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目的：对比单、双光纤Nd:YAG激光在新鲜离体猪肝中的作用特点和温度变化情况，为临床消融治疗提供参考。方法：采用5 W功率激光分别对新鲜离体猪肝进行单针单点及双针双点消融，观察二者在体外肝组织造成的消融灶形态、范围以及周围的温度变化。结果：消融灶从内向外分为碳化区、坏死区、移形区，双光纤组消融灶中心碳化区范围更大，细胞坏死更彻底，单光纤组激光消融灶纵横比（LD/TD）大于双光纤组（P＜0.001）。双光纤组消融灶横径（TD）及体积（V）大于单光纤组（P＜0.001），双光纤组消融灶纵径（LD）与单光纤组比较无统计学差异(P＞0.05)，两组消融中心旁开5 mm，10 mm处20 s、40 s、60 s温度对比无统计学差异(均P＞0.05)。结论：5 W条件下单、双光纤消融周围温度变化相似，单光纤适用于微小肿瘤消融，双光纤消融范围更大，可对较大癌结节一次性全覆盖消融。

英文摘要:

Objective:To compare the characteristics and temperature changes of single and double fiber Nd : YAG laser in fresh isolated pig liver,and to provide reference for clinical ablation treatment.Methods:Single-needle single-point and double-needle double-point ablations were performed on fresh isolated pig livers using a 5W power laser, and the morphology, range, and surrounding temperature changes of the ablation lesions caused by the two in vitro liver tissues were observed.Results:The ablation lesions were divided into carbonized area, necrotic area and deformed area from inside to outside.The carbonized area in the center of the ablation lesion in the double-fiber group was larger and the cell necrosis was more thorough.The aspect ratio (LD/TD) of the laser ablation lesion in the single-fiber group was larger than that in the double fiber group (P<0.001). The transverse diameter (TD) and volume (V) of the ablation lesion in the double-fiber group were larger than those in the single-fiber group (P<0.001). There was no significant difference in the longitudinal diameter (LD) of the ablation lesion between the double-fiber group and the single-fiber group (P>0.05). There was no significant difference in the temperature of 20s, 40s and 60s at 5mm and 10mm beside the ablation center between the two groups (all P>0.05).Conclusion:Under the condition of 5 W, the temperature changes around the single and double fiber ablation are similar. The single fiber is suitable for small tumor ablation, and the double fiber ablation range is larger,which can be used for one-time full coverage ablation of larger cancer nodules.

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