本文選題：食管和胃靜脈曲張 + 隨訪研究　； 參考：《重慶醫(yī)學》2015年12期

【摘要】：目的探討肝硬化食管靜脈曲張患者內(nèi)鏡套扎治療后的順應性對其治療預后的影響。方法隨訪512例肝硬化食管靜脈曲張并行內(nèi)鏡套扎治療的患者,按是否具有隨訪治療順應性分成順應組和對照組,比較兩組患者的再出血、再住院、死亡等隨訪指標,根據(jù)肝功能Child-Pugh分級比較兩組間的指標差異。結(jié)果隨訪順應性的差異主要由患者文化水平、收入情況及當?shù)蒯t(yī)療條件決定。順應組的病死率和再出血率均顯著低于對照組。Child-Pugh A級中的順應組與對照組的肝癌發(fā)現(xiàn)率(9.3%vs.1.67%)、肝移植率(10.2%vs.2.50%)、行脾切除和門奇靜脈斷流術(shù)(15.5%vs.3.4%)比較,差異有統(tǒng)計學意義(P0.05);Child-Pugh B級患者中順應組與對照組的再出血率(28.0%vs.53.5%)、死亡率(5.3%vs.9.8%)、腹水發(fā)生率(72.0%vs.49.2%)、生活質(zhì)量(64.0%vs.33.8%)及肝功能(77.3%vs.33.8%)比較,差異有統(tǒng)計學意義(P0.05);Child-Pugh C級患者兩組各指標比較,均差異無統(tǒng)計學意義(P0.05)。結(jié)論提高肝硬化食管靜脈曲張內(nèi)鏡治療的隨訪治療順應性可以減少肝硬化食管靜脈曲張老年患者的再出血率和病死率,對肝癌的發(fā)現(xiàn)、肝移植的早期干預均有意義。
[Abstract]:Objective to investigate the effect of compliance after endoscopic ligation on the prognosis of patients with esophageal varices due to cirrhosis. Methods 512 patients with esophageal varices of liver cirrhosis treated by endoscopic ligation were divided into compliance group and control group according to whether they had the compliance of follow-up treatment. The follow-up indexes such as rebleeding, rehospitalization and death were compared between the two groups. The indexes of the two groups were compared according to Child-Pugh grade of liver function. Results the difference of follow-up compliance was mainly determined by the patients' education level, income and local medical conditions. The mortality and rebleeding rate in compliance group were significantly lower than those in control group. Child-Pugh A grade compliance group and control group. The detection rate of liver cancer was 9.3vs.1.67. liver transplantation rate was 10.2vs.2.50. splenectomy and portal azygous vein devascularization were performed and compared with those in control group (15.5vs.3.4). There were significant differences in the rate of rebleeding between the compliance group and the control group (28.0vs.53.5g), the mortality rate was 5.3vs.9.8g, the incidence of ascites was 72.0vs.49.2cm, the quality of life was 64.0vs.33.8) and the liver function was 77.3vs.33.8. there were significant differences between the two groups. There was no significant difference between the two groups (P 0.05). Conclusion improving the compliance of endoscopic treatment of cirrhosis esophageal varices can reduce the rate of rebleeding and mortality of elderly patients with hepatic cirrhosis and esophageal varices. It is significant for the discovery of liver cancer and the early intervention of liver transplantation.
【作者單位】： 江西省萍鄉(xiāng)市湘雅萍礦合作醫(yī)院消化科;
【分類號】：R575.2

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