随访顺应性对急诊内镜套扎治疗肝硬化食管静脉曲张出血老年患者预后的影响

发布时间：2018-06-09 22:30

本文选题：食管和胃静脉曲张 + 随访研究　；参考：《重庆医学》2015年12期

【摘要】：目的探讨肝硬化食管静脉曲张患者内镜套扎治疗后的顺应性对其治疗预后的影响。方法随访512例肝硬化食管静脉曲张并行内镜套扎治疗的患者,按是否具有随访治疗顺应性分成顺应组和对照组,比较两组患者的再出血、再住院、死亡等随访指标,根据肝功能Child-Pugh分级比较两组间的指标差异。结果随访顺应性的差异主要由患者文化水平、收入情况及当地医疗条件决定。顺应组的病死率和再出血率均显著低于对照组。Child-Pugh A级中的顺应组与对照组的肝癌发现率(9.3%vs.1.67%)、肝移植率(10.2%vs.2.50%)、行脾切除和门奇静脉断流术(15.5%vs.3.4%)比较,差异有统计学意义(P0.05);Child-Pugh B级患者中顺应组与对照组的再出血率(28.0%vs.53.5%)、死亡率(5.3%vs.9.8%)、腹水发生率(72.0%vs.49.2%)、生活质量(64.0%vs.33.8%)及肝功能(77.3%vs.33.8%)比较,差异有统计学意义(P0.05);Child-Pugh C级患者两组各指标比较,均差异无统计学意义(P0.05)。结论提高肝硬化食管静脉曲张内镜治疗的随访治疗顺应性可以减少肝硬化食管静脉曲张老年患者的再出血率和病死率,对肝癌的发现、肝移植的早期干预均有意义。
[Abstract]:Objective to investigate the effect of compliance after endoscopic ligation on the prognosis of patients with esophageal varices due to cirrhosis. Methods 512 patients with esophageal varices of liver cirrhosis treated by endoscopic ligation were divided into compliance group and control group according to whether they had the compliance of follow-up treatment. The follow-up indexes such as rebleeding, rehospitalization and death were compared between the two groups. The indexes of the two groups were compared according to Child-Pugh grade of liver function. Results the difference of follow-up compliance was mainly determined by the patients' education level, income and local medical conditions. The mortality and rebleeding rate in compliance group were significantly lower than those in control group. Child-Pugh A grade compliance group and control group. The detection rate of liver cancer was 9.3vs.1.67. liver transplantation rate was 10.2vs.2.50. splenectomy and portal azygous vein devascularization were performed and compared with those in control group (15.5vs.3.4). There were significant differences in the rate of rebleeding between the compliance group and the control group (28.0vs.53.5g), the mortality rate was 5.3vs.9.8g, the incidence of ascites was 72.0vs.49.2cm, the quality of life was 64.0vs.33.8) and the liver function was 77.3vs.33.8. there were significant differences between the two groups. There was no significant difference between the two groups (P 0.05). Conclusion improving the compliance of endoscopic treatment of cirrhosis esophageal varices can reduce the rate of rebleeding and mortality of elderly patients with hepatic cirrhosis and esophageal varices. It is significant for the discovery of liver cancer and the early intervention of liver transplantation.
【作者单位】：江西省萍乡市湘雅萍矿合作医院消化科;
【分类号】：R575.2

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