卡维地洛对肝硬化食管胃静脉曲张再出血的预防作用

Preventive effect of carvedilol on gastroesophageal variceal rebleeding in patients with liver cirrhosis

目的探讨卡维地洛对肝硬化食管胃静脉曲张再出血的预防作用。方法将2014年1月~2016年6月肝硬化食管胃静脉曲张于我院就诊且行内镜下治疗的60例患者纳入研究并依据随机数字表法分组。对照组30例患者术后常规口服普奈洛尔,观察组30例则采用卡维地洛,治疗6个月。比较两组治疗前后门静脉内径、门静脉主干血流量(QPV)、脾脏厚度改善情况,比较两组临床疗效。结果治疗后,观察组门静脉内径、门静脉主干血流量(QPV)、脾脏厚度均小于对照组,差异有统计学意义(P<0.05);观察组肝功能好转率、腹水好转率、食管胃静脉曲张好转率、再出血发生率均更低,差异有统计学意义(P<0.05);观察组总有效率96.67%(29/30),高于对照组的70.00%(21/30),差异有统计学意义(P<0.05)。结论卡维地洛与普奈洛尔均是预防肝硬化食管胃静脉曲张再出血的有效药物,但前者效果更为显著,值得推广。

Objective To investigate the preventive effect of carvedilol on esophageal and gastric variceal rebleeding in patients with liver cirrhosis. Methods 60 patients with esophageal variees in our hospital from January 2014 to June 2016 were treated with endoscopic therapy, and were randomLy divided into two groups according to random data table. In the control group, 30 patients received routine oral administration of F Naylor, and 30 patients in the observation group were treated with carvedilol for 6 months. The portal vein diameter, portal vein blood flow（QPV） and spleen thick- ness were compared before and after treatment, and the clinical efficacy of the two groups was compared. Results After treatment, the diameter of portal vein, the blood flow volume of portal vein（QPV） and the thickness of spleen in the ob- servation group were all less than those in the control group, the difference was significant（P〈0.05）; The improvement rate of liver function, the improvement rate of ascites, the improvement rate of esophageal and gastric varices and the incidence of rebleeding in the observation group were lower than those in the observation group, and the difference was significant（P〈0.05）; The total effective rate of the observation group was 96.67%（29/30）, which was higher than 70.00% of the control group （21/30）, the difference was significant（P〈0.05）. Conclusion Carvedilol and F Naylor are effective drugs to prevent esophageal and gastric varices rebleeding in cirrhosis, but the former is more effective and worthy of promotion.