據(jù)世界衛(wèi)生組織發(fā)布的資料顯示，全世界新發(fā)肝癌病例有50% 以上在中國(guó)。而在中國(guó)，每天約1萬(wàn)人確診癌癥，平均每分鐘就有7人確診，肝癌的病死率居第二位，僅次于肺癌。在人們眼里，肝癌就是名副其實(shí)的“癌王”。然而，肝癌只要早發(fā)現(xiàn)，就沒(méi)有那么可怕，甚至無(wú)需手術(shù)治療。
According to the information released by the WHO, more than 50% of the
world's new cases of liver cancer are in China. In China, about 10
thousand people are diagnosed with cancer every day, with an average of 7
confirmed cases per minute, and the fatality rate of liver cancer ranks
second, second only to lung cancer. In the eyes of people, liver cancer
is the real "king of cancer". However, as long as the liver cancer is
discovered early, it is not so terrible, and no surgery is needed.
專(zhuān)家指出，2厘米以內(nèi)的早期肝癌不用做手術(shù)，用射頻消融治療即可，之后每三個(gè)月復(fù)查一次，10年生存率可達(dá)74%。射頻消融的出現(xiàn)讓原本無(wú)法通過(guò)手術(shù)、放療、化療治療的腫瘤患者重獲希望。
Experts pointed out that within 2 centimeters of the early stage of
liver cancer without surgery, with radiofrequency ablation treatment,
then every three months to review once, 10 years survival rate of 74%.
The emergence of radiofrequency ablation has made it possible for the
cancer patients who were unable to be treated by surgery, radiotherapy
or chemotherapy.
射頻消融針治療肝癌的原理圖。
The principle of radiofrequency ablation needle for the treatment of liver cancer.
什么是射頻消融？
What is radiofrequency ablation?
射頻消融是指在影像（CT、彩超）的引導(dǎo)下，經(jīng)皮穿刺、將消融電極，準(zhǔn)確刺入腫瘤部位，利用射頻電波的能量將腫瘤組織加熱到95℃，使腫瘤組織產(chǎn)生局部高溫并完全壞死，從而達(dá)到治療腫瘤的目的。目前，射頻消融技術(shù)已廣泛運(yùn)用于各種實(shí)體瘤，特別對(duì)肝臟腫瘤而言，幾乎成為了首選的標(biāo)準(zhǔn)療法（已納入醫(yī)保），并且具有創(chuàng)傷小、治愈率高、費(fèi)用低、并發(fā)癥少的優(yōu)點(diǎn)。
Radiofrequency ablation is refers to the image (CT, ultrasound) guided
percutaneous puncture, the ablation electrode, accurate puncture tumor,
using radiofrequency energy to the tumor tissue is heated to 95 DEG C,
the tumor tissue to produce a local high temperature and complete
necrosis, so as to achieve the purpose of treatment of cancer. At
present, radiofrequency ablation technology has been widely used in
various solid tumors, especially for liver tumors. It has almost become
the first standard treatment (has been included in medical insurance),
and has the advantages of small trauma, high cure rate, low cost and
fewer complications.
射頻消融系統(tǒng)一般包含射頻發(fā)生器、消融電極和皮膚電極，三者與人體組織一起構(gòu)成一個(gè)完整的回路。將電極針直接刺入人體病變組織，射頻發(fā)生器產(chǎn)生高頻交變電流（常用頻率200-500
kHz），電流從電極針末端的裸露部分進(jìn)入周?chē)M織，使得電極針周?chē)M織內(nèi)的極性分子和離子振動(dòng)、摩擦，繼而轉(zhuǎn)化為熱能。隨著手術(shù)的繼續(xù)，熱能逐漸向外周傳導(dǎo)，可使組織內(nèi)的溫度超過(guò)60℃，病變組織發(fā)生隨之不可逆地?zé)崮套冃约皦乃?，達(dá)到治療目的。
Radiofrequency ablation systems generally include radiofrequency
generators, ablation electrodes and skin electrodes, which constitute a
complete loop with human tissue. The electrode needle directly into the
body tissues, RF generator generates high frequency alternating current
(common frequency 200-500 kHz), the current from the exposed part of the
needle electrode tip into the surrounding tissue, the polar molecules
and ions around the needle electrode vibration and friction within the
organization, and then transformed into heat. As the operation
continues, the heat energy is gradually transmitted outward, enabling
the temperature in the tissue to exceed 60 degrees, and the pathological
tissue will undergo irreversible geothermal coagulation, degeneration
and necrosis, so as to achieve the purpose of treatment.
