内镜超声引导下胰腺射频消融治疗最佳功率的实验研究

目的探索内镜超声引导下猪胰腺射频消融治疗的最佳功率。方法6只健康活体猪按随机数字表法随机分为2组，分别采用内镜超声引导下经胃壁穿刺（超声内镜组）和开腹直视（开腹直视组）的方式对胰腺进行射频消融，各组预设功率分别为5w、10w和15w，监测射频消融过程中阻抗变化情况，射频消融结束时记录消融时间，采用超声内镜和肉眼直视测量胰腺凝固性坏死灶宽径，并对胰腺组织行病理观察。结果6只猪均顺利完成射频消融，术中猪生命体征平稳，无并发症征象。病理均显示胰腺凝固性坏死灶形成，相同射频消融功率下超声内镜组和开腹直视组胰腺凝固性坏死灶宽径肉眼测量值接近，均在10w功率下最大，分别为11．0mm和10．0mm。结论内镜超声引导下猪胰腺射频消融的最佳功率为10w，在此基础上可进一步探索临床胰腺射频消融的最佳功率。

The optimal power of experimental endoscopic ultrasonography-guided pancreas radiofrequency ab-lation therapy

Objective To explore the optimal power of experimental pancreatic endoscopic ultra- sonography （EUS）-guided radiofrequency ablation （RFA） therapy. Methods Six healthy live minipigs were randomly divided into two groups according to random number table, which received RFA under EUS or in ]aparotomy. Each pig in each group was randomly allocated to received RFA at different power （5 W, 10 W, 15 W）. The impedance was monitored and the time for each therapy was recorded. The width diame- ter of coagulation necrosis from RFA was measured by EUS and gross pathology. Results RFA was comple- ted in all pigs smoothly with stable life signs and without complications. Gross and micro pathologic observa- tion confirmed formation of coagulation necrosis lesions. The width diameter of lesions from EUS-RFA was similar to that from surgery RFA, both having a maximum value at 10 W power （11 mm VS 10 ram）. Conclusion The optimal power of experimental pancreatic EUS-RFA in pig is 10W, which should be further explored for the clinical purpose.