摘要
目的研究肾脏血流对射频消融效果的影响。方法6只狗采用手术暴露两侧肾脏,对上、下极进行多电极射频消融,消融前随机对每只狗行一侧肾脏肾蒂阻断(实验组),另一侧不阻断(对照组)。在相似的位置插入电极针。消融前、中、后行B超监测,并观察B超在肾脏消融中的作用及射频消融的并发症。然后取肾脏行组织病理学检查,测量消融灶的大小进行对比。结果未阻断肾蒂组损毁灶呈尖端指向髓质的楔形,阻断肾蒂组近似球形,但损毁灶的组织学改变相同。实验组和对照组冠状面,矢状面最大径和深度分别为(3.70±0.26)cm和(2.10±0.18)cm、(3.70±0.22)cm和(2.60±0.54)cm、(3.50±0.21)cm和(2.20±0.48)cm,P<0.001。时实超声消融灶表现为不规则的强回声,影像周围不规则。并发症有肉眼血尿,小的包膜下血肿。结论射频消融对肾脏能造成快速、完全凝固性坏死损害;肾脏血流明显影响消融灶范围和形态;肾脏消融是安全的;超声对评估消融灶大小价值不大,但可以引导电极针准确定位在治疗区。
[Objective] To study the effect of renal blood flow in radiofrequency ablation of animal kidney. [Methods] The upper and lower pole of each kidney was exposed surgically in 6 hybrid dogs. In each kidney a 8- electrode dry radiofrequency thermal ablation probe was inserted at an identical location and depth （1.5cm） and deployed to a diameter of 2.5 cm. The left or right renal hilum of each dog was clamped during radiofrequency ablation. Administration was performed by B-ultrasonography before, during and after radiofrequency ablation. All dogs were sacrificed immediately. The size and shape of the lesions created were measured and examined histologically. Complications of radiofrequency thermal ablation were observed. [Results] The radiolesions showed spherical contour and wedge shape of tip direction to medulla with and without hilar occlusion, respectively. The largest dimension of the lesion was with and without hilar occlusion （3.70±0.26） cm and （2.10±0.18） cm, （3.70±0.22） cm and （2.60±0.54） cm, （3.50±0.21） cm and （2.20±48） cm, respectively. The difference was statistically significant （P 〈 0.001）. Mean time to reach the average target impedance of 100Ω was not statistically significant （8 versus 12 minutes with and without hilar occlusion）. Microscopically radiolesions with and without hilar occlusion appeared similar. B-ultrasound confirmed probe placement but did not monitor lesion progression. Intraoperative complication occurred in 3 dogs with gross hematuria and 1 point with small hematoma under renal capsule. [Conclusions] In the dog＇model renal radiofrequencythermal ablation creates rapidly and completely devitalized coagulated necrosis of consistent size and shape. Renal blood flow occlusion may result in larger lesions. It is not reliable for us to value the size and shape of the ablated lesions according to B-ultrasound in the early period.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2006年第12期1837-1839,1842,共4页
China Journal of Modern Medicine
关键词
射频消融
肾脏
超声
radiofrequency ablation
kidney
dog
ultrasonography
