微波凝固止血治疗肝脏活动性出血的可行性  

Feasibility study on coagulation of hepatic active bleeding site with microwave

作　　者：吴鸿莉[1] 宋宏萍[2] 周晓东[2] 于铭[2] 韩增辉[2] 曹军英[1] 蒋苏齐[1] 王占江[1] 

机构地区：[1]沈阳军区总医院特诊科,沈阳110016 [2]第四军医大学西京医院超声科

出　　处：《中华医学超声杂志（电子版）》2011年第9期1899-1904,共6页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：全军医药卫生科研基金科技攻关项目(08G166)

摘　　要：目的探讨微波凝固止血治疗肝脏活动性出血的可行性。方法 12只新西兰大白兔暴露肝脏。实验动物经肝素化后,彩色多普勒超声引导下18G半自动活检针击发穿刺损伤肝组织及小血管结构,建立肝脏活动性出血模型。实验动物随机均分为对照组、60W组和80W组3组,每组各4只动物,每只动物做3～5个活动性出血点,各组间作点对点对照。60W组和80W组分别用相应功率微波凝固止血,对照组不做任何治疗。比较3组出血量、止血时间和凝固点碳化率。结果 80W组和60W组的平均出血量均低于对照组,差异有统计学意义[(0.09±0.12)gvs(1.83±0.52)g,χ2=25.00,P<0.05;(0.10±0.10)gvs(1.83±0.52)g,χ2=23.00,P<0.05];80W组的平均出血量与60W组比较差异无统计学意义(χ2=2.00,P>0.05)。80W组止血时间较60W组短,止血速度快,差异有统计学意义[(13.1±4.2)svs(18.3±7.9)s,T+=4.5000,T-=115.5000,P=0.000]。80W组凝固中心碳化率高于60W组,差异有统计学意义(13/16vs5/16,χ2=8.127,P=0.004)。结论微波凝固止血是一种快速、有效的治疗肝脏活动性出血的方法。60W的微波功率可以有效止血并且无明显碳化,止血时间为10～40s。Objective To test the feasibility of using microwave to produce rapid hemostasis of liver active bleeding. Methods Twelve new Zealand white rabbits were anesthetized, and their livers were exposed. After heparinized, the animals were randomly divided into 80 W group, 60 W group and control group. Guided by color Doppler ultrasonography, an 18 G semi-automatic biopsy needle was inserted into the hepatic parenchyma, injuring the hepatic parenchyma and small blood vessel to create active bleeding. There were about 3-5 hepatic active bleeding sites created in one animal. Paired comparisons were performed among three groups. The microwave antenna was posed to the bleeding site worked with 80 W or 60 W. A corresponding site of active bleeding in another animal without application of microwave served as a control. Significant differences of blood loss, hemostasis time and carbonization rate were tested. Results 80 W and 60 W groups showed significantly less mean blood loss than control group [(0.09±0.12)g vs (1.83±0.52)g, χ 2=25.00, P<0.05;(0.10±0.10)g vs (1.83±0.52)g, χ 2=23.00, P <0.050]. There was no significant difference of blood loss between 80 W group and 60 W group (χ 2=2.00, P>0.05). 80 W group had less hemostasis time than 60 W group [(13.1±4.2)s vs (18.3±7.9)s, T+=4.5000, T-=115.5000, P=0.000], but had higher carbonization rate than 60 W group (13/16 vs 5/16, χ 2=8.127, P=0.004). Conclusions Coagulation with microwave is a rapid and effective method to arrest hepatic active bleeding. Sixty W can effectively induce hemostasis without significant carbonization, and the time of duration is 10 s to 40 s.

关 键 词：彩色多普勒超声检查 肝脏 活动性出血 微波 

分 类 号：R575[医药卫生—消化系统]