三种口径电极双针射频蛋清热凝物形态分析

MORPHOLOGICAL ANALGYSIS OF BIPOLAR RADIOFREQUENCY THERMOSET PRODUCED BY DIFFERENT GAUGE RADIONICS CANNULAE

目的:双电极射频热凝术用于治疗骶髂关节痛和盘源性疼痛等病痛时,效果明显优于单电极射频热凝术。在能形成有效连续热凝的前提下,双针间距越大,适用的病患也越广。本研究目的是观察双极射频模式下不同口径电极针形成热凝物的形态,了解双极射频作用范围并为临床应用提供参考。方法:选用可视性好的鸡蛋清作为热凝介质,选用5mm等长工作端(active tip)而口径分别为22G、21G及20G的成对Baylis射频电极针,按从2mm到16mm的以2mm等差间距平行排列深入在鸡蛋清中,给予90℃的射频热凝180s,并重复5次。对形成的热凝物表面形态摄像记录和图像数据分析。结果:22G针、21G针和20G针分别在8mm、12mm和14mm的电极间距下形成最长的带状热凝(strip thermoset),其最大热凝面积分别为88.70mm2、118.15mm2和135.00mm2。三种口径电极针随电极间距增大而形成热凝物长度增大的同时其最大宽度及电极外侧热凝物长度未随电极间距增大而明显增大。结论:在本实验条件下,当工作端长度相同时,增加电极针直径可增大形成带状热凝物的两电极的最大间距和热凝物面积,但电极针外侧热凝物长度没有随间距增大而增加。这些结果对临床使用双极射频有参考意义。

Objective： Compared with monopolar radiofrequency （RF）, bipolar RF thermocoagulation has been generally accepted to be a better treatment for patients with sacroiliac joint dysfunction, discogenic pain et al. In the precondition of forming continuous strip thermoset, the larger distance between two probes, the more related patients could be benefit from it. Our objective is to analyze the relationship between gauge of radionics cannulae and thermoset morphology. Methods ： Egg white was used as the protein medium. Pairs of 22 gauge （G）, 21G and 20G Baylis radionics cannulae with the same active tip （5mm） were used, secured in a parallel position 2, 4, 6, 8, 10, 12, 14, 16 mm apart and submerged in egg white. 90℃ 180 seconds radiofrequency thermocoagulation was repeated 5 times. The progress of thermoset formation was photographed and analyzed. Results： In the same experimental condition, continuous strip thermoset of 22G, 21G and 20G radionics cannulae were formed, when the eannulae were spaced 8mm, 12mm and 14mm correspondingly, the maxim thermoset area of each group was 88.70 mm^2, 118.15 mm^2 and 135.00 mm^2 respectively. As the distance between two probes increased, final distance of continuous strip thermoset of 22G, 21G and 20G increased proportionally, but final height and maximal outside cannulae thermoset distances did not increased. Conclusions： With the same active tips, bipolar RF does create a continuous strip thermoset that is proportional in size to the diameter of the cannulae. When the distance increased, the thermoset area can be increased by augmenting RF time until the maximum reached, but maximal outside cannulae thermoset distance does not increased respectively.