胆囊旁和近结肠肝脏组织的射频消融

Peri-gallbladder and Colon Wall Tissue Necrosis after Hepatic Radiofrequency Ablation

【目的】在活体上观察多极射频消融电极展开不同直径、消融时间与组织坏死的关系,并评价消融区域组织坏死程度,分别了解在近胆囊和结肠肝曲部位肝脏消融对胆囊和结肠的影响。【方法】家猪6只,体质量(47±2.5)kg。静脉麻醉,每肝内分为5个位点进行射频消融。其中2组将消融电极展开到3cm,每组5个点分别行5min和10min消融,包括距离胆囊床(5±1)mm,行10min射频消融;距离结肠肝曲(5±1)mm处,行10min射频消融,并观察消融结果。另3组电极展开到5cm,每组5个点分别行5min、10min和15min组织间消融。【结果】消融电极展开到3cm行5min治疗组,5个点局部消融区域组织达到完全坏死;10min×5min消融治疗坏死范围相似。大体病理上消融相邻区域胆囊,结肠未见有坏死,镜下病理显示胆囊壁、结肠周围有慢性炎症并有纤维增生表现。消融电极展开到5cm,5min消融组织间有活性成分,15min,10min均可保证消融区域完全坏死。【结论】可根据需要调整多极消融电极展开大小,在肝内接近胆囊区域、结肠肝曲部位消融安全,可发挥较好的作用。

[Objective]The study was performed to evaluate the necrosis after hepatic multi-electrode radiofrequency ablation （RFA）, also to assess the feasibility and safety of RFA of hepatic tissue adjacent to the gallbladder wall and to the colon wall in a porcine model. [Methods] Six normal swine （mean weight 47 kg × 2.5 kg） in vein anesthesia were treated with RFA in the liver with 5 min,10 min, under 3 cm opening in one cycle, and with 5 min, 10 min, and 15 min RFA under 5 cm opening in one cycle. Those include RFA area adjacent to gallbladder and to colon wall about 5 mm × 1 mm. [Result] The area was completely necrotic with 5 min, 10 min with 3 cm opening in one cycle. The necrosis area was not completely necrotic with 5 min, but it showed completely necrosis with 10 min, 15 min under 5 cm opening in one cycle. In pathology, the adjacent gallbladder wall and colon wall were not found any necrosis and chronic inflammation cells were found in ablation area and in the wall of gallbladder and colon. [Conclusion] The multi-electrode can be changed its opening diameter and provide a relative suitable ablation shape. It was safety to the adjacent gallbladder and colon wall about 5 mm × 1 mm distance in radiofrequency ablation.