上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (7): 993-.doi: 10.3969/j.issn.1674-8115.2017.07.019

• 论著（临床研究） • 上一篇    下一篇

肝硬化失代偿期患者并发肠梗阻的临床特点及相关危险因素分析

宋亚兰，罗玲，张运芝   

  1. 重庆医科大学附属第二医院感染病科，重庆 400010
  • 出版日期:2017-07-28 发布日期:2017-08-25
  • 通讯作者: 罗玲，电子信箱：314620906@qq.com
  • 作者简介:宋亚兰（1992—），女，硕士生；电子信箱：1170771745@qq.com
  • 基金资助:
    重庆医科大学附属第二医院优秀青年人才基金项目（201443）

Analysis of clinical characteristics of decompensated cirrhosis patients with intestinal obstruction and related risk factors#br#

SONG Ya-lan, LUO ling, ZHANG Yun-zhi   

  1. Department of Infectious Diseases, the Second Affiliated Hospital of Chongqing Medical  University, Chongqing 400010, China
  • Online:2017-07-28 Published:2017-08-25
  • Supported by:
    Excellent Young Talent Fund of the Second Affiliated Hospital of Chongqing Medical University, 201443

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摘要： 目的 · 分析肝硬化失代偿期患者并发肠梗阻的临床特点及危险因素。方法 · 收集 2010 年 3 月—2016 年 3 月收治的 1 783 例肝 硬化失代偿期患者的临床资料，筛选出并发肠梗阻患者128 例 (7.18%) 作为观察组，随机抽取未并发肠梗阻患者128 例作为对照组。 回顾性研究 2 组患者的临床资料，对临床特征进行对比分析，并采用 Logistic 回归分析相关危险因素。结果 · 肝硬化失代偿期患者并 发肠梗阻的临床症状隐匿，容易被漏诊或延迟诊断。观察组腹痛、腹胀、呕吐、停止排便排气、发热、自发性腹膜炎、腹水、电解质 紊乱的发生率显著高于对照组（P<0.05）。单因素分析结果显示：年龄、腹部手术史、白细胞计数、血清钾、血清钠、中性粒细胞百 分比、血清白蛋白为肝硬化失代偿期患者并发肠梗阻的危险因素。进一步的多因素回归分析结果显示：年龄、腹部手术史、白细胞计 数、血清钾、血清钠、中性粒细胞百分比、血清白蛋白是肝硬化失代偿期患者并发肠梗阻的独立危险因素。结论 · 年龄≥ 50 岁、有 腹部手术史、合并腹腔感染、低钾、低钠、低血清白蛋白的肝硬化失代偿期患者容易并发肠梗阻。

关键词: 肝硬化 , 肠梗阻 , 临床特征, 危险因素

Abstract:

Objective · To analyze the clinical characteristics of decompensated cirrhosis patients with intestinal obstruction and related risk factors.  Methods · Clinical data of 1 783 decompensated cirrhosis patients treated between March 2010 and March 2016 were collected. Of them, 128 (7.18%) patients with intestinal obstruction were screened as the observation group and 128 patients without intestinal obstruction were randomly selected as the control group. Clinical data of two groups were retrospectively investigated, clinical characteristics were compared and analyzed, and related risk factors were analyzed with the Logistic regression analysis.  Results · The clinical symptoms of decompensated cirrhosis patients with intestinal obstruction were hidden and misdiagnoses or delayed diagnoses were common. The incidences of abdominal pain, abdominal distension, vomiting, stop exhaust defecate, ascites, electrolyte disorders, fever, and spontaneous peritonitis were significantly higher in the observation group than in the control group (P < 0.05). The results of univariate analysis showed that age, history of abdominal surgery, white blood cell count, serum sodium, serum potassium, neutrophil percentage, and serum albumin were risk factors for decompensated cirrhosis patients with intestinal obstruction. The results of multivariate analysis indicated that age, history of abdominal surgery, white blood cell count, serum sodium, serum potassium, neutrophil percentage, and serum albumin were independent risk factors for decompensated cirrhosis patients with intestinal obstruction.  Conclusion · Decompensated cirrhosis patients with age ≥ 50 years old, a history of abdominal surgery, the abdominal cavity infection, low potassium, hyponatremia, and lower serum albumin are likely to develop the intestinal obstruction.

Key words: cirrhosis, intestinal obstruction, clinical characteristics, risk factors