Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350025, China.
Afr Health Sci. 2023 Sep;23(3):655-663. doi: 10.4314/ahs.v23i3.76.
To analyse the risk factors of secondary hemorrhage and survival rate in cirrhotic patients with esophagogastric variceal rupture and to compare the efficacy and safety of endoscopic hemostasis and TIPS (transjugular intrahepatic portosystemic shunt).
A total of 120 patients with secondary bleeding after endoscopic treatment of esophagogastric varicose bleeding with cirrhosis in our hospital during the past 3 years were retrospectively analysed. There were 65 males and 55 females, ranging in age from 49 to 74 years old, with an average of (59.5 ± 8.4) years old. The etiology, degree of varicose veins, bleeding location, hemostasis method, Infection, ascites, portal vein thrombosis or cancer thrombus, albumin, platelets, prothrombin activity, Child Pugh (Child-Pugh classification is a diagnostic criterion for liver reserve function) grade were compared in each group. The risk factors of treatment failure and analyse the survival time was analysed.
There were statistically significant differences in varicosis degree, infection, ascites, portal vein thrombosis or cancer thrombus, child Pugh grade, albumin and prothrombin activity between the failed Endoscopy group and the successful hemostasis group (P< 0.05). There were statistically significant differences in child Pugh grade, albumin and prothrombin activity between the failed TIPS treatment group and successful hemostasis group (P< 0.05). There was no significant difference in 1-year survival between the endoscopy group and the TIPS group.
Severe varicose veins, infection, ascites, portal vein thrombosis or cancer thrombus, child pugh classification, albumin, and prothrombin activity were the major risk factors for failed secondary endoscopic therapy, child Pugh classification, albumin and prothrombin activity were the main risk factors for failure TIPS treatment. There is no significant difference in long-term survival between the two methods.
分析肝硬化食管胃静脉曲张破裂出血患者再出血的危险因素和生存率，并比较内镜止血和 TIPS（经颈静脉肝内门体分流术）的疗效和安全性。
回顾性分析我院近 3 年来内镜治疗肝硬化食管胃静脉曲张出血后再出血的 120 例患者。男 65 例，女 55 例，年龄 49～74 岁，平均（59.5±8.4）岁。比较两组患者的病因、静脉曲张程度、出血部位、止血方法、感染、腹水、门静脉血栓或癌栓、白蛋白、血小板、凝血酶原活动度、Child-Pugh 分级等。分析治疗失败的危险因素和生存时间。
内镜治疗失败组和内镜治疗成功组在静脉曲张程度、感染、腹水、门静脉血栓或癌栓、Child-Pugh 分级、白蛋白和凝血酶原活动度方面差异有统计学意义（P<0.05）；TIPS 治疗失败组和 TIPS 治疗成功组在 Child-Pugh 分级、白蛋白和凝血酶原活动度方面差异有统计学意义（P<0.05）。内镜组和 TIPS 组 1 年生存率差异无统计学意义。
重度静脉曲张、感染、腹水、门静脉血栓或癌栓、Child-Pugh 分级、白蛋白、凝血酶原活动度是内镜治疗失败的主要危险因素，Child-Pugh 分级、白蛋白、凝血酶原活动度是 TIPS 治疗失败的主要危险因素。两种方法的长期生存率差异无统计学意义。
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