冷循环式多极射频控制Ⅳ级脾外伤出血的实验研究  

Controlling Hemorrhage from Ⅳ Grade Spleenic Trauma by Multipolar Radiofrequency Ablation with Internally Cooled Electrodes in Porcine Models

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,广州市510010

出　　处：《中国超声医学杂志》2009年第10期927-930,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家博士后科学基金(No.20070420150)

摘　　要：目的探讨多极射频对控制Ⅳ级脾外伤活动性出血的价值。方法麻醉状态下开腹建立14只巴马小型猪Ⅳ级脾外伤伴活动性出血模型。随机选2只不进行任何治疗,作为对照组。余12只随机平均分为2组,均采用冷循环式多极射频进行止血,其中1组采用等边三角形方式布针,另1组采用等距直线方式布针,余射频参数相同。布针成功后,开始射频治疗,比较2组射频止血效果。结果三角形布针组脾活动性出血均被成功控制,治疗时间为(3.2±0.7)min。直线布针组仅1例脾活动性出血被成功控制,另5例治疗失败。三角形布针组与直线布针组之间在射频时间、血压、出血量及凝固灶长径等方面具有显著性差异(P<0.05),凝固灶横径无显著差异(P>0.05)。对照组2只均死亡。结论多级射频能快速、有效控制Ⅳ级脾外伤的活动性出血,不同的布针方式止血效果不同。Objective To study the value of muhipolar radiofrequency ablation （RFA） with internally cooled electrodes in controlling hemorrhage from IV grade spleenic injury. Methods A grade IV spleen injury with hemorrhage was created in fourteen pigs under general anesthesia. Two of these models were randomly selected to accept no treatment as a control group. The left pigs were randomly divided into two even groups which were treated by using multipolar RFA with internally cooled electrodes to control the active bleeding from the injured spleens. The electrodes were inserted into the injured sites with equilateral triangle shape in one group and the other group in a straight line. Results The hemorrhages from the injured spleen were successfully controlled by the heat created by the muhipolar RFA with internally cooled electrodes in the equilateral triangle shape group. Mean ablation time was 3.2±0.7 minutes. In the straight line group only one pig＇s active bleeding was successfully stopped. Significant differences of the ablation time, blood pressure, blood loss and the longitudinal diameter of the coagulation zone were found between the two treatment groups （P〈0.05） . The pigs in the control group died of the blood loss. Conclusions The mulitpolar RFA with internally cooled electrodes can fast and effectively control the hemorrhages from Ⅳ grade spleenic injury and the shape of the electrodes inserted into the spleen affects the treatment results.

关 键 词：多极 射频 脾外伤 出血 

分 类 号：R445.1[医药卫生—影像医学与核医学] R657.6[医药卫生—诊断学]