Portal vein embolization by fine needle ethanol injection :experimental and clinicalstudies

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:yanqingilu
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
AIM To improve the technique of intraportal embolization (PVE) therapy, a new embolic method, was devised and the safety, effectiveness and feasibility were evaluated. METHODS PVE with intraportal ethanol injection via a fine needle was performed in 28 normal dogs, 22 SD rats, and 24 cirrhotic SD rats. After PVE, portography, histological and functional alteration of the liver were evaluated in dogs and rats, and the changes in portal hemodynamics as well as hepatic anatomy were observed in rats. In the clinical study, PVE by ethanol injection was performed in 61 patients with hepatocellular carcinoma under the guidance of portoechography with intraportal injection of CO 2. The effect of PVE was evaluated by ultrasonography and laparotomy. RESULTS The effectiveness and toxicity were dependent on the dose of ethanol. In the dogs, 0 25*!mg/*!kg of ethanol caused incomplete embolization with least liver damage, while 1 0*!mg/*!kg induced complete embolization with a high mortality of 57 1% (4/*!7) due to respiratory arrest. The dose of 0 5*!mg/*!kg resulted in complete embolization with slight toxicity to the liver. In the rats, the survival rate was 100% in normal group but 40 9% in cirrhotic models after ethanol injection by dose of 0 05*!mg/*!100*!g . PVE for cirrhotic rats with 0 03*!mg/*!100*!g of ethanol induced satisfactory embolization with significant hypertrophy in nonembolized lobes, and only slight damage to the hepatic parenchyma, and transient alteration in liver function, portal pressure and portal flow. In the clinical study, 12 cases with reverse portal flow were excluded judged by portoechography. Satisfactory embolization was gained in 90 2% (55/*!61) of the remaining patients determined by ultrasonography and surgery. All cases ran an uneventful postembolization course with no aberrant embolization. CONCLUSION PVE with intraportal ethanol injection of appropriate dosage via a fine needle is safe and effective and has several advantages comparing with transcatheter method. Portoechography is a mandatory approach for the prevention of aberrant embolization. AIM To improve the technique of intraportal embolization (PVE) therapy, a new embolic method, was devised and the safety, effectiveness and capacity were evaluated. METHODS PVE with intraportal ethanol injection via a fine needle was performed in 28 normal dogs, 22 SD rats , and 24 cirrhotic SD rats. After PVE, portography, histological and functional alteration of the liver were evaluated in dogs and rats, and the changes in portal hemodynamics as well as hepatic anatomy were observed in rats. In the clinical study, PVE by ethanol The injection was performed in 61 patients with hepatocellular carcinoma under the guidance of portoechography with intraportal injection of CO 2. The effect of PVE was evaluated by ultrasonography and laparotomy. RESULTS The effectiveness and toxicity were dependent on the dose of ethanol. In the dogs, 0 25*!mg/*!kg of ethanol caused incomplete embolization with least liver damage, while 1 0*!mg/*!kginduced complete embolization with a high m The dose of 0 5*!mg/*!kg resulted in complete embolization with slight toxicity to the liver. In the rats, the survival rate was 100% In normal group but 40 9% in cirrhotic models after ethanol injection by dose of 0 05*!mg/*!100*!g . PVE for cirrhotic rats with 0 03*!mg/*!100*!g of ethanol induced satisfactory Embolization with significant hypertrophy in nonembolized lobes, and only slight damage to the hepatic parenchyma, and transient alteration in liver function, portal pressure and portal flow. In the clinical study, 12 cases with reverse portal flow were excluded judged by portoechography. Satisfactory embolization was Gain in 90 2% (55/*!61) of the remains patients determined by ultrasonography and surgery. All cases ran an uneventful postembolization course with no aberrant embolization. CONCLUSION PVE with intraportal ethanol injection of appropriate dosage via a fine needle is safe and EffectiVe and has several claims compared with transcatheter method. Portoechography is a mandatory approach for the prevention of aberrant embolization.
其他文献
渣减少金属收得率,造成耐材损耗,使脱碳困难和不易控制,因此,渣越少越有利。如果在铁水进入转炉前就把其中的大部分硫、磷、硅去除,就可以减少渣量。日本 Slag reduces the
马钢二铁厂二号高炉上料系统,自1983年7月开始应用秤量自动补偿微型电子计算机控制入炉原料的秤量操作,取得了良好效果. 1、实现了操作标准化、统一化过去人工上料往往存在
ORIGINALARTICLEDown-regulationofHsp90couldchangecellcycledistributionandincreasedrugsensitivityoftumorcells.MAJORPOINTSOFTHECOMMENTEDARTICLEUsinganantisenseRNAa
上海市冶金工业局连铸技术考察组一行五人,应日本三菱商事株式会社邀请,于1983年9月4日至20日赴日进行连铸技术考察,主要考察了三个不锈钢连铸车间,三个炭钢连铸车间,一个水
自1990年4月至1998年12月,我们对42例中晚期胃癌病人行R_3淋巴结清扫手术,取得了满意效果,病人痊愈出院,五年生存率达到42.1%。现总结临床应用及手术方法如下。1 临床资料 本
摩羯座的人(12.22-1.19) 严谨内敛,一切都从最现实的观点出发,大都喜欢脚踏实地从零做起,并追求实实在在的结果,他们实际感还体现在促使自己不断地提高工作质量和改善生活环
患者男性67岁病案号985663患者高血压病史1a,血压最高213/12kPa;糖尿病史5a,长期服用降糖药。因发作性双侧颞部头痛1a,于1997年10月13日入院。查体:Bp186/93kPa,除腕、踝关节以下浅感觉异常外,余未见阳性体征。实... Pat
在探求生产氢氧化饰或氧化钸简便经济的工艺流程试验中,根据稀土元素离子势Φ值原理,用萃取钐铕钆后的萃原液作原料,采用下述工艺流程,获得较为满意的结果。工艺流程: 萃原
食管癌采用手术治疗是首选的方法,但其中有相当一部分的肿瘤穿透食管壁向外侵犯,与周围组织有不同程度的粘连,影响到手术切除的成功率,但一般的胃镜及X线钡餐造影检查难以查明这一
一、概况美国肯尼科特矿物公司的犹他炼铜厂为了遵从国家环境空气质量标准花费3.0亿美元进行了改造。旧的熔炼系统于1978年5月停止生产,改造后的熔炼系统从那时起投入生产。