体外肝组织微波消融范围的研究

目的 研究微波消融治疗在离体人肝组织的消融灶形态及范围.方法 通过在不同初始功率、作用时间下对离体人肝组织进行单针微波消融,超声及大体解剖观察消融灶的形态及范围,镜下观察消融灶病理学变化.结果 相同初始功率组消融灶随作用时间延长而增大；在相同作用时间下初始功率70 W组消融灶大于初始功率50 W组,其差异均有统计学意义（P＜0.05）.超声显示消融灶范围较大体解剖测量范围大,两者比较差异具有统计学意义（P＜0.05）.病理检查见消融灶中心凝固区肝组织均凝固坏死,距凝固区边缘0.5 cm处有1例可见残存水肿肝细胞、1 cm处有17例可见残存肝细胞组织.结论 微波消融灶呈椭圆形,其范围随初始功率及作用时间增加而扩大,超声测量比大体解剖消融范围大,消融灶与周围组织间有移行带.

Experimental study on microwave ablation of liver tissue in vitro

Objective To investigate the abaltion zone of liver tissue by microwave ablation in vitro. Methods The mirowave ablation to liver tissue were monitored by ultrasound. The experiments by single electrode needle were performed with different combination of output power and time. After end of trial, the longitudinal specimens were cut open. The view and size of ablation zone were recorded with naked eyes. The pathological changes displayed by optical microsope were recorded as well. Results Under the same initial output power the ablation lesions expanded with time （P 〈 0.05） ;the ablation lesions in 70 W-power was bigger than that in 50 W-power with the same time（P 〈 0. 05 ）. Ultrasonic measurement of the ablation zone was bigger than the real one （ P 〈 0. 05 ）. Under optical microsope, the center of ablation zone liver tissue manifested topical coagulative necrosis. With the distance 0. 5 cm from solidification zone edge only one specimen remained liver cells,and there were 17 cases at the distance of 1 cm. Conclusions Microwave ablation zones in the liver tissue are significantly expanded with increase of energy power and prolongation of ablation time. The size is bigger in ultrasound scanning than that of the pathomorphology. There is transitional zone between the ablative lesion and the adjacent tissue.