普萘洛尔辅助治疗预防肝硬化患者食管胃静脉曲张出血的效果观察  

Propranolol auxiliary treatment to prevent cirrhosis patients withesophageal and gastric variceal bleeding effect observation

作　　者：尉飞[1] 

机构地区：[1]河南中医学院第一附属医院,河南郑州450000

出　　处：《临床医药文献电子杂志》2014年第8期449-449,452,共2页Electronic Journal of Clinical Medical Literature

摘　　要：目的：探讨和研究普萘洛尔辅助用药对肝硬化患者食管胃静脉曲张出血的预防作用。方法：病例选取为2010.1~2012.12之间我院收治的82例肝硬化门静脉高压食管胃静脉曲张破裂出血的患者，患者在发生急性活动性出血后42例观察组患者在急性出血得到控制后给予奥曲肽泵入，并对无输血指征的患者给予普萘洛尔进行二级预防，其余42例对照组患者则在发生出血后仅给予奥曲肽治疗，方法同观察组，治疗过程中观察两组患者的体征变化情况，统计两组患者再出血发生率并对比。结果：观察组42例患者中3例发生早期再出血，再出血发生率7.1%，对照组42例患者中13例发生早期再出血，发生率30.9%，观察组显著低于对照组（P〈0.05）。从不良反应来看，两组患者均未出现严重相关不良反应。结论：对于肝硬化食管胃静脉曲张出血患者而言，单纯应用奥曲肽预防再出血效果并不显著，辅助性应用普萘洛尔进行二级预防能够有效的提高疗效，达到持续降低门静脉高压的作用，值得在临床上推广和应用。Objective： To investigate and research assistant drug propranolol bleeding gastric varices in patients with cirrhosis preventive effect of the esophagus.Methods： Case select between 2010.1 ~ 2012.12 our hospital 82 cases of liver cirrhosis and portal esophageal varices in patients with high-pressure bleeding, in patients with acute active bleeding was observed after 42 cases of patients with acute bleeding under control after giving octreotide pumped, and patients without blood transfusion indications given propranolol for secondary prevention, and the remaining 42 cases in the control group of patients will be given only after the occurrence of bleeding octreotide treatment methods were observed with the observation group, the treatment process signs of change, the statistical incidence of rebleeding two groups of patients and contrast. Results： 42 patients in the observation group three cases occurred early rebleeding, rebleeding rate of 7.1% in the control group of 42 patients, 13 cases occurred early rebleeding, the incidence of 30.9% in the observation group was signiifcantly lower than the control group （P〈0.05）. Adverse reactions from the point of view, the two groups were no serious adverse reactions related.Conclusion： For esophageal variceal bleeding in patients with cirrhosis, the simple application of octreotide prevent rebleeding effect is not signiifcant, auxiliary secondary prevention propranolol can effectively improve the efifcacy, to continue to reduce the role of portal hypertension, worthy of promotion and application in clinical practice.

关 键 词：肝硬化 食管胃静脉曲张出血 普萘洛尔 奥曲肽 

分 类 号：R657.31[医药卫生—外科学]