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[目的]探讨Child-Pugh评分对肝硬化食管胃底静脉曲张破裂出血(EVB)患者的预后风险因素及其死亡风险的临床评估。[方法]经内镜、腹部B超、CT等检查确诊为肝硬化食管胃底静脉曲张破裂出血患者99例,其中出血控制并好转患者81例(好转组),死亡患者18例(死亡组)。对2组肝硬化EVB患者进行Child-Pugh评分,检验各主要指标,进行二元Logistic回归分析。[结果]死亡组患者非初次出血比率、72h再出血比率、Child-Pugh评分均高于好转组(P<0.05);Child-Pugh C级患者的死亡风险分别为A级和B级患者的12.500倍和4.018倍(P<0.05),72h再出血和非初次出血患者的死亡风险分别为72h内无活动性出血和初次出血患者的8.826倍和3.143倍(P<0.05);Child-Pugh评分、72h再出血是肝硬化EVB患者的独立死亡危险因素,OR值分别为1.480和7.060。[结论]Child-Pugh评分增高、72h再出血均预示肝硬化EVB患者生存率降低、近期死亡风险增加。
[Objective] To evaluate the clinical and prognostic factors of Child-Pugh score in patients with cirrhosis esophagogastric variceal bleeding (EVB). [Methods] Ninety-nine patients with end-stage esophagogastric variceal bleeding were diagnosed by endoscopy, abdominal ultrasonography, CT, etc. Among them, there were 81 patients with bleeding control and improvement (improvement group) and 18 patients died (death group) . Child-Pugh scores of two groups of patients with cirrhosis EVB were tested, and the main indexes were tested and analyzed by binary logistic regression. [Results] The rate of non-primary hemorrhage, rehydration rate at 72h and Child-Pugh score in death group were higher than that in turn group (P <0.05). The risk of death in Child-Pugh C group was 12.500 Times and 4.018 times (P <0.05) respectively. The risk of death in patients with rebleeding and non-primary hemorrhage at 72 hours was 8.826 and 3.143 times higher than those without active hemorrhage and primary hemorrhage within 72 hours respectively (P <0.05) Rebleeding at 72h was an independent risk factor for death in cirrhotic patients with EVB, with ORs of 1.480 and 7.060, respectively. [Conclusions] The increased Child-Pugh score and rebleeding at 72 h indicate that the survival rate of patients with liver cirrhosis EVB is reduced and the risk of recent death is increased.