Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata 950-1104, Japan.
World J Gastroenterol. 2013 Feb 28;19(8):1278-82. doi: 10.3748/wjg.v19.i8.1278.
To determine whether fluid injection during radiofrequency ablation (RFA) can increase the coagulation area.
Bovine liver (1-2 kg) was placed on an aluminum tray with a return electrode affixed to the base, and the liver was punctured by an expandable electrode. During RFA, 5% glucose; 50% glucose; or saline fluid was infused continuously at a rate of 1.0 mL/min through the infusion line connected to the infusion port. The area and volume of the thermocoagulated region of bovine liver were determined after RFA. The Joule heat generated was determined from the temporal change in output during the RFA experiment.
No liquid infusion was 17.3 ± 1.6 mL, similar to the volume of a 3-cm diameter sphere (14.1 mL). Mean thermocoagulated volume was significantly larger with continuous infusion of saline (29.3 ± 3.3 mL) than with 5% glucose (21.4 ± 2.2 mL), 50% glucose (16.5 ± 0.9 mL) or no liquid infusion (17.3 ± 1.6 mL). The ablated volume for RFA with saline was approximately 1.7-times greater than for RFA with no liquid infusion, representing a significant difference between these two conditions. Total Joule heat generated during RFA was highest with saline, and lowest with 50% glucose.
RFA with continuous saline infusion achieves a large ablation zone, and may help inhibit local recurrence by obtaining sufficient ablation margins. RFA during continuous saline infusion can extend ablation margins, and may be prevent local recurrence.
确定射频消融（RFA）过程中注射液体能否增加凝固区域。
将牛肝（1-2 公斤）置于带返回电极的铝托盘上，将可膨胀电极穿刺入肝脏。在 RFA 过程中，通过与注入口相连的输液管以 1.0 mL/min 的速度连续输注 5%葡萄糖、50%葡萄糖或生理盐水。RFA 后测定牛肝热凝固区域的面积和体积。根据 RFA 实验过程中输出的时间变化确定焦耳热。
无液体输注时为 17.3 ± 1.6 mL，与 3cm 直径球体的体积（14.1 mL）相似。生理盐水连续输注时平均热凝固体积明显大于无液体输注（17.3 ± 1.6 mL）、5%葡萄糖（21.4 ± 2.2 mL）或 50%葡萄糖（16.5 ± 0.9 mL）。生理盐水 RFA 的消融体积约为无液体输注 RFA 的 1.7 倍，两者差异有统计学意义。生理盐水 RFA 过程中产生的总焦耳热最高，50%葡萄糖最低。
连续生理盐水输注的 RFA 可实现大的消融区域，并通过获得足够的消融边界帮助抑制局部复发。连续生理盐水输注的 RFA 可扩大消融边界，有助于预防局部复发。
