肝癌合并上消化道出血患者急诊胃镜下止血治疗后死亡的相关因素分析

Factors influencing death in patients with liver cancer undergoing emergent gastroscopic hemostasis for upper gastrointestinal tract bleeding

目的探讨肝癌合并上消化道出血患者急诊胃镜下止血治疗后死亡的相关因素分析。方法选取2016年8月至2018年7月间武汉市红十字会医院收治的122例肝癌合并上消化道出血患者进行回顾性分析,采用单因素分析和多因素Logistic回归分析对影响患者死亡的因素进行研究。结果 122例患者均行胃镜止血治疗,治疗后死亡23例,存活99例。单因素分析显示,血常规中红细胞压积(HCT)、血红蛋白(HGB)、血清白蛋白(ALB)、血小板(PLT)、门静脉血栓和Child-Pugh分级,为导致患者死亡的影响因素,差异均有统计学意义(均P <0. 05)。多因素Logistic回归分析显示,HCT、HGB、ALB、PLT、门静脉血栓和Child-Pugh分级为患者死亡的独立危险因素,差异均有统计学意义(均P <0. 05)。结论血常规中部分指标、治疗前患有门静脉血栓和Child-Pugh分级为肝癌合并上消化道出血患者死亡的独立危险因素。

Objective To analyze the factors influencing death in patients with liver cancer undergoing emergent gastroscopic hemostasis for upper gastrointestinal tract bleeding.Methods A total of 122 patients with liver cancer combined with upper gastrointestinal tract bleeding were retrospectively analyzed at Wuhan Red Cross Hospital from August 2016 to July 2018 were selected.Univariate analysis and multivariate Logistic regression analysis were used to analyze factor influencing patient’s death.Results Of the 122 patients undergoing emergent gastroscopic hemostasis,23 died and 99 survived.Univariate analysis showed that hematocrit(HCT),hemoglobin(HGB),albumin(ALB),platelet count before(PLT),treatment,portal vein thrombosis and Child-Pugh grade were the factors influencing patient’s death(all P<0.05).For routine blood,glutamic-pyruvic transaminase(ALT),cholinesterase(CHE),the location of bleeding,the amount of bleeding before treatment and the way of hemostasis were not the factors influencing patient’s death.Multivariate Logistic regression analysis showed that HCT,HGB,ALB,PLT,portal venous thrombus and Child Pugh classification were independent risk factors for patient’s death.Conclusion Some indexes of blood routine,portal vein thrombosis before treatment and Child-Pugh classification was independent risk factors for death in patients with liver cancer undergoing emergent gastroscopic hemostasis for upper gastrointestinal tract bleeding.