肝硬化合并上消化道出血的相关因素分析及预后评估

目的 探讨肝硬化合并上消化道出血的相关因素及预后评估。方法 对1990-01～2004-09 502例住院病人临床资料进行统计分析。结果 肝硬化合并上消化道出血以男性及中老年人多发，食道胃底静脉曲张破裂、门脉高压性胃病、消化性溃疡为主要病因，易合并失血性休克、肝性脑病、肝肾综合征等并发症，饮酒及及非甾体类药物为主要诱因，内科治疗有效率(2周)为89、84％，死亡率为10．16％，主要死亡原因为失血性休克、肝肾综合征、肝性脑病。结论 肝硬化合并上消化道出血与性别、年龄、季节等多因素相关，病因、肝功、合并症、年龄等因素影响预后。

Analysis of the Relative Factors and Prognosis of Upper Gastrointestinal Bleeding in Patients with Hepatic Cirrhosis

Objective To explore the relative factors and prognosis of upper gastrointestinal bleeding in patients with hepatic cirrhosis. Methods The clinical data of upper gastrointestinal bleeding of 502 inpatients from January 1990 to September 2004 were statistically analyzed. Results Males and middle-aged patients with hepatic cirrhosis occurred upper gastrointestinal bleeding more frequently, and the most commom causes were vessel rupture of esophage or gastric varices, portal hypertensive gastropathy, and peptic ulcer. The most common complications of upper gastrointestinal bleeding were severe bleeding shock, hepatic encephaopathy, hepatorenal syndrome,etc. Drinking wine and NSAIDs were the most common inducements of upper gastrointestinal bleeding. The efficient rate of medical management was 89.84%,the death rate was 10.16%, and the most common death causes were shock of severe bleeding, hepatic encephalopathy, and hepatorenal syndrome. Conclusion Sex,age, and season,etc. were related to upper gastrointestinal bleeding in patients with hepatic cirrhosis. Bleeding causes, liver function, complications, and age, etc. were factors affecting prognosis.