入肝血流阻断下射频消融后毁损灶周围肝组织的病理变化

目的:评估血流阻断射频术后毁损灶周围正常肝脏组织的病理变化。方法:兔VX2肝肿瘤接种成功后分为单独射频组与射频联合入肝血流阻断组(联合射频组)。射频采用冷循环射频消融治疗(参数设定为30 W,8 min),入肝血流阻断采用Pringle法。1周后处死动物,通过HE染色观察术后毁损灶周围肝脏组织的病理变化。结果:与单独射频组比较,联合射频组毁损灶周边正常肝组织内中央静脉及Glisson鞘周围可见大量炎症细胞聚集,且肝细胞肿胀,门静脉、中央静脉扩张、胆管上皮增生等病理变化均更明显(均P<0.05)。结论:血流阻断后射频对毁损灶周围正常肝组织的病理损害较单独射频的损害严重。

Pathological changes in liver surrounding ablation zone after radiofrequency ablation combined with hepatic inflow vascular occlusion

Objective: To evaluate the pathological changes of normal liver tissues surrounding the ablation zone after radiofrequency ablation(RFA) combined with hepatic blood inflow occlusion. Methods: VX2 liver tumor transplantation models were established in rabbits,and then they were assigned to undergo RFA alone(RFA group) or RFA plus hepatic blood inflow occlusion(RFA + hepatic occlusion group).RFA was performed using a cool-tip radiofrequency electrode(radiofrequency parameters setting: 30 W,8 min),and hepatic blood inflow occlusion was done with the Pringle maneuver.The animals were sacrificed one week later and the pathological changes in liver tissues around the ablation zone were examined by using H&E staining. Results: Compared with RFA group,the surrounding liver tissues in RFA + hepatic occlusion group showed a larger number of inflammatory cells accumulating in the areas around central veins and Glisson’s sheaths,and other pathological changes such as liver cell swelling,expansion of portal vein and central vein,proliferation of bile duct epithelial cells were all more evident in RFA + hepatic occlusion group(all P<0.05). Conclusion: RFA plus hepatic blood inflow occlusion exerts more severe pathological damage in the liver tissues surrounding the ablation zone than RFA alone.