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目的:通过观察肝性脑病患者不同的临床结局,探讨造成肝性脑病患者结局差异的影响因素。方法:整群抽取2012年11月至2015年1月在新疆医科大学第六附属医院住院治疗且符合纳入排除标准的肝性脑病患者180例作为研究对象,回顾性收集患者一般资料及临床资料,并用统计学方法分析患者的结局及其影响因素。结果:影响肝性脑病患者临床结局因素显著性由高到低依次为Child分级、是否电解质紊乱、并发症数、诱发因素数、凝血酶原活动度(PTA)、是否大量腹水、Alb、是否并发肝肾综合征(HRS)、Cr、是否并发上消化道出血;进一步通过Logistic回归分析发现Child分级(P=0.002)、是否大量腹水(P=0.012)、PTA(P=0.043)、是否并发HRS(P=0.026)及并发症个数(P=0.000)是影响患者结局的独立危险因素。结论:对于肝性脑病的患者,Child高等级、多腹水、伴有HRS、多并发症、高PTA均提示患者临床结局容易恶化,对该类肝性脑病患者应采取合适的干预措施来改善患者临床结局,延长患者寿命。
Objective: To observe the different clinical outcomes of patients with hepatic encephalopathy and explore the influencing factors of the differences in outcome of patients with hepatic encephalopathy. Methods: A total of 180 patients with hepatic encephalopathy hospitalized in the Sixth Affiliated Hospital of Xinjiang Medical University from November 2012 to January 2015 were enrolled in this study. The general data and clinical data of patients were retrospectively collected. And statistical methods to analyze the outcome of patients and its influencing factors. Results: The clinical outcomes of patients with hepatic encephalopathy were clinically significant (Child to grade, with electrolyte imbalance, number of complications, number of triggers, prothrombin activity (PTA), large amount of ascites, Alb, with or without complications) Childhood grade (P = 0.002), large amount of ascites (P = 0.012), PTA (P = 0.043), whether complicated with HRS or not were found by Logistic regression analysis. (P = 0.026) and the number of complications (P = 0.000) were independent risk factors affecting the outcome of patients. Conclusion: Child high grade, multiple ascites, HRS, multiple complications and high PTA all indicate that patients with hepatic encephalopathy are likely to have worse clinical outcomes. Appropriate intervention measures should be taken to improve the patients with hepatic encephalopathy Clinical outcome, prolong patient’s life.