心得安预防门脉高压引起初次消化道出血的疗效观察

目的:观察心得安预防门脉高压症消化道出血的疗效、不良反应及临床应用的注意事项。方法选择本院102例肝硬化食道胃底静脉曲张患者,随机分为心得安组(52例)和安慰剂组(25例)。对出血发作的病情、持续的时间、输血量的多少、对止血药物的反应、生存期以及副反应进行观察。结果随访12个月,治疗组出血发生率为19.2%,安慰剂组为28%,两组差异无显著意义。随访20个月,治疗组出血发生率28.8%,安慰剂组48%,两组比较有显著性差异(P<0.05),但生存时间无显著差异。结论心得安对预防门脉高压症消化道初次出血有明显疗效,但不能延长肝硬化病人的生存期。

Therapeutic Effect of Propranolol for the Prevention of Gatrointestinal Bleeding in Patients with Cirrhosis and Portal Hypertention

Objective:To investigate therapeutic efficacy of Propranolol in preventing gastrointestinal bleeding of patients with cirrhosis and portal hypertention.Method:The patients with esophageal and gastric varices were randomly divided into pro- pranolol treated group (52 cases) and placebo group (50 cases).Pathogenetic condition of bleeding,bleeding duration and bleeding amount,reaction of antihemorrhagic,life span and adverse reaction were observed.Result:incidence rate of bleeding of propra- nolol treated group was 19.2% in the 12 months of follow up observation,and 28% in the placebo group.There was no obvious difference of incidence rate of bleeding between two groups.However,in the 20 months of follow-up observation,incidence rate of bleeding of propranolol treated group was 28.8%,significantly higher that of placebo group.Additionally,there was no obvious dif- ference of live time between two groups.Conclusion:The efficacy of Propranolol for the prevention of gastrointestinal first bleed- ing in patients with cirrhosis and portal hypertemion is remarkable,but it cannot prolong the survival period of these patients.