Clinical Characteristics And Prognostic Factors Of Upper Gastrointestinal Hemorrhage In Patients With Liver Cirrhosis

Objectives In this study,the clinical data of patients with liver cirrhosis complicated with upper gastrointestinal bleeding were analyzed comprehensively,and the clinical characteristics and prognostic factors of upper gastrointestinal hemorrhage in patients with liver cirrhosis was discussed.Methods In this study,614 patients with liver cirrhosis admitted to Tangshan Hongci Hospitall and the Affiliated Hospital of North China University of Technology from January 2014 to June 2018 were retrospectively analyzed.According to the complication of upper gastrointestinal bleeding,168 cases were divided into case group(hemorrhage group)and 446 cases into control group(non-hemorrhage group).168 patients with hemorrhage were divided into two groups according to their prognosis(first death due to upper gastrointestinal hemorrhage),65 cases in case group(first death due to upper gastrointestinal hemorrhage)and 103 cases in control group(non-first death due to upper gastrointestinal hemorrhage).General cardinal data of all patients were collected,such as age,sex,etiology of liver cirrhosis,family history,past history(history of coronary heart disease,hypertension,diabetes,splenectomy),etc.Laboratory test indicators: including blood routine: Hb,WBC,PLT;liver function: ALT,AST,ALB,CHE,TBIL,CTP score;renal function: Cr,BUN;GLU;blood lipid: TC,TG;electrolyte: K+,Na+;coagulation function: PT,APTT,FIB,TT;Shock index;Complications of cirrhosis: esophagogastric varices,ascites,hepatic encephalopathy,portal vein thrombosis,hepatorenal syndrome,hepatopulmonary syndrome,infection,cholelithiasis,etc.Imaging indicators: left gastric vein diameter,portal vein diameter,splenic vein diameter,spleen thickness and so on.The collected data were analyzed by SPSS 20.0 statistical software.Logistic regression analysis was used to analyze the risk factors of upper gastrointestinal bleeding in patients with liver cirrhosis,and to explore the risk factors of prognosis in patients with liver cirrhosis complicated with upper gastrointestinal bleeding.Results Analysis of factors affecting upper gastrointestinal bleeding in patients with liver cirrhosis,The single factor analysis found that family history,etiology of cirrhosis,ChildPugh grading of liver function,esophagogastric varices,ascites,hepatic encephalopathy,portal vein thrombosis,infection,Hb,PLT,ALB,CHE,TBIL,CTP score,BUN,Na+,PT,left gastric vein diameter,portal vein diameter and other factors were associated with cirrhosis complicated with upper gastrointestinal tract.Hemorrhage was related(P < 0.05).Multivariate analysis showed that Child-Pugh classification of liver function,esophagogastric varices,ascites,portal vein thrombosis and the diameter of left gastric vein were risk factors for upper gastrointestinal bleeding in patients with cirrhosis.Analysis of the factors influencing the prognosis of cirrhosis complicated with upper gastrointestinal hemorrhage,Univariate analysis showed that ascites,hepatic encephalopathy,portal vein thrombosis,Child-Pugh grading of liver function,esophagogastric varices,shock index,Hb,PLT,PT,ALB,TBIL,CTP score,chromium,left gastric vein diameter,portal vein diameter were associated with prognosis of upper gastrointestinal hemorrhage in cirrhosis(P< 0.05).Multivariate analysis showed that shock index,portal vein thrombosis,hepatic encephalopathy and esophagogastric varices were risk factors for prognosis of upper gastrointestinal bleeding in cirrhosis.Conclusions Clinical characteristics of upper gastrointestinal bleeding in patients with liver cirrhosis: when the Child-Pugh grading of liver function increases,the degree of esophagogastric varices increases,ascites grading increases,portal vein thrombosis occurs,the risk of upper gastrointestinal bleeding in patients with liver cirrhosis increases,which is the risk factor of upper gastrointestinal bleeding in patients with liver cirrhosis.Risk factors influencing the prognosis of upper gastrointestinal hemorrhage in cirrhosis: when shock index increases,portal vein thrombosis occurs,hepatic encephalopathy grade increases,esophagogastric varices increase,the mortality risk of upper gastrointestinal hemorrhage in cirrhosis increases,which is a significant risk factor for prognosis of liver cirrhosis complicated with upper gastrointestinal bleeding.Figure 0;Table 26;Reference 255...