Clinical and statistical aspects of the development and course of bleeding From varicose veins of the esophagus in patients with chronic viral hepatitis
DOI:
https://doi.org/10.11603/2414-4533.2021.2.12301Keywords:
chronic viral hepatitis C, esophageal varices, upper gastrointestinal bleeding, portal hypertensionAbstract
The aim of the work: to determine the features of the course of portal hypertension complicated by bleeding from varicose veins of the esophagus in patients with chronic viral hepatitis C.
Materials and Methods. We collected, processed and analyzed the results of treatment of 46 patients with bleeding from varicose veins of the esophagus (VVE) hospitalized in Dnipro Clinical Ambulance for 2017. The main etiological factor that led to the development of portal hypertension in this group of patients was cirrhosis of the liver on the background of chronic viral hepatitis C. The degree of blood loss in this category of patients was distributed as follows: minimal – in 13 cases (28.3 %), medium – in 16 (34.8 %), large and massive – in 8 (17.4 %) and 9 (19.6 %) respectively.
All patients underwent assessment of liver function using clinical and laboratory methods.
Results and Discussion. It was found that the level of total bilirubin in the serum of 22 (47.8 %) patients was within the reference values, the level was exceeded less than 2 times in 14 patients (30.4 %), in 10 cases (21.7 %) revealed an increase in bilirubin by more than 2 times.
Analysis of the level of transferases in patients with HCV complicated by bleeding from varicose veins revealed that ALT within the reference values were detected in 29 cases (63.1 %), an increase of less than twice (n2) was observed in 12 cases (26.1 %), more than double the level of transferase was found in 5 cases (10.8 %).
Liver failure was assessed according to the Child-Pugh classification. It was found that grade A deficiency was observed in 23 patients (50 %), grade B – in 16 (34.8 %), grade C – in 7 (15.2 %).
As a result of the treatment, 36 patients (78.3 %) were discharged with improvement, in 10 episodes (21.7 %) there was a lethal outcome.
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