The control and prognostic factors analysis of acute gastroesophageal variceal hemorrhage
10.3760/cma.j.issn.0254-1432.2012.08.004
- VernacularTitle:急性食管胃底静脉曲张出血的控制及预后因素分析
- Author:
Min WANG
;
Qianqian ZHANG
;
Jianming XU
- Publication Type:Journal Article
- Keywords:
Esophageal and gastric varices;
Gastrointestinal hemorrhage;
Prognosis;
Endoscopy
- From:
Chinese Journal of Digestion
2012;32(8):519-522
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the correlation between the bleeding control time,treatment and prognosis in acute gastroesophageal variceal hemorrhage and to explore the predictive factors in treatment failure.Methods The clinical data of 309 patients with acute gsstroesophageal variceal hemorrhage was collected.The bleeding control was retrospectively analyzed within and at two hours after treatment,over two hours but less than six hours,over six hours but less than five days,at and after five days.The correlation between bleeding control time and mortality rate was analyzed.The differences in success rate of bleeding control and mortality rate between medication treatment alone and medication combined with endoscopic treatment were compared.Logistic regression mode was used to analyze the predictive factors of treatment failure.Results Of the 309 acute gastroesophageal variceal hemorrhage hospitalized patients,the failure of bleeding control within and at two hours,over two hours but less than six hours and over six hours but less than five days were 79 cases,25 cases and 26 cases respectively and there were one,four and 16 cases who died respectively.The success rate of bleeding control by medication treatment alone was 57.93％ (179/309) and the mortality was 10.36％ (32/309). The success rate of bleeding control by medication combined with treatment under endoscope was 82.35％ (28/34) and the mortality rate was 0.The results of Logistic regression mode analysis indicated that the admission systolic blood pressure (≤90 mm Hg,1 mm Hg=0.133 kPa),increase of total bilirubin,increase of Child-Pugh grade and ascites were the predictive factors of treatment failure.Conclusions The time of bleeding control failure mostly was within two hours.With time extended,the mortality increased. The success rate of bleeding control by medication combined with endoscopic treatment was higher and the mortality was lower.The admission systolic blood pressure lower than 90 mm Hg,increase of total bilirubin,increase of Child-Pugh grade and ascites may be the predictive factors of treatment failure.
