| Summary: | Background : Hematemesis and/or melena are complaints frequently occurring in
patients with heart sirosis with varicose veins of gastroesophagous. Hematemesis
and/or melena occur because there is varicose vein bleeding. Each bleeding
episode brings mortality rate ranged from 25% to 30%. Prevention of varicose
vein bleeding using appropriate portal anti-hypertensive medicine may minimize
mortality risk.
Purpose : This research aimed to understand profile of use of portal antihypertension
and evaluate use of portal anti-hypertensive medicine consisting of:
exact dosage and therapy outcome.
Method : This research is observational-descriptive study and it was conducted
retrospectively. Subjects of research were patients of RSPU Dr. Sardjito
Yogyakarta receiving portal anti-hypertensive medicine from January of 2008 to
December of 2010. Collectable data were reviewed and discussed by references of
most recent guidelines.
Result : 41 inclusive cases indicated that 92.7% of patients used propranolol and
7.3% of patients used isosorbid mononitrate. Given outcome of use of portal antihypertensive
medicine based on hematemesis and/or melena incidences in patients
using propranolol as primary prophylaxis, one patient (11.1%) experienced
hematemesis, while, in patients using isosorbid mononitrate, it could prevent
incidence of hematesis and/or melena. In patients using propranolol as secondary
prophylaxis, 11 patients (37.9%) experienced hemetemesis and/or melena, while
in patients using isosorbid mononitrate, it could not prevent incidence of
hematesis and/or melena.
Conclusion : In propranolol secondary prophylaxis, there were 9 patients using
propranolol and one patient using isosorbid mononitrate. Based on achievable
responses, there was one patient experiencing hematemesis. It was caused by non
optimum propranolol dosage. While one patient using isosorbid mononitrate could
prevent hematemesis and/or melena in patients with liver Cirrhosis. In secondary
prophylaxis, there were 29 patients using propranolol and two patients using
isosorbid mononitrate. Based on achievable responses, there were 11 patients
using propranolol experiencing hematemesis and/or melena. It was caused by non
optimum propranolol dosage and there was one patient using propranolol
experiencing hematemesis and/or melena.
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