国产Nd:YAP激光组织热损伤效应的比较研究

Comparative Study of Homemade Nd: YAP Laser Thermal Injury Effect on Tissues Therapy and its Measurement

目的:通过比较1 341 nm Nd:YAP与临床常用激光器脉冲Nd:YAG和连续Nd:YAG对皮肤、肌肉、静脉和肝脏组织的热损伤效应,了解Nd:YAP激光的作用特点,为其临床应用提供实验依据。方法:以大鼠作为实验对象,分为皮肤、肌肉组和静脉、肝脏组。皮肤、肌肉组:Nd:YAP激光、连续和脉冲Nd:YAG选择能量密度1000 J/cm2、2 000 J/cm2,静脉、肝脏组采用Nd:YAP激光和连续Nd:YAG两种激光器,能量密度选择500 J/cm2和1 000 J/cm2,对组织进行非接触式点状照射。照射过程中观察组织变化和损伤直径大小,并于照射后即刻、3天取材做病理切片,光镜下观察病理变化,比较相同能量密度下三种激光器对组织的热损伤和损伤修复情况。结果:皮肤、肌肉组:Nd:YAP激光在1 000 J/cm2条件下对组织的损伤以热凝固效应为主,2 000 J/cm2条件下组织发生明显气化、有一定的切割作用。相同能量密度下,脉冲Nd:YAP激光气化作用较两种Nd:YAG激光显著,而凝固损伤范围较连续Nd:YAG浅,较脉冲Nd:YAG深。肝脏、静脉组:Nd:YAP激光对肝脏的热凝固效应与Nd:YAG激光近似,气化作用明显;Nd:YAP激光对血管及其周围组织的凝固及气化作用均较连续Nd:YAG激光明显。结论:Nd:YAP激光具有良好的凝固与气化作用。

Object： By comparision of the thermal injury effect of Nd ： YAP laser with that of pulsed and con continuous wave Nd ： YAG laser to get more knowledge of the thermal injury effect of Nd ; YAP laser. Method ： Wister rats were used in the experiment, they were divided into two groups including skin muscle group and liver vein group. Three kinds of laser was used in the first group, Nd ： YAP and Continuous Wave Nd ： YAG laser were used in the latter group, both irradiating by uncontacted point irradiation. Energy density 1 000 J/cm^2 and 2 000 J/cm^2, 500 J/cm^2 and 1 000 J/cm^2 were used respectively. The injury was observed by eye during irradiation. The biopsy was taken at the moment, 3 days after irradiation. Histomorphologic changes of the injured tissue and its healing procedure were observed with light microscopy. Results： In skin muscle group, under 2 000 J/cm^2 the main thermal injury effect of Nd ： YAP laser is thermal coagulation effects. Under 2 000 J/cm^2 Nd：YAP laser has obvious gasification effect. Under the same energy density, the gasification effect of Nd：YAP laser is significant than that of two Nd：YAG lasers, while the depth of coagulation injury is smaller than that of Continuous Wave Nd：YAG laser and largerer than that of pulsed Nd：YAG laser. In liver group, the gasification effect of Nd：YAP laser is more evident than that of Continuous wave Nd：YAG laser. , although their thermal coagulation effects are resembling. In vein group, the thermal coagulation and gasification effects of Nd：YAP laser is heavier than that of Nd：YAG laser. Conclusion：Nd：YAP laser has both gasification incision and coagulation effects.