Utilidad de propranolol como predictor de severidad del grado de várices esofágicas según observación endoscópica
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2021
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Los betabloqueantes han tenido un impacto significativo en el tratamiento de la hipertensión portal, pero se desconoce la efectividad para prevenir la hemorragia por várices en grupos poblacionales de paciente de Ecuador. Objetivo: Detrminar la utilidad del propranolol como predictor de severidad del grado de várices esofágicas según observación endoscópica. Metodología: Estudio de enfoque cuantitativo, de diseño no experimental, analítico y de corte transversall. La muestra está conformada por 212 pacientes divididos en dos grupos de 106 pacientes cada uno: grupo proranolol y grupo control (ligadura de várices esofágicas). La unidad de análisis fue el Hospital Abel Gilbert Pontón. Se analizaron de forma retrospectiva historias clínicas del 1 d enero al 31 de diciembre del 2019. REsultados: El grupo propranolol presentó en el 74,5% y el grupo ligaduras presentó várices en el 97,2%. Se observó várices pequeñas en el grupo propranolol 87,7% y en el grupo ligadura fue de 28,3%. Engrupo propranolol se encontró 12,3% de puntos rojos y en el grupo ligaduras se encontró 63,2%. El 2,8% del grupo proranolol presentó sangrado variceal y el 6,6% sangró en el grupo que se realizó ligadura de várices esofágicas. Hubo 5,7% de afectos adversos en el grupo propranolo. Conclusión: El propranolol son un método eficaz profilaxis primaria para reducir el tamaño de las várices esofágicas y prevenir el sangrado en pacientes con cirrosis hepática, con mínima prevalencia de efectos adversos.
Beta-blockers have had a significant impact in the treatment of portal hypertension, but their effectiveness in preventing variceal bleeding in Ecuadorian patient populations is unknown. Objective: To determine the usefulness of propranolol as a predictor of severity of the degree of esophageal varices according to endoscopic observation. Methodology: Study with a quantitative approach, non-experimental, analytical and cross-sectional design. The sample is made up of 212 patients divided into two groups of 106 patients each: proranolol group and control group (ligation of esophageal varices). The unit of analysis was the Abel Gilbert Pontón Hospital. Clinical records were retrospectively analyzed from January 1 to December 31, 2019. Results: The propranolol group presented in 74.5% and the ligature group presented varices in 97.2%. Small varices were observed in the propranolol group 87.7% and in the ligation group it was 28.3%. In the propranolol group, 12.3% of red dots were found and in the ligature group, 63.2% were found. 2.8% of the proranolol group presented variceal bleeding and 6.6% bled in the group that underwent ligation of esophageal varices. There were 5.7% adverse effects in the propranolo group. Conclusion: Propranolol is an effective primary prophylaxis method to reduce the size of esophageal varices and prevent bleeding in patients with liver cirrhosis, with minimal prevalence of adverse effects.
Beta-blockers have had a significant impact in the treatment of portal hypertension, but their effectiveness in preventing variceal bleeding in Ecuadorian patient populations is unknown. Objective: To determine the usefulness of propranolol as a predictor of severity of the degree of esophageal varices according to endoscopic observation. Methodology: Study with a quantitative approach, non-experimental, analytical and cross-sectional design. The sample is made up of 212 patients divided into two groups of 106 patients each: proranolol group and control group (ligation of esophageal varices). The unit of analysis was the Abel Gilbert Pontón Hospital. Clinical records were retrospectively analyzed from January 1 to December 31, 2019. Results: The propranolol group presented in 74.5% and the ligature group presented varices in 97.2%. Small varices were observed in the propranolol group 87.7% and in the ligation group it was 28.3%. In the propranolol group, 12.3% of red dots were found and in the ligature group, 63.2% were found. 2.8% of the proranolol group presented variceal bleeding and 6.6% bled in the group that underwent ligation of esophageal varices. There were 5.7% adverse effects in the propranolo group. Conclusion: Propranolol is an effective primary prophylaxis method to reduce the size of esophageal varices and prevent bleeding in patients with liver cirrhosis, with minimal prevalence of adverse effects.
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Propranolol, Várices esofágicas y gástricas, Endoscopía gastrointestinal, Epidemiología analítica, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador