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目的探讨晚期血吸虫病(晚血)食管静脉曲张套扎术(EVL)后早期出血的发病特点。方法回顾性研究本院收治的206例行EVL治疗的晚血患者,统计出现术后早期出血的例次数、好发时间、原因或诱因、基础疾病、预后等。结果共有17例行EVL患者发生早期出血,其中1例死亡,早期出血率为8.25%,死亡率为0.5%。出血均发生于术后第4~12天,其中发生于术后第7~9天的有13例(76%)。导致出血的直接原因为套扎环脱落后创面出血;诱因是饮食不当(10例,58.8%)和腹压增加(6例,35%),不明原因1例。出血均发生于首次EVL术后肝功能Child-Pugh C级患者。结论EVL术后早期出血发病率和死亡率均较低,好发时间为术后第7~9天,应注意饮食因素和护理,肝功能Child-Pugh C级患者是早期出血的重点高危人群。
Objective To investigate the incidence of early bleeding after advanced laparotomy (late blood) esophageal variceal ligation (EVL). Methods A retrospective study of 206 patients admitted to our hospital with EVL in patients with late-onset blood was performed. The number of cases with early postoperative bleeding, the timing of the onset, the causes or the causes, the underlying diseases and the prognosis were retrospectively analyzed. Results A total of 17 patients with EVL had early hemorrhage, of which 1 died, with an early bleeding rate of 8.25% and a mortality rate of 0.5%. Bleeding occurred in the first 4 to 12 days after surgery, which occurred in the first 7 to 9 days after surgery in 13 cases (76%). The direct cause of bleeding was the hemorrhage of the wound after the ligation of the collar. The causes of the bleeding were improper diet (10 cases, 58.8%) and increased abdominal pressure (6 cases, 35%), with unknown cause in 1 case. Hemorrhage occurred in Child-Pugh C-level liver function after the first EVL. Conclusions The incidence of early bleeding and mortality of EVL after operation are both low. The onset time is 7 days to 9 days after operation. Dietary factors and nursing should be noticed. Child-Pugh C-level liver function is the most important risk of early hemorrhage.