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[内镜高频电流及激光干预的技术特性]

[Technological characteristics of endoscopic high frequency current and laser interventions].

作者信息

Reidenbach H D

机构信息

Forschungsbereich Medizintechnik/HLT, Fachhochschule Köln.

出版信息

Zentralbl Chir. 1993;118(12):774-9.

PMID:8147152
Abstract

High frequency current and laser radiation perform two possibilities to generate therapeutic and surgical heat. The integration of these two technologies into endoscopy resulted in important ancillary techniques in the hands of a surgeon. Starting from the principal methods for coagulation and dissection of tissue the respective technological aspects at the interaction of high frequency currents and intensive laser radiation with different wavelengths on biological tissue are illustrated. Mono- and bipolar HF-techniques as well as the light-guide assisted laser method in the contact and non-contact mode are explained. The special problems in endoscopy arising from the reduction in visibility by haemorrhages and the development of smoke at the thermally induced coagulation may be overcome successfully by the simultaneous instillation of a nearly isolating liquid during the HF-treatment. The so-called electrohydrothermosation (EHT) method is presented and several probes and instruments for endoscopic hemostasis and microsurgery are explained. For an increase in safety at the endoscopic application of HF-current the use of the bipolar technique is recommended and several technological developments used in this mode are pointed out. It is shown that the absorption of radiation through the water-content of the tissue is mainly responsible for the reactions which may be produced with laser-light. Furthermore it is mentioned that the range of lasers which might be used has a large spectrum of medical applications which had been even increased especially by the new erbium and holmium solid state lasers.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

高频电流和激光辐射提供了两种产生治疗性和手术性热量的可能性。将这两种技术整合到内窥镜检查中,在外科医生手中形成了重要的辅助技术。从组织凝固和切割的主要方法出发,阐述了高频电流和不同波长的强激光辐射与生物组织相互作用时各自的技术方面。解释了单极和双极高频技术以及接触和非接触模式下的光导辅助激光方法。在高频治疗期间通过同时注入一种几乎绝缘的液体,可以成功克服内窥镜检查中因出血导致视野降低以及热诱导凝固时产生烟雾而出现的特殊问题。介绍了所谓的电水热疗法(EHT)方法,并解释了几种用于内窥镜止血和显微手术的探头和器械。为了提高高频电流在内窥镜应用中的安全性,建议使用双极技术,并指出了在这种模式下使用的几种技术发展。结果表明,组织含水量对辐射的吸收是激光可能产生的反应的主要原因。此外,还提到可使用的激光范围具有广泛的医学应用,特别是新的铒和钬固态激光器进一步扩大了其应用范围。(摘要截选至250字)

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