Development of therapy for esophageal varices:medical splenectomy and formation of intrahepatic shunt

食管静脉曲张治疗进展：医学脾切除及肝内分流术

• 批准号: 61480186
• 负责人: OKUDA Kunio
• 金额: $ 3.78万
• 依托单位: Chiba University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1986
• 资助国家: 日本
• 起止时间: 1986 至 1987
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-61480186/
• 关键词: esophageal varices; liver cirrhosis; idiopathic portal hypertension; portal hypertensive dog; percutaneous transhepatic obliteration of esophageal varices; 内視鏡的食道静脈瘤硬化治療; パルスドップラー法; 超音波トランジットタイム血流計; 電磁流量計; 門脈血流量; 脾動脈血流量

Esophageal verices is one of major causes of death in patients with portal hypertension such as liver cirrhosis, idiopathic portal hypertension,hepatocellular carcinoma stc.An operation consisting of esophageal transection and splenectomy is the best treatment for esophageal varices but it cannot be applied to patients with poor hepatic functional reserve.In these patients percutaneous transhepatic obliteration of esophageal varices and endoscopic sclerotherapy of esophageal verices have been performed.In this study,to develop a better medical treatment for esophageal varices,we studied portal hemodynamics in patients with liver cirrhosis and those with idiopathic portal hypertension, and in portal hypertensive dogs which we made.We could demonstrate that portal venous inflow (blood flow into the portal vein system)was significantly increased in patients with liver cirrhosis and those with idiopathic portal hypertension as well as in portal hyertensive dogs compared with their controls(normal subjects and nomal dofs).We further evaluated the effects of elective endoscopic sclerotherapy in comparison with elective percutaneous transhepatic obliteration of esophageal varices in patients with liver cirrhosis and esophageal varices.We could demonstrate that elective endoscopic intravariceal sclerotherapy is superior to elective percutaneoous transhepatic obliteration of esophageal verices in the prevention of recurrent variceal hemorrhage and mortality in nonalcholic cirrhosis.

食管遗传是门静脉高血压患者的主要原因之一，例如肝肝硬化，特发性门户高血压，肝细胞癌STC。已经进行了食管食管遗传的差异和内窥镜硬化疗法。在这项研究中，为了开发更好的食管静脉管食管静脉曲张的医学治疗，我们研究了肝脏肝硬化患者的门静脉血流动力学，患有特定性的幼犬和端口上的患者可以证明（我们可以表现出血液流量）。与对照相比，与肝硬化以及患有特发性门静脉高压以及门静脉犬的患者相比（正常受试者和名义DOF）。内窥镜内经术硬化疗法优于选择性的经皮的经皮肝遗忘，在预防非血管肝硬化的复发性静脉曲张出血和死亡率方面，食管老师的遗传剂量优越。

项目成果

Sujiro Sugita;Kunihiko Ohnishi;Masaaki Saito;Kunio Okuda: American Journal of Physiology. (1987)

Sujiro Sugita；Kunihiko Ohnishi；Masaaki Saito；Kunio Okuda：美国生理学杂志。

Hidetaka Terabayashi et al.: Gastroenterology. 93. 1205-1209 (1987)

Hidetaka Terabayashi 等人：胃肠病学。

Hidetaka Terabayashi et al.: "Prospective controlled trial of elective endoscopic sclerotherapy in comparision with percutaneous transhepatic obliteration of esophageal varices in patients with nonalcoholic cirrhosis" Gastroenterology. 93. 1205-1209 (1987

Hidetaka Terabayashi 等人：“非酒精性肝硬化患者选择性内镜硬化疗法与经皮肝穿刺食管静脉曲张闭塞术的前瞻性对照试验”胃肠病学。

Kunihiko Ohnishi et al.: "Changes of splanchnic circulation with progression of chronic liver disease studied by echo-Doppler flowmetry" American Journal of Gastroenterology. 82. 507-511 (1987)

Kunihiko Ohnishi 等人：“通过回波多普勒血流测定法研究慢性肝病进展中内脏循环的变化”美国胃肠病学杂志。

Kunihiko Ohnishi et al.: Gastroenterology. 93. 129-134 (1987)

Kunihiko Ohnishi 等人：胃肠病学。