| 摘要: |
| ［摘要］ 目的 探讨肝硬化门静脉高压患者食管胃静脉曲张（GOV）出血的临床特点及防治。方法 本研究纳入临床资料完整的330例住院肝硬化患者，其中肝硬化门静脉高压非GOV出血患者138例，首次出现GOV出血患者105例，GOV再出血患者87例。回顾性分析肝硬化门静脉高压GOV出血的临床特点，并以肝硬化非GOV出血组为对照，采用logistic回归分析GOV首次出血的危险因素。结果 330例肝硬化患者中，192例肝硬化并发GOV出血，一级预防管理中，既往接受一级预防患者21例(10.93%)，其中接受非选择性β受体阻滞剂（NSBB）药物治疗6例（3.13%），经内镜治疗15例（7.81%）；二级预防管理中，既往接受二级预防患者125例(65.10%)，其中经NSBB药物治疗18例（9.38%），内镜治疗69例（35.94%），介入治疗56例（29.17%）。Child-Pugh分级（OR=1.651，95%CI：1.115～2.444，P=0.012）、感染（OR=2.062，95%CI：1.055～4.032，P=0.034）。结论 Child-Pugh分级、感染是肝硬化门静脉高压GOV出血发生的独立危险因素。对于肝硬化门静脉高压患者GOV出血一级预防、二级预防及治疗存在不足，需要加大高危人群的筛查、提高首次及再次出血的预防。 |
| 关键词: 肝硬化 食管胃静脉曲张出血 一级预防 二级预防 危险因素 |
| DOI：10.3969/j.issn.1674-3806.2021.08.07 |
| 分类号:R 657.3+1 |
| 基金项目:广西科技计划项目（编号：桂科AD17129027）；广西卫健委重点（培育）实验室建设项目（编号：ZZH2020006）；广西壮族自治区人民医院青年基金项目（编号：QN2020-11） |
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| A study on the clinical characteristics, prevention and treatment of gastroesophageal varices bleeding in cirrhotic portal hypertension |
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WANG Wen-juan, ZHANG Guo, YU Lei, et al.
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Department of Gastroenterology, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To investigate the clinical characteristics, and the prevention and treatment of gastroesophageal varices(GOV) bleeding in patients with cirrhotic portal hypertension. Methods A total of 330 liver cirrhosis inpatients with complete clinical data were included in this study. Among them, there were 138 cases with non-GOV bleeding in cirrhotic portal hypertension,105 cases with GOV bleeding for the first time,and 87 cases with GOV rebleeding. The clinical characteristics of GOV bleeding in cirrhotic portal hypertension were retrospectively analyzed. The risk factors of GOV first bleeding were analyzed by logistic regression with non-GOV bleeding group as control. Results Among the 330 patients with liver cirrhosis, 192 patients had liver cirrhosis complicated with GOV bleeding. In the primary prevention management, 21 patients(10.93%) previously received primary prevention, including 6 patients(3.13%) treated with non-selective beta blocker(NSBB) and 15 patients(7.81%) treated with endoscopy. In the secondary prevention management, 125 patients(65.10%) previously received secondary prevention, including 18 patients(9.38%) treated with NSBB, 69 patients(35.94%) treated with endoscopy, and 56 patients(29.17%) treated with interventional therapy. Child-Pugh grade(OR=1.651, 95%CI: 1.115-2.444, P=0.012) and infections(OR=2.062, 95%CI: 1.055-4.032, P=0.034). Conclusion Child-Pugh grade and infections were the independent risk factors for development of GOV bleeding in cirrhotic portal hypertension. For patients with cirrhotic portal hypertension, there are inadequacies in the primary prevention, secondary prevention and treatment of GOV bleeding. It is necessary to strengthen the screening of high-risk populations and improve the prevention of first-time bleeding and rebleeding. |
| Key words: Liver cirrhosis Gastroesophageal varices(GOV) bleeding Primary prevention Secondary prevention Risk factors |
