Clinical Analysis Of Esophageal Varices And Upper Gastrointestinal Bleeding After Liver Cirrhosis

Objective:By analyzing the general information and laboratory and auxiliary examinations of 151 cirrhotic patients with upper gastrointestinal bleeding due to moderate and severe esophageal varices,198 patients with esophageal varices but no hemorrhage Auxiliary examination,to explore the clinical characteristics of upper gastrointestinal bleeding caused by moderate and severe esophageal varices in patients with liver cirrhosis,the risk factors of bleeding,and the risk factors of moderate and severe esophageal varicose veins.For prevention and treatment and noninvasive monitoring of non-bleeding patients with liver cirrhosis.Methods:This article analyzes 151 patients who were diagnosed with liver cirrhosis and were diagnosed with liver cirrhosis from January 01,2015 to December 31,2018in the Department of Gastroenterology,Infection and other departments of the First Hospital of Lanta University and had upper gastrointestinal bleeding due to rupture of esophageal varices The clinical data of the patients were analyzed to analyze the causes of these cirrhotic patients,whether it was the first bleeding,the treatment method,and whether the blood was transfused during the treatment.At the same time period,198 patients with liver cirrhosis who had esophageal varices but did not have upper gastrointestinal bleeding,analyze their blood routine,biochemical,coagulation,abdominal ultrasound and other indicators to find out the indicators that are closely related to moderate and severe esophageal varices;according to the above statistical results of 151 patients,they are divided into two Group,one group was the first bleeding group with a total of 75 patients,and the other group was the non-first bleeding group with a total of 76 patients.These two groups were compared with livers without upper gastrointestinal bleeding but with moderate to severe esophageal varices The laboratory and auxiliary examinations of patients with cirrhosis were compared and analyzed to find out the risk factors of bleeding in patients with liver cirrhosis with moderate to severe esophageal varices.The statistical data involved in this article is analyzed using SPSS 24.0 softwareResult:1.General situation:Of the 151 cirrhotic patients with moderate to severe esophageal varices bleeding,62%(94 cases)of liver cirrhosis caused by hepatitis B virus,rather than liver after hepatitis B virus Sclerosis accounted for 38%(57 cases);among them,patients with first upper gastrointestinal bleeding accounted for 49.7%(75 cases),and patients with non-first upper gastrointestinal bleeding accounted for50.3%(76 cases);Endoscopic treatment accounted for 67%(101 cases),drug treatment accounted for 26%(38 cases),TIPS treatment accounted for 7%(12 cases);in the course of treatment for 61%(92 cases)required blood transfusion for 39%(59cases)did not need blood transfusion treatment.2.Indicators closely related to moderate and severe esophageal varicose veins:patients with mild esophageal varices and moderate to severe esophageal varicose veins There is a significant difference in vein diameter(P<0.05),while ALT has no correlation with moderate and severe esophageal varices(P>0.05),and white blood cells,total cholesterol,triglycerides are strongly negatively correlated with moderate and severe esophageal varices(r<0,|r|?0.7),while portal vein width,spleen thickness,and splenic vein inner diameter are strongly positively correlated with moderate and severe esophageal varices(r>0,|r|?0.7),while INR is associated with moderate and severe esophageal veins Varicose was moderately positively correlated(r>0,0.7?|r|?0.4);when white blood cells<3.95×10~9/L or platelets<87×10~9/L or total cholesterol<3.56mmoL/L or triglycerides<0.80 mmoL/L or portal vein width>12.5mm or spleen thickness>47mm or splenic vein inner diameter>8.5mm,it indicates that the patient has moderate to severe esophageal varices.3.High risk factors for bleeding due to rupture of esophageal varices:white blood cells,total cholesterol,and splenic vein inner diameter are significantly different between the first bleeding group and the non-bleeding group(P<0.05).The lower the total cholesterol,the wider the splenic vein inner diameter The greater the risk of first bleeding(P<0.05);white blood cells,total cholesterol,portal vein width,spleen thickness,and splenic vein diameter are significantly different between the non-first bleeding group and the non-bleeding group(P<0.05),the lower the total cholesterol is not the first The greater the risk of bleeding(P<0.05).Conclusion1.Hepatitis B is still the most common cause of liver cirrhosis.The proportion of patients with liver cirrhosis due to moderate to severe esophageal varices is high.Most treatment options are endoscopic treatment,and most patients are in treatment.Blood transfusion is required during the procedure.2.In patients with liver cirrhosis,the lower the total cholesterol and triglycerides,the greater the portal vein width,spleen thickness,and splenic vein inner diameter value,and the possibility of moderate to severe esophageal varices is greater.3.The lower the total cholesterol,the greater the risk of bleeding in patients with moderate to severe esophageal varices cirrhosis.