超声导引经皮肝内注射乙酸的初步实验研究

A Preliminary Experimental Study of US Guided Percutaneous Intrahepatic Acetic Acid Injection

为评估超声导引经皮注射乙酸（ＰＡＩ）治疗肝脏肿瘤的可行性，向１０只正常兔肝内经皮注射５０％乙酸，采用经皮注射无水乙醇作对照，观察病理变化及血清谷丙转氨酶（ＡｌＴ）的动态变化；另向３７只大鼠肝内直接注射不同剂量的５０％乙酸或乙醇，比较坏死区的大小。结果显示，与乙醇相比，乙酸注射局部组织坏死较完全且范围较大，周围组织修复较早且ＡｌＴ的峰值较低。根据电镜结果推断，乙酸造成细胞坏死的机理可能是通过固定蛋白质及直接破坏细胞膜性结构。因此，ＰＡＩ可能是一种可行的治疗方法。

In order to assess the feasibility of US guided percutaneous acetic acid injection (PAI) therapy for liver tumors, 50% acetic acid was percutaneously injected into the livers of 10 rabbits. Whereas in the control group percutaneous ethanol injection (PEI) was used. Pathologic changes and AlT serial changes were observed chronologically. In addition, different amount of 50% acetic acid or ethanol was directly injected into the livers of 37 rats in order to compare the sizes of the necrotic area. The results showed that necrosis was more complete, necrotic area was larger, repair of the surrounding hepatic tissue was earlier and peak of AlT was lower in the PAI group than in the PEI group. On the basis of electronmicroscopic results, the necrosis was caused by acetic acid due to not only its desiccating action on proteins, but also destruction of membranous structure of the cell. Therefore, PAI may be a feasible therapeutic method.