中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2014年
3期
212-215
,共4页
林满霞%徐明%黄光亮%谢晓燕%郑曙光%刘保娴%吕明德
林滿霞%徐明%黃光亮%謝曉燕%鄭曙光%劉保嫻%呂明德
림만하%서명%황광량%사효연%정서광%류보한%려명덕
激光消融%肝脏%温度
激光消融%肝髒%溫度
격광소융%간장%온도
Laser ablation%Liver%Temperature
目的 了解激光消融在离体和活体肝组织的消融特性和温度变化,为临床制定消融方案提供参考.方法 采用7W和5W两种功率激光仪对离体猪肝进行单针单点消融;采用5W功率激光仪对活体兔肝进行单针单点消融.两者能量输出均为1800J.观察不同功率激光在体内外肝组织造成的消融范围、形态以及5W功率激光消融过程中的温度变化.结果 激光消融灶为光纤向前发射形成,呈类椭圆形.消融灶从内向外可分为黑色碳化区及褐白色坏死区.离体猪肝实验,功率5W激光平均消融范围1.9 cm ×1.2 cm×1.2 cm,碳化范围1.1 cm ×0.5 cm ×0.5 cm;功率7W激光消融范围2.5 cm×1.5 cm ×1.5 cm,碳化范围1.4 cm ×0.7 cm ×0.7 cm.功率5W的消融中心、旁开5 mm及旁开10 mm的平均最高温度分别为243.57℃、62.47℃、34.27℃.活体兔肝实验,功率5W所获消融范围约为1.4cm×1.1 cm×1.1 cm.消融中心旁开5 mm及10 mm的平均最高温度分别为62.26℃、44.35℃.结论 激光消融对体内外肝组织造成的凝固坏死范围较小,能量较为集中.由于其对肝功能和周围组织影响小,故可用于危险部位的小肿瘤消融.
目的 瞭解激光消融在離體和活體肝組織的消融特性和溫度變化,為臨床製定消融方案提供參攷.方法 採用7W和5W兩種功率激光儀對離體豬肝進行單針單點消融;採用5W功率激光儀對活體兔肝進行單針單點消融.兩者能量輸齣均為1800J.觀察不同功率激光在體內外肝組織造成的消融範圍、形態以及5W功率激光消融過程中的溫度變化.結果 激光消融竈為光纖嚮前髮射形成,呈類橢圓形.消融竈從內嚮外可分為黑色碳化區及褐白色壞死區.離體豬肝實驗,功率5W激光平均消融範圍1.9 cm ×1.2 cm×1.2 cm,碳化範圍1.1 cm ×0.5 cm ×0.5 cm;功率7W激光消融範圍2.5 cm×1.5 cm ×1.5 cm,碳化範圍1.4 cm ×0.7 cm ×0.7 cm.功率5W的消融中心、徬開5 mm及徬開10 mm的平均最高溫度分彆為243.57℃、62.47℃、34.27℃.活體兔肝實驗,功率5W所穫消融範圍約為1.4cm×1.1 cm×1.1 cm.消融中心徬開5 mm及10 mm的平均最高溫度分彆為62.26℃、44.35℃.結論 激光消融對體內外肝組織造成的凝固壞死範圍較小,能量較為集中.由于其對肝功能和週圍組織影響小,故可用于危險部位的小腫瘤消融.
목적 료해격광소융재리체화활체간조직적소융특성화온도변화,위림상제정소융방안제공삼고.방법 채용7W화5W량충공솔격광의대리체저간진행단침단점소융;채용5W공솔격광의대활체토간진행단침단점소융.량자능량수출균위1800J.관찰불동공솔격광재체내외간조직조성적소융범위、형태이급5W공솔격광소융과정중적온도변화.결과 격광소융조위광섬향전발사형성,정류타원형.소융조종내향외가분위흑색탄화구급갈백색배사구.리체저간실험,공솔5W격광평균소융범위1.9 cm ×1.2 cm×1.2 cm,탄화범위1.1 cm ×0.5 cm ×0.5 cm;공솔7W격광소융범위2.5 cm×1.5 cm ×1.5 cm,탄화범위1.4 cm ×0.7 cm ×0.7 cm.공솔5W적소융중심、방개5 mm급방개10 mm적평균최고온도분별위243.57℃、62.47℃、34.27℃.활체토간실험,공솔5W소획소융범위약위1.4cm×1.1 cm×1.1 cm.소융중심방개5 mm급10 mm적평균최고온도분별위62.26℃、44.35℃.결론 격광소융대체내외간조직조성적응고배사범위교소,능량교위집중.유우기대간공능화주위조직영향소,고가용우위험부위적소종류소융.
Objective To evaluate the ablation zone and temperature changes in the liver caused by laser ablation in vitro and in vivo.Methods Single needle single point laser ablation was performed in vitro with porcine liver using 5 W and 7 W-power and in vivo with rabbit liver using 5 W-power.All energy outputs were 1 800 J.The ablation zone and temperature changes were evaluated.Results Coagulation caused by laser ablation was divided into a black carbonized area and a brown white necrotic area from inside to out,respectively.The mean in vitro ablation range obtained by 5 W and 7 W-power laser ablation was 1.9 cm × 1.2 cm × 1.2 cm and 2.5 cm × 1.5 cm × 1.5 cm,respectively.The mean in vitro black carbonized range obtained by 5 W and 7 W-power laser ablation was 1.1 cm × 0.5 cm × 0.5 cm and 1.4 cm × 0.7 cm ×0.7 cm,respectively.The average maximum temperature using 5 W-power was 243.57 ℃,62.47 ℃ and 34.27 ℃ in the ablation center,5 mm from the center,and 10 mm from the center,respectively.For in vivo liver experimentation,the average maximum temperature using 5 W-power was 62.26 ℃ and 44.35 ℃5 mm and 10 mm from the center,respectively.Conclusion Laser ablation can cause coagulation necrosis of the liver tissue in vitro and in vivo,and the ablation range increased with increasing power.Laser ablation may have potential use in the ablation of tumor localized in critical sites.
