Er：YAG激光对新鲜离体猪舌切割效果的研究

doi:10.3969/j.issn.1674-8115.2026.04.006

摘要/Abstract

摘要：

目的·系统研究掺铒钇铝石榴石（erbium-doped yttrium aluminum garnet，Er：YAG）激光的不同参数组合对新鲜离体猪舌的切割深度和热损伤程度的影响，并探讨其在舌组织精准切割中的应用价值。方法·选取新鲜离体猪舌作为实验对象，在不同功率、频率、移动速率及水气比条件下使用Er：YAG激光切割。实验结束后，对切割组织进行固定、包埋及切片，采用苏木精-伊红（hematoxylin and eosin，H-E）染色，在显微镜下观察切割区域，分别测量其切割深度和热损伤程度。切割深度以组织消融的最大深度为准，热损伤程度则以热损伤区域的平均宽度进行评估。结果·实验均采用长脉冲模式。在频率20 Hz、移动速率0.250 mm/s、水气比4∶4的条件下，功率从1.6 W增至3.2 W时，消融深度由（2.336±0.049）mm增至（4.271±0.147）mm，热损伤区域宽度则由（12.849±0.834）μm增至（19.649±1.055）μm；提示高功率虽可增强消融，但热影响同步增强。在功率2.4 W、移动速率0.250 mm/s、水气比4∶4的条件下，频率从10 Hz增至20 Hz时，消融深度从（1.272±0.120）mm提升至（3.042±0.021）mm，热损伤区域宽度从（17.647±0.726）μm降至（12.944±0.815）μm；说明在相同功率下，高频率因脉冲能量较低，可在提升切割效率的同时减少瞬间热损伤。在功率2.4 W、频率20 Hz、水气比4∶4的条件下，移动速率由0.125 mm/s增加至0.500 mm/s时，消融深度由（3.824±0.060）mm降至（2.230±0.206）mm，热损伤区域宽度亦由（17.711±1.177）μm降至（10.203±0.475）μm；提示加快激光移动速率可减少能量沉积与热扩散。在功率2.4 W、频率20 Hz、移动速率0.250 mm/s的条件下，水气比2∶2、4∶4与6∶6时的热损伤区域宽度分别为（16.276±0.316）μm、（12.944±0.815）μm和（10.764±0.270）μm；说明水气比对热损伤具有明显的冷却效应。在所有参数组合下，热损伤区域的平均宽度均小于25 μm，提示Er：YAG激光在软组织切割过程中产生的热效应相对可控。结论·通过合理选择Er：YAG激光参数组合，可在保证有效切割的同时，将热损伤控制在较低水平，从而实现组织保护与手术精细化操作的统一。

关键词: 掺铒钇铝石榴石激光, 舌, 切割

Abstract:

Objective ·To systematically investigate the effects of different parameter combinations of erbium-doped yttrium aluminum garnet (Er:YAG) laser on the cutting depth and thermal damage extent in fresh ex vivo porcine tongue tissue, and to explore its potential application value in precise cutting of tongue tissue. Methods ·Fresh ex vivo porcine tongue specimens were selected as experimental models. The tissues were irradiated under various parameter settings, including different power, frequencies, scanning speeds, and water-to-air ratios. Following irradiation, the samples were fixed, embedded, and sectioned. Hematoxylin and eosin (H-E) staining was performed, and the cutting areas were observed under a microscopy to measure the cutting depth and the extent of thermal damage. The cutting depth was defined as the maximum depth of tissue ablation, while the extent of thermal damage was assessed based on the average width of the thermally affected zone. Results ·The experiments were conducted in long pluse mode. Under the conditions of a frequency of 20 Hz, a scanning speed of 0.250 mm/s, and a water-to-air ratio of 4:4, as the power increased from 1.6 W to 3.2 W, the ablation depth increased from (2.336±0.049) mm to (4.271±0.147) mm, while the width of the thermal damage zone increased from (12.849±0.834) μm to (19.649±1.055) μm, indicating that although higher power enhances ablation, it simultaneously increases thermal effects. At a power of 2.4 W, a scanning speed of 0.250 mm/s, and a water-to-air ratio of 4:4, when the frequency increased from 10 Hz to 20 Hz, the ablation depth increased from (1.272±0.120) mm to (3.042±0.021) mm, while the width of thermal damage zone decreased from (17.647±0.726) μm to (12.944±0.815) μm, suggesting that under the same power, a higher frequency (with lower pulse energy) can improve cutting efficiency while reducing instantaneous thermal damage. At a power of 2.4 W, a frequency of 20 Hz, and a water-to-air ratio of 4:4, when the scanning speed increased from 0.125 mm/s to 0.500 mm/s, the ablation depth decreased from (3.824±0.060) mm to (2.230±0.206) mm, and the width of thermal damage zone decreased from (17.711±1.177) μm to (10.203±0.475) μm, indicating that increasing the scanning speed reduces energy deposition and thermal diffusion. At a power of 2.4 W, a frequency of 20 Hz, and a scanning speed of 0.250 mm/s, the thermal damage widths at water-to-air ratios of 2:2, 4:4, and 6:6 were (16.276±0.316) μm, (12.944±0.815) μm, and (10.764±0.270) μm, respectively, indicating that the water-to-air ratio has a significant cooling effect on thermal damage. Under all tested parameter combinations, the average width of the thermal damage zone remained below 25 μm, suggesting that the thermal effects induced by the Er:YAG laser during soft tissue cutting are relatively controllable. Conclusion ·By appropriately selecting the combination of Er:YAG laser parameters, effective cutting can be ensured while keeping low thermal damage, thereby achieving a balance between tissue protection and precise surgical operation.

