肝炎后肝硬变合并消化性溃疡90例诊治分析

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目的 研究肝炎后肝硬变合并消化性溃疡的临床特点 ,探讨小剂量普萘洛尔对肝硬变合并消化性溃疡愈合的影响。方法 肝炎后肝硬变合并消化性溃疡 90例 ,随机分为治疗组 (A组 ) 4 6例 ,口服普萘洛尔加西咪替丁 ;对照 1组 (B组 ) 4 4例 ,口服维生素B6加西咪替丁。另外选单纯性消化性溃疡 4 4例作为对照2组 (C组 ) ,治疗方法与B组相同。结果 肝硬变合并消化性溃疡的发病中位年龄较单纯性消化性溃疡晚 12年 ,溃疡部位以胃溃疡居多 ,合并出血率高 ,与C组比较差异有显著意义 (P <0 0 1)。普萘洛尔可明显提高其溃疡的愈合率 ,与B组比较差异有显著意义 (P <0 0 5 )。结论 肝硬变合并消化性溃疡难以治愈 ,且易合并出血 ,门静脉高压因素可能从中发挥了作用 ,小剂量普萘洛尔有助于肝硬变合并消化性溃疡的愈合。 Objective To study the clinical characteristics of posthepatitic cirrhosis with peptic ulcer and to explore the effect of small doses of propranolol on the healing of cirrhosis combined with peptic ulcer. Methods Ninety patients with posthepatitic cirrhosis and peptic ulcer were randomly divided into treatment group (group A) 46 cases, oral propranolol plus cimetidine; control group 1 (group B) 44 cases, oral vitamin B6 Garcinibutin. Another menu of pure peptic ulcer 4 4 cases as a control group 2 (C group), treatment and B group the same. Results The median age of patients with cirrhosis complicated with peptic ulcer was 12 years later than that of simple peptic ulcer. The ulcer was mostly gastric ulcer with high bleeding rate, which was significantly different from that of C group (P <0.01) . Propranolol significantly increased the healing rate of ulcer, which was significantly different from that of group B (P <0.05). Conclusions Cirrhosis combined with peptic ulcer is difficult to cure, and it is easy to combine hemorrhage. The portal hypertension may play a role in it. A small dose of propranolol can help the healing of cirrhosis and peptic ulcer.
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