射频消融联合醋酸及高渗氯化钠对消融体积的影响

The ex-vivo experimental study on RFA combined with acetic acid and hypertonic saline injection

目的探讨射频消融(RFA)联合醋酸及高渗氯化钠对消融体积的影响。方法RFA联合50%醋酸及5%NaCl对离体牛肝进行消融。实验分5组,Ⅰ组:单纯RFA组,Ⅱ组:RFA联合纯醋酸组,Ⅲ组:RFA联合蒸馏水组,Ⅳ组:RFA联合10%氯化钠组,Ⅴ组:RFA联合50%醋酸及5%氯化钠组。结果在固定消融条件的情况下,所形成的平均消融体积长径Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ组分别为3.08、3.18、3.08、4.32和4.46cm;短径分别为2.99、2.98、2.77、4.29和4.44cm。Ⅳ组和Ⅴ组所形成的平均消融体积明显大于其他各组,消融时间较其他各组明显延长,Ⅱ组和Ⅴ组对血管旁组织有一定的消融作用。结论RFA消融联合50%醋酸及5%NaCl可显著扩大消融体积,醋酸溶液可沿组织间隙渗透,对血管旁组织进行消融。

Objective To investigate the influence of RFA combined with acetic acid and hypertonic saline injection on the destructed volume. Methods Fresh ex vivo ox liver was subjected to RFA combined with 50% acetic acid and hypertonic saline injection. Five group were set up：group Ⅰ,RFA alone; group Ⅱ, RFA combined with pure acetic acid; group Ⅲ, RFA combined with distilled water; group Ⅳ, RFA combined with 10% sodium chloride; group Ⅴ,RFA combined with 50% acetic acid and 5% saline injection. Results Ex-vivo experiments under fixed RFA conditions demonstrated the average anteroposterior diameter of ablation volume in groups Ⅰ , Ⅱ ,Ⅲ, Ⅳ and Ⅴ was respectively 3.08,3.18,3.08, 4.32 and 4.46 cm respectively; the average transverse diameter was 2.99,2.98,2.77,4.29 and 4. 44 cm respectively. The RFA time in groups Ⅳ and Ⅴ was longer than in other groups ,and ablation volume larger obviously than other groups too. Perivascular tissues were ablated in groups Ⅱ and Ⅴ. Conclusion RFA combined with acetic acid and hypertonic saline could significantly enlarge the destructed volume. Acetic acid solution can penetrate along with tissue space and ablate perivascular tissues.