CAJ | 학술논문

目的探讨不同功率、时间下,射频消融对离体猪胰腺的消融范围,建立关于射频对离体猪胰腺消融的回归方程.方法在射频消融的两个参数(功率、时间)可取值的范围内(5～20 W,20～240s),取功率参数4个,时间参数11个,组成44种不同组合,每种组合执行2次,建立一个包含88种参数组合的随机化表,共对离体胰腺进行88次消融实验.观察消融过程中的声像图变化,测量消融灶的宽度(Y),并行病理学检查.利用逐步回归法对2个参数的9个指数的9个项(时间、功率、时间×功率、时间的平方项、功率的平方项、时间的平方根项、功率的平方根项、时间的对数项、功率的对数项)进行选择,获取最佳模型,并制定回归方程.结果启动射频消融后,声像图上可见沿导管工作区域逐渐出现长条形的回声增强区域,并逐渐增宽.消融灶形成以消融探头为中心线的近似圆柱体,灰白色,与周边正常胰腺组织境界较清晰,射频功率为15、20 W时可出现碳化坏死组织.最优的逐步回归模型显示,功率的平方项与时间的对数项均与消融宽度呈正线性相关关系,模型的回归决定系数为0.71,拟合图和残差散点图均显示拟合效果较好.最终建立了关于消融宽度的回归方程:Y =0.005×E2+0.9374×In(t)-0.6943.结论建立了不同功率、时间参数组合下射频消融效果的具有统计学意义的标准方程式,为临床内镜超声引导下射频消融治疗胰腺肿瘤提供实验基础依据.
목적 탐토불동공솔、시간하,사빈소융대리체저이선적소융범위,건립관우사빈대리체저이선소융적회귀방정.방법 재사빈소융적량개삼수(공솔、시간)가취치적범위내(5～20 W,20～240s),취공솔삼수4개,시간삼수11개,조성44충불동조합,매충조합집행2차,건립일개포함88충삼수조합적수궤화표,공대리체이선진행88차소융실험.관찰소융과정중적성상도변화,측량소융조적관도(Y),병행병이학검사.이용축보회귀법대2개삼수적9개지수적9개항(시간、공솔、시간×공솔、시간적평방항、공솔적평방항、시간적평방근항、공솔적평방근항、시간적대수항、공솔적대수항)진행선택,획취최가모형,병제정회귀방정.결과 계동사빈소융후,성상도상가견연도관공작구역축점출현장조형적회성증강구역,병축점증관.소융조형성이소융탐두위중심선적근사원주체,회백색,여주변정상이선조직경계교청석,사빈공솔위15、20 W시가출현탄화배사조직.최우적축보회귀모형현시,공솔적평방항여시간적대수항균여소융관도정정선성상관관계,모형적회귀결정계수위0.71,의합도화잔차산점도균현시의합효과교호.최종건립료관우소융관도적회귀방정:Y =0.005×E2+0.9374×In(t)-0.6943.결론 건립료불동공솔、시간삼수조합하사빈소융효과적구유통계학의의적표준방정식,위림상내경초성인도하사빈소융치료이선종류제공실험기출의거.
Objective To investigate the extent of radiofrequency ablation of pig pancreas in vitro with various power and duration,and to establish the regression equation of radiofrequency ablation of porcine pancreas in vitro.Methods Among the 4 settings of power (from 5 w ～ 20 w) and 11 settings of duration (from 40s ～ 240s),44 combinations were selected,and every combination was performed twice,then a randomization table including 88 combinations was established,and 88 ablation procedures on porcine pancreases in vitro were performed.The uhrasonography changes were observed,ablation widths (Y) were measured,and pathological examination was performed.In order to construct optimal model and to establish the regression equation of radiofrequency ablation,9 parameters (duration,power,duration × power,the square of duration,the square of power,the square root of duration,the square root of power,the natural logarithm of duration,the natural logarithm of power) derived from duration and power were analyzed via stepwise regression method.Results A rectangular echo enhanced region was observed along the working area of catheter when radiofrequency ablation started,and it gradually became wider during ablation.A hoar-like cylindrical ablation region that was clearly different from surrounding normal pancreatic tissue was formed.Carbonation of necrotic tissue could be observed after radiofrequency ablation under 15 w or 20 w.The optimal model showed a linear positive correlation between ablation width (Y) with the square of power and the natural logarithm of duration.The coefficient of determination of this model was 0.71.Both Fitting curve and Residual scatter diagram showed good fitting effect.Finally,a significant regression equation of radiofrequency ablation was established:Y (mm) =0.005 × E2 + 0.9374 × ln (t)-0.6943.Conclusions A significant regression equation of radiofrequency ablation is established,which provides experimental base for EUS-guided radiofrequency ablation of pancreatic tumors in clinical practice.