【摘要】 背景与目的:CT引导下经皮无水乙醇消融(percutaneous ethanol ablation,PEA)在肝癌、肺癌及肾上腺无功能腺瘤等实体肿瘤的治疗中得到广泛应用,但目前有关经皮无水乙醇消融治疗肾脏实体肿瘤的实验及临床应用仍未见报道。本研究通过CT引导下经皮无水乙醇消融兔肾VX2肿瘤,探讨无水乙醇消融治疗肾脏肿瘤的有效性、安全性和可行性。方法:将25只已建立兔肾VX2肿瘤的新西兰大白兔随机分为治疗组15只和对照组10只。治疗组行CT引导下经皮无水乙醇消融并测量碘油沉积区致密影最大截面面积,对照组不接受治疗。1周后取出两组兔荷瘤肾脏,测量两组肿瘤大小及治疗组肿瘤凝固坏死区最大截面面积。对比观察实验兔治疗后伤口有无感染及生活习性的改变。结果:25只兔共形成25个肾脏肿瘤,最大截面积为1.38～2.25cm2,平均(1.61±0.04)cm2,两组肿瘤大小差异无统计学意义(P>0.05)。治疗组经皮无水乙醇消融后,碘油沉积面积大小1.31～1.85cm2,平均(1.56±0.05)cm2;PEA治疗1周后,治疗组肿瘤大小1.35～1.85cm2,平均(1.58±0.03)cm2,对照组肿瘤大小1.67～2.17cm2,平均(1.94±0.03)cm2,两组对比差异有统计学意义(P<0.05)。治疗组肿瘤凝固坏死区面积大小1.27～1.78cm2,平均(1.54±0.04)cm2,与碘油沉积面积比较,差异无统计学意义(P>0.05)。消融区肿瘤组织呈嗜酸性改变及不规则片状凝固性坏死。治疗组动物均未出现明显不良反应及并发症。结论:CT引导下经皮无水乙醇消融可有效灭活兔肾VX2肿瘤组织;CT引导下经皮无水乙醇消融兔肾VX2肿瘤无明显不良反应及并发症,安全可行。更多还原

【Abstract】 Background and Objective:CT-guided percutaneous ethanol ablation(PEA) has been widely used in treating solid tumors such as hepatoma, lung cancer, adrenal nonfunctional adenoma.This study was to explore the efficacy, safety and feasibility of CT-guided PEA in treating renal tumor in rabbit.Methods:Twenty-five rabbits carrying VX2 tumor were randomized into PEA group(15 rabbits) and control group(10 rabbits).After CT-guided PEA, the area of the largest cross section lipiodol deposition in PEA group was measured.After one week, the kidneys carrying VX2 tumor were removed, tumor size in both groups and the area of the largest cross section coagulation necrosis in PEA group were measured.Wound infection and the changes of living habits of the rabbits were observed after experiment.Results:A total of 25 VX2 tumors were developed in the 25 rabbits.The area of the largest cross section was 1.38-2.25 cm2, with an average of(1.61±0.04) cm2.There was no significant difference in tumor size between the two groups.After ablation, the area of lipiodol deposition in PEA group was 1.31-1.85 cm2, with an average of(1.56±0.05) cm2.At one week after ablation, the area of the largest cross section of tumors was significant smaller in PEA group than in control group(1.58±0.03) cm2 vs.(1.94±0.03) cm2, P<0.05;the area of coagulation necrosis in PEA group was 1.27-1.78 cm2, with an average of(1.54 ±0.04) cm2, and was similar to the area of lipiodol deposition(P>0.05).Tumor tissue in ablation areas showed acidophilia changes and irregular coagulation necrosis.There was no obvious complication in PEA group.Conclusion:CT-guided PEA can effectively inactivate rabbit kidney VX2 tumors, and it is a safe and feasible treatment without obvious complications.更多还原