THE EFFECTS OF CHRONIC ENDOSCOPIC VARICEAL SCLEROTHERAPY ON SYSTEMIC AND SPLANCHNIC HEMODYNAMICS IN PATIENTS WITH CIRRHOSIS

被引:3
作者
OTA, K [1 ]
SHIJO, H [1 ]
KOKAWA, H [1 ]
KUBARA, K [1 ]
KIM, T [1 ]
AKIYOSHI, N [1 ]
YOKOYAMA, M [1 ]
OKUMURA, M [1 ]
机构
[1] FUKUOKA UNIV,SCH MED,DEPT INTERNAL MED 1,JONAN KU,FUKUOKA 81480,JAPAN
关键词
HYPERDYNAMIC CIRCULATION; PORTOSYSTEMIC COLLATERAL;
D O I
10.2169/internalmedicine.33.745
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim of this study was to determine whether endoscopic variceal sclerotherapy affects systemic or splanchnic hemodynamics. We measured hemodynamic parameters before and after the first course of sclerotherapy in 35 patients with cirrhosis. Following sclerotherapy, there was a significant decrease in cardiac index and a significant increase in systemic vascular resistance. Changes in hepatic venous pressure gt adient varied from patient to patient with no statistically significant change in the group overall. However, all 20 patients with a decline in the hepatic venous pressure gradient had a concomitant decrease in cardiac index and/or a large extravariceal shunt. The multivariate analysis disclosed that the decrease in cardiac index was a statistically significant contributor for the decline in hepatic venous pressure gradient. We conclude that the obliteration of esophageal varices by sclerotherapy significantly reverses the hyperdynamic circulatory state in patients with cirrhosis. Spontaneous changes in systemic hemodynamics and the interaction with hepatic hemodynamics must be taken into account when evaluating hepatic hemodynamics in patients undergoing variceal sclerotherapy.
引用
收藏
页码:745 / 751
页数:7
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