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时间:2018-09-11
《肝硬化并上消化道出血52例临床分析.doc》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、肝硬化并上消化道出血52例临床分析【关键词】上消化道出血;肝硬化;内镜检查;胃[摘要]目的探讨肝硬化合并上消化道出血患者的出血原因,指导治疗。方法对52例肝硬化合并上消化道出血生命体征平稳的患者(即血压、脉搏在正常范围内,神志清楚)行急诊胃镜检查及Childpugh分级[1]。结果(1)52例肝硬化合并上消化道出血的原因:食管胃底静脉曲张破裂出血(简称静脉曲张破裂出血)占51.92%,非静脉曲张破裂出血占48.08%,两者比较,差异无显著性(P>0.05)。在ChildpughA级中,静脉曲张破裂出血占23.08%,非静脉曲张破裂出血占5.
2、77%,两者比较,差异有显著性(P<0.05),在ChildpughC级中,非静脉曲张破裂出血占25.00%,静脉曲张破裂出血占11.53%,两者比较,差异有显著性(P<0.05);(2)非静脉曲张破裂出血原因包括消化性溃疡和门脉高压性胃病,在ChildpughC级中,门脉高压性胃病出血占17.31%,消化性溃疡出血占7.69%,两者比较,差异有显著性(P<0.05)。结论肝硬化合并上消化道出血的病因中,除了食管胃底静脉曲张破例出血的原因外,门脉高压性胃病及消化性溃疡也是其重要的原因,尤其在肝功能分级在ChildpughC级的患
3、者中非静脉曲张破裂出血较多,治疗时更应引起注意和重视。[关键词]上消化道出血;肝硬化;内镜检查;胃ClinicalanalysisoncirrhosiscomplicatedbyuppergastrointestinalhemorrhageLIUJiyou.TheSixthPeople’sHospitalofXuzhou,Xuzhou221006,China[Abstract]ObjectiveTostudythecausesofbleedingofpatientswithcirrhosiscomplicatedbyuppergastrointe
4、stinalhemorrhage.Methods52caseswereselected(normotensive,normalpulseandawareness).GastroscopyandChildpughscalingwereperformed.Results(1)Weanalyzedthecausesofuppergastrointestinalhemorrhagein52patients,amongwhichOesophagusStomachrupturedvarices(inshort:rupturedvarices),nonvari
5、cealbleedingwere51.92%,48.08%,bothhadnoobviousdifference(P>0.05).ButindifferentratingsofChild,bothhadthedifference.InclassA,varicesrupturewascardinalreasonofthebleeding;intheclassC,nonvaricealbleedingwascardinalreasonofthebleeding,bothhadtheobviousdifference(P<0.05).(2)
6、Thereasonofnonvaricealbleedingincludedthepepticulcerand4portalhypertensivegastropathies.IntheclassC,theportalhypertensivegastropathywasthecardinalreasonofbleeding,bothhadtheobviousdifference(P<0.05).ConclusionAmongthecausesofuppergastrointestinalhemorrhageincirrhoticpatien
7、ts,portalhypertensivegastropathyandpepticulcersarealsotheimportantreasonofthegastrointestinalhemorrhageandthecaseshouldbevaluedinthepatientswiththeliverfunctionChildclassCparticularly.[Keywords]uppergastrointestinalhemorrhage;livercirrhosis;endoscopy;stomach肝硬化合并上消化道出血是最常见急危重
8、症之一,它严重威胁着患者生命,不同的出血原因其治疗方案也不尽相同,肝硬化合并上消化道出血的患者如果全部都按静脉曲张破裂出血治疗势必导致治
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