新型胆道射频消融导管在离体猪肝应用的实验研究∗

摘要

Objective To estimate the effects of a novel radiofrequency ( RF) ablation catheter, the HabibTM EndoHPB, with various settings of powers and times. Methods We used resected fresh pig livers to examine at 37�0℃. The RF application was per-formed step by step at 5, 10, and 15 W power and 60, 90, 120,150s, respectively. The change of temperature, macroscopic( the lengths of the short and long axes) and microscopic findings of the ablation area were evaluated at each setting. Results The highest temperature of the ablation area at 5W power and 60, 90, 120 and 150s were 42�0℃ to 54�0℃, at 10W power and 60, 90, 120 and 150s were 52�0℃ to 70�0℃, and at 15W power and 60, 90 and 120s were 62�0℃ to 77�0℃. The lengths of the short axis of the ab-lation area at 10W power and 60, 90, 120 and 150s were (8�5±0�8)mm, (9�0±0�8)mm, (9�5±0�8)mm and (10�0±0�8)mm, re-spectively. The lengths of the long axis at 10W power and 60, 90,120 and 150s were (21�0±1�0)mm, (23�5±1�0)mm, (25�5± 1�0)mm and (30�0±1�0)mm, respectively. Although the lengths of the short and long axes at 5, 10 and 15W increased gradually with power, there were no obvious differences in either short or long axis lengths between 10 and 15W power( P<0�05) . Microscopic examination of the ablationareashowed liver tissue dissociationed, cell spacing increased and extensive cellular degenerationed. The de-gree increased as power/time increased. And liquefactive necrosis sheet was appeared at 10W power and 120s or 15W power and 150s. Conclusion Although the clinical ablation setting at 10W power and 90 to 120s is suitable, ultimately the ablation power and time should be adjusted according to our experimental result.%目的：观察新型胆道双极射频消融导管HabibTM EndoHPB设置不同功率及持续时间的消融效果。方法在恒温下（37�0℃）使用新型胆道射频消融导管对新鲜离体猪肝进行实验，分别设置功率5、10和15W，时间60、90、120和150s。观察在不同功率/时间参数时，消融区域的温度、宏观（短轴/长轴）及微观的变化。结果设置功率5W、时间60～150s，消融区域的最高温度为42�0～54�0℃；10W、60～150s，最高温度为52�0～70�0℃；15W、60～120s，最高温度为62�0～77�0℃。10W和60、90、120及150s时，短轴长度（mm）分别为8�5±0�8、9�0±0�8、9�5±0�8及10�0±0�8；长轴长度（mm）分别为21�0±1�0、23�5±1�0、25�5±1�0及30�0±1�0。5、10、15W时，短轴和长轴长度均有小幅增大，其中功率为10W及15W时，两组差异无统计学意义（ P＞0�05）。镜下消融区域均出现肝组织解离、细胞间距变大、细胞广泛变性，程度随着功率和时间增加而加重，且在10W、150s及15W、120s时，出现片状液化性坏死。结论 HabibTM EndoHPB导管设置功率10W、时间90至120s进行消融比较合适，在临床实际操作中可参考本实验结果进行适当的调整。