Treat the ulcer colitis _'s treatment through the mesenterium artery conduit

Treat the ulcer colitis _'s treatment through the mesenterium artery conduit
Treat ulcer colitis through the mesenterium artery conduit

World Chinese digests the magazine The 0th roll Original Articles of the 8th issue of 1998

Author: Zhu XiaoLing Li wins for former times

Unit: Gi medicine of the People's Hospital of Liaoning Province Shenyang of Liaoning Province 110015

Keyword: Colitis, ulcer medicinal treatment; Splash nylon offering medicine and dosage; Colitis, ulcer radioactive nuclide is apparent to look like

Curative effect of drug injection via intro-arterial catheter on ulcerative colitis

ZHU Xiao-Ling and LI Sheng-Xi

Department of Gastroenterology, Liaoning Provincial People' s Hospital, Shenyang 110015, Liaoning Province, China

Subject headingscolitis, ulcerative/drug therapy; prednisolone/administration and dosage; colitis, ulcerative/radionuclide imaging

Abstract

AIMTo study the curative effects of drug injection through intro-arterial catheter on ulcerative colitis.

METHODSThirteen patients were treated on the next day after admission with a catheter entered into the super ior or inferior mesenteric artery, through femoral artery. DSA was performed at first and the extent and degree of the diseased part was confirmed. Methylprednisolone was injected into the inferior mesenteric artery slowly. The changes of the patient' s clinical symptoms and physical signs were observed 3 days later, and added with enema. The patients' clinical symptoms, physical signs and routine stool examination were recorded at the end of the first week, first month and the second month. Long-term follow-up was made.

RESULTSOne to three days after " impact treatment" through catheter, the clinical symptoms of most patients were ameliorated and mucoid puris bloody stool disappeared. After enema treatment for one to two months, the clinical symptoms did not recur. Routine stool examination turned normal. Colonoscopy revealed that the lesions disappeared, and only three patients relapsed, and the above treatment was repeated during the follow-up for one to four years.

CONCLUSIONDrug injection into mesenteric arteries can control clinical symptoms in active stage and ameliorate the lesions of colon mucosa. Drugs can be concentrated at the diseased areas with less systemic side-effects.

Chinese books and reference materials classification numberR574.620.53

Summary

PurposeStudy and inject and treat the result of ulcer colitis through the conduit mesenterium artery.

Method1993/1997 charge, live in the intersection of Liaoning Province and the People's Hospital digest the intersection of activity and period ulcer 13, patient of colitis, of ward. Patient's Nikkei arteria femoralis' intubate once after being admitted to hospital is to the upper or lower artery of mesenterium, go ahead of the rest the whole the intersection of colon and digital subtraction (DSa), confirm the intersection of pathological change and range and intensity, then artery inject methyl Meticortelone compound preparation slowly to mesenterium through conduit. Clinical symptom and physical sign of observing the person who works up future trouble of the note change the situation. After 3d, add and treat with enema. The intersection of record and 1wk treat, 1, the intersection of 2mo and symptom of patient, physical sign, routine and the intersection of intestines and mirror change situation. And follow up a case by regular visits to the patient for a long time.

Result1d- 3d after the conduit is assaulted and treats, most patients' clinical symptom is improved rapidly. The mucus suppuration blood situation basically disappears after 1wk. After enema 1mo- 2mo, have not seen that recur. The excrement is regular to return to normal. The intestines mirror show original pathological change and disappear. Examine the intersection of 1a- and 4a at the same time, recur, do again the intersection of conduit and treatment except 3 because of symptom, Wei Yu see, recur.

The conclusion is injected and treated ulcer colitis through the conduit mesenterium artery, can control the clinical symptom of activity one rapidly, improve intestines mucomembranous pathological change. Treatment this have some density high medicine not merely, whole body side effect little, medicine can uniform distribution give much trouble enteric sections of characteristic of capillary, and the digital subtraction (DSa) can clearly illustrate pathological change range and intensity. Diagnose and treat disposable completion, is worth further investigating.

