ABSTRACT
Objective: To analyze the related risk factors for esophageal variceal bleeding (EVB) in patients with hepatocirrhosis and portal hypertension, so as to provide clinical evidences for establishing preventive measures for EVB. Methods: Using "* esophag *", "varice *", "bleeding", "hemorrhage", and "risk factor *" as the key words, we searched the clinical studies (1986-2006) about the risk factors of EVB in hepatocirrhosis patients in PubMed, Medline, Chinese Biomedical Database, Elsevier Database, OVID Database, etc. for Meta-analysis. The odds ratio(OR)of each risk factor was estimated and the 95% confidence interval[95% CI] was calculated. Results: Totally 19 papers met our criteria and were included in this Meta-analysis. The 19 papers involved 995 EVB patients and 1 854 controls. Meta-analysis revealed that a hepatic function of Child C, decreased prothrombin activity, hypoalbuminemia, severe esophageal varices, positive red-color sign, extended portal vein width and splenic vein width, thrombopenia, leucopenia and anemia were the risk factors of EVB; a hepatic function of Child A and mild esophageal varices were the protective factors of EVB. The gender, age, hepatic function of Child B, ascites, hepatic encephalopathy, hyperbilirubinemia and midrange esophageal varices were not significantly associated with EVB. Conclusion: Improvement of poor hepatic function, blood coagulation status, hypoalbuminemia and treatment & prevention of severe esophageal varices (by endoscopic variceal ligation, devascularization and shunt) can help to reduce the incidence of EVB.
ABSTRACT
Objective:To analyze the related risk factors for esophageal variceal bleeding(EVB)in patients with hepatocirrhosis and portal hypertension,so as to provide clinical evidences for establishing preventive measures for EVB. Methods:Using"*esophag*","varice*","bleeding","hemorrhage",and"risk factor*"as the key words,we searched the clinical studies(1986-2006)about the risk factors of EVB in hepatocirrhosis patients in PubMed,Medline,Chinese Biomedical Database,Elsevier Database,OVID Database,etc.for Meta-analysis.The odds ratio(OR)of each risk factor was estimated and the 95% confidence interval[95% CI]was calculated.Results:Totally 19 papers met our criteria and were included in this Meta-analysis.The 19 papers involved 995 EVB patients and 1854 controls.Meta-analysis revealed that a hepatic function of Child C,decreased prothrombin activity,hypoalbuminemia,severe esophageal varices,positive red-color sign,extended portal vein width and splenic vein width,thrombopenia,leucopenia and anemia were the risk factors of EVB;a hepatic function of Child A and mild esophageal varices were the protective factors of EVB.The gender,age,hepatic function of Child B,ascites, hepatic encephalopathy,hyperbilirubinemia and midrange esophageal varices were not significantly associated with EVB. Conclusion:Improvement of poor hepatic function,blood coagulation status,hypoalbuminemia and treatment & prevention of severe esophageal varices(by endoscopic variceal ligation,devascularization and shunt)can help to reduce the incidence of EVB.