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高频不可逆电穿孔消融猪胰腺组织的效果观察
DOI: 10.12449/JCH240523
医学伦理声明本实验中的所有操作均遵守动物福利法规，且已通过上海甲干生物科技有限公司伦理委员会批准，批号：JGLL-20210316002。
利益冲突声明：本文不存在任何利益冲突。
作者贡献声明：幸嵘负责实验设计和操作，资料分析，撰写论文；杜霁儒负责资料分析，撰写论文；翁原驰负责动物实验操作；王峰参与实验设计及修改论文；刘超负责拟定写作思路，指导撰写文章并最后定稿。幸嵘、杜霁儒对本文贡献等同，同为第一作者。
Effect of high-frequency irreversible electroporation in the ablation of porcine pancreatic tissue
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摘要:
目的 探索高频不可逆电穿孔（H-FIRE）消融猪胰腺组织的效果。 方法 采用开腹手术，借助针式电极对12只猪释放电脉冲，按照场强数值小、中、大设置三组参数（1 000 V/cm、1 500 V/cm、2 500 V/cm）进行消融。通过比较各组术后恢复情况、消融面积、组织病理学表现等数据验证H-FIRE消融猪胰腺组织的安全性、有效性。计量资料两组间比较使用配对t检验。 结果 所有实验猪均存活，且获得明确的消融效果，各组组织病理学均提示，消融有效彻底，消融区与正常组织区分界明显，小场强组、中场强组、大场强组平均消融面积分别为（30.96±3.73）mm2、（51.93±25.26）mm2、（108.90±55.23）mm2，大、中场强组消融面积均显著大于小场强组（P值均<0.05），中场强组与大场强组消融面积差异无统计学意义（P>0.05）。 结论 在特定的消融参数下，对猪胰腺进行H-FIRE消融安全、有效。 Abstract:Objective To investigate the effect of high-frequency irreversible electroporation （H-FIRE） in the ablation of pig pancreatic tissue. Methods Laparotomy was conducted in this study， and needle electrodes were used to release electric pulses in 12 pigs. Three sets of parameters were established for ablation at the low， medium， and high values of field strength （1 000 V/cm， 1 500 V/cm， and 2 500 V/cm）. The groups were compared in terms of the data including postoperative recovery， ablation area， and histopathological features to validate the safety and efficacy of H-FIRE in the ablation of porcine pancreatic tissue. The paired t-test was used for comparison of continuous data between two groups. Results All pigs in the experiment survived and showed a good effect of ablation. The histopathological analysis of all groups showed thorough and effective ablation， with a clear boundary between the ablated area and the normal tissue area. The mean ablation area in the low， medium， and high field strength groups was 30.96±3.73 mm2， 51.93±25.26 mm2， and 108.90±55.23 mm2， respectively， and the high and medium field strength groups had a significantly larger ablation area than the low field strength group （both P<0.05）， while there was no significant difference in ablation area between the medium and high field strength groups （P>0.05）. Conclusion H-FIRE ablation is safe and effective for porcine pancreatic tissue under specific ablation parameters. -
Key words:
- Pancreatic Neoplasms /
- Electroporation /
- Ablation Techniques /
- Animal Experimentation
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根据《世界医学协会赫尔辛基宣言》《涉及人的健康相关研究国际伦理准则》和我国《涉及人的生物医学研究伦理审查办法》《人体器官移植条例》《人类辅助生殖技术和人类精子库伦理原则》《药物临床试验伦理审查工作指导原则》等的相关规定以及国际通行的动物福利和伦理准则，本刊要求：
凡是动物实验研究，必须符合我国实验动物管理和使用相关规定，并经由动物伦理委员会审批；凡是涉及人的生物医学研究，无论是前瞻性研究、横断面研究、回顾性研究，还是在人体上或使用取自人体的标本等进行的研究，亦或是采用心理学、流行病学、社会医学方法对人群进行的调查研究，都需要得到患者知情同意、通过伦理委员会审批。作者须在研究方法中列明开展伦理审查的机构委员会名称及审查文件批号。
本刊伦理内容规范书写格式如下：
本研究方案经由***医院伦理委员会（或实验动物伦理委员会）审批，批号：ABC1234，患者均签署知情同意书（或符合实验室动物管理与使用准则）。
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注： a，胰腺行H-FIRE消融过程中；b，消融后撤除电极针（箭头所示为消融部位）。
图 1 实验猪行H-FIRE消融术中情况
Figure 1. Intraoperative situation during the H-FIRE ablation procedure in the experimental pigs
注： a～c（小、中、大场强），实线勾画出区域即消融区，其中心表现为片状坏死，周围胰腺组织变性，纤维组织增生，炎细胞浸润（HE染色， ×0.86， ×0.45，×0.31）；d～f（小、中、大场强），显示损伤灶内胰腺组织变性坏死及局灶出血改变（HE染色，×20）。
图 2 实验猪胰腺行H-FIRE消融术后7天病理表现
Figure 2. Pathological findings at 7th day after H-FIRE ablation
注： a，T1W横断面显示主胰管扩张，胰管近端胰头消融区域斑片状低信号，边界清晰；b，T2W横断面显示消融区为不均匀高信号，边界欠清；c，增强扫描显示消融区域内无强化，边界较清晰。箭头所示实线勾画的区域即消融灶。
图 4 实验猪胰腺行H-FIRE消融术后7天MRI表现
Figure 4. MRI findings at 7th day after H-FIRE ablation
表 1 实验室检查结果
Table 1. Laboratory test results
指标 术前（n=12） 术后第7天（n=12） t值 P值 红细胞计数（×1012/L） 6.86±1.09 6.81±1.16 0.11 0.915 血红蛋白（g/L） 121.00±5.73 119.00±9.31 0.59 0.568 白细胞计数（×109/L） 15.22±1.40 20.50±2.02 10.63 <0.001 血小板计数（×109/L） 388.00±109.01 438.67±84.06 1.31 0.216 血清淀粉酶（U/L） 3 170.67±1 235.67 2 988.00±1 403.83 0.41 0.688 
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