心得安预防门脉高压引起初次消化道出血的疗效观察

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

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。

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 varlces were randomly divided into propranolol treated group （52 cases ） and placebo group （50 cases ）. Pathogenetic condition of bleeding, bleeding duration and bleeding amount ,reaction of anfihemorrhagic, life span and adverse reaction were observed. Result： incidence rate of bleeding of propranolol 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 difference of live time between two groups. Conclusion： The efficacy of Propranolol for the prevention of gastrointestinal first bleeding in patients with cirrhosis and portal hypertension is remarkable, but it cannot prolong the survival period of these patients.