Ultrasonic focusing knife (commonly known as "Haifu knife") is a treatment method for various solid benign and malignant tumors (such as liver cancer, breast cancer and hysteromyoma).
Chinese name: ultrasonic ablation surgery composition: ultrasonic focusing knife, ultrasonic scalpel features: image monitoring advantages: non-invasive treatment principle, treatment characteristics, treatment advantages, main hospitals, ultrasonic scalpel, treatment principle. It is also called ablation in histopathology by using the characteristics that ultrasound can penetrate human tissues and focus on a specific target area to gather energy to sufficient intensity, so that the focus area can reach instantaneous high temperature and destroy the target area tissue. So as to achieve the purpose of destroying the lesion area, and the tissues outside the lesion area are not damaged. Treatment characteristics (1) image monitoring: Real-time monitoring of ultrasound images is used to determine the target tumor selected in the plan. The whole treatment process is controlled by the system, and the feedback of treatment effect is provided in time. ⑵ Accuracy: The energy at the focus can cause coagulative necrosis of the tissue at the focus, and there is no damage to the surrounding tissue or the tissue on the vocal tract. The boundary between the treatment area and the non-treatment area is only 6 to 10 units wide. ⑶ Free movement: Lesions and monitoring probes can move freely in space, and three-dimensional combined scanning treatment can be realized. Doctors can choose fast, flexible and effective treatment schemes according to different patients and different tumors. ⑷ Thorough treatment: The treatment planning software of focused ultrasound tumor treatment system can help doctors accurately lock and remove the whole tumor tissue. There is no upper limit to the tumor volume that can be treated. ⑸ Controllable treatment: In the whole treatment process, real-time imaging technology can provide video feedback for doctors, and adjust the treatment dose at any time according to the change of digital gray scale. Treatment advantages: The whole treatment process is non-invasive, non-bleeding, and does not require anesthesia, which truly realizes the treatment of tumors in vivo from outside and kills tumor tissues. During the treatment, the focus depth of ultrasound was changed by moving the ultrasound therapeutic head, and the whole myoma was conformal ablated by using the combined scanning mode of point-line-face-body. 1, non-invasive treatment in vitro, completely destroying internal lesions; No surgery, no radiation injury; No surgical exposure or puncture guidance is required; It will not damage the tissue through which the ultrasonic wave passes or the normal structure outside the target area. 2. The treatment with low total cost can obviously shorten the hospitalization time of patients; No blood transfusion during treatment; Significantly reduce the postoperative complications of patients, patients with little pain, and recover quickly after treatment; Reduce the use of broad-spectrum antibiotics after operation. 3. In vitro scanning therapy with uniform dose distribution makes the ultrasonic energy distribution in the target area uniform; It solves the problem of minimally invasive interventional therapy (microwave, radio frequency, laser, cryotherapy, etc.). ) Rely on the therapeutic head for energy diffusion, and the therapeutic dose distribution is uneven. 4. The lethal dose of ultrasound in the target area is non-selective and completely destroys any tissue in the target area; According to the principle of surgical resection, the lesions in the body are "excised" from the outside. 5. The three-dimensional conformal therapy group is suitable for conformal scanning therapy, which fully ensures the complete destruction of internal lesions from the outside; Not limited by tumor shape. 6. Treatment that is not limited by tumor size can completely destroy cancer blocks of any size in the body. 7. Treatment of selective destruction of blood vessels Under normal circumstances, only blood vessels with a diameter less than 2mm in the tumor are destroyed, which effectively ensures the safety of treatment; Enlarging the treatable range of the lesion makes it possible to treat some tumor patients who cannot accept surgery due to vascular anatomical factors; Promote the repair of local normal tissues. Stereotactic localization of tumor during real-time treatment; Ultrasonic monitoring device monitors the whole treatment process in real time, effectively preventing off-target. Real-time treatment 9. Judge the curative effect in real time during the treatment, and timely evaluate whether there is coagulation necrosis and skin damage in the treatment area through the changes of the target area before, during and after treatment. 