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目的:探讨急性食管胃静脉出血预后的影响因素,找出治疗失败的主要原因。方法:回顾性分析2011年12月至2014年12月我院收治的80例急性食管胃静脉出血患者的临床资料,对预后相关因素进行Logistic回归分析,分析控制出血所用时间与死亡率的关系,评价止血方式与有效率、病死率的关系。结果:不同控制出血时间治疗失败患者的死亡率比较,差异具有统计学意义(P<0.05);入院时收缩压≤90 mm Hg、总胆红素升高、肝功能分级提升、腹水、门冬氨酸氨基转移酶升高、出血程度是预后的危险因素,内镜检查是预后的保护因素。结论:急性食管胃静脉出血患者控制出血时间≤2 h时,失败率最高,随着时间的推移,病死率逐渐增加,针对危险因素采取干预措施,可以降低病死率,提高预后效果。
Objective: To investigate the influencing factors of the prognosis of acute esophageal and gastric venous hemorrhage and find out the main reasons for the failure of treatment. Methods: The clinical data of 80 patients with acute esophageal and gastric venous hemorrhage admitted in our hospital from December 2011 to December 2014 were retrospectively analyzed. Logistic regression analysis was used to analyze the prognostic factors. The relationship between the time spent controlling bleeding and the mortality was analyzed. Evaluation of hemostasis and efficiency, mortality. Results: The mortality of patients with different control bleeding time was statistically significant (P <0.05). On admission, the systolic blood pressure was less than or equal to 90 mm Hg, the total bilirubin was increased, the liver function was graded, the ascites, aspartate Elevated aminotransferase, the degree of bleeding is a risk factor for prognosis, endoscopy is a prognostic factor. CONCLUSION: In patients with acute esophageal and gastric venous bleeding, the failure rate is the highest when the bleeding time is less than 2 h. With the passage of time, the case fatality rate gradually increases. Taking the intervention measures for risk factors can reduce the mortality rate and improve the prognosis.