植入式微波水冷电极消融活体犬肺

摘要

目的 探讨植入式微波水冷电极不同时间、功率组合消融犬活体肺组织的范围和特点.方法 应用植入式微波水冷电极对20只健康成年杂种犬采用不同时间、功率组合进行消融:1组(40W×120 s,n=1),2组(40W×180 s,n=1),3组(40W×240 s,n=1),4组(40 W×300 s,n=2),5组(50W×120 s,n=1),6组(50W×180 s,n=2),7组(50W×240 s,n=2),8组(50W× 300 s,n=2),9组(60 W×120 s,n=2),10组(60 W×180 s,n=2),11组(60 W×240 s,n=2),12组(60W×300 s,n=2).术中分别于消融针旁开1 cm及周边充血带处测温,术后取肺组织肉眼观察消融灶形态、特点,测量并比较各组消融灶长、宽径,消融灶组织送病理检查.结果 消融4组中1只犬因麻醉意外于术前死亡；19只犬完成实验,共247个消融灶,肉眼观呈椭球形,自中心至外周分别为中心碳化区、凝固区及周边充血带.11组[长径(3.38±0.39)cm、宽径(1.70±0.23)cm]与12组[长径(3.33±0.27)cm、宽径(1.63±0.35)cm]消融灶最大,且大于非水冷式微波电极在相同功率更短时间内(60W×600 s)获得的消融灶[长径(1.54±0.19)cm、宽径(1.13±0.14)cm],差异有统计学意义(P=0.016).12组针道周边肉眼可见炭化区.各组消融针旁开1 cm处温度均达70℃以上,周围充血带温度均在50～60℃,带宽0.6～1.0 cm.结论 植入式微波水冷电极消融犬活体肺组织的最佳组合条件为60 W×240 s,其消融范围大,无中心炭化区,较非水冷式微波电极消融具有更大优势.%To investigate the area and advantages of water-cooled microwave ablation with different power and time. Methods Water-cooled microwave ablation was performed on 20 canines with different power and times Group 1 (40 W×120 s, n=l), group 2 (40 W×180 s, n=l), group 3 (40 W×240 s, n=l), group 4 (40 WX300 s, n=2), group 5 (50 W×120 s, n=l), group 6 (50 W×180 s, n=2), group 7 (50 W×240 s, n=2), group 8 (50 W×300 s, n = 2), group 9 (60 WX120s, n=2), group 10 (60 WX180s, n=2), group 11 (60WX240 s, n=2), group 12 (60 WX 300 s. n~2). Temperatures were measured in both 1 cm to the electrode and the red zone in the operation. The shape and features of ablation foci were observed, and the size was measured and compared. Pathological examination was made as well. Results One canine died before ablation because of anesthesia, and 19 canines completed experiment. Totally there were 247 ablation foci with ellipsoid shape. Carbonization area, coagulation area and congestion area were seen from the center to the border of the ablation foci. Thediameter and width of ablation foci in group 11 ([3. 38±0.39]cm, [l.70± 0. 23]cm) and group 12 ([3. 33±0. 27]cm, [1. 63±0. 35]cm) were the largest, which were larger than 60 WX600 s (diameter [1. 54±0. 19)cm, width [1. 13±0.14]cm) induced with non-water cooled microwave ablation (P —0.016). Carbonization could be seen around the electrode in group 12. The temperatures measured in point 1 cm to the electrode were 50—60℃, and the range of peripheral reactive band was 0. 6—1. 0 cm in every group. Conclusion Combination of 60 WX 240 s in water-cooled microwave ablation can get large ablation area, and no carbonization in the center, therefore having more advantages than non-water-cooled microwave ablation.