普萘洛尔辅助治疗肝硬化上消化道大出血效果观察

The Effect of Propranolol in the Treatment of Massive Hemorrhage of Upper Digestive Tract in Cirrhosis

目的探讨在常规治疗基础上,加用普萘洛尔治疗肝硬化上消化道大出血的效果。方法收集2019年1—12月中国人民解放军北部战区空军医院收治的肝硬化上消化道大出血患者60例,随机分为观察组和对照组各30例。对照组采用采用醋酸生长抑素持续静脉滴注进行治疗,观察组在其基础上加用普萘洛尔进行治疗,两组均治疗至消化道活动性出血停止后72 h。比较两组患者的呕血停止时间、输血量、再出血发生率;并比较两组治疗前后门静脉及脾静脉血流动力学指标变化。结果两组患者呕血停止时间、输血量和生长抑素用量差异均有统计学意义(P<0.05)。两组患者治疗前门静脉及脾静脉各血流动力学指标差异无统计学意义(P>0.05),而治疗后上述指标差异均有统计学意义(P<0.05)。结论普萘洛尔辅助治疗肝硬化上消化道大出血可以明显改善常规治疗的止血效果,并且进一步调节内脏血流动力学稳定性。

Objective To investigate the effect of propranolol in the treatment of massive hemorrhage of upper gastrointestinal tract in cirrhosis on the basis of routine treatment.Methods From January to December 2019,60 patients with massive hemorrhage of upper digestive tract in cirrhosis admitted to Air Force Hospital of Northern Theater of the Chinese People’s Liberation Army were randomly divided into observation group and control group,with 30 cases in each group.The control group was treated with continuous intravenous drip of somatostatin acetate,and the observation group was treated with propranolol on the basis of it.Both groups were treated for 72 hours after the cessation of gastrointestinal active bleeding.The stop time of emesis,the amount of blood transfusion and the incidence of rebleeding were compared between the two groups.Results There were significant differences in the stopping time of emesis,the amount of blood transfusion and the amount of somatostatin between the two groups(P<0.05).There was no significant difference in hemodynamic index of portal and spleen veins before treatment between the two groups(P>0.05),but the above indexes were improved significantly after treatment.Conclusion Propranolol can improve the hemostatic effect of routine treatment and further regulate the stability of visceral hemodynamics.