射频消融过程肿瘤破裂相关物理学因素的理论性模拟研究  

Theoretical simulation of physical factors related to tumor burst during radiofrequency ablation

作　　者：姜凯[1] 陈照军 刘洋[1] 陈永卫[1] 苏明[1] 赵向前[1] 张文智[1] 王敬[1] 董家鸿[1] 黄志强[1] 

机构地区：[1]解放军总医院肝胆外科,北京100853 [2]中国石油大学(华东)化学工程学院、重质油国家重点实验室,山东青岛266555

出　　处：《解放军医学杂志》2014年第2期94-98,共5页Medical Journal of Chinese People's Liberation Army

基　　金：国家科技支撑计划项目(2012BAI06B01)~~

摘　　要：目的探讨射频消融(RFA)过程中发生肝细胞癌破裂的相关物理学因素。方法以不同体积的密闭小球作为肿瘤模拟计算对象,球体内选择水作为介质。模拟RFA加热过程,观察在密闭球体内温度不同的情况下,小球内壁所承受的压力变化。结果随着密闭球体内部温度升高,其内壁所承受的压力呈几何倍数增加,从最初的7.38kPa(40℃)逐步升高到70.14kPa(90℃),增加约9.5倍;当球内温度升至100℃时,其内壁压力达到101.33kPa,与外界大气压平衡;若继续升温,则水介质出现大量气化,体积迅速膨胀,如升高至120℃时,球内压力增加至198.64kPa,150℃时则达到476.24kPa。结论肿瘤内部压力随温度升高呈几何级数迅速增加,当温度达到100℃以上时,肿瘤内液体发生气化膨胀,使瘤体内压力超过外界压力,是导致RFA过程中肿瘤破裂的主要因素。Objective To explore the relative physical factors influencing tumor burst during radiofrequency ablation （RFA） treatment of hepatocellular carcinoma （HCC）. Methods Watertight globes of different size filled with water were used to simulate tumor mass of HCC, and then they were heated to a balanced gradient inner temperature similar to that occurring during RFA treatment. The changes in inner pressure of the wall of globes were then recorded according to gradient balanced temperature. Results Responding to a gradually elevation of inner temperature, the inner pressure against the watertight globe wall increased exponentially from 7.38kPa at 40℃ to 70.14kPa at 90℃, i.e. there was a about 9.S-fold increase at 40℃. The inner pressure could reach a pressure of 101.33kPa at 100℃. Continued heating to above 100℃, the vaporized water expanded the globe, the inner pressure would reach to 198.64kPa when the temperature reached 120℃, and the inner pressure would reach 476.24kPa when the temperature reached 150℃. Conclusions The inner pressure of tumor increases exponentially along with rise of temperature, especially so when heated above 100℃. The vaporization of liquid inside of the tumor could exceed the inner pressure, and it is considered as the major factor in producing tumor burst during RFA treatment.

关 键 词：导管消融术 癌 肝细胞 破裂 压力 

分 类 号：R735.7[医药卫生—肿瘤]