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纸质出版:2014
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肝硬化合并非静脉曲张性上消化道出血临床分析[J]. 中山大学学报(医学科学版), 2014,35(2).
Clinical Analysis of Non-variceal Upper Gastrointestinal Bleeding in Cirrhotic Patients[J]. Journal of Sun Yat-sen University (Medical Sciences), 2014, 35(2).
【目的】 总结分析肝硬化合并非静脉曲张性上消化道出血的临床特征?【方法】 回顾性分析我们科2011年6月30日至2012年7月1日上消化道出血患者(>18周岁)464例
将肝硬化非静脉曲张性上消化道出血患者共60例的临床资料
与同期肝硬化患者食管静脉曲张破裂出血患者158例的临床资料进行对比研究
同时与非肝硬化非静脉曲张上消化道出血患者246例的内镜特点进行比较
并对3组的临床预后进行分析?【结果】肝硬化非静脉曲张出血占同期肝硬化并上消化道出血的比率为27.5%
肝硬化静脉曲张破裂出血占同期肝硬化并上消化道出血的比率为72.5%
肝硬化非静脉曲张出血占同期上消化道出血的比率为12.9%?肝硬化非静脉曲张上消化道出血临床表现以呕吐咖啡样物为主
肝硬化静脉曲张破裂出血临床表现以呕血为主;肝硬化非静脉曲张上消化道出血人群患高血压的概率明显高于肝硬化静脉曲张破裂出血人群;在非静脉曲张上消化道出血内镜分析中
肝硬化患者以十二指肠溃疡的发生率最高
肝硬化组比非肝硬化组更易患胃溃疡及食管溃疡?【结论】 肝硬化患者出现非静脉曲张性出血并非罕见
以十二指肠溃疡的发生率最高
肝硬化患者更易患胃溃疡及食管溃疡
及时的内镜检查对治疗的决策至关重要?
【Objective】 To investigate the clinical characters of non-variceal upper gastrointestinal bleeding in cirrhotic patients through retrospective analysis. 【Methods】 All consecutive adult patients with upper gastrointestinal bleeding (UGIB) (age≥ 18 years) admitted from June 2011 to July 2012 were prospectively registered. During a 12-month period
a retrospective population-based study including all the UGIB of 464 people was conducted. Sixty cases (12.9%) with non-variceal upper gastrointestinal bleeding in cirrhotic patients were included. Compared with 158 cases with variceal upper gastrointestinal bleeding in cirrhotic patients
there were significant differences in epidemiologic features
clinical course and clinical outcomes. Endoscopic findings of non-esophageal variceal bleeding (NEVB) are different between cirrhotic patients and non-cirrhotic patients. 【Results】 The non-cirrhotic patients with NEVB accounted for the ratio of non-cirrhotic patients with upper gastrointestinal hemorrhage was 27.5% in the same period. Variceal bleeding in cirrhosis accounted for the ratio of upper gastrointestinal bleeding with cirrhosis was 72.5%. The cirrhotic patients with NEVB over the same period accounted for the ratio of gastrointestinal bleeding was 12.9%. Clinical manifestations of non-variceal upper gastrointestinal bleeding with cirrhosis are vomiting coffee-like compounds based. Hematemesis is the most frequent clinical manifestation of variceal upper gastrointestinal bleeding in cirrhotic patients. Our results show that cirrhotic patients with NEVB may develop hypertension more often than non-cirrhotic patients. However
gastric and esophageal ulcers as a source of NEVB are more frequent in cirrhotic patients. 【Conclusions】 Cirrhotic patients with non-variceal bleeding is not uncommon for the highest incidence of duodenal ulcer. Cirrhotic patients are more susceptible to be gastric ulcer and esophageal ulcers. Prompt endoscopy is essential for the treatment decision.
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