肝臓静脈流出阻害の管理
1Department of Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi.
Lancet (London, England)
|September 18, 1993
まとめ
肝臓静脈流出阻害 (HVOO) の管理は,標的の介入によって改善されました. 肝臓静脈の問題に対するサイド・ツー・サイド・ポートカヴァル・シャントと,下腔静脈のブロックに対する風船血管造形手術は,効果的な治療法を提供し,多くの患者に症状の緩和をもたらします.
科学分野:
- 肝臓病理学 肝臓病理学
- 血管外科 血管外科
- 介入放射線学とは,介入放射線学です.
背景:
- 肝静脈流出阻害 (HVOO) は,ポータル高血圧の珍しい原因です.
- HVOOに対する保守的な治療は,一般的に無効であり,積極的な管理戦略を必要とします.
研究 の 目的:
- 肝臓静脈流出阻害に対する管理プロトコルの策定と評価.
- 阻害部位に基づいてHVOOに対するさまざまな外科的および介入的処置の有効性を評価する.
主な方法:
- 1978年から1992年の間にHVOOを患った75人の患者を対象とした前向きな研究.
- HVOOの分類は,肝静脈閉塞 (24人の患者),下腔静脈閉塞 (44人の患者),複合閉塞 (7人の患者) となっている.
- プロキシマル・スプレノレナル・シャント,気球拡張,サイド・トゥ・サイド・ポートカヴァル・シャント,気球血管造形などの治療法の評価.
主要な成果:
- サイド・トゥ・サイド・ポートカヴァル・シャントは,肝臓静脈阻害に対する有望な効果を示した (4/6 健在).
- バルーン血管新生手術は,IVC阻害に対して非常に成功しました (28/30成功,4の回復).
- 全体として,75人の患者のうち44人が症状のない状態で,22人が死亡し,7人が不完全な治療を受けた.
結論:
- HVOOの積極的な管理が推奨されています.
- サイド・トゥ・サイド・ポートカヴァル・シャントは,肝臓静脈閉塞の治療に推奨されます.
- バルーン血管整形手術は,下静脈塞の好ましい治療法です.
関連する概念動画
01:28Esophageal Varices-II: Clinical Features and Management
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:30Venous Thrombosis IV: Nursing Management
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
01:22Portal Hypertension
Portal hypertension is an increase in blood pressure within the portal venous system. Normally, this pressure is less than 5 mmHg. It is considered clinically significant when it rises above 10 mmHg. At this threshold, complications from altered blood flow and venous congestion emerge.EtiologyPortal hypertension arises from conditions that impede blood flow through the liver. The most common cause is cirrhosis, in which chronic liver injury leads to fibrotic scarring. This fibrosis narrows or...
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care
Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
01:26Mitral Stenosis III: Medical Management
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...