Lundell L, Leth R, Lind T, Lönroth H, Sjövall M, Olbe L
Department of Surgery, Sahlgren's Hospital, University of Göteborg, Gothenborg, Sweden.
Acta Chir Scand. 1990 Oct;156(10):711-5.
Forty-one patients admitted with first episode of bleeding from esophageal varices were enrolled in a trial of the efficacy of oral propranolol to prevent rebleeding during the course of endoscopic sclerotherapy until obliteration. Single-blind randomization to sclerotherapy alone or with propranolol was used. At monthly endoscopy the varices were injected with 1% Aethoxysclerol until obliteration. If bleeding recurred, additional sclerotherapy was given. There was no intergroup difference in time to eradication of varices (8.1 vs. 7.7 months). The cumulative number of bleedings from varices and from distal esophageal ulcerations was identical in the two study groups. Five patients in the control group but only one in the propranolol group died of bleeding in the study period, a difference of only borderline significance (chi 2 = 4.08, df = 1). There were no specific side effects of propranolol. Thus propranolol did not significantly reduce the frequency of rebleeding until variceal obliteration, but could have had some influence on the gravity of rebleeding.
41例首次因食管静脉曲张出血而入院的患者参与了一项关于口服普萘洛尔在内镜硬化治疗直至静脉曲张闭塞过程中预防再出血疗效的试验。采用单盲随机分组，一组仅接受硬化治疗，另一组在硬化治疗基础上加用普萘洛尔。每月进行内镜检查时，用1%乙氧硬化醇注射静脉曲张直至闭塞。若再次出血，则给予额外的硬化治疗。两组消除静脉曲张的时间无差异（8.1个月对7.7个月）。两个研究组中来自静脉曲张和食管远端溃疡的累计出血次数相同。在研究期间，对照组有5例患者死于出血，而普萘洛尔组仅有1例，差异仅具有临界显著性（χ² = 4.08，自由度 = 1）。普萘洛尔无特定副作用。因此，在静脉曲张闭塞之前，普萘洛尔并未显著降低再出血的频率，但可能对再出血的严重程度有一定影响。
