Judy M M, Matthews J L, Goodson J R, Hults D F, Viherkoski E, Aronoff B L
Advanced Laser Applications Laboratory, Baylor Research Institute, Dallas, Texas 75226.
Lasers Surg Med. 1992;12(2):222-30. doi: 10.1002/lsm.1900120218.
This study examines the depth of thermal coagulation and charring in swine liver, kidney cortex, tongue (inferior surface), skeletal muscle, inflated lung, and skin resulting from in vivo incision with simultaneous coaxial CO2 and Nd:YAG (1.064 microM) laser beams. At values of 20 w and 40 w, respectively, and at values of 30 w and 60 w, respectively, of combined CO2 and Nd:YAG laser radiation, coagulation depths determined histologically in liver were significantly greater (P less than 0.01) than in the other tissues and were significantly less in inflated lung (P less than 0.05) than in other tissues for the larger laser power settings employed. Coagulation depths achieved at 10 w and 20 w, respectively, and at 20 w and 40 w, respectively, of CO2 and Nd:YAG laser power were comparable to those obtained by other workers in liver and other relatively vascular tissues using a contact Nd:YAG laser tip. Charring depths obtained at power settings of 30 w (CO2) and 60 w (Nd:YAG) were greater in liver (P less than 0.001) than in all other tissues examined. Hemostasis during incision was achieved only for values of the ratio of CO2 to Nd:YAG laser power in the range 2-3 in the more vascular tissues, liver and kidney cortex, whereas hemostasis was achieved also in the lesser vascular tissues at higher values. These results strongly suggest the usefulness of combined simultaneous CO2 and Nd:YAG laser beams in surgery of the more vascular organs and tissues.
本研究考察了在猪的肝脏、肾皮质、舌（下表面）、骨骼肌、充气肺和皮肤中，由同轴CO2和Nd:YAG（1.064微米）激光束同时进行体内切割所导致的热凝固和炭化深度。对于组合的CO2和Nd:YAG激光辐射，分别在20瓦和40瓦的值以及分别在30瓦和60瓦的值下，组织学测定的肝脏凝固深度显著大于其他组织（P<0.01），并且对于所采用的较大激光功率设置，充气肺中的凝固深度显著小于其他组织（P<0.05）。分别在10瓦和20瓦以及分别在20瓦和40瓦的CO2和Nd:YAG激光功率下实现的凝固深度，与其他研究人员使用接触式Nd:YAG激光头在肝脏和其他相对血管丰富的组织中获得的凝固深度相当。在30瓦（CO2）和60瓦（Nd:YAG）功率设置下获得的肝脏炭化深度大于所有其他检查组织（P<0.001）。在肝脏和肾皮质等血管较丰富的组织中，仅当CO2与Nd:YAG激光功率之比在2至3的范围内时，切割过程中才能实现止血，而在血管较少的组织中，在较高比值时也能实现止血。这些结果有力地表明，CO2和Nd:YAG激光束同时联合在血管较丰富的器官和组织手术中具有实用性。
