CAJ | 학술논문

背景:热疗在食管癌综合治疗中取得厂明显的疗效,放置食管金属支架后的食管煽患者,能否进行深部热疗尚不清楚.目的:实验拟观察射频深部热疗中金属支架对猪食管黏膜的损伤程度.设计、时间及地点:观察性实验,于2004-10/2005-01在泸州医学院附属医院肿瘤科完成.材料:取普通肉猪13只,体质星35-40kg.记忆合金带膜食管支架,由常州市智业医疗仪器研究所提供.方法:采用SR-1000射频深部热疗机对放胃金属支架的13只猪食管进行体外加热.存金属支架上缘上4 cm、支架中心处、支架下缘处、支架下缘下2 cm处和支架下缘下4 cm处的食管黏膜处分别设置5个观察点.频率40.82 MHz.极板25 cmx25 cm.功率500～700W加热30min.主要观察指标:肉眼观察5个观察点食管黏膜的损伤情况,并取5个脱察点处的食管黏膜作病理学检查.结果:纳入普通肉猪13只,实验过程1 只猪死于麻醉,4只猪的测温线出现故障.8只猪进入结果分析.①8只猪40个观察点处的食管黏膜肉眼损伤程度为0～1级,经统计学等级资料的秩和检验H=2.734,各删察点损伤程度相比,差异无显著性意义(P=0.255).②显微镜下显示食管粘膜损伤程度为0～2级,经统计学等级资料的秩和检验H=2.734,各观察点损伤程度相比,差异无显著性意义(P=0.255).结论:存射频深部热疗中,食符金属支架置入本身不引起明显的食管黏膜机械性损伤,亦不加重食管黏膜的热损伤,金属内支架置入后行射频深部热疗在近期足安全可行的.
배경:열료재식관암종합치료중취득엄명현적료효,방치식관금속지가후적식관선환자,능부진행심부열료상불청초.목적:실험의관찰사빈심부열료중금속지가대저식관점막적손상정도.설계、시간급지점:관찰성실험,우2004-10/2005-01재로주의학원부속의원종류과완성.재료:취보통육저13지,체질성35-40kg.기억합금대막식관지가,유상주시지업의료의기연구소제공.방법:채용SR-1000사빈심부열료궤대방위금속지가적13지저식관진행체외가열.존금속지가상연상4 cm、지가중심처、지가하연처、지가하연하2 cm처화지가하연하4 cm처적식관점막처분별설치5개관찰점.빈솔40.82 MHz.겁판25 cmx25 cm.공솔500～700W가열30min.주요관찰지표:육안관찰5개관찰점식관점막적손상정황,병취5개탈찰점처적식관점막작병이학검사.결과:납입보통육저13지,실험과정1 지저사우마취,4지저적측온선출현고장.8지저진입결과분석.①8지저40개관찰점처적식관점막육안손상정도위0～1급,경통계학등급자료적질화검험H=2.734,각산찰점손상정도상비,차이무현저성의의(P=0.255).②현미경하현시식관점막손상정도위0～2급,경통계학등급자료적질화검험H=2.734,각관찰점손상정도상비,차이무현저성의의(P=0.255).결론:존사빈심부열료중,식부금속지가치입본신불인기명현적식관점막궤계성손상,역불가중식관점막적열손상,금속내지가치입후행사빈심부열료재근기족안전가행적.
BACKGROUND: Thermotherapy has achieved remarkable therapeutic effect on patients with esophageal cancer. However, there are still some problems which cannot be answered today, such as the damage of esophageal mucosa during deep thermotherapy when metal stent is placed in esophagus. OBJECTIVE: To study the metal stent-caused damages to esophageal mucosa of pigs in radiofrequency hyperthermia. DESIGN, TIME AND SETTING: Observational study which was performed in the Department of Tumor, Affiliated Hospital of Luzhou Medical College from October 2004 to January 2005. MATERIALS: 13 pigs weighing 35-40 kg were used in this study. Esophagus stent of memory alloy with membrane was provided by Zhiye Medical Apparatus Institute of Changzhou, China METHODS: Five points were located for measurement, i.e. the middle of the stent, the exit of the stent, 2 cm and 4 cm a distance from the exit and 4 cm from the entrance. Esophagus of 13 pigs was heated for 30 minutes by SR-1000 radiofrequency hyperthermia machine in frequency of 40.82 MHz, pole plate of 25 cm Ⅱ 25 cm and power of 500-700 W. MAIN OUTCOME MEASURES: The esophageal mucosa was observed with naked eyes. And optical microscopy was used to observe the changes of the esophageal mucosa. RESULTS: Because one pig died of anesthesia and there were troubles of thermal detector lines in 4 pigs, only 8 pigs were included in the final analysis. Level of damage of esophageal mucosa on five temperature checkpoints was observed from grade 0 to 1 in naked eyes, and the difference of damaged level between five checkpoints was not obvious in statistics (H=2.0, P=0.157). Level of the damage was observed from grade 0 to 2 in microscope, and the difference was not obvious in statistics too (H=2.734, P=0.255). CONCLUSION: Influence of the metal stent on esophageal mucosa can be neglected in radiofrequency hyperthermia, and metal stent does not cause obvious mechanical damage or thermal damage to esophageal mucosa of pigs. It is safe and feasible to carry out radiofrequency hyperthermia on placed metal stent esophagus.