Department of Hepatobiliary and Pancreatic Surgery, Leicester General Hospital, Leicester LE5 4PW, UK.
Am J Surg. 2012 Nov;204(5):666-70. doi: 10.1016/j.amjsurg.2009.12.019. Epub 2010 May 7.
Electrolytic ablation (EA) destroys tissues through extreme pH changes in the local microenvironment. An ex vivo perfused liver model was used to assess the systemic effects of EA on the acid-base balance without the influence of compensatory organs (lungs and kidneys).
Eleven pigs were perfused extracorporeally at 39°C with autologous blood; 4 also underwent EA after 1 hour of reperfusion. Arterial blood samples were obtained hourly.
pH and CO(2) levels did not change throughout the experiments. A significant increase of HCO(3)-, anion gap, base excess, and lactate was present after the third hour. No differences were observed between EA experiments and controls.
EA does not alter the acid-base balance even when the confounding influence of compensatory organs is removed. Such findings should be considered when planning ablations in patients with renal failure or respiratory diseases in which EA could avoid undesirable metabolic changes.
电解消融（EA）通过局部微环境中的极端 pH 值变化来破坏组织。本研究采用离体灌注肝脏模型来评估 EA 对酸碱平衡的全身影响，而不受代偿性器官（肺和肾）的影响。
11 头猪在 39°C 下用自体血进行体外灌注；其中 4 头在再灌注 1 小时后进行 EA。每小时采集动脉血样。
整个实验过程中 pH 值和 CO2 水平没有变化。在第三个小时后，HCO3-、阴离子间隙、碱剩余和乳酸显著增加。EA 实验与对照组之间无差异。
即使去除了代偿性器官的混杂影响，EA 也不会改变酸碱平衡。在计划患有肾衰竭或呼吸系统疾病患者的消融术时，应考虑到这些发现，因为 EA 可以避免不良的代谢变化。
