Clinical Study Of Liver Cirrhosis Complicated With Pulmonary Embolism

Objective:To explore the influencing factors and short-term prognosis of patients with cirrhosis complicated with pulmonary embolism by comparing the general situation,etiology,clinical symptoms,pleural effusion and ascites,auxiliary examination data,adverse events within 30 days,length of hospital stay,hospitalization expenses of patients with cirrhosis complicated with pulmonary embolism and those without pulmonary embolism.Method:A total of 214 patients with liver cirrhosis admitted to Kunming Medical University from January 2015 to October 2020 were retrospectively collected.According to the results of CTPA,the patients were divided into cirrhosis complicated with pulmonary embolism group(experimental group)and cirrhosis without pulmonary embolism group(control group).To explore the risk factors of pulmonary embolism in patients with liver cirrhosis by collecting the patients’ age,gender,vital signs at admission,height,weight,clinical symptoms,pleural effusion,ascites,causes of liver cirrhosis,complications of liver cirrhosis,complications,auxiliary examination data,and comparing the clinical data of experimental group and control group.To evaluate the short-term prognosis of pulmonary embolism in patients with liver cirrhosis by collecting the number of adverse events,hospitalization costs and hospitalization days,calculating the incidence of adverse events,and comparing the incidence of adverse events,hospitalization days and hospitalization costs in the two groups.Results:According to the results of CTPA,there were 72 cases in experimental group and 142 cases in control group.1.Comparison of general data:(1)comparison of baseline:there was no statistical difference in gender and vital signs.The experimental group was older than the control group,the difference was statistically significant(P<0.05).(2)There were 28 cases(38.9%)of patients with malignant tumor in the experimental group,34 cases(23.9%)in the control group,46 cases(63.9%)in the experimental group with infection and 57 cases(40.1%)in the control group.The rates of malignant tumor and infection in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).(3)In the comparison of complications,there was no significant difference in hypertension,diabetes and coronary heart disease between the two groups(P>0.05).2.Etiological comparison of cirrhosis:in the experimental group,there were 41 cases(43.1%)of cirrhosis after viral hepatitis,2 cases(2.8%)of alcoholic cirrhosis,3 cases(4.2%)of autoimmune cirrhosis,34 cases(47.2%)of cirrhosis of other and unknown causes.In control group,there were 70 cases(49.3%)of cirrhosis after viral hepatitis,2 cases(1.4%)of alcoholic cirrhosis,8 cases(5.6%)of autoimmune cirrhosis,58 cases(40.8%)of cirrhosis of other and unknown causes.There was no significant difference between the two groups(P>0.05).3.Comparison of clinical symptoms:The incidence of dyspnea,chest pain,hemoptysis,syncope and fever had no significant difference in two groups.(P>0.05).4.Comparison of ascites and pleural effusion:the experimental group had 50 cases of ascites(69.4%),48 cases of pleural effusion(66.7%),and the control group had 73 cases of ascites(51.4%),46 cases of pleural effusion(32.4%).The incidence of ascites and pleural effusion in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).5.Auxiliary examination data comparison:biochemical test indexes:the TP and ALB levels in the experimental group were lower than in the control group,the difference was statistically significant(P<0.05).Blood cell parameters:the differences of all the indexes included were not statistically significant(P>0.05).Blood coagulation function:the INR and DD in the experimental group were higher than in the control group,and AT was lower than in the control group,the difference was statistically significant(P<0.05).Infection index:the PCT,HSCRP and IL-6 levels in experimental group were significantly higher than in the control group,the difference was statistically significant(P<0.05)..Transthoracic echocardiography:there was no significant difference between the two groups(P>0.05).6.Correlation analysis:age,INR,DD,PCT,HSCRP,IL-6,ascites,pleural effusion,cough,expectoration,malignant tumor and infection were positively correlated with cirrhosis complicated with pulmonary embolism,while TP,ALB and AT level were negatively correlated with cirrhosis complicated with pulmonary embolism.7.Multivariate logistic regression analysis showed that serum ALB level,pleural effusion and malignant tumor were the independent influencing factors of pulmonary embolism,pleural effusion and malignant tumor were the risk factors,serum albumin level was the protective factor.8.Comparison of hospitalization expenses and length of stay:the hospitalization expenses of experimental group were higher than those of the control group,the difference was statistically significant(P<0.05),and there was no statistically significant difference between the two groups(P>0.05).According to the length of hospital stay ≤10 days,10-20 days,>20 days grouping,the proportion of patients in experimental group with length of hospital stay ≤10 days was lower than that in the control group,and the proportion of patients with length of hospital stay of 10-20 days,>20 days was higher than that in the control group,the difference was statistically significant(P<0.05).9.There were 12 patients with adverse events in this study,8 cases(11.1%)in experimental group and 4 cases(2.8%)in control group.The incidence of adverse events in experimental group was higher than that in control group,and the difference was statistically significant(P<0.05).Conclusion:1.In patients with liver cirrhosis,patients with pulmonary embolism are older than those without pulmonary embolism,and more complicated with ascites,pleural effusion and infection.2.There are significant differences in the level of TP,ALB,INR,DD,PCT,HSCRP,IL-6 between patients with pulmonary embolism and patients without pulmonary embolism,and these indicators are related to pulmonary embolism.3.Low serum ALB level,pleural effusion and malignant tumor may be the independent risk factors of cirrhosis complicated with pulmonary embolism.4.In patients with liver cirrhosis,patients with pulmonary embolism are more likely to have short-term adverse events,higher hospitalization costs,longer hospitalization days and heavier disease burden than patients without pulmonary embolism.