食管胃底静脉曲张破裂出血患者再出血的危险因素分析

摘要

Objective:Tostudytheesophagealgastricvaricesbleedinginpatientswithriskfactorsofrebleeding.Methods:All 126 cases of esophageal gastric varices bleeding( EGVB)patients as the research object,according to rebleeding rate were divided into bleeding group(group A,n=57)and control group(group B,n=69). Retrospective analysis of the clinical data, compared the differences in factors of age,sex,serum total bilirubin,prothrombin time,platelet count,red color sign,portal vein diameter,esophageal varices and so on of patients in two groups,and for non conditional Logistic regression analysis of signifi-cant index difference line,recorded related risk factors. Results:No significant difference between two groups in gender,age, grade of liver function with such general clinical data and serum total bilirubin levels,thrombin time index(P>0. 05). The in-cidence of recurrent bleeding and platelet count in EGVB patients was negatively correlated,was positive correlation between the degree of esophageal varices,red color sign,portal vein diameter,prothrombin time. Conclusion:The prothrombin time too long,severe esophageal varices,portal vein diameter increased and reduced platelet counts are the risk factors contributing to rehaemorrhagia of EGVB patients,with a red sign is the most prominent,physicians should pay attention to.%目的：探讨食管胃底静脉曲张破裂出血患者再出血的危险因素。方法：选取126例食管胃底静脉曲张破裂出血（EGVB）患者为研究对象，根据其再出血情况分成再出血组（A组，n=57）和对照组（B组，n=69）两组。回顾性分析其临床病历资料，比对两组患者在年龄、性别、血清总胆红素水平、凝血酶原时间、血小板计数、红色征、门静脉内径、食管静脉曲张程度等因素上的差异，并针对差异显著指标行非条件Logistic回归分析，记录其相关危险因素。结果：两组患者性别、年龄、肝功能分级等一般临床资料及血清总胆红素水平、凝血酶时间等指标对比，差异无统计学意义（P>0.05）；EGVB患者再出血的发生同血小板计数呈负相关性，同食管静脉曲张程度、红色征、门静脉内径、凝血酶原时间等呈正相关性。结论：凝血酶原时间过长、重度食管静脉曲张、门静脉内径增加及血小板计数减少等均为导致EGVB患者再次出血的危险因素，以红色征最为突出，医师需对此类患者重点留意。