高原兔脑射频热凝毁损灶的病理观察

In vivo pathologic study of lesions produced with a computerized radiofrequency on rabbit in high altitude

目的 确定高原环境中射频热凝毁损参数指标并指导临床手术。 方法 在海拔 36 5 8m高原 ,采用成熟家兔进行不同温度和时间条件下单、双极毁损脑组织 ,分别在术后 4h、7d、14d进行取材 ,测定毁损灶的直径和长度 ,并观察其病理变化。 结果 热凝毁损造成的病灶中心为凝固性坏死 (术后 4h:D4.5± 0 .35 m m;L 4.0± 0 .2 5 m m,术后 7d:D5 .8± 0 .45mm;L 5 .4± 0 .35 m m,术后 14d:D5 .0± 0 .2 5 mm;L 4.7± 0 .2 0 mm) ,周边组织变性。术后当天病灶周围无明显炎症反应。术后 7d出现炎症反应 :表现为炎性细胞的增生和浸润 ,毛细血管增生和扩张充血 ,周围组织的水肿 ,脑胶质细胞轻度增生。术后 14d炎症反应减退 ,周围组织轻度水肿 ,脑胶质细胞增生明显。 结论 高原立体定向 Vim或 PVP毁损的合适温度和时间是 6 5～ 70℃ 6 0 s.

Objective To study the pathologic changes of lesions produced with a computerized radiofrequency in rabbit brain in high altitude. Method In the subcortical white matter of 20 adult white rabbits, the lesions were made at designed temperature(65℃?70℃) time (60s)and different electrodes(monopolar or bipolar). Animals were sacrificed after 4 hours?7days?14 days. Lesions were photographed and measured under magnification. Result The coagulated masses were ellipsoid with a central area of coagulation necrosis and cellular proliferation, well-demarcated borders, signs of boiling or carbonization were not present in any lesion. The lesions produced by 65～70℃ 60 s were irreversible. Conclusion In high altitude , the opportune temperature and time of radiofrequency is 65～70℃ 60 s?