Are Child's Class C Patients With Acute Variceal Bleeding Worth Treating?

[摘要] In the ten year period January 1980 to December 1989, 102 patients with Child’s Class C liver disease(Pugh's Modification) were admitted with acute variceal bleeding to one surgical unit with a policy ofearly sclerotherapy. There were 56 males and 46 females; the average age was 55 years (range 28–77).Fifty-three suffered from alcoholic cirrhosis. Four died before definitive treatment could be carried out,three from liver failure and one from uncontrolled bleeding. Of the remaining 98 patients, eight hadurgent oesophageal transection with three deaths from hepatorenal failure; 90 had sclerotherapy with 19hospital deaths, nine from recurrent bleeding, eight from liver failure often coupled with renal failureand two from respiratory complications. Of the 76 who survived to leave hospital, 52 received chronicinjection sclerotherapy, 10 had elective oesophageal transection and 14 did not have further electiveintervention for various reasons. Surviving patients have been followed up at a special Liver Clinic withminimum follow up of one year. Although no patient has yet survived ten years, the one, five and eightyear survivals of 50%, 21% and 13% suggest that salvage of thdse patients is worthwhile.

[学科分类] 过敏症与临床免疫学