CAJ | 학술논문

目的比较微波与射频对离体猪股骨干骺端的制热效应,以指导临床应用.方法取20条新鲜成年猪股骨,根据数据随机法分成微波组与射频组2组,每组10个股骨样本分别采用微波和射频进行加热凝固.加热功率为60 W,加热时长为300 s,旁开加热点5、10、15 mm 测温,比较两种热疗技术的凝固范围和形状以及温度分布和变化趋势.结果60 W·300 s 微波和射频凝固的纵径分别为37.1±3.2 mm,28.3±2.5 mm,前者明显大于后者( P<0.05),横径分别为21.3±1.6 mm,19.8±1.4 mm,前者明显大于后者( P<0.05).微波消融后出现明显的炭化带,凝固区及充血带分布,射频消融后仅可观察到明显的凝固区.射频形成的凝固体较微波更接近球形.微波和射频的中心温度分别为126.2±1.51℃,100.2±0.70℃,前者明显高于后者( P<0.05),旁开10 mm 处温度分别为91.5±3.7℃,58.3±2.4℃,前者明显高于后者( P<0.05).射频消融与微波消融各测温点分别在210 s 与255 s 内达到稳态,二者距离加热中心越近温度越高,上升速度越快.微波消融中心温度可达到120℃以上,射频消融中心温度不超过100℃.结论微波和射频对离体猪股骨干骺端凝固形状及凝固范围存在差异,中心温度和旁开10 mm 处温度,微波显著高于射频.微波较射频热场温度高,凝固范围大,在较大骨肿瘤的治疗中宜选用微波,射频消融较微波有更好的温控性.了解各自的制热特性有利于两种技术的合理选择.
목적비교미파여사빈대리체저고골간후단적제열효응,이지도림상응용.방법취20조신선성년저고골,근거수거수궤법분성미파조여사빈조2조,매조10개고골양본분별채용미파화사빈진행가열응고.가열공솔위60 W,가열시장위300 s,방개가열점5、10、15 mm 측온,비교량충열료기술적응고범위화형상이급온도분포화변화추세.결과60 W·300 s 미파화사빈응고적종경분별위37.1±3.2 mm,28.3±2.5 mm,전자명현대우후자( P<0.05),횡경분별위21.3±1.6 mm,19.8±1.4 mm,전자명현대우후자( P<0.05).미파소융후출현명현적탄화대,응고구급충혈대분포,사빈소융후부가관찰도명현적응고구.사빈형성적응고체교미파경접근구형.미파화사빈적중심온도분별위126.2±1.51℃,100.2±0.70℃,전자명현고우후자( P<0.05),방개10 mm 처온도분별위91.5±3.7℃,58.3±2.4℃,전자명현고우후자( P<0.05).사빈소융여미파소융각측온점분별재210 s 여255 s 내체도은태,이자거리가열중심월근온도월고,상승속도월쾌.미파소융중심온도가체도120℃이상,사빈소융중심온도불초과100℃.결론미파화사빈대리체저고골간후단응고형상급응고범위존재차이,중심온도화방개10 mm 처온도,미파현저고우사빈.미파교사빈열장온도고,응고범위대,재교대골종류적치료중의선용미파,사빈소융교미파유경호적온공성.료해각자적제열특성유리우량충기술적합리선택.
@@@@Objective To compare the heating effects between microwave and radiofrequency ablation in porcine femoral metaphysis. Methods Microwave and radiofrequency were applied for 300 seconds at 60 Watts in 20 porcine femoral metaphysis. Thermo sensors were placed at 5, 10 and 15 mm from the electrodes, and temperatures were recorded using an advanced temperature monitor system. The diameter, shape and temperature in the ablation zone, the pathologic appearance of the ablation zone and the distribution and variation tendency of temperature were compared between microwave and radiofrequency ablation. Results The longitudinal diameters of lesions ablated with microwave and radiofrequency were ( 37.1±3.2 ) mm and (28.3±2.5 ) mm respectively, and the former was significantly longer than the later ( P<0.05 ). The transverse diameters were ( 21.3±1.6 ) mm and ( 19.8±1.4 ) mm respectively, and the former was significantly longer than the later ( P<0.05 ). The carbonized zone, coagulation zone and hyperemia zone could be found apparently from the microwave group, but only the coagulation zone could be found from the radiofrequency group. The radiofrequency induced more spherical lesions than microwave did. The central temperatures of microwave and radiofrequency were ( 126.2±1.51 )℃and ( 100.2±0.70 )℃respectively, and the former was significantly higher than the later ( P<0.01 ). The temperatures 10mm from the centers of microwave and radiofrequency were ( 91.5±3.7 )℃ and ( 58.3±2.4 ) ℃ respectively, and the former was significantly higher than the later ( P<0.01 ). The microwave and radiofrequency groups could reach the steady-state at 210 s and 255 s independently. The shorter the distance to the heating point, the higher the temprature rdached, and faster the temprature rose. The heating center temperature of microwave could reach over 120℃, while the heating center temperature of radiofrequency could reach a point below 100 ℃. Conclusions Lesions induced by radiofrequency and microwave have some differences in shape and temperature distribution. The temperature of the heating zone and the boundary of microwave are higher and larger than that of radiofrequency. Microwave is a better choice for larger bone tumors. Compared with microwave, the ternprature of radiofrequency group could be better controlled. The understanding of these differences will help us better use these ablation techniques.