【作者】 任龙喜； 尹建； 焦守国；

【Author】 REN Long -xi,YIN -jian,JIAO Shou -guo

【机构】 北京市垂杨柳医院骨科；

【摘要】 [目的]比较1064 nm波长的Nd:YAG激光和980 nm波长的半导体激光对椎间盘髓核组织的生物热效应。[方法]利用Nd:YAG激光和半导体激光分别对山羊脊柱标本进行照射,按照激光最终照射能量的不同各分为200J、400J、600J、800J、1000J五组,观察照射前后标本的质量差和照射过程中椎间盘周边的温度变化情况,操作结束后水平切开椎间盘观察汽化腔形态,并利用游标卡尺测量汽化腔的长、宽轴。[结果]两种激光照射前后标本的质量差随能量的增大而增加;在相同的能量下,980 nm半导体激光照射前后标本的质量差要高于Nd:YAG激光照射前后标本的质量差,在能量分别为200J、400J时比较,P<0.05,能量为600J、800J、1000J时比较P<0.01;照射过程中椎间盘前缘、后缘、椎间孔内侧壁的温度变化值随激光能量的增加而升高;当以同一能量进行照射时,980 nm半导体激光照射过程中椎间盘周边的温度变化值高于Nd:YAG激光相同位点处的温度变化值(P<0.01)。Nd:YAG激光照射后肉眼观察汽化腔的形态大致呈圆形或卵圆形,而980 nm半导体激光照射后的汽化腔形态接近于椭圆形。当以同一能量照射时,980 nm半导体激光的汽化腔长轴大于Nd:YAG激光汽化腔的长轴(P<0.01);当能量为200J时,Nd:YAG激光汽化腔的宽轴大于980 nm半导体激光汽化腔的宽轴(P<0.05),能量为400J时P<0.01,能量由600J至1000J时两者无统计学差别(P>0.05)。[结论]980 nm波长的半导体激光对椎间盘髓核组织的消融能力优于波长1064 nm的Nd:YAG激光,而Nd:YAG激光的安全性相对较高。更多还原

【Abstract】 [Objective]To compare the bio-heating effectiveness to nucleus pulposus between 1064nm Nd:YAG laser and 980nm diode laser.[Method]The goat spine specimen(GSS)were radiated by Nd;YAG laser and 980nm diode laser,and they were divided into five groups according to the final energy from 200J to 1000J.The ablated quality of nucleus pulposus after radiating and the changes of temperature at three important sites around discs during radiating were observed.After procedure,slit the disc horizontally and observe the morphous of the cavity.Then measure the long and wide axis of cavity by sliding caliper.[Result]The ablated quality of GSS was greater at higher radiating energy in both lasers.At the same energy,the ablated quality of GSS was greater in 980nm diode laser than in 1064nm Nd:YAG laser.There is statistical significance when at 200J,400J group (P<0.05)and at 600J,800J,1000J group(P<0.01).The changes of temperature at the anterior border,posterior border of discs and at the intervertebral foramen were greater at higher energy during radiating.The changes of temperature at the same site during radiating were higher in 980nm diode laser when using the same energy(P<0.01).The cavities made by Nd;YAG laser are toroid or ovale under naked eye observation,while the cavities made by 980nm diode laser are elliptic.There is statistical significance when compare the long axis between two lasers at the same energy(P<0.01).When compare the wide axis,there is statistical significance at the 200J(P<0.05)group and at the 400J(P<0.01)group,there is no statistical significance at the 600J,800J,1000J energy group.[Conclusion]980 nm diode laser has better ablation ability to nucleus pulposus than 1064nm Nd:YAG laser,but the latter is more safe.更多还原