2024 , Vol. 21 >Issue 12: 1124 - 1131
DOI: https://doi.org/10.3877/cma.j.issn.1672-6448.2024.12.005
新型微纳秒脉冲电场消融仪器的研发及动物实验研究
Copy editor: 汪荣
收稿日期: 2024-09-23
网络出版日期: 2025-01-23
基金资助
国家自然科学基金项目（82027803，81971623，82171937 和82202151）浙江省“尖兵”“领雁”科技计划项目（2024C03092）浙江省自然科学基金项目（Y24H180007）
版权
Development of novel microsecond-nanosecond pulsed electric field ablation equipment and its animal experimental study
Received date: 2024-09-23
Online published: 2025-01-23
Copyright
目的
探讨微纳秒脉冲电场（μs-nsPEFs）消融新技术的安全性和有效性，主要包含消融范围、肌肉收缩程度及对重要脉管结构的保护作用等。
方法
本研究利用3D 电场仿真软件建立三维模型，再进行超声引导下开腹消融手术。选用4 头雌性白猪，将白猪随机分为μs-nsPEFs 和纳秒脉冲电场（nsPEFs）两组（每组各2 头），比较两组术前仿真模拟电场分布、术中量化肌肉收缩程度、术后造影面积和组织病理学表现等，探索μs-nsPEFs 消融猪肝脏组织的安全性和有效性。计量资料组间比较采用Student’s t 检验。
结果
使用COMSOL 软件绘制的3D 仿真电场分布图显示，μs-nsPEFs的最大消融面积为（6.06±0.02）cm2；nsPEFs 的最大消融面积为（5.00±0.03）cm2（P＜0.01）。术后10 min 的超声造影（CEUS）结果显示，μs-nsPEFs 组消融面积为（4.70±1.62）cm2，nsPEFs 组为（4.33±1.55）cm2（P＞0.05）。术后第7 天超声探查μs-nsPEFs 组存在低回声区域，而nsPEFs 组未发现明显的低回声区域。术后第7 天的HE 染色切片评估提示μs-nsPEFs 消融区边界明确，面积为（0.15±0.08）cm2，而nsPEFs 组未提示消融灶。胆囊壁HE 染色切片提示μs-nsPEFs 术后第7 天消融病灶周围血流通畅，胆囊整体结构保持完整，肝肾功能指标未出现异常。
结论
新型μs-nsPEFs 技术不仅能够有效控制术中肌肉收缩和保护脉管结构，还能使肝脏消融效果持久有效，具有良好的临床应用前景。
李琚 , 陈强 , 张洵 , 谢丽婷 , 蒋天安 . 新型微纳秒脉冲电场消融仪器的研发及动物实验研究[J]. 中华医学超声杂志（电子版）, 2024 , 21(12) : 1124 -1131 . DOI: 10.3877/cma.j.issn.1672-6448.2024.12.005
Objective
To investigate the safety and efficacy of the new microsecond-nanosecond pulsed electric field (μs-nsPEF) ablation technology, focusing on ablation range, degree of muscle contraction,and protection of vital vascular structures.
Methods
A three-dimensional (3D) model was established using 3D electric field simulation software, followed by an ultrasound-guided open-abdomen ablation procedure.Four pigs were randomly assigned to μs-nsPEF (n=2) and nanosecond pulsed electric field (nsPEF) groups(n=2).Safety and efficacy of μs-nsPEFs in porcine liver tissue were evaluated by comparing preoperative simulated electric field distributions, intraoperative muscle contraction measurements, postoperative ablation area, and histopathological findings between the two groups.Student's t-test was used for comparisons between groups.
Results
3D electric field distribution maps created with COMSOL software showed a maximum ablation area of 6.06±0.02 cm2 for the μs-nsPEF group and 5.00±0.03 cm2 for the nsPEF group (P＜0.01).Contrast-enhanced ultrasound (CEUS) imaging 10 minutes post-ablation indicated an ablation area of 4.70±1.62 cm2 for the μs-nsPEF group and 4.33±1.55 cm2 for the nsPEF group (P＞0.05).Ultrasound examination on postoperative day 7 revealed a hypoechoic area in the μs-nsPEF group, whereas no such area was observed in the nsPEF group.H&E staining on postoperative day 7 showed a well-defined ablation boundary in the μs-nsPEF group with an area of 0.15±0.08 cm2, while no ablation lesion was observed in the nsPEF group.H&E staining of the gallbladder wall indicated that on postoperative day 7, blood flow around the μs-nsPEF ablation site remained unobstructed, the gallbladder structure was intact, and liver and kidney function indicators showed no abnormalities.
Conclusion
The novel μs-nsPEF technique demonstrates sustained and effective liver ablation while ensuring muscle contraction and vascular protection during surgery, indicating promising clinical applications.
±s 表示，组间比较采用Student’s t 检验，P＜0.05 为差异具有统计学意义。CEUS 造影图像和3D 仿真电场分布图像通过Image J 软件进行勾画和分析消融面积。表1 μs-nsPEFs 消融前后P01 号白猪血清电解质及肝肾生化指标分析 |
| 电解质及生化指标 | 术前2h | 术后2h | 术后7d |
|---|---|---|---|
| 天门冬氨酸氨基转移酶（U/L） | 36.00 | 88.00 | 29.20 |
| 丙氨酸氨基转移酶（U/L） | 77.60 | 99.30 | 68.20 |
| 白蛋白（g/L） | 39.16 | 37.97 | 35.28 |
| 总蛋白（g/L） | 60.11 | 67.63 | 64.97 |
| 球蛋白（g/L） | 29.82 | 29.66 | 29.69 |
| 碱性磷酸酶（U/L） | 77.70 | 78.20 | 58.90 |
| 胆固醇（mmol/L） | 1.69 | 1.42 | 1.77 |
| 肌酐（μmol/L） | 106.10 | 110.50 | 106.40 |
| 谷氨酰转肽酶（U/L） | 35.10 | 41.00 | 36.70 |
| 葡萄糖（mmol/L） | 5.99 | 4.77 | 5.13 |
| 总胆红素（μmol/L） | 1.22 | 1.30 | 1.20 |
| 甘油三酯（mmol/L） | 0.25 | 0.60 | 0.22 |
| 尿素（mmol/L） | 3.37 | 8.23 | 3.46 |
| 钙（mmol/L） | 2.33 | 2.37 | 2.29 |
| 无机磷（μmol/L） | 1.99 | 1.98 | 1.96 |
| 钾（mmol/L） | 4.53 | 4.33 | 4.49 |
| 钠（mmol/L） | 144.50 | 141.70 | 141.20 |
| 氯（mmol/L） | 98.20 | 97.80 | 98.90 |
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