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[目的]探讨失代偿期肝硬化患者临床特点、死亡原因及影响预后的危险因素。[方法]选取失代偿期肝硬化病例205例作为研究对象,分析死亡组与生存组临床指标差异、死亡原因、死亡危险因素等。[结果]死亡组患者WBC高于生存组,Hb、ALB均低于生存组,差异有统计学意义(P<0.05),死亡组PT、APTT延长超过生存组,死亡组AST、TB、CRP明显高于生存组,上述指标2组差异均有统计学意义(P<0.05)。2组PLT、ALT、ALP、GGT比较差异无统计学意义(P>0.05)。失代偿期肝硬化患者的死亡原因主要为:上消化道出血并失血性休克、慢性肝功能衰竭、合并严重感染等。Logistic回归分析的结果表明:死亡的主要危险因素包括:年龄(≥60岁)、伴有出血(≥400ml)、PT延长、伴有中-大量腹水、慢性肝衰竭、合并感染等。[结论]对于失代偿期肝硬化患者伴有上述危险因素者应积极加强临床干预,对合并感染者应积极抗感染治疗,同时注意失代偿期肝硬化患者并发症的治疗。
[Objective] To investigate the clinical features, causes of death and risk factors of prognosis in patients with decompensated cirrhosis. [Methods] Totally 205 cases of decompensated cirrhosis were selected as study objects, and the differences of clinical indexes between death group and survival group, causes of death and risk factors of death were analyzed. [Results] The WBC in the death group was higher than that in the survival group, and the levels of Hb and ALB in the death group were lower than those in the survival group (P <0.05). The PT and APTT in the death group prolonged more than those in the survival group. The AST, TB and CRP in the death group were significantly Higher than the survival group, the above two indicators were statistically significant difference (P <0.05). There was no significant difference in PLT, ALT, ALP and GGT between the two groups (P> 0.05). The main causes of death in patients with decompensated cirrhosis: upper gastrointestinal bleeding and hemorrhagic shock, chronic liver failure, with severe infection. Logistic regression analysis showed that the main risk factors for death were age (≥60 years), bleeding (≥400ml), prolongation of PT, moderate to severe ascites, chronic liver failure and co-infection. [Conclusion] Patients with decompensated cirrhosis should be actively involved in the intervention of the above risk factors, active anti-infective therapy should be taken for patients with combined infection, and pay attention to the treatment of complications in patients with decompensated cirrhosis.