10. Dose control therapy can judge the curative effect of the target area in real time, control the therapeutic dose by feedback, and make the lethal dose evenly distributed in the target area. Main Hospital Chinese People's Liberation Army General Hospital (Beijing 30 1 Hospital) 307 Hospital China People's Liberation Army First Affiliated Hospital Chongqing Medical University Second Affiliated Hospital Chongqing Fourth Military Medical University Three Gorges Central Hospital (Xi) Xijing Hospital Affiliated to Jixi People's Hospital in Heilongjiang Province Henan University (Nanyang) Heather Hospital Affiliated to Guangdong Medical College (Shenzhen) Futian Hospital, Hong Kong Mary Hospital, Churchill Hospital in England, European Cancer Center of Oxford University, Russian National Medical Surgery Center, Cisanello Hospital of University of Pisa, Italy, Affiliated Hospital of Chiba University Medical College, HMT Hospital of Spain, Russian Central Bank Hospital, Ultrasonic Ablation Treatment Center of Notre Dame Hospital of Ruyi Island, Korea, and Clinica E.T Clinic of Japan. Fusion Treatment Center Ultrasonic Ablation Treatment Center of American Hospital in Rome, Italy Ultrasonic scalpel is not what we usually see. It is an ultrasonic wave that can cut the internal tissues of human body like a real knife by using the principle of ultrasonic wave. The principle of ultrasonic scalpel in the treatment of tumors is that hundreds of high-energy ultrasonic waves (equivalent to 50,000 ordinary B-ultrasound machines) are emitted by an ultrasonic transmitter by using the powerful penetrating power of ultrasonic waves. Focusing on tumor tissue like concentrated solar energy, using high-energy ultrasonic cavitation to rupture the cell membrane of tumor tissue, and at the same time, the huge energy released by high-energy ultrasound is quickly converted into heat energy, and the temperature of tumor tissue at the instant focus reaches 70℃-100℃. The ultrasonic scalpel identifies and locks the tumor in this way: the ultrasonic scalpel has a tumor identification system, which can accurately detect the location and size of the tumor. Then the image information is transmitted to the computer. After receiving the information, the computer can automatically lock the tumor. Under the control of computer, ultrasonic waves can pass through normal tissues of human body and reach tumor tissues without damage, which can not only kill tumor cells, but also damage normal tissues around tumors. Ultrasonic scalpel treatment and indications are: mainly suitable for abdominal, pelvic and body surface tumors. It mainly includes: pancreatic cancer, liver cancer, benign and malignant tumors of kidney and adrenal gland, gastric cancer, rectal cancer, colon cancer, prostate cancer, prostatic hyperplasia, bladder cancer, uterine cancer, hysteromyoma, ovarian cancer, various abdominal and pelvic metastatic cancers, etc. Ultrasonic scalpel treatment has no harm to human body, because ultrasonic wave is a mechanical wave, which does not contain radiation and has no harm to human body. Ultrasonic scalpel treatment is a non-invasive treatment method. There are no operations and stab wounds during the treatment, and patients have no pain when receiving treatment. The advantages of ultrasonic scalpel treatment are: no surgery, no stabbing, no bleeding, no trauma and no anesthesia. Reliable curative effect. Combined with surgery, chemotherapy and radiotherapy, the best therapeutic effect can be obtained. A new way to treat solid tumors-high intensity focused ultrasound therapeutic instrument-high intensity focused ultrasound technology is an ultrasonic surgical treatment technology that appeared in the 1940s. It focuses the ultrasonic energy emitted by ultrasonic waves on human tissues in a certain focusing way, and forms a region with high sound intensity in the tissues, so that the temperature of the tissues in it can reach above 70℃ within 0.5-5 seconds, and these tissue cells can be coagulated and necrotic without damaging normal tissues outside the focus area. This non-invasive treatment method avoids the toxic side effects and radioactive accumulation of radiotherapy and chemotherapy, and also avoids the pain and injury of surgery. It is especially suitable for patients with deep tumor lesions and unsuitable for surgery, and is welcomed by doctors and patients. In foreign countries, the development of this product is currently in the technical research and clinical stage, and it has not yet formed a commodity. According to experts, the innovation of the system lies in splicing six spherical concave piezoelectric ceramic pieces into a hemispherical concave self-focusing transducer array, and adopting new technologies such as acoustic matching, first pan-audio operation and special three-dimensional curved focusing transducer to obtain better focusing ultrasonic field and electroacoustic conversion efficiency; Three-dimensional reconstruction, computer-aided intervention (CAMI) technology and ablation identification technology pioneered in China are applied to high-intensity focused ultrasound, which effectively improves the effectiveness and efficacy evaluation of tumor treatment. Multi-degree-of-freedom accurate positioning and imaging to ensure product accuracy; It has the function of system sound field self-inspection, and can provide the parameters of focused sound field by starting the automatic measurement software of system sound field. This project has obtained the national invention patent. First, the treatment principle HIFU treatment is mainly carried out through several aspects. 1. Thermotherapeutic effect should be: Under normal circumstances, the critical point of lethal temperature of tumor cells is 42.5~43.0℃, and that of normal cells is 45℃. For liver tissue, local temperature exceeding 58℃ can cause coagulation necrosis of tissue. Different from low-power focused ultrasound, HIFU therapeutic instrument focuses high-intensity ultrasound energy on the treatment area, which can quickly raise the tissue temperature of the target area to above 70℃ within 0.5 seconds, thus making the protein in the cells in the treatment area coagulate and necrotize rapidly, which has therapeutic effect. 2. Cavitation effect: Tumor cells are mechanically destroyed by the violent expansion and contraction of bubbles. 