0 foreword

Since 1993, the our academy, to 13 (16 times) Patient of a ulcer colitis of the activity, while adopting past therapeutic method, through inject, treat by the intersection of conduit and competent the intersection of mesenterium and artery, result good, as follows report.

A target and method

1.11993/1997 of the activities and a ulcer colitis of target are in hospital 13 patients, 4 men, 9 women, age and 13 years old - 59 years old, 39 average years olds. According to the 9th diagnostic standard of practical clinical practice[1],4 hairdoes of the beginning in 13, an acute breaking out one, chronic recuring 4, 4 cases of chronic continuation. The number of the condition is one slightly, intermediate 6, severe 6. Pathological change range: The whole the intersection of colitis and 5, the intersection of left and half colitis 7, the intersection of rectum and second the intersection of form and 1 of colitis. Other intestines diseases such as the chronic bacillary dysentery except the whole example, chronic amoeba.

1.2Method Patient do conduit treatment promptly next day admitted to hospital. Adopt Seldinger technology, insert the conduit the artery on the mesenterium or under the mesenterium through the arteria femoralis, go ahead of the rest the whole the intersection of colon and digital subtraction (DSa), confirm the intersection of pathological change and range and intensity, then artery inject slowly to mesenterium through conduit(0.5h- 1h) Methyl Meticortelone 80mg- 1000mg. Clinical symptom and physical sign of 3d after observing ia. Behind the 3d, add, come loose No. 3 Branch with tin, 0.2 metronidazole, the intersection of the rhizome of Chinese goldthread and plain 0.3 the intersection of grade and medicine unite enema treat 2mo (need hormone) . The bad one of curative effect, and divide into for 4 times to take with nitrogen sulfanilamide pyridine 4g- 6g of the willow. Continuous 1mo- 2mo. The intersection of record and 1wk treat, 1, symptom, physical sign, the intersection of excrement and routine and the intersection of intestines and mirror of 2mo change. Run side by side and follow up a case by regular visits to for a long time.

2 results

The whole the intersection of group and case have obvious the intersection of mucus and the intersection of suppuration and blood before the treatment, 5 persons who greater thans 10 times every day among them, 4- 4 for 10 times person, person who smaller thans 4 times is 4. Which have at various degrees abdominal pain and on serious after being worried. The belly has tenderness. 5 have abdominal distension, nausea, vomit, accompany by symptom, 2, with hyperpyrexia while being other among them. The excrement and urine is checked as the obvious mucus suppuration blood, the intestines mirror change for activity one. After the conduit treats 1d, the mucus suppuration blood situation is obviously lightened, defecate the number of times is reduced, physical sign lightens or disappears. 3 have a small amount of the intersection of mucus and blood only behind the 3d, the others basically return to normal (Table 1) . The majority gets control, physical sign and disappears in symptom after conduit and enema treat 1wk. Consolidate and treat 1, 2mo, the condition has not seen it is repeated, has reexamined the intestines mirror after 2mo, see original mucomembranous pathological change disappear, the mucous membrane returns to normal.

The whole group's case examines 1a- 4a at the same time, except the conduit treatment takes place to do again again because of symptom in 3, the others have not been seen to recur. About complication, have false polyp and narrow to form intestines already before the 4 treatment, the others do not have complication that appear.

Ulcer patient's clinical manifestation before and after treatment of colitis of Table 1 (n)





When

Mucus

Belly

Li are urgent

Disgusting

Send

Belly

Erupt simultaneously

Examine

Intestines mirror





Among

Piss of blood

Ache

And then heavy

Vomiting

It is hot

Tenderness

Disease

Unusual

Finding





0

13

12

11

5

2

10

4

13

Activity one





1d

4

2

2

0

1

1



12





3d

3

1

0

0

0

0



7





1wk

2

0

0

0

0

0



7





1mo

0

0

0

0

0

0

4

1

Relieve one





2mo

0

0

0

0

0

0

4

0

Pathological change disappears





3 is discussed

Ulcer colitis is a kind of chronic colitis with unidentified reason, pathological change is mainly limited to the mucous membrane of colon, take ulcer as the core, involve more rectum and carry colon is and can to carry expanding far far, so that spread all over the whole colon. Last suppuration blood, suffer from abdominal pain symptom it is main and on serious after being worried. The course of disease is long, the weight of condition differs, break out repeatedly. Can have some and the intersection of whole body and complication, acute colon expand, punch, bleed, false the intersection of polyp and form, canceration, the intersection of colon and narrow and intestinal obstruction, anaemia,etc..

