射频热疗猪肝脏的实验观察及测温可行性研究  

Role of regional radiofrequency hyperthermia after hepatic artery block in the normal pig liver

作　　者：罗京伟[1] 徐国镇[1] 熊京红[1] 刘晓云[1] 王维虎[1] 李晔雄[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所肿瘤医院放射治疗科,北京100021

出　　处：《中华放射肿瘤学杂志》2003年第1期58-60,共3页Chinese Journal of Radiation Oncology

摘　　要：目的　通过动物猪实验研究射频热疗对肝动脉阻断后肝叶以及正常肝叶间的温度差别、正常肝脏耐受高温的阈值、热疗后病理形态学的变化、热疗并发症等。方法　将 70kg猪在静脉麻醉下 ,通过股动脉插管、泛影葡胺示踪发现肝右动脉并用碘油进行阻断 ,模拟肝癌介入治疗相似的条件 ,然后SR 1 0 0 0深部射频热疗机进行全肝加温。加温过程中放置四路热电偶进行动态测温 :通过肝动脉插管置入一根测温线至肝右动脉 ,左右肝分别通过穿刺置入热电偶 ,第四根置入直肠。全过程由电脑自动记录不同测温部位的温度变化。结果　热疗 1h后阻断肝叶即肝右叶的温度由疗前的 39.1℃上升至 49.3℃ ,温度升高 1 0 .2℃ ;而作为对照的左肝温度由疗前的 39.7℃上升至 46 .5℃ ,温度升高 6 .8℃ ;阻断的肝右动脉内温度升高 3 .3℃ ,直肠内温度升高 3 .2℃。疗后饲养动物 1周处死 ,解剖过程中发现肝右叶坏死明显 ,肝左叶形态正常 ,两叶间形态学改变明显 ,并且有明显的界限 ;病理组织学所见与肉眼所见相似。加热局部区域皮肤有浅Ⅱ度烫伤 ,脂肪层有局灶性坏死液化改变。结论　阻断肝叶和正常肝叶在同样的加热条件下温度差别明显 ;动脉阻断的肝叶坏死明显 ,而正常肝叶可以耐受 46 .5℃的高温而不产生明显的病理形态学改变 ;Objective To study the temperature difference , tolerated high tem perature, pathological changes between normal and blocked hepatic artery in radiofrequency hyperthermia for pig liver. Methods Mature pig was used with ioding blocked right hepatic artery. Heat of the whole liver was giv en for 1 hour by SR-1000 radiofrequency hyperthermia with four thermocouple pr obes to measure the temperature of the right hepatic artery, right and le ft norm al liver and rectum. Results Temperature of blocked right liver increased by 10 .2?℃ from 39.1?℃ to 49.3?℃ as compared with the left liver of which the temperature rose by 6.8?℃ from 39.7?℃ to 46.5?℃ but t he temperature of righ t hepatic artery and rectum rose only by 3.3?℃, 3.2?℃ respectively. A fter sacrificing the pig one week later,on lobe exploration, seve re necrosis was observed in the right lobe but the left lobe was normal with a clear demarcation between the two lobes . Conclusions Hepatic arterial iodine embolization potenti ates radiofrequency hyperthermia in the liver. Liver with blocked artery showed conspicuous necrosis but liver with normal un-blocked artery was able to toler ate 46.5?℃.This provides some evidence for the combination of regional hyperthermia and hepatic artery block in th e treatment of advanced liver cancer.

关 键 词：温热疗法 治疗性栓塞 温度记录法 病理学 猪肝 

分 类 号：R730.5[医药卫生—肿瘤]