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背景:热疗在食管癌综合治疗中取得了明显的疗效,放置食管金属支架后的食管癌患者,能否进行深部热疗尚不清楚。目的:实验拟观察射频深部热疗中金属支架对猪食管黏膜的损伤程度。设计、时间及地点:观察性实验,于2004-10/2005-01在泸州医学院附属医院肿瘤科完成。材料:取普通肉猪13只,体质量35～40kg。记忆合金带膜食管支架,由常州市智业医疗仪器研究所提供。方法:采用SR-1000射频深部热疗机对放置金属支架的13只猪食管进行体外加热。在金属支架上缘上4cm、支架中心处、支架下缘处、支架下缘下2cm处和支架下缘下4cm处的食管黏膜处分别设置5个观察点。频率40.82MHz,极板25cm×25cm,功率500～700W;加热30min。主要观察指标:肉眼观察5个观察点食管黏膜的损伤情况,并取5个观察点处的食管黏膜作病理学检查。结果:纳入普通肉猪13只,实验过程1只猪死于麻醉,4只猪的测温线出现故障。8只猪进入结果分析。①8只猪40个观察点处的食管黏膜肉眼损伤程度为0～1级,经统计学等级资料的秩和检验H=2.734,各观察点损伤程度相比,差异无显著性意义(P=0.255)。②显微镜下显示食管粘膜损伤程度为0～2级,经统计学等级资料的秩和检验H=2.734,各观察点损伤程度相比,差异无显著性意义(P=0.255)。结论:在射频深部热疗中,食管金属支架置入本身不引起明显的食管黏膜机械性损伤,亦不加重食管黏膜的热损伤,金属内支架置入后行射频深部热疗在近期是安全可行的。
BACKGROUND: Hyperthermia has obtained obvious curative effect in the comprehensive treatment of esophageal cancer. It is not clear whether esophageal cancer patients after esophageal metal stent placement can conduct deep hyperthermia. OBJECTIVE: To observe the degree of damage to pig esophageal mucosa caused by metal stent in radiofrequency deep hyperthermia. DESIGN, TIME AND SETTING: Observational experiments were performed at Department of Oncology, Affiliated Hospital of Luzhou Medical College from October 2004 to January 2005. Material: Take 13 ordinary pigs, body weight 35 ~ 40kg. Memory alloy membrane esophageal stent, provided by the Institute of Changzhou City Institute of Medical Devices. Methods: Thirteen swine esophageal tubes with metal stents were heated in vitro by SR-1000 deep-sea radiotherapy machine. Five observation points were set on the upper edge of the metal stent 4 cm, at the center of the stent, at the lower edge of the stent, at 2 cm under the lower edge of the stent and at 4 cm below the lower edge of the stent. Frequency 40.82MHz, 25cm × 25cm plate, power 500 ~ 700W; heating 30min. MAIN OUTCOME MEASURES: The damage of esophageal mucosa in 5 observation points was visually observed, and esophageal mucosa at 5 observation points were taken for pathological examination. Results: Thirteen ordinary pigs were included. One pig died of anesthesia during the experiment and the temperature of four pigs failed. Eight pigs entered the result analysis. ① The gross lesions of esophageal mucosa in 40 observation points of 8 pigs were in the range of 0 to 1, and there was no significant difference in the damage degree between the observation points by rank sum test (H = 2.734) of statistical grade data (P = 0.255 ). ② The degree of esophageal mucosal damage was 0 ~ 2 under the microscope. There was no significant difference (P = 0.255) in the degree of injury between the observation points by the rank sum test of statistical grade data H = 2.734. Conclusion: In radiofrequency deep hyperthermia, esophageal metal stent implantation itself does not cause obvious mechanical damage of esophageal mucosa, and does not aggravate esophageal mucosal thermal injury. It is safe and feasible in the near future to perform radiofrequency deep hyperthermia after metal stent implantation of.