fa تعیین ارزش پیش آگهی معیار بالینی MELD و CTP در خون‌ریزی از واریس مری در بیماران سیروتیک بستری شده در بخش گوارش بیمارستان امام خمینی ارومیه در سال‌های 87-88 آناتومی آناتومی پژوهشي(توصیفی- تحلیلی) Research <p style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl" class="Chekide"><font face="Times New Roman"><b style="mso-ansi-font-weight: normal"><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA">بحث و نتیجه گیری: </span></b><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA">ریسک فاکتورهای </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt" lang="AR-SA">خون‌ریزی</span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"> مجدد از واریس مری به طور کامل شناخته نشده‌اند. هدف از این مطالعه تعیین ارزش پیش گویی معیار بالینی </span><font size="2"><span style="mso-fareast-language: EN-US mso-bidi-language: FA mso-ansi-language: EN-AU" dir="ltr" lang="EN-AU">MELD</span><span dir="rtl"></span></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"><span dir="rtl"></span> و </span><font size="2"><span style="mso-fareast-language: EN-US mso-bidi-language: FA mso-ansi-language: EN-AU" dir="ltr" lang="EN-AU">CTP</span><span dir="rtl"></span></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"><span dir="rtl"></span> در </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt" lang="AR-SA">خون‌ریزی</span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"> حاد واریس مری و </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt" lang="AR-SA">خون‌ریزی</span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"> مجدد از واریس مری می‌باشد. <p></p></span></font></p><p style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl" class="Chekide"><font face="Times New Roman"><b style="mso-ansi-font-weight: normal"><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA">مواد و روش کار: </span></b><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA">92 بیمار سیروتیک بستری شده در بیمارستان امام خمینی را تحت مطالعه قرار گرفت. توانایی پیش‌گویی معیار </span><font size="2"><span style="mso-fareast-language: EN-US mso-bidi-language: FA mso-ansi-language: EN-AU" dir="ltr" lang="EN-AU">MELD</span><span dir="rtl"></span></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"><span dir="rtl"></span> با </span><font size="2"><span style="mso-fareast-language: EN-US mso-bidi-language: FA mso-ansi-language: EN-AU" dir="ltr" lang="EN-AU">CTP</span><span dir="rtl"></span></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"><span dir="rtl"></span> تحت مقایسه قرار گرفت. <p></p></span></font></p><p style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl" class="Chekide"><font face="Times New Roman"><b style="mso-ansi-font-weight: normal"><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA">نتایج: </span></b><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA" lang="FA">میانگین امتیاز </span><font size="2"><span style="mso-fareast-language: EN-US mso-bidi-language: FA" dir="ltr">MELD</span><span dir="rtl"></span></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA" lang="FA"><span dir="rtl"></span> در 39 بیماری که با شکایت </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt" lang="AR-SA">خون‌ریزی</span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA" lang="AR-SA"> </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA" lang="FA">گوارشی بستری شده بودند 2/7± 7/18 و میانگین امتیاز 59 بیماری که در بدو بستری با شکایتی غیر از </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt" lang="AR-SA">خون‌ریزی</span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA" lang="AR-SA"> </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA" lang="FA">گوارشی بستری شده بودند 8/6± 9/14 بود</span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"> (014/0=</span><font size="2"><span style="mso-fareast-language: EN-US mso-bidi-language: FA mso-ansi-language: EN-AU" dir="ltr" lang="EN-AU">P</span><span dir="rtl"></span></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"><span dir="rtl"></span>). </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA" lang="FA">میانگین امتیاز </span><font size="2"><span style="mso-fareast-language: EN-US mso-bidi-language: FA" dir="ltr">C.T.P</span><span dir="rtl"></span></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA" lang="FA"><span dir="rtl"></span> در 39 بیماری که با </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt" lang="AR-SA">خون‌ریزی</span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA" lang="AR-SA"> </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA" lang="FA">گوارشی مراجعه کرده بودند 6/1± 05/9 و میانگین امتیاز </span><font size="2"><span style="mso-fareast-language: EN-US mso-bidi-language: FA" dir="ltr">C.T.P</span><span dir="rtl"></span></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA" lang="FA"><span dir="rtl"></span> در 53 بیماری که در بدو بستری با شکایتی غیر از </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt" lang="AR-SA">خون‌ریزی</span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA" lang="AR-SA"> </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA" lang="FA">گوارشی بستری شده بودند 5/1± 5/8 بوده است</span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"> (05/0</span><span dir="ltr"></span><span style="mso-fareast-language: EN-US mso-bidi-language: FA mso-ansi-language: EN-AU" dir="ltr" lang="EN-AU"><span dir="ltr"></span><font size="2">(P></font></span><span dir="rtl"></span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"><span dir="rtl"></span>.