减少脑组织术中冷冻切片冰晶形成的处理方法

Processing method of reducing ice crystal formation of brain tissue frozen section

目的探讨减少脑组织术中冷冻切片冰晶形成的方法,以提高脑组织冷冻切片的质量,为脑组织术中病理诊断和临床手术方案的制定提供保障。方法选取海南省人民医院神经外科2015年1月至2017年12月术中送检新鲜脑组织标本147例,根据随机数表法分成三组,每组49例。第一组采用不同取材厚度,第二组采用不同标本含有液体处理方法,第三组采用不同的冷冻锤和速冻使用方法进行制作脑组织冷冻切片,镜下观察和比较冰晶形成的情况。结果脑组织取材厚度为0.3 cm的冰晶形成得分为(8.8±1.1)分,而取材厚度为0.2 cm的冰晶形成得分(9.0±0.8)分,两者比较差异无统计学意义(P>0.05),但分别高于取材厚度为0.4 cm的冰晶形成得分和取材厚度为0.5 cm的冰晶形成得分[分别为(6.3±2.5)分和(5.5±2.1)分],差异均有统计学意义(P<0.05);脑组织含有液体时以滤纸吸干冰晶形成得分为(8.6±0.9)分,未将液体吸干冰晶形成得分为(5.1±2.2)分,前者高于后者,差异有统计学意义(P<0.05);脑组织冷冻方式为使用冷冻锤和启动速冻功能冰晶形成得分为(8.7±1.1)分,使用冷冻锤和不启动速冻功能冰晶形成得分(6.5±2.3)分,不使用冷冻锤和启动速冻功能冰晶形成得分(6.3±2.6)分,不使用冷冻锤和不启动速冻功能冰晶形成得分(5.4±2.5)分,前者均高于后三者,差异均有统计学意义(P<0.05)。结论选择恰当的取材厚度、吸干标本中的液体以及使用冷冻锤和速冻功能加速组织冷冻可减少脑组织术中冷冻切片冰晶的形成,提高脑组织冷冻切片质量。

Objective To explore the methods to reduce the formation of ice crystals during brain frozen section, so as to improve the quality of frozen section of brain tissue and to provide a guarantee for pathological diagnosis and clinical operation of brain tissue. Methods A total of 147 fresh brain tissue samples were selected from Department of Neurosurgery in Hainan General Hospital from January 2015 to December 2017, which were randomly divided into three groups according to random number table method, with 49 cases in each group. Group 1 used different thickness of materials, Group 2 used treatment of specimens containing liquid, and Group 3 used different freezing hammer and quick freezing method to make frozen section of brain tissue. The formation of ice crystals was observed and compared under the microscope. Results The score of ice crystal formation for 0.3 cm thickness（8.8±1.1） showed no significant difference with that of 0.2 cm thickness（9.0 ± 0.8）, P〈0.05, but the score for 0.3 cm thickness was higher than that of 0.4 cm thickness（6.3±2.5） and 0.5 cm thickness（5.5±2.1）, P〈0.05. When the brain tissue containing liquid was dried by filter paper, the score of the ice crystal formation was（8.6±0.9）, significantly higher than（5.1±2.2） of the tissue without drying（P〈0.05）.The score of the ice crystal formation for using freezing hammer and quick freezing method was（8.7±1.1）, which was significantly higher than（6.5±2.3） for using freezing hammer only,（6.3±2.6） for using quick freezing method only, and（5.4 ± 2.5） for using none of these two methods（P〈0.05）. Conclusion Selecting appropriate thickness of the specimen,paying attention to dry the liquid in the specimens, and using freezing hammer and speed function to accelerate tissue freezing can reduce the formation of ice crystals, so as to improve the quality of frozen section of brain tissue.