组织胶联合聚桂醇急诊内镜下注射治疗食管胃底静脉曲张破裂后出血预后因素分析

发布时间：2019-03-05 17:16

【摘要】：目的探讨组织胶联合聚桂醇急诊内镜下注射治疗食管胃底静脉曲张破裂后出血预后因素。方法回顾性分析132例食管胃底静脉曲张出血患者,统计患者再出血率,按照是否出血分为观察组和对照组,统计分析再出血的影响因素。结果观察组[国际标准化比率(INR)1.5、门静脉右支直径(RVD)8.5 mm]患者的百分率、终末期肝病模型(MELD)评分、4因子的纤维化指数(FIB4)评分、凝血酶原时间(PT)及总胆红素(TB)高于对照组(χ~2=6.693和21.827,P=0.028和0.000;t=7.217、32.041、11.674和7.554,P=0.026、0.000、0.000、0.000和0.026),而血钠、血白蛋白低于对照组(t=16.043和15.271,均P=0.000)。Logistic回归分析显示,INR1.5、MELD评分、FIB4评分及PT为组织胶联合聚桂醇治疗后再出血的独立危险因素,而RVD8.5 mm、血钠、血白蛋白是预后保护因素。结论肝功能进一步恶化以及凝血功能障碍可能是导致组织胶联合聚桂醇治疗食管胃底静脉曲张(GOV)再出血预后的影响因素。
[Abstract]:Objective to investigate the prognostic factors of esophageal and gastric variceal bleeding treated by tissue glue combined with polycinnamol emergency endoscopic injection. Methods 132 patients with esophageal and gastric variceal bleeding were analyzed retrospectively. The rebleeding rate was counted and divided into observation group and control group according to the bleeding or not. The influencing factors of rebleeding were analyzed statistically. Results the percentage of patients in the observation group [international standardized ratio (INR) 1.5, right portal vein diameter (RVD) 8.5 mm], end-stage liver disease model (MELD) score, factor 4 fibrosis index (FIB4) score, Prothrombin time (PT) and total bilirubin (TB) were higher than those in control group (蠂 ~ 2, 6.693 and 21.827, P = 0.028 and 0.000, respectively). T = 7.217, 32.041, 11.674 and 7.554, P = 0.026,0.000,0.000,0.000 and 0.026), while serum sodium and albumin were lower than those in the control group (t = 16.043 and 15.271, P < 0.001). Logistic regression analysis showed that the INR1.5,MELD score was significantly lower than that of the control group (t = 16.043 and 15.271, P < 0.001). FIB4 score and PT were independent risk factors for rebleeding after histo-gel combined with polycinnamol therapy, while RVD8.5 mm, serum sodium and albumin were prognostic factors. Conclusion the further deterioration of liver function and coagulation dysfunction may be the factors leading to the prognosis of esophageal and gastric variceal (GOV) rebleeding treated with tissue glue and polycinnamol.
【作者单位】：河南省南阳市中心医院消化内科1病区;河南省南阳市中心医院普通外科肝脏病区;
【分类号】：R575.2

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