一个随机对照试验的propranolol使用在绑定程序中用于食道腹出血的二次预防食道腹出血
Wen-Chi Chen1,2,3, Tsung-Chieh Yang2,4, Pei-Chang Lee2,4
1Division of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
透视性水绑定加非选择性β-阻断剂,直到根除为预防食道水再出血的长期治疗一样有效. 这种方法为肝硬化患者提供了可比的安全概况.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 临床医学 临床医学
背景情况:
- 食道水出血 (EVB) 的二次预防通常涉及内透视水绑定 (EVL) 与非选择性β-阻断剂 (NSBB) 结合.
- 目前的护理标准包括无限期地继续NSBB,但最优的持续时间仍在争论中.
研究的目的:
- 为了比较EVL加NSBB之间的再出血率,直到食道静脉瘤 (EEV) 的根除,以及EVL加长期NSBB用于EVB的二次预防.
- 为了评估较短的NSBB持续时间的非劣等性.
主要方法:
- 肝硬化和受控EVB患者被随机分为两个组.
- 组A接受了EVL加Propranolol直到EEV;组B接受了EVL加继续Propranolol.
- 在随访期间,复发性静脉动脉在两组中都通过绑定进行了管理.
主要成果:
- 在这两组中,随访时间的中位数超过23个月 (每组n=106).
- 复出率相似:A组11.3%,B组10.4% (差异为0.9%,95%CI-7.5%至9.3%),确定非劣等性.
- 组间的脱补偿率和死亡率是可比的.
结论:
- 在二次EVB预防中,EVL加上罗,直到EEV不低于EVL加上长期罗.
- 需要进一步研究其对脱补偿和无移植生存的影响.
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