高频超声导管消融活体犬心肌的实验研究  

Experimental Ablation of Ventricular Myocardium of Canine In Vivo Induced by High Frequency Ultrasonic Catheterization

作　　者：黄晶[1,2] 王志刚[1,2] 李增高[1,2] 董军[1,2] 赵纯亮[1,2] 刘锦[1,2] 冉海涛[1,2] 殷跃辉[1,2] 王智彪[1,2] 

机构地区：[1]重庆市重庆医科大学第二医院 [2]电子工业部第二十六研究所

出　　处：《中国超声医学杂志》1999年第6期407-409,共3页Chinese Journal of Ultrasound in Medicine

基　　金：四川省教委重点科研项目资助

摘　　要：目的：本文探讨超声消融心室肌的可行性及作用特点。方法：用频率１０．４ＭＨｚ，外径７Ｆ的超声导管自开胸活体犬心外膜以不同时间和声强消融心肌，观察消融深度和形态结构特征；测量消融产生的温度变化。结果：消融深度与消融时间和声强呈良好相关，消融深度可达１０ｍｍ以上且边界清晰。当消融时间较长时，消融区近于圆形，而高声强短时间作用消融区呈椭圆形或矩形。消融中心温度可高达７８℃，而消融表面温度稍微增高。结论：超声可产生边清晰和深入的心肌消融，其消融深度和形状在一定程度上可控。提示超声可有效地消融心室肌深部病灶。Objective:To probe the feasibility and the role of ultrasonic energy in ablating ventricular myo cardium of experimental canine by an ultrasonic catheterization system.Methods:7F diameter ultrasonic catheter with 10 4 MHz frequency and 52 W/cm 2 maximal ultrasonic power intensity were used.Ultrasonic energy to deliver in scheduled durations and intensities on 11 canines epicardial myocardium with a small transducer mounted on tip of the catheter.The relationship of lesion depth versus ablation duration and ultrasonic intensity were investigated.At the end of ultrasonic ablation,the myocardiac temperature,the shape of lesion area,the histology changes and the ultrastructure were all studied.Results:Neither arrhythmia nor conductive disorder was observed during ultrasonic ablation in all.The border of lesion area was clearly discernible,and verified by histology and ultrastructure observation.Ventricular myocardium ablation was deeper,induced by 38 W/cm 2 for 45～60 seconds,up to 10 10±1 67mm in depth.Higher ultrasonic intensity and shorter ablation duration made the ablation area an ellipse or rectangle shape,and longer duration of energy delivery made the lesion area much circular.It also showed that the more the thickness of the ventricular wall,the more ablation effects occurred.The temperature within myocardium was much higher than surface,epieardiac temperature only slightly increased.Deeper ventricular myocardiac ablation could be induced by high frequency ultrasound than induced by radiofrequency catheter.The depth and shape of ultrasonic lesion area ablation can be controlled in some degree by setting up various intensiteis of ultrasonic energy delivery and various durations,neither arrhythmias nor conduction disorder occured.Conclusion:Ultrasonic energy can ablate of ventricular myocardiac lesion safely,effectively and beneficially,and also for treatment of ventricular tachycardia.

关 键 词：心肌 消融 高频 超声导管消融 心律失常 治疗 

分 类 号：R541.705[医药卫生—心血管疾病] R454.3[医药卫生—内科学]