Choi Seung Hong, Lee Jeong Min, Lee Kyoung Ho, Kim Se Hyung, Lee Jae Young, Han Joon Koo, Choi Byung Ihn
Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744.
AJR Am J Roentgenol. 2005 Oct;185(4):878-84. doi: 10.2214/AJR.04.1395.
The purpose of our study was to compare radiofrequency cauterization, embolization using an absorbable gelatin sponge, and a Histoacryl-Lipiodol mixture plugging as postbiopsy bleeding reduction methods after splenic core needle biopsy in a dog model.
Eleven mongrel dogs were randomly separated into nonheparinized (n = 5) and heparinized (n = 6) groups. Eight splenic biopsies per animal were performed using an 18-gauge automated core biopsy needle: two as controls, two ablated by radiofrequency, two embolized using an absorbable gelatin sponge, and two plugged using a Histoacryl-Lipiodol mixture. Procedure times and postbiopsy bleeding amounts were assessed. Statistically significant differences were determined by repeated measures analysis of variance; the Tukey-Kramer test for multiple comparisons was used for post hoc comparisons. Three-day follow-up CT scans were obtained to check for procedure-related complications or delayed bleeding.
The postbiopsy bleeding reduction groups showed significantly less blood loss than the control group for both the nonheparinized (p < 0.0001) and heparinized groups (p < 0.0001). In the heparinized group, both radiofrequency cauterization (p < 0.01) and gelatin sponge embolization (p < 0.05) significantly reduced bleeding compared with Histoacryl-Lipiodol mixture plugging. Gelatin sponge embolization was the longest procedure (p < 0.001). On follow-up CT, no delayed bleeding was observed. However, multiple Histoacryl-Lipiodol emboli were observed in the splenic and portal veins in all the dogs we treated.
Radiofrequency cauterization was found to be the most useful postbiopsy bleeding reduction method in terms of the amount of bleeding and the procedure time.
我们研究的目的是在犬模型中比较射频烧灼、使用可吸收明胶海绵栓塞以及用Histoacryl-碘油混合物封堵作为脾组织芯针活检后减少出血的方法。
11只杂种犬随机分为未肝素化组（n = 5）和肝素化组（n = 6）。每只动物使用18号自动组织芯针进行8次脾活检：2次作为对照，2次用射频消融，2次用可吸收明胶海绵栓塞，2次用Histoacryl-碘油混合物封堵。评估操作时间和活检后出血量。通过重复测量方差分析确定统计学上的显著差异；采用Tukey-Kramer多重比较检验进行事后比较。进行为期三天的随访CT扫描以检查与操作相关的并发症或延迟出血情况。
活检后出血减少组在未肝素化组（p < 0.0001）和肝素化组（p < 0.0001）中出血量均显著少于对照组。在肝素化组中，与Histoacryl-碘油混合物封堵相比，射频烧灼（p < 0.01）和明胶海绵栓塞（p < 0.05）均显著减少了出血。明胶海绵栓塞的操作时间最长（p < 0.001）。随访CT检查未观察到延迟出血。然而，在我们治疗的所有犬中，脾静脉和门静脉中均观察到多个Histoacryl-碘油栓子。
就出血量和操作时间而言，射频烧灼是最有用
