Savolainen H O
Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital.
Ann Chir Gynaecol. 1993;82(1):37-41.
Besides being thrombogenic, lasers may have direct adverse effects on different constituents of blood itself, when used intraluminally in angioplasty. This pilot study was therefore designed to examine the effect of continuous wave (CW Nd: YAG) and pulsed wave (XeCl excimer) laser irradiation on whole blood coagulation and fibrinolysis in vitro using thromboelastography (TEG). TEG showed shortened reaction and coagulation times after three and six seconds with 10 W of continuous wave laser irradiation of 10 ml of blood. The clot formation rate and maximal amplitude were decreased with CW laser and the plasma clot lysis at one hour was significantly increased (P < 0.05). The effect of the pulsed wave laser was less pronounced. The exposure of whole blood to laser irradiation accelerated coagulation and enhanced fibrinolysis. The clinical significance of the findings is to be settled since the thrombogenicity of lasers is mainly caused by their effect on the vessel wall and thereby the on platelet-wall interaction.
除了具有血栓形成性外，当激光用于血管成形术的腔内治疗时，可能会对血液本身的不同成分产生直接的不良影响。因此，本初步研究旨在使用血栓弹力图（TEG）体外检测连续波（连续波钕：钇铝石榴石）和脉冲波（氙氯准分子）激光照射对全血凝血和纤维蛋白溶解的影响。TEG显示，用10瓦连续波激光照射10毫升血液3秒和6秒后，反应时间和凝血时间缩短。连续波激光使血凝块形成率和最大振幅降低，1小时时血浆凝块溶解显著增加（P<0.05）。脉冲波激光的作用不太明显。全血暴露于激光照射下会加速凝血并增强纤维蛋白溶解。由于激光的血栓形成性主要是由其对血管壁的作用以及由此对血小板 - 壁相互作用的影响所引起的，这些发现的临床意义有待确定。
