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目的探讨肝性脑病(HE)结局的危险因素。方法回顾性分析1998年4月至2008年4月我科收治的52例肝硬化合并HE患者的临床资料,选择17项临床、理化因素,分析其对HE短期生存的影响。结果全组患者在治疗30 d内死亡16例(30.8%)。影响生存的单因素为:血清胆红素、血清白蛋白、凝血酶原活动度、Child-Pugh分级、血清钠、腹水、上消化道出血、继发感染、治疗方法、HE分级;Logistic回归模型分析表明肝功能Child-Pugh分级、血清钠、上消化道出血、继发感染、治疗方法等5项指标与HE短期生存明显相关。结论肝功能Child-Pugh分级、血清钠、上消化道出血、继发感染、治疗方法等是影响HE结局的危险因素,准确把握这些危险因素为改善HE患者的短期预后及采取合适的治疗策略提供了前提和基础。
Objective To investigate the risk factors of hepatic encephalopathy (HE) outcome. Methods The clinical data of 52 patients with liver cirrhosis complicated with HE who were treated in our department from April 1998 to April 2008 were retrospectively analyzed. Seventeen clinical and physicochemical factors were selected to analyze their effects on the short-term survival of patients with HE. Results All patients died within 30 days of treatment in 16 cases (30.8%). The single factors influencing survival were serum bilirubin, serum albumin, prothrombin activity, Child-Pugh classification, serum sodium, ascites, upper gastrointestinal bleeding, secondary infection, treatment, HE classification; Logistic regression model Analysis showed that liver function Child-Pugh grading, serum sodium, upper gastrointestinal bleeding, secondary infection, treatment and other five indicators were significantly correlated with short-term survival of HE. Conclusion Child-Pugh classification of liver function, serum sodium, upper gastrointestinal bleeding, secondary infection and treatment are the risk factors influencing the outcome of HE, and accurate grasp of these risk factors is to improve the short-term prognosis of HE patients and to provide appropriate treatment strategies The premise and foundation.