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目的了解我院肝炎后肝硬化患者的临床特征。方法对2003年12月至2006年11月在本院消化科和感染科住院的4173例肝炎后肝硬化患者作回顾性研究,并对其中在2006年2-11月期间的住院患者进行终点随访。结果肝炎后肝硬化的年龄分布主要在30~60岁(83.1%),男女比例为4.15∶1;肝炎后肝硬化代偿期3 121例(74.79%),失代偿期1 052例(25.21%)。单纯乙型病毒性肝炎感染3 623例(86.82%),单纯丙型病毒性肝炎后肝硬化223例(5.34%),乙肝或丙肝重叠其他肝炎病毒者274例(6.57%)。77.73%的肝炎肝硬化患者有食道胃底静脉曲张(GEV),47.48%的肝硬化患者有门脉高压性胃病(PHG),发生率与GEV的严重程度相关。住院期间,713例上消化道出血者中,GEV破裂出血者占274例(38.43%),PHG及消化性溃疡(PU)出血分别占319例(44.74%)和101例(14.17%)。582例肝炎肝硬化死亡患者中,HBsAg(+)患者573例(病死率51.90%,573/1 104),HBsAg(-)患者9例(病死率4.48%,9/201),RR=11.53;死因以上消化道出血为主(77.15%)。结论乙肝引发的肝硬化是我国肝炎后肝硬化主要类型,上消化道出血是其最直接的死因,而PHG和GEV破裂出血是上消化道出血的主要原因。
Objective To understand the clinical characteristics of patients with posthepatitic cirrhosis in our hospital. METHODS: A retrospective study was performed on 4173 patients with posthepatitic cirrhosis who were hospitalized in our Department of Gastroenterology and Infectious Diseases from December 2003 to November 2006. The end-point follow-up of hospitalized patients during the period from November to November 2006 . Results The age distribution of posthepatitic cirrhosis was mainly between 30 and 60 years old (83.1%), the male-female ratio was 4.15:1. The post-hepatitis cirrhosis compensated period was 3 121 (74.79%) and the decompensated period was 1 052 (25.21 %). There were 3 623 cases (86.82%) of pure hepatitis B infection, 223 (5.34%) cases of pure hepatitis C post-cirrhosis and 274 (6.57%) cases of hepatitis B or C overlapping other hepatitis viruses. 77.73% of patients with hepatic cirrhosis have esophageal varices (GEV), and 47.48% of patients with cirrhosis have portal hypertensive gastropathy (PHG). The incidence is related to the severity of GEV. During hospitalization, 274 cases (38.43%) had GEV rupture, and 319 cases (44.74%) and 101 cases (14.17%) had PHG and peptic ulcer bleeding respectively in 713 cases of upper gastrointestinal bleeding. Among 582 patients with hepatitis cirrhosis, 573 (51.90%, 573/1 104) were HBsAg (+) patients and 9 (HBeAg) patients were HBsAg (-) patients with mortality of 4.48% Causes of death above the main gastrointestinal bleeding (77.15%). Conclusion Hepatic cirrhosis caused by hepatitis B is the main type of posthepatitic cirrhosis in our country. Upper gastrointestinal bleeding is the most direct cause of death. PHG and GEV rupture are the main causes of upper gastrointestinal bleeding.