活体猪肝微波消融前肝内注射蒸馏水和生理盐水的对比实验研究

Comparison of Microwave Ablation Using Fluids Preinjection: In Vivo Porcine Liver

目的通过设置不同的消融功率,于消融前向活体猪肝内注射蒸馏水和生理盐水,探讨组织的含水量及离子浓度对微波消融范围和温度场的影响,并比较二者对消融范围和温度场的影响程度。方法应用2 450 MHz植入式冷循环微波天线对活体猪肝分别行主机输出功率为60 W、80 W以及消融时间为10 min微波消融,于消融前预先用PTC针向猪肝组织内注射5 m L蒸馏水(蒸馏水组)或5 m L生理盐水(生理盐水组),并设置对照组(无液体注射)。分别将测温针放置于微波天线旁开0.5 cm(t_1)、1.0 cm(t_2)、1.5 cm(t_3)处测量温度。三组每个功率各完成5个消融灶的实验,总共获得30个消融灶。测量并比较消融后消融灶的长径(Dl)、短径(Ds),记录微波天线旁开0.5 cm、1.0 cm、1.5 cm处的温度变化,并绘制各个功率设置下的温度曲线。结果主机输出功率相同时,实验组的Dl和Ds均大于对照组,实验组t_1、t_2、t_3处的温度比对照组增高(P<0.05)。结论相同的主机输出功率以及相同的消融时间时,微波消融前于肝内注入少量蒸馏水或生理盐水有望提高消融灶的消融范围。

Objective To detect whether or not the efficacy of microwave ablation （MWA） could be improved by preinjected distilled water or 0.9% NaC1 solution in in vivo porcine livers. Methods All animal experiments were performed in compliance with the guidelines of our animal use committee. Microwave ablations were performed in in vivo porcine livers with a cooled-shaft antenna in different microwave ablation parameter groups （60 W, 80 W for 10 minutes）. Before ablation, 5 mL of distilled water or 0.9% NaCl solution was injected into the targeted liver tissue. Ablations without fluid injection were served as control. Each power setting was applied for 5 ablations with 10-min duration for each. The long-axis diameter （D1） and short-axis diameter （Ds） for each ablation were measured. The tissue temperature at a distance of 0.5, 1.0, and 1.5 cm from the antenna was measured and temperature curves were recorded. Results For the same power readout, DI, Ds of experimental group （preinjection of distilled water or 0.9% NaC1 solution） were larger than the control group （P 〈0.05）. The tissue temperatures for the experimental group were significantly higher than those for the control group （P 〈0.05）. Conclusions Preinjection of distilled water and 0.9% NaC1 solution can achieve larger coagulation volumes and higher temperature in ablation zone than those for ablations without fluid injection in in vivo porcine livers.