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目的探讨医用1.44μm波长脉冲Nd∶YAG激光对犬胃壁组织作用的量效关系及其临床意义。方法采用脉宽640μs,频率5 Hz、最大单脉冲能量1 J的1.44μm脉冲Nd∶YAG激光,按单脉冲能量0(对照)、0.2、0.5和0.8 J,每次照射脉冲数1、5、10、20、40、80进行分组,每组5只比格犬,对比格犬的胃黏膜进行活体照射。取照射处胃壁常规制作组织切片,HE染色,显微镜下观察,计算机成像与测量,获取气化区宽度、气化区深度、凝固带宽度与凝固带深度等数据,绘制量效关系曲线,分析作用机制。结果试验可观测到各种组织效应表现,最大气化区宽度(1864.8±225.0)μm、最大凝固带宽度(1770.2±165.9)μm、最大气化区深度(1787.4±93.7)μm,出现在单脉冲能量0.8 J、80脉冲数/次剂量组;最大凝固带深度(1327.8±86.3)μm,出现在单脉冲能量0.5 J、80脉冲数/次剂量组。结论1.44μm Nd∶YAG脉冲激光对犬胃黏膜作用的组织效应程度与单脉冲能量和每次照射脉冲数呈正相关趋势。该激光作为手术刀有较强气化能力,其凝固层厚度足以保证术中止血、创面清洁,能满足胃部手术的需要。
Objective To investigate the dose-response relationship and clinical significance of medical NdFeB-doped Nd:YAG laser on gastric wall in dogs. Methods Pulse width of 640μs, frequency of 5 Hz, the maximum pulse energy of 1 J 1.44μm pulsed Nd:YAG laser, according to the single pulse energy 0 (control), 0.2,0.5 and 0.8 J, each irradiation pulse number 1,5, 10,20,40,80 were grouped, each group of 5 beagle dogs, beagle dogs gastric mucosa in vivo irradiation. The tissue sections of the stomach at the irradiation site were routinely made, HE staining, microscopic observation, computerized imaging and measurement, and the data of the width of the gasification zone, the depth of the gasification zone, the width of the solidification zone and the depth of the solidification zone were obtained. mechanism. Results The results showed that the width of the largest gasification zone (1864.8 ± 225.0) μm, the maximum solidification zone width (1770.2 ± 165.9) μm and the depth of the largest gasification zone (1787.4 ± 93.7) μm were all observed in single-pulse Energy 0.8 J, pulse number 80 / dose group; maximum solidification zone depth (1327.8 ± 86.3) μm, appeared in the single pulse energy of 0.5 J, 80 pulses / dose group. Conclusion The tissue effect of 1.44μm Nd: YAG pulsed laser on gastric mucosal mucosa in dogs shows a positive correlation with the single pulse energy and pulse number per irradiation. The laser as a scalpel has strong vaporization ability, the thickness of the solidified layer is enough to ensure intraoperative hemostasis, wound clean, to meet the needs of gastric surgery.