| Objective Hepatorenal syndrome(hepatorenal syndrome,HRS)are middle-late leads to a common cause of acute renal failure in patients with cirrhosis,also seriously affect the prognosis of patients with diseases,this article through clinical observation of the clinical characteristics of patients with liver cirrhosis complicated with hepatorenal syndrome,calculated from the incidence of hepatorenal syndrome patients,analyze the related risk factors,lead to hepatorenal syndrome and observe trey vasopressin the curative effect of treatment of hepatorenal syndrome and the related factors influencing the curative effect,finally for all patients with terlipressin treatment for 6 months follow-up,to observe the prognosis of patients with risk factors influencing the prognosis of patients,for the future clinical risk assessment of patients,prognosis and treatment to provide the reference.Methods Observe our hospital department of gastroenterology on January 1,2015 to December 31,2015 the new patients with liver cirrhosis in hospital within six months,according to the occurrence of hepatorenal syndrome were divided into HRS group and non HRS group,compared two groups of patients with clinical characteristics,through the single factor analysis and logistic multivariate regression analysis to determine the related risk factors,and continued to watch until December 31,2015,choose to use all terlipressin treatment of hepatorenal syndrome patients,observe the treatment effectiveness and related factors affecting the curative effect,and the patients for the first time after trey vasopressin treatment for 6 months of follow-up,to observe the prognosis and related factors affecting the prognosis.Results Overall incidence of hepatorenal syndrome in 9.13%,with gastrointestinal bleeding(OR 1.578,95% CI 1.006 to 3.287,P < 0.05),a large number of ascites(OR 2.353,95% CI 1.677 to 4.829,P < 0.05),with bacterial peritonitis(OR 2.671,95% CI 1.251 to 5.693,P < 0.05),the MELD score(OR 6.754,95% CI2.519 ~ 11.679,P < 0.01),serum sodium concentration(OR 1.892,95% CI 1.264 ~ 2.989,P < 0.05),plasma albumin levels(OR 0.641,95% CI 0.373 to 0.857,P < 0.05)are risk factors related to cause disease.Use terlipressin treatment patients overall effective rate was67.44%,of which type I patients with hepatorenal syndrome treatment effectiverate of 55.6%,type II treatment of hepatorenal syndrome 72.88% efficient,whether with bacterial peritonitis(OR 0.514,95% CI 0.146 to0.841,P < 0.05),the MELD score(OR 1.644,95% CI 1.089 to 2.482,P < 0.05),the levels of e GFR(OR 0.770,95% CI 0.628 to 0.944,P < 0.05)associated with terlipressin curative effect,and statistically significant.6 months follow-up,found that the final effective follow-up of 86 cases of patients,including trey vasopressin 58 patients with effective treatment,28 patients with invalid.All patients with 25 cases of reentry half a year,readmission rate 29.07%,24 cases of death,the mortality rate of 27.91%.All the effective treatment in patients with19 cases of recurrence,the recurrence rate was 32.76%.Death in a time of 0.3305 months;And found that merge infection(OR 2.634,95% CI 1.251 ~ 5.659,P < 0.05),the MELD score(OR 4.354,95% CI 1.799 to 11.541,P < 0.05)statistically difference,related to the prognosis of patients.Conclusion The hepatorenal syndrome overall incidence,prognosis is poor,with gastrointestinal bleeding,a large number of ascites,with bacterial peritonitis,MELD score and occurrence of hepatorenal syndrome is related,concentration of serum sodium,plasma albumin levels and negatively correlated to the occurrence of hepatorenal syndrome.Terlipressin overall effective rate was 67.4% in the treatment of hepatorenal syndrome,If with bacterial peritonitis,MELD score,and onset of e GFR levels associated with the curative effect of terlipressin,merge infection,MELD score is associated with poor prognosis,using a terlipressin can reduce mortality,and survival in patients with effective treatment,to improve the prognosis of patients. |
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