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gan ying hua bing fa shang xiao hua dao chu xue 82 li lin chuang fen xi
Author(s): 
Pages: 18-19
Year: Issue:  4
Journal: THE MEDICAL JOURNAL OF INDUSTRIAL ENTERPRISE

Abstract: 目的:区分肝硬化并发上消化道出血的不同原因,观察其临床及实验室等方面差异,探讨更为合理而有效的治疗.方法:通过对82例肝硬化并发上消化道出血急诊胃镜检查,38例为非食管静脉曲张破裂出血,44例为食管静脉曲张破裂出血,分别用不同方法治疗,观察两组止血效果及再出血率.并比较两组在出血方式、Child肝功能分级、超声、实验室检查等方面差异.结果:肝硬化非食管静脉曲张破裂出血在止血效果及再出血率方面明显好于肝硬化食管静脉曲张破裂出血.与肝硬化非食管静脉曲张破裂出血相比,肝硬化食管静脉曲张破裂出血急而凶险,出血量大,多以呕血为主,常伴有周围循环衰竭,其预后凶险,死亡率高,肝功能状态较差,Child分级多在B级以上,脾功能亢进明显,血小板常低于5万以下.门静脉压力较高其内径常大于1.5cm.内镜下食管曲张静脉明显曲张常有红色症.结论:肝硬化并发上消化道出血应尽可能作急诊胃镜检查,明确出血原因,进行合理而有效的治疗,既减轻患者的经济负担,也提高了临床疗效.
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