肝硬化食管胃底静脉曲张患者早期再出血危险因素分析

Analysis of Risk Factors for Early Rebleeding in Patients with Liver Cirrhosis of Esophagus and Gastric Varices

目的探讨肝硬化食管胃底静脉曲张患者早期再出血的危险因素。方法选取2019年10月—2020年10月因肝硬化GEVB首次出血在辽健铁煤集团总医院接受治疗的患者112例,根据是否发生早期再出血将其分为未出血组和再出血组,比较两组患者的一般资料及相关临床指标,利用Logistic回归分析患者早期再出血的危险因素。结果112例患者中早期再出血的发生率为16.07%(18/112),未出血的发生率为83.93%(94/112)。Logistic回归分析表明,脾脏厚度是GEVB患者早期再出血的危险因素,脾脏越厚,早期再出血风险越大;白蛋白(ALB)、钠离子(Na^(+))是早期再出血的保护因素,ALB、Na^(+)水平越高,出血发生风险越小。结论脾脏厚度是肝硬化GEVB患者早期再出血的危险因素,ALB、Na^(+)是早期再出血的保护因素,在止血过程中,应给予这些指标更多关注,减少再出血风险。

Objective To investigate the risk factors of early rebleeding in patients with liver cirrhosis of gastric and esophagus variceal bleeding(GEVB).Methods A total of 112 patients who were treated in our hospital for first bleeding from GEVB due to liver cirrhosis from October 2019 to October 2020 were selected.According to whether early rebleeding occurred,they were divided into non-bleeding group and rebleeding group.The general data and related clinical indicators of the two groups were compared,and the risk factors of early rebleeding were analyzed by Logistic regression.Results The incidence of early rebleeding among 112 patients was 16.07%(18/112),and the incidence of non-bleeding was 83.93%(94/112).Logistic regression analysis showed that spleen thickness is a risk factor for early rebleeding in patients with GEVB.The thicker the spleen,the greater the risk of early rebleeding.ALB and Na+are protective factors for early rebleeding.The higher the level of ALB and Na^(+),the lower the risk of bleeding.Conclusion Spleen thickness is a risk factor for early rebleeding in patients with liver cirrhosis and GEVB.ALB and Na^(+)are protective factors for early rebleeding.In the process of hemostasis,more attention should be paid to these indicators to reduce the risk of rebleeding.