食管静脉曲张内镜下硬化治疗后再出血的危险因素研究

Analysis of the risk factors in rebleeding after endoscopic esophageal variceal sclerotherapy

[目的]探讨食管静脉曲张患者内镜下硬化治疗（EVS）后早期再出血的危险因素。[方法]选取2013年5月-2014年10月我院确诊的食管曲张静脉破裂出血经EVS治疗患者行回顾性研究,其中22例EVS治疗后6周内食管静脉曲张再出血患者纳入再出血组,其余68例纳入未出血组,统计分析EVS治疗后早期再出血的危险因素。[结果]2组Child-Pugh分值、凝血酶原时间、白蛋白水平、门静脉直径及血清Na值比较,差异有统计学意义（P=0.037、0.006、0.015、0.026、0.017）。多因素分析表明EVS治疗前Child-Pugh分值、凝血酶原时间、门静脉直径及血清Na值为EVS治疗后早期再出血的独立危险因素。[结论]Child-Pugh分值较高、凝血酶原时间较长、门静脉较宽及血清Na值较高可能预示EVS治疗后早期再出血风险高。

[Objective]To analyze the risk factors for rebleeding after esophageal variceal sclerotherapy（EVS）.[Methods]The records of patients treated with EVS due to cirrhosis in our endoscopy center were surveyed.Totally 90 procedures of EVS had been performed in the period between 2011 and2014.According to the outcome,the patients were divided into rebleeding and non-rebleeding groups.A lot of items were analyzed,including gender,age,types of cirrhosis.[Results]Comparative analysis showed the scores of Child-Pugh（P=0.037）,prothrombin time（P=0.006）,albumin（P=0.015）,portal vein diameter（P=0.026）and serum sodium（P=0.017）significantly differet between the rebleeding and non-rebleeding groups.Child-Pugh,prothrombin time,portal vein diameter and serum sodium which were analyzed by Logistic retrospective analysis were independent risk factors of rebleeding after EVS.[Conclusion]The rebleeding rate after EVS is effected by Child-Pugh,prothrombin time,portal vein diameter and serum sodium.Therefore,measures for prevention and teratment should be adopted to reduce rebleeding rate.