Key words: erbium-doped yttrium aluminum garnet (Er:YAG) laser, tongue, cutting

中图分类号:

R781.1

欧阳文珺, 陶疆. Er：YAG激光对新鲜离体猪舌切割效果的研究[J]. 上海交通大学学报（医学版）, 2026, 46(4): 467-474.

Ouyang Wenjun, Tao Jiang. Study on the cutting effects of Er:YAG laser on fresh ex vivo porcine tongue[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026, 46(4): 467-474.

图/表 5

表1 激光参数组合列表

Tab 1 List of laser parameter combinations

Parameter group	Mode	Pulse energy/mJ	Frequency/Hz	Power/W	Speed/(mm·s^-1)	Water-to-air ratio
a	LP	80	20	1.6	0.250	4∶4
b	LP	120	20	2.4	0.250	4∶4
c	LP	160	20	3.2	0.250	4∶4
d	LP	240	10	2.4	0.250	4∶4
e	LP	160	15	2.4	0.250	4∶4
f	LP	120	20	2.4	0.250	4∶4
g	LP	120	20	2.4	0.125	4∶4
h	LP	120	20	2.4	0.250	4∶4
i	LP	120	20	2.4	0.500	4∶4
j	LP	120	20	2.4	0.250	2∶2
k	LP	120	20	2.4	0.250	4∶4
l	LP	120	20	2.4	0.250	6∶6

图1 Er:YAG激光功率对切割深度及热损伤程度的影响Note： A. Incisions created on porcine tongue tissue under different Er:YAG laser power settings, with microscopic observation of cutting depth and thermal damage. B. Effect of laser power on ablation depth. C. Effect of laser power on thermal damage.

Fig 1 Effects of Er:YAG laser power on cutting depth and thermal damage

图2 Er: YAG激光频率对切割深度及热损伤程度的影响Note： A. Incisions created on porcine tongue tissue under different Er:YAG laser frequencies, with microscopic observation of cutting depth and thermal damage. B. Effect of frequency on ablation depth. C. Effect of frequency on thermal damage.

Fig 2 Effects of Er:YAG laser frequency on cutting depth and thermal damage

图3 Er: YAG激光移动速率对切割深度及热损伤程度的影响Note： A. Incisions created on porcine tongue tissue under different Er:YAG laser scanning speeds, with microscopic observation of cutting depth and thermal damage. B. Effect of scanning speed on ablation depth. C. Effect of scanning speed on thermal damage.

Fig 3 Effects of Er:YAG laser scanning speed on cutting depth and thermal damage

图4 Er: YAG激光水气比对切割深度及热损伤程度的影响Note： A. Incisions created on porcine tongue tissue under different Er:YAG laser water-to-air ratios, with microscopic observation of cutting depth and thermal damage. B. Effect of water-to-air ratio on ablation depth. C. Effect of water-to-air ratio on thermal damage.

Fig 4 Effects of Er:YAG laser water-to-air ratio on cutting depth and thermal damage

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