冷循环式多极与集束单极射频经皮凝固治疗闭合性肝外伤的实验研究

目的对比研究冷循环式多极与集束单极射频凝固治疗猪闭合性肝外伤的技术特点。方法采用自制小型撞击器撞击16只健康家猪肝区,建立闭合性肝外伤伴活动性出血模型,随机平均分为两组。在超声造影引导下,一组采用冷循环式多极射频经皮凝固治疗肝活动性出血,另一组采用集束单极射频治疗。治疗1h后,剖杀动物病理对照两组凝固止血效果。结果16只动物模型肝损伤级别为Ⅰ～Ⅳ级,两组肝活动性出血均被成功控制。两组平均治疗时间比较差异无显著（P〉0.05）;两组凝固灶形态不同,冷循环式多极射频治疗组平均凝固灶横径大于集束单极射频凝固治疗组,两组间比较差异有显著性（P〈0.05）;冷循环式多极射频治疗组针杆温度较低、集束单极射频凝固治疗组穿刺操作时间短,两组间比较差异有显著性（P〈0.05）。结论冷循环式多极和集束单极射频均能在超声造影引导下有效控制Ⅰ～Ⅳ级实验猪闭合性肝外伤的活动性出血,但凝固治疗中各具不同的特点。

Controlling Hemorrhage of Closed Hepatic Trauma in Pigs:Comparative Study between Multipolar Radiofrequency with Internally Cooled Electrodes and Clustered Electrode Radiofrequency

Objective To compare the technical characteristics of multipolar radiofrequency（RF）with internally cooled electrodes and clustered electrode RF in controlling hemorrhage of closed hepatic trauma in pigs.Methods Animal models with closed hepatic trauma with active bleeding were created by self-made impactors on hepatic areas of 16 healthy domestic pigs.Animals were randomly divided into two equal groups.Multipolar RF with internally cooled electrodes and clustered electrode RF were performed to control the hemorrhage of the injured livers.One hour after treatment,results were compared.Results The injury grades were from Ⅰ to Ⅳ.Hemorrhages were successfully controlled in all cases.No significant differences of the treatment time（P〉0.05）and significant differences of the transverse diameters（P〈0.05）were observed between the two groups.During the treatment,electrode＇s temperatures and carbonization scale in clustered electrode RF group were higher than those in multipolar RF group（P〈0.05）.Microscopy revealed obvious histological difference of lesions between the two groups.Conclusion Both multipolar RF with internally cooled electrodes and clustered electrode RF were effective in controlling hemorrhages of closed hepatic trauma.But they had different characteristics in treatment.