摘要
目的 观察射频消融（radiofrequency ablation，RFA）犬肝内大胆管旁的病理学改变。方法 健康成年杂种犬20只，随机分4组。RFA射频针统一张开20mm，射频治疗时，能量由小到大序贯使用，开始能量为5W，以后每1min升高5W，最高可达95W的情况下，距肝内大胆管旁不同距离（1．0～2．9mm、3．0～4．9mm、5．0～7．9mm、8．0～10．0mm）行RFA，术后观察相关胆管的病理学改变。结果 在肝内大胆管旁行RFA，当距离为1．0～2．9mm时，整个胆管壁全层均坏死或部分全层坏死；距离为3．0～4．9mm时，部分胆管壁全层坏死和胆管上皮细胞空泡样改变；当距离为5．0～10．0mm时，胆管上皮细胞胆管空泡样改变或正常。结论 RFA位于肝内大胆管旁时，距离≥5．0mm时胆管上皮细胞改变损伤是轻微的、可逆的，而距离〈5．0mm时胆管损伤是较严重的、不可逆的。
Objective To observe the pathologic changes of biliary tract injury nearby major intrahepatic ducts in dogs after radiofrequency ablation （RFA）. Methods Twenty healthy adult hybrid dogs were randomly divided into four groups and treated with RFA that was performed at different distances （1.0=2.9 mm, 3.0=4.9 mm, 5.0=0.79 mm and 8.0=10.0 mm） from nearby major intrahepatic ducts, with 2 cm of needles opening and gradual increase of the power of RFA machine from 5 watt to 95 watt （5 watt increase per minute）. After that, the pathologic changes were observed. Results During the course of RFA treating nearby major intrahepatic ducts, there was seen necrosis of full-thickness or partial bile duct wall was seen at distance of 1.0=2.9 mm, full-thickness necrosis of partial bile duct wall and vacuolus change of biliary duct epithelium at distance of 3.0=4.9 mm and vacuolus change or normal of biliary duct epithelium at distance of 5.0=10.0 mm. Conclusions RFA treating nearby major intrahepatic ducts at distance over 5.0 mm may cause slight and reversible changes of biliary duct epithelium but that at distance less than 5.0 mm can result in serious and irreversible injury of the biliary duct wall.
出处
《消化外科》
CSCD
2006年第3期223-226,共4页
Journal of Digestive Surgery
关键词
胆管损伤
射频消融
Biliary duct injury
Radiofrequency ablation
