比较超声造影与腹腔镜在经皮射频凝固治疗猪闭合性肝外伤中的应用价值

目的比较超声造影和腹腔镜在经皮射频凝固治疗闭合性肝外伤中的应用价值。方法采用自制小型撞击器撞击猪肝区，建立24只猪闭合性肝外伤伴活动性出血模型，随机平均分为超声造影组和腹腔镜组。分别采用超声造影和腹腔镜检查诊断猪肝部被撞击情况，引导经皮射频凝固止血治疗并进行疗效评估。将治疗结果与病理结果进行对照分析。结果24只猪闭合性肝外伤伴活动性出血模型成功建立，超声造影和腹腔镜检查对闭合性肝外伤的诊断符合率均为100％，两组损伤区热凝固治疗射频电极置入准确性均为100％，两组间治疗时间及凝固范围比较差异无统计学意义（P〉0．05）；治疗后超声造影和腹腔镜检查，肝活动性出血均被成功控制。结论超声造影和腹腔镜均可快速、准确诊断闭合性肝外伤，并引导经皮射频凝固治疗及治疗后对疗效的准确评估。

Comparison of contrast-enhanced ultrasound and laparoscope in percutaneous radiofrequency ablation for the treatment of closed hepatic trauma

Objective To compare the application value of contrast - enhanced ultrasound （CEUS） and laparoscope in percutaneous radiofrequency ablation（PRFA） for the treatment of closed hepatic trauma. Methods Blows were applied on twenty four heparinized and anesthetized domestic pigs, which resulted in closed liver trauma. The models were randomly divided into two groups： CEUS group and laparoscope group. Then the injury diagnosis, PRFA hemostasis treatment guidance and the therapeutic effect evaluation after treatment were examined by CEUS and laparoscope, and the results were compared with pathological results. Results Twenty four closed liver trauma models with active bleeding were successfully established in pigs. The accuracy for diagnosing hemorrhage of closed liver trauma was 100% in two groups. There were no significance difference in the treatment times and ablation region between the two groups （ P 〉 0.05）. No bleeding was found in the livers in all treated pigs after the PRFA treatment. Conclusion CEUS and laparoscope can diagnose closed liver trauma quickly and accurately, ans can also guide PRFA treatment, exactly evaluate the therapeutic effect after treatment.