肝源性溃疡45例临床分析与治疗探讨

目的研究乙肝后肝硬化患者消化性溃疡的临床特点,探讨小剂量心得安对肝源性溃疡愈合的影响.方法肝源性溃疡45例,观察其发病年龄、临床表现、溃疡部位、HP感染率和并发出血率及溃疡愈合率等特点.随机分为治疗组,用心得安 泰胃美治疗;对照组,用维生素B6 泰胃美治疗.另外选单纯性消化性溃疡22例,作为对照组2组,治疗方法与对照组相同.结果肝源性溃疡发病年龄较单纯性消化性溃疡晚10年,溃疡部位以胃溃疡居多和并发出血率高,心得安可明显提高肝源性溃疡愈合率与对照组具统计学意义(P<0.05).结论肝源性溃疡难以治愈且易并发出血,门静脉高压因素可能从中发挥作用,小剂量心得安有助于肝源性溃疡愈合.

A clinical analysis and managements of 45 cases of hepatogenic ulcer

Aim The clinical features of hepatogenic gastric ulcer secondary to cirrhosis from B hepatitis was observed and its management with light doses of propanolol tried.Methods 45patient with hepatogenic ulcer were divided at random into group A(n=23) treated with propanolol + tagamet and group B(n=22) with vitamin B6+tagament.A group C of patients with peptic ulcer(n=22) managed by vitamin B6+ tagament too was enrolled as another control.Results In general hepatogenic ulcer occurred at an age of 10 years older than the peptic ulcer,with a distribution solely within stomach and a higher risk of bleeding.The use of propanolol produced significant positive effect(P<0.05) in ulcer healing.Conclusion Management with light doses of propanolol was effective for hepatogenic gastric ulcer,however it has been unlikely to respond to tranditional therapy and prone to bleed because of portal hypertension.