<p></p></span></font></p><p style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl" class="Chekide"><font face="Times New Roman"><b style="mso-ansi-font-weight: normal"><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA">بحث</span></b><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA">: معیار </span><font size="2"><span style="mso-fareast-language: EN-US mso-bidi-language: FA mso-ansi-language: EN-AU" dir="ltr" lang="EN-AU">MELD</span><span dir="rtl"></span></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="EN-AU"><span dir="rtl"></span> </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA">می‌تواند </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt" lang="AR-SA">خون‌ریزی</span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"> از واریس را پیش بینی کند اما </span><font size="2"><span style="mso-fareast-language: EN-US mso-bidi-language: FA mso-ansi-language: EN-AU" dir="ltr" lang="EN-AU">CTP</span><span dir="rtl"></span></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="EN-AU"><span dir="rtl"></span> </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA">این توانایی را ندارد. </span><font size="2"><span style="mso-fareast-language: EN-US mso-bidi-language: FA mso-ansi-language: EN-AU" dir="ltr" lang="EN-AU">MELD</span><span dir="rtl"></span></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"><span dir="rtl"></span> و </span><font size="2"><span style="mso-fareast-language: EN-US mso-bidi-language: FA mso-ansi-language: EN-AU" dir="ltr" lang="EN-AU">CTP</span><span dir="rtl"></span></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="EN-AU"><span dir="rtl"></span> </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA">هیچ کدام توانایی پیش بینی </span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt" lang="AR-SA">خون‌ریزی</span><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-fareast-language: EN-US mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-ansi-language: EN-AU" lang="FA"> مجدد را ندارند. </span><span style="mso-fareast-language: EN-US mso-bidi-language: FA mso-ansi-language: EN-AU" dir="ltr" lang="EN-AU"><p></p></span></font></p> <p> <strong><i> Background & Aims </i></strong><strong>: </strong>Risk factors for r ebleeding following acute variceal haemorrhage are incompletely understood. The aim of this study was to determine the predictor validity of model for end stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP) in acute variceal bleeding and rebleeding. </p><p> <strong><i> Method </i></strong>: The study included 92 cirrhotic patients of Imam Khomeini hospital. The predictive capability of CTP and MELD score were compared. </p><p> <strong><i> Results </i></strong>: The mean MELD score in 39 patients with variceal bleeding was 18.7±7.2, and in 59 patients without bleeding was 14.9±9.8 (P=0.014). The mean CTP score in 39 patients with variceal bleeding was 9.05±1.6, and in 59 patients without bleeding was 8.5± 1.5 (p>0.05). </p><p> <strong><i> Conclusion </i></strong>: MELD was significantly better than CTP score for predicting in hospital bleeding. </p><p>  MELD and CTP were not efficacious scores for predicting variceal rebleeding. </p><p> <strong><i> </i></strong>  <strong>Source:</strong> Urmia Med J 2011: 22(5): 491 ISSN: 1027-3727 </p> سیروز، خون‌ریزی واریسی، MELD، CTP Variceal bleeding, Model for end stage liver disease score, Child-Turcotte-Pugh (CTP) 416 421 http://umj.umsu.ac.ir/browse.php?a_code=A-10-582-198&slc_lang=fa&sid=1 Ramin Behroozian رامین بهروزیان Rbehroozian@gmail. com 370031947532846004238 370031947532846004238 Yes Urmia University Of Medical Sciences دانشگاه علوم پزشکی ارومیه Peivand Mohammadi پیوند محمدی 370031947532846004239 370031947532846004239 No Urmia University of Medical Sciences دانشگاه علوم پزشکی ارومیه Kamran Shateri کامران شاطری 370031947532846004240 370031947532846004240 No Urmia University of Medical Sciences دانشگاه علوم پزشکی ارومیه Reza Purali رضا پورعلی 370031947532846004241 370031947532846004241 No , Urmia University of Medical Sciences دانشگاه علوم پزشکی ارومیه