胰腺冷冻有效性和安全性的实验研究  

Efficacy and safety of pancreas freezing

作　　者：邱大卫[1] 牛立志[1] 穆锋[1] 彭祥[1] 周亮[1] 李海波[1] 李蓉蓉[1] 徐克成[1] 倪嘉瓒[2] 蒋灵芝[2] 胡以则[3] 郝卓芳[3] 

机构地区：[1]广州复大肿瘤医院肿瘤科,广州510300 [2]深圳大学生命科学学院 [3]广州医学院第二医院

出　　处：《中华胰腺病杂志》2010年第2期124-127,共4页Chinese Journal of Pancreatology

摘　　要：目的 观察胰腺冷冻前后其血液生化指标和组织变化,为胰腺癌冷冻疗法的开展提供依据.方法 将15只正常猪分为深度冷冻组（5头）、浅度冷冻组（5头）、不冷冻组（3头）和正常组（2头）.麻醉后开腹暴露猪胰腺,将氩氦冷冻治疗系统探针插入胰腺,深、浅冷冻组分别采用100%和10%的氩气输出功率,冷冻温度分别为-130～-140℃和-110～120℃,形成直径15～20 mm的冰球,然后输入氦气,复温至10～20℃,维持3 min,重复冷冻-复温一个循环.不冷冻组仅插入探针,正常组仅开腹、关腹.检测实验前后血淀粉酶、IL-6、C反应蛋白（CRP）含量,第7天处死动物取胰腺行光镜及电镜观察.结果 胰腺的冷冻部位呈黑褐色坏死区,与未冷冻组织有明确界限;镜下见冷冻中心区及侧中心区有明显组织坏死,超微结构全部被破坏、消失,线粒体断嵴脱颗粒,粗面内质网脱颗粒.13头（86.7%）猪术后血淀粉酶增高,多数在第6天降至正常.5头猪（33.3%）血IL-6轻度增高.各组血清CRP水平均无明显改变.所有实验动物均健康存活直到被处死.结论 冷冻对实验动物胰腺组织有明确的致死性消融作用,该疗法安全性良好,无严重并发症.Objective To observe the blood biochemical and histological changes before and after pancreas freezing, to provide evidence for cryosurgery for pancreatic cancer. Methods Fifteen healthy pigs were divided into deep frozen group （n = 5）, shallow frozen group （n = 5）, non-frozen group （n = 3） and normal group （n = 2）. After anesthesia and Iaparotomy, a probe of the Argon-Helium Surgical System was inserted into the pancreas, 100% and 10% argon output power were used in deep and shallow frozen group, respectively;and the temperature were - 130 ～ - 140℃ and - 110 ～ - 120℃, respectively;which results in an ice-ball with 15 ～ 20 mm in diameter. Then helium gas was inputted to increase the temperature to 10 ～ 20℃ for three minutes;then the whole process was repeated. A probe was inserted into the pancreas in the non-frozen group only and only laparotomy was performed in non-grozen group normal group and normal group. Serum amylase, IL-6, CRP levels before and after the experiment was determined;the pigs were sacrificed at day 7 and the pancreas was harvested for light microscope and electron microscope examination. Results The frozen pancreatic tissue became pitchy necrosis zone, and it could be distinguished from non-frozen tissue;there were obvious tissue necrosis in the center and para-center of frozen area, and the ultra-structure were destroyed and disappeared, mitochondria degranulation and rough endoplasmic reticulum degrannlation were observed. Serum amylase was elevated in 13 （86.7%） pigs and most returned to normal at 6th day. Serum IL-6 was slightly elevated in 5 （33.3%） pigs. There was no significant difference among all the groups in term of serum CRP. All the pigs were alive until the time of sacrifice. Conclusions Cryosurgery has affirmative fatal ablative effects on pancreatic tissue, and it is safe with no serious complications.

关 键 词：胰腺肿瘤 冷冻疗法 动物实验 有效性 安全性 

分 类 号：R735.9[医药卫生—肿瘤]