Lo G H, Lai K H, Lee S D, Tsai Y T, Lo K J
Department of Medicine, Veterans General Hospital-Kaohsiung, Taiwan, Republic of China.
J Gastroenterol Hepatol. 1993 Jul-Aug;8(4):358-62. doi: 10.1111/j.1440-1746.1993.tb01528.x.
Variceal recurrence and rebleeding are common after initial obliteration by injection sclerotherapy. To investigate whether propranolol can maintain variceal obliteration by sclerotherapy, 59 patients with oesophageal variceal bleeding after sclerotherapy were enrolled. Patients were allocated to propranolol treatment (30 patients) or served as controls (29 patients). After a mean follow up of 2 years and 4 months, 53 patients completed the study. Fifty-eight per cent of the propranolol group versus 77% of the control group experienced recurrent varices (P = 0.20). Fifteen per cent of the propranolol group versus 11% of the control group developed cardiac varices. Recurrent variceal bleeding was encountered in 27% of the propranolol group and 19% of the control group. Three patients in the propranolol group, compared with two patients in the control group, died of massive variceal bleeding. Eighty per cent of them bled from cardiac varices. Both groups had similar survival rates. We therefore concluded that the use of propranolol after variceal obliteration by sclerotherapy can neither prevent oesophagogastric variceal recurrence nor prevent further rebleeding.
在通过注射硬化疗法进行初始闭塞后，静脉曲张复发和再出血很常见。为了研究普萘洛尔是否能维持硬化疗法造成的静脉曲张闭塞，59例硬化疗法后发生食管静脉曲张出血的患者被纳入研究。患者被分配到普萘洛尔治疗组（30例患者）或作为对照组（29例患者）。经过平均2年4个月的随访，53例患者完成了研究。普萘洛尔组58%的患者与对照组77%的患者出现静脉曲张复发（P = 0.20）。普萘洛尔组15%的患者与对照组11%的患者出现贲门静脉曲张。普萘洛尔组27%的患者和对照组19%的患者出现静脉曲张再出血。普萘洛尔组有3例患者，与对照组的2例患者相比，死于大量静脉曲张出血。其中80%的患者因贲门静脉曲张出血。两组的生存率相似。因此，我们得出结论，在通过硬化疗法闭塞静脉曲张后使用普萘洛尔既不能预防食管胃静脉曲张复发，也不能预防进一步的再出血。
