摘要
目的:对比研究超声引导下两种肝癌模型建立的效果。方法:选取40只清洁级新西兰白兔作为实验动物,采用随机数字表法将新西兰白兔分为观察组和对照组,每组20只。观察组采用戊巴比妥钠与速眠新复合麻醉,在超声引导下行穿刺道封堵改良建模术。对照组采用戊巴比妥钠麻醉,行单纯超声引导下经皮穿刺植瘤术。比较两组的手术时间、麻醉诱导时间及术中苏醒率,记录两组肿瘤种植结果,比较两组建模术后超声和DSA血管造影效果。结果:观察组建模术中麻醉诱导时间较对照组显著缩短,术中白兔苏醒率显著低于对照组,差异均有统计学意义(P<0.05)。两组手术时间差异无统计学意义(P>0.05)。观察组白兔术中无死亡,对照组死亡2只,观察组术中白兔死亡率低于对照组,但两组间差异无统计学意义(P>0.05)。观察组17只肝内种植成瘤,2只肝外腹壁浸润,1只未发现瘤体,成瘤率为95%。对照组9只肝内种植成功,5只腹壁浸润,3只腹膜腔种植,1只未发现瘤体,成瘤率为85%,两组成瘤率差异无统计学意义(P>0.05)。两组白兔建模术后60 d存活率差异无统计学意义(P>0.05)。观察组异位种植率显著低于对照组,差异有统计学意义(P<0.05)。两组术后2周、3周及4周时肿瘤病灶直径均显著大于术后1周,差异有统计学意义(P<0.05)。两组白兔肿瘤病灶被首次超声检查发现时均以等回声表现为主,病灶直径约2.5 cm左右时DSA造影多可见“抱球征”。在术后3周时可发现肿瘤坏死病灶,病灶中心无回声,彩色多普勒超声检查提示无血流信号。超声检查结果与病理结果具有良好的一致性(r=0.993,P=0.000)。结论:复合麻醉与穿刺道封堵用于超声引导下肝癌建模术有助于提高手术安全性,降低异位种植率,术后超声可用于动态监测瘤体生长情况。
Objective:To study the effect of two liver cancer models under ultrasound guidance.Methods:40 clean New Zealand white rabbits were selected as the experimental animals,and the New Zealand white rabbits were divided into observation group and control group by random number table method,with 20 rabbits in each group.The observation group received the compound anesthesia of pentobarbital sodium and sumianxin,and the operation of improved modeling by puncture tract closure were performed under ultrasound guidance.The anesthesia with pentobarbital sodium and the percutaneous tumor grafting by using the ultrasound-guidence was performed in the control group.The operation time,anesthesia induction time,and intraoperative recovery rate were compared between the two groups.The results of tumor implantation of the two groups were recorded.The effects of postoperative ultrasound and the angiography of DSA in the two groups were compared.Results:The anesthesia induction time in the operation of establishing the model were significantly shortened compared with the control group,and the recovery rate of white rabbits in the operation was significantly lower than the control group(P<0.05).There was no significant difference in operation time between the two groups(P>0.05).There was no intraoperative death of white rabbits in the observation group and 2 cases in the control group.The intraoperative mortality in the observation group was lower than that in the control group,while there was no significant difference between the two groups(P>0.05).In the observation group,17 cases were implanted into the liver,2 cases were infiltrated into the extrahepatic abdominal wall,1 case was not found tumor body,and the tumor formation rate was 95%.There were 9 cases implanted successfully,5 cases infiltrated by abdominal wall,3 cases implanted in peritoneal cavity,1 case not found tumor body in the control group,the tumor formation rate was 85%.There was no statistical difference in tumor forming rate between the two groups(P>0.05).The difference of 60 days survival rate after modeling operation between the two groups was no significant difference(P>0.05).The rate of ectopic implantation in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).The diameter of tumor focus of the two groups in two weeks,three weeks,and four weeks after operation were significantly larger than that in one week,and the difference was statistically significant(P<0.05).The tumor was found to be mainly isoechoic by the first ultrasound examination in the two groups,and the"ball holding"sign was mostly seen in DSA when the diameter of focus was about 2.5cm.The tumor necrosis could be found at 3 weeks after the operation,with no echo in the center of the lesion,and the color doppler ultrasound examination showed no blood flow signal.The results of the ultrasonic examination were in good agreement with those of pathology(r=0.993,P=0.000).Conclusion:The combined anesthesia and transcatheter closure for ultrasound-guided liver cancer modeling can improve the safety of the operation,reduce the rate of heterotopic planting,and the postoperative ultrasound can be used to dynamically monitor tumor growth.
作者
汪德兵
杨鹏
黄智
许敏
王黎洲
周石
WANG De-bing;YANG Peng;HUANG Zhi(Department of Interventional Radiology,Affiliated Hospital of Guizhou Medical University,Guiyang 50004,China)
出处
《放射学实践》
CSCD
北大核心
2021年第5期658-662,共5页
Radiologic Practice
基金
国家自然科学基金(81960328)。
关键词
肝癌模型
超声检查
兔
成瘤率
复合麻醉
Liver cancer model
Ultrasonography
Rabbit
Tumorigenesis rate
Compound anesthesia
