一种新型的超声联合微泡治疗肝创伤的止血方法
赵晓晨 李露 李陶 吴盛正 赵阳 刘青 钟渝 刘政
第三军医大学第二附属医院超声科
目的：探索肝脏创伤后出血，用一种新型超声联合微泡产生空化作用止血的实验研究。
方法：止血治疗使用脉冲式超声空化治疗仪，治疗头频率831 kHz，峰值负压4.3 MPa，平均声强0.4 W/cm2。20只新西兰大白兔开腹后建立肝脏创伤模型，实验兔随机分为3组：治疗组（n=8）、单纯超声组（n=6）、假照组（n=6）。治疗组治疗同时联合静脉注射微泡，单纯超声组及假照组作为对照组，只进行单纯超声和假照治疗。肝创伤模型建立后收集初始出血速度，出血视觉评分和10分钟出血量作为止血疗效的评价，超声造影评价肝脏血流灌注情况。三组9只新西兰大白兔实验完后立即取治疗区域肝组织进行组织学检查。
结果：统计结果显示三组初始出血速度基本一致，治疗组（0.10±0.08ML/s）、单纯超声组（0.12±0.04 ML/s）、假照组（0.12±0.06 ML/s）。治疗组兔肝创伤切口治疗2分钟后出血立即停止，但在单纯超声组或假照组治疗后切口继续出血。视觉评分和10分钟出血量统计结果（P*
结论：超声联合微泡为肝脏创伤提供一种简单、新型的止血方法。
Objectives: To explore the haemostatic effects of microbubble-enhanced ultrasound (MEUS) at a very low acoustic intensity on the bleeding liver of rabbits.Methods: Liver incisions made on 20 rabbits were treated with a pulsed therapeutic ultrasound transducer.The transducer was operated at 831 KHz with an acoustic intensity of 0.4 W/cm2.The treatment was coordinated with intravenous injection of microbubbles.Ultrasound only and sham treatment served as the controls.Visual bleeding score and 10-min bleeding volume were evaluated for haemostatic efficacy .Contrast-enhanced ultrasound (CEUS) was performed to ae the liver perfusion.Nine treated livers were harvested f or acute histological examination.Results: Regarding the bleeding incisions made on rabbit livers, the haemorrhage stopped immediately after 2 min of MEUS treatment but bleeding continued in the controls treated by ultrasound or microbubble injection alone.The bleeding scores and the 10-min haemorrhagic volumes dropped significantly in the MEUS group compared with those of the controls (p
