Ahmad Irfan, Khan Anwaar A, Alam Altaf, Butt Arshad Kamal, Shafqat Farzana, Sarwar Shahid
Medical Unit 1, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan.
J Coll Physicians Surg Pak. 2009 May;19(5):283-6.
To compare the efficacy of propranolol, propranolol with nitrate, band ligation, and band ligation with propranolol and nitrate for the prevention of esophageal variceal rebleeding.
A prospective randomized trial.
Department of Gastroenterology and Hepatology, Sheikh Zayed Hospital, Lahore, from November 2003 to July 2005.
One hundred and sixty cirrhotic patients with esophageal variceal bleeding were randomized to four treatment groups (propranolol, propranolol plus isosorbide mononitrate, band ligation, band ligation plus propranolol and nitrate) with 40 patients in each group. Patients were followed for 6 months after the enrolment of last patient. Primary end points were recurrence of esophageal variceal bleeding and death. Treatment complications were noted.
Four treatment groups were comparable regarding baseline characteristics. Esophageal variceal rebleeding occurred in 22% patients in band ligation plus drugs group, 26% patients in drug combination group, 31% patients in banding group and 38% patients in propranolol group (p=0.41). Difference in mortality rates was also not significant.
There was no significant difference between treatment groups in prevention of esophageal variceal rebleeding.
比较普萘洛尔、普萘洛尔联合硝酸盐、套扎术以及套扎术联合普萘洛尔和硝酸盐预防食管静脉曲张再出血的疗效。
一项前瞻性随机试验。
2003年11月至2005年7月，拉合尔谢赫扎耶德医院胃肠病与肝病科。
160例肝硬化食管静脉曲张出血患者被随机分为四个治疗组（普萘洛尔组、普萘洛尔加单硝酸异山梨酯组、套扎术组、套扎术加普萘洛尔和硝酸盐组），每组40例。最后一名患者入组后对患者随访6个月。主要终点为食管静脉曲张再出血和死亡。记录治疗并发症。
四个治疗组的基线特征具有可比性。套扎术加药物组22%的患者发生食管静脉曲张再出血，药物联合组26%的患者发生，套扎术组31%的患者发生，普萘洛尔组38%的患者发生（p = 0.41）。死亡率差异也无统计学意义。
各治疗组在预防食管静脉曲张再出血方面无显著差异。