3. Immunity: The necrotic tumor tissue can play the role of * * * body immunity at the same time, and produce anti-tumor effect in the later stage. Second, the therapeutic feature HIFU produces coagulative necrosis or lesions in the target tissue. Its remarkable feature is that a clear transition zone is produced in the treatment area and other areas. The transition zone is less than 50μm, and contains only 5 ~ 7 layers of cells, which directly kills the target tissue, but does not or slightly damage the surrounding tissues, which is different from other three-dimensional therapeutic instruments such as gamma knife (it still has great damage around the target area). The study of animal liver found that the temperature in the center of the lesion was the highest, reaching 53℃. This temperature can completely denature protein of cells and cause coagulation and necrosis of target tissues. In isolated liver tissue, under a certain sound intensity, the longer the irradiation time, the higher the temperature in the center of the focal zone and the larger the biological focal zone, but the temperature rise zone at the outer edge of the focal zone is almost the same (all 4.5mm). Anatomical and pathological examination also confirmed that the boundary between the injured tissue and the surrounding normal tissue is clear. In living liver tissue, the temperature 2.5 mm away from the periphery of the lesion is normal. The temperature rise area of living tissue is narrower than that of in vitro tissue, which may be caused by the heat dissipation of living tissue through blood flow around the target area. This result shows that HIFU can effectively destroy the target tissue, but the surrounding tissue is not affected or has little influence [4]. It is precisely because of the different tissue effects inside and outside the target area that HIFU therapy has the following characteristics. Advantages: (1) non-invasive: it only acts on the target tissue, and its adjacent tissues and organs are not affected. (2) Monitorability: During the treatment, the therapeutic effect can be monitored through the changes of ultrasonic shadow of tissue necrosis after treatment. Side effects: Very few, only a few have skin damage. Third, the indications are wide. At the depth of 3- 15cm from the body surface, most solid tumors in abdominal cavity, pelvic cavity and body surface can be treated with focused ultrasound. Patients who are old and weak, or have obvious complications of other organs (such as liver, kidney and pancreas) and other obvious surgical contraindications can also be treated; For advanced tumors, besides killing primary tumor cells locally, radiotherapy and chemotherapy can also be combined to improve the therapeutic effect of radiotherapy and chemotherapy. For tumors that cannot be surgically removed, they are not sensitive to radiotherapy and chemotherapy, or they are unwilling to be surgically removed again after surgery. At this time, the high-intensity focused ultrasonic scalpel can shrink or necrosis the tumor entity, which is beneficial to relieve symptoms, improve the living conditions of patients and improve their immunity and quality of life. High intensity focused ultrasound (HIFU) is a hyperthermia method that can coagulate and necrotize tumor tissue in vivo from outside. It focuses the ultrasonic energy on one point, so that the tissue temperature at the focus suddenly rises (65℃- 100℃), and the tumor tissue is destroyed by high temperature, thus achieving the purpose of killing tumor cells, while the surrounding normal tissues are not affected. When ultrasonic waves propagate in the human body, the ultrasonic energy is absorbed by human tissues and converted into heat energy (in sunlight, it is light waves that are absorbed by the human body and converted into heat energy). Normal tissues of human body can take away most of the heat through effective blood circulation, so the temperature change of normal tissues is relatively small and slow, while the blood circulation of tumor tissues is only 2%- 15% of that of normal tissues, and the blood circulation is very poor, because it is not heat-resistant, and the temperature changes obviously. This characteristic of tumor cells makes it an excellent target of "ultrasonic scalpel". On the one hand, tumor cells undergo coagulation necrosis during the treatment of "ultrasonic scalpel"; On the other hand, its own blood supply vessels are also in a state of occlusion and coagulation, which makes tumor cells lose nutrition. The two factors work together, which eventually leads to the death of tumor cells and is gradually digested and absorbed by the body. Compared with other methods to treat tumors, high intensity focused ultrasound has the following advantages: no surgical trauma. 2. High temperature, rapid heating and precise focusing can instantly coagulate and necrotize tumor tissue. 3. No radiation damage, no need for protection. 4. Chemotherapy has no toxic side effects. 5. It has synergistic effect with radiotherapy and chemotherapy. China's high-intensity focused ultrasound therapy technology began to be applied in clinic on 1998, which played a very positive role in ablating tumors, improving patients' clinical symptoms and improving their quality of life. It is suitable for treating hysteromyoma, adenomyoma, breast tumor, recurrent pelvic and abdominal cavity and metastatic solid mass, pancreatic cancer, liver cancer, etc. In recent years, this technology has been rapidly popularized at home and abroad, and it is increasingly welcomed by patients.