ACTH, adrenocortical hormone and sulfa drug, in order to treat the effective medicine of ulcer colitis at present. Adopt the vein to instil, take orally or keep enema law more on clinic. It can cause the bad reaction to employ all over for a long time, though some enema treatment can reduce the bad reaction of using medicine all over, walk body posture and colon conduct and pathological change distribute different influence, medicine irritated can precise to act on the intersection of pathological change and perhaps. Adopt the disposable heavy dose of mesenterium artery to assault and treat, some medicine is tall in density, curative effect is good, there are less side effects of whole body, the medicine can be distributed over the capillary which is given much trouble the enteric Section evenly, reach the precise therapeutic effect. Assaulting not merely can control activity a patient's symptom and physical sign to treat rapidly, improve intestines mucomembranous pathological change, huge colon to person who is poison, false polyp form and canceration, the intersection of colon and the intersection of narrow and intestinal obstruction,etc. and long-term complication too can play good prevention function. Bludgon into, complement, come loose with tin treat, first the intersection of nitre and thiazole, the intersection of the rhizome of Chinese goldthread and the intersection of plain, sulfanilamide,etc. and medicine unite the enema treatment, can make the mucous membrane of damaged intestines resume gradually. This group, 1d- 3d after conduit treatment, most patients' clinical symptom is improved rapidly, the intersection of mucus and the intersection of suppuration and blood situation disappear basically behind the 1wk, complement, treat the intersection of 1mo- and 2mo with enema, symptom meet that recur.

The morbidity mechanism of ulcer colitis does not still know very much, may relate to immunity, heredity, infect, the allergic and spiritual neural factor. Hormone has very strong resisting inflammation, resisting allergic, antitoxic blood disease and immune inhibitory activity, can inhibit infection and non-infective inflammation. In acute initial stage in inflammation, increase blood vessel to be getting nervous, lighten congestion, reduce penetrating of capillary, inhibit inflammation from passing synthetic and release of the quality,etc.. On later stage as to chronic inflammation or acute inflammation, its function can be inhibited into the forming organized in hyperplasia and granulation of fibrous cells, lighten scar and adhesion that inflammation caused. So adopt disposably to pour into the treatment of methyl Meticortelone compound preparation by the conduit, can control the acute pathological change of activity one rapidly, improve clinical symptom, there is better prevention function too in the forming of the long-term complication. Treatment with past therapeutic method this compare, have, use medicine precise, with instant effect, the intersection of curative effect and kind, the intersection of side effect and little long-term the intersection of complication and little advantage, method simple, operate easily, can clear, offer, give much trouble intestines piece and pathological change intensity through digital subtraction (DSa), diagnose and treat disposable completion, is worth deepening the discussion in the future.

6, chief physician, Deputy Director. Publish professional the intersection of thesis and 30 this, obtain the intersection of Liaoning Province and the intersection of scientific and technological progress and 3 the intersection of grade and award, award Ministry of Public Health outstanding returned students.

Communication authorZhu XiaoLing, 110015, Shenyang of Liaoning Province, gi medicine of the People's Hospital of Liaoning Province.

Correspondence to:ZHU Xiao-Ling, Department of Gastroenterology, Liaoning Provincial People' s Hospital, Shenyang 110015, Liaoning Province, China

Accept draft date 1998-04-14

4 references

1 Liu start Great Britain and edit. Practical clinical practice. 9th. 1995: 1374-1380
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