乙肝肝硬化伴食管胃底静脉曲张破裂出血术后超长住院日患者影响因素分析

doi:10.3969/j.issn.1006-5253.2023.04.011

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摘要目的研究乙肝肝硬化伴食管胃底静脉曲张破裂出血患者术后发生超长住院日的影响因素，为减少超长住院日的发生提供依据。方法采用回顾性研究方法，收集2013年1月至2022年6月在某院经内镜下组织胶注射联合套扎术治疗的1 201例乙肝肝硬化伴食管胃底静脉曲张破裂出血的患者信息，将患者住院日超过29 d定义为超长住院日（n=63例）。对研究对象进行统计描述，通过多因素logistic回归分析筛选出独立危险因素，用受试者工作特征曲线（ROC）下面积评估联合检测的价值。结果经logistic回归分析发现，发病到手术时长≥8 d、转科次数≥2次、并发失血性休克、并发医院感染是乙肝肝硬化伴食管胃底静脉曲张破裂出血患者术后发生超长住院日的独立危险因素，联合以上4个因素预测的ROC曲线下面积为0.877，具有一定的临床价值。结论当乙肝肝硬化伴食管胃底静脉曲张破裂出血患者发病到手术时长≥8 d，转科次数≥2次、并发失血性休克、并发医院感染时，发生术后超长住院日的可能性较大，需要引起临床注意，提早预防。

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	陈英姿
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	郑雨薇

关键词 ：食管胃底静脉曲张, 转科室, 超长住院日

Abstract：Objective To study the influencing factors of prolonged hospitalization days in patients with hepatitis B cirrhosis and esophagogastric variceal bleeding, to provide a basis for reducing the occurrence of prolonged hospitalization days.Methods A retrospective study was conducted to collect the information of 1 201 patients with hepatitis B cirrhosis and esophagogastric variceal bleeding who underwent endoscopic tissue glue injection combined with ligation in Taizhou Hospital Affiliated to Wenzhou Medical University from January 2013 to June 2022. We defined more than 29 days of hospitalization as ultralong hospitalization days (n=63 cases). Multivariate logistic regression analysis was used to screen out independent risk factors, and the area under the receiver operating characteristic curve (ROC) was used to evaluate the value of combined detection for statistical description.Results Logistic regression analysis showed that the days from onset to surgery ≥8, number of department transfers≥2 times, complicated with hemorrhagic shock and hospital infection were independent risk factors for ultralong postoperative hospitalization, and the ROC curve area was 0.877, so there was clinical value in it.Conclusion When the time from onset to operation lasts 8 days and above, and the number of postoperative transfers is twice and above complicated with hemorrhagic shock and nosocomial infection, patients with hepatitis B cirrhosis and esophagogastric variceal bleeding are more likely to have prolonged postoperative hospital stay, which needs to cause clinical attention and early prevention.

Key words： esophagogastric varice transfer department prolonged hospitalization stay

收稿日期: 2023-03-01

通讯作者: 郑雨薇，Email：386273686@qq.com

引用本文:

陈英姿，李爽爽，毕晓洁，陈超超，郑雨薇. 乙肝肝硬化伴食管胃底静脉曲张破裂出血术后超长住院日患者影响因素分析[J]. 中国医院统计, 2023, 30(4): 294-298.
Chen Yingzi，Li Shuangshuang，Bi Xiaojie，Chen Chaochao，Zheng Yuwei. Analysis of influencing factors of prolonged hospitalization days in hepatitis B cirrhotic patients with esophagogastric variceal bleeding. journal1, 2023, 30(4): 294-298.

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