射频治疗肝肿瘤单针消融范围的活体狗实验研究  

Experimental Study in the Size of the Zone of Coagulative Necro- sis in Radiofrequency Ablation in the Treatment of Liver Cancer

作　　者：刘树佳[1] 李文媚[1] 袁湘瑜[1] 熊莲花[1] 郭健[1] 冯秀娥[1] 陈祥洪[1] 

机构地区：[1]东莞市人民医院肿瘤外科,广东东莞523018

出　　处：《国际医药卫生导报》2005年第24期13-15,共3页International Medicine and Health Guidance News

基　　金：东莞市科技局社会发展攻关基金资助(基金编号:B2003-5)

摘　　要：目的探讨减少或增大射频电极针的杀伤范围的方法。方法在电极针不同张开程度下或联合无水酒精注射下或肝门阻断下或不同功率起步、不同速度提高功率,测定活体狗肝的消融范围。结果电极针全张开、3/4张开、1/2张开、1/4张开,肝组织的损毁范围垂直径由3.84±0.33(cm)逐步递减至3.37±0.10(cm)、2.89±0.10(cm)、1.90±0.09(cm),P<0.01;联合瘤内无水酒精注射后单针射频消融的范围垂直径由3.84±0.33(cm)升至3.99±0.10(cm),P>0.05;阻断肝门后单针射频消融的范围垂直径由3.84±0.33(cm)升至4.25±0.09(cm),P<0.01;功率从10W起步、10W↑/min,功率从25W起步、25W↑/min,功率从40W起步、40W↑/min。其单针射频消融的范围垂直径由3.84±0.33(cm)降至3.69±0.03(cm)及3.44±0.03(cm)、且坏死不彻底,P<0.05。结论肝组织的坏死范围与射频电极的张开程度成正相关,肝门阻断后肝组织的坏死范围增加,相同条件下起步功率越大、功率上升越快,坏死越少。消融范围可受电极针的张开程度控制、肝门血流阻断、低功率起步,缓慢提高功率可以提高单针消融范围。合并无水酒精注射,或许可以提高单针消融范围。Objectives To evaluate the methods how to reduce or increase the size of the zone of coagulative necrosis during the treatment with radiofrequency ablation. Methods With the hook electrodes 25 percent, 50 percent, 75 percent fully deployed during the treatment with radiofrequency ablation： Combined use of ethanol injection before the treatment with radiofrequency ablation： Vascular inflow occlusion is performed by clamping the hepatic artery and portal vein in the porta hepatis（Pringle meaeuver） during the treatment with radiofrequency ablation Treatment starting at lOW of power with 10W/minute advances up to 90W , Treatment starting at 25W of power with 25W/minute advances up to 90W , Treatment starting at 40W of power with 40W/minute advances up to 90W. After that , measure the zone of coagulative necrosis. Results Treatment With the hook electrodes 25 percent, 50 percent, 75 percent, fully deployed ,the diameter of the zone of coagulative necrosis was from 1.90±0.09 （cm） up to 2.89±0.10 （cm）, 3.37±0.10 （cm）, 3. 84±0.33 （cm）,P〈0. 01： Treatment combined use of ethanol injection the diameter of the zone of coagulative necrosis was from 3. 84±0.33 （cm） up to 3.99±0.10 （cm）,P〉0.05; Treatment combined use of vascular inflow occlusion, the diameter of the zone of coagulative necrosis was from 3. 84 ± 0. 33 （cm） up to 4.25±0.09 （cm）,P〈0.05; Treatment starting at 10W, 25W, 40W of power, the diameter of the zone of coagulative necrosis was from 3.84±0.33 （cm） down to 3.69±0.03 （cm）, 3.44±0.03 （cm）, P〈0. 05. Conclusion The size of the zone of coagulative necrosis may reduce by shrinking from the hook electrodes. Use of vascular inflow occlusion ,starting at a lower of power may increase the size of the zone of coagulative necrosis. Combined use of ethanol in iection may or may not enhance the effectiveness.

关 键 词：射频 无水酒精 狗 肝肿瘤 单针消融 

分 类 号：R735.7[医药卫生—肿瘤]