肝硬化上消化道出血患者并发门静脉血栓的风险因素与防护策略

Risk factors and protection strategies of inducing portal vein thrombosis in patients with liver cirrhosis and upper gastrointestinal bleeding

目的探讨肝硬化上消化道出血患者并发门静脉血栓的风险因素与防护策略。方法选取2018年1月至2020年1月医院收治的肝硬化上消化道出血患者124例为研究对象,采用自制调查问卷表对患者门静脉血栓发生率及相关影响因素进行调查,分析肝硬化上消化道出血并发门静脉血栓的影响因素及护理策略。结果肝硬化上消化道出血患者中,出现门静脉主干血栓18例(14.52%),肠系膜上静脉血栓6例(4.84%),脾静脉血栓1例(0.81%),出现门静脉系统血栓总例数25例(20.16%);经单因素分析结果显示,肝功能分级、脾切除术、门静脉内径、PLT指数、D-二聚体水平、凝血功能、脾脏厚度、脾静脉内径是影响肝硬化上消化道出血患者并发门静脉血栓的相关因素(P<0.05);经多因素Logistic回归分析结果显示,患者肝功能分级、门静脉内径、血小板(PLT)指数均为肝硬化上消化道出血患者并发门静脉血栓的独立危险因素(P<0.05)。结论患者肝功能分级、门静脉内径、PLT指数均为肝硬化上消化道出血患者并发门静脉血栓的独立危险因素,应对独立危险因素采取针对性的护理措施,降低肝硬化上消化道出血门静脉血栓发生风险。

Objective To explore the risk factors and protection strategies of inducing portal vein thrombosis in patients with liver cirrhosis and upper gastrointestinal bleeding.Methods To select 124 cases of patients with liver cirrhosis and upper gastrointestinal hemorrhage admitted to hospital from January 2018 to January 2020 as the study objects.A self-made questionnaire was used to investigate the incidence of portal vein thrombosis and related influencing factors to analyze the influencing factors and nursing strategies of inducing portal vein thrombosis in patients with liver cirrhosis and upper gastrointestinal bleeding.Results Among patients with liver cirrhosis and upper gastrointestinal hemorrhage,18 cases(14.52%)had main portal vein thrombosis,6 cases(4.84%)had superior mesenteric vein thrombosis,1 case(0.81%)had splenic vein thrombosis,and 25 cases(20.16%)had portal vein system thrombosis.Univariate analysis showed that the classification of patient's liver function,splenectomy,portal vein diameter,platelet(PLT)index,D-dimer level,coagulation function,spleen thickness,and splenic vein diameter were the related factors that affected patients with cirrhosis and upper gastrointestinal hemorrhage complicated by portal vein thrombosis(P<0.05).Multivariate Logistic regression analysis showed that the patient's classification of liver function,portal vein diameter,and PLT index were the independent risk factors that affected patients with cirrhosis and upper gastrointestinal hemorrhage complicated by portal vein thrombosis(P<0.05).Conclusion The patient's classification of liver function,portal vein diameter,and PLT index were the independent risk factors that affected patients with cirrhosis and upper gastrointestinal hemorrhage complicated by portal vein thrombosis.A targeted nursing measures should be taken for independent risk factors to reduce the risk of portal vein thrombosis in cirrhosis of the upper gastrointestinal tract.