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目的探讨肝硬化合并上消化道出血患者的临床特点和诊治方法。方法回顾性分析73例肝硬化合并上消化道出血患者的出血原因、诱因和治疗方法。结果50例为食道胃底静脉曲张破裂出血(68.5%),13例为门脉高压性胃病出血(17.8%),10例为消化性溃疡出血(13.7%)。出血诱因包括饮酒17例(23.3%),药物(非甾体类为主)20例(27.4%),过度劳累14例(19.2%),精神刺激14例(19.2%),原因不明8例(10.9%)。出血与肝功分级、并发症有相关性(P<0.01),与病因无相关性。经综合治疗,2周内无活动性出血65例,总有效率为89.0%。结论对于肝硬化合并上消化道出血患者应掌握临床特点、及早查明出血原因并进行相应治疗。
Objective To investigate the clinical features, diagnosis and treatment of patients with cirrhosis and upper gastrointestinal bleeding. Methods Retrospective analysis of 73 cases of cirrhosis with upper gastrointestinal bleeding in patients with causes, incentives and treatment. Results Fifty patients had esophageal variceal bleeding (68.5%), thirteen patients with portal hypertensive gastropathy (17.8%) and ten patients with peptic ulcer bleeding (13.7%). The predisposing factors included alcohol consumption in 17 cases (23.3%), drugs (mainly nonsteroidal) in 20 cases (27.4%), over exertion in 14 cases (19.2%), mental stimulation in 14 cases 10.9%). Bleeding and liver function grading, complications were related (P <0.01), and no correlation with the cause. After comprehensive treatment, no active bleeding within 2 weeks in 65 cases, the total effective rate was 89.0%. Conclusion For patients with cirrhosis and upper gastrointestinal bleeding should have clinical features, early detection of bleeding causes and the corresponding treatment.