Risk Factors For Early Rebleeding Of Esophageal And Gastric Varices In Cirrhosis

Objective:To find the risk factors of cirrhosis with esophageal and gastric variceal early rebleeding.Reduce the incidence of early rebleeding in patients with esophageal and gastric variceal.Improving the prognosis of the patients,obtaining the data support for clinical,raising social and economic benefit.Methods:Collected the clinical data of patients with liver cirrhosis bleeding who were diagnosed and treated in Shaanxi People's Hospital from January 2014 to January 2016.The clinical data were collected and divided into case group and control group according to the occurrence of early rebleeding in 6 weeks.Compared and analyzed the clinical data,laboratory and imaging examinations of the two groups.To find out the risk factors of the early rebleeding.Results:There were 325 cases altogether and 66 patients(n = 20.31%)with early rebleeding in the case group and 259 patients(n = 79.69%)in the control group with no rebleeding in the same time.Between them,the single factor analysis result is:diabetes mellitus(p=0.001),platelets(p=0.001),total bilirubin(p=0.001),prothrombin time(p=0.001),international normalized ratio(p=0.002),portal vein diameter(p=0.001),splenic vein(p=0.039),spleen length(p=0.004),spleen thickness(p=0.005),spleen size(p=0.009),platelet and spleen length ratio(p=0.001),platelet and spleen size ratio(p=0.001),portal vein thrombosis(p=0.001),esophageal varices(p=0.01),red syndrome(p=0.008),Child-Pugh classification of liver function(p=0.004).The logistic regression analysis is:1.The average value of the diameter of portal vein and splenic vein diameter,spleen length,platelet and spleen length ratio,total bilirubin,prothrombin time,international normalized ratio in the case group is significantly higher than that of control group(P<0.05).2.The mean value of platelet in case group was lower than that in control group(P=0.001).3.There was no significant difference between the two groups in portal vein thrombosis,red sign,Child-Pugh grade of liver function and the degree of esophageal varices(P<0.05).4.The level of esophageal varices was positively correlated with Child-Pugh grade of liver function,correlation coefficient r=0.416,P<0.05.5.There was no correlation between the antiviral therapy and the incidence of early rebleeding in patients with viral liver cirrhosis who had no history of antiviral drug use(P=0.546).6.In the case group,the usage rate of the propranolol was lower than that of the control group(P=0.024).7.The choice of treatment methods had no significant effect on liver cirrhosis rebleeding.Conclusion:1.The diameter of portal vein and splenic vein diameter,spleen length,Platelet count,platelet and spleen length ratio,blood coagulation index(PT,INR)and total bilirubin may be risk factors of cirrhosis with esophageal and gastric variceal rebleeding.2.The risk of early rebleeding in cirrhotic patients with portal vein thrombosis.3.The Child-Pugh classification of liver function and the degree of esophageal varices is a risk factor for cirrhosis esophageal and gastric varices of early rebleeding,liver function Child-Pugh grade C,severe esophageal varices,red syndrome for early positive cirrhosis patients greater risk of rebleeding.4.Child-Pugh grading of liver function was correlated with the degree of esophageal varices,and there was a positive correlation between them.5.There was no correlation between the antiviral therapy and the incidence of early rebleeding in patients with viral cirrhosis and no history of antiviral drug use.6.The usage rate of the propranolol in patients with EGVB can significantly reduce the risk of early rebleeding.7.In the two grade prevention,endoscopic injection sclerotherapy and endoscopic variceal ligation on the early liver cirrhosis patients with EGVB rebleeding rate had no significant difference.