激光局部热凝固肝组织的动态病理学研究

Dynamic pathological changes of hepatic tissue after laser-induced thermocoagulation

目的研究激光热消融肝组织的动态病理学变化。方法应用自行研制的实体肿瘤半导体锥形散射激光治疗系统热消融健康家兔的肝组织,观察距光纤不同距离肝组织温度变化及消融后1、2个月的病理学变化。结果术后家兔均成活,热凝固10min光纤中心、距光纤中心5、10mm处肝组织温度分别为96.39℃±3.97℃、60.79℃±6.21℃、46.10℃±4.58℃。术后7d肝功能与治疗前比较差别无显著性意义(P>0.05)。术后1个月可见消融区为平均横径25.0mm灰白色凝固坏死带和厚度约平均2.4mm纤维包膜;术后2个月可见消融区中心为平均直径13.0mm灰白色凝固坏死区,外周为平均厚度3.0mm的完整包膜。结论半导体锥形散射激光可安全有效热消融肝组织,提示该技术有可能成为热消融治疗肝癌的一种新方法。

Objective To observe the dynamic pathological changes of hepatic tissue after laser-induced thermocoagulation. Methods The hepatic tissue of 16 rabbits were thermocoagulated by diode-laser with scanner fiber tip, the temperature was measured at 5mm, 10mm from laser tip. The pathological changes were observed at 1 m and 2 m after laser thermocoagulation. Results The temperatures of hepatic tissue at 0mm, 5mm and 10mm from laser tip were reached to 96.39℃±3.97℃, 60.79℃±6.21℃ and 46.10℃±4.58℃ respectively after 10 min thermocoagulation. All the rabbits survived, the hepatic function at 7d after operation had no significant difference from that of preoperation. The diameters of hepatic necrosis from thermocoagulation were 25.0 mm and 13.0 mm at 1 and 2 month after operation, and the diameters of surrounding fibrosis were 2.4mm and 3.0mm respectively. Conclusion The hepatic tissue can be coagulated safely and effectively by diode-laser with scanner fiber tip, and the technique may be applied in treatment of hepatic carcinoma.