肝硬化门脉高压患者胃肠道出血的影响因素研究

Risk factors of gastrointestinal bleeding in patients with liver cirrhosis and portal hypertension

目的:探究分析影响肝硬化门脉高压患者胃肠道出血的相关危险因素。方法:选取2011-03~2014-03在我院治疗的肝硬化门脉高压胃肠道出血患者40例,按照年龄相差不超过2岁的原则选择同时期在我院治疗的肝硬化门脉高压无胃肠道出血患者40例,观察患者的一般临床资料、肝功能Child-Pugh评分、食管静脉曲张程度、胃底静脉曲张程度、冠状静脉怒张程度、HP感染、红色征、门静脉内径和脾静脉内径。结果:两组患者间年龄、病因情况、HP感染、胃底静脉曲张程度比较差异无统计学意义(P>0.05);肝功能分级比较未出血组明显优于出血组(P<0.05);出血组门静脉内径、脾静脉内径明显大于非出血组(P<0.05);未出血组食管静脉曲张程度、冠状静脉怒张程度、红色征状况显著优于出血组(P<0.05);出血组男性患者明显多于未出血组(P<0.05)。结论:肝硬化门脉高压患者胃肠道出血的危险因素包括性别、肝功能Child-Pugh分级、门静脉内径、红色征程度、冠状静脉怒张程度、脾静脉内径与食管静脉曲张程度。

Objective:To explore the risk factors of gastrointestinal bleeding in patients with liver cirrhosis and portal hypertension.Methods:Fourty patients with liver cirrhosis,portal hypertension and gastrointestinal bleeding from March 2011 to March 2014 in our hospital were selected in this study.The same number of patients with liver cirrhosis and portal hypertension but without gastrointestinal bleeding were also included according to the age difference of no more than 2years at the same time.General clinical data were collected.Liver function Child-Pugh score,degrees of esophageal varices,gastric varices,coronary venous engorgement,and HP infection,red sign,portal vein diameter and splenic vein diameter were evaluated.Results:There were no obvious differences between the two groups in the age,etiology,HP infection and gastric varices(P >0.05).Liver function grade was significantly better in non-bleeding group than that in bleeding group(P<0.05).Diameters of portal vein and splenic vein were larger in bleeding group than those in non-bleeding group(P <0.05).Degrees of esophageal varices,coronary venous engorgement and red sign were significantly better in non-bleeding group than those in bleeding group(P<0.05).More male patients were found in bleeding group than in non-bleeding group(P <0.05).Conclusion:The risk factors of gastrointestinal bleeding in patients with liver cirrhosis and portal hypertension include gender,liver function Child-Pugh grade,diameters of portal vein and splenic vein,red sign,degrees of esophageal varices and coronary venous engorgement.