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目的:比较高频诱导热疗(HiTT)联合不同药物与RF2000TM消融离体猪肝的病理改变。方法:20个离体猪肝随机分为A组:HiTT+生理盐水;B组:HiTT+顺铂(DDP,0.4mg/mL);C组:HiTT+乙酸(30%);D组:RF2000TM射频。消融结束后沿针道纵行切开毁损灶,测量其平行径、垂直径,并计算出毁损灶的体积、类圆率及应用病理大切片技术检验消融灶坏死的彻底性。结果:A组平行径〔(5.5±0.5)cm〕较B〔(4.5±0.8)cm〕、C〔(4.5±0.7)cm〕、D〔(4.6±0.3)cm〕组均大,P<0.05;A组〔(4.3±0.4)cm〕、D组〔(4.0±0.3)cm〕垂直径较B组〔(3.6±0.6)cm〕、C组〔(3.5±0.5)cm〕均大,P<0.05;A组体积〔(52.6±13.5)cm3〕较B组〔(32.1±15.8)cm3〕、C组〔(30.5±11.2)cm3〕、D组〔(38.6±7.4)cm3〕组均大,P<0.05,而D组体积较B、C组也大,P<0.05;D组类圆率(0.86±0.05)较A组(0.78±0.07)、B组(0.80±0.10)、C组(0.79±0.09)更接近1.0,P<0.05。各组标本制成病理大切片后,连续切片观察,均未见消融灶有正常的肝小叶和组织岛存在。结论:四种射频方式均消融彻底,且HiTT联合生理盐水能获得最大的消融灶体积,而RF2000TM产生的形态最接近圆形。
OBJECTIVE: To compare the pathological changes of isolated porcine liver with high-frequency induction hyperthermia (HiTT) and different drugs and RF2000TM. Methods: Twenty liver piglets were randomly divided into group A: HiTT + saline; group B: HiTT + cisplatin (DDP 0.4 mg / mL); group C: HiTT + acetic acid (30%); After the end of ablation, the lesions were cut along the longitudinal axis of the needle and the parallel and vertical diameters of the lesions were measured. The volume of the lesions, the roundness rate and the thoroughness of the necrotic lesions were examined by pathology. Results: The mean diameter of parallel group (5.5 ± 0.5) cm in group A was significantly larger than that in group B (4.5 ± 0.8) cm, C (4.5 ± 0.7) cm and D (4.6 ± 0.3) (4.0 ± 0.3) cm in group D was (3.6 ± 0.6) cm in group D, (3.5 ± 0.5) cm in group A, (P <0.05). The volume of group A (52.6 ± 13.5) cm3 was significantly higher than that of group B (32.1 ± 15.8 cm3), group C (30.5 ± 11.2 cm3), group D (P <0.05), while the volume of group D was larger than that of group B and C (P <0.05). The rounding rate of group D was significantly higher than that of group A (0.78 ± 0.07), group B (0.80 ± 0.10), C Group (0.79 ± 0.09) was closer to 1.0, P <0.05. All the specimens were made into large pathological sections and observed continuously. None of the lesions showed normal hepatic lobules and tissue islands. CONCLUSIONS: All four radiofrequency ablations are completely ablated, and HiTT combined with saline achieves the largest ablation volume, whereas RF2000TM produces the closest circular shape.