轻型肝外伤冷循环式多极射频凝固止血的实验研究  

Multipolar Radiofrequency Ablation with Internally Cooled Electrodes in Controlling Hemorrhage from Low-grade Hepatic Injures： an Animal Study

作　　者：李叶阔[1] 王莎莎[1] 朱贤胜[1] 程琦[1] 罗国新[1] 王小燕[1] 霍枫[2] 

机构地区：[1]广州军区总医院超声影像科,广州市510010 [2]广州军区总医院肝胆外科

出　　处：《中国超声医学杂志》2009年第9期831-834,共4页Chinese Journal of Ultrasound in Medicine

基　　金：基金项目：广东省自然科学基金资助（No.06019712）

摘　　要：目的 探讨冷循环式多极射频控制轻型肝外伤活动性出血的价值。方法开腹锐性切割6只健康家猪肝，建立24处轻型肝外伤伴活动性出血模型，Ⅰ、Ⅱ级各12处，根据损伤级别各自再随机平均分为2组。Ⅰ、Ⅱ级组中随机挑选1组为治疗组，其余1组为对照组。治疗组进行冷循环式多极射频凝固止血治疗，对照组不进行任何治疗。结果治疗组肝活动性出血均被成功控制。Ⅱ级组射频凝固时间长于Ⅰ级组，分别为（4．4±0．5）min、（3．6±0．2）min。Ⅱ级组凝固灶纵径大于Ⅰ级组分别为（4．4±0．2）cm、（3.5±02）cm，横径相当，分别为（2．6±0．2）cm、（2．5±0．3）cm。射频凝固时间及凝固灶纵径在Ⅰ、Ⅱ级间差异具有显著性（P〈0．05）。射频1h后治疗组各切口均未发生再出血。伤后1h，对照组各切口仍发生活动性出血。结论冷循环式多极射频能有效控制轻型肝外伤的活动性出血，损伤级别越高射频凝固时间越长。Objective To study the value of multipolar radiofrequency ablation （RFA） with internally cooled e lectrodes in controlling hemorrhage from low grade hepatic injuries. Methods Twenty-four incisions were evenly made to Ⅰ and Ⅱ grades hepatic injuries in six domestic pigs. In advance, the incisions were evenly divided into two groups according to the grades. In the same grade, one of the group was randomly used to be treated with the multipolar RFA to stop the active bleeding from the injured livers and the other group as control group which accepted non treat- ments. Results The hemorrhages from the injured livers were successfully controlled by the heat created by the multipolar RFA with internally cooled electrodes in the two treatment groups. Mean ablation time in grade Ⅱ and grade Ⅰ group were 4.4±0.5 minutes and 3.6 ± 0.2 minutes respectively. Mean longitudinal diameters of coagulation zone were 4.4±0.2 cm and 3.5±0.2 cm respectively and the transverse diameters were 2.6±0.2 cm and 2.5±0.3 cm respectively. Significant differences of the ablation time and the longitudinal diameter of the coagulation zone were found between the two treatment groups （P〈0.05） . No re-bleeding occurred one hour after the RFA in the treatment groups. Active bleeding was still found in every incision in the control group one hour after injured. Conclusions The mulitpolar RFA with internally cooled electrodes is effective to stop the hemorrhages from low-grade hepatic injuries and the ablation time rises up with the increase of the grade of liver traumas.

关 键 词：肝外伤 出血 多极 射频 

分 类 号：R657.18[医药卫生—外科学] R711.52[医药卫生—临床医学]