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材料与方法:作者研究了由于食道静脉曲张破裂而胃肠出血住进Beaujon医院的16个肝硬化病人。通过急诊内窥镜检查确定了出血的部位。所有病人的肝硬化诊断都有组织学的证明:13人是慢性酒精中毒性肝硬化,原因不明性肝硬化有3人。在胃肠出血发生之前,他们均无黄疸,腹水,和肝性脑病。随意将这些病人分成两组。接受心得安治疗的8个人为一组,每日两次口服心得安,不断加量直至病人心率减少大约25％,需时3～6天。心得安剂量:40～80mg,一日两次,要维持一个月。另一组的8个人服安慰剂,每次1片,每日两次,共一个月。在连续给心得安或安慰剂之前及开始给药之后一个月的一段时间内做了下述研究:测量肝静脉楔嵌压(WHVP)与肝静脉游离压(FHVP)之间的梯度,在导管内注射2毫升的造影剂,以不见其反流作为楔嵌压的标志;用靛青绿连续灌注法来估价肝血流;用热稀释法
Materials and Methods: We studied 16 cirrhotic patients admitted to Beaujon Hospital due to gastrointestinal bleeding due to ruptured esophageal varices. The site of bleeding was confirmed by emergency endoscopy. All patients with cirrhosis have been histologically proven: 13 were chronic alcoholic cirrhosis and 3 were of unknown liver cirrhosis. None of them had jaundice, ascites, and hepatic encephalopathy until gastrointestinal bleeding occurred. Feel free to divide these patients into two groups. The group of 8 individuals who received an Anesthesia treatment was orally taken twice daily. The dosage was increased continuously until the patient’s heart rate was reduced by about 25%, which took 3 to 6 days. Relief dose: 40 ~ 80mg, twice a day, to maintain a month. Another group of 8 people taking placebo, each one, twice daily for a total of one month. The following study was done within a month of continuous administration of propranolol or placebo and for a period of one month after initiation of dosing: A gradient between hepatic venous wedge pressure (WHVP) and hepatic venous free pressure (FHVP) was measured, Injection of 2 ml of contrast agent to see the reflux as a sign of wedge pressure; with indocyanine green continuous perfusion method to assess the hepatic blood flow; with thermal dilution method