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心得安联合内镜套扎术预防食管静脉曲张再出血的疗效分析
The efficacy of propranolol plus endoscopic variceal ligation for the prevention of variceal rebleeding
文章发布日期:2012年01月18日  来源:  作者:杨 力 程 浩 赵赛菊等  点击次数:2400次  下载次数:504次

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【摘要】:目的比较心得安联合内镜套扎治疗与单独内镜套扎治疗预防食管静脉曲张再出血的疗效。方法65例食管静脉曲张破裂出血的患者随机分为心得安联合内镜套扎治疗组(33例),单独内镜套扎治疗组(32例),平均随访12个月,比较两组间再出血率,门脉高压性胃病,食管静脉曲张复发和胃底静脉曲张的发生率。 结果两组治疗后随访第6,12个月显示,与单独内镜套扎治疗比较,心得安联合内镜套扎治疗显著降低再出血率(15.2% vs 37.5%,21.2% vs 46.9%,P<0.05),门脉高压性胃病(18.2% vs 438%,30.3% vs 56.3%,P<0.05) , 食管静脉曲张复发 (15.2% vs 37.5%,24.2% vs 50.0%,P<0.05)和胃底静脉曲张的发生率(12.1% vs 34.4%,21.2% vs 46.9%,P<0.05)。结论心得安联合内镜套扎治疗是二级预防食管静脉曲张出血的首选治疗方法。
【Abstract】:ObjectiveBoth betaBlockers and endoscopic variceal ligation (EVL) have proven to be valuable methods in the prevention of variceal rebleeding. The aim of this study was to compare the efficacy of propranolol plus EVL versus EVL alone as secondary prophylaxis for variceal bleeding. MethodsA total of 65 patients with esophageal variceal bleeding were randomized to receive EVL alone (32 patients) and propranolol plus EVL (33 patients),who received oral propranolol after EVL . The median followup period was 12 months. The rates of rebleeding,portal hypertensive gastropathy (PHG), variceal recurrence and formation of gastric fundus varices were compared between the two groups. ResultsAt 6, 12 months,propranolol plus EVL treatment significantly reduced rebleeding rates(15.2% vs 37.5%,21.2% vs 469%,P<0.05) and the rates of portal hypertensive gastropathy(18.2% vs 43.8%,30.3% vs 56.3%,P<0.05) , variceal recurrence(15.2% vs 37.5%,24.2% vs 50.0%,P<0.05) and formation of gastric fundus varices (12.1% vs 34.4%,21.2% vs 46.9%,P<005) compared to EVL alone. ConclusionPropranolol plus EVL should be recommended as the first line treatment for secondary prophylaxis of esophageal variceal bleeding.
【关键字】:食管和胃静脉曲张;心得安;内镜套扎
【Key words】:esophageal and gastric varices; propranolol; endoscopic variceal ligation
【引证本文】:

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