微泡增强的脉冲超声治疗脾创伤出血机制的初步探讨  

The mechanism of haemostatic effects induced by microbubble enhanced ultrasound on splenic trauma

作　　者：区文财[1] 柳建华[1] 何景光[1] 萧淑宜[1] 杜洪[1] 邱春花[1] 

机构地区：[1]广州医科大学附属广州市第一人民医院,广州510180

出　　处：《广州医药》2015年第1期5-7,共3页Guangzhou Medical Journal

基　　金：广州市医药卫生科技项目(20121A011007)

摘　　要：目的初步探讨微泡增强的脉冲式超声治疗脾创伤出血的作用机制。方法 14只健康家犬随机分为3组,超声微泡组(MEUS组)6只、单纯超声组(TUS组)4只、单纯微泡组(MB组)4只。开腹切割脾建立脾破裂出血模型,MEUS组用脉冲式超声治疗仪辐照伤口,同时静脉匀速推注微泡;TUS组超声治疗时静脉推注生理盐水;MB组超声治疗仪假照的同时静脉推注微泡。治疗完毕,进行超声造影评价,并送病理组织学检查。结果 MEUS组造影示靶区造影增强缺损或者低灌注,但较粗大血管仍为增强显影。病理组织学见脾窦、微小血管扩张充血、血管周围组织水肿,血小板聚集,微小血管血栓形成。结论微小血管血栓形成、微血管淤血扩张、周围组织水肿压迫是超声联合微泡治疗脾创伤出血的可能机理。Objective To investigate the mechanism of haemostatic effect induced by microbubble （MB） enhanced therapeutic ultrasound （TUS） on splenic trauma. Methods 14 healthy dogs were divided into 3 groups. Six animals were treated by microbubble-enhanced therapeutic ultrasound （MEUS）, the other eight animals were treated with TUS only group （n =4） and the MB only （n =4） served as the controls. The spleens of all animals were surgically exposed and a 20 mm long, 5 mm deep incision was created on the spleens using scalpel. Contrast enhanced ultrasound （CEUS） was performed to assess the blocking effects of splenic circulation. The targeted spleens were harvested for pathological examination. Results A non-enhanced or perfusion defect region was formed within the treated area. The histological results showed Splenic sinus hyperemia, microvascular hyperemia, perivascular tissue edema, platelet aggregation and intravascular thrombosis. Conclusion The mechanism of haemostatic effect on splenic trauma by microbubble enhanced ultrasound maybe intravascular thrombosis, microvascular hyperemia and perivascular tissue edema oppression simultaneously.

关 键 词：微泡 脉冲式超声 脾脏 机制 止血 

分 类 号：R657.6[医药卫生—外科学]