Efficacy And Security Of High-intensity Focused Ultrasound(HIFU) For Hepatoblastoma Of Children With The Aid Of Artificial Hydrothorax

Objectives:To evaluate the availability and security of high-intensity focusedultrasound (HIFU) for hepatoblastoma of children with the aid of artificialhydrothorax.Methods:18lesions in14children with hepatoblastoma received generalanesthesia using trachea cannula. Some saline was injected into rightthoracic cavity to turn artificial pleural fluid. Observe and record meaninvasive arterial pressure（IABP）， heart rate(HR)，peak airway pressure（Ppeak）,compliance of lung（Cmpl）， end-tidal carbon dioxide partialpress（PETCO2）and oxygen saturation（SpO2%）separately at5min afterintubation(T0),10min after establishment of artificial hydrothorax(T1),30min after HIFU treatment(T2),1h after HIFU treatment(T3),2h afterHIFU treatment(T4) and the end of HIFU treatment(T5). Blood gad ananlysis and temperature were mad at T0to T5and24h after HIFUtreatment(T6). On the first day and seventh day after HIFU treatment, chestX-ray was mad to evaluate the hydrothorax and lungs. Before and afterHIFU treatment MRI was mad to evaluate the availability.Results:200ml-300ml saline was injected to turn artificial pleural fluid. DuringHIFU treatment，all the children were steady in various parameters ofhaemodynamics. After establishment of artificial hydrothorax, Ppeak wasincreased significantly than T0（P＜0.05）and maintained at the high level;Cmpl was decreased than T0（P＜0.05）. PETCO2was increasedsignificantly after T2（P＜0.05）;After T2, temperature was increasedsignificantly than T0（P＜0.05）,At the end of treatmentT5,the temperaturedecreated significantly than T0（P＜0.05）,then one day after HIFUtreatment, temperature was increased significantly than T0again（P＜0.05）.PO2and PCO2were both increased significantly after T1（P＜0.05）.But PH were not change significantly（P＞0.05）and the fluctuationsof the respiratory parameters what were said above were all within the safetymargin. X-ray showed that artificial hydrothorax was absorbed within7daysafter HIFU treatment. Severe complications just like pneumothorax orhaemothorax had never been seen in the children. Postoperative imagingstudies (MRI or sonography) prompted all children with lesions reach a predetermined radio frequency ablation effect.Conclusion:High-intensity focused ultrasound (HIFU) for hepatoblastoma ofchildren with the aid of artificial hydrothorax is safe and effective.