激光在肺组织消融灶与输出功率、能量的效应观察研究  

Observational study on effect of laser in different power and energy on lung tissue

作　　者：崔琪浩 俞小卫[1] CUI Qi-hao;YU Xiao-wei(Department of Respiratory and Critical Care Medicine,the Affiliated Changzhou NO.2 People’s Hospital of Nanjing Medical University,Changzhou,Jiangsu 213003,China)

机构地区：[1]南京医科大学附属常州二院,江苏常州213003

出　　处：《临床肺科杂志》2023年第6期892-897,共6页Journal of Clinical Pulmonary Medicine

摘　　要：目的探索离体肺组织激光消融灶与输出功率、能量的效应关系,为临床开展激光消融肺部肿瘤提供参考。方法使用980nm半导体激光仪对离体猪肺组织进行激光消融,根据不同功率与能量组合设定28个消融参数,每个参数重复6次,观察肺组织激光消融损伤形态,探究不同消融功率、能量与消融灶大小、形状之间关系。结果激光消融灶为激光经光纤向前发射形成,消融灶起始端与光纤裸露端起点重合,消融灶中心为空腔,空腔内表面为黑色炭化组织,向外为呈棕褐色改变的坏死组织,与周围正常肺组织界限清晰,消融效果确切;功率不变时,消融灶体积随能量增大而增大,3W组及5W组分别在能量为1500J及1800J时进入体积上升平台期;能量不变时,消融灶体积随功率增大而增大,在1200J~2100J范围内尤为显著。但高功率组(10W、15W)消融灶球度系数明显小于低功率组(3W、5W),消融灶呈长条状,与多为球形的肺部瘤灶适配性差,低功率组消融灶更接近球形,球度系数大,更具有适形性。结论980nm半导体激光消融肺组织效果确切,消融灶体积随输出能量和功率增加而增加。高功率消融灶体积虽较低功率大,但适形性低,对于肺部瘤灶的激光消融推荐输出功率10W以下为宜。其中5W为较适宜消融功率,消融能量选择不超过1800J为宜,适用于1cm以下的肺瘤灶。Objective To explore the relationship of laser ablation foci in isolated lung tissue with output power and energy,so as to provide evidence for clinical laser ablation in lung tumors.Methods Laser ablation was performed on vitro porcine lung by 980nm semiconductor laser therapy intrustment.The 28 ablation parameters were set according to the different ablation power and energy combinations,and each ablation parameter was repeated 6 times.The lesion morphology of lung tissue after laser ablation was observed,and the relationship of ablation power and energy with the size and shape of the lesion was explored.Results The laser ablation lesion was formed by the fiber-optic forward emission,the starting-end of which coincided with the starting-end of the bare fiber.The center of the ablation foci was cavity,the inner surface of the cavity was black carbonized tissue,the outward was brown necrotic tissue,the boundary with the surrounding normal lung tissue was clear,and the ablation effect was exact.The ablation foci increased in volume with increasing energy when the power was constant.When the ablation power was 3W,the volume of the ablation foci increased slower after energy above 1500J,entering the platform period.When the ablation power was 5W,the volume of the ablation foci basically remained unchanged after energy above 1800J.When the energy was constant,the volume of ablation foci increased with the growth of power,which was significant in the energy range of 1200J-2100J.Although the volume of ablation foci in the high power(10W and 15W)groups were larger than that in the low power(3W and 5W)groups,but the sphericity coefficient was significantly smaller than that in the low power groups.The shape of laser foci in the high power groups showed long strips,which had poorer suitability for spherical lung tumor.Conclusion The 980nm semiconductor laser ablation of lung tissue is very effective.The volume of ablation foci increases with the growth of output power and energy.Although the volume of ablation foci in hig

关 键 词：半导体激光 热消融 肺组织 功率 能量 

分 类 号：R734.2[医药卫生—肿瘤]