不同温度无水乙醇消融兔VX2移植性肝癌实验探究.docVIP

不同温度无水乙醇消融兔VX2移植性肝癌实验探究 　 作者：黄金华， 鹿连伟， 顾仰葵， 高飞， 李文全， 陈林 【摘要】 【目的】 探讨不同温度无水乙醇瘤内注射对兔VX2移植性肝癌消融治疗效果。【材料与方法】 32只新西兰大白兔肝内植入瘤块，随机分为25 ℃、50 ℃、60 ℃、70 ℃ 4组，各8只，在CT导向下经皮穿刺向瘤内注入不同温度的无水乙醇各1 mL， CT扫描测定碘油范围，一周后取肿瘤行病理学检查，观察相同剂量不同温度无水乙醇对肿瘤组织所致凝固坏死的范围。【结果】 肿瘤坏死面积随温度增加而扩大，50 ℃组与常温组差异无统计学意义，60 ℃和70 ℃组与常温组差异有统计学意义，60 ℃组和70 ℃组差异有统计学意义（P均＜ 0.0）。【结论】 加热至60 ℃以上的无水乙醇对兔VX2移植性肝癌的消融效果较常温好，是一种不增加无水乙醇用量又能达到扩大消融范围的肝癌局部消融方法。 【关键词】 肿瘤模型； VX2肿瘤； 乙醇； 实验研究 Abstract:【Objective】 To discuss the therapeutic efficacies of percutaneous injection using absolute ethanol of different temperatures in rabbits bearing hepatic vx2 tumors. 【Methods】 Thirty-two rabbits with hepatic VX2 tumor were randomly divided into 4 groups (group of 25 ℃, 50 ℃, 60 ℃, and 70 ℃) and there were 8 rabbits in each group. The tumors of each animal were percutaneously injected into 1 mL absolute ethanol of planned temperature guided by CT scan and the size of ablation zone was measured. Tumors were examined by the pathological methods 1 week later to observe the coagulation necrosis size using the same dose but different temperatures. 【Results】 The coagulation necrosis size was increased followed with temperature increase of absolute ethanol in the same dose. There was no statistical significance between 50 ℃ group and normal temperature group, there was statistical significance between normal temperature group and groups of 60 ℃ and 70 ℃, and there was statistical significance between 60 ℃ group and 70 ℃ group. 【Conclusion】 Percutaneous injection using absolute ethanol of over 60 ℃ has more effect than normal temperature and it′s a good local ablation method to treat implantation solid VX2 tumor of rabbits in the liver,which can obviously enlarge the ablation ranges and need not add the absolute ethanol dosage. Key words: neoplasm model; VX2 neoplasm; ethanol; experimental study 自1983年日本学者Sugiura等[1]首先采用无水乙醇化学消融(percutaneous ethanol injection，PEI)方法治疗肝癌以来， PEI已成为肝癌局部重要治疗手段并在全身多处实体肿瘤治疗中得到应用。本研究以兔VX2移植性肝癌为实验对象，采用注射剂量相同但温度不同的无水乙醇瘤内注