内镜下治疗食管胃底静脉曲张出血后再出血的危险因素分析

Analysis of risk factors for rebleeding after endoscopic treatment of esophagogastric variceal bleeding

目的探讨内镜下治疗食管胃底静脉曲张出血后再出血的危险因素。方法收集2018年3月至2022年5月于江南大学附属医院接受内镜下治疗的78例食管胃底静脉曲张出血患者的临床资料,按照术后3个月内是否再出血将其分为再出血组(n=21)和对照组(n=57)。统计患者术后再出血情况,分析与再出血相关的影响因素。结果再出血组患者年龄、重度静脉曲张比例、肝功能C级比例、国际标准化比值均高于对照组患者,凝血酶原时间长于对照组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄≥60岁、重度静脉曲张、肝功能C级、凝血酶原时间﹥13 s、国际标准化比值﹥1.2均是内镜下治疗食管胃底静脉曲张出血后再出血的危险因素(P﹤0.05)。结论年龄≥60岁、重度静脉曲张、肝功能C级、凝血酶原时间﹥13 s、国际标准化比值﹥1.2均是内镜下治疗食管胃底静脉曲张出血后再出血的危险因素,临床中应密切关注上述危险因素,及时进行干预治疗。

Objective To investigate the risk factors of rebleeding after endoscopic treatment of esophageal and gastric varices bleeding.Method The clinical data of 78 patients with esophageal and gastric variceal bleeding who received endoscopic treatment in the Jiangnan University Affiliated Hospital from March 2018 to May 2022 were collected.According to whether there was rebleeding within 3 months after the operation,they were divided into rebleeding group(n=21)and control group(n=57).The postoperative rebleeding rate of the patients was counted,factors associated with rebleeding were analyzed.Result The age,the proportion of severe varicose veins,the proportion of liver function grade C,and the international normalized ratio in the rebleeding group were higher than those in the control group,and the prothrombin time was longer than that in the control group,the differences were statistically significant(P<0.05).The results of multivariate analysis showed that age≥60 years old,severe varices,liver function grade C,prothrombin time>13 s,and international normalized ratio>1.2 were all risk factors for rebleeding after endoscopic treatment of esophagogastric variceal bleeding factor(P<0.05).Conclusion Age≥60 years,severe varices,liver function grade C,prothrombin time>13 s,and international normalized ratio>1.2 are all risk factors for rebleeding after endoscopic treatment of esophagogastric variceal bleeding.In clinical practice,close attention should be paid to the above risk factors,intervention and treatment should be carried out timely.