肝硬化食管静脉曲张出血内镜治疗后早期再出血的危险因素分析

目的探讨内镜治疗肝硬化食管静脉曲张破裂出血(EVB)后早期再出血的危险因素。 方法回顾分析2016年8月至2018年8月因肝硬化食管静脉曲张(EV)首次出血就诊于包头医学院二附院并采用内镜下治疗的患者资料，依据术后6周内是否再出血分再出血组和未出血组，对两组患者的一般资料、肝功能、血常规、凝血、门静脉血栓、门静脉异常分流等情况进行单因素分析，探讨内镜治疗EV术后早期再出血的危险因素。 结果(1)入组患者共450例，治疗后6周内出血27例，止血成功率94%；(2)单因素分析AST、GGT、TBIL、ALB、PTA、TG、肝功能、Child-Pugh分级、EV程度、门静脉血栓、门静脉异常分流在出血和未出血组之间的差异具有统计学意义；(3)多因素Logistic回归分析结果显示AST等是影响EV术后再出血的危险因素；ALB、门静脉异常分流是影响EV术后再出血的保护因素(P<0.05)。 结论AST、GGT、PTA、TG、肝功能Child-Pugh分级、EV程度、门静脉血栓是影响EV术再出血的危险因素；ALB、门静脉异常分流是影响EV术后早期再出血的保护因素。

Analysis of risk factors for early rebleeding after endoscopic treatment of cirrhotic esophageal varices bleeding

ObjectiveTo explore the risk factors for endoscopic treatment of early rebleeding after rupture of esophageal varices (EVB) in patients with cirrhosis. MethodRetrospective analysis of from August 2016 to Auguet 2018 patients with esophageal varices (EV) first bleeding in Second Affiliated Hospital of Baotou Medical College and the use of endoscopic treatment of patients. Patients with rebleeding within 6 weeks after surgery were divided into rebleeding group and non-bleeding group. Multivariate analysis was performed on the general data, liver function, blood routine, blood coagulation, portal vein thrombosis, and abnormal portal vein shunt in the two groups.Mirror treatment of risk factors for early rebleeding after esophageal varices. Result(1)A total of 450 patients were enrolled, and 27 patients had bleeding in the early stage (within 6 weeks) after treatment.The success rate of hemostasis was 94%.(2)Univariate analysis of AST(aspartate aminotransferase) GGT(γ-glutamyltransferase), TBIL(total bilirubin), ALB(albumin), PTA (prothrombin activity), The difference between TG (triglyceride), liver function Child-Pugh classification, esophageal varices, portal vein thrombosis, and portal vein abnormal shunt was statistically significant between the bleeding group and the non-bleeding group.(3)Multivariate logistic regression analysis showed that AST, GGT, PTA, TG, liver function Child-Pugh classification, esophageal varices, and portal vein thrombosis were the main risk factors for early rebleeding after esophageal varices(within 6 weeks). ALB and abnormal portal vein shunt were the main protective factors affecting early rebleeding after esophageal varices(P<0.05). ConclusionAST, GGT, PTA, TG, Child-Pugh classification of liver function, degree of esophageal varices, and portal vein thrombosis are the main risk factors for early rebleeding after esophageal varices(within 6 weeks); ALB and abnormal portal vein shunt are affecting esophagus the main protective factor for early rebleeding after varicose veins.