肝炎肝硬化失代偿期患者首发食管胃底静脉出血或腹水的临床特征探讨

目的探讨肝炎肝硬化失代偿期患者首发食管胃底静脉曲张破裂出血或腹水临床特征。方法将90例肝炎肝硬化失代偿期患者随机分为出血组40例和腹水组50例。2组均予实验室检查,包括血液分析:血红蛋白、血小板总数;电解质:血钾、血钠;肝功能试验:白蛋白;血糖;肾功能:尿素氮、肌酐;凝血功能:凝血酶原时间(PT)、凝血酶原时间活动度(PTA)、部分凝血酶原时间(APTT)。腹部B型超声测量门、脾静脉宽度。结果出血组血红蛋白水平低于腹水组,血糖及钠离子水平高于腹水组,差异均有统计学意义(P<0.05)。2组血小板总数、血钾、白蛋白、血尿素氮、肌酐、PT、PTA、APTT和门、脾静脉宽度等方面差异无统计学意义(P>0.05)。结论肝炎肝硬化失代偿期患者首发食管胃底静脉曲张破裂出血者多见高血糖和低血红蛋白,首发腹水者更多见低血钠。

Clinical characteristic discuss of starting esophageal and gastric venous bleeding or ascites in patients with decompensated liver cirrhosis

Objective To discuss the clinical characteristic discuss of starting esophageal and gastric venous bleeding or ascites in patients with decompensated liver cirrhosis. Methods 90 cases patients with decompensated liver cirrhosis were randomly divided into bleeding group 40 cases and ascites group 50 cases. Both of 2 groups were given laboratory tests, inclu-ding blood analysis： hemoglobin, platelet total ; electrolytes： potassium, sodium; liver function tests： albumin; sugar; renal func-tion： blood urea nitrogen, creatinine; coagulation： prothrombin time （ PT）, prothrombin time activity （ PTA ）, partial thrombo-plastin time （AFIT）. Measured the width of portal vein, splenic vein by B-type ultrasound. Results The hemoglobin levels of bleeding group was lower than that of ascites groups, blood glucose and sodium level of bleeding group were higuer than those of ascites group, the differences were statistically significant （ P 〈 0.05 ）. Platelet total number, potassium, albumin, blood urea ni-trogen, creatinine, PT, PTA, AFIT and width of portal vein, splenic vein of 2 groups had no significant difference （ P 〉 0.05 ）. Conclusion Patients with decompensated, liver cirrhosis and esophageal variceal bleeding starters were more common high blood sugar and low hemoglobin, starting ascites more common hyponatremia.