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研究应用微波经纤维胆道镜治疗肝内胆管狭窄。方法 :模拟在人肝内胆管进行胆道镜检查条件下 ,取新鲜猪肝和人肝进行微波凝灼肝内胆管的实验 ,并在临床上应用国产IV -B型微波治疗仪 ,采用功率80mA ,时间 5～ 8s/次 ,将 1.7mm直径的同轴天线 ,经纤维胆道镜活检口插入至肝内胆管狭窄口进行凝灼治疗。结果 :微波能对浸泡在 0 .9%生理盐水注射液中的猪肝内胆管进行凝灼治疗 ,使被凝灼的胆管上皮、肌层的细胞、其邻近的肝小叶血管和小叶间纤维结缔组织发生不同程度的凝固性坏死 ,在其周围的肝细胞无凝固性坏死。证明微波能凝灼肝内胆管狭窄 ,对肝功能损害较少。临床应用使 2 8例 35处的肝内Ⅰ～Ⅲ级胆管狭窄得以解除并取净这些胆管内的结石 ,无胆道出血等并发症。结论 :本研究充分发挥了微波技术和纤维胆道镜技术的优势 ,是一个安全、确切有效、设备简单、操作容易、治疗时间短的治疗肝内胆管狭窄的新方法。
Research application of microwave choledochoscopy in the treatment of intrahepatic bile duct stricture. Methods: To simulate the intrahepatic bile duct coagulation of fresh pig liver and human liver under the conditions of choledochoscopy of human intrahepatic bile duct, and to apply domestic IV-B microwave therapeutic apparatus in clinic. The power of 80mA, Time 5 ~ 8s / time, 1.7mm diameter coaxial antenna, the fiber choledochoscope biopsy port inserted into the intrahepatic bile duct stenosis for coagulation treatment. RESULTS: Microwave treatment of the intrahepatic biliary ducts immersed in 0.9% saline injection resulted in the formation of connective tissue in the biliary epithelium, myometrial cells, adjacent hepatic lobules, and interlobular fibrosis Tissue necrosis occurred in varying degrees of coagulation, in the surrounding liver cells without coagulation necrosis. Prove that microwave coagulation of intrahepatic bile duct stricture, less damage to liver function. Clinical application of 28 cases of 35 intrahepatic grade Ⅰ ~ Ⅲ bile duct stenosis can be removed and take these bile duct stones, no bleeding complications such as biliary tract. Conclusion: This study gives full play to the advantages of microwave technique and choledochofiberscopy and is a new method for the treatment of intrahepatic biliary stricture which is safe, accurate and effective, simple in equipment, easy to operate and short in treatment time.