肝动脉血流对氩氦超低温冷冻效果影响的初步实验研究

Primary experimental study of the liver artery effect on Cryoablation of malignant liver tumors

目的:分析肝动脉血流通畅与否、靶冷冻区域肝动脉直径大小及相互关系,对氩氦超低温冷冻效果的影响。方法:选择成年犬12只,随机分为2组,每组6只,分别行肝动脉暂时阻断及氩氦冷冻术(实验组)和氩氦冷冻术(对照组)。每只动物均取近肝门和远离肝门两个冷冻靶点。分别于术后即刻、7d、14d处死实验动物,观察肝脏大体改变,测量冷冻范围,取靶区肝组织行病理检查。结果:1)两组同一时间点在同一冷冻部位实验组温度更低;每组两个不同冷冻部位在同一时间点近肝门处温度较高。2)近肝门冷冻靶点最大坏死直径均大于远肝门靶点;在同一冷冻靶点位置,实验组坏死直径大于对照组坏死直径。3)病理检查可见实验组坏死更彻底、持续时间更长,在术后14d远肝门区仍可见直径约1mm血管受损。结论:肝动脉血流和肝动脉直径大小及二者的协同作用是影响氩氦超低温冷冻效果的重要因素之一。

Objective： To analyze and explore the effect of flow and the diameter of liver artery on Cryoablation of malignant liver tumors. Methods： adult experimental dogs were randomly divided into two groups, with each of six. The experimental group were underwent liver artery obstruction and cryoablation whereas the control group with only eryoablation. Every dog had two cryoablation cites of near and far away the entry of liver artery. Animals were sacrificed immediately or 7d and 14d after the treatment. General changement of the liver were observed and the extent of cryoablation were measured. Pathological examination of the target and surrounding area have been done. Results： （1）At the same time point and same cryoablation site, experimental group had a lower temperature than the contral group; target temperature near the entry of the liver artery was higher in each group at the same time point. （2） The diameter of the cryoablation range near the entry of the liver artery was longer than that of far away in each group, and the diameter of experimental group was longer than the contral group.（3） In experimental group, the necrosis was more thorough and the duration time was longer than the control group. The vessel damages of as little as 1mm around the target area was observed even after 14 days of cryoablation. Conclusion： Liver artery flow and the diameter of the vessels are the important factors of the effieiency in cryoablation.