Marcuard S P, Sinar D R, Silverman J F, Finley J L
Department of Medicine, School of Medicine, East Carolina University, Greenville, North Carolina 27858-4354.
Dig Dis Sci. 1989 Jul;34(7):1053-6. doi: 10.1007/BF01536373.
Endoscopic laser photocoagulation of ulcers is increasingly used to produce hemostasis in patients who are actively bleeding or in patients with stigmata of recent hemorrhage. Little information is available describing ulcer healing rates after laser treatments. The aim of this study was to compare the healing rates of gastric ulcers treated with laser energy (Nd:YAG) with untreated ulcers in dogs. Two standard gastric ulcers (12-14 mm diameter) were created in each dog stomach using an ulcer maker (Quinton) under endoscopic guidance and one was randomly selected for laser treatment (L), while the other served as control (C). Ten laser spots were applied circumferentially around the ulcer crater with a mean energy of 595 J per ulcer. Ten dogs were studied; four of which were sacrificed after one week and six after two weeks. Healing of treated ulcers was compared with that of control ulcers and expressed as a percentage of the initial ulcer surface. Histologic injury and reepithelialization were scored by two pathologists unaware of the treatment. Laser-treated ulcers healed significantly slower than untreated ulcers at one week (53% L vs 94% C, P less than 0.05) and histologic injury was greater in ulcers treated with laser photocoagulation. At two weeks, only 82% of the laser-treated ulcer surface was healed in comparison with 94% (P less than 0.05) healing in untreated ulcers, although the mean histologic injury score was not different at two weeks. Reepithelialization was decreased both at one week (11% L vs 71% C, P less than 0.01) and at two weeks (75% L vs 100% C, P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
内镜激光光凝术越来越多地用于对正在出血的患者或有近期出血迹象的患者进行止血。关于激光治疗后溃疡愈合率的信息很少。本研究的目的是比较用激光能量(钕钇铝石榴石)治疗的犬胃溃疡与未治疗溃疡的愈合率。在内镜引导下,使用溃疡制作器(昆顿)在每只犬的胃中制造两个标准胃溃疡(直径12 - 14毫米),随机选择一个进行激光治疗(L),另一个作为对照(C)。在溃疡 crater 周围圆周施加十个激光点,每个溃疡平均能量为595焦耳。研究了十只犬;其中四只在一周后处死,六只在两周后处死。将治疗溃疡的愈合情况与对照溃疡进行比较,并以初始溃疡表面的百分比表示。由两名不知道治疗情况的病理学家对组织学损伤和再上皮化进行评分。激光治疗的溃疡在一周时愈合明显慢于未治疗的溃疡(53% L对94% C,P小于0.05),激光光凝治疗的溃疡组织学损伤更大。在两周时,激光治疗的溃疡表面仅有82%愈合,而未治疗溃疡的愈合率为94%(P小于0.05),尽管两周时平均组织学损伤评分没有差异。再上皮化在一周时(11% L对71% C,P小于0.01)和两周时(75% L对100% C,P小于0.01)均降低。(摘要截断于250字)