多形等离子体手术刀在爆炸伤模型中的清创效果研究  

Study of debridement effects of multi shapes of plasma scalpels in explosion injury model

作　　者：郑宏烨 李宇[2] 徐梓恒 韦禹帆 张博雅 李晏[2] 朱荔 李席如 ZHENG Hong-ye;LI Yu;XU Zi-heng;WEI Yu-fan;ZHANG Bo-ya;LI Yan;ZHU Li;LI Xi-ru(School of Medicine,Nankai University,Tianjin 300071,China;Department of General Surgery,the First Medical Center of Chinese People's Liberation Army General Hospital,Beijing 100853,China)

机构地区：[1]南开大学医学院,天津300071 [2]解放军总医院第一医学中心普通外科,北京100853

出　　处：《医疗卫生装备》2025年第2期31-38,共8页Chinese Medical Equipment Journal

基　　金：军队科研项目(2022SYSZZKY18)。

摘　　要：目的:探究3种等离子体手术刀在爆炸伤动物模型中的清创效果,并与钢制手术刀和高频电刀进行对比。方法:首先,利用高压气体冲击配合预置金属弹片在9头长白猪右后肢内侧面腹股沟区域构建爆炸伤创面模型。其次,以宽型、箭型、针型等离子体手术刀为实验组,钢制手术刀和高频电刀为对照组进行清创。清创过程中记录各设备的工作温度和清创时间,并在术后取创面标本进行病理分析。对比宽型、箭型、针型等离子体手术刀与高频电刀、钢制手术刀的清创效率,以及电切和电凝模式下宽型、箭型、针型等离子体手术刀与高频电刀4种设备的最高工作温度和组织热损伤深度(钢制手术刀因无热量产生不参与对比)。采用GraphPad Prism 9.5.1软件进行统计学分析。结果:3种多形等离子体手术刀的清创效率与钢制手术刀、高频电刀比较差异无统计学意义(P>0.05)。清创手术过程中,3种等离子体手术刀的最高工作温度与高频电刀相比更低,差异有统计学意义(P<0.05)。在电切和电凝模式下,3种等离子体手术刀的热损伤深度均较高频电刀小,差异有统计学意义(P<0.05)。4种设备电凝模式的热损伤深度均大于电切模式,差异有统计学意义(P<0.05)。结论:多形等离子体手术刀能有效完成清创手术,清创效能与钢制手术刀和高频电刀相当,且等离子体手术刀的工作温度更低,对组织产生的热损伤更小,具有更好的创面保护效能。Objective To explore the debridement effects of 3 types of plasma scalpels for the animal model of explosion injury,and to compare them with the steel scalpel and high-frequency electrosurgical scalpel.Methods Firstly,blast wounds were constructed in the right inguinal regions of 9 Landrace pigs by high-pressure gas impact combined with preset metal shrapnel.Secondly,debridement was carried out in experimental groups with wide-,arrow-or needle-type plasma scalpel and in control groups with steel and high-frequency electrisurgical scalpel,with the operating temperature and debridement time recorded during the procedure and trauma specimens analyzed pathologically after the debridement;comparisons were performed among the five types of scalpels in terms of debridement effect,and among the four ones in terms of maximum operating temperature and depth of tissue thermal damage under electrocutaneous cutting and electrocoagulation modes with the steel scalpel excluded because it did not generate any heat.GraphPad Prism 9.5.1 software was used for statistical analysis.Results There were no significant differences in debridement effect found between the three plasma scalpels and the steel and high-frequency electrosurgical scalpels(P>0.05).The three types of plasma scalpels had the maximum operating temperature lower significantly than that of the high-frequency electrosurgical scalpel during debridement(P<0.05).Under electrosection and electrocoagulation modes the three plasma scalpels had the depths of tissue thermal damage statistically less than that by the high-frequency electrosurgical scalpel under electrosection and electrocoagulation modes(P<0.05).The depths of tissue thermal damage by the four scalpels under electrocoagulation mode were obviously greater than those under electrosection mode(P<0.05).Conclusion Multi shapes of plasma scalpels behave well in debridement with low operating temperature,little tissue thermal damage and high efficiency for wound protection and the same efficacy with the steel scalpel

关 键 词：等离子体 手术刀 清创术 爆炸伤模型 低温大气压等离子体 清创效果 

分 类 号：R318.6[医药卫生—生物医学工程] TH777[医药卫生—基础医学]