インドシアニングリーンを用いた食道静脈瘤の半導体レーザー治療

吲哚菁绿半导体激光治疗食管静脉曲张

• 批准号: 09671339
• 负责人: SUZUKI Hiroaki
• 金额: $ 1.86万
• 依托单位: JIKEI UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09671339/
• 关键词: ESOPHAGEAL VARICES; DIODELASER; INDOCYANINE GREEN; (diode-laser)半導体レーザー; インドシアン2グリーン(ICG); 内視鏡治療

Endoscopic sclerotherapy and variceal ligation are widely accepted as the first choice of treatment for esophageal varices. However, its safety and efficacy has not been completely achieved yet.We developped ICG enhanced diode laser photosclerotherapy as preventive treatment for bleeding esophageal varices. Submucosal injection of wave length-specific dye (ICG : indocyanine green) could provide enhanced diode laser beam absorbtion selectively in the submucosal tissues around esophageal varices. First of all, we clarified the efficacy and safety of this new technique esperimentally using dog's esophagus and then applied it in 6 cases of esophageal varices. In the experimentally study, thermal injuries in the mucosa and submucosa were selectively induced without surface defects during irradiation. A month follow up e*oscopy showed degenerated mucosa and submucosa to be replaced with fibrosis while no changes were observed in the muscle layer. Based on these findings, we therefore, applied this technique in 6 patients of esophageal varices after EVL treatment. Complete eradication was archieved within 2 weeks in all cases. A mild stenosis was seen in 2 patients, which was easily treated by balloon dilatation. It is concluded that ICG dye enhanced diode laser photosclerotherapy would be useful as a simple, safe and effective alternative to prevent bleeding from esophageal varices.

内镜下硬化治疗和套扎术是治疗食管静脉曲张的首选方法。然而，其安全性和有效性尚未完全实现，我们开发了ICG增强的半导体激光光硬化疗法作为预防性治疗食管静脉曲张出血。粘膜下注射波长特异性染料（ICG：吲哚菁绿色）可选择性增强食管静脉曲张周围粘膜下组织对半导体激光的吸收。首先，我们以犬食管为实验材料，阐明了这种新技术的有效性和安全性，并将其应用于6例食管静脉曲张患者。在实验研究中，在没有表面缺陷的情况下，在粘膜和粘膜下层中选择性地诱导热损伤。术后1个月随访，粘膜及粘膜下层变性，肌层无明显改变。基于这些发现，我们因此在6例食管静脉曲张患者EVL治疗后应用该技术。所有病例均在2周内完全根除。2例患者出现轻度狭窄，可通过球囊扩张轻松治疗。结论：ICG染料增强的半导体激光光硬化治疗是一种简单、安全、有效的预防食管静脉曲张出血的方法。

项目成果

日野 昌力: "食道静脈瘤に対するICG dye enhanced diode laser photosclerotherapy" Gastroenterological Endoscopy. 40・11. 1957-65 (1998)

Masaki Hino：“食管静脉曲张的ICG染料增强二极管激光治疗”胃肠内窥镜检查40・11（1998）。

SHORYOKU HINO: "EXPERIMENTAL AND CLINICAL STUDIES OF ICG DYE ENHANCED DIODE LASER PHOTOSCLEROTHERAPY FOR ESOPHAGEAL VARICES" GASTROENTEROLOGICAL ENDOSCOPY. 40-11. 1957-1965 (1998)

Shoryoku HINO：“ICG 染料增强二极管激光光硬化疗法治疗食管静脉曲张的实验和临床研究”胃肠病内窥镜。

日野 昌力: "食道静脈瘤に対するICG dye enhanced diode laser photosclerotherapy" Gastroenterological Endoscopy. 40・11. 1957-1965 (1998)

Masaki Hino：“食管静脉曲张的ICG染料增强二极管激光治疗”胃肠内窥镜检查1957-11（1998）。