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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Controlled trial of ligation plus nadolol versus nadolol alone for the prevention of first variceal bleeding.
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Controlled trial of ligation plus nadolol versus nadolol alone for the prevention of first variceal bleeding.

机译：结扎加纳多洛尔与单独使用纳多洛尔预防首次曲张静脉出血的对照试验。

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摘要

Both nadolol and ligation have proved to be effective in the prophylaxis of first variceal bleeding. This study was conducted to evaluate the effects and safety of combining nadolol with ligation. Cirrhotic patients with high-risk esophageal varices but without a bleeding history were considered for enrolment. Eligible patients were randomized to receive band ligation plus nadolol (Combined group, 70 patients) or nadolol alone (Nadolol group, 70 patients). In the Combined group multiligators were applied. Patients received regular ligation treatment at an interval of 4 weeks until variceal obliteration. Nadolol was administered at a dose to reduce 25% of the pulse rate in both the Combined group and the Nadolol group. Both groups were comparable in baseline data. In the Combined group 50 patients (71%) achieved variceal obliteration. The mean dose of nadolol was 52 +/- 16 mg in the Combined group and 56 +/- 19 mg in the Nadolol group. During a median follow-up of 26 months, 18 patients (26%) in the Combined group and 13 patients (18%) in the Nadolol group experienced upper gastrointestinal bleeding (P = NS). Esophageal variceal bleeding occurred in 10 patients (14%) in the Combined group and nine patients (13%) in the Nadolol group (P = NS). Adverse events were noted in 48 patients (68%) in the Combined group and 28 patients (40%) in the Nadolol group (P = 0.06). Sixteen patients in each group died. CONCLUSION: The addition of ligation to nadolol may increase adverse events and did not enhance effectiveness in the prophylaxis of first variceal bleeding.
机译：纳多洛尔和结扎法均被证明可有效预防首次静脉曲张破裂出血。进行这项研究以评估纳多洛尔与结扎剂联合使用的效果和安全性。具有高风险食管静脉曲张但无出血史的肝硬化患者被考虑入组。符合条件的患者被随机分为乐队结扎加纳多洛尔（合并组，70例）或单独使用纳多洛尔（纳多洛尔组，70例）。在组合组中，使用了多连接器。患者每隔4周接受常规结扎治疗，直至静脉曲张消失。联合用药组和纳多洛尔组均以降低脉搏率25％的剂量给予纳多洛尔。两组的基线数据具有可比性。在合并组中，有50例患者（71％）达到了静脉曲张闭塞术。纳多洛尔的平均剂量在联合组中为52 +/- 16 mg，在纳多洛尔组中为56 +/- 19 mg。在26个月的中位随访期间，联合组的18例患者（26％）和纳多洛尔组的13例患者（18％）发生了上消化道出血（P = NS）。食管静脉曲张破裂出血在联合组中有10例（14％），在纳多洛尔组中有9例（13％）（P = NS）。联合组48例患者（68％）和纳多洛尔组28例患者（40％）出现不良事件（P = 0.06）。每组16例患者死亡。结论：将纳多洛尔加入结扎可能增加不良事件，并且未增强预防首次静脉曲张破裂出血的有效性。

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