肝源性溃疡的临床特点与治疗探讨

The Clinical Characters and to Evaluate the Curative Effect of Hepatogenic Ulcer

目的：研究乙肝后肝硬化患者消化性溃疡的临床特点，探讨小剂量心得安对肝源性溃疡愈合的影响。方法：肝源性溃疡４５例，观察其发病年龄、临床表现、溃疡部位、ＨＰ感染率、合并出血率及溃疡愈合率等特点。随机分为治疗组（Ａ组）２３例，用心得安＋泰胃美口服治疗；对照组（Ｂ组）２２例，用维生素Ｂ６＋泰胃美口服治疗。另外选单纯性消化性溃疡２２例，作为对照２组（Ｃ组），治疗方法与Ｂ组相同。结果：肝源性溃疡发病年龄较单纯性消化性溃疡晚１０年，溃疡部位以胃溃疡居多，合并出血率高，较对照Ｃ组有显著性差异（Ｐ＜０．０１）。心得安可明显提高肝源性溃疡愈合率，与对照Ｂ组具统计学意义（Ｐ＜０．０５）。结论：肝源性溃疡难以治愈且易合并出血，门静脉高压因素可能从中发挥作用，小剂量心得安有助于肝源性溃疡愈合。

Purpose: To study the clinical characters of hepatogenic ulcer occured in the posthepatic cirrhosis patients and to evaluate the curative effect of prapanolol on these patients. Methods: 45 cases of hepatic ulcer were randomly divided into two graups: group A(23 cases) were treated with prapanolol and tagamet and basic therapy; group B(22 cases) were treated with vitamin B6 and tagamet therapy. We also had so cases of simple peptic ulcer as controls which were treated in the same way of group B. Results: The age of hepatogenic ulcer was about 10 years older than that usual peptic ulcer patients.Most cases of hepatic ulcer were gastric ulcer. It hemorrhage rate was much higher. Comparing with group C, group A had the obvionsly (P<0.01) and increased effective rate of hepatogenic ulcer healed than that group B(P<0.05). Conclusions: Hepatogenic ulcer was difficult to treat. It hemorrhage rate was much higher due to portal hypertension and small dose of prapanolol is healed for hepatogenic ulcer.