HIFU消融脾脏治疗脾功能亢进的动物实验研究

Animal experimental study on HIFU ablation of spleen for the treatment of hypersplenism

目的:探讨高强度聚焦超声(HIFU)消融脾脏治疗脾功能亢进的可行性和有效性.方法:15只健康成年杂种犬随机分为对照组(A)、脾静脉结扎(SVL)组(B)和SVL+HIFU治疗组(C).SVL术后3wk对C组犬开腹行HIFU脾脏消融.观察3组犬外周血像、脾脏体积、消融后并发症及脾脏病理学变化.结果:结扎脾静脉主干及主要分支,可形成犬淤血性脾肿大、脾亢.HIFU消融区域可见凝固性坏死,血管闭塞,血栓形成.坏死能逐渐吸收、纤维化或包裹机化.无脾脓肿、脾破裂等并发症出现.消融后脾脏体积明显缩小,外周血红细胞、血小板逐渐恢复正常.结论:HIFU消融脾脏治疗实验性脾肿大和脾亢是可行和有效的,该技术可以作为临床脾亢治疗的新尝试.

AIM： To investigate the feasibility and effectiveness of HIFU ablation of spleen for the treatment of hypersplenism. METHODS ： Fifteen healthy mongrel dogs were randomly divided into control group （group A）, splenic vein ligation （SVL） group （group B）, and SVL ＋ HIFU treatment group （group C）. Dogs in group C underwent splenic ablation with HIFU under direct vision via laparotomy 3 weeks after SVL. The peripheral blood cell counts, size of spleen, complications and histopathological changes were measured regularly. RESULTS： Thrombocytopenia, erythropenia and splenomegaly were presented in the dogs with SVL. Coagulative necrosis, vascular occlusion, thrombosis of spleen were demonstrated under induction of HIFU irradiation. Lesion was gradually absorbed and fibrosed or encapsulated. No major complications including abscess or rupture of spleen occurred. The size of spleen in group C was obviously smaller than that before therapy. The counts of PLT and RBC in group C increased gradually after therapy. CONCLUSION： HIFU is feasible and effective for experimental splenomegaly and hypersplenism. This method holds promise for future clinical applications in therapy of hypersplenism.