肝硬化消化道出血病因学分析

目的 总结肝硬化患者消化道出血的临床特征,分析其出血病因,为诊疗工作提供依据.方法 回顾性分析海南省人民医院2008～2011年肝硬化并消化道出血住院患者157例临床资料,并进行分析总结.结果 157例平均发病年龄为56.25岁,男性136例,占86.62％,冬春季高发.上消化道出血主要病因为食管胃底静脉曲张破裂,占57.96％、消化性溃疡,占17.83％、门脉高压性胃病,占14.65％,病死率分别为25.27％、14.29％、34.78％,差异无统计学意义(x2=0.84,P＞0.05)；下消化道主要为门脉高压性结肠病,占5.10％,病死率为12.5％.Child A、B、C级患者的病死率分别为9.59％、25.49％、51.52％,差异有统计学意义(x2=5.61,P＜0.05). 结论 非静脉曲张性出血在肝硬化患者中多见,肝功能Child C级患者的病死率明显增高.

Analysis of etiology in gastrointestinal bleeding due to liver cirrhosis.

Objective To investigate etiology in gastrointestinal bleeding due to liver cirrhosis so as to provide references for the clinical diagnosis and treatment. Methods Clinical data of 157 liver cirrhotic patients with gastrointestinal bleeding who received treatment in Hainan Provincial People＇s Hospital between 2008 and 2011 were reviewed retrospectively,the blecding causes were investigated. Results The mean age of patients was 56.25 years old with a male predominance （86.62%）. It often happened in winter and spring. Esophagogastric variceal （57.96%）was the leading cause for upper gastrointestinal bleeding,next were peptic ulcer （17.83%）and portal hypertensive gastropathy （14.65%）. The fatalities were 25.27%, 14.29% and 34.78% respectively, and the differences were not significant （P〉0.05）. Portal hypertensive colonopathy（5.10% ）was the leading cause for lower gastrointestinal bleeding, and the fatality was 12.5%. The fatahties of Child A, B and C groups were 51.52%, 25.49% and 9.59% respectively, and the differences were significant （P〈0.05）. Conclusion Nonvariceal gastrointestinal bleeding was frequent in liver cirrhotic patients. The fatality was significantly high in Child C group patients.