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目的探讨哌唑嗪预防肝硬化食管胃静脉曲张破裂出血复发的效果及其作用机制。方法对 35例治疗组患者和 35例对照组患者进行前瞻性对照研究 ,在用药前后用彩色多普勒超声仪检测其门静脉系统血流动力学的变化 ,并动态监测患者的血压、心率、肝肾功能及食管胃静脉曲张破裂出血复发情况。结果用药 10天后治疗组门静脉血流量、脾静脉血流量显著下降 ,于 4周后门静脉血流量、脾静脉血流量、门静脉内径、脾静脉内径 ,分别下降为 10 5 1 3± 378 5ml min ,5 4 8.3± 331.1ml min ,1.3± 0 .4cm ,0 .9± 0 .2cm ,与用药前比较差异有显著性 ,临床上未见明显副反应 ;随访 2年 ,对照组再出血率和病死率均显著高于治疗组 ,两组中Child -pughC级患者的病死率无显著性差异。结论哌唑嗪预防食管胃静脉曲张破裂出血的复发是安全有效的 ,值得在临床进一步研究和试用。
Objective To investigate the effect and mechanism of prazosin in preventing recurrence of hemorrhagic esophagogastric variceal bleeding in cirrhotic patients. Methods 35 patients in the treatment group and 35 patients in the control group were prospectively controlled. The changes of the portal system hemodynamics were measured by color Doppler before and after treatment. The blood pressure, heart rate, Renal function and esophagogastric variceal bleeding recurrence. Results After 10 days of treatment, the portal vein blood flow and splenic vein blood flow decreased significantly. After 4 weeks, the portal vein blood flow, splenic vein blood flow, portal vein diameter and splenic vein diameter decreased to 10 5 1 3 ± 378 5 ml min, 5 4 8.3 ± 331.1ml min, 1.3 ± 0.4cm, 0.9 ± 0.2cm, compared with before treatment, the difference was significant clinical no significant side effects; follow-up of 2 years, the control group of rebleeding rate and mortality Were significantly higher than the treatment group, two groups of Child-pughC grade mortality was no significant difference. Conclusion Prazosin in the prevention of recurrent esophageal and gastric variceal bleeding is safe and effective, it is worth further clinical study and trial.