肝炎后肝硬变合并消化性溃疡90例诊治分析

Diagnosis and management of posthepatitic cirrhosis complicated with peptic ulcer

目的 研究肝炎后肝硬变合并消化性溃疡的临床特点 ,探讨小剂量普萘洛尔对肝硬变合并消化性溃疡愈合的影响。方法 肝炎后肝硬变合并消化性溃疡 90例 ,随机分为治疗组 (A组 ) 4 6例 ,口服普萘洛尔加西咪替丁 ;对照 1组 (B组 ) 4 4例 ,口服维生素B6加西咪替丁。另外选单纯性消化性溃疡 4 4例作为对照2组 (C组 ) ,治疗方法与B组相同。结果 肝硬变合并消化性溃疡的发病中位年龄较单纯性消化性溃疡晚 12年 ,溃疡部位以胃溃疡居多 ,合并出血率高 ,与C组比较差异有显著意义 (P <0 0 1)。普萘洛尔可明显提高其溃疡的愈合率 ,与B组比较差异有显著意义 (P <0 0 5 )。结论 肝硬变合并消化性溃疡难以治愈 ,且易合并出血 ,门静脉高压因素可能从中发挥了作用 ,小剂量普萘洛尔有助于肝硬变合并消化性溃疡的愈合。

Objective To study the clinical characteristics of posthepatitic cirrhosis complicated with peptic ulcer patients and to evaluate the therapeutic effect of propranolol on these patients.Methods 90 cases of posthepatitic cirrhosis complicated with peptic ulcer were randomly divided into two groups:group A(46 cases) were treated with propranolol and cimetidine,group B(44 cases) were treated with vitamin B 6 and cimetidine.44 control cases with simple peptic ulcer were treated with the same regimen as group B.Results The age of patients with posthepatitic cirrhosis complicated with peptic ulcer was about 12 years older than those with sinple peptic ulcer.Most cases of posthepatitic cirrhosis complicated with peptic ulcer were gastric ulcer.The hemorrhage rate in posthepatitic cirrhosis complicated with peptic ulcer was much higher than in group C(P<0.01).The healing rate of posthepatitic cirrhosis complicated with peptic ulcer was significantly higer in group A than in group B(P<0.05)Conclusion Posthepatitic cirrhosis complicated with peptic ulcer is difficult to be cured.The increased hemorrhage rate is probably due to portal hypertension,and small dose of propranolol seems to be benifical for healing of posthepatitic cirrhosis complicated with peptic ulcer.