从能量角度计算2μm激光对犬前列腺组织汽化重量的体外实验研究  

Correlation between released laser energy and vaporized prostate tissue weights:an ex-vivo study with the 2 micron continuous wave laser

作　　者：赵怀明 郭和清[1,2] 严景民[1] 张蕾[1] 刘兰兰[1] 杨永红[1] 孙斌[1] 姚志勇[1] 穆大为[1] 周高标[1] 

机构地区：[1]解放军空军总医院泌尿外科,北京100142 [2]安徽医科大学空军总医院临床学院

出　　处：《临床泌尿外科杂志》2014年第4期346-349,352,共5页Journal of Clinical Urology

摘　　要：目的:通过体外观察2μm激光对犬前列腺组织的汽化重量与消耗激光能量之间的关系,探讨计算经尿道2μm激光前列腺手术中组织汽化重量的有效方法,并且观察2μm激光在不同功率及不同操作方式下的热损伤深度的变化。方法:从非相关试验死亡的成年混血狗摘取新鲜前列腺组织标本20例,共分成4组,每组5例。在37℃生理盐水持续冲洗的环境中,Revolix 2μm激光通过自制手持式激光操作件分别在40W和70W功率下以汽化切割和单纯汽化的方式处理标本,处理前后组织重量差即为汽化的组织重量,术后记录消耗的激光能量和激光累计发射时间。分析汽化的组织重量与消耗的激光能量之间的相关性。术后的前列腺组织经苏木精-伊红(HE)染色进行组织学分析。结果:随着能量从40W增加到70W,汽化切割组的汽化效能降低,差异有统计学意义(P=0.027);但是单纯汽化组的汽化效能增高,差异有统计学意义(P=0.001)。在70W功率下,汽化的组织重量与消耗的激光能量呈线性相关(Pearson相关系数r=0.868,P=0.001)。相同操作方式下,40W和70W产生的热凝固层深度差异无统计学意义。相同功率下,单纯汽化组的热凝固层深度>汽化切割组,差异有统计学意义(P<0.001)。结论:在体外模拟经尿道2μm激光前列腺手术情况下,通过消耗的激光能量可以计算出被汽化的前列腺组织重量;相同操作方式下,2μm激光输出功率的大小不影响热损伤的深度;相同功率下,单纯汽化相比汽化切割会加深2μm激光的热损伤,但仍在手术安全范围内。Objective： To explore the effective method to calculate vaporized tissues during endoscope prostate surgery with the 2 micron continuous wave laser by observing the association between vaporized canine prostate tissue weights and released laser energy in an ex-vivo study and to assess the thermal damage at different output power and different operating modes. Method： A total of 20 canine prostates were divided into four groups ran- domly. A 2 micron continuous wave laser with output power of 40 W and 70 W ablated tissue in a vaporesection or vaporization mode. Experiments were performed in a basin containing 0.9 % sodium chloride solution at a tempera- ture of 37 ℃. Vaporized canine prostate tissue weights were measured by recording the pre-and post-ablation sam- ple weight with an analytical balance. Released laser energy and laser emitting time were gained from the records of the laser. The ablated tissues were stained with hematoxylin and eosin for histological examination. Result： With the increase of output power from 40 W to 70 W, the ablation efficiency in the vaporesection mode decreased （ P = 0. 027）, while the ablation efficiency increased in the vaporization mode （ P = 0. 001）. The data showed a linear relationship between vaporized prostate tissue weights and released laser energy （Pearson correlation coeffi- cient r = 0. 868, P = 0. 001） at the output power of 70 W. Moreover the corresponding depths of coagulation zones had no significant differences under the same operating mode. In addition, under the same output power, vaporiza- tion produced a significantly deeper coagulation zone than that produced by vaporesection （ P 〈0. 001）. Conclu- sion： The amount of prostatic tissues vaporized by 2 micron continuous wave lasers could be calculated from the released laser energy through the linear relationship between vaporized prostate tissue weights and released laser energy, In the same operating mode, the output power of 2 micron continuous wave lasers did not affect the dep

关 键 词：激光 前列腺 能量 犬 组织损伤 

分 类 号：R697[医药卫生—泌尿科学]