激光消融离体和活体兔肝组织实验研究

Evaluating laser ablation of rabbit liver tissue in vitro and in vivo

目的了解激光消融在离体和活体肝组织的消融特性和温度变化，为临床制定消融方案提供参考。方法采用7w和5W两种功率激光仪对离体猪肝进行单针单点消融；采用5W功率激光仪对活体兔肝进行单针单点消融。两者能量输出均为1800J。观察不同功率激光在体内外肝组织造成的消融范围、形态以及5W功率激光消融过程中的温度变化。结果激光消融灶为光纤向前发射形成，呈类椭圆形。消融灶从内向外可分为黑色碳化区及褐白色坏死区。离体猪肝实验，功率5W激光平均消融范围1．9cm×1．2cm×1．2cm，碳化范围1．1cm×0．5cm×0．5cm；功率7w激光消融范围2．5cm×1．5cm×1．5cm，碳化范围1．4cm×0．7cm×0．7cm。功率5w的消融中心、旁开5mm及旁开10mm的平均最高温度分别为243．57℃、62．47℃、34．27℃。活体兔肝实验，功率5w所获消融范围约为1．4cm×1．1cm×1．1cm。消融中心旁开5mm及10mm的平均最高温度分别为62．26℃、44．35℃。结论激光消融对体内外肝组织造成的凝固坏死范围较小，能量较为集中。由于其对肝功能和周围组织影响小，故可用于危险部位的小肿瘤消融。

Objective To evaluate the ablation zone and temperature changes in the liver caused by laser ablation in vitro and in vivo. Methods Single needle single point laser ablation was performed in vitro with porcine liver using 5 W and 7 W-power and in vivo with rabbit liver using 5 W-power. All energy outputs were 1 800 J. The ablation zone and temperature changes were evaluated. Results Coagulation caused by laser ablation was divided into a black carbonized area and a brown white necrotic area from inside to out, respectively. The mean in vitro ablation range obtained by 5 W and 7 W-power laser ablation was 1.9 cm × 1.2 cm × 1.2 cm and 2. 5 cm × 1.5 cm × 1.5 cm, respectively. The mean in vitro black carbonized range obtained by 5 W and 7 W-power laser ablation was 1.1 cm × 0.5 cm × 0. 5 cm and 1.4 cm × 0. 7 cm × 0.7 cm, respectively. The average maximum temperature using 5 W-power was 243.57℃, 62.47℃ and 34. 27℃ in the ablation center, 5 mm from the center, and 10 mm from the center, respectively. For in vivo liver experimentation, the average maximum temperature using 5 W-power was 62. 26℃ and 44. 35℃ 5 mm and 10 mm from the center, respectively. Conclusion Laser ablation can cause coagulation necrosis of the liver tissue in vitro and in vivo, and the ablation range increased with increasing power. Laser ablation may have potential use in the ablation of tumor localized in critical sites.