Therapeutic Ultrasound, Part II * . High Intensity Focused Ultrasound: A Method of Hemostasis
Therapeutic Ultrasound, Part II * . High Intensity Focused Ultrasound: A Method of Hemostasis
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治疗性超声，第二部分 * 。
DOI：
10.1046/j.1540-8175.2001.00309.x
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
L. Crum
中科院分区：
文献类型：
--
作者：
Robert J. Siegal;S. Vaezy;R. Martin;L. Crum
声止血是超声研究的一个新领域，它是利用高强度聚焦超声（HIFU）诱导活动性出血、损伤实体器官和血管的止血。在动物研究中，即使给予大剂量肝素，HIFU应用后约1分钟内也能抑制由实质和血管损伤引起的中度至大量出血。此外，声止血在烧灼大面积肝脏方面显示出前景，为不出血切除异常组织提供了一种方法。HIFU的两种不同的物理机制似乎有助于止血：(1)热机制，其中声音的吸收导致温度升高；(2)机械机制（声空化），其中气体和蒸汽充满的空隙以大位移振幅振荡。热机制导致约1秒内温度升高超过70℃，而机械机制似乎导致组织结构破坏和可能释放凝血诱导组织因子。在HIFU作为临床工具的进一步发展中，最重要的是HIFU治疗的靶向和监测。我们已经初步成功地将HIFU与超声成像相结合，从而开发出一种图像引导的治疗系统。图像引导声止血可以为外科和院前环境提供一种有价值的止血方法，应用于创伤和选择性手术。
Acoustic hemostasis is a new field of ultrasound research in which high intensity focused ultrasound (HIFU) is used to induce hemostasis in actively bleeding, injured solid organs and blood vessels. In animal studies, moderate to profuse bleeding from parenchymal and vascular injuries has been arrested within approximately 1 minute of HIFU application, even when a large dose of heparin was administered. Moreover, acoustic hemostasis has shown promise in cauterizing large regions of liver, providing a method for bloodless resectioning of abnormal tissue. Two distinct physical mechanisms of HIFU appear to contribute to hemostasis: (1) a thermal mechanism in which absorption of sound leads to temperature elevations, and (2) mechanical mechanisms (acoustic cavitation) in which gas and vapor‐filled voids oscillate with large displacement amplitudes. While the thermal mechanism results in a temperature increase in excess of 70°C in about 1 second, the mechanical mechanism appears to result in structural disruption of tissue and possible release of coagulation‐inducing tissue factors. Of utmost importance in further development of HIFU as a clinical tool is targeting and monitoring of the HIFU treatment. We have obtained initial success in integrating HIFU with ultrasound imaging so as to develop an image‐guided therapy system. Image‐guided acoustic hemostasis may provide a valuable method of hemostasis in surgical and prehospital settings with applications in trauma and elective surgery.
影响因子：
1.5
作者：
Rodney A. White;G. Kopchok;Shi-Kaung Peng;R. Fujitani;Geoffrey H. White;Stanley R. Klein;Jouni Uitto
通讯作者：
Rodney A. White;G. Kopchok;Shi-Kaung Peng;R. Fujitani;Geoffrey H. White;Stanley R. Klein;Jouni Uitto