微泡增强非聚焦超声治疗兔肝创伤  

Microbubble-enhanced non focused ultrasound for treatment of hepatic trauma in rabbits

作　　者：田猛[1] 赵大威[1] 阳建政 杜鹏[1] 王孝君[1] 李陶[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所超声科,重庆400042

出　　处：《中国医学影像技术》2016年第3期328-332,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(81271586);重庆市自然科学基金(cstc2012jjB10034)

摘　　要：目的探讨微泡增强的非聚焦超声治疗肝脏创伤的价值。方法用25只健康新西兰大白兔建立肝脏创伤出血模型,并随机分为超声(US)组、微泡(MB)组和超声微泡(USMB)组,根据不同的声功率,将USMB组分为3个亚组:USMB1(0.11 W)、USMB2(0.55 W)和USMB3(1.10 W);每组5只实验动物。评价治疗前出血量、治疗后渗血量以及视觉评分,并进行CEUS分析治疗区域的血流灌注水平,最后取肝脏标本行组织学HE染色、分析肝板和肝窦面积比例变化。结果 USMB组治疗后渗血量和视觉评分均显著低于US组(P均<0.05);3个USMB亚组治疗后即刻的CEUS峰值声学密度值(PI)均明显低于US组(P均<0.05);USMB组肝细胞明显水肿并压迫肝窦、汇管区血管和中央静脉,USMB1、USMB2亚组肝板/肝窦面积比率分别为48.75±9.91、35.66±8.43,明显高于US组的1.98±0.07(P均<0.05)。结论微泡增强的非聚焦超声可以对肝脏创伤进行快速止血且不影响正常肝脏的血流灌注。Objective To explore the value of microbubble-enhanced non focused ultrasound for hepatic trauma in rabbits.Methods All of 25 hepatic trauma rabbit models which had hepatic injury were included and randomly divided into ultrasound（US）group,microbubble（MB）group and ultrasound and microbubble（USMB）group.Based on different acoustic intensity,15 rabbits in the USMB group were randomly divided into three subgroups：USMB1（0.11 W）,USMB2（0.55 W）and USMB3（1.10 W）,each subgroup contained five rabbits.The blood bleeding pre-and post-treatment and visual score post-treatment were evaluated.The contrast-enhanced ultrasound was used to analyze the level of blood perfusion of treatment area.The liver specimens were stained using HE to analyze area ratio variation of hepatic plate/hepatic sinusoid.Results The blooding weigh and visual scores after treatment of the USMB group were significantly lower than that of the US group（all P〈0.05）.Initial peak intensity（PI）ratio after treatment of three USMB subgroup was significantly lower than that of the US group（all P〈0.05）.Hepatic cell in the USMB group became edema and compress the hepatic sinus,blood vessels in the portal area and the central vein,hepatic plate/hepatic sinusoid area ratio were 48.75±9.91 and 35.66±8.43 in the USMB1 and USMB2subgroups,respectively,significantly higher than that in the US group（1.98±0.07,P〈0.05）.Conclusion The microbubbles-enhanced non focused ultrasound can be used to make rapid hemostasis on hepatic trauma and does not affect the blood perfusion of normal liver in rabbits.

关 键 词：微泡 肝创伤 空化效应 止血 超声治疗 

分 类 号：R445.1[医药卫生—影像医学与核医学] R-332[医药卫生—诊断学]