肝硬化门静脉高压症食管胃底曲张静脉破裂出血医院内死亡原因分析

摘要：目的:探讨肝硬化门静脉高压症食管胃底曲张静脉破裂出血患者住院期间的死亡原因。方法:对近 3年收治的186例患者及在住院期内死亡的24例患者的临床资料进行回顾性分析。结果:186中择期手术130例，3例（2.31 %）因术后肝衰竭或其他并发症死亡；急诊手术28例，术后因肝衰竭或其他并发症死亡5例（17.86 %）；未行手术治疗28例，16例死亡，其中12例死于出血无法控制。结论:大出血非手术治疗无法控制而又未及时手术是导致肝硬化门静脉高压症食管胃底曲张静脉破裂出血患者最重要的医院内死亡原因，对此类患者及时采取急诊手术对降低门静脉高压症大出血患者的病死率具有重要意义。

Analysis of the causes of in-hospital death from variceal bleeding in cirrhotic patients with portal hypertension

Abstract:Objective:To analyze the cause of in-hospital death from variceal bleeding in cirrhotic patients with portal hypertension.Methods :The clinical data of variceal bleeding in cirrhotic patients with portal hypertension admitted in recent three years to our hospital were analyzed retrospectively.Results:Among the186 cases of variceal bleeding, 130 patients received elective operation, and 3 of them（2.31 %） died from hepatic failure or other complications; 28 patients received salvage surgery and 5 of them（17.86 %）died from hepatic failure or the other complications; 28 patients had nonoperative treatment, and 16 died, of which 12 patients died from uncontrolled bleeding.Conclusions:Massive bleeding uncontrolled by nonoperative treatment and failure to perform prompt operation are the chief reasons for inhospital death in portal hypertensive patients with ruptured bleeding gastroesophageal varices. Prompt emergency surgery is of vital importance in decreasing mortality from massive bleeding in these portal hypertension patients.