超声刀和结扎速血管闭合系统闭合血管的可靠性及组织损伤程度研究

Evaluation of harmonic scalpel and ligasure sealing system in reliability of vascular occlusion and extent of tissue damage

目的研究超声刀和结扎速血管闭合系统闭合血管的可靠性及组织损伤程度。方法普通雌性狗2只,分别用超声刀和结扎速闭合并切断狗两侧动静脉血管,测量血管破裂压。血管破裂压实验完成后,将闭合血管剪断,制成切片,观察血管组织损伤程度。结果结扎速闭合的血管破裂压明显高于超声刀。超声刀能有效闭合直径3mm或更细的血管。结扎速能成功闭合所有血管。超声刀闭合血管组织损伤从闭合边缘延伸距离小于结扎速,组织损伤主要局限在血管壁外膜层。结扎速组织损伤扩至外膜层和肌肉层。结论结扎速闭合血管的可靠性大于超声刀,特别是直径大于3mm的血管。超声刀能有效闭合直径3mm或更细的血管,组织损伤程度小于结扎速。

[Objective] Evaluation of harmonic scalpel and ligasure sealing system in reliability of vascular occlusion and extent of tissue damage. [Methods] Two common female dogs were used in this experiment. Harmonic scalpel and ligasure were used to seal and excise respectively the bilateral arteries and veins of the dogs, and then, we measured the bursting pressure of the blood vessels. After the bursting trials were completed, the vessels were excised and sections were performed, and then we reviewed the extent of tissue damage of the vessels. [Results] The bursting pressure sealed by ligasure was larger than harmonic scalpel. Harmonic scalpel could effectively sealed 3 mm and less in diameter. Ligasure could successfully seal all the vessels tested. Harmonic scalpel mean extending distance of tissue damage from the edge of the seal in blood vessels specimens was less than ligasure, tissue change was predominantly localized to the adventitial layer. Ligasure tissue change extended into the adventitial and muscular layers. [Conclusions] Ligasure vessel sealing system is more reliable than harmonic scalpel in sealing vessels, especially to the vessels of larger than 3 mm in diameter. Harmonic scalpel can effectively seal the vessels of 3 nun and less in diameter, the extent of tissue damage is less than ligasure.