热碘油栓塞阻断兔肝VX2肿瘤血供的研究

Influence of Embolization with Heated Lipiodol on Blood Supply of VX2 Hepatic Tumor in Rabbit

[目的]应用多普勒超声观察热碘油栓塞阻断兔肝VX2肿瘤血供的效果及其对肝脏血流动力学指标的影响。[方法]30只载瘤兔,随机分为3组,分别采用37°C生理盐水(对照)、37°C碘油及60°C热碘油经兔肝动脉灌注治疗,1周后多普勒超声观察肿瘤血供、肝动脉最大血流速度(Vmax)、阻力指数(RI)、门静脉平均血流速度(V)、门静脉血管内径的变化。[结果]治疗前,所有病灶能量及彩色多普勒均可检测出瘤内及瘤周较丰富血流信号,治疗后显示60℃热碘油组瘤内及瘤周血流信号均明显减弱,部分消失。治疗后60℃热碘油组肝动脉血流速度与37℃碘油组比明显降低(P=0.004),与对照组比阻力指数增大(P=0.021),门静脉血流速度及内径与其他两组比无明显变化(P均>0.05);60℃热碘油组存活期41.0±3.0d与对照组31.5±3.0d相比有显著差异(P=0.006)。[结论]热碘油栓塞可更有效地阻断兔肝VX2肿瘤供血,延长荷瘤兔生存期。

[Purpose ] To investigate the changes of the blood supply of hepatic tumor and the hemodynamics indexes of liver after embolization with heated lipiodol via hepatic artery in VX2 rabbit model by Doppler ultrasonography. [Methods l Thirty rabbits with VX2 hepatic tumors were randomly divided into three groups, with physiological saline （37℃）, lipiodol（37℃） and lipiodol （60℃） respectively via hepatic artery. The change of blood supply of the tumor, the maximum blood flow velocity （Vmax） and the resistent index （RI） of hepatic artery, the average blood flow rate （V） and the blood vessel inner diameter of portal vein were recorded by Doppler ultrasonography 1 week after embolization. IResultsl Observed with power and color Doppler ultrasound, the blood flow signal in the tumor and at the edge of tumor was aplenty in all three groups before embolization. The blood flow signal whether in the tumor or at the edge of tumor was reduced markedly in 60℃ lipiodol group compared with other groups, and the blood flow signal in 60℃ lipiodol group partially disappear. The maximum blood flow velocity of hepatic artery in 60℃ lipiodol group was obviously lower than that in 37℃ lipiodol group（P=0.004）, and the resistant index of hepatic artery in 60℃ lipiodol group was obviously higher than that in control group（P=0.021）. However the average blood flow rate and the blood vessel inner diameter of portal vein in 60℃ lipiodol group were no difference compared with those in other groups （P〉0.05）. The survival of 60℃ lipiodol group 41.0±3.0d was significantly longer than that of the control group 31.5±3.0d （P=0.006）. [Conclusions ] Embolization with 60℃ lipiodol can block the blood supply of hepatic tumor and effectively prolong the survival in VX2 rabbit model.