关键词: 肝硬化, 食管胃底静脉曲张破裂出血, 危险因素, 再出血

Abstract: Objective To investigate the risk factors and prevention as well as treatment of rebleeding in patients with liver cirrhosis complicated with esophageal and gastric variceal bleeding (EGVB) in Shenzhen.Methods The clinical data of 548 cases with liver cirrhosis complicated with esophageal and gastric varices in Shenzhen were collected and divided into bleeding group and non-bleeding group according to whether there was bleeding. The age, sex, cause of liver cirrhosis and results of auxiliary examinations (including platelet count, liver function, coagulation function, spleen diameter and ascites, etc.) of the two groups were retrospectively analyzed and compared. The related risk factors of EGVB and the prevention and treatment of rebleeding were investigated.Results The results of univariate analysis showed that there were significant differences in 9 factors, including the cause of liver cirrhosis, Child-Pugh grade, ascites, hepatic encephalopathy and platelet count between the two groups (all P<0.05). Multivariate logistic regression analysis showed that platelet count and albumin were negatively correlated with EGVB (OR value is between 0~1), and ascites was positively correlated with EGVB (OR value is 3.068). In the bleeding group, 109 cases (about 51.4%) received prophylactic treatment for rebleeding, including 90 cases of endoscopic therapy, 2 cases of surgical therapy, 1 case of interventional therapy and liver transplantation, and 15 cases of combined therapy.Conclusion Patients with esophageal and gastric varices who with ascites in Shenzhen may be more prone to variceal bleeding, which should be paid attention to in clinical practice. At the same time, attention should be paid to clinical protective measures, and if necessary, normative secondary prevention and treatment should be feasible.

Key words: Liver cirrhosis, Esophageal and gastric varices bleeding, Risk factors, Rebleeding