Background Excessive blood loss is the leading cause of early death from closed abdominal injuries, and there is still lack of quick and effective hemostatic techniques.

Objective To explore the hemostatic effect of ultrasound flash mode-assisted microwave coagulation for active liver hemorrh.

Methods A total of 24 miniature pigs were randomly divided into the treatment group and the control group, with 12 pigs in each group. Under guidance, two puncture bleeding points were created at three sites near the diaphragm, gallbladder, and hepatic artery. The treatment group received ultrasound mode-assisted microbubble microwave ablation (Flash MBs MWA), while the control group received microwave ablation (MWA). The heart rate blood pressure changes, hemostatic time, ultrasound image echo area, hematocrit test, and pathological changes in liver cells were compared between the two groups.

Result The hemostatic time near the diaphragm (2.25 ± 0.43 min vs 5.17 ± 0.80 min, P ＜0.001), near the gallbladder (2.42 ± 0.49 min vs 6.17 ± 0.8 min, P ＜0.001), and near the hepatic artery (5.50 ± 0.50 min vs 9.67 ± .85 min, P ＜0.001) were shorter in the Flash MBs MWA group than in the MWA group. Flash MBs MWA group showed significantly enhanced echoes in the microwave ablation area under ultrasound, with the contrast agent leakage stopped and clear boundaries with surrounding. After treatment, the red blood cell count, hemoglobin, hematocrit, and platelet count were higher in the Flash MBs MWA than in the MWA group (P＜0.05). There were no significant differences in liver function indicators between the two groups (P＞0.5). Pathological analysis of the Flash MBs MWA group showed varying degrees of hepatic sinus congestion and dilation.

Conclusion Ultrasound-activated microubbles combined with microwave ablation can effectively treat active liver hemorrhage, providing a portable and effective treatment option for timely diagnosis and hemostasis control in emergency and scenarios.