食管胃静脉曲张破裂出血预后相关因素的研究进展

林凡榆; 黄华; 路明亮

doi:10.3969/j.issn.1001-5256.2018.11.036

食管胃静脉曲张破裂出血预后相关因素的研究进展

DOI: 10.3969/j.issn.1001-5256.2018.11.036

昆明医科大学第二附属医院消化内科

基金项目:

昆明医科大学百名中青年学术技术骨干项目(60117190431);昆明医科大学博士研究生创新基金(2018S133)；

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中图分类号: R575.2
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出版历程
- 出版日期: 2018-11-20

Research advances in prognostic factors for patients with esophagogastric variceal bleeding

Research funding:

摘要

摘要: 食管胃静脉曲张破裂出血是肝硬化常见的并发症之一,也是消化内科常见的急危重症之一,起病急,再出血率及病死率高。加强对影响预后相关因素的认识,对降低患者的早期再出血率及病死率有重要的临床意义。肝硬化合并食管胃静脉曲张出血患者发生再出血及死亡的相关因素众多,其中危险因素包括高龄、性别、CTP分级C级、低血小板计数、高白细胞计数、出血史、门静脉增宽、内镜下红色征阳性、静脉曲张程度较重、感染等;反之,淋巴细胞百分比、血清钠、非选择性β-受体阻滞剂及抗生素的应用是其保护因素。分析了上述预后因素,进一步了解这些因素影响患者预后的相关机制和危险程度。而如何通过上述危险因素建立风险评估模型,探索更优的个体化治疗及护理方案,降低患者再出血及死亡风险是目前的主要研究方向。
- 食管和胃静脉曲张 /
- 出血 /
- 预后 /
- 综述
Abstract: Esophagogastric variceal bleeding is one of the most common complications of liver cirrhosis and is also one of the most critical diseases in the department of gastroenterology, with the features of acute onset and high rebleeding and mortality rates. Strengthening the understanding of related prognostic factors has great clinical significance in reducing early rebleeding rate and mortality rate. There are many factors associated with rebleeding and death in patients with esophagogastric variceal bleeding. Risk factors include advanced age, sex, Child-Turcotte-Pugh class C, low platelet count, high leukocyte count, bleeding history, portal broadening, widening of the portal vein, a positive red-color sign under an endoscope, severe varices, and infection, while the percentage of lymphocytes, serum sodium, and the use of non-selective β-blockers and antibiotics are protective factors. By analyzing these prognostic factors, we can learn more about their mechanisms and risk degree. At present, related research mainly focuses on the exploration of better individual treatment regimens and nursing strategies based on the risk assessment models established using these risk factors to reduce the risk of rebleeding and death.
- esophageal and gastric varices /
- hemorrhage /
- prognosis /
- review

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参考文献(40)

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