吲哚菁绿染色对980nm半导体激光消融髓核组织效果的影响

Effect of indocyanine green-dying on the 980nm diode laser ablating nucleus pulposus

目的:观察吲哚菁绿(indocyanine green,ICG)染色对980nm半导体激光消融髓核组织效果的影响。方法:选取新鲜山羊腰椎标本并制成脊柱功能单位(SFU)144个,随机选择24个行预实验,余120个随机分为空白组、蒸馏水组和ICG染色组,每组40个,再根据给予能量不同随机分为5小组。蒸馏水组与ICG染色组分别在髓核内注射100μl蒸馏水或ICG,测定质量后应用980nm半导体激光器分别以总能量70、210、350、490、630J对标本行连续脉冲式激光照射以汽化髓核组织,术后再次测定质量,并计算照射前后标本质量差(髓核消融量)。结果:髓核组织消融量随激光照射能量增大而增多,在70、210、350、490、630J的总能量时空白组的髓核消融量分别为0.0754±0.0046g、0.1170±0.0306g、0.1454±0.0410g、0.1560±0.0058g和0.1742±0.0429g,各能量组间比较P<0.01;蒸馏水组的髓核消融量分别为0.0596±0.0110g、0.0719±0.0228g、0.1246±0.0293g、0.1518±0.0079g和0.2133±0.0513g,各能量组间比较P<0.01;ICG染色组的髓核消融量分别为0.0699±0.0098g、0.1067±0.0154g、0.1978±0.0569g、0.2224±0.0358g和0.2626±0.0241g,各能量组间比较P<0.01。在较低总能量(E<490J)照射下蒸馏水组消融量较其他两组少,而当总能量达630J时,蒸馏水组消融量高于空白组,但仍低于ICG染色组。在相同激光能量照射下,总能量低于350J时,ICG染色组髓核消融量较空白组无明显差别,而当能量高于350J时染色剂组较空白组有显著性差异(P<0.01)。空白组汽化率为0.4mg/J,ICG染色后为0.5mg/J。结论:半导体激光消融髓核组织量随能量增大而增多;ICG可以提高半导体激光的汽化率,在总能量高于350J时ICG染色能够增强980nm半导体激光消融髓核组织的效果。

Objective：To investigate the effect of indocyanine green（ICG） dying on 980nm diode laser ablating nucleus pulposus.nethod：Fresh goat lumbar samples were selected and 144 spine functional units （SFU） were made and randomly classified to three groups：the blank group,the distilled water group and the ICG-dying group,each group was further divided into 5 subgroups according to the laser energy.The distilled water group and the ICG dying group were injected 100μl distilled water or ICG to the nucleus pulposus respectively and weight was determined.Then the nucleus pulpous of the specimens were radiated by a 980nm diode laser at the total energy of 70,210,350,490,630J on impulse,and the weight was determined again.Result： The ablation of nucleus pulposus accreted with the addition of laser energy.The ablation of each group at the total energy of 70,210,350,490,630J respectively was accounted as follows.The blank group：0.0754±0.0046g, 0.1170±0.0306g.0.1454±0.0410g,0.1560±0.0058g and 0.1742±0.0429g,Comparison among the energy groups was P〈0.01.The distilled water group：0.0596±0.0110mg,0.0719±0.0228g,0.1246±0.0293g,0.1518±0.0079g and 0.2133 ±0.0513g, energy group comparison （P〈0.01 ） .The ICG-dying group ： 0.0699±0.0098g,0.1067±0.0154mg, 0.1978±0.0569g,0.2224±0.0358g and 0.2626±0.0241g,energy group comparison （P〈0.01）.At the equal energy level,the ablation of the blank group was less than the other two groups at a lower energy（E〈490J）.However, the distilled water group was more than the blank group when the energy was higher than 630J,but less than the ICG-dying group.At the equal energy level,there was no difference in ablation between the ICG-dying group and the blank group when the energy was lower than 350J.However there was dramatic difference when the energy was higher than 350J（P〈0.01 ）.The vaporize rate of the blank group was 0.4mg/J and the ICG-dy- ing group was 0.5mg/J respectively.Conclusion：The ablation of nucleus pulosus accreted with the increase of energy,ICG-dying could raise the vaporize rate,which enhanced the ability of 980nm diode laser ablating nucleus pulposus.