糖尿病对肝硬化食管静脉曲张患者内镜治疗后再出血的影响

中华消化内镜杂志 Pub Date : 2020-01-20 DOI:10.3760/CMA.J.ISSN.1007-5232.2020.01.007

Xi Wang, Xuecan Mei, Na Zhang

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引用次数: 0

摘要

目的探讨合并糖尿病对肝硬化食管静脉曲张患者内镜治疗后再出血的影响。方法对2015年6月至2018年3月在安徽医科大学第一附属医院接受内镜下静脉曲张结扎或内镜下注射硬化治疗的207例肝硬化食管静脉曲张破裂出血患者进行回顾性研究。根据治疗后6个月内是否再次出血，将病例分为出血组（n=54）和非出血组（n=153）。采用单因素分析和logistic回归分析对术后出血的影响因素进行分析。结果单因素分析显示：性别构成、年龄、有无门静脉血栓形成、吸烟史、饮酒史（P=0.05）、高血压、血小板计数、总胆红素水平、白蛋白水平、丙氨酸氨基转移酶水平、凝血酶原时间、食管静脉曲张程度、，出血组与非出血组手术方法差异无统计学意义（P均≥0.05）。两组在糖尿病、血红蛋白水平、血糖水平、腹水组成和肝功能分级组成方面均存在显著差异（均P<0.05），结果显示糖尿病是内镜治疗食管静脉曲张后再出血的独立危险因素（P=0.008，OR=2.973，95%CI:1.322-6.689），糖尿病患者更容易再次出血。关键词：糖尿病；肝硬化；食管静脉曲张；内镜下静脉曲张结扎术；内镜注射硬化治疗；重新休眠

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Effects of diabetes on rebleeding after endoscopic treatment in liver cirrhosis patients with esophageal varices

Objective To investigate whether combined diabetes affects rebleeding after endoscopic treatment in cirrhosis patients with esophageal varices. Methods A total of 207 liver cirrhosis cases with esophageal varices bleeding who underwent initial treatment of endoscopic variced ligation or endoscopic injection sclerotherapy in the First Affiliated Hospital of Anhui Medical University from June 2015 to March 2018 were included in the retrospective study. The cases were divided into bleeding group (n=54) and non-bleeding group (n=153) according to the presence or absence of rebleeding within 6 months after treatment. The influencing factors on postoperative bleeding were analyzed by univariate analysis and logistic regession analysis. Results Univariate analysis showed that gender composition, age, presence or absence of portal vein thrombosis, smoking history, drinking history (P=0.05), hypertension, platelet count, total bilirubin level, albumin level, alanine aminotransferase level, prothrombin time, degree of esophageal varices, and surgical methods were not significantly different (all P≥0.05) between the bleeding group and the non-bleeding group. There were significant differences in diabetes, hemoglobin level, blood glucose level, ascites composition, and liver function grade composition between the two groups (all P<0.05). Combined diabetes (yes/no), hemoglobin levels, blood glucose levels, ascites (none-mild/medium-severe), liver function Child-Pugh classification (Grade A/B-C), and history of drinking (yes/no) were included in multivariate analysis, and results showed that diabetes was an independent risk factor for rebleeding after endoscopic treatment of esophageal varices (P=0.008, OR=2.973, 95%CI: 1.322-6.689). Conclusion After endoscopic treatment of liver cirrhosis patients with esophageal varices, rebleeding is more likely to occur in patients complicated with diabetes. Key words: Diabetes mellitus; Liver cirrhosis; Esophageal varices; Endoscopic variceal ligation; Endoscopic injection sclerotherapy; Rebleeding

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来源期刊

中华消化内镜杂志

CiteScore

0.10

自引率

0.00%

发文量

7555

期刊介绍： Chinese Journal of Digestive Endoscopy is a high-level medical academic journal specializing in digestive endoscopy, which was renamed Chinese Journal of Digestive Endoscopy in August 1996 from Endoscopy. Chinese Journal of Digestive Endoscopy mainly reports the leading scientific research results of esophagoscopy, gastroscopy, duodenoscopy, choledochoscopy, laparoscopy, colorectoscopy, small enteroscopy, sigmoidoscopy, etc. and the progress of their equipments and technologies at home and abroad, as well as the clinical diagnosis and treatment experience. The main columns are: treatises, abstracts of treatises, clinical reports, technical exchanges, special case reports and endoscopic complications. The target readers are digestive system diseases and digestive endoscopy workers who are engaged in medical treatment, teaching and scientific research. Chinese Journal of Digestive Endoscopy has been indexed by ISTIC, PKU, CSAD, WPRIM.