经皮盐酸、乙酸肝内注射对肝组织的消融作用  

Experimental study of percutaneous hydrochloric acid and acetic acid injection in normal rabbit liver

作　　者：张卫星[1] 邓卫萍[2] 黄耀[1] 

机构地区：[1]深圳市第四人民医院外二科,广东深圳518033 [2]深圳市第四人民医院胃镜室,广东深圳518033

出　　处：《临床和实验医学杂志》2009年第6期82-85,共4页Journal of Clinical and Experimental Medicine

基　　金：2007年深圳市福田区公益性科研项目(医疗卫生类)非资助项目(FTWS020)

摘　　要：目的观察经皮盐酸、乙酸溶液肝内注射所产生的作用范围的大小、可控性和坏死程度的彻底性,并和无水乙醇作比较,评价其替代无水乙醇作为肝癌瘤内注射制剂的应用前景。方法新西兰白兔45只。随机分为A、B、C、D、E5个组。每组9只,A组为18%盐酸组,B组为9%盐酸组,C组为50%乙酸组,D组为25%乙酸组,E组为无水乙醇组。再根据注射剂量将每组9只随机分配到a、b、c三个亚组,每亚组3只,a亚组0.5ml,b亚组为1.0ml,c亚组为1.5ml,每只动物肝脏内只进行一次药液注射。按病理结果是否完全坏死,作用范围是否局限,注射时是否溢出损伤肝包膜及腹腔脏器,肝、肾功能有无改变,超声是否能监控注射时的作用范围5个方面来评分。每个方面2分,总计10分。结果A组3个剂量每只兔子平均得分8.6(77/9),B组3个剂量平均得分8.8(79/9),明显高于C组6.6(59/9)和D组6.8(61/9)。无水乙醇对照组平均每只兔子得分5.0(45/9)。结论18%和9%的盐酸溶液肝内注射所产生的肝组织坏死,比乙酸和无水乙醇更为彻底,范围也更局限,可能成为理想的瘤内注射制剂。Objective To observe the echo image change and necrotic degree of ultrasound - guided hydrochloric acid and acetic acid in- jection in normal rabbit liver and compare the effect with that of percutaneous ethanol injection. Methods Forty - five New Zealand rabbits were divided into 5 groups at random with 9 rabbits in each group. Group A received hydrochloric acid injection at concentration of 18%, while group B at 9%. Group C received 50% acetic acid injection at concentration of 50%, while group D at 25%. Group E received anhydrous alcohol injec- tion. Then the nine rabbits in each group were further divided into subgroup a, b and c at random with 3 rabbits in each subgroup. Subgroup a, b and C received injection doses at 0.5rnl, 1.0ml and 1.5ml respectively. Each rabbit received injection just one time. All the results were evalu- ated according to the following five criterions： whether completely necrotic or not （approved by pathology）, whether localized or not, whether spil- led out or not, whether damaged to renal and liver funetion and whether the effect of injection was monitored by ultrasound. Total score was 10 with 2 score for each criterion. Results The average scores of group A and group B were 8.6（77/9） and 8.8（79/9） , obviously higher than those of group C 6.6（59/9） and group D 6.8（61/9）. While group E was 5.0（45/9）. Conclusion The necrosis was more thorough and localized with 18% and 9% hydrochloric acid injection in comparison with acetie acid and ethanol injection. It may be an ideal intratumoral injection agent for the treatment of cancer.

关 键 词：肝脏 盐酸 乙酸 乙醇 注射 消融 

分 类 号：R735.7[医药卫生—肿瘤]