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目的评价普萘洛尔预防肝硬变食管静脉曲张患者初次上消化道出血的作用。方法以往无消化道出血史的肝硬变门脉高压患者31例,长期服用普萘洛尔(实验组),并随访2年。按Kaplan-Meier法计算未出血患者百分率;用时序检验(log-rank test)分别与接受脾切除+断流术或分流术(手术组),以及未予特殊降门脉压治疗的对照组随访患者进行比较。结果随访24个月时,普蔡洛尔实验组未出血患者百分率显著高于对照组(89.6%比53.8%,P<0.05),而与手术组(93.3%)无显著性差异(P>0.20)。结论长期服用普萘洛尔能显著降低肝硬变门脉高压患者初次消化道出血的发生率。
Objective To evaluate the effect of propranolol in the prevention of primary upper gastrointestinal bleeding in cirrhotic patients with esophageal varices. Methods In the past, 31 patients with cirrhosis and portal hypertension without history of gastrointestinal bleeding were treated with propranolol (experimental group) for a long time and were followed up for 2 years. Kaplan-Meier method was used to calculate the percentage of non-hemorrhagic patients. The patients were followed up by log-rank test in splenectomy + disconnection or shunt (operation group), and control group without special reduction of portal pressure Patients were compared. Results At 24 months of follow-up, the percentage of patients without hemorrhage in the experimental group was significantly higher than that in the control group (89.6% vs 53.8%, P <0.05), but not significantly different from that in the operative group (93.3%) ). Conclusion Long-term use of propranolol can significantly reduce the incidence of primary gastrointestinal bleeding in cirrhotic patients with portal hypertension.