文章摘要

高频焊接仪闭合动脉血管的安全性与可靠性研究

作者: 1潘东岳, 1厉周, 1杨少华, 1王卫卫, 1周华彬, 1蔡寨, 1韩帅, 2陈军, 2黄德群
1 南方医科大学珠江医院 普通外科，广东 广州 510282
2 外科，广东 广州 510282；2. 广东省医疗器械研究所 国家医疗保健器具工程技术研究中心，广东 广州 510500
通讯: 厉周 Email: Leezhou888@126.com
蔡寨 Email: czhaidr@126.com
DOI: 10.3978/.10.3978/j.issn.1005-6947.2016.06.016
基金: 广东省战略性新兴核心技术攻关基金资助项目, 2011A081402004 广州市科技计划基金资助项目, 201508030035

摘要

目的：探讨高频焊接仪（HFWD）闭合动脉血管的安全性与可靠性。方法：将6头西藏小型猪均随机分为HFWD组与超声刀组（HS组），全麻后分离裸化颈、股动脉，分别采用HFWD与HS闭合离断血管。比较两组血管闭合后的爆破压、闭合时间、闭合过程中的最高温度及闭合处病理热损伤。结果：不区分血管管径大小时，HFWD组平均爆破压高于HS组（489.64 mmHg vs. 439.88 mmHg，P<0.05），当血管直径≤3 mm时，HFWD组与HS组爆破压无明显差异（593.40 mmHg vs. 572.48 mmHg，P>0.05），对于直径>3~5 mm、>5~7 mm的血管，HFWD组爆破压均大于HS组（457.02 mmHg vs. 404.32 mmHg；418.51 mmHg vs. 342.84 mmHg，均P<0.05）；无论血管直径大小，HFWD组闭合血管所需时间均少于超声刀（均P<0.05）。HFWD组闭合处的平均最高温度低于HS组（65.91 ℃ vs. 105.25 ℃，P<0.05）；HFWD组闭合处血管壁胶原变性及血管平滑肌损伤程度轻于HS组。结论：HFWD闭合动脉血管是安全可靠的。
关键词： 动脉 焊接 超声外科手术

Safety and reliability of using high-frequency electric welding device for arterial closure

Authors: 1PAN Dongyue, 1LI Zhou, 1YANG Shaohua, 1WANG Weiwei, 1ZHOU Huabin, 1CAI Zhai, 1HAN Shuai, 2CHEN Jun, 2HUANG Dequn
1 Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
2 Guangdong Institute of Medical Instruments, National Engineering Research Center for Healthcare Devices, Guangzhou 510500

CorrespondingAuthor:LI Zhou Email: Leezhou888@126.com

Abstract

Objective: To investigate the safety and reliability of using high-frequency electric welding device (HFWD) for arterial closure. Methods: Six Tibetan minipigs were equally randomized into HFWD group and harmonic scalpel group (HS group). Under general anesthesia, carotid and femoral arteries of the pigs were isolated and skeletonized, and were then closed and divided using HFWD or HS, respectively. The bursting pressure of the vessels after sealing, sealing time, maximum temperature during sealing and the pathological injuries in the sealing area were compared between the two groups. Results: In all vessels without distinction of diameter, the average burst pressure after sealing in HFWD group was significantly higher than that in HS group (489.64 mmHg vs. 439.88 mmHg, P<0.05); in vessels with diameter ≤3 mm, the burst pressure showed no significant difference between HFWD group and HS group (593.40 mmHg vs. 572.48 mmHg, P>0.05); in vessels with diameter either >3~5 mm or >5~7 mm, the burst pressure in HFWD group was significantly higher than that in HS group (457.02 mmHg vs. 404.32 mmHg; 418.51 mmHg vs. 342.84 mmHg, both P<0.05). No matter what the vessel diameter was, the sealing time in HFWD group was significantly shorter than that in HS group (all P<0.05). The average maximum temperature during sealing in HFWD group was significantly lower than that in HS group (65.91 ℃ vs. 105.25 ℃, P<0.05). The collagen denaturation and smooth muscle injury in vascular wall of the sealing site were milder in HFWD group than those in HS group. Conclusion: Using HFWD for arterial closure is safe and reliable.
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