110例肝硬化病人转归分析

目的：为了了解肝硬化转归的相关因素，我们将五年来在我院住院诊治的110名肝硬化患者的情况进行回顾性的分析总结。方法：回顾性肝硬化病人的初诊年龄；复诊次数；肝硬化病因；肝功能损害的程度(child分级)；并发症发生的情况；以及病人死亡的情况及原因，将数据进行统计学处理并进行分析。结果：1．110例患者平均年龄58．8岁。男女性两组的年龄差别无显著性(P＞0．05)。2．肝硬化的主要病因为病毒性肝炎。3．第一次就诊时肝功能损害程度：①Child C级58.0％；②Child B级，38．2％；③Child A级3．6％。其中出院者中，BiL异常41．3％；死亡者中，BiL异常76．7％，两者差异较显著(P＜0．01)。4．病人转归情况：110例患者中，1次或多次住院后好转出院的患者为69．1％(76/110)；1次或多次住院后，死亡的患者为27．3％(30/110)。5．并发症及其转归：①消化道出血37．3％(37／110人)；②感染30．9%（30/110人)，其中颅内感染5例；③肝性脑病18．3％(30／110人)；④原发性肝癌15．5％(17／110)；⑤肝肾综合征12．7％(14／110)；⑥其它合并症11．8％(13／110)。其中好转出院的病人中有并发症的占51．3％(41／80；死亡患者中存在有并发症的占93.3％(38／30）。两者比较有显著的差异(P＜0．01)。6．死亡原因：1)肝性脑病40％(12／视)；2)消化道出血26．7％(8/30)；3)肝肾综合征10％(3／30)；4)其他23．3％(7／30）。7．存活时间：死亡者平均存活时间为4．7年；好转出院者乎均存活时间8．3年。结论：与肝硬化的转归相关因素有：①首诊的肝功能损害程度，特别是血清胆红素的水平有关，肝功能损害重，胆红素水平高，预后差。②有严重并发症存在预后差。存活时间明显缩短。②对慢性肝病患者在早期进行干预和健废教育指导，对延长患者生命，提高生活质量应该是十分有意义的。

An Analysis of the Prognosis in 110 Livercirrhotic Patients

Objective: To study the related factors of prognosis of livercirrhotic patients. Methods: The records of 110 in - patients with cirrhosis were reviewed. The age of the first time to visit doctor, the caution of cirrhosis, the degree of the liver function injury, the complications, the death and its causes and survival time were recorded. Results: The main cause of cirrhosis is virus hepatitis . The mean age of the first time to visit a doctor was 58.8 years old. Eighty (72.7 %) patients got improve and discharged, while the remaining 30 (27.3%) patients died. The abnormal bilirubin level was seen in 76.7% (23/30) patients who died and 41.3% (33/80) patients who discharged (P < 0.01).Liverfunction was Child C,B and A grade in 58% , 38.2% and 3.6% patients respectively. The complications included gastrointestinal bleeding (37.3%,37/110), hepatic encephalopathy (18.3%,20/110),primary carcinoma of liver( 15.5% , 17/110) and hepatorenal syndrome (12.7% , 14/110) .The incidence rate of complications in dead patient group (93.3%,28/30) was significantly higher than the discharge patient group (51.3%, 41/80) (P<0.01) .The death causes were hepatic encephalopathy (40% , 12/30) .gastrointestinal bleeding (26.7% , 8/30) and hepatorenal syndrome (10% , 3/30). Up to present, the average survival time for those dead patients was 4.7 years and for those discharged patients were 8.3years. Conclusion: The degree of liver function injury and serious complications directly influence prognosis of cirrhotic patients. The correct interference earlier and correct prevent instruction for the patients of cirrhosis should be important.