肝硬化并上消化道出血170例内镜诊治分析

目的:探讨肝硬化并上消化道出血的原因及内科治疗效果。方法:170例肝硬化上消化道出血患者行急诊胃镜,确定出血原因,并予内科治疗,观察治疗效果。结果:170例患者中食道或胃底静脉曲张破裂(EGVB)出血99例,门脉高压性胃病(PHG)出血41例,肝源性溃疡(HU)出血30例,出血率分别为58％,24.1％,17.6％。肝功能越差,静脉曲张越明显,以中重度为主,重度静脉曲张各组间差异显著(P<0.05)。肝功能越差,静脉曲张越明显,肝源性溃疡发生率越高,各组间有明显差并(P<0.05)。肝源性溃疡中Hp阳性率43.3％,说明HU的发生与Hp感染关系不大。治疗效果以非EGVB出血明显,达87.3％。结论:肝硬化上消化道出血的原因有EGVB、PHG、HU,以EGVB为主。内科治疗效果以非EGVB出血明显。

Endoscopic analysis of 170 cases upper gastrointestinal hemorrhage for liver cirrhosis.

Objective:To study the cause of upper gastrointestinal hemorrhage for liver cirrhosis and the effect of medical therapy. Methods: 170 cases upper gastrointestinal hemorrhage for liver cirrhosis had a emergency endoscopy exmination,determined the cause of bleeding,observed the effect of drug therapy. Results: In 170 cases, esophageal and gastric varices bleeding(EGVB)99 cases,portal hypertension gastric(PHG)41eases, hepatic ulcer 30 cases, bleeding rate was 58% ,24.1% , 17.6% . The more bad hepatic function, the more marked varices, servere degree varices had a marked variance (P< 0.05)between groups. With hepatic function change, hepatic ulcer occurrent rate had a marked variance(P<0.05) between groups. In drugs therapy,the effect of non esophageal and gastric varices was marked,the hemortatic rate was 87.3% Conclusions:The cause of upper gastrointestinal hemorrhage for liver cirrhosis has esophageal and gastric varices, portal hypertension gastric, hepatic ulcer. In drugs therapy, non esophageal and gastric varices bleeding has a marked effect.