微波消融对正常家猪支气管影响的实验研究

Experimental investigations of the effects of microwave ablation on bronchus in normal domestic swine

目的通过观察微波消融(MWA)后各级支气管的病理变化,探讨MWA对支气管的影响,为临床应用提供实验依据。方法10只健康家猪分为2组,进行经皮穿刺正常肺组织MWA,分别于消融后3 d(A组)、28 d(B组)各处死5只,观察消融区形态及大小和各级支气管的病理表现。结果B组活检消融损伤区最大纵径、最大横径小于A组活检消融损伤区最大纵径、最大横径(纵径:t=4.911,P=0.001;横径:t=3.251,P=0.009);随着支气管腔的变小,微波对支气管的损伤加重;对主支气管、二级支气管的损伤较轻;未出现支气管瘘;主支气管、二级支气管消融后28 d呈恢复表现。结论微波消融对于二级以上支气管损伤较轻,且可于28 d有恢复趋势,CT引导下经皮穿刺MWA治疗肺部肿瘤是一种可以耐受且对大支气管影响轻微的微创治疗方法。

Objective To investigate the effects of microwave ablation on bronchus of different grades in order to provide experimental evidence for clinical treatment by observing pathological changes in the bronchus of difiercnt-grades after microwave ablation. Methods The precutaneous microwave ablations on normal puhnonary tissues was performed in ten health domestic swine. Five swine were killed 3 days after the ablation （group A） and the other 5 swine were killed 28 days after precutaneous microwave ablations （group B）. The shapes and sizes of ablative area were measured and the pathological manifestations of bronchus of different grades were evaluated. Results The maximal longitudinal and transverse diameter of the thermal damage zone in the biopsy of group B were smaller than those in the biopsy of group A （the longitudinal diameter： P 〈0.01 ;the transverse diameter： P 〈 0.01 ）. The microwave damage was aggravated in small bronchus,as compared with that in large bronchus, The bronchial fistula was nut found. The recovery of larger bronchus was found in group B. Infiltration of lymphocytes and plasmocytes was found in lung tissues after MWA. Conclusion The damages of microwave ablation in larger bronchus is mild which can be recovered slightly 28 days after ablation. CT-directed percutaneous MWA has slight effects on the main bronchus and on the second grade bronchus. It is one of the tolerable and safe therapies with minimal invasion for lung tumors.