肝硬化上消化道出血患者预后的影响因素分析

Influencing factors of prognosis in patients with cirrhosis complicated by upper gastrointestinal bleeding

目的分析肝硬化上消化道出血患者预后的影响因素。方法抽取2019年10月至2021年10月义马市人民医院收治的136例肝硬化上消化道出血患者为研究对象,按照发病28 d内生存情况将其分为生存组(108例)及死亡组(28例),统计两组临床资料,分析影响患者预后的危险因素。结果死亡组72 h内再次出血、Child-Pugh C级、出血量>500 ml、贫血、中重度腹水、休克指数>1.5、肝性脑病、食管胃底静脉曲张者比例高于生存组(P均<0.05),72 h内再出血(OR=2.21,95%CI 1.44~3.38)、Child-Pugh C级(OR=2.33,95%CI 1.86~2.92)、休克指数>1.5(OR=2.41,95%CI 1.93~2.99)、并发肝性脑病(OR=2.51,95%CI 1.37~4.61)、食管胃底静脉曲张(OR=2.44,95%CI 1.61~3.69)是影响肝硬化上消化道出血患者预后的危险因素(P均<0.05)。结论72 h内再出血、Child-Pugh分级C级、休克指数>1.5、并发肝性脑病等是影响肝硬化上消化道出血患者预后的危险因素。

Objective To analyze the influencing factors of prognosis in patients with cirrhosis complicated by upper gastrointestinal bleeding.Methods A total of 136 patients with liver cirrhosis complicated by upper gastrointestinal bleeding who were admitted to Yima People’s Hospital from October 2019 to October 2021 were selected as the research objects,and the selected patients were divided into survival group(108 cases)and death group(28 cases)according to the survival status within 28 days after onset.The clinical data of the two groups were collected,and the risk factors affecting the prognosis of the patients were analyzed.Results The proportion of rebleeding within 72 hours,Child-Pugh C grade,bleeding volume>500 ml,anemia,moderate to severe ascites,shock index>1.5,hepatic encephalopathy,and esophagogastric varices in the death group were higher than those in the survival group(all P<0.05).Rebleeding within 72 hours(OR=2.21,95%CI 1.44-3.38),Child-Pugh grade C(OR=2.33,95%CI 1.86-2.92),shock index>1.5(OR=2.41,95%CI 1.93-2.99),concurrent hepatic encephalopathy(OR=2.51,95%CI 1.37-4.61),esophagogastric varices(OR=2.44,95%CI 1.61-3.69)were risk factors affecting the prognosis of patients with cirrhosis complicated by upper gastrointestinal bleeding(all P<0.05).Conclusions Rebleeding within 72 hours,Child-Pugh grade C,shock index>1.5,concurrent hepatic encephalopathy are the risk factors affecting the prognosis of patients with cirrhosis complicated by upper gastrointestinal bleeding.