超声造影在经皮射频凝固治疗闭合性肝外伤评价价值的实验研究

Value of contrast-enhanced ultrasonography in the treatment of blunt hepatic trauma by percutaneous radiofrequency coagulation:an animal experiment

目的研究超声造影对闭合性肝外伤经皮射频凝固治疗的评价。方法采用撞击器撞击16只猪肝区,建立闭合性肝外伤伴活动性出血模型。将动物模型随机分为治疗组和对照组,每组各8只。采用超声造影引导射频针刺入肝实质损伤区进行射频治疗。射频治疗后即刻及1h后进行超声造影检查。对照组不进行治疗,撞击后即刻及1h后进行超声造影检查。将超声造影结果与病理结果进行对照研究。结果撞击后即刻,所有猪肝超声造影均可见活动性出血信号。射频针在超声造影下均准确刺入肝实质损伤病灶。射频治疗后即刻,超声造影检查,7例未见肝活动性出血信号,1例仍见肝活动性出血信号,经再次射频凝固治疗后,超声造影未见肝活动性出血信号。射频治疗后1h,治疗组超声造影未见肝活动性出血。对照组在撞击后即刻及撞击后1h,超声造影均可见肝活动性出血信号。结论超声造影术前能准确评估闭合性肝外伤的情况,术中能精确引导射频针刺入肝实质损伤病灶,术后能及时、准确评估疗效,在闭合性肝外伤经皮射频凝固治疗中具有重要的价值。

Objective To study the value of contrast-enhanced ultrasonography in the treatment of blunt hepatic trauma by pereutaneous radiofrequency coagulation.Methods After animal models of blunt hepatic trauma were created in sixteen domestic pigs, they were randomly divided into two even groups： a treatment group and a control group. Radiofrequency electrode was inserted into the sites of the damaged livers to treat hepatic hemorrhage under the guidance of contrast-enhanced ultrasonography. Contrast-enhanced ultrasonography was used to evaluate the treatment effects. The therapeutic results were compared with pathologic examinations. Results Hemorrhage signals were detected by contrast-enhanced ultrasonography in all cases instantly after the injury. Radiofrequeney needle was accurately inserted into the injured sites of the liver under the guidance of the contrast - enhanced ultrasonography, which were confirmed by pathologic examinafions. No active bleeding was found by contrast-enhanced ultrasonography in all cases except one instantly after radiofrequeney treatment. And hemorrhage signal disappeared after the second radiofrequency treatment in this case. In the control group： bleeding signals were still detected in all cases.Conclusion Contrast- enhanced ultrasonography is useful in the treatment of blunt hepatic trauma by percutaneous radiofrequency coagulation： accurately diagnosing the grades of the hepatic trauma before the treatment, precisely guiding the accurate insertion of radiofrequency electrode in operation, promptly and accurately evaluating the treatment effects after the radiofrequeney coagulation