Nd∶YAG激光组织间照射血管瘤后即刻瘤腔内血液学变化

Immediate Hematologic Changes in Local Cavity of Hemangioma Induced by Nd∶YAG Laser Interstitial Irradiation

目的 研究Nd∶YAG激光组织间照射血管瘤后即刻瘤腔内血液学的变化。方法 收集适合Nd∶YAG激光组织间照射治疗且照射前后可自瘤腔内各抽取10ml血液的血管瘤病人6例,以Nd∶YAG激光行血管瘤组织间照射,照射功率密度为531×103Wcm2,能量密度为797×104Jcm2。激光照射前及照射后即刻取血进行血液细胞学、生化学、酶学、免疫学、流变学等共24项指标检测。结果 激光照射后即刻瘤腔内血液红细胞、白细胞、血小板数及血红蛋白含量下降(均P<005),丙氨酸转氨酶、天冬氨酸转氨酶、乳酸脱氢酶、全血粘度(切变率190s、46s、575s)、血浆粘度、红细胞比积、红细胞刚性指数、红细胞聚集指数、血液还原粘度、低切变率下血液相对粘度升高(均P<005),血液生化学、免疫学各指标无明显变化。结论 激光组织间照射后血液粘滞度升高,因此要注意防止血栓的形成。

Objective In order to investigate the immediate hematologic changes in local cavity of hemangioma induced by Nd∶YAG laser interstitial irradiation. Methods Six cases of hemangioma were selected which was suitable for Nd∶YAG laser interstitial irradiation and for enough quantity(10 ml) of blood sample obtainable. They were interstitially irradiated by Nd∶YAG laser. Results There were significant changes in various hematologic and hemorheologic parameters. Erythrocyte, leucocyte, platelet and hemoglobin were all decreased (P<0 05). The whole blood viscosity (shear rate 190/s, 40/s, 5 75/s), plasma viscoity, hematocrit value, erythrocyte rigidity index, erythrocyte aggregation index, whole blood reduced viscosity and low shear rate blood relative viscosity were increased (P<0 05). There were no notable changes in the hematologic, hemorheologic and immunologic parameters (P>0 05). The hematologic and enzymologic parameters: ALT, AST and LDH were significantly increased(P<0 05). CPK and ALP were not notablly changed (P>0 05). Conclusions The blood viscosity in local cavity of hemangioma was increased after interstitial Nd∶YAG laser irradiation. Attention should be paid to the possibility of thrombosis. But long period observation did not confirm this phenomenon. So we would believe that this is a temporary danger and does not exert long term side effect on the body.