篇名 | Dynamic Cooling for Laser Photocoagulation :In Vivo & Ex Vivo Studies |
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卷期 | 22:1 |
並列篇名 | 動力冷卻配合光凝療法之試管外研究及臨床病例報告 |
作者 | 張承仁 、 曾義豐 、 魏福全 |
頁次 | 25-32 |
關鍵字 | Dynamic cooling 、 Nd:YAG laser 、 Chicken combs 、 Hemangiomas 、 動力冷卻 、 銣雅鉻雷射 、 雞冠 、 血管瘤 、 EI 、 SCI |
出刊日期 | 200203 |
雷射治療血管瘤成功的先決條件是經由選擇性光熱效應破壞皮下擴張的血管而不造成表皮的傷害。因此,吾人設計出在毫秒間噴射式冷卻系統配合雷射的照射將局部表皮冷卻下來。本實驗的目的即是在檢視此冷卻系統合併銣雅鉻雷射對動物模型及血管瘤作用的效能。動物模型的選擇為豬肝及雞冠。銣雅鉻雷射照射能量為20至60瓦特。利用紅外線溫度偵測回饋系統來控制冷媒噴射出的時間。當體表溫度上升至攝氏36至45度時,約30至100毫秒的冷媒即可噴出。豬肝於冷卻與雷射照射後觀察及測量其顯微組織之變化動物模型(雞冠)則在冷卻及雷射照射各一小時及14天後觀察其組織之變化。本實驗結果顯示,銣雅鉻雷射可造成1.0 ± 0.2豪米深度的組織破壞同時噴射冷卻仍可保持表皮之完整無傷。因此,在銣雅鉻雷射對深部組織造成光凝療效的同時噴射冷卻系統可有效的保護表皮。本方法可對人類血管瘤做有效的治療。
When a cryogen spurt is applied to the skin surface for an appropriately short period of time (on the order of milliseconds), the cooling remains localized in the epidermis, while leaving the temperature of the deeper vessels of hemangiomas unchanged. The purpose of our study is to examine the effectiveness of dynamic cooling in protecting superficial tissue structures during continuous Nd:YAG laser illumination of in vivo and ex vivo models for hemangiomas. The bovine liver and highly vascularized chicken combs were selected as the models for hemangiomas.
The Nd:YAG laser illumination ranged from 20 to 60 W. A feedback system utilizing infrared radiometry monitored the surface temperature and controlled delivery time of the cryogen spurt. When the surface temperature during laser illumination reached 36-45℃, a 30-100 m/sec cryogen spurt was delivered. Animals were observed 1 hour to 14 days
following each experiment. Gross and histological analyses were performed. Nd:YAG laser illumination resulted in deep (up to 1.0 ± 0.2 mm) tissue photocoagulation, while dynamic cooling preserved the overlying epidermis and papillary dermis. In conclusion, dynamic cooling is effective in protecting the epidermis and papillary dermis, while achieving deep tissue photocoagulation during Nd:YAG laser illumination. This procedure is effective for the treatment of hemangioma in the humans.