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目的研究肝硬化患者上消化道出血与细菌感染的关系。方法根据患者合并细菌感染与否将郑煤集团总医院收治的138例肝硬化患者分为观察组(合并细菌感染)62例,对照组(未合并细菌感染)76例。统计两组患者上消化道出血的发生率;并评估两组上消化道出血患者的出血严重程度,采用ChildPugh分级标准评价肝功能,统计腹水、休克、肝性脑病的发生率及再出血发生率、4周内病死率。统计软件采用SPSS 20.0,计量资料用均数±标准差(xˉ±s)表示,采用t检验,计数资料用率(%)表示,采用χ2检验,P<0.05表示差异有统计学意义。结果观察组上消化道出血者发生率为54.84%,对照组为35.53%,两组比较差异有统计学意义(P<0.05)。观察组上消化道出血重度发生率为17.65%;对照组为0,两组差异有统计学意义(P<0.05)。观察组肝功能Child-Pugh评分[(11.82±2.73)分]、再出血发生率及(35.29%)、4周内病死率(23.53%)均高于对照组[(9.02±1.77)分、22.22%、11.11%],两组比较差异有统计学意义(P<0.05)。结论细菌感染可能是诱发肝硬化患者上消化道出血的重要因素,且对患者出血严重程度、肝功能及预后造成影响。
Objective To study the relationship between upper gastrointestinal bleeding and bacterial infection in cirrhotic patients. Methods According to the patients with bacterial infection or not, 138 patients with cirrhosis who were admitted to Zhengzhou General Hospital were divided into observation group (with bacterial infection) in 62 cases and control group (without bacterial infection) in 76 cases. The incidence of upper gastrointestinal bleeding was calculated in both groups. The severity of hemorrhage in two groups of patients with upper gastrointestinal hemorrhage was evaluated. The ChildPugh classification was used to evaluate the liver function. The incidence of ascites, shock, hepatic encephalopathy and the incidence of rebleeding , 4 weeks mortality. Statistical software using SPSS 20.0, measurement data with mean ± standard deviation (x ˉ ± s) said, using t test, count data with the rate (%) that the use of χ2 test, P <0.05 said the difference was statistically significant. Results The incidence of upper gastrointestinal bleeding in the observation group was 54.84%, while that in the control group was 35.53%. There was significant difference between the two groups (P <0.05). The incidence of upper gastrointestinal bleeding was 17.65% in the observation group and 0 in the control group, with significant difference between the two groups (P <0.05). The Child-Pugh score [(11.82 ± 2.73) points], the rate of rebleeding and (35.29%) in the observation group and the mortality rate in the 4 weeks (23.53%) were significantly higher than those in the control group (9.02 ± 1.77) and 22.22 %, 11.11%], the difference between the two groups was statistically significant (P <0.05). Conclusions Bacterial infection may be an important factor in inducing upper gastrointestinal bleeding in cirrhotic patients and has an impact on the severity of bleeding, liver function and prognosis in patients.