ORGAN HEMOSTASIS IN TRAUMA BY HIGH INTENSITY ULTRASOUND

高强度超声对创伤中器官的止血

• 批准号: 6041506
• 负责人: ROY W MARTIN
• 金额: $ 39.87万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-02-22 至 2003-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6041506
• 关键词: Animalia; animal morbidity; animal mortality; bile ducts; biomedical equipment development; blood coagulation; blood vessel occlusion; collagen; disease /disorder model; hemodynamics; hemorrhage; hemostasis; histogenesis; iatrogenic disease; liver; liver regeneration; longitudinal animal study; monitoring device; multiple organ failure; nonhuman therapy evaluation; spleen; surgery; trauma; ultrasound blood flow measurement; ultrasound therapy

High intensity focused ultrasound (HIFU) is an exciting new therapeutic technology with numerous significant potential clinical benefits. This technique involves delivering high levels of energy (e.g., 2000 watts/ cm2) to a region of tissue and elevating its temperature to 60 - 80 degrees C within seconds. The effect is similar to the way a magnifying glass focuses sunrays onto a piece of paper to burn it. This ultrasound action can ablate tumors, pre-coagulate a region of an organ to be surgically resected and obtain hemostasis in hemorrhaging parenchyma and vessels. Further, regions of tissue can be treated that are not only on the organ surface but deep within the organ itself, without appreciable exposure or harm to the intervening tissue. Specifically, the researchers at the University of Washington have demonstrated the potential of HIFU in achieving rapid hemostasis in vivo, using models of organ and blood vessel injuries. Herein, a research team of bioengineers and surgeons proposes to further develop, refine and clinically test HIFU methodology for the operating room. Traumatic liver and spleen injury are the focus because they are common injuries with high morbidity and mortality, where conventional therapies have limited efficacy. Plans are made to a) investigate HIFU hemostasis mechanisms, b) engineer practical surgical devices, c) optimize the devices, d) refine and test them in pre-clinical, in vivo hemorrhage models, e) clinically test them in liver and spleen trauma, and f) finally conduct clinical assessment in reducing trauma mortality and morbidity. Two surgical problem areas will be investigated: 1) when the bleeding site is visible to the surgeon and 2) when blood or investing tissue hide it. Thus, two hemostasis device styles will be developed. The first will be simple probes for HIFU application when the bleeding region is visible. The second will be more complicated and include simultaneous ultrasound detection methods for locating the bleeding site and electronic focusing for guiding HIFU to the bleeding regions. The investigators believe these devices will promote significantly improved and cost effective methods for stopping bleeding in the injured liver and spleen. The devices will facilitate accelerated hemostasis, reduced blood loss, increase splenic salvage, shorten surgical time, avoid damage control surgery and attendant secondary repair, and finally improve hemodynamics in patients with multiple injuries. Thus, the investigators believe that their proposed studies will result in a new and clinically applicable methodology for reducing mortality and morbidity in abnormal trauma.

高强度聚焦超声（HIFU）是一种令人兴奋的新技术， 治疗技术具有许多显著的潜在临床益处。 该技术涉及输送高水平的能量（例如，2000瓦/ cm 2）的组织区域，并将其温度升高至60 - 80摄氏度 几秒钟内。其效果类似于放大镜聚焦的方式 太阳光照射到一张纸上使其燃烧。这种超声波作用可以烧蚀 肿瘤，预凝固待手术切除的器官区域，并获得 在扩张的实质和血管中止血。此外，组织区域 不仅在器官表面，而且在器官深处 本身，没有明显的暴露或损害介入组织。 具体来说，华盛顿大学的研究人员已经证明， HIFU在体内实现快速止血的潜力，使用模型 器官和血管损伤。 在此，一个由生物工程师和外科医生组成的研究小组提出， 为手术室开发、完善和临床测试HIFU方法。 外伤性肝、脾损伤因其常见而成为重点 高发病率和死亡率的损伤，其中常规疗法 有限的功效。制定计划以a）研究HIFU止血机制， B）设计实用的手术装置，c）优化装置，d）改进和 在临床前、体内出血模型中测试它们，e）临床测试它们 在肝脏和脾脏创伤中，以及f）最后进行临床评估， 降低创伤死亡率和发病率。两个手术问题区域将 研究：1）当外科医生可以看到出血部位时，以及2）当 因此，两种止血装置类型将被 开发第一个将是用于HIFU应用的简单探头， 出血区域可见。第二个将更加复杂，包括 用于定位出血部位的同步超声检测方法， 电子聚焦，用于引导HIFU到达出血区域。调查人员 我相信这些设备将促进显着改善和成本效益 肝、脾损伤止血方法。这些设备将 促进加速止血，减少失血，增加脾脏 抢救，缩短手术时间，避免损伤控制手术和护理 二次修复，最终改善多个患者的血流动力学 受伤因此，研究人员认为，他们提出的研究将 导致一种新的和临床上适用的方法来降低死亡率 和异常创伤的发病率。