第二代氩离子凝固疗法对人离体胃组织的热组织学效应
Thermal tissue effects of the second-generation argon plasma coagulation on human stomach tissue: An ex vivo study

摘要：目的 探讨第二代氩离子凝固疗法(VIO APC)不同作用模式、功率及作用时间对人离体胃组织的热损伤效应。方法 外科手术切除的大体正常的胃标本，采用VIO APC进行处理。功率分别设为15、30、45、60、75、90、105、120W，作用时间3、5、10s，模式分别为强力电凝模式(forced, F)、脉冲电凝模式1(pulsed 1, P1)、脉冲电凝模式2(pulsed 2，P2)，记录最大损伤直径及损伤深度。结果 胃组织的损伤深度与功率(P<0.001)、能量(P=0.008)及不同的作用模式(P=0.013)均相关; 胃组织的最大损伤直径与功率(P<0.001)、作用时间(P=0.001)、能量(P<0.001)及作用模式(P=0.001)均相关。胃组织有害损伤的发生主要与作用模式(P=0.012)有关。损伤深度为P1>F>P2(P<0.05)，而损伤的最大直径为P2>P1>F(P<0.05)。结论 不同模式的VIO APC对胃肠组织产生不同的作用效果。与F模式相比，P1模式主要产生较深的组织损伤效应，而P2模式则产生直径较大但较表浅的损伤效应。但以上模式均可产生累及肌层的损伤。
ABSTRACT: Objective To explore the thermal effects of the second-generation argon plasma coagulation (VIO APC/APC2) on ex vivo human stomach tissue with different mode, output power and application time. Methods The thermal effects of VIO APC were studied on fresh surgery-resected human stomach tissues. Different output powers were combined with mode “forced (F)”, “pulse, effect 1 (P1)” and “pulse, effect 2 (P2)”; three application time, the depth and maximum diameter of each injury were recorded. Results The depth of tissue injuries was correlated with output power (P<0.001), energy (P=0.008) and mode (P=0.013). The maximum diameter of injuries was correlated with output power (P<0.001), application duration (P=0.001), energy (P<0.001) and mode (P=0.001). The incidence of harmful damage was only related to mode (P=0.012). The depth of tissue injuries was P1>F>P2 (P<0.05), and the maximum diameter of injuries was P2>P1>F (P<0.05). Conclusion Different modes of VIO APC can create different thermal effects on the gastric tissues. Compared with F mode, P1 mode creates deeper injuries while P2 mode creates larger but shallow injuries. All the three modes may cause injuries involving muscularis propria