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[氩激光对金黄地鼠颊囊黏膜血管及大、微循环的影响。活体显微镜研究(作者译)]

[The effect of the argon laser on the vessels, the macro- and microcirculation of the mucosa of the hamster cheek-pouch. An intravitalmicroscopic study (author's transl)].

作者信息

Lenz H, Eichler J

出版信息

Laryngol Rhinol Otol (Stuttg). 1975 Jul;54(7):612-9.

PMID:129631
Abstract

The mucosa of the cheek-pouch of five golden Syrian Hamsters was irradiated with the beam of an argonionlaser (diameter 0.5 mm and 200 mW). The effect on the micro- and macro-vessels and the bloodstream, especially of the microcirculation, is studied intravitalmicroscopically. In the microcirculation and also in the small and large venous and arterial vessels a restriction of bloodstream, praestasis, pendulumstream, stream reversal and some white microthrombi, -- emboli and agglutination of erythrocytes are visible. The bloodless welding of the vessels takes place even before the evaporation and coagulation necrosis of the surrounding epithelium of the mucosa as a result of the relatively selective effect of the Argon Laser on the reddish vessel-system by a continuous narrowing of the vessels-walls to the complete loss of their lumen rather than by a thrombosis. Firstly the capillaries, the venoles and the arterioles are obliterated, then those of middle size and at last the large venae and arteries in which case large vessels function for a moment as smaller ones. A continuously growing imbibition with increasing duration of the laser irradiation can be observed. Three clinically important phenomenon, depending on the laserdose can be observed: 1. a partial, 2. a subtotal and total obliteration of the network of the vessels, and 3. a total destruction of the blood-vessels and also of the tissue. Therefore clinically a subtotal or total network obliteration of the blood-vessels of strongly vascularised tissues, haemangiomas, teleangiectasias in case of morbus Rendu-Weber-Osler and livid enlarged nasal conchae might be obtained. Further a total tissue-destruction with a break in the continuity of the tissue for example with strongly vascularised carcinoma or its metastases might be effected.

摘要

用氩离子激光束(直径0.5毫米,功率200毫瓦)照射5只金黄叙利亚仓鼠颊囊的黏膜。通过活体显微镜研究其对微血管和大血管以及血流,特别是微循环的影响。在微循环以及小静脉和大动脉中,可以看到血流受限、血流淤滞、摆动血流、血流逆转以及一些白色微血栓——栓子和红细胞凝集。由于氩激光对微红血管系统具有相对选择性作用,血管壁持续变窄直至管腔完全消失,而非通过血栓形成,血管在周围黏膜上皮蒸发和凝固坏死之前就发生了无血焊接。首先是毛细血管、小静脉和小动脉闭塞,然后是中等大小的血管,最后是大静脉和大动脉,在这种情况下,大血管会暂时发挥较小血管的功能。可以观察到随着激光照射时间延长,吸收不断增加。根据激光剂量可观察到三种具有临床重要性的现象:1. 血管网络部分闭塞;2. 血管网络次全闭塞和完全闭塞;3. 血管以及组织完全破坏。因此,临床上对于血管高度丰富的组织、血管瘤、遗传性出血性毛细血管扩张症(Rendu-Weber-Osler病)中的毛细血管扩张以及青紫肿大的鼻甲,可能实现血管网络的次全或完全闭塞。此外,对于血管高度丰富的癌或其转移灶等,可能实现组织的完全破坏并导致组织连续性中断。

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