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目的 通过动物猪实验研究射频热疗对肝动脉阻断后肝叶以及正常肝叶间的温度差别、正常肝脏耐受高温的阈值、热疗后病理形态学的变化、热疗并发症等。方法 将 70kg猪在静脉麻醉下 ,通过股动脉插管、泛影葡胺示踪发现肝右动脉并用碘油进行阻断 ,模拟肝癌介入治疗相似的条件 ,然后SR 1 0 0 0深部射频热疗机进行全肝加温。加温过程中放置四路热电偶进行动态测温 :通过肝动脉插管置入一根测温线至肝右动脉 ,左右肝分别通过穿刺置入热电偶 ,第四根置入直肠。全过程由电脑自动记录不同测温部位的温度变化。结果 热疗 1h后阻断肝叶即肝右叶的温度由疗前的 39.1℃上升至 49.3℃ ,温度升高 1 0 .2℃ ;而作为对照的左肝温度由疗前的 39.7℃上升至 46 .5℃ ,温度升高 6 .8℃ ;阻断的肝右动脉内温度升高 3 .3℃ ,直肠内温度升高 3 .2℃。疗后饲养动物 1周处死 ,解剖过程中发现肝右叶坏死明显 ,肝左叶形态正常 ,两叶间形态学改变明显 ,并且有明显的界限 ;病理组织学所见与肉眼所见相似。加热局部区域皮肤有浅Ⅱ度烫伤 ,脂肪层有局灶性坏死液化改变。结论 阻断肝叶和正常肝叶在同样的加热条件下温度差别明显 ;动脉阻断的肝叶坏死明显 ,而正常肝叶可以耐受 46 .5℃的高温而不产生明显的病理形态学改变 ;阻断的肝动脉
OBJECTIVE To study the difference of temperature between hepatic and normal liver lobes after hepatic artery radiofrequency ablation, the threshold of normal liver temperature tolerance, the change of pathological morphology after hyperthermia and the complication of hyperthermia by animal experiments. Methods 70 kg pigs were anesthetized by intravenous anesthesia, femoral artery cannulation, diastolic meglumine trace of the right hepatic artery and blockade with lipiodol to simulate the similar conditions of interventional treatment of liver cancer, and then deep radiofrequency catheter ablation Machine for liver warming. During the heating process, four thermocouples are placed for dynamic temperature measurement: one temperature measurement line is placed through the hepatic artery to the right hepatic artery, the left and right liver are respectively inserted into the thermocouple by puncturing, and the fourth is placed into the rectum. The whole process automatically records the temperature changes of different temperature measurement parts by the computer. Results The temperature of the liver lobes, ie, the right lobe of the liver, was increased from 39.1 ° C to 49.3 ° C and the temperature increased by 1.02 ° C after 1 h of hyperthermia, whereas the temperature of the left liver increased from 39.7 ° C 46 .5 ℃, the temperature increased by 6.8 ℃; blocked right hepatic artery temperature increased by 3.3 ℃, rectal temperature increased 3.2 ℃. After treatment, the animals were sacrificed for 1 week. The necrosis of the right lobe of the liver was observed during the anatomy. The morphology of the left lobe of the liver was normal and the morphological changes of the two lobes were obvious. The pathological findings were similar to the macroscopic findings. Heating the local area of shallow Ⅱ degree scalded skin, fatty layer of focal necrosis liquefaction changes. Conclusions The temperature difference between blocking hepatic lobe and normal hepatic lobe under the same heating conditions is obvious. Arterial occlusion of hepatic lobar necrosis is obvious, but the normal liver lobe can tolerate 46.5 ℃ high temperature without obvious pathological changes ; Blocked hepatic artery