不同循环冷冻消融术对西藏小型猪肝部冷冻消融效果的比较/A comparison of dual-and triple-freeze protocols for liver cryoablation in a Tibet pig
YAO Fei, ZENG Jianying, CHEN Jibing et al.
【摘要】
目的: 以西藏小型猪为模型，比较肝部双循环冷冻一复温与三循环冷冻复温消融效果的差异。
方法: 西藏小型猪9头，开腹后行肝冷冻消融术。每头猪分别实施两循环冷冻复温(10-5 10-5，min)消融和三循环冷冻一复温(5-5-5-5-10-5，min)消融，两组总冷冻时间相同。冷冻过程中分别测量冷冻中心点温度、冷冻形成冰球最大直径。术后7 d取肝组织解剖、测量冷冻引起的表面损伤区最大长径及内部坏死区最大长径，并观察冷冻区域病理变化情况。
结果: 三循环冷冻组形成的冰球表面最大长径大于两循环组；7 d后两冷冻组冷冻后形成表面和深度损伤区大小相近。两循环冷冻组与三循环组冷冻损伤区病理分区相同，但三循环冷冻组引起完全坏死区域更大。
结论: 相同的冷冻时间内，三循环冷冻组对肝脏的冷冻消融效果更好。
【关键词】肝脏；冷冻消融；西藏小型猪
[Abstract]
Objective This study compares a dual-freeze protocol with a triple-freeze protocol for hepatic cryoablation in the Tibetan pig model．Method Cryoablation with a dual(10 5-10-5 min) and triple-freeze(5 5-5-5-10 5 min)protocol for the normal 1ivers of 9 Tibet pigs was performed under exposed operation. Temperature changes of cryoprobes and diameter changes of iceballs were measured during the ablation，and seven days later the pathological changes of cryozones were reviewed and the surface and depth cryolesions were measured．
Results Compared with cryoablation with two freeze-thaw cycles，there was a greater iceball diameter for cryoablation by three freeze-thaw cycles. Also, seven days after cryosurgery，there were similar surface and deep cryolesions in dual-and triple-freeze protocols．Pathologically，the triple freezing protocol was associated with a longer zone of complete necrosis．
Conclusions With the same freezing time(20 lnin)，the triple-freeze protocol may become a more powerfulliver ablation method in cryosurgical application.
[Key words] Liver; Cryoablation; Tibet pig model
不同循环冷冻消融术对西藏小型猪肝部冷冻消融效果的比较.pdf