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目的探讨植入式射频毁损活体肝组织的优化工作方式,了解射频毁损肝组织的病理特征.方法应用 RF2000型射频治疗仪及 LeVeen 电极针,术中对5只实验猪肝脏分别进行了30,50,70及90W,递升式单相(50W起始,每分钟升10W～90W)、递升式双相(单相毁损完成30s以70W 继续毁损)几种方式毁损,观察肝毁损灶的范围、形状、温度、术中可能的并发症及 HE.染色和 NADH 肝细胞活力染色即刻评定肝细胞坏死程度.结果射频毁损中央区为均匀一致彻底的球形凝固性坏死,外围为大约2 mm 的出血带,尚存部分活力;以递升式双相毁损产生的毁损灶较大,可达4.0 cm×3.5 cm×3.5 cm,毁损灶中心温度可达132℃.以90W 毁损产生的坏死灶较小约1.5 cm×1.5 cm×1.0cm;以30W 毁损阻抗始终不上升,但中心温度仍达60℃,产生的毁损灶约0.7 cm×0.5 cm×0.5 cm.术中可见自限性腹腔出血、膈肌或胃灼伤.结论植入式射频以递升式双相毁损方式可有效、理想地毁损肝组织,值得推广应用.
Objective To investigate the optimized working methods of implanted RF destruction of living liver tissue and to understand the pathological features of RF damaged liver tissue. Methods RF2000 radiofrequency therapeutic apparatus and LeVeen electrode needles were used. The livers of 5 experimental pigs were performed during operation. 30, 50 , 70 and 90W, step-up single phase (50W starting, 10W to 90W per minute), step-up biphasic (single phase damage is completed for 30s to continue damage in 70W) several ways to damage, observe the scope, shape of liver lesions The temperature, intraoperative complications, and HE staining and NADH hepatocyte viability staining were used to assess the degree of hepatocyte necrosis. The results showed that the central area of radiofrequency lesions was uniform and complete spherical coagulative necrosis, and the periphery was about 2 mm of hemorrhage. Some of the surviving dynamism; the lesions produced by progressive biphasic lesions are larger, up to 4.0 cm x 3.5 cm x 3.5 cm, and the lesion center temperature can reach 132 °C. The necrosis lesions caused by 90 W lesions are smaller by about 1.5 cm. ×1.5 cm ×1.0cm; Impairment impedance at 30W does not always rise, but the center temperature still reaches 60°C. The resulting lesion is about 0.7 cm×0.5 cm×0.5 cm. Self-limited intraperitoneal hemorrhage, diaphragm or stomach burn can be seen during the operation. Conclusion The implanted RF is step-up Effective manner with damage, liver damage ideally, should be widely applied.