超声引导经皮Nd:YAG激光肝组织光凝固术的基础研究

Experimental Study on Ultrasound Guided Percutaneous Nd: YAG Laser Photocoagulation of Animal Livers

作者等采用Nd：YAG激光以2～5W输出功率，照射5～20分钟，对离体猪肝、狗肝进行了体外光凝固实验，并在超声引导下对犬、小型猪肝脏进行了经皮穿刺组织间光凝固的在体实验。激光照射中实时监测了受照组织的温度变化及其范围，观察了超声影像与肝组织改变的对应关系，对比了激光照射能量与肝组织温度变化、热损伤程度的关系。实验结果表明，超声引导下经皮Nd：YAG激光肝肿瘤凝固术是可行的，并为进一步的临床研究提供了有参考价值的实验数据。

Interstitial Nd: YAG laser photocoagulation experiments on normal liver of pigs and mongrel dogs were carried out in vitro, in vivo and under ultrasound monitoring percutaneously. 1. 06μm Nd: YAG laser was delivered by 400μm optic fiber with 2~ 5W output for 5, 10, 15, 20 minutes irradiation. Intrahepatic temperature during laser exposure was taken at 5, 10, 15, 20mm beyond the lasing points. The sizes of thermal necrosis were evidenced by ultrasound imaging, temperature and specimen measurements under naked eyes and histopathologic examinations.Vaporization, carbonization, coagulation and edema appeared after irradiation with 3~5W. The pathologic changes were demonstrated by sonogram as echo-free, hyperechoic image, hypoechoic halo and acoustic shadow. The temperature measurements showed that coagulative necrosis appeared at 45 ℃ to 50℃ areas and vaporization or carbonization happcned in over 150℃ areas. The relationships between histologic changes,laser energy, temperature and sonogram are compared. The results indicate that ultrasound-guided percutaneous Nd: YAG laser treatment of liver neoplasms is feasible and the data might be useful for clinical trials.