Clinical Features,Risk Factors,Prognostic Factors Of Cirrhotic Patients With Upper Gastrointestinal Bleeding

Purpose:To explore the clinical features of patients with upper gastrointestinal bleeding.And to study the risk factors and prognostic factors of cirrhotic patients with upper gastrointestinal bleeding.So as to provide references for clinical treatment.Methods:315 patients of cirrhotisis were selected in internal medicine department of our hospital from December 2015 to December 2016 and divided into bleeding group(142 cases)and non-bleeding group(173 cases)according to whether hemorrhage happened.142 cases of bleeding group were divided into survival group(101 cases)and death group(41 cases).The general information,biochemical indicators,endoscopy findings,laboratory results,imageological diagnosis results of bleeding group and non-bleeding group were compared.The 21 risk factors of bleeding group and non-bleeding group were compared.The relationship of risk factors and upper gastrointestinal bleeding were decided by Logistic regression analysis.The general information,biochemical indicators,endoscopy findings,laboratory results,imageological diagnosis results of survival group and death group were compared.The 24 prognostic factors of bleeding group and non-bleeding group were compared.The relationship of prognostic factors and prognosis of cirrhotic patients with upper gastrointestinal bleeding were decided by Logistic regression analysis.Result:Vomiting blood,vomiting dark red blood,vomiting brown gastric content,dark red bloody stools,black stools,weakness,abdominal pain,satiety,OB positive of faeces were the clinical features of patients with upper gastrointestinal bleeding.History of upper gastrointestinal bleeding,coronary vein,varices of fundus of stomach,red-color sign,Child-Pugh,portal venous diameter,ascites,serum creatinine,prothrombin time,hemoglobin,blood platelet count of bleeding group and non-bleeding group had significant differences,(P<0.05).Course of the disease,age,sex,cause of liver cirrhosis,serum albumin,serum bilirubin,white blood cell count,diameter of splenic veinof bleeding group did not have significant differences,(P>0.05).Varices of fundus of stomach,prothrombin time,ascites,portal venous diameter were the 4 independent risk factor of upper gastrointestinal bleeding of cirrhotic patients.Cause of liver cirrhosis,history of upper gastrointestinal bleeding,shock index,splenectomy,infection,liver masses Child-Pugh,ascites,portal venous diameter,serum creatinine,prothrombin time,serum bilirubin,hemoglobin,blood platelet count of survival group and death group had significant differences,(P<0.05).Course of the disease age,sex,serum albumin,white blood cell count,splenectomy,hepatic encephalopathy,hepatic encephalopathy,portal thrombosis,hepatorenal syndrome,diameter of splenic vein of survival group and death group did not have significant differences,(P>0.05).Shock index,serum bilirubin,splenectomy were the 3 independent prognostic factors of cirrhotic patients with upper gastrointestinal bleeding.Conclusion:Varices of fundus of stomach,prothrombin time,ascites,portal venous diameter were the 4 independent risk factor of upper gastrointestinal bleeding of cirrhotic patients.Shock index,serum bilirubin,splenectomy were the 3 independent prognostic factors of cirrhotic patients with upper gastrointestinal bleeding.