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目的 研究肝硬化食管静脉曲张出血 (CEVB)硬化治疗的各种因素对预后生存的影响 ,并进行定量分析 ,建立生存模型 ,估计生存率。方法 对我院 1 987年 4月至 2 0 0 0年 6月间 670例CEVB硬化治疗患者的 2 9项预后因子及生存期的随访资料采用Kaplan Meier法进行生存率的估计 ,以Cox比例风险模型进行危险因素分析。结果 Cox模型分析结果为肝功能Child分级与曲张静脉转归是 2个显著影响预后生存的因素。 1、3、5年生存率分别是 93 2 9%、85 2 4 %、74 2 7%。肝功能Child分级为A、B、C级者 ,1年生存率分别是 98 88%、95 97%、82 32 % ,5年生存率分别是 91 42 %、78 35 %、49 48% ,其生存曲线有明显差异。食管曲张静脉转归分为消失、基本消失、Ⅰ度、Ⅱ度、Ⅲ度 ,其 1年生存率分别是 96 0 8%、93 94%、85 84%、85 0 0 %、53 85 % ,5年生存率分别是 81 45 %、67 76 %、72 89%、61 59%、35 90 % ,生存曲线有明显差异 ,其Cox模型单因素和多因素分析P值分别为 0 0 0 0和 0 0 2 0。但 5条曲线在 50个月时有聚合趋势 ,可能说明硬化治疗静脉曲张改善保持时间约为 4年。肝功能ChildC级时静脉曲张转归为消失和基本消失者 ,其 1年生存率均为 88 2 4 % ,2年生存率为77 98%～ 83 63 % ,仍高于总体肝功能ChildC级时?
Objective To study the influence of various factors on the prognosis of cirrhosis esophageal variceal bleeding (CEVB) sclerosis and to conduct quantitative analysis to establish a survival model to estimate the survival rate. Methods The follow-up data of 29 prognostic factors and survival of 670 patients with CEVB sclerotherapy from April 1987 to June 2004 in our hospital were estimated by Kaplan Meier method. The Cox proportional hazards Model for risk factor analysis. Results Cox model analysis results for liver function Child classification and varicose veins are two factors that significantly affect the prognosis of survival. The 1-, 3- and 5-year survival rates were 93.29%, 85.24% and 74.27% respectively. Liver function Child grade A, B, C grade, 1-year survival rates were 98 88%, 95 97%, 82 32%, 5-year survival rates were 91 42%, 78 35%, 49 48% There are significant differences in survival curves. Esophageal varices were divided into disappeared, disappeared, Ⅰ degree, Ⅱ degree, Ⅲ degree, the 1-year survival rate was 96 0 8%, 93 94%, 85 84%, 85 0 0%, 53 85% The 5-year survival rates were 81 45%, 67 76%, 72 89%, 61 59%, 35 90%, respectively. The survival curves were significantly different. The P values of univariate and multivariate analysis of Cox model were 0 0 0 0 and 0 0 2 0. However, the trend of the five curves converging at 50 months may indicate that cirrhosis treatment varicose veins improve retention time of about 4 years. Liver function ChildC grade varicose veins disappear and disappeared, the 1-year survival rates were 88 2 4%, 2-year survival rate was 77 98% to 83 63%, still higher than the overall liver function ChildC level ?