高强度聚焦超声损毁兔腹腔神经节的效果

The ablative effect of high intensity focused ultrasound on the celiac ganglion in rabbits

目的观察不同声强高强度聚焦超声(HIFU)损毁兔腹腔神经节的效果。方法 33只新西兰大白兔随机分为3组,每组11只,分别用剂量为50 W／cm2×10 s(A组)、10 W／cm2×50 s(B组) 的HIFU照射腹腔神经节,对照组(C组)不照射。照射后4 h各组随机抽取1只兔,光镜下观察腹腔神经节的变化,其余10只照射后连续3 d观察胃肠功能变化,连续30 d观察下肢运动和皮肤外观,照射后30 d每组再随机抽取一只兔,光镜下观察腹腔神经节的变化。结果照射后4 h,A、B组均出现神经节间质水肿、缩小及核浓缩,照射后30 d腹腔神经节内见大量的纤维和卫星细胞增生,但A组更明显。照射后1、2 d A组腹泻发生率高于B、C组(P<0．05),A组粪便含水率最高(P<0．05)。照射后 30 d内3组均未出现跛行和下肢皮肤坏疽。结论高声强、短时间的HIFU可损毁兔腹腔神经节而不影响毗邻的腹主动脉和脊髓,其后可发生一过性腹泻。

Objective To investigate the ablative effect of high intensity focused ultrasound （HIFU） on the celiac ganglion （CG） and the subsequent change in gastro-intestinal （GI） function. Methods Thirty-three New Zealand white rabbits of both sexes aged 5-10 months weighing 1.6-2.7 kg were randomly divided into 3 groups （n = 11 each） according to the dose of HIFU （intensity x time） ： group A 50 W·cm^2 ×10 sec; group B 10 W·cm-2 ×10 sec and group C no HIFU. Upper abdomen was opened through median incision under general anesthesia. CG was exposed to HIFU. One animal was killed in each group at 4h after operation and CG was obtained for microscopic examination. The GI function was observed for 3 days in the rest 10 animals in each group. The motor function of the hind limbs and the appearance of skin were observed for 30 days after operation. One animal in each group was killed 30 days after HIFU and CG was obtained for microscopic examination. Results Stroma edema was observed in group A and B 4 hours after HIFU. The neurons became smaller and the nuclei condensed, and fiber hyperplasia and satellite cells were observed in CG 30 days after HIFU in group A and B. The incidence of diarrhea was significantly increased in group A as compared with group B and C （P 〈 0.05）. The moisture of the stool in group A was the highest among the 3 groups （ P 〈 0.05）. No motor dysfunction of the hind limbs or skin gangrene was observed in the 30 days after operation. Conclusion CG could be seriously damaged by HIFU of high intensity and short duration without damage to the adjacent aorta and spinal cord.