肝静脉压力梯度测定对食管静脉曲张套扎术后早期再出血的预测价值

Evaluation and threshold value of hepatic vein pressure gradient for early postoperative rebleeding after endoscopic esophageal varices ligation

摘要:

目的 研究肝静脉压力梯度（HVPG）对食管静脉曲张套扎术（EVL）后早期再出血的预测价值。方法 选取该院2014年1月-2015年1月收治的120例EVL后早期再出血患者作为研究对象，收集其各项临床重要参数，并进行HVPG测量，采用Logistic回归分析的方法对评估阈值进行分析。结果 饮酒、早期出血、胆红素、心率、输血量、Child-Pugh评分和自终末期肝病模型（MELD）评分组间比较差异有统计学意义（P <0.05）；HVPG=16.98 mmHg，为预测再出血的阈值，且在该时间内的预测准确性最高。结论 HVPG对EVL术后早期再出血具有预测价值。

Abstract:

Objective To assess the value of hepatic venous pressure gradient in the evaluation of early postoperative hemorrhage after endoscopic esophageal varices ligation (EVL). Methods 120 cases of rebleeding after EVL from January 2014 to January 2015 as subjects. Collect and study clinical indexes such as the venous pressure gradient, then used logistic regression analysis method to analyze the threshold assessment. Results Drinking, hemorrhage in early stage, bilirubin, heart rate, blood transfusion, child Pugh score and MELD score were significant differences (P < 0.05); HVPG=16.98 mmHg, for the prediction of rebleeding threshold, and in the time of the highest predictive accuracy. Conclusion The hepatic venous pressure gradient has an accurate evaluation value for early postoperative hemorrhage after endoscopic esophageal varices ligation.