| Co-Investigator(Kenkyū-buntansha) |
NIHEI Zenro Tokyo Medical and Dental University, Fac.of Med, Lecturer, 医学部, 講師 (00189341)
三島 好雄 東京医科歯科大学, 医学部, 教授 (00010158)
北郷 邦昭 東京医科歯科大学, 医学部, 助手 (00161472)
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| Budget Amount *help |
¥2,000,000 (Direct Cost: ¥2,000,000)
Fiscal Year 1996: ¥400,000 (Direct Cost: ¥400,000)
Fiscal Year 1995: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1994: ¥1,100,000 (Direct Cost: ¥1,100,000)
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| Research Abstract |
The aim of this research is to investigate pathophysiology of acute mesenteric ischemia (AMI), and to establish the judgment for intestinal viability. Experimental studies ; 1) Histological changes after 2-hour mesenteric artery ligation were mostly limited in the mucosal layr, on the other hand, marked congestion, hemorrhage and edema in the submucosal layr were observed in early stage after venous ligation. 2) Acute mesenteric ischemia after 1 or 2-hr SMA or SMV occlusion, following 1-hr reperfusion in rabbits. SMV-group showed a significant fall of blood pressure during SMV occlusion. Local blood flow, assessed by Laser Doppler flowmetry (LDF), of SMV-group were significantly lower than that of SMA-group. 3) LDF was an useful method to judge the intestinal viability both in arterial and venous occlusion. Clinical study ; 17 patients of acute superior mesenteric arterial occlusion (SMAO) and seven of acute superior mesenteric venous thrombosis (SMVT) were analyzed retrospectively. Mean age was 69 in SMAO and 59 in SMVT,and in SMAO,13 cases had histories of cardiovascular diseases. Presenting symptoms were nonspecific, but the onset of SMAO were often sudden, but those of SMVT were insidious. In most cases of SMAO,small and large bowel were diffusely affected, but in SMVT,segmental infarctions of small intestine were characteristic. In SMAO,mortality was 65% and most of the cases died within one month ater operation. In SMVT,mortality was 43% and 2 cases died 6 months after operation due to recurrence of SMVT.Early diagnosis, postoperative intensive care in SMAO and long-term prophylaxis of recurrent thrombosis in SMVT are critical for successful management of AMI.
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