Analysis Of Risk Factors For Esophagogastric Variceal Bleeding In Patients With Liver Cirrhosis

BackgroundLiver cirrhosis is an end-stage liver disease caused by chronic liver disease,as the disease progresses,liver tissue fibrosis and severe structural damage lead to hepatocyte dysfunction and portal hypertension,frequently associated with esophagogastric variceal bleeding risks,is a dangerous and fatal complication of late cirrhosis.For clinicians,it is particularly important to identify the risk factors of EVB early through commonly used clinical indicator.In recent years,scholars at home and abroad have made great efforts to assess the risk of rupture and bleeding of esophageal and gastric varices through commonly used clinical indicators,but the risk factors are still controversial.ObjectiveTo investigate the risk factors of liver cirrhosis complicated with esophagogastric variceal bleeding through clinical commonly used indexes,early assessment of patients at high risk of esophagogastric variceal bleeding,to facilitate timely and effective prevention and treatment measures to reduce the incidence of disease and improve the survival rate of patients.MethodsA total of 60 patients with liver cirrhosis complicated by esophagogastric variceal bleeding were selected as the bleeding group in the First Affiliated Hospital of Xinxiang Medical College From July 2017 to July 2019,and 125 patients with gastroesophageal varices at the same period were selected as non-bleeding group.The general data,laboratory indicators,Child-Pugh classification of liver function,gastroscopy results,ultrasound or imaging results of the two groups were analyzed by single factor analysis,the indicators with different results of single factor analysis(P<0.05),and then perform binary logistic regression analysis.Results1.This study found that patients with esophagus and gastric varices had more males than females,with males accounting for 60.54%and females for 39.46%.The ratio of males to females was 1.53:1,and the majority of patients are over 40 years of age.2.There were significant differences in red sign,degree of esophageal varices and gastric varices between the two groups(?~2=73.427,65.780,16.355,P<0.05).3.The prothrombin time(PT)and thrombin time(TT)in the bleeding group were significantly longer than those in the non-bleeding group(P<0.05).The platelet count(PLT),serum albumin(ALB)and fibrinogen(FIB)were significantly lower than those in non-bleeding group(P<0.05).The white blood cell count(WBC),total bilirubin(TBIL),activated partial thromboplastin time(APTT)and serum creatinine(CRE)levels were not significant difference between the two groups(P>0.05).4.There were significant differences in the spleen of thickness,internal diameter of portal vein,portal vein thrombosis,ascites and Child-Pugh classification between the two groups(P<0.05).5.The statistical significance of red sign,degree of esophageal varices,gastric varices,PT,TT,PLT,ALB,FIB,spleen thickness,internal diameter of portal vein,portal vein thrombosis,ascites,Child-Pugh grade were analyzed by binary Logistic regression analysis,the results showed that serum albumin was the protective factor of EVB(OR=0.874,95%CI:0.788 to 0.968,P=0.01),the red sign(OR=4.106,95%CI:1.392 to 12.113,P=0.011)and severe esophageal varices(OR=4.389,95%CI:1.084 to 17.774,P=0.038)were the independent risk factors of EVB.Conclusion1.Red sign and severe esophageal varices are the risk factors of liver cirrhosis complicated with esophagogastric variceal bleeding.Serum albumin is the protective factor of liver cirrhosis complicated with esophagogastric variceal bleeding.2.PT prolongation and the platelet count reduction may not directly lead to esophagogastric variceal bleeding.