内容紹介
肝硬変に合併した胃静脈瘤に対しバルン閉塞下逆行性経静脈的塞栓術(B-RTO)を施行した37例を対象に超音波ドプラにて施行前と1週後の門脈血行動態を評価した。30例では門脈本幹血流量が増加したが、7例では不変あるいは低下を示し、有意に予後不良であった。多変量解析にて門脈本幹血流量の非増加は独立した予後不良因子であることが示された。
This study aimed to determine the prognostic effect of portal hemodynamic responses after balloonoccluded retrograde transvenous obliteration (B-RTO) for gastric varices in cirrhosis patients. Portal response was assessed by the changes in flow volume in the portal trunk (PFV) between before and 7 days after B-RTO. Thirty patients showed increased PFV (Group I) and 7 patients showed no increase in PFV (Group II). The survival rate was significantly lower in Group II (83.3% at 1 year and 66.7% at 3 years) than in Group I (96.7% at 1 year, 81.5% at 3 years, and 61.8% at 5 years; P = 0.012). Multivariate analysis identified only no increase in portal response (hazard ratio 8.086; P = 0.005) as an independent factor for poor prognosis.
目次
This study aimed to determine the prognostic effect of portal hemodynamic responses after balloonoccluded retrograde transvenous obliteration (B-RTO) for gastric varices in cirrhosis patients. Portal response was assessed by the changes in flow volume in the portal trunk (PFV) between before and 7 days after B-RTO. Thirty patients showed increased PFV (Group I) and 7 patients showed no increase in PFV (Group II). The survival rate was significantly lower in Group II (83.3% at 1 year and 66.7% at 3 years) than in Group I (96.7% at 1 year, 81.5% at 3 years, and 61.8% at 5 years; P = 0.012). Multivariate analysis identified only no increase in portal response (hazard ratio 8.086; P = 0.005) as an independent factor for poor prognosis.