微創醫療電燒對組織熱損傷及組織沾黏之研究

Research of thermal injury and anti-adherence on tissue by monopolar electrosurgery in minimal invasive surgery

詹修菱(Hsiu-Ling Jan)

指導教授 ： 林哲堂

共同指導教授 ： 歐耿良

臺北醫學大學/口腔醫學院/牙醫學系碩博士班/碩士(2011年)

https://doi.org/10.6831/TMU.2011.00072

摘要

本研究使用批覆鐵氟隆之市售電燒刀與批覆氮化鉻之單極電燒刀，觀察其對肝臟組織造成之熱損傷和組織沾黏器械程度，實驗結果發現兩組電燒刀造成之組織溫度上升以批覆鐵氟龍之市售電燒刀較高，且組間有達到統計學上之顯著差異；兩組切割之損傷組織皆於術後三天到達組織發炎和壞死之高峰，批覆氮化鉻之單極電燒刀之優異處為於使用中瓦數能量切割組織時，對組織造成之熱損傷較批覆鐵氟龍之市售電燒刀低，且傷口癒合期組織修復較快速，術後一週後組織壞死現象明顯低於批覆鐵氟龍之市售電燒刀；因此經氮化鉻表面處理之單極電燒刀可改善傳統電燒刀之缺失，適用於局部出血凝結與切割組織。

關鍵字

微創手術 ； 單極電燒刀 ； 組織熱損傷 ； 氮化鉻

並列摘要

Monopolar electrosurgical unit with commercially available Teflon-coating and Nitride chromium-coating probe surface were used in my research to evaluate the thermal injury and tissue adherence on liver tissue. My experiment result discovered that the raising tissue temperature were significantly higher in commercially available Teflon-coating monopolar electrosurgical unit than nitride chromium-coating electrosurgical unit. The tissue inflammatory response and cell necrosis process reached the highest point on three days after treatment by both group, the advantages of chromium nitride- coating monopolar electrosurgical unit were induce less thermal injury on liver tissue while cutting tissue in middle power setting and show few cell necrosis response one week after treatment which indicated a faster wound healing compared to commercially available Teflon-coating monopolar electrosurgical unit. In conclusion, monopolar electrosurgical unit coating with chromium nitride is better than the one coating with Teflon and suitable for use in small area coagulation and tissue cutting.

並列關鍵字

Minimal invasive surgery ； Monopolar coagulation ； Tissue thermal injury ； Nitride chromium

參考文獻

Aigner N, Fialka C, Fritz A, Wruhs O, Zoch G. Complications in the use of diathermy. Burns 1997;23(3):256-64.

Ainslie KM, Bachelder EM, Borkar S, et al. Cell Adhesion on Nanofibrous Polytetrafluoroethylene (nPTFE). Langmuir 2006;23(2):747-54.

Arito H, Soda R. Pyrolysis products of polytetrafluoroethylene and polyfluoroethylenepropylene with reference to inhalation toxicity. Ann Occup Hyg 1977;20(3):247-55.

Barshilia HC, Rajam KS. Raman spectroscopy studies on the thermal stability of TiN, CrN, TiAlN coatings and nanolayered TiN/CrN, TiAlN/CrN multilayer coatings. J. Mater. Res 2004;9(11):3196-3205.

Bienk EJ, Reitz H, Mikkelsen NJ. Wear and friction properties of hard PVD coatings. Surface and Coatings Technology 1995;76-77(Part 2):475-80.