摘要目的 探讨射频、微波、高频介导的热治疗(HITT)、激光等4种消融方法固化的凝固范围.方法 对离体猪肝在不同条件下应用4种消融方法进行固化,观察并记录剖面状况和凝固范围.将12只猪分成4组,亦采用4种消融方法,使用离体实验所用的相同条件固化在体猪肝,观察并记录剖面状况及凝固范围.结果 在体猪肝实验中射频组,电极针开放至3cm及5cm,消融时间分别为5.5、10 min时,凝固范围分别是2.12 cm×1.83 cm×2.07 cm、2.59 cm×2.19 cm×2.19 cm及4.57 cm×2.58 cm×2.61 cm及4.64 cm×2.70 cm×2.76 cm.微波组,微波功率为80W,消融时间分别是3、5、6、10 min时,凝固范围分别是2.53 cm×1.84 cm ×1.23 cm、2.74 cm×2.08 cm×1.62 cm、2.85 cm×2.09 cm×1.59 cm及3.38 cm×3.34 cm×1.77 cm.HITT组,消融时间分别是5及10 min,消融温度为85℃时凝固范围分别是2.53 cm×1.70 cm×0.90 cm及3.03 cm×2.07 cm×1.53 cm.激光组,采用单针凝固及4针耦合凝固,凝固范围在功率为2.0、2.5、10,0、12.0 W时分别是0.95 cm×1.05 cm×0.85 cm,1.05 cm×1.10cm×0.90 cm及2.45cm×1.45 cm×1.95 cm,2.55 cm×1.55cm×2.05 cm.离体猪肝实验中,4种方法的凝固范围均比相对应条件下在体猪肝的凝固范围有不同程度的增大.结论 通过对离体与在体猪肝的4种物理消融方法的实验研究,表明射频、微波及HITT凝固范围较大,其中射频消融效果更稳定,激光消融凝固范围较小,为临床治疗时物理消融方法的选择提供了技术参数.

abstractsObjective To evaluate and compare embolization area following four different ablation techniques,including radiofrequency ablation,microwave ablation,high frequency induced thermotherapy(HITT)and laser ablation.Methods A total of 12 pigs were used in the in vivo studies and divided into 4 groups,corresponding to the four different ablation techniques.These four ablation techniques were also studied in pig liver in vitro under same conditions as in the in vivo experimental group for embolization.Liver cross section status and embolization area were observed and recorded.Results With in vitro radiofrequency ablation using a 3 cm radiofrequency needle electrode for 5.5,10 minutes,embolization areas were 2.12 cm×1.83 cm×2.07 cm and 2.59 cm×2.19 cm×2.19 cm.respectively.With the use of a 5 cm radiofrequency needle electrode for 5.5.10 minutes,the embolization areas were larger at 4.57 cm×2.58 cm×2.61 cm and 4.64 cm×2.70 cm×2.76 cm.respectively.For in vitro microwave ablation experiments,microwave power was adjusted to 80 W and ablation time set at 3,5,6,and,10 minutes.The corresponding embolization areas were 2.53 cm×1.84 cm × 1.23 cm,2.74 cm×2.08 cm×1.62 cm,2.85 cm×2.09 cm×1.59 cm and 3.38 cm×3.34 cm×1.77 cm.For the in vitro HITT experiments,ablation temperature was set at 85℃ for a duration of 5 or 10 minutes.The corresponding embolization areas were 2.53 cm×1.70 cm×0.90 cm and 3.03 cm×2.07 cm×1.53 cm,respectively.Finally,forin vitrolaser ablation experiments,the single needle embolization method was applied with power adjusted to 2.0 W and 2.5 W.The embolization areas were 0.95 cm×1.05 cm×0.85 cm and 1.05 cm×1.10 cm×0.90 cm.However.when the four needle capacitive coupling method was used with power adjusted to 10.0 W and 12.0 W,the embolization areas were 2.45 cm×1.45 cm×1.95 cm and 2.55 cm×1.55 cm×2.05 cm.For all in vivo experiments in using the four ablation techniques,the embolization areas in the pig livers were larger to varying degrees compared to the corresponding in vitro experiments.Conclusion These results provided data on the extent of embolization destruction using four different physical ablation methods,and may be useful in helping to identify an appropriate physical ablation technique in clinical therapy.