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目的应用高强度聚焦超声(high intensity focused ultrasound,HIFU)辐照正常猪胰腺,观察辐照后生化指标及胰腺组织的病理变化,评价其有效性和安全性,探讨HIFU治疗胰腺疾病的理论依据。方法 6只杂种猪随机等分为2组。常规麻醉后,应用FEP-BY02型HIFU治疗机辐照正常猪胰腺。A、B两组动物分别于术后当天和第5天杀死取胰腺行病理学检查。B组动物术后监测血、尿淀粉酶等指标。结果所有动物的HIFU治疗过程顺利,治疗中生命体征平稳,耐受性良好,未发生皮肤烧伤。剖腹探查均未发现胃肠脏器损伤及胰腺炎等。B组治疗后恢复良好,全部存活至5天,辐照后血、尿淀粉酶等最初几天升高后降为正常。病理学检查A、B两组所有标本在HI-FU辐照区均发现凝固性坏死灶,与周围组织分界清楚。B组见细胞坏死更彻底,交界处见炎性细胞浸润及纤维结缔组织增生。结论超声引导HIFU消融在体猪胰腺,效果肯定、安全可行。
Objective To apply high intensity focused ultrasound (HIFU) to irradiate normal porcine pancreas, observe the post-irradiation biochemical indicators and the pathological changes of pancreatic tissue, evaluate its efficacy and safety, and discuss the theoretical basis for HIFU treatment of pancreatic diseases. Methods Six hybrid pigs were randomly divided into two groups. After normal anesthesia, normal pig pancreas was irradiated with a FEP-BY02 HIFU treatment machine. Animals of group A and B were killed on the day of surgery and on day 5, respectively. The pathological examination of pancreas was performed. Group B animals were monitored for postoperative blood and urine amylase and other indicators. Results The HIFU treatment of all animals was successful, with stable vital signs during treatment, good tolerability, and no skin burns. Laparotomy did not find gastrointestinal organ injury and pancreatitis. After treatment, group B recovered well and all survived until 5 days. After irradiation, blood and urine amylase increased to normal after the first few days. Pathological examination All the specimens of group A and B were found to have coagulation necrosis in the HI-FU irradiation area, with clear boundary with the surrounding tissue. In group B, cell necrosis was more complete, and inflammatory cell infiltration and fibrous connective tissue hyperplasia were seen at the junction. Conclusion Ultrasound-guided HIFU ablation in pancreas is effective, safe and feasible.