首次择期食管静脉曲张硬化剂治疗后胸腔积液危险因素分析
发布时间：2018-08-28 15:03
【摘要】：目的:探讨首次择期食管静脉曲张硬化剂治疗后胸腔积液的危险因素。方法:回顾性分析2013年12月至2016年12月在广西医科大学一附院首次接受择期食管静脉曲张硬化剂治疗的肝硬化患者的临床资料,收集可能与首次择期食管静脉曲张硬化剂治疗后胸腔积液的危险因素,按术后有无胸腔积液进行分组,进行危险因素分析,寻找首次择期硬化剂治疗后胸腔积液的独立危险因素。结果:收集首次行食管静脉曲张硬化剂治疗患者119例,排除46例(14例急诊手术,14例合并肺部感染,4例合并术前胸腔积液,2例并发术后近期出血,2例合并心功能不全,2例为原发性肝癌,2例同时行套扎术,6例资料不全),纳入分析73例病例,男性65例,女性8例,平均年龄52.35岁。其中硬化剂后无胸腔积液者52例,出现胸腔积液21例(28.76%),术后出现胸腔积液患者治疗有效20例,死亡1例。两组进行单因素分析提示曲张静脉直径(χ~2=10.77,P=0.008),肝功能Child-Pugh分级(χ~2=7.70,P=0.019)、腹水量(χ~2=13.07,P=0.001)、血清白蛋白[P=0.000,95%CI(-9.30~-4.28)]、凝血酶原时间[P=0.038,95%CI(0.08~2.98)]、血白细胞计数[P=0.005,95%CI(1.26~6.22)]、硬化剂剂量[P=0.013,95%CI(1.21~9.73)]为首次择期食管静脉曲张硬化剂治疗后胸腔积液的危险因素。logistic回归分析结果显示腹水量[B=1.551,OR=5.61,95%CI(1.30~24.13),P=0.031]、血清白蛋白[B=-0.230,OR=0.69,95%CI(0.54~0.87),P=0.011],术后白细胞计数[B=1.877,OR=1.333,95%CI(1.01~1.76),P=0.044]是首次择期食管静脉曲张硬化剂治疗后胸腔积液的独立危险因素。结论:1、首次择期食管静脉曲张EIS后胸腔积液发生率为28.8%;2、曲张静脉直径、肝功能分级、凝血酶原时间、硬化剂剂量与首次择期食管静脉曲张EIS后胸腔积液的有关;3、腹水量、术后血白细胞计数与首次择期食管静脉曲张EIS后胸腔积液发生率呈正相关,而血清白蛋白与首次择期食管静脉曲张EIS后胸腔积液的发生率成负相关。
[Abstract]:Objective: to investigate the risk factors of pleural effusion after the first selective treatment of esophageal varices with sclerosing agent. Methods: the clinical data of cirrhotic patients who were treated with selective esophageal variceal sclerosing agent for the first time from December 2013 to December 2016 in the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed. To collect the risk factors of pleural effusion after the first selective esophageal variceal sclerotherapy, and to analyze the risk factors according to whether there is pleural effusion after operation. To find out the independent risk factors of pleural effusion after the first selective sclerotherapy. Results: 119 patients were treated with esophageal varices sclerosing agent for the first time. 46 cases were excluded (14 cases of emergency operation, 14 cases of pulmonary infection, 4 cases of preoperative pleural effusion, 2 cases of postoperative hemorrhage, 2 cases of cardiac insufficiency, 2 cases of primary hepatocellular carcinoma, 2 cases of primary liver cancer, 2 cases of primary hepatic carcinoma and 6 cases of incomplete data). 73 cases were analyzed, There were 65 males and 8 females with an average age of 52.35 years. There were 52 cases without pleural effusion after sclerosing agent, 21 cases (28.76%) with pleural effusion, 20 cases with postoperative pleural effusion and 1 case died. 涓ょ粍杩涜鍗曞洜绱犲垎鏋愭彁绀烘洸寮犻潤鑴夌洿寰，
本文编号：2209736
[Abstract]:Objective: to investigate the risk factors of pleural effusion after the first selective treatment of esophageal varices with sclerosing agent. Methods: the clinical data of cirrhotic patients who were treated with selective esophageal variceal sclerosing agent for the first time from December 2013 to December 2016 in the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed. To collect the risk factors of pleural effusion after the first selective esophageal variceal sclerotherapy, and to analyze the risk factors according to whether there is pleural effusion after operation. To find out the independent risk factors of pleural effusion after the first selective sclerotherapy. Results: 119 patients were treated with esophageal varices sclerosing agent for the first time. 46 cases were excluded (14 cases of emergency operation, 14 cases of pulmonary infection, 4 cases of preoperative pleural effusion, 2 cases of postoperative hemorrhage, 2 cases of cardiac insufficiency, 2 cases of primary hepatocellular carcinoma, 2 cases of primary liver cancer, 2 cases of primary hepatic carcinoma and 6 cases of incomplete data). 73 cases were analyzed, There were 65 males and 8 females with an average age of 52.35 years. There were 52 cases without pleural effusion after sclerosing agent, 21 cases (28.76%) with pleural effusion, 20 cases with postoperative pleural effusion and 1 case died. 涓ょ粍杩涜鍗曞洜绱犲垎鏋愭彁绀烘洸寮犻潤鑴夌洿寰，
本文编号：2209736
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