【摘要】 目的　使用不同功率的钕∶钇铝石榴石激光烧灼肺，了解能量与伤度的关系及修复过程，试图为临床应用提供安全的数值依据。　方法　１２ 条犬均用１０ ～５０ Ｗ 的激光切除截面积约１ｃｍ２ 的犬肺，记录切除时间，测量凝固支气管及肺血管的最大直径及耐压值；电刀、普通刀切除＋ 缝合作自身对照，分别于术后即刻、３ 天、２ 周和５ 周各处死３ 条犬，取标本行组织学检查。　结果　１２ 条犬术后无死亡。激光切除肺的时间随能量增加而缩短（ｒ ＝ － ０－９５５９ ，Ｐ＜０－０５） ；激光能凝固直径１－５ｍ ｍ 支气管及肺血管，凝固支气管可耐受４ｋＰａ（３０ｍ ｍ Ｈｇ） 压力１０ 秒钟无漏气；组织学早期以凝固性坏死和炎性渗出为主，２ 周后肉芽组织形成，但疤痕的成熟需５ 周以后。　结论　钕∶钇铝石榴石激光肺切除时以３０ Ｗ 为宜，以２０ Ｗ 散焦凝固漏气、出血的创面，最大限度保存了肺功能，明显优于电刀和普通刀＋ 缝合，特别适合于需行肺部手术且合并肺功能不全者。更多还原

【Abstract】 Objective For understanding the relation between the power and lesion dimension, and the reparative process. Five different power of neodymium:yttrium aluminum garnet(Nd:YAG) laser were used in lung resection to provide the safe data for clinical application. Methods Twelve dogs were used to lung wedge resection by 10~50W energy of laser. Lung resective time was recorded and the largest diameter of bronchus and pulmonary vessel were measured which could be sealed by laser. Electrotome and silk suture were used control. Animals were killed:(1)immediately after operation,(2)the third postoperative day,(3)the second week, and (4)the fifth week after surgery. All lesions were pathologically examined. Results No dogs died postoperatively. Lung resective time was shortened as the power of Nd:YAG laser increased ( r =-0 9559, P <0 05),On the cut surface 1 5mm diameter of pulmonary vessel or bronchus were well coagulated by 20W energy of laser in a defocused mode. No airleak occurred under 4kPa(30mmHg) positive intropulmonary pressure. There were coagulation necrosis and inflammatory infiltrates in early stage due to laser damage, the granulation tissues formed at 2nd week to replace necrosis and scar was shown 5th week postoperatively. Conclusion 30W power of Nd∶YAG laser is the best selection for lung resection in mini invasive thoracic surgery.Cut surface is well coagulated by 20W power in a defocused mode. In this condition, Lung function could be preserved in great degree.Laser lung resection has more advantage than electrotome and suture.更多还原