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目的探讨肝硬化并发食管胃静脉曲张出血(esophageal and gastric variceal bleeding,EGVB)早期再出血的影响因素。方法 105例出血患者根据出血停止后6周内有无再出血进一步分为再出血组(22例)和未再出血组(73例),比较两组诱因、既住上消化道出血(UGH)史、血生化、凝血相关因素、出血程度、静脉曲张分级、腹水程度及肝功能Child-Pugh分级,分析各因素对早期再出血的影响。结果两组在诱因(感染、进粗糙食物、大量放腹水)、既往上消化道出血史、血生化(Na+、TBIL、ALB)、凝血相关因素(PT、PTA、PLT)、出血程度、腹水程度、肝功能Child-Pugh分级及静脉曲张grade G分级方面差异均有非常显著性(P<0.01,P<0.001),但两组在预防用药、AST、ALT差异无显著性(P>0.05)。结论诱因、既往出血史、血生化(Na+、TBIL、ALB)、凝血功能、出血程度、腹水程度、静脉曲张程度及Child-Pugh分级均是早期再出血的影响因素,改善这些因素对于预防早期再出血可能有帮助。
Objective To investigate the influencing factors of early rebleeding of esophageal and gastric variceal bleeding (EGVB). Methods 105 patients with hemorrhage were further divided into re-bleeding group (n = 22) and non-re-bleeding group (n = 73) according to the presence or absence of rebleeding within 6 weeks after stopping the bleeding. History, blood biochemistry, coagulation related factors, bleeding degree, varicose vein grading, ascites and liver function Child-Pugh grading, analysis of the impact of various factors on early rebleeding. Results The two groups were divided into three groups: predisposing (infection, rough food, large amount of ascites), previous gastrointestinal bleeding history, blood biochemical (Na +, TBIL, ALB), coagulation related factors (PT, PTA, PLT) (P <0.01, P <0.001). However, there was no significant difference between the two groups in the prophylaxis, AST and ALT (P> 0.05). CONCLUSION: The predisposing factors, history of prior hemorrhage, blood biochemical (Na +, TBIL, ALB), coagulation, hemorrhage, ascites, varicose veins and Child-Pugh grading are the influencing factors of early rebleeding. Bleeding may help.