肝硬化非静脉曲张破裂出血的内科诊治(附97例报告分析)

目的研究肝硬化非静脉曲张破裂出血的内科诊治特点.方法对该院收治的经急诊胃镜确诊的97例肝硬化非静脉曲张破裂出血患者的临床资料进行统计分析.结果非静脉曲张破裂出血占全部肝硬化上消化道出血的33%,以消化性溃疡和门脉高压性胃病并出血为主要原因,占79%.出血量以中等量出血为多,占47%.出血量的多少和肝功能Child-Pagh分级有关,其中C级患者比例明显大于A和B级患者.内科综合治疗的止血率为87%.结论非静脉曲张破裂出血在肝硬化上消化道出血中占有相当比例;急诊胃镜检查对明确出血病因有重要意义;内科保守治疗有较好的止血效果.

Medical diagnosis and treatment of non-variceal rupture bleeding in liver cirrhosis

Objective: To study the medical diagnosis and treatment of non_variceal rupture bleeding in liver cirrhosis. Methods: 97 cases of non-variceal rupture bleeding for confirm diagnosis by emergency gastroscopy were analysed. Result: Non-variceal rupture bleeding took 33% of hemorrhage of upper digestive tract in liver cirrhosis. The main bleeding reasons were peptic ulcer or portal hypertensive gastropathy complicated hemorrhage (79%). Medium dose heorrhage was common (47%), and the hemorrhage amount was related to hepatic function. According to Child-Path grading, C-level patients had a higher propertion than A-B-levels. The hemostatic rate of medical combined treatmemt was 87%. Conclusion: Non-variceal rupture bleeding takes considerable proportion in hemorrhage of upper digestive tract in liver cirrhosis. Emergency gastroscopy has important role to determine the etiological diagnosis. Medial treatment has better hemostatic effects.