肝硬化患者死亡相关危险因素分析

发布时间：2018-06-08 00:19

本文选题：肝硬化 + 并发症　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的研究影响肝硬化患者住院期间死亡的相关危险因素。方法收集2001年12月到2015年4月宁夏医科大学总医院收住入院的肝硬化患者共7287例,将好转出院的6981例定义为存活组,院内死亡的306例定义为死亡组。收集两组患者的病例资料:一般资料、常见并发症、是否出现肝衰竭及合并疾病。两组间单因素分析采用卡方检验;将有统计学意义的指标纳入多因素Logistic回归模型分析肝硬化患者住院期间死亡的相关危险因素;P0.05为差异有统计学意义。结果1、一般资料死亡组中,男性239例(78.10%),女性67例(21.90%);汉族262例(85.62%),回族36例(11.76%),蒙古族6例(1.96%),满族2例(0.65%);最小年龄0.42岁(5个月),最大年龄88岁,平均年龄为(54.57±13.23)岁;其中51.63%为46岁~65岁的中年患者。2、并发症死亡组中各并发症的发生率均高于存活组,两组间比较有统计学差异(P0.05)。死亡组中前三位的并发症依次为上消化道出血61.76%、感染57.52%、肝性脑病37.91%。3、肝衰竭死亡组中出现肝衰竭的患者占15.03%,高于存活组1.83%,两组间比较有统计学差异(P0.05)。4、合并疾病死亡组患者合并心脏病、高血压病、脑血管病及糖尿病的比例高于存活组,两组间比较有统计学差异(P0.05)。死亡组中前三位的合并疾病依次为糖尿病16.67%,高血压病9.15%,心脏病5.56%。5、多因素分析将单因素分析中有统计学意义的指标进行多因素Logistic回归,结果表示年龄(OR=1.020)、上消化道出血(OR=6.734)、感染(OR=2.462)、肝性脑病(OR=3.316)、肝肾综合征(OR=2.672)、原发性肝癌(OR=1.754)、电解质平衡紊乱(OR=1.886)、肝衰竭(OR=2.485)及心脏病(OR=2.258)为肝硬化患者住院期间死亡的相关危险因素。结论1、本研究肝硬化死亡组患者多为中年,男性多于女性。2、本研究肝硬化死亡组患者发生率前三位的并发症是上消化道出血、感染、肝性脑病。3、年龄、多数并发症(上消化道出血、感染等)、出现肝衰竭及合并心脏病为肝硬化患者住院期间死亡的相关危险因素。
[Abstract]:Objective to study the risk factors of death in patients with liver cirrhosis during hospitalization. Methods A total of 7287 patients with liver cirrhosis admitted to the General Hospital of Ningxia Medical University from December 2001 to April 2015 were collected. 6981 patients who recovered and discharged from hospital were defined as survival group and 306 patients who died in hospital were defined as death group. Collect the case data of the two groups: general data, common complications, liver failure and associated diseases. Univariate analysis between the two groups using chi-square test; the statistical significance of the indicators into the multivariate logistic regression model to analyze the risk factors related to death in patients with liver cirrhosis during hospitalization P0.05 for the difference was statistically significant. Results 1 in the general data death group, 239 males (78.10m) and 67 females (21.90), 262 Han (85.62), 36 Hui (11.76), 6 Mongolian (1.96), 2 Manchu (0.65), 0.42 (5 months, 88 years old, mean 54.57 卤13.23) years of age; 51.63% of them were middle aged patients aged 46 to 65 years old. The incidence of complications in the death group was higher than that in the survival group, and there was significant difference between the two groups (P 0.05). The first three complications in the death group were upper gastrointestinal hemorrhage 61.76g, infection 57.52, hepatic encephalopathy 37.91.3The proportion of patients with liver failure in the death group was 15.03, higher than that in the survival group 1.833.There was a statistical difference between the two groups (P0.05.4). Group B patients with heart disease, The proportion of hypertension, cerebrovascular disease and diabetes mellitus was higher than that of survival group, and there was significant difference between the two groups (P 0.05). In the death group, the first three diseases were diabetes 16.67, hypertension 9.15, heart disease 5.56, multivariate analysis and multivariate logistic regression. The results showed that the related risk factors of death in patients with liver cirrhosis were the age of OR1. 020, the upper gastrointestinal hemorrhage of 6. 734, the infection of OR2. 462, the hepatic encephalopathy 3. 316, the hepatorenal syndrome of 2. 672, the primary liver cancer of 1. 754, the electrolyte imbalance of OR1. 886, the liver failure OR2. 485) and the heart disease OR2. 258). Conclusion 1, the mortality group of cirrhosis in this study is mostly middle-aged, male is more than female. The first three complications in the death group of liver cirrhosis are upper gastrointestinal hemorrhage, infection, hepatic encephalopathy and age. Most complications (upper gastrointestinal bleeding, infection, etc.), liver failure and heart disease were risk factors for death in patients with liver cirrhosis.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R575.2

【相似文献】