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Application of CO2 laser in the Neurosurgical Microscopic Operation

CO2激光在神经外科显微手术中的应用

基本信息

批准号：
58440057
负责人：
INABA Yutaka
金额：
$ 24.45万
依托单位：
Tokyo Medical and Dental University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (A)
财政年份：
1983
资助国家：
日本
起止时间：
1983 至 1985
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-58440057/
关键词：
CO2 laser Nd:YAG laser 同軸同時多種レーザー照射脳外科手術器械

项目摘要

The effect of puls-wave form CO2 laser was compared with that of continuous wave form using the 60z of Nihon-Infrared Industry Company. The tissue change by the puls wave form CO2 laser exposure was three times more than that of continous wave form CO2 laser if the power is the same in both lasers. The breakdown of the BBB was the greatest 24 hours after the exposure, but was still repaired one week thereafter.The lasers in the next study were pulse wave form CO2 and YAG lasers, employed separately or simultaneously using 130 YZ of Nihon Infrared Industries Company. The efficiency of laser exposure for hemostasis was greatest in Nd:YAG laser alone followed by combined CO2 and Nd:YAG laser and least in CO2 laser alone. In the combination of CO2 and Nd:YAG lasers, the more the power of Nd:YAG laser used, the less the hemorhage occurred. The size of the lesion by the combined laser exposure was greater than that of CO2 or Nd:YAG laser alone. Nd:YAG laser contributed to increase the diameter, and the CO2 laser the depth of the lesion.Effect of Nd:YAG and CO2 laser beam on micro-vasculature was examined in experimental animal. Soft x-ray microangiography and histological examination of brain after Nd:YAG laser exposure revealed broad avascular or oligovascular zone din the irradiated and the surrounding edematous tissue, in which the survived vessels showed narrowing and tapering without significant leak of blood. These findings seemed to correspond to high hemostatic capability of Nd:YAG laser. Vascular structure in the surrounding edematous layer after CO2 laser exposure, on the other hand, was not so significantly affected by exposure as in Nd:YAG laser, and congested and sometimes reptured vessels were found close to the central vaporized tissue defect in the coagulation layer which might cause postexposure hemorrhage.

用日本红外线工业公司的60z型激光器对连续波和连续波CO_2激光器的效果进行了比较。在相同功率下，普尔斯波CO2激光照射的组织变化是连续波CO2激光照射的3倍。BBB的破坏在照射后24小时最大，但在一周后仍得到修复。下一研究中的激光器是脉冲波形CO2和YAG激光器，分别或同时使用日本红外工业公司的130 YZ。单纯Nd：YAG激光的止血效率最高，其次是CO2和Nd：YAG激光的联合治疗，单纯CO2激光的止血效率最低。CO_2激光与Nd：YAG激光联合应用时，Nd：YAG激光功率越大，出血量越少。联合激光照射的病变范围大于单独CO2或Nd：YAG激光照射。Nd：YAG激光使病变直径增大，CO_2激光使病变深度增加，观察了Nd：YAG激光和CO_2激光对实验动物微血管的影响。Nd：YAG激光照射后的软X线微血管造影和组织学检查显示，照射区及周围水肿组织中存在广泛的无血管区或少血管区，其中存活的血管呈狭窄和锥形，无明显的血液渗漏。这些发现似乎与Nd：YAG激光的高止血能力相对应。另一方面，CO2激光照射后周围水肿层中的血管结构不像Nd：YAG激光那样受到照射的显著影响，并且在凝固层中的中央汽化组织缺损附近发现充血，有时破裂的血管，这可能导致术后出血。