不可逆电穿孔与冷冻治疗消融猪肝脏组织对比分析

目的对比分析不可逆电穿孔(IRE)及冷冻治疗对猪肝实质的消融效果。方法将4只实验用小型猪,随机分为2组,每组2只。第1组先于CT引导下采用IRE及冷冻治疗分别进行肝脏消融,消融后常规饲养;30天后以同法消融第2组小型猪,术中及术后对小型猪行螺旋CT平扫及增强扫描,扫描完成后处死两组实验动物并取出肝脏,采用10%甲醛溶液固定,将标本整体切片行病理学检查。结果术中CT平扫显示冷冻消融区域边界清晰,IRE消融边界不清;术后增强CT扫描显示IRE及冷冻消融区域术后即刻均未见强化。大体标本:IRE消融区域边界清晰,血管、胆管结构良好;冷冻消融区域边界模糊,局部可见出血。结论 IRE及冷冻治疗对猪肝组织消融效果良好,而IRE对肝内血管、胆管具有保护作用,可用于肝门、大血管区域的消融。

Comparison of irreversible electroporation with cryotherapyablation in porcine liver tissue

Objective To compare the effect of irreversible electroporation (IRE) and cryotherapy ablation on porcine liver. Methods A total of 4 experimental miniature pigs were randomly divided into two groups (each n=2). In first group, the cryotherapy ablation and IRE under CT guidance were performed, and then the pigs were breed conventionally. After 30 days, the same way were performed in second group. All pigs underwent spiral CT plain scan and enhanced scan, and then 4 pigs were sacrifice to remove the liver and fix with 10% formaldehyde solution for pathological examination. Results Intraoperative CT plain scan showed, the boundary of ablation zone was clear in cryotherapy, however it was fuzzy in IRE. and the enhancement zone were not observed on enhanced CT image both of them. The liver specimens showed, the boundary of ablation zone was clear in IRE, with intact vessel and biliary duct, however it was fuzzy and with partly bleeding in cryotherapy. Conclusion The ablation effects of IRE and cryosurgical ablation on porcine are good, while IRE show a protective effect of vessel and biliary duct, can be used for the ablation zone near porta hepatis and trunk vessel.