Microbubble-enhanced non-focused ultrasound treatment of posttraumatic liver hemorrhage / 中华创伤杂志

ABSTRACT

Objective To investigate the effect of microbubble-enhanced non-focused ultrasound on posttraumatic liver hemorrhage.Methods Twenty healthy New Zealand white rabbits with posttraumatic liver hemorrhage were divided into control group,microbubble group,ultrasound with microbubble group,and heparin with ultrasound and microbubble group according to the random number table,with five rabbits per group.Thrombin time (TT),prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (FIB),and coagulation reaction time (R value) and mechanical strength (A value) of the thrombelastogram were detected.Pre-and post-treatment bleeding were measured to evaluate the hemostatic effect.Liver specimens were harvested to perform histopathological study with HE staining.Results TT [(25.8 ± 11.3) s] and APTF [(58.7 ± 18.7) s] in heparin with ultrasound and microbubble group showed significant prolongation compared with other three groups (P ＜ 0.05).Control group showed higher FIB than other three groups,but the differences were insignificant (P＞0.05).PT did not differ significantly among groups (P＞0.05).R value [(78.3±5.1) min] and A value [(0.13 ± 0.05)mm] in heparin with ultrasound and microbubble group differed significantly from these in other three groups (P0.05 ).After treatment,bleeding area in heparin with ultrasound and microbubble group [(2.2 ±1.3)cm2] wasincreased when compared to ultrasound with microbubble group[(0.8+0.7) cm2](p< 0.05 ), butboth were lower than that in control group [( 5.7+0.6)cm2 ]and microbubble group [( 5.3 ±0.6)cm2]( P<0.05). HE staining showed significant hepatic cell edema in ultrasound with microbubble groupand heparin with ultrasound and microbubble group that compressed hepatic sinus,blood vessels in theportal area and central vein,and significant blood stasis in blood vessels.Conclusion Microbubblesenhanced non-focused ultrasound has good hemostatic effect for posttraumatic liver hemorrhage.