Risk factors for bleeding esophageal varices in patients with hepatocirrhosis:a Meta-analysis / 第二军医大学学报

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.