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乙型肝炎肝硬化食管胃底静脉曲张破裂出血患者预后的影响因素分析
作者姓名:陈焯彬  廉承凯
作者单位:广西钦州市第一人民医院感染科,广西 钦州,535000;广西钦州市第一人民医院感染科,广西 钦州,535000
摘    要:目的研究乙型肝炎肝硬化食管胃底静脉曲张破裂出血患者预后影响因素。方法选取2015年1月至2018年1月于我院接受治疗的乙型肝炎肝硬化食管胃底静脉曲张破裂出血患者95例为研究对象,根据患者预后的不同分为预后良好组(n=77)和预后不良组(n=18),对影响患者预后的因素进行分析。结果单因素分析显示,两组患者的年龄、出血量、Child-Pugh分级、血红蛋白水平及24 h内再出血发生率比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示,患者的出血量及Child-Pugh分级是影响乙型肝炎肝硬化食管胃底静脉曲张破裂出血患者预后的独立危险因素(P<0.05)。结论出血量及Child-Pugh分级是导致乙型肝炎肝硬化食管胃底静脉曲张破裂出血患者预后不良的独立危险因素,因此,控制出血量及改善肝功能是降低患者死亡率的有效措施。

关 键 词:乙型肝炎肝硬化  食管胃底静脉曲张破裂出血  CHILD-PUGH分级  血红蛋白  出血量

Prognostic analysis of hepatitis B cirrhosis patients with esophageal varices bleeding
Authors:CHEN Zhuo-bin  LIAN Cheng-kai
Institution:(Infection Department, the First People's Hospital of Qinzhou, Qinzhou 535000, China)
Abstract:Objective To study the prognostic factors of hepatitis B cirrhosis patients with esophagogastric varices bleeding. Methods From January 2015 to January 2018, a total of 95 hepatitis B cirrhosis patients with esophagogastric varices bleeding who received treatment in our hospital were selected as reasearch objects. According to the different prognosis, the patients were divided into good prognosis group (n=77) and poor prognosis group (n=18). The factors affecting the prognosis of the patients were analyzed. Results Univariate analysis result showed that the age, bleeding volume, Child-Pugh classification, hemoglobin level and 24-hour rebleeding rate in the two groups were significantly different (P<0.05). Multivariate Logistic regression analysis result showed that bleeding volume and Child-Pugh classification were independent risk factors for prognosis in hepatitis B cirrhosis patients with esophagogastric variceal bleeding(P<0.05). Conclusion The amount of bleeding and Child-Pugh classification are independent risk factors for poor prognosis in patients with hepatitis B cirrhosis and esophageal varices bleeding. Therefore, controlling bleeding volume and improving liver function are effective measures to reduce mortality.
Keywords:hepatitis B cirrhosis  esophageal varices bleeding  Child-Pugh classification  hemoglobin  bleeding volume
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