射频消融联合肝动脉栓塞治疗兔肝癌的安全性

Combined therapy of radiofrequency ablation with transcatheter artery embolization in rabbit model of hepatic carcinoma

目的:研究射频消融(RFA)与肝动脉栓塞(TAE)联合治疗VX2兔肝移植瘤的安全性.方法:将VX2肿瘤块植入实验兔的肝脏内,建立兔肝癌模型.将36只兔肝癌模型随机分为4组,每组9只,A组行单纯RFA治疗,B、C、D组分别在TAE治疗后1、4、7d行RFA治疗;术前及术后检查实验兔肝、肾功能和存活情况.结果:实验兔术后出现精神萎靡、纳差、嗜睡,以B组及C组最重,A组最轻.A组及D组无动物死亡,B、C组分别死亡3、2只.各组ALT值均在治疗后第1天最高.A组(178.4±49.2U/L)、D组(208.2±65.5U/L)分别与B组(385.0±213.1U/L)和C组(289.2±192.6U/L)比较,差异有统计学意义(P<0.05),B组与C组,D组与A组之间比较,均无统计学意义;各组治疗后4、7dALT值比较均无统计学意义.各组UREA值组间比较差异也无统计学意义.结论:栓塞后1、4d行射频治疗对肝脏功能将产生严重的影响,栓塞后7d进行射频治疗相对比较安全.单纯射频及联合治疗对肾功能无明显影响.

AIM： To investigate the safety about the combined therapy of radiofrequency ablation （RFA） with transcatheter artery embolization （TAE） in rabbits with VX2 hepatic carcinoma. METHODS： VX2 tumor tissues were implanted into the rabbit＇s liver to establish liver cancer model. Thirty-six rabbits with hepatic carcinoma were assigned to 4 groups randomly （n = 9）. Group A received RFA treatment only; group B, C, D received TAE treatment 1, 4, 7 d prior to RFA treatment respectively. The ALT and UREA levels of the experimental rabbits were measured before and after each treatment. RESULTS： Decreased appetite, drowsiness and dispiritedness were observed in the rabbits, especially in group B and C. No death was ob- served in group A and group D, but there were 3 deaths in group B and 2 deaths in group C. ALT levels were the highest at the first day in all groups. The difference was significant at the first day between group B （385.0 ± 213.1 U/L）, C （289.2 ± 192.6 U/L） and A （178.4 ± 49.2 U/L）, D （208.2 ± 65.5 U/L） respectively （P 〈 0.05）, but not significant between group B and C, group A and D; There were no differences between each group at the 4^th day and 7^th day. No statistical significance in UREA levels was observed among the four groups. CONCLUSION： RFA at 1, 4 d after TAE might impact liver function severely. RFA, is relatively safe at 7 d after TAE treatment. Combined therapy of RFA and TAE exerts no impact on renal function in all groups.