Chang C K, Hendy Mary Pat, Smith J Michael, Recht Matthew H, Welling Richard E
Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio 45220, USA.
Ann Surg Oncol. 2002 Jul;9(6):594-8. doi: 10.1007/BF02573897.
We studied the effects of radiofrequency ablation, relative to hepatic blood flow, on the volume and shape of the resulting tissue necrosis. The extent of necrosis is directly proportional to the size of the electrode and inversely related to blood flow, which dissipates the heat generated.
Two areas of necrosis were created in each of eight porcine livers, which were assigned to four groups according to blood flow occlusion: no occlusion, occlusion of the hepatic artery and portal vein, occlusion of the hepatic veins, and complete hepatic vascular occlusion. After 25 minutes of liver reperfusion, the animals were euthanized, and the livers were examined.
Complete vascular occlusion resulted in the greatest area of necrosis (28.6 +/- 3.4 cm(3)), followed by occlusion of the hepatic artery and portal vein (19.2 +/- 5.9 cm(3)), occlusion of hepatic veins (14.4 +/- 2.6 cm(3)), and no occlusion (4.9 +/- 1.5 cm(3)). The volume of the necrotic areas created during complete vascular occlusion were significantly greater than those created with no occlusion, as well as those created with only the hepatic artery and portal vein occluded (P <.05).
Complete vascular occlusion, combined with radiofrequency ablation, increases the volume of necrosis and creates a more spherical ablative area.
我们研究了相对于肝血流，射频消融对所产生的组织坏死体积和形状的影响。坏死范围与电极大小成正比，与耗散产生热量的血流成反比。
在8头猪的肝脏中各制造两个坏死区域，根据血流阻断情况将其分为四组：不阻断、肝动脉和门静脉阻断、肝静脉阻断以及完全肝血管阻断。肝脏再灌注25分钟后，对动物实施安乐死并检查肝脏。
完全血管阻断导致的坏死面积最大（28.6±3.4立方厘米），其次是肝动脉和门静脉阻断（19.2±5.9立方厘米）、肝静脉阻断（14.4±2.6立方厘米）以及不阻断（4.9±1.5立方厘米）。完全血管阻断期间产生的坏死区域体积显著大于不阻断以及仅阻断肝动脉和门静脉时产生的坏死区域体积（P<.05）。
完全血管阻断联合射频消融可增加坏死体积并形成更呈球形的消融区域。
