摘要
目的:探讨肝硬化合并上消化道出血患者的出血原因,并指导治疗。方法:对52例肝硬化合并上消化道出血患者均行急诊胃镜检查及Child-pugh分级。结果:(1)52例肝硬化合并上消化道出血的原因: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,无显著性差异(P>0.05)。在Child-pughA级中,静脉曲张破裂出血占23.08%,非静脉曲张破裂出血占5.77%,两者比较,有显著性差异(P<0.05),在Child-pughC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,有显著性差异(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Child-pughC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,有显著性差异(P<0.05)。结论:肝硬化合并上消化道出血病因中,门脉高压性胃病及消化性溃疡也是消化道出血的重要原因,尤其在肝功能Child-pughC级的患者中更应引起重视。
Objective： To observe 52 cirrhotic patients with upper gastrointestinal hemorrhage to make clear the reason of hemorrhage and direct the treatment. Methods： Fifty-two cirrhotic patients with upper gastrointestinal hemorrhage were emergency gastroscopied and rated on the basis of Child-pughs. Results. （1）We analyzed the causes of upper gastrointestinal hemorrhage in 52 patients, among which ruptured varices, non-variceal bleeding were 51.92 %, 48.08%, both had no obvious differenee（P〉0.05）. But in different ratings of Child, both had the difference. In class A,varices rupture was cardinal reason of the bleeding; in the class C, non-variceal bleeding was cardinal reason of the bleeding,both had the obvious difference（P〈0.05）. （2）the reason of nonvariceal bleeding included the peptic ulcer and portal hypertensive gastropathies. In the class C, the portal hypertensive gastropathy was the cardinal reason of bleeding, both had the obvious difference （P〈0.05）. Conclusion. Among the causes of upper gastrointestinal hemorrhage in cirrhotic patients, portal hypertensive gastropathy and peptic ulcers are also the important reason of the gastrointestinal hemorrhage and the case should be valued in the patients with the liver function Child class C particularly.
出处
《实用临床医学（江西）》
CAS
2006年第4期22-24,共3页
Practical Clinical Medicine
关键词
肝硬化
上消化道出血
内窥镜检查
静脉出血
liver cirrhosis
upper gastrointestinal hemorrhage
endoscopy,stomach
