CAJ | 학술논문

目的以西藏小型猪为模型,比较肝部双循环冷冻-复温与三循环冷冻复温消融效果的差异.方法西藏小型猪9头,开腹后行肝冷冻消融术.每头猪分别实施两循环冷冻-复温(10-5-10-5,min)消融和三循环冷冻-复温(5-5-5-5-10-5,min)消融,两组总冷冻时间相同.冷冻过程中分别测量冷冻中心点温度、冷冻形成冰球最大直径.术后7d取肝组织解剖、测量冷冻引起的表面损伤区最大长径及内部坏死区最大长径,并观察冷冻区域病理变化情况.结果三循环冷冻组形成的冰球表面最大长径大于两循环组；7 d后两冷冻组冷冻后形成表面和深度损伤区大小相近.两循环冷冻组与三循环组冷冻损伤区病理分区相同,但三循环冷冻组引起完全坏死区域更大.结论相同的冷冻时间内,三循环冷冻组对肝脏的冷冻消融效果更好.
목적 이서장소형저위모형,비교간부쌍순배냉동-복온여삼순배냉동복온소융효과적차이.방법 서장소형저9두,개복후행간냉동소융술.매두저분별실시량순배냉동-복온(10-5-10-5,min)소융화삼순배냉동-복온(5-5-5-5-10-5,min)소융,량조총냉동시간상동.냉동과정중분별측량냉동중심점온도、냉동형성빙구최대직경.술후7d취간조직해부、측량냉동인기적표면손상구최대장경급내부배사구최대장경,병관찰냉동구역병리변화정황.결과 삼순배냉동조형성적빙구표면최대장경대우량순배조；7 d후량냉동조냉동후형성표면화심도손상구대소상근.량순배냉동조여삼순배조냉동손상구병리분구상동,단삼순배냉동조인기완전배사구역경대.결론 상동적냉동시간내,삼순배냉동조대간장적냉동소융효과경호.
Objective This study compares a dual-freeze protocol with a triple freeze protocol for hepatic cryoablation in the Tibetan pig model.Method Cryoablation with a dual-(10-5-10-5 min)and triple-freeze (5-5-5-5-10-5 min) protocol for the normal livers of 9 Tibet pigs was performed under exposed operation.Temperature changes of cryoprobes and diameter changes of iceballs were measured during the ablation,and seven days later the pathological changes of cryozones were reviewed and the surface and depth cryolesions were measured.Results Compared with cryoablation with two freeze-thaw cycles,there was a greater iceball diameter for cryoablation by three freeze-thaw cycles.Also,seven days after cryosurgery,there were similar surface and deep cryolesions in dual-and triple-freeze protocols.Pathologically,the triple freezing protocol was associated with a longer zone of complete necrosis.Conclusions With the same freezing time (20 min),the triple-freeze protocol may become a more powerful liver-ablation method in cryosurgical application.