论文部分内容阅读
AIM To investigate mortality and rebleeding rate and identify associated risk factors at 6 wk and 5 d following acute variceal haemorrhage in patients with liver cirrhosis and schistosomal periportal fibrosis.METHODS This is a prospective study conducted during the period from March to December 2014. Patients with portal hypertension presenting with acute variceal haemorrhage secondary to either liver cirrhosis(group A) or schistosomal periportal fibroses(group B) presenting within 24 h of the onset of the bleeding were enrolled in the study and followed for a period of 6 wk. Analysis of data was done by Microsoft Excel and comparison between groups was done by Statistical Package of Social Sciences version 20 to calculate means and find the levels of statistical differences and define the mortality rates, the P value of < 0.05 was considered to be significant. RESULTS A total of 94 patients were enrolled in the study. Thirtytwo patients(34%) had liver cirrhosis(group A) and62(66%) patients had periportal fibrosis(group B).Mortality: The 6-wk and 5-d mortality were 53% and16% respectively in group A compared to 10% and 0%in group B(P value < 0.000 and < 0.004). In group A;a Child-Turcotte-Pugh class C and rebleeding within 5 d were significantly associated with 5-d mortality(P value< 0.029 and < 0.049 respectively) and Child- TurcottePugh class C was also a significant risk factor for 6-wk mortality(P value < 0.018). In group B; mortality was significantly associated with rebleeding within the 6-wk follow-up period and requirement for blood transfusion on admission(P value < 0.005 and < 0.049). Rebleeding:The 6-wk and 5-d rebleeding rate in group A were 56%and 25% respectively compared to 32% and 3% in group B(P value < 0.015 and < 0.002). Clinical presentation with encephalopathy was a significant risk factor for 5 d rebleeding in group A(P value < 0.005) while grade Ⅲperiportal fibrosis and requirement for blood transfusion on admission were significant risk factors for 6-wk rebleeding in group B(P value < 0.004 and < 0.02).CONCLUSION The 6-wk and 5-d mortality and rebleeding rate were significantly higher in patients with liver cirrhosis compared to patients with schistosomal periportal fibrosis.
AIM To investigate mortality and rebleeding rate and identify associated risk factors at 6 wk and 5 d following acute variceal haemorrhage in patients with liver cirrhosis and schistosomal periportal fibrosis. METHHODS This is a prospective study conducted during the period from March to December 2014. Patients with portal hypertension presenting with acute variceal haemorrhage secondary to either liver cirrhosis (group A) or schistosomal periportal fibroses (group B) presenting within 24 h of the onset of the bleeding were enrolled in the study and followed for a period of 6 wk. Analysis of data was done by Microsoft Excel and comparison between groups was done by Statistical Package of Social Sciences version 20 to calculate means and find the levels of statistical differences and define the mortality rates, the P value of <0.05 was considered to be significant. RESULTS A total of 94 patients were enrolled in the study. Thirtytwo patients (34%) had liver cirrhosis (group A) and62 (66%) pat † had had periportal fibrosis (group B) .Mortality: The 6-wk and 5-d mortality were 53% and 16% respectively in group A compared to 10% and 0% in group B (P value <0.000 and <0.004). In group A; a Child-Turcotte-Pugh class C and rebleeding within 5 d were significantly associated with 5-d mortality (P value <0.029 and <0.049 respectively) and Child- Turcotte Class C was also a significant risk factor for 6-wk mortality (P value <0.018). In group B; mortality was significantly associated with rebleeding within the 6-wk follow-up period and requirement for blood transfusion on admission (P value <0.005 and <0.049). Rebleeding: The 6-wk and 5-d rebleeding rate in group A were 56% and 25% respectively compared to 32% and 3% in group B (P value <0.015 and <0.002). Clinical presentation with encephalopathy was a significant risk factor for 5 d rebleeding in group A (P value <0.005) while grade IIIperiportal fibrosis and requirement for blood transfusion on admission were significant risk fac tors for 6-wk rebleeding in group B (P value <0.004 and <0.02) .CONCLUSION The 6-wk and 5-d mortality and rebleeding rate were significantly higher in patients with liver cirrhosis compared to patients with schistosomal periportal fibrosis.