心内膜微波逐点房颤消融术的温度场研究  

Study on the Temperature Field of the Endocardial Point-by-point Microwave Ablation of Atrial Fibrillation

作　　者：南群[1] 翟飞[1] 郭雪梅[1] 

机构地区：[1]北京工业大学生命科学与生物工程学院,北京100124

出　　处：《北京工业大学学报》2014年第10期1579-1585,共7页Journal of Beijing University of Technology

基　　金：国家自然科学基金资助项目(31070754);北京市教育委员会科研计划资助项目(km201410005028);北京市属高等学校高层次人才引进与培养三年行动计划(2013-2015年);北京工业大学基础研究基金项目(X4015999201401)

摘　　要：根据实际临床需求,针对房颤微波消融中常见的逐点消融术,探究时间功率和天线距离对相邻2个消融点消融效果的影响,找出最佳的消融功率和最佳天线距离,为临床治疗提供参考.构建了包括血液、心肌、脂肪的3层模型,采用2.45 GHz频率进行了电磁热耦合计算并得到了心肌中温度的分布.功率采取30、40、50和60 W,2个消融点之间的距离采取0.5、1、1.5和2 cm.结果表明:功率为30 W和40 W时会导致消融区域比较小;功率为60 W时会导致最高温度过高且消融的范围与功率为50 W的时候相比并没有显著的提升;相邻2个消融点间距为0.5cm和1 cm时会导致总消融区域比较小且最高温度过高;间距为2 cm时无法形成连续透壁的消融区域.因此50 W是最佳消融功率,1.5 cm是最佳消融2点间距,可以在保证最高温度不过高、连续透壁的情况下,获得比较大的总消融区域和较高的能量利用效率.在50 W、1.5 cm的最佳消融方案下,逐点消融2个点所需要的总消融时间为43.2 s,最高温度为87.2℃,连续透壁消融长度、心肌内部最大消融长度及最大消融宽度分别为2.486、2.770、1.865 cm.According to the actual demand of the clinical, the therapeutic schedule of point-by-point microwave ablation in atrial fibrillation was loused on. The relationship between input power, ablation point interval and effect after ablation in case of two adjacent ablation points were analyzed. The best fit input power and ablation point interval were found to provide some references for clinic treatment. 3D finite element models were built and thermal distribution in the myoeardium was obtained based on the coupled electromagnetic-thermal analysis with 2.45 GHz microwave power. Input powers and ablation point intervals were set to 30, 40, 50, 60 W and 0.5, 1 , 1.5, 2 cm, respectively. Simulation results show that when the power are 30 and 40 W, the low power will lead to small ablation area; when the power is 60 W, high power will lead to the excessive heat, and the ablation area is not significantly improved than 50 W power＇s area. When interval between two ablation points are 0.5 cm and 1 cm, theenergy efficiency. By using this ablation scheme, the total time ablation time in endocardial point-by- point microwave ablation is 43.2 s and the highest temperature is 87.18 ℃. The length of continuous transmural ablation, maximal ablation length and maximal ablation width are 2. 486, 2. 770, and 1. 865 cm, respectively.

关 键 词：房颤 微波消融 电磁热耦合 

分 类 号：Q819[生物学—生物工程]