小剂量心得安联合哌唑嗪预防食管胃底静脉曲张破裂再出血疗效观察

Prevention effect of small dose propranolol and furazosin on recrudescence of esophageal-gastric varices bleeding

目的 :探讨小剂量心得安联合哌唑嗪预防肝硬化食管胃底静脉曲张破裂出血复发的效果及作用机制。方法 :对24例治疗组和24例对照组患者进行前瞻性对照研究 ,在用药前后用彩色多普勒超声仪检测患者门静脉系统血流动力学变化 ,并动态观察患者的血压、心率和食管胃底静脉曲张破裂出血复发情况。结果 :用药一周后治疗组门静脉、脾静脉血流速度明显下降 ,4周后门静脉、脾静脉的内径、血流速度、血流量均明显下降,与用药前相比差异有非常显著性(P<0.01) ;随访2年 ,在childA级和childB级患者中对照组再出血发生率及病死率均高于治疗组 ,在childC级患者中两组差异无显著性。结论 :小剂量心得安联合哌唑嗪预防食管胃底静脉曲张破裂出血的复发是有效的。

Objective:To study the effects and the process mechanismof preventing recrudescence of esophageal-gastric varices bleeding in liver cirrhosis patients by combined using small dose propranolol and furazosin.Methods:24cases called treatment group and24cases called control group were prospective comparison researched.Changes of bloodstream dynamics of portal system were detected by using colour-doppler somascope before and after using medicine,and the blood pressure、heart rates and recrudescence of esophageal-gastric varices bleeding in paˉtients were observed with dynamic method.Results:The bloodstreamof portal and spleen vein was deeply decreased in treatment group after a week by using medicine,the diameter of portal and spleen vein and bloodstream speed,bloodstream volume were deeply decreased after4weeks and there was significant difference before and after using medicine(P<0.01).The recrudescence rate of esophageal-gastric varices bleeding and the death rate were higher in control group than that in treatment group in Child A and Child B after2years follow-up,while there was no difference between the two groups in Child C.Conclusion:It was effective of preventing recrudescence of esophageal-gastric varices bleeding by combined using small dose propranolol and furazosin.