ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effect of portal hypertension on prognosis in patients with decompensated liver cirrhosis.</p><p><b>METHODS</b>The clinical data of decompensated cirrhosis patients in our hospital, between 2003 and 2006, were retrospected and followed up. Model for end-stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP) classification was calculated using the standard formula. Kaplan-Meier survival analysis was used to compare the mortality in subgroups ranked by the syndromes. Cox proportional hazards regression was used to evaluate the effect of the syndromes on prognosis.</p><p><b>RESULTS</b>A cohort of 322 patients was admitted in this study at the end of the follow-up. The mortality of variceal bleeding, hepatic encephalopathy, a large volume ascites, spontaneous bacterial peritonitis, the type I and type II hepatorenal syndrome was 45.9%, 79.4%, 66.7%, 100%, 100% and 84.6% respectively. On the whole, the occurrence of all the syndromes was correlated with CTP classification and MELD score. Kaplan-Meier survival analysis showed that all of these syndromes, except for low to medium volume of ascites, significantly affected the survival rate (P<0.01). In Cox regression analysis, all the syndromes were the independent predictors of prognosis, the regression coefficient values of hepatic encephalopathy, spontaneous bacterial peritonitis, type I and type II hepatorenal syndrome, variceal bleeding and ascites were 0.973, 0.928, 0.935, 0.866, 0.464 and 0.369 respectively.</p><p><b>CONCLUSIONS</b>The portal hypertensive syndromes have significant effect on the prognosis of the patients with decompensated cirrhosis, hepatic encephalopathy is the worst one.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Esophageal and Gastric Varices , Epidemiology , Follow-Up Studies , Gastrointestinal Hemorrhage , Epidemiology , Hepatic Encephalopathy , Epidemiology , Hepatorenal Syndrome , Epidemiology , Hypertension, Portal , Epidemiology , Liver Cirrhosis , Mortality , Pathology , Models, Statistical , Predictive Value of Tests , Prognosis , Severity of Illness Index , Survival AnalysisABSTRACT
Objective To analyze the safety and diagnostic value of ultrasound-guided biopsy with simple biopsy clip in children.Methods Under simple biopsy clip 52 cases were performed percutaneous renal biopsy.Then the curative rate and the incidence rate of complications were evaluated.Results Of 52 cases,49 cases(94.23%) gained enough renal tissue specimen for histological evaluation;Three failed cases occurred at early stage,nothing was found at later stage.The main complication was macroscopic hematuria occurred only once or twice after the operation and perirenal hematoma in 1.92% of the cases.No other severe complications were found.Conclusions The biopsy clip is convenient and sterile,and can guide the biopsy device exactly and safely.The use of 18-gauge biopsy gun and the automated biopsy device in children can decrease the complication rate,which can be easily performed.