Asaki S, Nishimura T, Satoh A, Goto Y
Tohoku J Exp Med. 1983 Aug;140(4):339-52. doi: 10.1620/tjem.140.339.
To investigate the hemostatic mechanism of local ethanol injection, ethanol was injected into the gastric mucosa of five adult mongrel dogs and one guinea pig and histologic changes at acute and healing stages were followed. Following a local injection of absolute ethanol, the blood flow in small vessels at the site of injection became instantaneously arrested. Histopathologically, thrombosis of blood vessels in the mucosa and submucosa with edema, predominantly submucosal, was found 10 min after the ethanol injection. There was little or no inflammatory cell infiltration in the injected region. By 4 days after the injection, the base of the formed ulcer became stabilized with a uniform white coating, which, microscopically, was mainly composed of a thick layer of necrotized mucosal tissue. Ethanol showed fixative activity when applied to tissues at concentrations of greater than or equal to 20% although an ethanol concentration of at least 70% was required to accomplish adequate tissue fixation. With 95% or lower concentrations of ethanol, dehydration of tissue was insufficient, and hemostasis due to local vasoconstriction was less conspicuous than with absolute alcohol. Nevertheless, a fixative effect with consequent degeneration and necrosis of cells and secondary thrombosis was evident even at these ethanol concentrations. In patients treated with this hemostatic procedure, exposed blood vessels in the gastric ulcer became necrotized and corroded by fixation with injected absolute ethanol and disappeared from the base of the ulcer within 24 hr as seen in the animals.
为研究局部注射乙醇的止血机制，将乙醇注入5只成年杂种犬和1只豚鼠的胃黏膜，并观察急性和愈合阶段的组织学变化。局部注射无水乙醇后，注射部位小血管内的血流立即停止。组织病理学检查发现，乙醇注射10分钟后，黏膜和黏膜下层血管血栓形成，并伴有水肿，主要为黏膜下水肿。注射区域几乎没有炎性细胞浸润。注射后4天，形成的溃疡底部变得稳定，有一层均匀的白色覆盖物，显微镜下主要由一层厚厚的坏死黏膜组织组成。当乙醇浓度大于或等于20%时，对组织有固定作用，不过要实现充分的组织固定，乙醇浓度至少需要70%。乙醇浓度为95%或更低时，组织脱水不充分，局部血管收缩导致的止血效果不如无水乙醇明显。然而，即使在这些乙醇浓度下，细胞变性坏死及继发性血栓形成导致的固定作用仍很明显。在接受这种止血方法治疗的患者中，胃溃疡中暴露的血管被注入的无水乙醇固定、腐蚀，24小时内从溃疡底部消失，这与动物实验所见相同。
