Dixon J A, Berenson M M, McCloskey D W
Gastroenterology. 1979 Oct;77(4 Pt 1):647-51.
Determination of the efficacy and safety of endoscopic laser photocoagulation to control upper gastrointestinal bleeding is prerequisite to the general application of this treatment in humans. We studied photocoagulation hemostasis, penetration, and perforation produced by a 55-W neodymium-yag (Nd:YAG) laser to control standardized experimental gastric bleeding lesions in a heparinized canine model. Photocoagulation of bleeding lesions was 100% successful with an application time of 3.56 +/- 1.65 sec (mean +/- SD). Histologic examintion of the gastric wall revealed a depth of injury to the muscularis externa of 40-100% with greater than 2 sec photocoagulation. Continuous photocoagulation exceeding 4 sec produced an 80-100% depth of muscle injury. Perforation of the gastric wall occurred after 9.6 +/- 1.5 sec, and all dogs studied after perforation survived. These studies indicate that Nd:YAG photocoagulation is an effective method to control experimental gastric bleeding lesions with a ratio between mean photocoagulation hemostasis and perforation times of approximatley 1:3. Further studies are required to define the implications of photocoagulation injury to muscle and the role of the gastric serosa in laser applications.
确定内镜激光光凝术控制上消化道出血的有效性和安全性是该治疗方法在人体广泛应用的前提条件。我们研究了55瓦钕钇铝石榴石（Nd:YAG）激光产生的光凝止血、穿透和穿孔情况，以控制肝素化犬模型中的标准化实验性胃出血病变。出血病变的光凝成功率为100%，应用时间为3.56 +/- 1.65秒（平均值 +/- 标准差）。胃壁组织学检查显示，光凝时间超过2秒时，肌层损伤深度为40%-100%。连续光凝超过4秒会导致80%-100%的肌肉损伤深度。胃壁穿孔发生在9.6 +/- 1.5秒后，所有穿孔后研究的犬均存活。这些研究表明，Nd:YAG光凝术是控制实验性胃出血病变的有效方法，平均光凝止血时间与穿孔时间之比约为1:3。需要进一步研究来确定光凝对肌肉损伤的影响以及胃浆膜在激光应用中的作用。
