论文部分内容阅读
目的探讨术前肝功能分级对内镜下食管曲张静脉套扎术(EVL)疗效和预后的影响以及对手术病例选择的指导意义。方法对156例肝硬化食管曲张静脉套扎术的患者术前的肝功能进行终末期肝病模型(MELD)评分,将这些患者按MELD分值分为(≤7分)58例、(7～9分)54例、(≥9分)44例3个组,对这些患者随访套扎术后的远期生存率及生存状况。结果MELD≤7分的的患者中,50%生存率超过45个月,7～9分的的患者中,50%生存率在47．34个月,而≥9分的患者50%生存率在24．89个月。前两组的半数生存率显著大于第3组,生存率差异有统计学意义。结论EVL已成为临床治疗由食管静脉曲张引起的上消化道大出血的有效方法,术后生存率与术前肝功能有直接相关性,术前肝功能对套扎术病例的选择有指导意义。
Objective To investigate the effect of preoperative classification of liver function on the efficacy and prognosis of esophageal variceal ligation (EVL) and its guiding significance for the selection of surgical cases. Methods 156 cases of liver cirrhosis esophageal varices ligation patients with preoperative liver function end-stage liver disease model (MELD) score, these patients were divided according to MELD score (≤ 7 points) 58 cases, (7 ~ 9 ) 54 cases, (≥ 9 points) 44 cases of 3 groups, these patients were followed up long-term survival rate after ligation and survival. Results In patients with MELD ≤7, 50% survival rate was over 45 months, 50% survival rate was 47.34 months between 7 and 9 points, and 50% survival rate was ≥9% 24.89 months. The median survival rate of the first two groups was significantly greater than that of the third group, the difference was statistically significant. Conclusion EVL has become an effective method for the clinical treatment of upper gastrointestinal bleeding caused by esophageal varices. The postoperative survival rate is directly related to the preoperative liver function. Preoperative liver function is instructive for the choice of cases of ligation.