肝硬化食管静脉曲张套扎术后早期再出血危险因素分析

目的探讨肝硬化食管静脉曲张套扎术（EVL）后早期再出血的危险因素。方法选择我院收治的肝硬化食管静脉曲张破裂出血采用EVL治疗的患者80例,将其中发生再出血的20例设为观察组,未出血的60例设为对照组,比较分析两组临床资料,探讨术后早期再出血危险因素。结果 80例患者中,早期再出血发生率为25%,其中3例死亡,均由进食不当引起,对死亡患者行内镜检查,食管曲张静脉破裂为引起早期再出血的原因。门静脉血栓、肝功能Child-Pugh分级、血红蛋白、凝血酶原时间经Logistic回归分析,均为独立危险因素（P〈0.01）。术后早期再出血者肝功能分级C级影响较为明显（OR=65.0）,其他依次为凝血酶原时间（OR=33.5）、血红蛋白（OR=22.6）、门静脉血栓（OR=8.6）。结论依据患者的机体状况和再出血危险因素,将EVL与非选择性β受体阻断剂联合应用,可降低再出血和并发症发生率,延长患者生命,值得临床推广应用。

Early postoperative rebleeding risk factors of cirrhosis esophageal variceal ligation

Objective To explore early postoperative rebleeding risk factors of cirrhosis esophageal variceal ligation （EVL）. Methods Eighty patients treated with EVL were divided into observation group （20 patients with postoperative rehleeding） and con- trol group （60 patients without postoperative rebleeding）. Clinical data of both groups were compared and analyzed so as to explore ear- ly postoperative rebleeding risk factors. Results Early rebleeding incidence of 80 patients was 25% ,in which 3 patients died from im- proper diet. Esophageal varix rupture was the cause of early rebleeding. Portal vein thrombosis,liver function grade of Child-Pugh, he- moglobin,prothromhin time which were analyzed by Logistic retrospective analysis were independent risk factors （ P 〈0.01 ）. Among the grades of early postoperative bleeding in liver function, grade C （ OR = 65. 0） had obvious influence, the others were prothrombin time （ OR = 33.5 ）, hemoglobin （ OR = 22.6） and portal hypertension（ OR = 8.6）. Conclusion According to the patient＇ s organism and rebleeding risk factors,EVL combined with non selective 13-receptor blocker which has reduced rebleeding and complication rate can prolong the life of patients.