Analysis Of Clinical Characteristics Of Esophagogastric Variceal Bleeding Caused By Different Liver Cirrhosis

Objective:To analyze the clinical characteristics of the patients with esophagogastric variceal bleeding(EGVB)for the first time due to different etiology of liver cirrhosis,so as to provide the data reference for the treatment,prognosis and the time of return visit.Methods:We collected the clinical data of 126 patients who were diagnosed as the first EGVB due to cirrhosis in Hunan people's hospital from January 1,2010 to December31,2018.According to the diagnostic criteria of liver cirrhosis,the patients were divided into alcoholic cirrhosis group,posthepatitic cirrhosis group,cryptogenic cirrhosis group and primary biliary cirrhosis group.The clinical characteristics and the condition of rebleeding of the patients were analyzed.Meanwhile,the prognostic factors of first EGVB,the relationship between Child-Pugh grades and the first bleeding volume,and the relationship between Child-Pugh grades and the degree of esophageal and gastric varices were discussed.Results:1.There were significant differences in gender and agedistribution among the four causes of cirrhosis(P<0.05);EGVB caused by posthepatitic cirrhosis accounted for 57.9% of all patients,which was the main cause of this study.2.In winter,the incidence of EGVB was the highest in patients with cirrhosis;68.3% of all patients had EGVB for the first time within one year after the diagnosis of cirrhosis;there was no significant difference in the comparison of the first EGVB in patients with four etiologies in different time periods after diagnosis of cirrhosis(P>0.05);the degree of varicosity and the first bleeding volume of four etiologies had no significant difference(P>0.05);all the patients were divided into alcoholic cirrhosis group and non-alcoholic cirrhosis group,we compared the difference of the first bleeding volume between them,there was a significant difference between the two groups when the first bleeding volume was more than 1000 ml(P<0.05);the Child-Pugh grades of four etiologies had significant difference(P<0.05);the incidence of ascites,infection and hepatorenal syndrome among the four etiologies were compared,the difference was not obviously(P > 0.05),however,the incidence of hepatic encephalopathy among them was statistically significant(P<0.05),patients in the alcoholic cirrhosis group with thehighest rates of hepatic encephalopathy(23.1%).3.There was a positive correlation between Child-Pugh grades and the amount of first bleeding and the degree of esophageal and gastric varices(P<0.05,r>0).TBIL,ALB and Child-Pugh grades were independent predictors of the prognosis of the first EGVB patients with cirrhosis.4.The rebleeding rate of patients with alcoholic cirrhosis was higher than that of the other three causes,and the rebleeding rate of Child-Pugh grade C patients was higher than that of grade A and B patients,but the results were not remarkable difference(P>0.05);the rebleeding rate of patients with posthepatitic cirrhosis and primary biliary cirrhosis within one year was higher than that after one year,and the results showed obviously difference(P<0.05),for alcoholic cirrhosis group and cryptogenic cirrhosis group,there was no significant difference in the rate of rebleeding within one year and after one year(P>0.05);the rebleeding rate of Child-Pugh in grade B and C patients within one year was higher than that after one year,and it revealed notably difference(P<0.05),for Child-Pugh in grade A patients,there was no significant difference in the rate of rebleeding within one year and after one year(P>0.05).Conclusion:1.The peak period of first EGVB is one year after the diagnosis of cirrhosis,and winter is high risk season for first EGVB.2.At the time of the first EGVB,there was no significant relationship between the degree of esophageal and gastric varices and the causes of cirrhosis,and the bleeding volume in the alcoholic cirrhosis group was greater than that in the non-alcoholic cirrhosis group,and the incidence of alcoholic cirrhosis with hepatic encephalopathy is higher than that of posthepatitic cirrhosis,cryptogenic cirrhosis and primary biliary cirrhosis.3.The higher the Child-Pugh grade,the larger the first bleeding volume;the higher the Child-Pugh grade,the more serious the degree of esophageal and gastric varices.TBIL and Child-Pugh grades were the risk factors for the prognosis of the first EGVB,while ALB was the protective factor.4.The rate of rebleeding in group posthepatitic cirrhosis and group primary biliary cirrhosis within one year after the first EGVB was higher than that after one year,the rebleeding rate of Child-Pugh in grade B and C patients within one year was higher than that after one year,and these patients shouldhave a ruturn visit within one year after first EGVB.