射頻消融系統(tǒng)由射頻發(fā)生器、消融電極和皮膚電極組成。
The radiofrequency ablation system consists of a radiofrequency generator, a ablation electrode and a skin electrode.
冷極射頻消融系統(tǒng)
Radiofrequency radiofrequency ablation system
使用常規(guī)射頻消融術(shù)時(shí)，隨著電極溫度升高，會(huì)出現(xiàn)局部高溫，在電極表面形成血栓、焦痂和炭化，會(huì)影響能量輸出和消融效果。因此，為了提高消融效率和手術(shù)成功率，可以采用冷極射頻消融系統(tǒng)。
The use of conventional radiofrequency ablation, with the electrode
temperature rise, there will be a local high temperature, thrombosis,
eschar and carbonization on the electrode surface, will affect the
output power and ablation effect. Therefore, in order to improve the
efficiency of ablation and the success rate of surgery, a cold
radiofrequency ablation system can be used.
冷極射頻消融系統(tǒng)能提高腫瘤治療手術(shù)的成功率。
Cold radiofrequency radiofrequency ablation system can improve the success rate of tumor treatment.
冷極射頻消融系統(tǒng)采用含內(nèi)置管的電極針，通過(guò)冷循環(huán)泵，將冷鹽水持續(xù)泵入電極針中。內(nèi)置管電極針具有封閉式和開(kāi)放式兩種：
The cold polar radiofrequency ablation system adopts the electrode
needle containing the built-in tube, and through the cold circulation
pump, the cold water is continuously pumped into the electrode needle.
The inner tube electrode needle has two kinds of closed and open type.
封閉式：冷鹽水不進(jìn)入血液循環(huán)或待消融組織，通過(guò)冷鹽水在電極內(nèi)部循環(huán)，來(lái)降低電極針末端和臨近組織的溫度。
Closed type: cold saline does not enter the blood circulation or the
tissue to be ablated, circulate through the cold brine inside the
electrode, so as to reduce the temperature of the electrode tip and the
adjacent tissue.
開(kāi)放式：電極針末端具有冷鹽水出口，冷鹽水直接沖刷電極針末端和組織表面然后進(jìn)入血液，以此來(lái)直接冷卻消融電極和周?chē)M織。
Open type: the end of the electrode needle has the outlet of the cold
brine, the cold saline directly scour the electrode tip and the tissue
surface and then enter the blood, so as to directly cool the ablation
electrode and surrounding tissue.
冷極射頻消融方法降低了電極末端的溫度，減輕電極附近組織的炭化和氣化現(xiàn)象，降低組織的阻抗，提高放電輸出功率，使得損傷深度增加，從而保證了射頻消融的有效性。在臨床實(shí)踐中常規(guī)電極消融無(wú)效時(shí)，可應(yīng)用冷極消融。
The cold pole radiofrequency ablation method reduces the temperature at
the end of the electrode, lightens the carbonization and vaporization
phenomena near the electrode, reduces the impedance of the tissue,
increases the discharge power and increases the damage depth, thus
ensuring the effectiveness of the radiofrequency ablation. Cold
electrode ablation can be applied when conventional electrode ablation
is not effective in clinical practice.
蠕動(dòng)泵在射頻消融中的應(yīng)用
The application of peristaltic pump in radiofrequency ablation
某射頻消融系統(tǒng)的制造廠家采用了蘭格公司的蠕動(dòng)泵（www.longerpump.com.cn），配套在其冷極射頻消融系統(tǒng)上，作為冷循環(huán)泵，將冷鹽水持續(xù)泵入內(nèi)置管電極針中來(lái)冷卻電極針和組織，以保證電極針末端及周?chē)M織的表面溫度低于70℃，使針尖組織不會(huì)發(fā)生炭化、焦痂等問(wèn)題，提高消融效率、縮短消融時(shí)間、提高消融成功率。
A manufacturer of radiofrequency ablation system using a peristaltic
pump Lange company (www.longerpump.com.cn), supporting in the
radiofrequency ablation system, as the cold circulating pump, the cold
saline continued to pump into the tube with the needle electrode to cool
the electrode needle and organization, to ensure that the surface
temperature at the end of the needle electrode and surrounding tissue is
lower than 70 C, the organization will not tip problem carbonization,
eschar, improve the ablation efficiency and shorten the time and improve
the success rate of ablation ablation.
