Pinto H C, Abrantes A, Esteves A V, Almeida H, Correia J P
Department of Medicine 2, University Hospital of Santa Maria, Lisbon, Portugal.
Am J Gastroenterol. 1989 Oct;84(10):1239-43.
A study has been carried out on the 5-yr survival curves of 287 patients admitted with upper gastrointestinal bleeding and portal hypertension. In 78.7%, the cause of bleeding was from esophageal varices. Only 2.4% had noncirrhotic portal hypertension, and 80% were alcoholics. At 5 yr, the overall survival probability was 26.2%. The curve had three segments with survival rates of 69% at 2 wk and 46.6% at 12 months. According to Child's grade, the curves were very different at 2 wk, 12 months, and 60 months: Group A, 94.0, 78.0, and 51.8%; group B, 77.0, 46.0, and 32.2; group C, 52.0, 11.0, and 2.3%. The largest differences were observed in the first 2 wk immediately after the first bleeding. The recurrence of bleeding in a period of 6 months significantly decreased the survival. Age, as well as the introduction of prophylactic measures (propranolol or sclerotherapy), did not influence long-term survival. Alcohol abstinence was accompanied by better survival. This difference was due to the impact of abstinence only in group B patients.
对287例因上消化道出血和门静脉高压入院的患者进行了5年生存曲线研究。78.7%的出血原因是食管静脉曲张。只有2.4%患有非肝硬化门静脉高压，80%为酗酒者。5年时，总体生存概率为26.2%。该曲线有三个阶段，2周时生存率为69%，12个月时为46.6%。根据Child分级，2周、12个月和60个月时曲线差异很大：A组分别为94.0%、78.0%和51.8%；B组分别为77.0%、46.0%和32.2%；C组分别为52.0%、11.0%和2.3%。首次出血后最初2周内观察到的差异最大。6个月内出血复发显著降低了生存率。年龄以及预防性措施（普萘洛尔或硬化疗法）的采用对长期生存没有影响。戒酒者生存率更高。这种差异仅归因于B组患者中戒酒的影响。
