摘要
[目的]探讨失代偿期肝硬化患者临床特点、死亡原因及影响预后的危险因素。[方法]选取失代偿期肝硬化病例205例作为研究对象,分析死亡组与生存组临床指标差异、死亡原因、死亡危险因素等。[结果]死亡组患者WBC高于生存组,Hb、ALB均低于生存组,差异有统计学意义(P<0.05),死亡组PT、APTT延长超过生存组,死亡组AST、TB、CRP明显高于生存组,上述指标2组差异均有统计学意义(P<0.05)。2组PLT、ALT、ALP、GGT比较差异无统计学意义(P>0.05)。失代偿期肝硬化患者的死亡原因主要为:上消化道出血并失血性休克、慢性肝功能衰竭、合并严重感染等。Logistic回归分析的结果表明:死亡的主要危险因素包括:年龄(≥60岁)、伴有出血(≥400ml)、PT延长、伴有中-大量腹水、慢性肝衰竭、合并感染等。[结论]对于失代偿期肝硬化患者伴有上述危险因素者应积极加强临床干预,对合并感染者应积极抗感染治疗,同时注意失代偿期肝硬化患者并发症的治疗。
[Objective]To study the clinical characteristics, the cause of death, the risk factors of death in patients with deeompensated liver cirrhosis, [Methods]The total of 205 decompensated cirrhosis cases between January 2010 and May 2016 in our hospital digestion were investigated. The differences of the clinical indicators and the risk factors between death and survival group were analyzed. [Results] WBC in death group was higher than the survival group, Hb, ALB were lower than the survival group. Differences between the two groups had statistical significance（P〈0.05）. PT and APTT in death group were prolonged more than survive death. The levels of AST,TB and CRP in death group elevated higher than the survival group. Differences between the two groups had statistical significance（P〈0.05）. PLT,ALT, ALP, GGT differences between the two groups had no statistical significance （P〉 0.05）. The causes of death were mainly upper gastrointestinal hemorrhage and uncontrolled hemorrhagic shock, chronic hepatic failure, with severe infection. The death risk factors included age（over 60 years older）. The results of the Logistic re- gression analysis showed the relationship between the bleeding（more than 400 ml）, PT extension, accompa- nied a large number of ascites, chronic liver failure,infections, etc. [Conclusion]Patients with decompensat- ed liver cirrhosis accompanied with these risk factors should actively strengthen clinical intervention, patients with infection should be positive anti-infection treatment, at the same time we should pay attention to the treatment of complications.
出处
《临床消化病杂志》
2017年第1期39-42,共4页
Chinese Journal of Clinical Gastroenterology
关键词
肝硬化
死亡原因
危险因素
liver cirrhosis
the cause of death
risk factors
