食管静脉曲张套扎术对肝功能的影响及术后再出血的危险因素分析

摘要

目的:探讨肝硬化患者实施食管静脉曲张套扎术(EVL)对肝功能的影响并分析术后再出血的危险因素.方法:回顾性分析137例行EVL的肝硬化患者临床资料,根据患者术前的肝功能Child-Pugh分级将患者分为A级、B级、C级三组,分别收集患者术前及术后1周的肝功能结果,比较肝功能的变化;再根据患者术后是否发生再出血将患者分为出血组与未出血组,分析影响术后再出血的危险因素.结果:A级、B级、C级三组患者套扎后肝功能中的ALT,AST,T-Bil,D-Bil较前无显著变化(P＞0.05).共有13例患者EVL后出血,出血率为9.49％,logistic回归分析发现病程、肝功能分级、凝血酶原时间、腹水量为影响术后再出血的危险因素.结论:EVL对肝功能无明显影响,肝硬化患者的病程、肝功能分级、凝血酶原时间、腹水量为EVL后再出血的危险因素.%Objective:To investigate the influence of endoscopic variceal ligation (EVL) on liver function and analyze the risk factors of rebleeding after EVL.Methods:A total of 137 cirrhotic patients with esophageal varices who received EVL were retrospectively analyzed,and divided into group A,B,and C according to the Child-Pugh scores of liver function.We compared the liver function 1 week preoperatively and postoperatively.The patients were further divided into a rebleeding group and a non-rebleeding group after the EVL,and risk factors about rebleeding were analyzed.Results:There was no significant difference on ALT,AST,T-Bil,and D-Bil either preoperatively or postoperatively in group A,B,and C (P＞0.05).Thirteen patients (9.49％) rebled after the EVL.The course of disease,liver function,prothrombin time,and mass ascites were the risk factors of rebleeding.Conclusion:EVL has no obvious effect on liver function,and the course of disease,liver function,prothrombin time and mass ascites are risk factors ofrebleeding after EVL.