GINMU >
01 奈良県立医科大学 >
011 医学部 >
0112 紀要 >
01121 Journal of Nara Medical Association >
Vol.50 No.5 >
このアイテムの引用には次の識別子を使用してください:
http://hdl.handle.net/10564/542
|
タイトル: | 孤立性胃静脈瘤に対する内視鏡的硬化療法 |
その他のタイトル: | ENDOSCOPIC INJECTION SCLEROTHERAPY FOR SOLITARY GASTRIC VARICES |
著者: | 松村, 雅彦![](/dspace/image/metalink/link_ja.gif) |
キーワード: | solitary gastrlc varlces endoscopic injection sclerotherapy direct injection method ethanolamine oleate containing Iopamidol prognosis |
発行日: | 1999年10月31日 |
出版者: | 奈良医学会 |
引用: | Journal of Nara Medical Association Vol.50 No.5 p.390-401 |
抄録: | The author designed a direct injection method of endoscopic injection
sclerotherapy (EIS) for solitary gastric varices and here reports its methodology and
efficacy. The subjects studied were 105 patients with solitary gastric varices. Sixty-seven
of them were treated with EIS and 38 were observed without EIS. The sclerosant, 5%
ethanolamine oleate containing Iopamidol, was directly injected to the varices under X-ray
monitoring. The author developed techniques to improve retention of the sclerosant and to
minimize bleeding at the puncture site. Efficacy of EIS could be evaluated 1 to 3 months
later in 61 cases. The gastric varices disappeared by the EIS in 40 of 61 patients (65.6%)
and did not change in only 1 patient. In patients with bleeding varices, rate of hemostasis
was higher and cumulative rates of re-bleeding, bleeding deaths and mortality rate were
lower in patients with EIS than those with conservative treatment. In patients with non-
bleeding F₂ and F₃ varices, cumulative rates of bleeding, bleeding deaths and mortality rate
were also lower in patients with EIS than those with conservative treatment. Multivariate
analysis by the multiple logistic model revealed that high Child grading, loss of EIS and
bleeding on admission were significant factors for poor prognosis indicating bleeding and
death within 1 year. Angiography showed that the varices and feeding vessels disappeared
in almost all cases, but the drainage vessels were left in half the cases after EIS. As
complications, mild shock, pleural effusion and ascites were observed in a few cases. No
other serious complications were observed. The present study suggests that this direct
injection method of EIS is an effective treatment to control and prevent bleeding from
gastric varices. |
URI: | http://hdl.handle.net/10564/542 |
ISSN: | 13450069 |
出現コレクション: | Vol.50 No.5
|
このリポジトリに保管されているアイテムは、他に指定されている場合を除き、著作権により保護されています。
|