改良穿刺活检技术用于降低VX2肌肉肿瘤穿刺并发症的研究

摘要

Objective To investigate the effect of improved biopsy technique in reducing the risk of puncture hole hemorrhage and surrounding tumor cell metastasis induced by VX2 tumour puncture. Methods The VX2 tumor was implanted in thigh vastus lateralis of 22 rabbits to build VX2 tumor models. Twenty cases of adult rabbits with tumor on left leg were assigned into left group,and the puncture holes were implanted with bolt closure through casing after needle biopsy. The rabbits with tumor on right leg were assigned into right group,and were managed with traditional biopsy technique without closure of puncture holes. Ultrasonography was used to assess the bleeding of the puncture hole and adjacent area 1 hour after puncture;7 days after puncture,20 rabbits were killed,and the soft tissues outside tumor where the puncture needle was placed were obtained to conduct pathological examination. Results One hour later,the left group was lower than the right group in bleeding incidence〔(40% ,8 / 20)vs. (85% ,17 / 20);χ2 = 8. 64,P ﹤ 0. 005〕. The hematoma volume of the left group was lower than that of right group〔0(32) mm3 vs. 300(162) mm3;Z = 161,P ﹤ 0. 05〕. Seven days after puncture,the left group was lower than the right group in tumor cell metastasis rate at puncture needle passage〔(20% ,4 / 20) vs. (70% ,14 / 20);χ2 =10. 10,P ﹤ 0. 05〕. Conclusion Improved needle biopsy technology could lessen the incidence of bleeding at puncture hole, reduce the hematoma volume around puncture hole and reduce the risk for tumor cell metastasis in the adjacent soft tissues.%目的：探讨改良穿刺活检技术改善兔 VX2肌肉肿瘤穿刺孔出血及其周围肿瘤细胞转移的发生风险。方法将 VX2肿瘤组织包埋种植于22只家兔双侧股外侧肌内制作成 VX2肌肉肿瘤模型。其中20只左腿肿瘤设为左侧组，采用改良穿刺活检技术，穿刺后通过套管植入密封栓封堵穿刺孔；右腿肿瘤设为右侧组，采用传统穿刺活检技术，对穿刺孔不封堵。穿刺1 h 后对左侧组及右侧组穿刺孔及周围行彩色超声检查，评定两组家兔穿刺孔出血情况；穿刺7 d 后，处死20只家兔，取其肿瘤外穿刺针道软组织行病理学检查。结果穿刺1 h 后，左侧组肿瘤穿刺孔出血率（40％，8/20）低于右侧组（85％，17/20），差异有统计学意义（χ2＝8.64，P ﹤0.005）。左侧组穿刺孔血肿体积为0（32）mm3，小于右侧组的300（162）mm3，差异有统计学意义（Z ＝161，P ﹤0.05）。穿刺7 d 后，左侧组穿刺针道肿瘤细胞转移率（20％，4/20）低于右侧组（70％，14/20），差异有统计学意义（χ2＝10.10，P ﹤0.05）。结论改良穿刺活检技术可降低家兔穿刺孔出血发生率，使穿刺孔周围血肿体积缩小，降低周围软组织肿瘤细胞转移的发生风险。