肝动脉栓塞对微波凝固范围影响的实验研究  

Effect of hepatic artery embolization on the microwave coagulated area

作　　者：刘岩[1] 申宝忠[1] 李任飞[1] 杨光[1] 董宝玮[2] 梁萍[2] 

机构地区：[1]哈尔滨医科大学第三临床医学院放射科,150040 [2]解放军总医院超声室

出　　处：《中华肿瘤杂志》2003年第6期546-549,共4页Chinese Journal of Oncology

基　　金：哈尔滨市科委基金资助项目(2 0 0 2AA9CS1 512)

摘　　要：目的　通过活体动物实验 ,研究肝动脉栓塞后对微波凝固范围的影响。方法　选取 10只实验犬的 2 4个适合肝叶 ,分别进行单纯微波凝固 (对照组 )和肝动脉碘化油 +明胶海绵栓塞后微波凝固 (实验组 ) ,每组 12个肝叶。微波输出功率 50W ,输出时间为 3 0 0s和 40 0s。测温针与微波天线平行放置于其两侧 5～ 2 0mm范围内 ,测量温度分布情况。术后处死动物 ,沿穿刺针解剖肝脏 ,观察比较凝固灶的大小、形态。标本经福尔马林固定后 ,光镜下观察病理改变。结果　微波凝固术时 ,天线周围温度由内向外呈递减分布 ,实验组温度下降梯度明显低于对照组。当微波输出功率 50W、输出时间 3 0 0s时 ,对照组单极微波凝固形成纵径 2 5～ 3 3mm、横径 13～ 2 2mm的椭球形凝固灶 ,实验组形成纵径 3 3～ 44mm、横径 2 4～ 3 2mm的椭球形凝固灶。输出时间 40 0s时形成的凝固灶略大于输出时间 3 0 0s时的凝固灶 ,但差异无显著性。结论　肝动脉栓塞后可使肝动脉血流引起的散热效应消失 。Objective To study the effect of hepatic artery embolization on t he microwave coagulated area, an in vivo animal experiment. Methods Twenty-fou r suitable hepatic lobes of ten dogs were divided into two groups: microwave coa gulation alone 12 lobes(control group) and hepatic artery occlusion with iodized oil and gelatin sponge particles followed by microwave coagulation 12(experime nt group). Microwave coagulation was delivered with an output of 50 W for 300 or 400 seconds with thermal needles introduced parallel to and 5～20 mm from the p u ncture needle. After sacrifice of the dogs, their hepatic lobes were sectioned a long the puncture line. Then, the appearance and size of the coagulated area wer e recorded. The tissue specimens were fixed in formalin for light microscopic ev aluation. Results A decline in temperature gradient was detected from the cent er to the periphery of the affected tissue after the application of microwave co agulation, which was sharper in the control group than in the experimental group . Single polar microwave coagulation at 50 W for 300 seconds produced a necroti c volume of 25～33 mm in longitudinal diameter and 13～22 mm in transverse diamet er in control group, 33～44 mm and 24～32 mm in the experimental group. The co agulat ion area was slightly bigger when the duration of coagulation was 400 seconds th an 300 seconds, without significant difference. Conclusion Hepatic artery occlusion, inhibiting the heat loss caused by hepatic arterial bl ood flow, is able to significantly enlarge the necrotic volume of microwave coag ulation.

关 键 词：肝动脉栓塞 微波凝固 实验研究 肝肿瘤 治疗 

分 类 号：R735.7[医药卫生—肿瘤]