摘要
目的评价接受内镜下精准食管胃静脉曲张断流术(ESVD)患者的预后及生存状态。方法纳入2010年10月至2017年12月于首都医科大学附属北京地坛医院827例肝硬化伴食管胃静脉曲张破裂出血,并行ESVD治疗的患者。对患者的常规临床、实验室及影像学指标进行分析,随访患者的再出血和生存情况。将死亡患者以生存期1年为界,分为1年内死亡组和1年后死亡组,比较两组之间指标的差异。结果827例患者中,早期再出血16例,占1.93%;迟发性再出血248例,占29.99%。患者1年、2年、3年、4年及5年的累计生存率为91.8%、88.6%、85.3%、81.9%和75.5%。年龄、脾脏厚度、ALT、AST、总胆红素、肌酐、国际化标准比值及Child评分在1年内死亡组和1年后死亡组间存在显著差异(P<0.05)。结论ESVD在肝硬化伴食管胃静脉曲张破裂出血患者治疗中,获得了良好的近期及远期疗效。生存期较长患者的肝脏功能优于短期死亡组。
Objective To evaluate the prognosis and survival of patients undergoing endoscopic selective varices devascularization. Methods From Oct.2010 to Dec.2017, at the Ditan Hospital of Capital Medical University, 827 liver cirrhosis patients complicated with gastroesophageal variceal bleeding were underwent ESVD therapy. The routine clinical, laboratory and imaging variables of the patients were retrospectively analyzed, and the survival status and rehemorrhage was recorded by followed up. Patients who died during the follow-up time were further divided into die within 1 year group and die beyond1 year group, the variables were compared between the2 groups. T test, chi-square test and rank sum test were performed for groups comparison. Kaplan-meier method was used for descriptive survival analysis. Results Among the 827 patients,16 had early rebleeding (1.93%),248 had delayed rebleeding (29.99%). The cumulative survival rate of1,2,3, 4 and 5 years was 91.8%, 88.6%, 85.3%, 81.9% and 79.5%. Age, spleen thickness, ALT, AST, total bilirubin, creatinine, international standard ratios and Child score were significantly different between the short-term and long- term death groups ( P <0.05). Conclusion The short-term and long-term efficacy of ESVD in liver cirrhosis patients accompanied with esophageal and gastric variceal bleeding seems to be better than the traditional treatment group, showing good therapeutic effect.
作者
马佳丽
蒋煜
艾正琳
胡居龙
周玉玲
梁秀霞
李坪
MA Jia-li;JIANG Yu;AI Zheng-lin;HU Ju-long;ZHOU Yu-ling;LIANG Xiu-xia;LI Ping(Department of Gastroenterology, Beijing Ditan Hospital ofCapital Medical University, Beijing,100015, China)
出处
《现代消化及介入诊疗》
2019年第6期578-582,共5页
Modern Interventional Diagnosis and Treatment in Gastroenterology
