- 學位論文
二極體雷射於促進血液凝結之分析
The analysis of diode laser application in facilitated blood coagulation
摘要
身體因外傷流血時，血液循著凝血連鎖反應機制自然達到凝血作用以避免血液過度流失的情況產生。在某些情況下，例如血友病、von Wilillebrand疾病、及維生素K的缺乏或是某些藥物的應用，會導致凝血連鎖反應機制受到干擾而不能正常地實行凝血作用。原則上，凝血時間的長短會因人而異，且目前已知鮮少有”直接”及”體外”的醫學處置能”達到縮短凝血時間的目的。 此實驗介紹一種使用牙科二極體雷射透過直接及體外的照射，達到於傷口立即凝血之目的。 雷射,LASERS (Light Amplification by Stimulated Emission of Radiation）是一種單色、同調及集中的光能量。其中二極體雷射是位於波長範圍655nm至980nm之近紅外線雷射。雷射的波長決定著照射時生物組織中的吸收特質；當雷射照射於組織時，光能被轉換成熱產生光熱效應後導致組織升溫。組織溫度於50°C時血液開始凝結，60°C時組織蛋白質開始變性，達到100°C時水分開始蒸發，組織碳化則發生於溫度200°C.以上。典型的雷射手術是藉由以組織吸收雷射能量後升溫達到氣化程度進行切割或剝離進行。
並列摘要
After trauma or injuries, the wounded sites usually result to bleed. The blood will then undergo a physiological process called coagulation to achieve hemostasis in order to prevent excessive blood loss and to make the wound ready for further healing. However, the time required by the blood to start coagulating is determined by the individual’s phenotype through its coagulation cascade.1. There are several known diagnostic diseases or disorders which are related to the impairment of the coagulation cascade such as hemophilia, Von Willebrand disease, and deficiency of vitamin K… etc. In addition, drug application can also be a result of prolonged blood coagulation. This study; however, introduces a clinical method of directly and externally making a pool of blood instantly coagulate by the treatment of Diode laser. For example: to stop bleeding in a dental extraction sockets. LASERS （Light Amplification by Stimulated Emission of Radiation）emit a precise beam of monochromatic, coherent, and collimated light energy. The diode laser is a near-infrared continuous wave laser whose wavelength varies from 655nm to 980nm. The wavelength determines the absorption characteristic in biologic tissues.2 When the laser beam is applied to the tissue, the light energy is transformed into heat and causes a photo-thermal event resulting a temperature rise in the tissue. Different observed effects take place by different tissue temperature achieved. Coagulation begins at over 50°C, with protein denaturation at 60°C. Vaporization of water occurs at over 100°C, with carbonization of tissue at 200°C3,4. A typical laser surgery is achieved by the process of ablation, meaning tissue removal by converting it to a gaseous state or plume. Lasers have also been utilized to induce vascular occlusion and photocoagulation.