CAJ | 학술논문

目的探讨自制包裹液态氟碳的高分子微球增强高强度聚焦超声(HIFU)体外消融正常牛肝的最佳功率及体内消融正常兔肝的疗效.方法实验分为两部分:第一部分为HIFU消融离体牛肝实验,分别注射四种不同的药物后行HIFU消融,寻找最佳消融功率与时间.实验分为4组:1组,HIFU+生理盐水(NACL);2组,HIFU+乳酸/羟基乙酸共聚物(PLGA)；3组,HIFU+液态氟碳(PFH)；4组,HIFU+ PLGA+ PFH.第二部分应用HIFU消融正常兔肝,同样分为以上4组,分别经兔耳缘静脉注射药物后以相同的参数行HIFU消融,观测并相互比较各组靶区消融前后超声声像图面积、灰阶值及实际肝损伤情况.结果离体牛肝实验中2、3、4组均在150 W、2 s出现声像图灰度的变化和肝的凝固性坏死.正常兔肝实验中,3、4组靶区的平均超声灰阶值与面积大于1、2组,差异有统计学意义(P ＜0.001),且随时间延长其灰阶值与面积逐渐缩小,而3、4组间比较差异无统计学意义(P＞0.05)；病理检查1、2组肝组织未见明显损伤,3、4组靶区肝组织见出血性坏死或白色凝固性坏死.结论包裹液态氟碳的高分子微球可有效增强HIFU的消融效率,为一种较好的HIFU增效剂.
목적 탐토자제포과액태불탄적고분자미구증강고강도취초초성(HIFU)체외소융정상우간적최가공솔급체내소융정상토간적료효.방법 실험분위량부분:제일부분위HIFU소융리체우간실험,분별주사사충불동적약물후행HIFU소융,심조최가소융공솔여시간.실험분위4조:1조,HIFU+생리염수(NACL);2조,HIFU+유산/간기을산공취물(PLGA)；3조,HIFU+액태불탄(PFH)；4조,HIFU+ PLGA+ PFH.제이부분응용HIFU소융정상토간,동양분위이상4조,분별경토이연정맥주사약물후이상동적삼수행HIFU소융,관측병상호비교각조파구소융전후초성성상도면적、회계치급실제간손상정황.결과 리체우간실험중2、3、4조균재150 W、2 s출현성상도회도적변화화간적응고성배사.정상토간실험중,3、4조파구적평균초성회계치여면적대우1、2조,차이유통계학의의(P ＜0.001),차수시간연장기회계치여면적축점축소,이3、4조간비교차이무통계학의의(P＞0.05)；병리검사1、2조간조직미견명현손상,3、4조파구간조직견출혈성배사혹백색응고성배사.결론 포과액태불탄적고분자미구가유효증강HIFU적소융효솔,위일충교호적HIFU증효제.
Objective To study the optimal power of self-made polymeric microcapsules with liquid perfluorocarbon enhancing high intensity focused ultrasound (HIFU) ablation of normal bovine in vitro and the treatment efficacy of HIFU ablation of normal rabbit liver in vivo.Methods The experiment was divided into two parts:the first part was HIFU ablation of bovine in vitro:The bovine was injected different drugs before HIFU ablation to find the optimal power and treatment time.It was divided into four groups:①HIFU + 0.9％ NaCl(NACL) group; (② HIFU + poly( lactic-co-glycolic acid) (PLGA) group; ③ HIFU + perfluorohexane(PFH) group; ④ HIFU + PLGA + PFH group; The second part was HIFU ablation of normal rabbit liver.Similarly,It was also divided into four groups as above.Each group was undergone HIFU ablation with same parameters after ear vein injection of drug.Then the ultrasonographic changes and its value,and the actual situation of liver damage in target areas of each group were observed and compared before and after the ablation area.Results In experiments of vitro bovine,gray scale changes and coagulation necrosis could be seen in the liver in group 2,3,4 with HIFU power of 150 W and treatment time of 2 s.In experiment of normal rabbit liver,the average gray-scale of group 3 and 4 were larger than that in group 1 and 2,the difference was statistically significant (P ＜0.001),and its gray change area gradually reduced with time elapsed.While there was no statistically significant difference between group 3 and 4 ( P ＞0.05).In pathological specimens,there was no significant liver damage in group 1 and 2.There was hemorrhagic necrosis and white coagulation necrosis in group 3 and 4.Conclusions The polymeric microcapsules with liquid perfluorocarbon can effectively enhance the efficacy of HIFU ablation and be used as a good synergist for HIFU.