Abstract:Objective To investigate the influence factors of survival prognosis in patients with cirrhosis undergoing sclerotherapy for esophageal varices (EVS). Methods Clinical data of 180 patients with cirrhosis complicated with esophageal varices who underwent EVS in Beijing YouAn Hospital, Capital Medical University from January 2016 to December 2017 were retrospectively analyzed, and the patients were divided into the death group (43 cases) and the survival group (137 cases) according to their three-year survival. The general data of the two groups were compared, and the multivariate Cox proportional risk model was used to analyze the influencing factors related to prognosis. Results There were statistically significant differences between the two groups in Child-Pugh grade of liver function, volume of abdominal water, portal trunk thrombosis, portal trunk diameter, albumin, total bilirubin and prothrombin activity (P < 0.05). Multivariate Cox regression analysis showed that only Child-Pugh C grade in liver function was an independent risk factor for death (HR = 25.610, 95%CI:13.796-27.661, P < 0.001). Conclusion The severity of Child-Pugh grade of liver function is correlated with the survival prognosis of patients with cirrhosis after EVS, which has great clinical value in predicting the prognosis of patients.
刘远志 孙亚男 李鹏 吴燕京 武永乐 曾庆环 张世斌▲. 肝硬化患者食管静脉曲张硬化治疗术预后的影响因素研究[J]. 中国医药导报, 2021, 18(22): 109-112.
LIU Yuanzhi SUN Yanan LI Peng WU Yanjing WU Yongle ZENG Qinghuan ZHANG Shibin▲. Study of influence factors the prognosis of esophageal variceal sclerosis in patients with cirrhosis. 中国医药导报, 2021, 18(22): 109-112.
[1] Tangcheewinsirikul N,Suankratay C. Acute pulmonary embolism following endoscopic sclerotherapy for gastroesophageal variceal hemorrhage:A case report and literature review [J]. SAGE Open Med Case Rep,2019,7:2050 313X19838946.
[2] Michael PG,Antoniades G,Staicu A,et al. Pulmonary glue embolism:An unusual complication following endoscopic sclerotherapy for gastric varices [J]. Sultan Qaboos Univ Med J,2018,18(2):e231-e235.
[3] Frassei JDS,Franco CS,Brambilla VR,et al. Cyanoacrylate pulmonary embolism after endoscopic sclerotherapy of gastric varices [J]. Einstein(Sao Paulo),2021,19:eAI5778.
[4] Belramman A,Bootun R,Lane TRA,et al. Endovenous management of varicose Veins [J]. Angiology,2019,70(5):388-396.
[5] 中华医学会肝病学分会.肝硬化诊治指南[J].实用肝脏病杂志,2019,22(6):770-786.
[6] Nishiwaki S,Araki H,Jun T,et al. Clinical investigation of upper gastrointestinal hemorrhage after percutaneous endoscopic gastrostomy [J]. Dig Endosc,2010,22(3):185-187.
[7] Zhu K,Meng X,Qian J,et al. Partial splenic enbolization for hypersplenism in cirrhosis:A long-termoutcomein 62 patients [J]. Dig Liver Dis,2009,41(6):411-416.
[8] Halabi SA,Sawas T,Sadat B,et al. Early TIPS versus endoscopic therapy for secondary prophylaxis after management of acute esophageal variceal bleeding in cirrhotic patients:a meta-analysis of randomized controlled trials [J]. J Gastroenterol Hepatol,2016,31(9):1519-1526.
[9] Li X,Jiang T,Gao J. Endoscopic variceal ligation combined with argon plasma coagulation versus ligation alone for the secondary prophylaxis of variceal bleeding:a systematic review and meta-analysis [J]. Eur J Gastroenterol Hepatol,2017,29(6):621-628.
[10] Puente A,Hernández-Gea V,Graupera I,et al. Drugs plus ligation to prevent rebleeding in cirrhosis:an updated systematic review [J]. Liver Int,2014,34(6):823-833.
[11] Shi L,Zhang X,Li J,et al. Favorable effects of endoscopic ligation combined with drugs on rebleeding and mortality in cirrhotic patients:A network meta-analysis [J]. Dig Dis,2018,36(2):136-149.
[12] Duan Y,Jiang WW. Clinical effect of endoscopic lauromacrogol injection in treatment of esophageal varices:an analysis of 51 cases [J]. China Prac Med,2013,8(28):191-192.
[13] Dai C,Liu WX,Jiang M,et al. Endoscopic variceal ligation compared with endoscopic injection sclerotherapy for treatment of esophageal variceal hemorrhage A meta-analysis [J]. World J Gastroenterol,2015,21(8):2534-2541.
[14] 刁屠军,陈金联,朱金水.Child-pugh评分对肝硬化食管胃底静脉曲张出血患者预后风险因素的临床评估[J].临床消化病杂志,2016,28(1):39-42.
[15] 齐小健.肝炎肝硬化患者肝功能的检测价值[J].中国现代医生,2021,59(5):104-106.
[16] Wang J,Zhang Z,Yan X,et al. Albumin -Bilirubin (ALBI) as an accurate and simple prognostic score for chronic hepati-tis B-related liver cirrhosis [J]. Dig Liver Dis,2019,51(8):1172-1178.
[17] Fujita K,Nomura T,Morishita A,et al. Prediction of transplant-free survival through albumin-bilirubin score in primary biliary cholangitis [J]. J Clin Med,2019,8(8):1258.
[18] 王爽,柯盈月,李权伦,等.血清前白蛋白、胆碱酯酶、凝血酶原活动度水平联合Child-Pugh分级对肝硬化患者预后的判断[J].临床消化病杂志,2017,29(6):346-349.
[19] 罗加农,赖良.不同方法治疗肝硬化合并食管胃底静脉曲张破裂出血的效果对比[J].当代医药论丛,2019,17(4),19-20.
[20] 孙安民,王伟.肝纤维化指标与肝硬Child-Pugh分级的关系[J].中国伤残医学,2014(5):12-13.
[21] 周洪丽.肝硬化病人首次食管胃底静脉曲张破裂出血现状及其危险因素的调查分析[J].全科护理,2021,19(2),267-270.
[22] 陈蓓,饶丹霞,李佩佩.优质护理干预在行胃镜下食管曲张静脉结扎术治疗食管胃底静脉曲张患者围术期的应用[J].中国当代医药,2021,28(1):205-208.
[23] 程留芳,李青山,童新元.肝硬化食管静脉曲张出血患者硬化治疗的生存分析[J].中华内科杂志,2002,41(7):456-458.
[24] 刘丽敏,朱斌.肝硬化并发食管胃静脉曲张破裂出血的相关危险因素分析[J].中国医药导报,2020,17(25):96-99.
[25] Al-Khazraji A,Curry MP. The current knowledge about the therapeutic use of endoscopic sclerotherapy and endoscopic tissue adhesives in variceal bleeding [J]. Expert Rev Gastroenterol Hepatol,2019,13(9):893-897.