盐酸普萘洛尔联合奥美拉唑用于肝硬化上消化道出血二级预防的疗效分析  

Efficacy of propranolol combined with omeprazole in secondary prevention of upper gastrointestinal bleeding in liver cirrhosis patients

作　　者：马彦华[1] 黄通瑞[1] 常彦清 王晓玮[1] 

机构地区：[1]中国人民解放军北京军区联勤部第一离职干部休养所,石家庄市050000

出　　处：《临床合理用药杂志》2017年第25期28-30,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察盐酸普萘洛尔联合奥美拉唑用于肝硬化上消化道出血二级预防的疗效。方法将107例肝硬化合并上消化道出血患者随机分为联合预防组55例和单药预防组52例。联合预防组给予盐酸普萘洛尔联合奥美拉唑用于出血后二级预防,单药预防组给予普萘洛尔单药用于出血后二级预防。随访2组再次出血时间、程度,药物副作用、严重不良事件及一般病情变化。结果联合预防组患者总体再出血率、2次及以上再出血发生率均低于单药预防组,差异有统计学意义(P<0.05)。2组需要紧急医疗干预的出血发生率比较无统计学差异(P>0.05),但单药预防组发生2次出血的比例却明显高于联合预防组,差异有统计学意义(P<0.05)。联合预防组发生需要紧急医疗干预的无诱因自发性出血5例(9.1%),单药预防组3例(5.8%),2组间比较无统计学意义(P>0.05)。联合预防组不良反应发生率为41.8%(23/55),单药预防组为34.6%(18/52),组间比较差异无统计学意义(P>0.05)。结论盐酸普萘洛尔联合奥美拉唑用于肝硬化上消化道大出血的二级预防并不优于盐酸普萘洛尔的单独应用。Objective To observe the effects of propranolol combined with omeprazole on secondary prevention of upper gastrointestinal bleeding in liver cirrhosis patients. Methods 107 cases of cirrhosis with upper gastrointestinal bleeding were randomly divided into combined group 55 cases and 52 cases of single group. Combined group was given propranolol hydrochloride combined with omeprazole for secondary prevention after hemorrhage, Single group was given propranolol mono- therapy for secondary prevention after hemorrhage. Follow-up again bleeding time, degree, drug side effects, serious adverse events and general condition changes of two groups. Results The total rebleeding rate,2 times and above the incidence of rebleeding of combined group were lower than single group,the difference was statistically significant（ P 〈 0.05）. There was no significant difference in the incidence of hemorrhage between the two groups（ P 〉 0.05 ）, but the proportion of hemorrhage occurred in single group was significantly higher than that combined group （P 〈 0.05 ）. There were 5 cases （9.1% ） of spontane- ous bleeding without induction of emergency intervention and 3 cases（5.8% ） of single group. There was no significant difference between the two groups （P 〉 0.05 ）. The incidence of adverse reactions was 41.8% （23/55） in combined group and 34.6% （ 18/52 ） in single group, there was no significant difference between two groups （ P 〉 0.05 ）. Conclusion Propranolol combined with omeprazole used for secondary prevention of severe upper gastrointestinal bleeding in liver cirrhosis patients is not better than propranolol alone.

关 键 词：上消化道出血 盐酸普萘洛尔 奥美拉唑 二级预防 

分 类 号：R573.2[医药卫生—消化系统]