Microbubble-enhanced non-focused ultrasound treatment of posttraumatic liver hemorrhage

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 APTT [(58.7±18.7)s] in heparin with ultrasound and microbubble group showed significant prolongation compared with other three groups (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 (P 0.05). After treatment, bleeding area in heparin with ultrasound and microbubble group [(2.2±1.3)cm2]was increased when compared to ultrasound with microbubble group [(0.8±0.7)cm2] ( P<0.05), but both 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 group and heparin with ultrasound and microbubble group that compressed hepatic sinus, blood vessels in the portal area and central vein, and significant blood stasis in blood vessels. Conclusion Microbubbles-enhanced non-focused ultrasound has good hemostatic effect for posttraumatic liver hemorrhage. Key words: Liver; Hemostasis; Sonication