普萘洛尔联合奥美拉唑预防食管胃静脉曲张破裂再出血

目的：探讨联合普萘洛尔和奥美拉唑维持治疗对预防食管胃静脉曲张破裂再出血的疗效。方法：85例肝硬化门脉高压患者随机分为2组：Ⅰ组42例：普萘洛尔,Ⅱ组43例：联合普萘洛尔和奥美拉唑。维持治疗6个月并随访1年。观察治疗后2组患者食管胃静脉曲张程度、出血的复发率及胃黏膜的改善情况。结果：Ⅰ组和Ⅱ组食管胃静脉曲张加重程度无显著性变化（P〉0.05）;2组再出血的复发率分别为35.0%和15.0%,Ⅱ组显著低于Ⅰ组（P〈0.05）;内镜下胃黏膜恢复总有效率Ⅱ组为92.5%,Ⅰ组为60.0%,两组差异有统计学意义（P〈0.01）。结论：普萘洛尔联合奥美拉唑维持治疗可有效预防食管胃静脉曲张破裂再出血。

Efficacy of propranolol combined with omeprazole in prevention of the patients with rebleeding caused by rupture of esophageal and gastric varices

AIM： To study the efficacy of propranolol combined with omeprazole with maintenance therapy in prevention of the patients with rebleeding caused by rupture of esophageal and gastric varices.METHODS： 85 cases patients with hepatocirrhosis portal hypertension were divided into two groups randomly： groupⅠ（propranolol,n=42） and groupⅡ（propranolol plus omeprazole,n=43）.The duration of maintenance therapy was six months,and followed up one year.The aggravation of esophageal and gastric varices,recurrence rates of hemorrhage and the lesions of gastric mucosa were examined and evaluated by gastroendoscopy before and after the period of treatment.RESULTS： After one year＇s observation,the aggravation of esophageal and gastric varices among two groups had not significant difference（P〉0.05）;the annual recurrence rates of hemorrhage of groupⅠand groupⅡ were 35.0% and 15.0% respectively,the recurrence rates of hemorrhage in group Ⅱ was significantly lower than that of group Ⅰ（P〈0.05）,The total effective rates in improving gastric mucosa was 92.5% in group Ⅱ,while 60.0% in group Ⅰ,which was significantly lower than that of group Ⅱ（P〈0.01）.CONCLUSION： The effect of propranolol plus omeprazole in prevention of the patients with rebleeding caused by rupture of esophageal and gastric varices is effective.