胆汁淤积型猪肝硬化模型与正常猪肝的冷循环微波消融实验的对比研究  

Comparison between biliary cirrhosis and normal porcine liver treated with microwave ablation using a cooled-tip electrode

作　　者：范卫君[1] 王立刚[2] 郑延波[2] 张亮[1] 唐田[1] 李新[1] 姜华[1] 张建磊[1] 

机构地区：[1]华南肿瘤学国家重点实验室中山大学附属肿瘤医院影像介入中心,广州510060 [2]青岛大学附属毓璜顶医院介入科

出　　处：《中华医学杂志》2011年第41期2942-2946,共5页National Medical Journal of China

摘　　要：目的探讨胆汁淤积型肝硬化活体、离体猪肝（实验组）与正常活体、离体猪肝（对照组）在相同的冷循环微波消融条件下消融范围的区别。方法西藏小型猪共6只，实验组4只进行胆管结扎术，对成功建立的肝硬化模型开腹行冷循环微波消融术，同时对对照组（2只）行相同条件下的微波消融，观察消融灶形态学特征，测量消融灶纵轴、横轴，计算消融灶体积，并进行统计学分析；用HE染色法对消融灶进行病理学分析。结果实验组1只猪于胆管结扎后14d死亡，其余3只均成功建立胆汁淤积型肝硬化模型。实验组及对照组在相同条件下（功率70w，时间5min）行微波消融的实验结果：（1）正常猪肝活体消融范围的短轴、长轴及体积均较离体偏小[（2．04±0．05）cm、（3．14±0．11）cm和（6．8±0．5）cm^3，（2．30±0．18）cm、（3．60±0．08）cm和（10．0±1．7）cm^3]，且消融范围长轴及体积的差异均有统计学意义（P=0．000、0．031），但消融范围短轴的差异无统计学意义（P=0．060）。（2）肝硬化猪肝模型活体消融范围的短轴、长轴及体积均较离体偏小，且差异均有统计学意义[（1．90±0．10）cm、（2．95±0．12）cm和（6．0±0．8）cm^3，（2．08±0．08）cm、（3．08±0．75）cm和（7．0±0．5）cm^3，P=0．028、0．026、0．008]。（3）正常猪肝活体与离体消融的短轴、长轴及体积均大于相同消融条件下的硬化肝脏活体与离体消融的短轴、长轴及体积，且长轴及体积的差异有统计学意义（P=0．019、0．000，P=0.024、0，036），但消融短轴在活体及离体实验中差异均无统计学意义（P=0．110、P=0．090）。结论住功率70w，消融时间5min条件下，胆汁淤积型肝硬化活体与离体猪肝的消融范同小于正常猪肝的消融范围，活体猪肝的消融范围小于离体猪肝的消融范围。Objective To elucidate the difference in both in vivo and ex vivo microwave ablation in a biliary cirrhotic porcine liver model using a cooled-tip antenna. Methods Two months after biliary duetal ligation, liver biopsy was performed to confirm the establishment of biliary cirrhosis in 4 Tibetan miniature pigs. Microwave ablation with cooled-tip antenna was conducted under laparotomy using 70 W for five minutes in the experimental group （4 pigs）. The control group （2 pigs） also received microwave ablation using the same settings but no surgery. Both in-vivo and ex-vivo ablations were performed in the two groups. Morphological and pathological characteristics of the ablation areas were compared. Paired comparison among the groups were conducted using t-test. Results In the cirrhotic liver group, after ablation at 70 W for five minutes, the short and long axes and volume of in vivo ablation areas were （1.90 ± 0. 10） cm, （2.95 ± 0.12） cm, and （6.0 ± 0.8） cm3 compared to （2.08 ± 0.08） cm,（3.08 ± 0.75）cm, and （7.0±0. 5 ） cm3 of ex vivo ablation. In the normal liver group the dates were （2. 04± 0. 05 ） cm, （ 3.14± 0. 11 ） cm and （6. 8 ± 0. 5 ） cm3 ; （ 2. 30 ± 0. 18 ） cm, （ 3.60 ± 0. 08 ） cm and （ 10. 0 ± 1.7 ） cm3, respectively. In vivo ablation area was smaller than ex vivo ablation area in terms of short and long axes and volume （ P = 0. 028 0. 026, 0. 008, respectively）. With the same ablation settings, both in vivo and ex vivo ablation areas in normal pig liver were larger than their counterparts in cirrhotic liver in terms of the short and long axes and volume （P = 0. 019, P = 0. 000; P = 0. 024, P = 0. 036, respectively）, but the differences in the short axes of in vivo and ex vivo ablation areas failed to reach significance. Conclusion Both in vivo and ex vivo ablation areas in biliary cirrhotic pig liver were smaller than their counterparts in normal pig liver suggesting that, the ablation time or power should be relatively prolonged to

关 键 词：微波 导管消融术 肝硬化 

分 类 号：R735.7[医药卫生—肿瘤]