1470nm半导体激光治疗仪对犬前列腺切除术的有效性研究
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1.合肥大族科瑞达激光设备有限公司;2.浙江中医药大学

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Study on the efficacy of 1470 nm semiconductor laser therapy instrument for canine prostatectomy
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1.Hefei Dazhu Curestar Laser Equipment Co., Ltd;2.Zhejiang Chinese Medical University

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    摘要:

    目的 评估1470 nm半导体激光治疗仪(简称:科瑞达治疗仪)对犬前列腺切除术的有效性。方法 选取成年雄性Beagle犬28只,随机分为3组,即假手术组3只、试验组15只和同类对照组10只;其中试验组又分为120 W/50 W、150 W/50 W、160 W/50 W的汽化切割/凝固止血3个小组;同类对照组又分为120 W/50 W、150 W/50 W的汽化切割/凝固止血2个小组;每小组各5只。试验组和同类对照组均在电切镜下经膀胱颈入口行犬前列腺切除术。术中观察产品的操作适配性和有效性;术后观察犬的一般体征,以及在术前、术后即刻、3 d、7 d、28 d时取血测定血液生化和血液学指标;分别在术后1 h、4周时,行超声和电切镜下观察尿道前列腺部情况,并取前列腺组织进行H&E染色分析术后1 h的凝固层厚度和4周尿道上皮修复情况。结果 术中,试验品和同类对照品进行犬前列腺切除术的操作性能良好,具有较好的汽化切割和凝固止血性能;术后对犬的一般体征、血液学和血液生化指标均未见明显影响;且超声显示术后即刻均可见尿道扩张,尿道上皮回声略有增强;4周时,可见前列腺组织实质为略低回声,内部为均匀分布细小点状回声,包膜呈线状高回声,与假手术组一致。测量分析显示,试验组和同类对照组汽化切割前列腺组织重量约为0.91~1.33 g,切除比例达17.11~20.27 %;且随汽化切割功率的增加,激光发射时间逐渐减少,而汽化切割速度和效能均有所增加;但试验组与同类对照组比较均未见明显差异(P>0.05)。电切镜下可见试验组和同类对照组在术后1h时前列腺尿道部创面呈烧灼样改变,创面和正常尿路上皮分界明显;4周时,前列腺部尿路上皮已修复平整,和周围正常尿路上皮分界较模糊。同样,病理观察也显示,术后1 h时试验组和同类对照组均可见前列腺尿道口损伤明显,创面表面有少量碳化和凝固性坏死,少量炎性细胞聚集,凝固层厚度约在0.4 mm左右;术后4周时,假手术组前列腺尿道部形态未见异常,试验组和同类对照组均可见新生上皮基本覆盖创面,厚度较均匀,无凝固性坏死组织附在创面上,周围仍有轻度炎性反应,成纤维细胞增生明显,周围前列腺可见间质和上皮细胞增生,部分可见鳞状化生;前列腺包膜完好,周围神经血管形态未见异常。结论 科瑞达治疗仪对Beagle犬前列腺切除术是有效的,具有较好的汽化切割和凝固止血性能,且术后的各项生理指标较假手术组无显著差异。

    Abstract:

    Objective To evaluate the effectiveness of 1470 nm semiconductor laser therapeutic instrument (referred to as curestar therapeutic instrument) for prostatectomy in Beagle dogs. Method 28 adult male Beagle dogs were randomly divided into 3 groups: sham group (n=3), experimental group (n=15), and control group (n=10). The experimental group was further divided into 3 subgroups: 120 W/50 W, 150 W/50 W, and 160 W/50 W for vaporization cutting/coagulation hemostasis, while the control group was divided into 2 subgroups: 120 W/50 W and 150 W/50 W. 5 in each subgroup. Both the experimental group and the control group underwent canine prostatectomy through the entrance of the bladder neck under electrocision. The operational suitability and effectiveness of the product during surgery were observed. After the operation, the general condition of the dogs was observed, and blood biochemical and hematological indicators were measured at before, immediately, 3 days, 7 days, and 28 days after operation. At 1h and 4 weeks after surgery, B-ultrasound and electric resection were performed under anesthesia to observe the condition of the urethra and prostate, and the prostatic tissue was subjected to H&E staining for pathological observation. The thickness of the coagulation layer at 1h after the operation and the repair of the urethelial epithelium at 4 weeks were analyzed. Results During the operation, the experimental and control groups had good operability and showed good vaporization cutting and coagulation hemostasis performance. After the operation, there were no significant effects on the general condition, blood biochemical, and hematological indicators of the dogs. Ultrasound showed that the urethral expansion was visible immediately after the operation, and the echo of the urethral epithelium was slightly enhanced. At 4 weeks, the prostate tissue was slightly low-echo with uniformly distributed small point-like echoes inside, and the capsule was linearly high-echo, consistent with the sham group. The measurement and analysis showed that the weight of the vaporized prostate tissue in the experimental and control groups was about 0.91-1.33 g, with a resection rate of 17.11-20.27 %. And as the power of vaporization cutting increases, the laser emission time gradually decreases, while the vaporization cutting speed and efficiency both increase.However, there was no significant difference between the experimental and control groups (P>0.05). Under the electrocision microscope, a burn-like change was observed in the surgical wounds of the prostate urethra in the experimental group and the control group at 1 h after surgery, and the boundary between the wound and the normal urothelium was clearly visible. At 4 weeks, the urothelium of the prostate had been repaired and flattened, and the boundary with the surrounding normal urothelium was blurred. Similarly, pathological observations also showed that at 1 h after surgery, both the experimental and control groups showed significant damage to the prostate urethral orifice, with a small amount of carbonization and coagulative necrosis on the surface of the wound, a small amount of inflammatory cell infiltration, and a coagulation layer thickness of about 0.4 mm. At 4 weeks, the prostate urethral morphology of the sham group was normal, while the experimental group and the control group both showed new epithelial growth covering the wound, with uniform thickness and no coagulative necrosis tissue attached to the wound. Mild inflammatory reaction was still present in the surrounding area, fibroblast proliferation was obvious, and stromal and epithelial cell proliferation was visible in the surrounding prostate, some of which showed squamous metaplasia. The prostate capsule was intact and the morphology of the surrounding nerves and blood vessels was normal. Conclusion The curestar therapy instrument is effective for prostatectomy in Beagle dogs, with good vaporization cutting and coagulation hemostasis performance, and there was no significant difference in postoperative physiological indicators compared to the sham group.

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  • 收稿日期:2023-08-18
  • 最后修改日期:2024-02-19
  • 录用日期:2024-05-21
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