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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 of calculating the vaporization weight of tissue in transurethral 2-μm laser prostatectomy by observing the relationship between the vaporization weight and laser energy consumption of canine prostate tissue by 2μm laser in vitro and to observe the effect of 2μm laser at different power and different operating modes Under the thermal damage depth changes. Methods: Twenty fresh prostate specimens were collected from non-related adult Mulatto dogs and divided into 4 groups, 5 in each. Revolix 2μm laser was processed by vapor deposition and vaporization at 40W and 70W respectively by self-made hand-held laser operating device. The difference of tissue weight before and after treatment was the vaporized tissue weight , Recorded after the laser energy consumption and laser cumulative launch time. The correlation between vaporized tissue weight and consumed laser energy was analyzed. Postoperative prostate tissue was stained with hematoxylin-eosin (HE) for histological analysis. Results: With the increase of energy from 40W to 70W, the vaporization efficiency of the vaporized cutting group decreased with a statistically significant difference (P = 0.027). However, the vaporization efficiency of the vaporized group increased significantly with a statistically significant difference (P = 0.001). At 70 W, the vaporized tissue weight was linearly related to the laser energy consumed (Pearson’s correlation coefficient r = 0.868, P = 0.001). The same operation mode, 40W and 70W produced no difference in the depth of the thermal coagulation layer. At the same power, the depth of thermal coagulation layer in the vaporization group was significantly higher than that in the vaporization group (P <0.001). Conclusions: In the case of transurethral transurethral 2 μm laser prostate surgery, the weight of vaporized prostate tissue can be calculated by laser energy consumed. In the same operation mode, the output power of 2 μm does not affect the depth of thermal damage. Under the same power , Vaporization compared to pure vaporization will deepen 2μm laser thermal damage, but still within the scope of surgical safety.