Analysis Of Risk Factors Related To Upper Gastrointestinal Bleeding In End-stage Liver Disease

Objective:To explore the risk factors of end-stage liver disease(ESLD)complicated with upper gastrointestinal hemorrhage and provide a reference for early clinical intervention.Methods: Retrospectively included 600 patients with end-stage liver disease who were hospitalized in the First Affiliated Hospital of Xinjiang Medical University from January 2010 to January 2019,and 554 patients were included according to the exclusion criteria,including 154 patients with chronic liver failure In 400 patients with acute decompensation of cirrhosis,according to the presence or absence of upper gastrointestinal hemorrhage,they were divided into 54 patients with chronic gastrointestinal hemorrhage and upper gastrointestinal hemorrhage group,and 100 patients with non-bleeding group.200 cases in the group and 200 cases in the non-bleeding group.Summarize the patient’s general clinical data,laboratory and endoscopy and other data,and analyze the risk factors associated with upper-stage gastrointestinal bleeding in end-stage liver disease.Results: The chronic and acute liver failure bleeding group had a high incidence in the spring and summer seasons;the bleeding was mainly caused by infection;the first clinical symptoms were fatigue,abdominal distension,and yellowing of the skin and sclera;the most common complications were spontaneous peritonitis and hepatic encephalopathy;In the analysis of laboratory and other indicators: infection indicators(NE%,PCT,etc.),coagulation indicators(PT,FDP)and other indicators are statistically significant(P <0.05);the difference in the degree of gastric varices is statistically significant(Z =-6.575,P <0.05);multivariate analysis showed that FDP and gastric varices(severe)were 2 independent risk factors(P <0.05).In the cirrhotic acute decompensated hemorrhage group,the incidence rate was high in autumn and winter,and the bleeding was caused by diet;the first clinical symptoms were mainly hematemesis and black stool;the complications weremainly spontaneous peritonitis and hypersplenism;laboratory and other In the analysis of indicators: differences in liver function(ALT,AST,etc.)and infection indicators(hypersensitive CRP,IL-6,etc.)were statistically significant(P <0.05);degree of esophageal varices(Z =-11.46,P <0.05))And the degree of gastric varices were statistically significant(Z =-15.31,P <0.05).Multivariate analysis revealed four independent risk factors(induced by diet),NE%,APTT,and esophageal varices(severe)(P <0.05).Conclusion: The two independent risk factors for chronic liver failure and upper gastrointestinal bleeding are: FDP and varices(severe).The four independent risk factors for upper gastrointestinal bleeding in the acute decompensated cirrhosis group are:incentive(diet),NE%,APTT,esophageal varices(severe).