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目的比较肺部两循环冷冻-复温与三循环冷冻-复温消融术对肺组织冷冻消融效果的差异。方法采用西藏小型猪5头,开胸后行右肺冷冻消融术,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-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7d取肺组织解剖,测量冷冻引起的表面坏死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冰球表面最大长径大于两循环组;7d后两冷冻组局部肺组织冷冻后所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变化分区相同,但三循环冷冻组引起完全坏死区域更大,凋亡区域更小。结论相同的冷冻时间内,三循环冷冻组对肺部冷冻消融效果更好。
Objective To compare the effects of two cycles of lung freezing and rewarming and three cycles of freezing and rewarming on the ablation and ablation of lung tissue. Methods Five Tibetan miniature pigs were used. After thoracotomy, right lung cryoablation was performed. Each pig was subjected to two cycles of cryo-rewarming (10-5-10-5 min) and three cycles of freezing-rewarming -5-5-5-10-5, min) ablation, the two groups of the same total freezing time. During freezing, the freezing point temperature was measured and the maximum diameter of ice puff was formed by freezing. The lung tissue was dissected 7 days after operation to measure the maximum long diameter of the surface necrosis and the maximum long diameter of the internal necrosis caused by freezing, and the pathological changes of the frozen area were observed. Results The maximal diameter of ice hockey in the three-cycle freezing group was larger than that in the two-cycle group. After 7 days, the size of the surface and depth damage zone formed by local freezing in the two frozen groups were similar, and the pathological changes in the two freezing and three- However, the three-cycle freezing group caused more complete necrosis area and smaller apoptotic area. Conclusion In the same freezing time, the three-cycle freezing group had better effect on lung cryoablation.