自主研发电化学治疗同轴电极在动物模型中的初步应用

An initial application of self-made concentric electrode of electrochemotherapy in treatment of animal model

目的观察同轴电极和针式电极对肝脏毁损的情况,初步评价自主研发电化学治疗（EChT）同轴电极的应用价值。方法同轴电极和传统针式电极分别对5只犬肝脏进行EChT。在25 mA条件下,分别检测电量5、10、20、40、90 C时阴、阳极周围组织坏死量,并观察病变及相邻区域组织结构的变化。EChT前后检测血中肝脏酶ALT、AST、GGT和ALP的变化。结果两种电极的阴、阳极均随着电量的增大而组织毁损范围增大,其走向接近对数曲线。外周阴极的毁损体积较阳极为大,在相同电量作用下,同轴电极与传统针式电极效力相当。在阳极区呈凝固坏死,阴极水肿坏死。超微结构显示在阳极坏死程度与距电极的距离相关。阳极周围坏死边缘pH4.5~5.5,阴极周围坏死边缘pH9~10。EChT前后肝脏酶谱没有显著差异,但AST、ALT、GGT和ALP均有升高趋势。结论自主研发电化学治疗同轴电极与传统针式电极具有相近的肝脏毁损作用,毁损范围与电量呈正相关;并发症少,安全性高,是具有广泛临床治疗前景的电化学治疗电极。

Objective To observe comparison of liver lesions in concentric-and needle-electrodes and initially evaluate clinical value of self-made concentric electrode of electrochemotherapy（EChT）.Methods Livers of 10 dogs（5/5） were performed with EChT by concentric-and needle-electrodes,respectively.In the condition of 25mA,volumes of necrosis around anode and cathode were respectively measured at the electrical quantity of 5,10,20,40,and 90C,and the lesions,adjacent tissues and change of ultra-structures were observed.Levels of ALT,AST,GGT and ALP in blood were measured before and after EChT.Results The volumes of destructive lesions enlarged with increase of electrical quantities of anode and cathode,whose lines were like logarithmic curves.The lesion volume of peripheral cathode was large than that of anode.In the condition of equal electrical quantity,the effects of concentric-and needle-electrodes were equal.Coagulation necrosis was observed at anode,and edema necrosis at cathode.The ultra-structure showed that degree of the anode necrosis was correlated to its distance to the electrode.The PH of necrotic margin around anode ranged from 4.5 to 5.5 and that around cathode from 9 to 10.There were no significant differences between pre-EChT and post-EChT,but AST,ALT,GGT,and ALP all tended to increase.Conclusion The efficiencies of liver destructions are equivalent between concentric-and needle-electrodes.The destructive volume is positively correlated to electrical quantity.EChT with concentric electrode is clinically prospective with more safeties and less complications.