食管胃底静脉曲张破裂出血患者内镜下注射止血治疗后发生再出血的影响因素分析

Analysis on Influencing Factors of Rebleeding after Endoscopic Injection Hemostasis in Patients with Esophageal and Gastric Variceal Bleeding

目的分析食管胃底静脉曲张破裂出血患者内镜下注射止血治疗后发生再出血的相关影响因素。方法回顾性分析2018年10月至2020年10月于我院行内镜下注射止血治疗的120例食管胃底静脉曲张破裂出血患者的临床资料,统计患者治疗3 d后再出血发生情况,经单因素及多因素分析找出患者发生再出血的相关影响因素。结果120例食管胃底静脉曲张破裂出血患者经内镜下注射止血治疗后,有15例发生再出血,发生率为12.50%;经单因素和Logistic回归分析结果显示,Child-Pugh分级C级、静脉曲张血管数量>2支、曲张静脉内径较大是食管胃底静脉曲张破裂出血患者内镜下注射止血治疗后发生再出血的危险因素(OR>1,P<0.05)。结论食管胃底静脉曲张破裂出血患者内镜下注射止血治疗后发生再出血可能受Child-Pugh分级、静脉曲张血管数量、曲张静脉内径等因素影响,临床应重视对上述危险因素的早期评估,并积极采取对症措施进行干预,以降低内镜下注射止血治疗后再出血的发生风险。

Objective To analyze the related influencing factors of rebleeding after endoscopic injection hemostasis in patients with esophageal and gastric variceal bleeding.Methods The clinical data of 120 patients with esophageal and gastric variceal bleeding undergoing endoscopic injection hemostasis in our hospital from October 2018 to October 2020 were retrospectively analyzed,and the incidence of rebleeding after 3 days of treatment was counted.The related influencing factors of rebleeding were found out through univariate and multivariate analysis.Results Among 120 patients with esophageal and gastric variceal bleeding after endoscopic injection hemostasis,15 cases had rebleeding,with the incidence of 12.50%.Univariate and Logistic regression analysis results showed that Child-Pugh grade C,the number of varicose vessels>2,and the bigger inner diameter of varicose veins were the risk factors for rebleeding after endoscopic injection hemostasis in patients with esophageal and gastric variceal bleeding(OR>1,P<0.05).Conclusions Rebleeding after endoscopic injection hemostasis in patients with esophageal and gastric variceal bleeding may be affected by Child-Pugh grade,the number of variceal vessels,and the inner diameter of varicose veins.Clinically,early evaluation of the above risk factors is necessary to be focused on,and symptomatic interventions should be actively taken to reduce the risk of rebleeding after endoscopic injection hemostasis.