肝硬化门静脉高压症致EGVB经内镜下止血术后早期再出血的危险因素分析

目的探讨影响肝硬化门静脉高压症导致的食管胃底静脉曲张破裂出血经内镜下止血术后早期再出血的危险因素。方法选取肝硬化门静脉高压症食管胃底静脉曲张破裂出血并行内镜下止血术的患者452例,根据内镜下止血术后是否再出血分为出血组和未出血组,分析患者一般资料和各指标与再出血的关系,对术后早期再出血的危险因素行单因素及多因素Logistic回归分析。结果两组患者的血肌酐、凝血酶原时间、白蛋白、CTP评分、镜下表现的差异有统计学意义(P0.05),单因素Logistic回归分析显示血肌酐、凝血酶原时间、白蛋白、CTP评分、镜下出血与术后再出血存在相关性,进一步多因素Logistic回归分析提示凝血酶原时间(OR=3.743,P=0.002)、CTP评分(OR=2.716,P=0.015)、镜下出血(OR=1.863,P=0.009)为再出血的独立危险因素,白蛋白(OR=0.692,P=0.001)为再出血的保护因素。结论凝血酶原时间延长、CTP评分高、镜下出血为影响食管胃底静脉曲张破裂出血患者术后再出血的独立危险因素,白蛋白高为术后再出血的保护因素。

Risk factors analysis on early post-operative recurrent bleeding after esophageal gastric varices bleeding caused by hepatocirrhosis portal hypertension undergoing therapy of endoscopic hemostasis

Objective To study the risk factors on early post-operative recurrent bleeding after esophageal gastric varices bleeding (EGVB) caused by hepatocirrhosis portal hypertension undergoing therapy of endoscopic hemostasis.Method Choose 452 patients with EGVB caused by hepatocirrhosis portal hypertension undergoing therapy of endoscopic hemostasis and divide them into bleeding group and non-bleeding group.Analyze relationship between general information, each index and recurrent bleeding.Make single and multiple factor Logistic regression analysis on risk factors of early post-operative recurrent bleeding.Result There is significant difference on serum creatinine, prothrombin time, albumin, CTP score and microscopic manifestations between two groups (P<0.05).Single factor Logistic regression analysis shows that there is correlation between serum creatinine, prothrombin time, albumin, CTP score, microscopic manifestations and post-operative recurrent bleeding.Further multiple factor Logistic regression analysis indicates that prothrombin time (OR=3.743, P=0.002), CTP score (OR=2.716, P=0.015) and bleeding under microscope (OR=1.863, P=0.009) are independent risk factors of recurrent bleeding.Albumin (OR=0.692, P=0.001) is the protective factor of recurrent bleeding.Conclusion Prolonged prothrombin time, high CTP score and bleeding under microscope are independent risk factors of post-operative recurrent bleeding for EGVB patients.Albumin is the protective factor of recurrent bleeding.