在胃食道静脉出血为第一个不补偿事件的患者内镜连续治疗后的长期结果
Liu Huiru1, Li Jun2,3, Yu Yuexi1
1First Central Hospital of Tianjin Medical University, Tianjin Medical University, Tianjin, 300192, China.
Clinical and translational gastroenterology
|January 27, 2026
概括
重新出血显著影响了患有水出血的肝硬化患者的存活率. 对高风险患者来说,积极的治疗对于改善治疗结果至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 内镜干预措施 内镜干预
背景情况:
- 门高血压的进展和结局在肝硬化患者与初始的水出血是不太了解.
- 对于不同水亚型的顺序内镜治疗的长期临床影响的数据有限.
研究的目的:
- 评估顺序内镜治疗对患有水出血的肝硬化患者长期临床结果的影响.
- 分析不同水亚型 (EV,GOV1,GOV2,GOV3) 的复出和生存风险因素.
主要方法:
- 追溯分析196名住院的肝硬化患者,患有水出血.
- 分类为食道静脉 (EV),胃静脉1型 (GOV1),GOV2和GOV3组.
- 使用Fine-Gray测试,Kaplan-Meier生存分析和Cox比例风险回归的统计分析.
主要成果:
- 在5年内,子亚型 (从EV到GOV3) 的复出率逐渐增加.
- 随着随访时间的延长,生存率下降,与再出血率相反相关.
- 再出血是死亡率的一个独立预测因素 (HR: 3.518,p < 0.001).
- CTP评分,静脉的形状/类型和>3次内镜治疗是再次出血的重要风险因素.
结论:
- 复出血是主要的临床事件,也是患有水出血的肝硬化患者死亡的唯一独立预测因素.
- 应考虑在易重出血的高风险患者中进行救援的横性肝内移植系统分流 (TIPS).
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