AIM: To analyze the clinical risk factors for early variceal rebleeding after endoscopic variceal ligation (EVL).METHODS: 342 cirrhotic patients with esophageal varices who received elective EVL to prevent bleeding or...AIM: To analyze the clinical risk factors for early variceal rebleeding after endoscopic variceal ligation (EVL).METHODS: 342 cirrhotic patients with esophageal varices who received elective EVL to prevent bleeding or rebleeding at our endoscopy center between January 2005 and July 2010.were included in this study.The early rebleeding cases after EVL were confirmed by clinical signs or endoscopy.A case-control study was performed comparing the patients presenting with early rebleeding with those without this complication.RESULTS: The incidence of early rebleeding after EVL was 7.60%,and the morbidity of rebleeding was 26.9%.Stepwise multivariate logistic regression analysis showed that four variables were independent risk factors for early rebleeding: moderate to excessive ascites [odds ratio (OR) 62.83,95% CI: 9.39-420.56,P < 0.001],the number of bands placed (OR 17.36,95% CI: 4.00-75.34,P < 0.001),the extent of varices (OR 15.41,95% CI: 2.84-83.52,P = 0.002) and prothrombin time (PT) > 18 s (OR 11.35,95% CI: 1.93-66.70,P = 0.007).CONCLUSION: The early rebleeding rate after EVL is mainly affected by the volume of ascites,number of rubber bands used to ligate,severity of varices and prolonged PT.Effective measures for prevention and treatment should be adopted before and after EVL.展开更多
目的:探讨肝硬化食管静脉曲张破裂出血(esophageal varices bleeding,EVB)的危险因素.方法:回顾性分析178例肝硬化食管静脉曲张患者的临床资料,其中出血组118例,未出血组60例;分别统计2组24个指标,通过t检验、χ2检验和多因素非条件Logi...目的:探讨肝硬化食管静脉曲张破裂出血(esophageal varices bleeding,EVB)的危险因素.方法:回顾性分析178例肝硬化食管静脉曲张患者的临床资料,其中出血组118例,未出血组60例;分别统计2组24个指标,通过t检验、χ2检验和多因素非条件Logistic回归分析得出肝硬化EVB的危险因素.结果:出血组与未出血组之间红细胞计数、血红蛋白、血清白蛋白、凝血酶原活动度、肝功能Child B级、肝功能Child C级、既往E V B史、门静脉内径、脾静脉内径、脾脏厚度、红色征差异有统计学意义.多因素非条件Logistic回归分析结果提示血红蛋白(OR=0.204,P=0.001)、血清白蛋白(O R=0.126,P=0.000)与E V B风险呈负相关,既往E V B史(OR=3.622,P=0.01)、门静脉内径(OR=2.619,P=0.032)、红色征(OR=4.647,P=0.001)与EVB风险呈正相关.结论:贫血、低蛋白血症、既往EVB史、门静脉内径增宽、红色征阳性是EVB的独立危险因素.展开更多
文摘AIM: To analyze the clinical risk factors for early variceal rebleeding after endoscopic variceal ligation (EVL).METHODS: 342 cirrhotic patients with esophageal varices who received elective EVL to prevent bleeding or rebleeding at our endoscopy center between January 2005 and July 2010.were included in this study.The early rebleeding cases after EVL were confirmed by clinical signs or endoscopy.A case-control study was performed comparing the patients presenting with early rebleeding with those without this complication.RESULTS: The incidence of early rebleeding after EVL was 7.60%,and the morbidity of rebleeding was 26.9%.Stepwise multivariate logistic regression analysis showed that four variables were independent risk factors for early rebleeding: moderate to excessive ascites [odds ratio (OR) 62.83,95% CI: 9.39-420.56,P < 0.001],the number of bands placed (OR 17.36,95% CI: 4.00-75.34,P < 0.001),the extent of varices (OR 15.41,95% CI: 2.84-83.52,P = 0.002) and prothrombin time (PT) > 18 s (OR 11.35,95% CI: 1.93-66.70,P = 0.007).CONCLUSION: The early rebleeding rate after EVL is mainly affected by the volume of ascites,number of rubber bands used to ligate,severity of varices and prolonged PT.Effective measures for prevention and treatment should be adopted before and after EVL.
文摘目的:探讨肝硬化食管静脉曲张破裂出血(esophageal varices bleeding,EVB)的危险因素.方法:回顾性分析178例肝硬化食管静脉曲张患者的临床资料,其中出血组118例,未出血组60例;分别统计2组24个指标,通过t检验、χ2检验和多因素非条件Logistic回归分析得出肝硬化EVB的危险因素.结果:出血组与未出血组之间红细胞计数、血红蛋白、血清白蛋白、凝血酶原活动度、肝功能Child B级、肝功能Child C级、既往E V B史、门静脉内径、脾静脉内径、脾脏厚度、红色征差异有统计学意义.多因素非条件Logistic回归分析结果提示血红蛋白(OR=0.204,P=0.001)、血清白蛋白(O R=0.126,P=0.000)与E V B风险呈负相关,既往E V B史(OR=3.622,P=0.01)、门静脉内径(OR=2.619,P=0.032)、红色征(OR=4.647,P=0.001)与EVB风险呈正相关.结论:贫血、低蛋白血症、既往EVB史、门静脉内径增宽、红色征阳性是EVB的独立危险因素.