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使用多针可扩张电极进行肺射频消融时向肺实质内注入高渗盐水:猪模型实验结果

Infusion of hypertonic saline into the lung parenchyma during radiofrequency ablation of the lungs with multitined expandable electrodes: results using a porcine model.

作者信息

Iishi Tatsuhiko, Hiraki Takao, Mimura Hidefumi, Gobara Hideo, Kurose Taichi, Fujiwara Hiroyasu, Sakurai Jun, Yanai Hiroyuki, Yoshino Tadashi, Kanazawa Susumu

机构信息

Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.

出版信息

Acta Med Okayama. 2009 Jun;63(3):137-44. doi: 10.18926/AMO/31848.

Abstract

The present study was performed to clarify the effect of hypertonic saline infusion into the lung parenchyma on radiofrequency ablation (RFA) of the lungs. A total of 20 ablation zones were created in 3 pigs. The ablation zones were divided into 3 groups. Group 1 (n=6) consisted of ablation zones created by applying smaller radiofrequency (RF) power without saline infusion; group 2 (n=5) zones were created by applying greater RF power without saline infusion;and group 3 (n=9) zones were created by applying greater RF power with saline infusion. The techniques of saline infusion included administration of hypertonic saline 1 ml before RFA, followed by continuous administration at a rate of 1 ml/min during the first 2 min after the initiation of RFA. The ablation parameters and coagulation necrosis volumes were compared among the groups. Group 3 had a tendency toward smaller mean impedance than group 1 (p=0.059) and group 2 (p=0.053). Group 3 showed significantly longer RF application time than group 2 (p=0.004) and significantly greater maximum RF power than group 1 (p=0.001) and group 2 (p=0.004). Group 3 showed significantly larger coagulation necrosis volume (mean, 1,421mm3) than group 2 (mean, 858 mm3, p=0.039) and had a tendency toward larger necrosis volume than group 1 (mean, 878 mm3, p=0.077). Although this small study had limited statistical power, hypertonic saline infusion during RFA appeared to enlarge coagulation necrosis of the lung parenchyma.

摘要

本研究旨在阐明向肺实质内输注高渗盐水对肺部射频消融(RFA)的影响。在3头猪身上共创建了20个消融区域。消融区域分为3组。第1组(n = 6)由在不输注盐水的情况下施加较小射频(RF)功率创建的消融区域组成;第2组(n = 5)的区域是在不输注盐水的情况下施加较大RF功率创建的;第3组(n = 9)的区域是在输注盐水的情况下施加较大RF功率创建的。盐水输注技术包括在RFA前输注1 ml高渗盐水,然后在RFA开始后的前2分钟以1 ml/分钟的速度持续输注。比较了各组的消融参数和凝固性坏死体积。第3组的平均阻抗有比第1组(p = 0.059)和第2组(p = 0.053)更小的趋势。第3组的RF应用时间显著长于第2组(p = 0.004),最大RF功率显著大于第1组(p = 0.001)和第2组(p = 0.004)。第3组的凝固性坏死体积(平均1421mm3)显著大于第2组(平均858 mm3,p = 0.039),且有比第1组(平均878 mm3,p = 0.077)坏死体积更大的趋势。尽管这项小型研究的统计效力有限,但RFA期间输注高渗盐水似乎会扩大肺实质的凝固性坏死。

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