某射頻消融系統(tǒng)廠家用蘭格公司的蠕動(dòng)泵來(lái)冷卻內(nèi)置管電極針和組織。
A radiofrequency ablation system manufacturer uses Lange's peristaltic pump to cool the inner tube electrode needle and tissue.
該射頻消融系統(tǒng)廠家對(duì)蠕動(dòng)泵的要求是：
The requirements of the radiofrequency ablation system manufacturers for peristaltic pumps are:
嚴(yán)格無(wú)菌操作，避免術(shù)中患者感染。
Strictly aseptic operation to avoid the infection of the patients during the operation.
針對(duì)開(kāi)放式電極針，要求蠕動(dòng)泵的流量較小，為十幾毫升每分鐘至幾十毫升每分鐘。而針對(duì)封閉式電極針，要求蠕動(dòng)泵的流量較大，為150-200 ml/min。
In view of the open electrode needle, the flow rate of the peristaltic
pump is less than ten milliliters per minute to tens of milliliters per
minute. For the closed electrode needle, the flow rate of the
peristaltic pump is 150-200 ml/min.
蠕動(dòng)泵的工作噪音小于60 dBA。
The working noise of the peristaltic pump is less than 60 dBA.
對(duì)此，蘭格公司的蠕動(dòng)泵解決方案是：
In this regard, the solution of Langer's peristaltic pump is:
G700蠕動(dòng)泵 + YZ1515X泵頭 + 14# Tygon S3 E-LFL軟管
G700 peristaltic pump + YZ1515X pump head + 14# Tygon S3 E-LFL hose
該方案提供140 ml/min的流量，泵上電即可運(yùn)行，無(wú)需再提供控制信號(hào)，操作極其簡(jiǎn)單方便。
The scheme provides 140 ml/min of the flow, the pump can run on power,
without the need to provide control signal, operation is extremely
simple and convenient.
BT100-2J蠕動(dòng)泵 + YZ1515X泵頭 + 16# Tygon S3 E-LFL軟管
BT100-2J peristaltic pump + YZ1515X pump head + 16# Tygon S3 E-LFL hose
該方案提供1.6-76
ml/min的流量范圍。流量可手動(dòng)調(diào)節(jié)，也可通過(guò)接收外部控制器發(fā)出的控制信號(hào)，實(shí)現(xiàn)冷卻系統(tǒng)流量的自動(dòng)調(diào)節(jié)，根據(jù)病人的身體情況，實(shí)時(shí)調(diào)節(jié)流量，以維持電極針在較低溫度。并且BT100-2J還可接受腳踏開(kāi)關(guān)信號(hào)，在手術(shù)中可通過(guò)腳踏板控制冷卻系統(tǒng)的啟動(dòng)和停止，便于醫(yī)護(hù)人員的手術(shù)順利進(jìn)行。
The scheme provides the traffic range of 1.6-76 ml/min. The flow can be
manually adjusted. It can also automatically control the flow of the
cooling system by receiving the control signals from the external
controller, adjusting the flow rate in real time according to the
patient's physical condition, so as to maintain the electrode pin at a
lower temperature. Besides, BT100-2J can also accept foot switch
signals. During operation, the start and stop of cooling system can be
controlled by pedals, so that the operation of medical staff can be
carried out smoothly.
G700型蠕動(dòng)泵（左）和BT100-2J型蠕動(dòng)泵（右）。
G700 type peristaltic pump (left) and BT100-2J type peristaltic pump (right).
蘭格的蠕動(dòng)泵通過(guò)擠壓軟管輸送液體，液體只與管路內(nèi)壁接觸，且管路中無(wú)需閥門(mén)和密封件，完全避免了傳輸液體和泵之間的交叉污染。通過(guò)使用滿足衛(wèi)生等級(jí)要求的一次性管路，即可確保冷極射頻消融手術(shù)
Lange's peristaltic pump transfers liquid through the extruding hose.
The liquid only contacts with the inner wall of the pipeline, and the
valve and seals are not needed in the pipeline, so that the cross
contamination between the transmission liquid and the pump is avoided.
The radiofrequency ablation operation of the cold pole can be ensured by
using a disposable pipe that meets the requirements of the hygienic
grade
