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坦桑尼亚三级医院门静脉高压症患者的临床特征和治疗。

Clinical characteristics and management of patient with portal hypertension at tertial level hospital in Tanzania.

机构信息

Sekou Toure Regional Referral Hospital, P.O box 132, Mwanza, Tanzania.

Muhimbili University of Health and Allied Sciences, P.O box 65001, Dar es Salaam, Tanzania.

出版信息

BMC Cardiovasc Disord. 2024 Aug 16;24(1):428. doi: 10.1186/s12872-024-04072-x.

Abstract

BACKGROUND

Portal hypertension is a common diagnosis in Sub-Saharan African countries, with the majority of patients presenting late. This study aimed to understand Clinical characteristics, aetiology, the treatment offered in our setting, and factors associated with portal hypertension at a tertiary-level hospital, in Tanzania.

METHODOLOGY

A prospective cross-sectional observational single hospital-based study was conducted at MNH, from May 2021 to April 2022. A minimum of 152 subjects were required with an error of less than 5% and a study power of 80% at a 95% confidence interval. A structured questionnaire was used to collect data. Ethical clearance was obtained from the MUHAS/MNH IRB.

RESULTS

A total of 154 eligible participants consented and participated in this study. The mean age of participants was 42 ± 15.8 years (range 2-87). Most of the study participants were males 64.9% with a male-to-female (M: F) ratio of 1.8:1. Vomiting blood was the common symptom among the study participants 51.3%. Schistosomiasis 53.9% and viral infection 26.6% were the common etiologies followed by alcohol abuse 7.8%. Most were medically treated at 89.61% followed by radiological treatment at 8.44% while only 1.95% of patients received surgical treatment. There was a significant association between the grade of oesophagal varices and bleeding consequences (p-value < 0.01).

CONCLUSION

The majority of patients were medically treated while patients who require surgical care are unable to assess it. We recommend the establishment of a transplant services program to counteract the unmet need and more retrospective research toward policy establishment.

摘要

背景

门静脉高压症是撒哈拉以南非洲国家的常见诊断,大多数患者就诊较晚。本研究旨在了解坦桑尼亚一家三级医院的临床特征、病因、在当地提供的治疗方法,以及与门静脉高压症相关的因素。

方法

2021 年 5 月至 2022 年 4 月,在 MNH 进行了一项前瞻性、横断面、观察性的单中心医院研究。需要至少 152 名受试者,误差小于 5%,置信区间为 95%时研究能力为 80%。使用结构化问卷收集数据。MUHAS/MNHIRB 获得了伦理批准。

结果

共有 154 名符合条件的参与者同意并参与了这项研究。参与者的平均年龄为 42 ± 15.8 岁(范围 2-87 岁)。大多数研究参与者是男性,占 64.9%,男女比例为 1.8:1。呕吐血是研究参与者中最常见的症状,占 51.3%。血吸虫病 53.9%和病毒感染 26.6%是常见病因,其次是酒精滥用 7.8%。大多数患者接受药物治疗,占 89.61%,其次是放射治疗,占 8.44%,而只有 1.95%的患者接受手术治疗。食管静脉曲张的严重程度与出血后果之间存在显著关联(p 值<0.01)。

结论

大多数患者接受药物治疗,而需要手术治疗的患者无法评估。我们建议建立移植服务计划以应对未满足的需求,并进行更多针对政策制定的回顾性研究。

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