经皮射频凝固治疗闭合性肝外伤伴活动性出血的实验研究

Experimental research in percutaneous radiofrequency ablation in treating blunt hepatic trauma with active bleeding

目的 探讨经皮射频消融（PRFA）治疗闭合性肝外伤（BHT）的可行性。方法 建立16只小型猪BHT伴活动性出血区模型，随机分为治疗组和对照组，每组8只，对治疗组进行超声造影（CEUS）引导下PRFA治疗。将治疗结果与病理检查结果进行对照。结果治疗组7例经一次PRFA后，CEUS未见肝活动性出血信号，另1例经一次PRFA治疗后，CEUS仍可见肝活动性出血，经第二次PRFA治疗后，CEUS未见肝活动性出血信号。剖腹探查治疗组肝表面均覆盖一层凝血膜，均未见肝活动性出血。对照组肝周积血增多，肝损伤级别为Ⅰ～Ⅳ级，肝表面未形成凝血膜，均可见肝活动性出血。结论 PRFA是一种可行的治疗BHT的方法。

Objective To discuss the rationality of percutaneous radiofrequency ablation（PRFA） in treating blunt hepatic trauma（BHT）. Methods Sixteen pig-models with BHT and active bleeding were randomly divided into therapeutic group and control group. PRFA was performed under the guidence of contrast-enhanced ultrasonography（CEUS） in the therapeutic group. The therapeutic effects and pathologic findings were compared. Results In the therapeutic group, ablation area and some normal areas of hepatic surface were covered with a layer of coagulated blood. After the first PRFA treatment, active bleeding signals from the damaged area could be detected by CEUS only 1 case. The signal was completely disappeared after the second PRFA. In the control group,the accumulation of blood around the livers was increased,coagulated bloods were not formed on the liver surfaces,the grade of BHT was from I to IV, and active bleeding in the livers were found. Conclusions Some BHT can be treated by PRFA.