激光区域性血管阻断联合射频消融活体犬肝的实验研究  

Combined radiofrequency ablation with intrahepatic vascular occlusion using laser ablation in dogs： in vivo experimental studies

作　　者：林满霞[1] 徐明[1] 黄光亮[1] 谢晓燕[1] 刘保娴 田文硕[1] 纪巧[1] 匡铭[2] 吕明德[2] 

机构地区：[1]中山大学附属第一医院超声科中山大学超声诊断与介入超声研究所,广州510080 [2]中山大学附属第一医院肝胆外科,广州510080

出　　处：《中华超声影像学杂志》2015年第2期155-158,共4页Chinese Journal of Ultrasonography

摘　　要：目的 探索激光消融阻断活体犬肝区域大血管的可行性和条件,比较区域血管阻断联合射频消融和单纯射频消融对坏死范围的影响.方法 选用10只英国比格犬,随机分为联合消融组和射频消融组.联合消融组：首先测量肝叶动脉及门脉内径和流速,然后用1 800J总功率激光消融阻断左肝或中肝叶血管,用彩色多普勒超声和超声造影评估相应肝段血供情况,最后在血管阻断的肝段最大切面上进行单针单点射频消融.射频消融组：在左肝或中肝叶进行单针单点射频消融.两组动物均于术后第6d行超声造影评估消融范围.结果 联合消融组所选取门脉左/中叶支内径（0.6±0.1） cm,流速（14.6±2.7）cm/s;伴随肝动脉流速（45.2±12.3）cm/s.经过平均2.4次的激光消融后,彩色多普勒超声显示肝叶血管血流信号消失,超声造影显示肝叶大部分或全部增强减低或无增强;术后第6d超声造影显示联合消融组平均消融体积为（111.7±70.4）cm^3,单纯射频消融组平均消融体积为（10.0±2.0） cm^3,两者差异有统计学意义（P=0.032）.结论 激光消融可部分或完全阻断犬肝区域大血管,引起相应肝叶缺血或坏死,阻断区域性供血血管可扩大总体射频消融范围.Objective To explore the feasibility and experimental conditions of laser ablation in occluding great liver vessels of dogs and whether the volume of radiofrequency ablation （RFA） could be expanded by combining with intrahepatic vascular occlusion.Methods Ten UK Beagles were divided into two groups randomly.UK Beagles were numbered as D1 to D5 in group 1 and as D6 to D10 in group 2.Laser ablation,with the fiber exposed of 1.0 cm and total power of 1 800 J,was used to block the left or middle hepatic blood vessels of D1 ～ D5 in group 1 firstly.Laser ablation was end when color Doppler imaging showed no blood signal in the selected portal vein and hepatic artery.Contrast enhanced ultrasound （CEUS） was performed to assess the blood supply of the selected lobe of canine liver 30 min after laser ablation.Right after CEUS was performed,single point single ablation was carried out in this lobe using RFA.The same procedure of RFA was performed in the left or middle lobe of D6～D10 in group 2.The volume of radiofrequency ablation was measured using CEUS 6 days after ablation.Results Reduced or no enhancement was seen in the partial or entire liver lobe on CEUS after laser ablation.The average ablation volume was （111.7 ± 70.4）cm^3 in D1 ～D5 and （10.0 ± 2.0）cm^3 in D6～D10,respectively,the difference was statistically significant （P =0.032）.Conclusions Great liver vessels in dogs could be partially or completely occluded by using laser ablation,causing liver lobe to part or all of ischemia or necrosis,the volume of radiofrequency ablation could be expanded by blocking the blood vessels.

关 键 词：超声检查 微气泡 导管消融术 激光疗法 肝 

分 类 号：R735.7[医药卫生—肿瘤]