胆道内冷盐水灌注预防兔肝射频消融术中胆道急性热损伤的研究

Intraductal chilled saline perfusion to prevent the acute thermal injury of bile duct during radiofrequency ablation in rabbits

目的探讨活体兔肝于射频消融(RFA)术中行胆道内冷盐水灌注冷却(ICSP)对胆道免受热损伤的保护作用。方法取健康雄性新西兰大白兔16只随机分为2组,每组8只。实验组于RFA术前开腹行胆总管置管,并于RFA术中经胆总管置管行ICSP;对照组于RFA术前开腹,但未行胆总管置管及ICSP。RFA术中射频针针尖定位于距肝门部主胆管约5 mm。RFA术后行超声造影(CEUS)测量消融灶大小,并于RFA术后6 h取兔肝脏大体标本对消融灶旁主胆管行组织病理学检查。分析比较两组间RFA消融灶大小及主胆管损伤程度的差异。结果实验组与对照组间RFA消融灶大小差异无统计学意义;对照组RFA术后主胆管损伤程度比实验组严重(P<0.05)。结论于RFA术中行ICSP对胆管可以起到较好的保护作用。

Objective To determine whether intraductal chilled saline perfusion （ICSP） reduces thermal injury to bile ducts during radiofrequency ablation （RFA） in rabbits. Methods Sixteen healthy New Zealand white rabbits were randomly divided into two groups averagely. Experimental group were placed tubes in common bile duct after laparotomy, and ICSP was performed during RFA process, while control group accepted only laparotomy before RFA, and RFA lesions were created without ICSP. RFA electrodes were placed about 5 mm away from the hilus hepatis. RFA lesions were detected and measured by contrast-enhanced ultrasonography （CEUS） after RFA. After 6 hours, the rabbits were sacrificed and liver specimens were obtained for histopathologic observation of central bile ducts. Results Sizes of RFA lesions were not statistically different between both groups. As for the injury of central bile ducts, control group were more serious than experimental group significantly （P〈0.05）. Conclusion RFA-induced bile duct injury may be decreased significantly with ICSP.