Johanns W, Luis W, Janssen J, Kahl S, Greiner L
Medical Unit A, Klinikum Wuppertal, University of Witten/Herdecke, Germany.
Eur J Gastroenterol Hepatol. 1997 Jun;9(6):581-7. doi: 10.1097/00042737-199706000-00006.
Diathermy procedures are indispensable in interventional endoscopy. Argon beam coagulation is an innovative no-touch electrocoagulation technique in which high-frequency alternating current is delivered to the tissue through ionized argon gas.
Before clinical application, we conducted in-vitro studies to investigate the depth and diameters of tissue coagulation in fresh operative specimens from the stomach, small intestine and colon. Five different power/gas flow settings between 40 and 155 W and 2 and 7 l/min were used. The impact time (1-10s) and the incident angle of the probe (45 degrees and 90 degrees) were also varied. The maximum depth of necrosis was 2.4 mm, the maximum diameter 1.1 cm. No perforation occurred even in critical areas such as the colon and duodenum. We therefore performed argon beam coagulation in 66 consecutive patients. Two power/gas flow settings of 40 and 70 W and 2 and 3 l/min, respectively, were used. The impact time and incident angle were varied individually.
In 49 of the 50 patients with oozing haemorrhage from angiodysplastic lesions, polypectomy sites, erosions or ulcers or oozing of blood due to vascular penetration by tumours, definitive haemostasis was achieved in one to two sessions. In all 11 patients with residual sessile adenoma tissue, complete removal was possible. Oesophageal patency was restored in all five patients with stenosing tumours. In one patient with angiodysplasia of the caecal pole, an asymptomatic accumulation of gas in the submucosa was observed which resolved spontaneously. In two patients with extensive oesophageal carcinoma, there was a transitory--also asymptomatic--accumulation of gas in the mediastinum and peritoneal cavity but no evidence of perforation.
Argon plasma electrocoagulation is an effective and relatively low-cost alternative to laser therapy in gastrointestinal endoscopy.
透热疗法在介入性内镜检查中不可或缺。氩离子束凝固术是一种创新的非接触式电凝技术，高频交流电通过电离氩气传递到组织。
在临床应用前，我们进行了体外研究，以调查胃、小肠和结肠新鲜手术标本中组织凝固的深度和直径。使用了40至155瓦和2至7升/分钟之间的五种不同功率/气体流量设置。冲击时间（1 - 10秒）和探头入射角（45度和90度）也有所变化。坏死的最大深度为2.4毫米，最大直径为1.1厘米。即使在结肠和十二指肠等关键区域也未发生穿孔。因此，我们对66例连续患者进行了氩离子束凝固术。分别使用了40瓦和70瓦以及2升/分钟和3升/分钟的两种功率/气体流量设置。冲击时间和入射角分别进行了调整。
在50例因血管发育异常病变、息肉切除部位、糜烂或溃疡出血或肿瘤血管穿透导致渗血的患者中，49例在一到两个疗程内实现了确定性止血。在所有11例残留无蒂腺瘤组织的患者中，均有可能完全切除。所有5例患有狭窄性肿瘤的患者食管通畅得以恢复。在1例盲肠极血管发育异常患者中，观察到黏膜下无症状性气体积聚，该积气自行消退。在2例广泛食管癌患者中，纵隔和腹腔出现了短暂的——同样无症状的——气体积聚，但无穿孔迹象。
在胃肠内镜检查中，氩等离子体电凝术是激光治疗的一种有效且成本相对较低的替代方法。
