肝硬化门静脉高压并发上消化道出血的相关危险因素分析

Analysis of Related Risk Factors of Cirrhosis and Portal Hypertension Combined with Upper Gastrointestinal Hemorrhage

目的分析探讨肝硬化门静脉高压并发上消化道出血的相关危险因素。方法将2015年12月—2016年12月重庆市彭水县人民医院收治的124例肝硬化患者作为研究对象,其中并发上消化道出血的50例患者作为观察组,74例未出现上消化道出血的患者作为对照组,比较分析两组患者的临床资料。结果观察组患者食管胃低静脉曲张发生率为60.0%(30/50),显著高于对照组的20.3%(15/74),数据差异有统计学意义(P<0.05);观察组患者冠状静脉怒张的发生率为82.0%(41/50),显著高于对照组的51.4%(38/74),数据差异有统计学意义(P<0.05);两组患者肝功能分级差异有统计学意义;观察组脾静脉内径为(1.12±0.19)mm,显著高于对照组的(1.00±0.11)mm,数据差异有统计学意义(P<0.05);观察组门静脉内径为(1.44±0.26)mm,显著高于对照组的(1.19±0.22)mm,数据差异有统计学意义(P<0.05)。结论食管胃低静脉曲张、冠状静脉怒张、肝功能分级高、脾静脉内径及门静脉内径较大均为肝硬化门静脉高压并发上消化道出血的相关危险因素,要对此类高危患者予以重视,采取有效的护理干预措施,对改善患者预后,预防和治疗肝硬化重大并发症有重要临床意义。

Objective To analyze and study the related risk factors of cirrhosis and portal hypertension combined with Upper gastrointestinal hemorrhage. Methods 124 cases of patients with cirrhosis admitted and treated in our hospital from December 2015 to December 2016 were selected and divided into two groups, the observation group were 50 cases of patients with upper gastrointestinal hemorrhage, and the control group with 74 cases were patients without the upper gastrointestinal hemorrhage, and the clinical data were compared between the two groups. Results The incidence rate of esophageal and gastric varices in the observation group was obviously higher than that in the control group [60.0%（30/50） vs 20.3%（15/74）], and the difference was statistically significant（P〈0.05）, and the incidence rate of coronary vein dilation in the observation group was obviously higher than that in the control group [82.0%（41/50） vs 51.4%（38/74）],and the difference was statistically significant（P〈0.05）, and the difference in the classification of hepatic function between the two groups was obvious, and the diameter of splenic vein in the observation group was obviously higher than that in the control group, [（1.12±0.19）mm vs（1.00±0.11）mm], and the difference was statistically significant（P〈0.05）,and the portal vein diameter in the observation group was obviously higher than that in the control group[（1.44±0.26）mm vs（1.19±0.22）mm], and the difference was statistically significant（P〈0.05）. Conclusion The esophageal and gastric varices,coronary vein dilation, high classification of hepatic function, bigger diameters of splenic vein and portal vein are the related risk factors of cirrhosis and portal hypertension combined with upper gastrointestinal hemorrhage, therefore, we should pay attention to the high-risk patients, and use the effective nursing intervention measures, which is of important clinical significance to improving the prognosis of patients, and preventing and treating the severe complications of cirrhosis.