このエントリーをはてなブックマークに追加
ID 19767
Eprint ID
19767
FullText URL
Title Alternative
Changing conception of indication for peripheral arterial reconstruction surgery.
Author
Komoto, Yoshiaki
Nakao, Toshihiko
Sunakawa, Mitsuru
Yagi, Nobuko
Yorozu, Hidenori
Abstract
末梢動脈の慢性閉塞性疾患に対する直達血行再建術の長期の予後は必ずしも満足できるものではない。合成代用血管は,長期の植え込みにより内被の肥厚,退行性変性,および材質の変性の様な合併症により,特に小口径の合成代用血管の適応は極めて限られたものになっている。一方,医用質量分析装置を用いた虚血肢の実験的研究によると,自由に運動させた犬の虚血肢では,急性期に比較すると3カ月以後その組織循環は有意に増加することが明らかとなった。また,家兎を用いた実験的研究によると,炭酸泉浴に高濃度のラドン吸入を合併すると皮下組織の組織循環が約30%増加して,同時に皮下の酸素分圧が上昇することを確かめた。従って,切迫壊死の症例をのぞいて,末梢動脈の慢性閉塞性疾患々肢,特に間欠性跛行に対しては,自 然予後を考慮して歩行負荷,および炭酸泉,ラドン泉の温泉療法を用いた保存的療法が長期の予後上効果的である。
Abstract Alternative
Peripheral arterial reconstruction surgery for chronic occlusive diseases has not always produced satisfactory results according to long-term (5-10 years) follow-up studies. Furthermore, application of synthetic vascular prostheses of small caliber for peripheral reconstruction is quite restricted to certain circumstances, because of the complications derived from long-term implantation such as thickening and degeneration of the inner capsule and deterioration of the grafts used. On the other hand, experimental studies on ischemic limbs revealed a significant increase of tissue perfusion in 3, 6 and 12 months following ischemia was induced (p<0.001) compared with the acute ischemic stage in freely moving dogs by means of medical mass spectrometry. In addition, subcutaneous tissue perfusion was found increased by about 30 % with CO(2) bathings in combination with Radon inhalation of high concentration (over 5000 Bq/l), which was accompanied by an elevation of subcutaneous pO(2). Therefore, medical treatments such as walking exercise and bathings with CO(2) and Radon based on the natural history of chronic peripheral arterial occlusive diseases, particularly intermittent claudication, appear feasible.
Keywords
虚血肢 (lshemic limb)
末梢血行再建術 (Peripheral arterial reconstruction)
組織循環 (Tissue perfusion)
歩行運動 (Walking exercise)
温泉療法 (Balneotherapy)
Published Date
1988-08
Publication Title
環境病態研報告
Publication Title Alternative
Papers of the Institute for Environmental Medicine, Okayama University Medical Scool
Volume
volume59
Publisher
岡山大学医学部附属環境病態研究施設, 岡山大学医学部附属病院三朝分院
Publisher Alternative
Institute for Environmental Medicine, Okayama University Medical Scool
Start Page
54
End Page
61
ISSN
09133771
NCID
AN10084718
Content Type
Departmental Bulletin Paper
language
日本語
File Version
publisher
Refereed
False
Eprints Journal Name
mmc