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目的探讨肝硬化食管胃静脉曲张出血(EGVB)的影响因素。方法对2003年2月至2007年11月我院68例肝硬化EGVB患者和118例肝硬化非出血患者进行回顾性分析,比较2组进食粗糙食物、既往上消化道出血史、凝血功能、血小板计数(BPC),肝功能Child-Pugh分级,B超检查门静脉内径(PVC)、脾静脉内径(SVD)、脾脏厚度(SPT)及其斜径,胃镜观察食管胃静脉曲张部位、形态、数目、直径及红色征,并进行gradeG分级,分析各相关因素对出血的影响。结果2组在进食粗糙食物、既往上消化道出血史、凝血酶原时间(PT)、凝血酶原活动度(PTA)、BPC、PVD、SVD、SPT及斜径、肝功能Child-Pugh分级及静脉曲线gradeG分级方面差异均有显著性(P<0.01,P<0.001),但2组在腹水发生率差异无显著性(P>0.05)。结论进食粗糙食物、既往上消化道出血史、凝血功能障碍、血小板降低、反映门静脉高压严重程度的多项指标及肝功能Child-PughC级静脉曲张gradeGⅢ级均是EGVB的影响因素,EGVB与腹水无明显关联。
Objective To investigate the influencing factors of esophageal and gastric variceal bleeding (EGVB) in cirrhosis. Methods From February 2003 to November 2007, 68 patients with cirrhosis EGVB and 118 patients with non-hemorrhagic liver cirrhosis were retrospectively analyzed. The incidence of gastrointestinal bleeding, coagulation, platelets (BPC), Child-Pugh classification of liver function, PVC diameter, SVD, SPT and diameter of BSP were observed. Gastroscopy was used to observe the location, shape and number of esophagogastric varices, Diameter and red signs, grade grading, analysis of the impact of various factors on bleeding. Results The incidence of gastrointestinal bleeding, prothrombin time (PT), prothrombin activity (PTA), BPC, PVD, SVD, SPT and oblique diameter, Child-Pugh classification of liver function, (P <0.01, P <0.001). However, the incidence of ascites in the two groups had no significant difference (P> 0.05). Conclusion The incidence of gastrointestinal bleeding history, coagulation dysfunction, thrombocytopenia, multiple indicators reflecting the severity of portal hypertension and liver function grade-G grade of Child-PughC varicose veins are all the influential factors of EGVB. EGVB is associated with ascites Clearly related.