CAJ | 학술논문

目的体外比较70 W和120 W 2μm激光汽化切除良性前列腺增生(BPH)组织的速度、组织损伤和汽化比率.方法体外模型的构建来自BPH患者前列腺摘除术的新鲜前列腺组织标本5例.实验将每例前列腺组织的左右叶分为2组,70 W组和120 W组各5例.手术在盛有流动37℃生理盐水的水盆中进行,手术方式模拟体内汽化切除术,70 W和120 W两种能量分别完成2组前列腺组织的汽化切除.测定2μm激光前列腺的汽化切除速度.术后评估2种能量的汽化切除速度和汽化所占的比率,以及2 μm激光对前列腺组织坏死层和凝固层的影响.结果随着能量从70 W增加到120 W,汽化切除的速度从(5.21±0.66) g/5 min增加到(10.84±1.23) g/5 min,两组间汽化切除的速度、切割速度和汽化速度差异具有明显的统计学意义,均P =0.000.70 W和120 W组的汽化方式所占汽化切除术的比率分别是81％和87％.随着能量的增加,激光对组织穿透深度(坏死层)和凝固层深度却没有明显变化.70 W组和120 W组的组织坏死层/凝固层深度分别是(0.98±0.13)/(0.30 ±0.09)mm和(0.99±0.12)/(0.31±0.08)mm,P＞0.05,组间差异无统计学意义.结论 120 W和70 W 2μm激光汽化切除人BPH组织均具有安全性和高效性,120 W比70 W2 μm激光汽化切除速度更快.汽化方式是汽化切除术的主要方式.
목적 체외비교70 W화120 W 2μm격광기화절제량성전렬선증생(BPH)조직적속도、조직손상화기화비솔.방법 체외모형적구건래자BPH환자전렬선적제술적신선전렬선조직표본5례.실험장매례전렬선조직적좌우협분위2조,70 W조화120 W조각5례.수술재성유류동37℃생리염수적수분중진행,수술방식모의체내기화절제술,70 W화120 W량충능량분별완성2조전렬선조직적기화절제.측정2μm격광전렬선적기화절제속도.술후평고2충능량적기화절제속도화기화소점적비솔,이급2 μm격광대전렬선조직배사층화응고층적영향.결과 수착능량종70 W증가도120 W,기화절제적속도종(5.21±0.66) g/5 min증가도(10.84±1.23) g/5 min,량조간기화절제적속도、절할속도화기화속도차이구유명현적통계학의의,균P =0.000.70 W화120 W조적기화방식소점기화절제술적비솔분별시81％화87％.수착능량적증가,격광대조직천투심도(배사층)화응고층심도각몰유명현변화.70 W조화120 W조적조직배사층/응고층심도분별시(0.98±0.13)/(0.30 ±0.09)mm화(0.99±0.12)/(0.31±0.08)mm,P＞0.05,조간차이무통계학의의.결론 120 W화70 W 2μm격광기화절제인BPH조직균구유안전성화고효성,120 W비70 W2 μm격광기화절제속도경쾌.기화방식시기화절제술적주요방식.
Objective To compare the speed of vaporesection of human prostatic tissue with benign prostatic hyperplasia (BPH) and depth of tissue danage using 70 and 120 W 2 μm laser devices.Methods Fresh prostatic tissue specimens were obtained from 5 patients by open prostatectomy and divided into separate groups (70 and 120 W) based on the energy of laser output (70 and 120 W respectively).Trials were performed in acryl basin containing 0.9％ saline at 37 ℃.And then each prostate gland in vitro was vaporesected similarly as routine transurethral 2 μm laser vaporesection.70 W and 120 W power were applied for prostatic vaporesection.The 2 μm laser vaporization proportion and vaporesection speed were calculated postoperatively.Prostatic tissue was embedded for histological evaluation.After hematoxylin and eosin(H&E)staining and nicotinamide adenine dinucleotide-reduced (NADH) measurement,depth of coagulation zone and necrotic tissue layer were measured.The results of prostatic tissue between two groups were compared.Results With increasing output power,the speed (mean ± SD) of vaporesection of human prostatic tissue increased from (5.21 ±0.66) g/5 min at 70 W to (10.84 ± 1.23) g/5 min at 120 W.Significant differences existed in the speed of vaporesection,resection and vaporization between 120 W and 70 W devices (P =0.000).The proportion of vaporization mode was 81％ at 70 W and 87％ at 120 W during prostatic vaporesection.There was a stable penetration/coagulation depth with increasing power output for (0.98 ±0.13)/(0.30 ±0.09) mm at 70 W and (0.99 ±0.12)/(0.31 ±0.08) mm at 120 W.There were no significant differences in penetration and coagulation depth between 120 W and 70 W (P ＞ 0.05).Conclusions Both 120 and 70 W 2 μm Laser devices yield excellent performance and security in vaporesected human prostate tissue.The 120 W 2 μm laser offers significantly higher vaporesection rates than 70 W power.And vaporization mode is a predominant procedure of prostatic vaporesection.