射频消融术后胆管损伤的病理学研究.docVIP

射频消融术后胆管损伤的病理学研究 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：射频消融术后胆管损伤的病理学研究 1 1 材料与方法 2 2 结果 4 3 讨论 4 文2：糖尿病性心肌病的病理学研究 5 1 心功能的变化 6 2 临床病理研究报道 7 3 超微结构实验观察 7 4 展望 8 参考文摘引言： 8 原创性声明（模板） 9 文章致谢（模板） 10 正文 射频消融术后胆管损伤的病理学研究 文1：射频消融术后胆管损伤的病理学研究 【Abstract】 Objective To observe the pathologic changes of biliary tract injury nearby major intrahepatic ducts in dogs after radiofrequency ablation (RFA). Methods Twenty healthy adult hybrid dogs were randomly divided into four groups and treated with RFA that was performed at different distances ( mm, mm, mm and mm) from nearby major intrahepatic ducts, with 2 cm of needles opening and gradual increase of the power of RFA machine from 5 watt to 95 watt (5 watt increase per minute). After that, the pathologic changes were observed. Results During the coue of RFA treating nearby major intrahepatic ducts, there was seen necrosis of fullthickness or partial bile duct wall was seen at distance of mm, fullthickness necrosis of partial bile duct wall and vacuolus change of biliary duct epithelium at distance of mm and vacuolus change or normal of biliary duct epithelium at distance of mm. Conclusio RFA treating nearby major intrahepatic ducts at distance over mm may cause slight and reveible changes of biliary duct epithelium but that at distance less than mm can result in serious and irreveible injury of the biliary duct wall. 【Key words】 Biliary duct injury; Radiofrequency ablation 射频消融(radiofrequency ablation，RFA)是近年 发展 起来的介入治疗手段。射频波进入肝脏后通过激发分子振荡转化成热能，当温度60 ℃可使细胞死亡。临床应用这一原理治疗肝癌已取得相当疗效，特别是对小肝癌的治疗，目前在国内外广泛开展［1-3］。对于肝内大胆管旁肝肿瘤RFA治疗时， 可造成胆漏、 胆汁性腹膜炎、 胆管出血、胆管炎、胆管狭窄等胆道并发症， 但该问题的防治尚未引起足够重视［4-5］。本课题通过对犬肝门部胆管旁行RFA的实验观察，了解RFA距肝内大胆管不同距离的胆管病理学改变。 1 材料与方法 材料 健康成年杂种犬20只，第三军医大学实验动物所提供和饲养，体重(12±2)kg，雌性12只，雄性8只，随机分为4组，每组5只；射频治疗仪为绵阳立德公司LDRF120S多极射频消融仪，功率0～95 W，频率50 kHz；引导及动态观察采用美国GE公司产VOLUSON 730PRO型彩色超声诊断仪；速眠新注射液由军事医学 科学 院军事兽医研究所生产；盐酸氯胺酮注射液由江苏恒瑞医药股份有限公司生产。 方法 实验动物 普通健康成年杂种犬，体重(12±2)kg，雌性12只，雄性8只，随机分为4组，每组5只