摘要
目的比较在体兔肝脏对高渗盐水、冰醋酸以及冰醋酸高渗盐水(AAHS)混合溶液对于增大射频消融(RFA)毁损区范围的效果,选择出最佳的消融增效剂。方法30只大耳白兔分为6组,每组5只,A组单纯RFA;B组注射36%NaCl+RFA;C组注射50%冰醋酸溶液+RFA;D组注射50%AAHS溶液+RFA;E组单纯注射50%冰醋酸溶液;F组单纯注射36%氯化钠溶液。将兔分期处死后取出肝脏、固定,并对上述各种溶液对RFA的增效作用进行综合评价。结果同其他各组相比,A组最低阻抗值最大(P<0.05),B、D组同C组最低阻抗间的差异有统计学意义(P<0.05),而B组与D组最低阻抗间差异无统计学意义(P=0.997)。A组持续时间明显小于B、D组(P<0.05)。而B组与D组持续时间之间的差异无统计学意义(P>0.05)。C组与B、D组在射频持续时间上差异有统计学意义(P<0.05)。B、C、D组较A组能产生更大的凝固坏死区(P<0.05)。其中,D组凝固坏死区最大切面面积最大,与其他各组相比差异有统计学意义(P<0.05)。而B组与A、C、E组比较其消融最大切面面积的差异也有统计学意义(P<0.05)。在观察组兔术后1周CT扫描可见消融灶周边明显强化;术后3周CT扫描可见消融灶明显减小。观察组兔中共有6只发生了与手术相关的并发症(6/12;占50%):使用冰醋酸组的兔有4只(4/6)出现腹腔粘连和腹水,,而未使用冰醋酸组只有2例(2/6)。结论50%AAHS溶液注射同RFA联合比单纯RFA能获得更大的凝固坏死区范围,其对肝脏RFA的增效作用大于单一溶液的作用。
Objective To compare the effects of hypertonic saline, acetic acid and acetic acid- hypertonic saline (AAHS) solution on the ablated volume produced by hepatic radiofrequency ablation (RFA) in rabbits in vivo, and to determine the optimal synergist for radiofrequency ablation. Methods Thirty big-ear white rabbits were equally divided into group A (RFA alone), group B (RFA with 36% NaCl injection), group C (RFA with 50% acetic acid injection), group D (RFA with 50% AAHS injection),group E (50% AAHS injection alone), and group F (36% NaC1 injection alone), with five rabbits in each group. Follow-up exam with CT scanning was made. The experimental rabbits were sacrifieed by stages. The livers were collected and fixed in 10% formalin. Both the longitudinal and transverse diameter of the necrosis lesion produced by radiofrequency ablation were measured, the results were compared among groups.Results The difference in the lowest impedance value between group A and other groups was statistically significant (P 〈 0.05), but no significant difference in the lowest impedance value existed between group B and group C (P 〉 0.997). The persistent time of group A was significantly shorter than that of both group B and group D (P 〈 0.05), while significant difference in persistent time existed between group C and group B or group D (P 〈 0.05 ). The coagulation necrosis area in group B, C and D was significantly larger than that in group A (P 〈 0.05). The transverse coagulation necrosis area of group D was the largest (P 〈 0.05).Marked enhancement at the rim of coagulation necrosis lesions was observed on enhanced CT scans one week after the procedure. The coagulation necrosis lesions were obviously contracted three weeks after the treatment.Operation-related complications occurred in six rabbits (50%, 6/12). Peritoneal adhesion and ascites occurred in 4 rabbits receiving acetic acid (50%, 4/6) and in two rabbits not receiving acetic acid (33%, 2/ 6)
出处
《介入放射学杂志》
CSCD
北大核心
2009年第5期377-381,共5页
Journal of Interventional Radiology
关键词
肝脏介入手术
实验研究
射频消融
兔
实验动物
hepatic intervention
experimental study
radiofrequency ablation
rabbit, experimental