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目的:探讨CO2激光犬膀胱粘膜剥脱术的可行性与安全性。方法:开放手术条件下,采用经多晶锗空芯金属红外波导传输的CO2激光施行犬膀胱粘膜剥脱术,通过普通光镜观察、胶原纤维染色及静脉肾盂造影、膀胱压力—容量测定、血清肌酐检测等形态与功能评定的方法了解CO2激光对犬膀胱粘膜的剥脱效果、术后膀胱粘膜的再生、修复过程,以及泌尿系统机能的整体变化。结果:CO2激光可以在10~15min内实现对犬膀胱粘膜的完全剥脱,剥脱深度仅限于粘膜及粘膜下层,未见激光对膀胱肌层有明显的损害。主要并发症为程度不等的终末肉眼血尿,未见有严重膀胱出血、穿孔及尿漏的发生。术后4周时可见膀胱粘膜上皮完全再生,术后12周时膀胱及上尿路的形态与功能方面的各项指标与术前无明显差异,膀胱肌层未见有严重的纤维化改变。结论:CO2激光可以对犬膀胱粘膜进行有效地剥脱,CO2激光犬膀胱粘膜剥脱术具有一定可行性与安全性。
Objective: To investigate the feasibility and safety of CO2 laser in the treatment of bladder mucosal exfoliation. METHODS: Under open surgery, CO2 mucosal exfoliation was performed using CO2 laser delivered by polycrystalline germanium hollow metal infrared waveguide. The results of routine light microscopy, collagen staining and IVP, determination of bladder pressure and volume, serum creatinine Detection and other morphological and functional assessment methods to understand the CO2 laser stripping of the dog’s bladder mucosa, postoperative regeneration of the bladder mucosa, the repair process, and the overall changes in urinary system function. Results: CO2 laser could completely exfoliate the bladder mucosa in 10 ~ 15 min. The depth of exfoliation was only in the mucosa and submucosa. No laser damage to the bladder myometrium was observed. The main complications ranging from end to end gross hematuria, no severe bladder hemorrhage, perforation and urinary leakage occurred. At 4 weeks after operation, bladder mucosal epithelium was completely regenerated. There was no significant difference in the morphology and function of the bladder and upper urinary tract at 12 weeks after operation. There was no significant fibrosis in the bladder myometrium. Conclusion: CO2 laser can effectively exfoliate the bladder mucosa of canine, and CO2 laser canine mucosal exfoliation has some feasibility and safety.