目的研究经彩色多普勒超声定位体外超声聚焦刀在去肾交感神经术中的安全性和有效性。方法 8个月大健康雄性广西巴马小香猪18只,随机分为三组,消融组1、消融组2及对照组,每组6只。消融组1行超声聚焦刀双侧肾动脉交感神经消融术,每一点单次消融强度为280 W×2 s;消融组2每点消融强度为320 W×2 s;对照组于麻醉后仅以CDFI行肾动脉超声检查。所有动物于术前、术后即刻、术后7 d和28 d测血压、采集血样,并评估血液指标(包括去甲肾上腺素、肾功能等),术后28 d处死并观察组织形态与病理变化。结果与手术前比较,消融组2手术后第7 d收缩压下降[(132.67±6.86)mm Hg vs.(122.33±6.15)mm Hg],差异具有统计学意义(P0.05),第28 d收缩压下降[(132.67±6.86)mm Hg vs.(117.83±6.49)mm Hg],差异具有显著统计学意义(P0.01)。与对照组比较,消融组2在术后第7、28 d收缩压下降,差异具有统计学意义(P均0.05)。与手术前比较,消融组1、消融组2术后7d、术后28 d测得血浆NE浓度降低,差异具有显著统计学意义(P均0.01)。与对照组和消融组1比较,消融组2术后7 d与术后28 d NE浓度降低,差异具有显著统计学意义(P均0.01)。三组术前与术后、三组之间血肌酐、尿素氮、尿酸比较,差异无统计学意义(P均0.
Objective To study the efficacy and safety of extracorporeal high-intensity focused ultrasound (HIFU) through color Doppler ultrasonic locating in renal sympathetic denervation.Methods Male Bama minipigs (aged 8 months old,n=18) were randomly divided into ablation group 1 (HIFU=280 W×2 s), ablation group 2 (320 W×2 s) and control group (only CDFI, eachn=6). The blood pressure was detected, blood samples were collected and blood indexes [including norepinephrine (NE) and renal function] were reviewed in all minipigs before operation, immediately after operation, and 7 d and 28 d after operation. After operation for 28 d the minipigs were euthanatized and the changes of histopathology were observed.Results After operation for 7 d, systolic blood pressure (SBP) decreased [(132.67±6.86) mmHgvs. (122.33±6.15) mmHg,P 0.05) in 3 groups before and after operation and among 3 groups. The observation of light microscope showed that vascular wall membrane structure was completed wit