第二代氩离子凝固疗法对人离体胃组织的热组织学效应  

Thermal tissue effects of the second-generation argon plasma coagulation on human stomach tissue:An ex vivo study

作　　者：张莉[1] 董蕾[1] 柳嘉[2] 黎一鸣[3] 马师洋[1] 邹百仓[1] ZHANG Li;DONG Lei;LIU Jia;LI Yi-ming;MA Shi-yang;ZOU Bai-cang(Department of Gastroenterology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China;Department of Orthopedics,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China;Department of General Surgery,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学医学院第二附属医院消化科,陕西西安710004 [2]西安交通大学医学院第二附属医院骨科,陕西西安710004 [3]西安交通大学医学院第二附属医院普外科,陕西西安710004

出　　处：《西安交通大学学报（医学版）》2018年第1期84-87,92,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：中央引导地方科技发展专项资金项目子课题(No.2016ZY-HM-01)~~

摘　　要：目的探讨第二代氩离子凝固疗法(VIO APC)不同作用模式、功率及作用时间对人离体胃组织的热损伤效应。方法外科手术切除的大体正常的胃标本,采用VIO APC进行处理。功率分别设为15、30、45、60、75、90、105、120W,作用时间3、5、10s,模式分别为强力电凝模式(forced,F)、脉冲电凝模式1(pulsed 1,P1)、脉冲电凝模式2(pulsed 2,P2),记录最大损伤直径及损伤深度。结果胃组织的损伤深度与功率(P<0.001)、能量(P=0.008)及不同的作用模式(P=0.013)均相关;胃组织的最大损伤直径与功率(P<0.001)、作用时间(P=0.001)、能量(P<0.001)及作用模式(P=0.001)均相关。胃组织有害损伤的发生主要与作用模式(P=0.012)有关。损伤深度为P1>F>P2(P<0.05),而损伤的最大直径为P2>P1>F(P<0.05)。结论不同模式的VIO APC对胃肠组织产生不同的作用效果。与F模式相比,P1模式主要产生较深的组织损伤效应,而P2模式则产生直径较大但较表浅的损伤效应。但以上模式均可产生累及肌层的损伤。ObjectiveTo explore the thermal effects of the second generation argon plasma coagulation(VIO APC/APC2)on ex vivo human stomach tissue with different mode,output power and application time.MethodsThe thermal effects of VIO APC were studied on fresh surgery resected human stomach tissues.Different output powers were combined with mode“forced(F)”,“pulse,effect1(P1)”and“pulse,effect2(P2)”;three application time,the depth and maximum diameter of each injury were recorded.ResultsThe depth of tissue injuries was correlated with output power(P<0.001),energy(P=0.008)and mode(P=0.013).The maximum diameter of injuries was correlated with output power(P<0.001),application duration(P=0.001),energy(P<0.001)and mode(P=0.001).The incidence of harmful damage was only related to mode(P=0.012).The depth of tissue injuries was P1>F>P2(P<0.05),and the maximum diameter of injuries was P2>P1>F(P<0.05).ConclusionDifferent modes of VIO APC can create different thermal effects on the gastric tissues.Compared with F mode,P1mode creates deeper injuries while P2mode creates larger but shallow injuries.All the three modes may cause injuries involving muscularis propria.

关 键 词：氩离子凝固疗法 消融疗法 消化系统内镜 组织学效应 

分 类 号：R459.9[医药卫生—治疗学]