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系統識別號 U0007-1607201115255400
論文名稱(中文) 微創醫療電燒對組織熱損傷及組織沾黏之研究
論文名稱(英文) Research of thermal injury and anti-adherence on tissue by monopolar electrosurgery in minimal invasive surgery
校院名稱 臺北醫學大學
系所名稱(中) 牙醫學系碩博士班
系所名稱(英) School of Dentistry
學年度 99
學期 2
出版年 100
研究生(中文) 詹修菱
研究生(英文) Hsiu-Ling Jan
學號 M204097012
學位類別 碩士
語文別 中文
口試日期 2011-06-09
論文頁數 80頁
口試委員 共同指導教授-歐耿良
指導教授-林哲堂
委員-吳其昌
委員-陳順隆
委員-林明宏
中文關鍵字 微創手術  單極電燒刀  組織熱損傷  氮化鉻 
英文關鍵字 Minimal invasive surgery  Monopolar coagulation  Tissue thermal injury  Nitride chromium 
學科別分類
中文摘要 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。
英文摘要 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.
論文目次 1.標題 i
2.審定書 ii
3.致謝 iii
4.目錄 iv
5.中文摘要 vii
6.英文摘要 viii
第一章 緒論
1.1 研究動機與重要性 1
1.2 研究目的 2
第二章 文獻探討
2.1 接觸式微創手術器械 4
2.1.1 單極電燒刀表面批覆塗層PTFE之處理 7
2.1.2 單極電燒刀表面批覆塗層CrN之處理 8
2.2 微創器械與臨床應用 10
2.2.1 微創器械於臨床使用上之癥結點 10
2.3 組織熱損傷與傷口癒合進程 12
第三章 研究材料與方法
3.1 氮化鉻薄膜之物性分析 14
3.2.1 觀察表面批覆鐵氟龍薄膜之市售電燒刀與表面披覆氮化鉻薄膜電燒刀於成豬肝臟使用不同瓦數能量造成之熱損傷 16
3.2.2觀察表面批覆鐵氟龍薄膜之市售電燒刀與表面披覆氮化鉻薄膜電燒刀於大鼠肝臟造成之短期與長期熱損傷 19
第四章 分析與結果
4.1 披覆氮化鉻薄膜電燒刀之物性分析 22
4.2 表面披覆鐵氟龍薄膜之市售電燒刀與批覆氮化鉻薄膜電燒刀之比較 22
4.2.1豬隻體內實驗數據分析 22
4.2.1.1受損組織型態觀察 22
4.2.2大鼠體內實驗數據分析 23
4.2.2.1熱影像儀數據分析 23
4.2.2.2受損組織型態觀察 24
4.2.2.3傷口癒合進程 25
4.2.2.4細胞發炎與凋亡 26
第五章 討論
5.1 氮化鉻薄膜物性分析 28
5.2 單極電燒刀之探頭表面處理對組織熱損傷之影響 30
第六章 結論與建議 35
第七章 參考文獻 37
附錄 45
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