（P〉0.05）。干预组患者再次出血率为31.1%,明显低于对照组的64.4%,差异有统计学意义（P〈0.05）。干预组死亡率为4.4%,明显低于对照组的15.6%,差异有统计学意义（P〈0.05）。结论 在原发病积极规范治疗基础上,进行合理的饮食干预,可预防肝硬化合并食管胃底静脉曲张出血患者再出血,降低死亡率。

Objective To explore the effects of esophageal varices patients with dietary intervention on gastrointestinal bleeding. Methods 90 patients with cirrhosis complicated by esophageal and gastric varices bleeding from January 2011 to June 2013 of our department were selected,and were divided into contrast group （n=45） and intervention group （n=45） according to hospital chronologically.The contrast group was cared by conventional methods.The intervention group was on the basis of the active treatment original disease.From the enter hospital assessment,one guidance,dietary intervention, self-management, and other aspects of comprehensive follow-up of institutionalized dietary intervention. The initial bleeding rebleeding rate and mortality between two group was compared. Results The initial bleeding rate of the patients in intervention group was 28.9%,which was lower than that of the contrast group,which rate was 33.3%, there was no significant difference between two groups （P〉0.05）.The bleeding rate of the intervention group was 31.1%, which was significantly lower than 64.4% in the control group,with significant difference （P〈0.05）.The death rate of in- tervention group was 4.4%,lower than 15.6% in the control group,with significant difference （P〈0.05）. Conclusion The patients of esophageal varices with cirrhosis,primary disease need a timely standard treatment,and a reasonable diet intervention,which can prevent rebleeding in patients and reduce mortality.