Swain C P, Mills T N, Dark J M, Lewin M R, Bown S G, Northfield T C, O'Sullivan J P, Salmon P R
Gastroenterology. 1984 Jan;86(1):93-103.
The drawbacks of monopolar electrocoagulation in the control of gastrointestinal bleeding include tissue adherence, unpredictable energy deposition, and a high incidence of tissue damage. Introduction of a conductive interfacial film of liquid between the monopolar electrode and the bleeding point during electrocoagulation may overcome these drawbacks. A prospective, controlled study was undertaken to evaluate the efficacy and safety of a monopolar electrode in liquid and dry modes when used to coagulate experimental canine bleeding ulcers. All experiments were done in open fashion via a gastrotomy with hand-held electrodes. An analog computer, which could be connected between a standard electrosurgical generator and the electrode, was designed and built to monitor and control the energy delivered to the tissue. Both liquid and dry electrodes were highly effective in stopping bleeding. The liquid electrode was found to be superior to the dry electrode in that tissue adherence was eliminated and energy deposition was more predictable, varying less with angle of incidence. The liquid electrode caused less macroscopic serosal damage and less full-thickness histologic damage if the total energy or number of pulses was limited; however, both caused microscopic full-thickness damage in one-half of the experimental ulcers treated, although no perforations occurred.
单极电凝控制胃肠道出血的缺点包括组织粘连、能量沉积不可预测以及组织损伤发生率高。在电凝过程中，在单极电极和出血点之间引入一层导电液体界面膜可能会克服这些缺点。进行了一项前瞻性对照研究，以评估单极电极在液体模式和干燥模式下用于凝固实验性犬出血性溃疡时的疗效和安全性。所有实验均通过剖腹术以开放方式进行，使用手持电极。设计并制造了一台模拟计算机，它可以连接在标准电外科发生器和电极之间，以监测和控制传递到组织的能量。液体电极和干燥电极在止血方面都非常有效。发现液体电极优于干燥电极，因为消除了组织粘连，能量沉积更可预测，随入射角的变化更小。如果总能量或脉冲数受到限制，液体电极造成的宏观浆膜损伤和全层组织学损伤较少；然而，在一半接受治疗的实验性溃疡中，两者都造成了微观全层损伤，尽管没有发生穿孔。
