冷冻与射频治疗对猪肾盂肾盏肾段血管的损伤作用

Changes of renal pelvis and calyx and subsegmental vessel after cryotherapy and radiofrequency ablation in a porcine model

目的探讨冷冻和射频治疗对猪肾盂肾盏肾段血管的损伤作用。方法选择30～60kg体重母猪30头,分为3组。干性射频组(n=9),湿性射频组(n=9)和冷冻组(n=12)。分别观察在干性射频、湿性射频和冷冻治疗后肾脏重要组织结构肾盂、肾盏和肾段血管的变化。结果冷冻组的肾脏重要组织结构均有明显损伤,平均最大病损范围为肾盂(3.41×1.94±-0.61×1.04)mm、肾盏(4.05×2.26±0.44×1.10)mm、肾段血管(4.32×2.53±0.56×0.21)mm,无尿囊肿形成和尿漏发生。干性射频组平均最大病损范围为肾盂(2.08×1.45±0.46×0.33)mm、肾盏(1.71×0.92±0.58×0.63)mm、肾段血管(3.61×2.16±0.16×0.87)mm,尿囊肿2例,尿漏2例。湿性射频组平均最大病损范围为肾盂(1.98×1.18±1.05×0.78)mm、肾盏(3.71×1.74±-0.11×0.31)mm、肾段血管(3.43×2.32±-0.55×1.02)mm,尿囊肿4例,尿漏3例。结论干性射频、湿性射频和冷冻治疗对猪肾肾盂、肾盏和肾段血管均有一定损伤,近期并发症明显。

Objective To study the pathologic changes of renal pelvis and calyx and subsegmental vessel after renal cryosurgery and radiofrequency ablation in a porcine model.Methods Thirty female pigs (30-60 kg),were divided into three groups:dry radiofrequency group (DRF,n=9),wet radiofrequency group (WRF,n=9),and cryosurgery group (Cryo,n=12).The effect of cryotherapy,DRF,and WRF on vital kidney structures in a porcine model was investigated by purposefully targeting the renal pelvis,a major calyx,and a subsegmental renal vessel.Results Range of pathologic change in Cryo group:renal pelvis (3.41× 1.94± -0.61× 1.04) mm,calyx (4.05× 2.26± 0.44× 1.10) mm,subsegmental vessel (4.32× 2.53± 0.56× 0.21) mm.No urinary fistula and urinoma were demonstrated;in DRF group:renal pelvis (2.08× 1.45± 0.46× 0.33) mm,calyx (1.71× 0.92± 0.58× 0.63) mm,subsegmental vessel (3.61× 2.16± 0.16× 0.87) mm.There were 2 cases of urinoma and 2 cases of urinary fistula;in WRF group:renal pelvis (1.98× 1.18± 1.05× 0.78) mm,calyx (3.71× 1.74± -0.11× 0.31) mm,subsegmental vessel (3.43× 2.32± -0.55× 1.02) mm.There were 4 cases of urinoma and 3 cases of urinary fistula.Conclusion Cryotherapy,DRF and WRF would cause obvious damage to renal pelvis and calyx and subsegmental vessel in a porcine model.