肝硬化并上消化道出血30例临床诊治分析探讨

Clinical Analysis of 30 Cases of Cirrhosis and Upper Gastrointestinal Hemorrhage

目的回顾性分析肝硬化并上消化道出血的出血原因以及临床诊治效果。方法对2014年1月—2017年1月我院收治的肝硬化并上消化道出血患者的临床资料进行回顾性分析。结果胃镜检查下显示食管静脉曲张破裂出血患者14例,占46.66%,门脉高压性胃出血患者8例,占26.66%,消化道溃疡出血患者6例,占20.00%,急性胃黏膜病变出血患者1例,占3.33%,胃癌出血患者1例,占3.33%;30例患者治疗后成功止血患者25例,占83.33%,继发感染4例,占13.33%,死亡1例,占3.33%。结论肝硬化并上消化道出血的出血原因中,食管静脉曲张破裂出血、门脉高压性胃出血以及消化道溃疡出血占很高的比例,在临床治疗过程中,需要辅以胃镜进行出血原因检查,有针对性的进行抢救与治疗。

Objective To retrospectively analyze the causes of bleeding and the clinical diagnosis and treatment of liver cirrhosis complicated with upper gastrointestinal bleeding. Methods The clinical data of patients with cirrhosis and upper gastrointestinal bleeding admitted in our hospital from January 2014 to January 2017 were retrospectively analyzed. Results Gastroscopy showed esophageal varices bleeding in 14 cases, accounting for 46.66%, portal hypertensive gastric bleeding occurred in 8 cases, accounting for 26.66%, peptic ulcer bleeding in 6 cases, accounting for 20.00%. There were 1 patients with acute gastric mucosal lesion, accounting for 3.33%, gastric cancer bleeding in 1 cases, accounting for 3.33%; 30 patients succeeded in hemostasis after treatment, 25 cases, accounting for 83.33%, secondary infection occurred in 4 cases, accounting for 13.33%, 1 case died, accounting for 3.33%. Conclusion For Liver cirrhosis and upper gastrointestinal bleeding, esophageal variceal bleeding, portal hypertensive stomach bleeding and gastrointestinal ulcer bleeding accounted have a high proportion of the clinical treatment process. In the course of clinical treatment, gastroscopy should be performed to check the cause of bleeding, and targeted rescue and treatment should be carried out.