腹腔镜手术超声止血刀封合血管安全性的实验研究

Experimental Study of Security with the Ultrasonically Activated Scalpel to Seal Blood Vessel

目的 探讨超声止血刀封合血管能够抵制管腔内多大高压以及血管封合的安全范围 .方法 将犬的四肢及腹部不同管径的血管游离出体外 ,使用超声止血刀进行无张力封合 ,使其管腔内压力逐渐升至 30 0mmHg ,观察①封合端破裂 ;②血管壁非封合处破裂 ;③管腔内达到预期压力 30 0mmHg .结果 当管腔内压力达到 30 0mmHg时 ,皆无血管壁破裂 ,仅腹主动脉 5次封合的封合端发生 3次破裂 ,其余动、静脉封合端都能够抵制管腔内 30 0mmHg的压力 .结论 超声止血刀对直径≤ 9mm的动脉以及直径≤ 10mm的静脉封合能够抵制管腔内 30 0mmHg压力 ,超声止血刀可以封合此管径范围内的动。

Objective To analyze the margin of safety by ultrasonically activated scalpel in sealing blood vascular. Methods In an anesthetized living dog, segments of the artery and vein separated from the four limbs, abdominal, and cervical vessels were sealed by ultrasonically activated scalpel at either end of the vessel. The intraluminal pressure of the sealed segments was increased until ①the sealed end burst,②the vessel wall burst, or③the predetermined pressure(300mmHg) was obtained. Results In none of the cases did the vessel wall burst when the predetermined pressure was obtained. The sealed end was not ruptured by ultrasonically activated scalpel except for aorta abdominalis at an intraluminal pressure of up to 300mmHg. Conclusions It is safe and effective to use ultrasonically activated scalpel in sealing artery(diameter≤9mm) and vein(diameter≤10mm) when subjected to an intraluminal pressure of up to 300mmHg.