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山羊外侧静脉闭塞中微波消融与激光消融的比较

Microwave ablation versus laser ablation in occluding lateral veins in goats.

作者信息

Wang Xu-Hong, Wang Xiao-Ping, Su Wen-Juan, Yuan Yuan

机构信息

Department of Surgery II, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China.

出版信息

J Huazhong Univ Sci Technolog Med Sci. 2016 Feb;36(1):106-110. doi: 10.1007/s11596-016-1550-6. Epub 2016 Feb 3.

Abstract

Increasing number of endovenous techniques are available for the treatment of saphenous vein reflux and endovenous laser ablation (EVLA) is a frequently used method. A newly developed alternative, based on thermal therapy, is endovenous microwave ablation (EMA). This study evaluated the effect of the two procedures, in terms of coagulation and histological changes, in occluding lateral veins in goats. Twelve animals were randomized into two group, with 6 treated with EMA (EMA group), and the rest 6 with EVLA (EVLA group). Results of coagulation, including coagulation, fibrinolysis and platelet activation, were assessed at three or four different time points: before, immediately after, 24 h (and 48 h) after ablation. The diameter change, a measure of efficacy, was ultrasonographically measured before and 1 month after the ablation. Histological changes were grossly and microscopically evaluated immediately, 1 and 3 month(s) after the ablation. The length of the ablated vein and preoperative average diameter were comparable between the two groups. In both EMA and EVLA groups, several coagulation parameters, fibrinolysis and platelet activation parameters only underwent slight changes. Ultrasound imaging displayed that the diameter reduction of the veins treated by EMA was significantly larger than by EVLA, in consistent with the results of macroscopic examination. Microscopic examination revealed necrosis and thickening of the vein wall, and occlusion of the lumen within 3 months after ablation in both EMA and EVLA groups. It is concluded that EMA is a minimally invasive therapy, which appears to be safe and effective for treatment of lateral veins in goats.

摘要

越来越多的静脉内技术可用于治疗大隐静脉反流,而静脉内激光消融术(EVLA)是一种常用的方法。一种基于热疗法新开发的替代方法是静脉内微波消融术(EMA)。本研究从凝血和组织学变化方面评估了这两种手术方法对山羊外侧静脉闭塞的效果。将12只动物随机分为两组,6只接受EMA治疗(EMA组),其余6只接受EVLA治疗(EVLA组)。在三个或四个不同时间点评估凝血结果,包括凝血、纤维蛋白溶解和血小板活化:消融前、消融后即刻、消融后24小时(和48小时)。在消融前和消融后1个月超声测量直径变化,作为疗效的指标。在消融后即刻、1个月和3个月对组织学变化进行大体和显微镜评估。两组之间消融静脉的长度和术前平均直径相当。在EMA组和EVLA组中,几个凝血参数、纤维蛋白溶解和血小板活化参数仅发生轻微变化。超声成像显示,EMA治疗的静脉直径减小明显大于EVLA治疗的静脉,这与大体检查结果一致。显微镜检查显示,EMA组和EVLA组在消融后3个月内均出现静脉壁坏死和增厚以及管腔闭塞。结论是,EMA是一种微创治疗方法,似乎对山羊外侧静脉的治疗安全有效。

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