离体与在体实验探讨集束电极射频消融肾组织  

Effect of radiofrequency ablation on in vivo and in vitro renal tissue

作　　者：刘禧[1] 段云友[1] 赵柏山[1] 孙嗣国[2] 卞玲[3] 鲍国强[3] 陈升[1] 阮骊韬[1] 

机构地区：[1]第四军医大学唐都医院超声诊断科,陕西西安710038 [2]第四军医大学唐都医院骨科,陕西西安710038 [3]第四军医大学唐都医院普通外科,陕西西安710038

出　　处：《第四军医大学学报》2004年第23期2138-2140,共3页Journal of the Fourth Military Medical University

基　　金：陕西省科学基金项目 (2 0 0 1SM47)

摘　　要：目的 :探讨集束电极射频对在体与离体两种状态下正常肾脏组织的消融作用及评价超声测量肾组织消融灶的准确性 .方法 :在体实验应用 6只大白兔麻醉后暴露肾脏 ,离体实验采用新鲜离体肾 10只 ,使用不同的起始功率和电极直径进行消融 ,记录消融时间 ,超声观测消融灶并与实体标本进行对比 .结果 :①毁损区与正常组织之间分炭化区、凝固性坏死区、充血水肿带三层结构 ;②相同条件下在体状态达到峰值阻抗所需时间较离体状态下要长 ,消融灶更大 .③离体状态下解剖测值与超声测值差异无显著性意义 (P >0 .0 5 ) ,在体状态下解剖测值与超声测值差异具有显著性意义 (P <0 .0 5 ) .结论 :集束电极射频消融肾组织的形态及消融时间与肾脏的血流状态有关 ,对于血流丰富的肾组织射频即刻超声测量易于低估或高估消融灶的大小 .AIM: To study the effect of radiofrequency ablation on the in vivo or in vitro renal tissues and to evaluate the veracity of ultrasonography measurement in renal radiofrequency. METHODS: Six rabbits were sacrificed for the in vivo experiment and ten in vitro kidneys were used in vitro experiment. The kidneys were exposed after anesthesia and then the electrode was inserted into the pole of the kidney. Radio frequency ablation was performed with different original power and ablation size. The time was recorded. Every kidney was scanned with ultrasonography and the parameters were recorded. The specimen was excided and measured anatomically and the difference was compared between ultrasonography and anatomy. RESULTS: ①There were three layers between lesion and normal region: Carbonization region, coagulation necrosis region and edema cincture. ②On the same electrode size and original power, in vivo condition seemed to need more time to reach the peak impedance. ③The difference between ultrasonographical and anatomical size of lesions was significant in vivo but not significant in vitro. It seemed that the lesion in vivo was larger than that of in vitro under the same conditions (P<0.05). CONCLUSION: The size and shape of ablation lesion is related to the renal blood condition. Low original power is considered in plenty blood supplied tissues to get larger lesion area, but expanding space of radiofrequency coagulation in renal tissue demands caution. Ultrasonography is prone to overestimate or underestimate of lesion size at the instant moment of ablation.

关 键 词：射频消融 肾 超声检查 

分 类 号：R737.11[医药卫生—肿瘤]