Analysis Of Related Factors Of Refractory Ascites And Portal Vein Thrombosis In Patients With Liver Cirrhosis

Objective:To explore the clinical risk factors of refractory ascites and portal vein thrombosis in patients with liver cirrhosis,and provide valuable predictive indicators for early clinical diagnosis.Method:Patients with decompensated liver cirrhosis who met the research requirements in the Second Hospital of Jilin University from January 2016 to September 2019 were listed as the research subjects,39 patients who met the guidelines for the diagnosis of RA and were confirmed to have PVT by imaging for group A,73 patients with decompensated cirrhosis at the same stage were randomly selected as group B,with a total of 112 patients.The collected observation indicators include general information,the results of the first fasting hematological examination after a clear diagnosis,imaging examination and complications.Summarizing the differences between the indicators and reading relevant literature to select meaningful indicators,using statistical software SPSS25.0 to analysis and screen out the possible risk factors related to the occurrence of disease.Result:1.Comparison of groups A and B: Etiology?Diabetes?Age?Spontaneous bacterial peritonitis(SBP)? Gastrointestinal bleeding(GIB)? Albumin(ALB)?Glutamyltranspeptidase(GGT)?Cholinesterase(CHE)?Blood urea nitrogen(BUN)?Antithrombin ?(AT?)?International normalizde ratio(INR)?White blood cell(WBC)?Hemoglobin(HB)were not related to RA and PVT in patients with liver cirrhosis,and the difference was not statistically significant(P> 0.05).2.Comparison of groups A and B: MELD score(t =-4.49,P <0.01)? Serum creatinine(Scr)(t =-2.25,P <0.05)?Serum retinol binding protein(SRBP)(t = 7.10,P <0.01)?Concentration of serum sodium(PNa +)(t = 8.32,P <0.01)?D-dimer(DD)(t =-4.26,P <0.01)?Platelet(PLT)(t = 2.95,P <0.05)?Diameter of main portal vein(MVP)(t =-10.52,P <0.01)and splenic vein(SPV)(t =-2.48,P <0.05)?Hepatic encephalopathy(HE)(?~2= 5.96,P <0.05)were related to RA and PVT in patients with liver cirrhosis,and the difference was statistically significant(P <0.05).3.The above-mentioned significant factors were analyzed by binary logistic regression: MELD score increased(OR=1.80,P <0.05),Inner diameter of MVP widened(OR=1.80,P <0.05),PNa +(OR=0.6,P < 0.05)and SRBP(OR=0.72,P<0.05)decreased were independent risk factors of RA and PVT in patients with liver cirrhosis.Conclusions:1.MELD score?Scr?DD?diameter of MVP and SPV?PLT?PNa +?SRBP and HE are related risk factors for cirrhosis with RA and PVT;2.MELD score increased ? Inner diameter of MVP widened ? PNa+ and SRBP decreased are high risk factors for cirrhosis with RA and PVT.Patients with decompensated liver cirrhosis should be regularly reviewed color doppler ultrasound or multirow spiral computed tomography to estimate diameter of MVP,discover the formation of PVT in time and give reasonable treatment.Calculating the MELD scores and paying attention to renal function in the treatment and follow-up of patients are very important,higher Scr often indicates that impaired glomerular filtration function,lower SRBP and PNa + indicate liver synthesis capacity decreased and impaire renal tubular function.Improving the function of liver and kidney and correcting hyponatremia can delay disease progression.