摘要
目的:探讨终末期肝病模型(MELD)评分系统对晚期肝病患者的食管胃底静脉曲张出血的评估价值。方法:本组病例包括128例肝硬化失代偿期的住院病人,根据有无食管胃底静脉曲张出血病史分为已出血组(n=58)和未出血组(n=70),于0个月时测定相关指标,计算MELD值,同时分别随访3个月和6个月的再出血情况。结果:出血组的INR、血清肌酐、总胆红素以及得出的MELD值显著高于未出血组(P<0.01)。在随访的3个月和6个月,出血组发生出血的比例明显高于未出血组,分别为27.6%vs14.3%,39.7%vs20%。出血组和未出血组随着MELD评分等级的升高,新发生食管胃底静脉曲张出血的人数比例增加,尤以高MELD评分组(≥25分)出血率最高。结论:MELD评分系统对食管胃底静脉曲张出血有一定的评估价值。
Objective：To investigate the application of model for ending liver disease （MELD） scoring system on evaluating cirrhosis bleeding from esophageal varices in the patients with end-stage liver disease. Methods：One hundred and twenty-eight patients with de- compensated liver cirrhosis were divided into two groups：bleeding group （n=58） and non-bleeding group （n=70）. The patients were followed-up for 3-6 months. MELD scoring system was compared and analyzed in different groups. Results：At the beginning of the study, the levels of international normalized raio （INR）,serum creatinine and total bilirubin and median MELD score were higher in bleeding group than that in non-bleeding group （P〈0.01）. In month 3 and 6, the incidence of esophageal varices bleeding in bleeding group was higher than that in non-bleeding group,27.6% vs 14.3% ,39.7% vs 20% ,respectively.The incidence of esophageal varices bleeding increased according to the MELD grade. When the MELD score was more than 25, the incidence was the highest. Conclusion ：The patients with cirrhosis bleeding from esophageal varices have higher MELD score, and MELD scoring system could be a relatively good evaluating method on cirrhosis bleeding from esophageal varices.
出处
《现代医药卫生》
2009年第10期1445-1447,共3页
Journal of Modern Medicine & Health
