一种新的激光心肌打孔方法研究

Study of a New Direct Transmyocardial Laser Channels.

本实验旨在研究一种新的ＣＯ２激光心肌打孔方法改善急性心肌缺血。８只犬结扎冠状动脉左前降支获得急性心肌缺血动物模型，在缺血区随机分为Ａ、Ｂ二区，Ａ区不打孔作为自身空白对照，Ｂ区在心脏跳动情况下被激光打孔，在打孔时将滤波片放在光关节臂和心脏表面之间。结果：（１）心外膜电图，∑ＳＴ，打孔后３０分钟，Ａ、Ｂ二区差值具有显著意义（Ｐ＜０．０２０）；ＮＳＴ，打孔后２０分钟，Ａ、Ｂ二区比较有显著差异（Ｐ＜０．００５）。（２）病理学，冰冻切片Ｈ．Ｅ染色，激光孔没有碳化层，水肿层仅为５０ｕｍ，激光孔和周围血管相通，血管内可见血液的各种有形成份。实验表明，在形成急性心肌缺血情况下及时采用这种新的心肌打孔方法进行打孔能再造一套有效的血液供应系统，明显改善缺血程度，缩小缺血范围。

The purpose of this experiment is to study the effects of a new transmyocardial CO2 laser channels on AMI in dogs.Method:8 dogs were used in this experiment.The ischemic zone prodced by ligation of LAD were divided into control (A) and experimental(B) zone at random.B zone was acupuncted with 100 W CO2 laser and A zone was not done.A filter was put in between light arm and heart surface when laser irridiation Result:1.Epicardial electrograms:∑ST:It was marked significant at 30 minute after laser acupuncture (p<0.020).NST:The comparision of NST between A zone and B zone had distinct difference at 20 minute after acupuncture (p<0.005).2.Histalogy:Histological slides showed evidence that the laser channels is open.the chanhels is free of the layer of carbonization and the oedema layer is 50 um,The laser beam can penetrate a thick myocardium nearly without heat damage,Conclusion:The result of this study that the new transmyocardial CO2 laser channel was efficient for AMI.