食管胃底静脉曲张破裂出血死亡相关危险因素分析

发布时间：2018-04-11 13:43

本文选题：食管胃底静脉曲张破裂出血 + 死亡　；参考：《浙江大学》2014年硕士论文

【摘要】：目的：探讨食管胃底静脉曲张破裂出血(EGVB)患者的死亡相关危险因素。方法：回顾性分析2013年3月～2014年2月因EGVB收住浙江大学附属第一医院的281例患者的临床和实验室资料,通过统计分析方法寻找死亡相关危险因素。结果：EGVB患者死亡率为18.5%,食管胃底静脉曲张破裂出血量,本次治疗方式,白细胞,血红蛋白,白蛋白,谷丙转氨酶,谷草转氨酶,凝血酶原时间,总胆红素,国际标准化比值,肌酐,Child-Pugh分级,肝性脑病,腹水,门脉高压性胃病等15项临床和实验室资料在死亡组和存活组之间有显著性差异(P0.05),出血量、白蛋白和肝性脑病为EGVB死亡的独立危险因素。结论：临床上应加强相关指标的监测,在止血的基础上采取及时补充血容量,维持肝硬化患者血清白蛋白水平,纠正肝性脑病,维护肝功能等个体化治疗方案以提高治疗效果,降低死亡率,并在适当之时予以内镜、手术等二级预防。
[Abstract]:Objective: to investigate the risk factors of death in patients with esophageal variceal variceal bleeding (EGVB).Results the mortality rate of patients with 10% EGVB was 18.5. The bleeding volume of esophageal varices, leukocyte, hemoglobin, albumin, alanine aminotransferase, alanine aminotransferase, prothrombin time, total bilirubin, international standardized ratio,There were significant differences in 15 clinical and laboratory data of creatinine Child-Pugh grade, hepatic encephalopathy, ascites, portal hypertensive gastropathy between death group and survival group (P 0.05). Blood loss, albumin and hepatic encephalopathy were independent risk factors of EGVB death.Conclusion: it is necessary to strengthen the monitoring of related indexes in clinic, to take timely supplement of blood volume on the basis of hemostasis, to maintain the level of serum albumin in patients with liver cirrhosis, to correct hepatic encephalopathy, to maintain liver function and so on, in order to improve the therapeutic effect.Reduce mortality and, where appropriate, give secondary prevention such as endoscopy, surgery and so on.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575.2

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