口腔颌面部静脉畸形Nd:YAG激光光热凝固治疗温度场和热损伤预测评估方法研究

Nd:YAG laser photocoagulation is an important treatment for venous malformations (VMs) in oral and maxillofacial regions. For enhancing the prognosis and avoiding side effects, doctors have been facing a great challenge on choosing suitable laser parameters which including the width and energy of laser pulse, irradiation time, the temperature and lasting time of cooling and so on. Temperature field and thermal damage model which based on the laser-tissue interaction research is an effective method for the evaluation of prognosis and side effects after laser therapy. The aim of this study is fulfilling the demands of laser parameters’ optimization. The key point of this study is clarification of the optical and themophysical parameters’ dynamic changes during blood photocoagulation. The anticipated results of this interdisciplinary study is the invention of precise method for the evaluation of temperature field and thermal damage which composed of numerous simulation, in vitro model and animal model. The main line of this study is temperature field and thermal damage research of VMs in oral and maxillofacial regions irradiated by Nd:YAG laser with different parameters. The relationship between fundamental study of Nd:YAG laser irradiating effects on VMs in oral and maxillofacial regions and clinical prognosis by the research of optical phantom and animal model. The inventions with intellectual property rights from above studies will be applied to establish a novel system with convenient usage and excellent performance in the prediction and evaluation of the VMs prognosis after Nd:YAG laser treatment with various laser parameters. And thus, a multidisciplinary research platform and novel clinical mode of laser therapy for vascular anomalies will be feasibility on the basis of this study.

Nd:YAG激光光热凝固术是口腔颌面部静脉畸形（venous malformations,VMs）治疗的重要手段。激光脉宽、能量、治疗时间和表面冷敷量等参数选择是否合理是决定治疗效果的关键，也是临床中亟需解决的重要问题。基于激光组织相互作用研究的温度场和热损伤建模是预测评估疗效和副作用的有效方法。本项目针对临床激光参数最优化的迫切需求，重点解决血液光热凝固光学和热物性参数动态改变问题，研究由数学模型、离体模型和动物模型所组成的临床实际温度场和热损伤精确预测评估系统。本项目以激光照射VMs所致温度场和热损伤研究为主线；以光学仿体、动物模型研究为桥梁；建立Nd:YAG激光与VMs相互作用基础研究与临床治疗效果之间的关系。最终研制一套具有自主知识产权、使用方便、性能优异的Nd:YAG激光治疗口腔颌面部VMs临床评估预测系统，从而为构建多学科交叉的脉管性疾病激光治疗研究平台和临床诊疗模式奠定基础。

激光与生物组织相互作用原理研究是激光医学理论和临床实验研究的基础。实现对激光在组织中传播的精确估计是计算激光治疗疗效和对副作用预测评估的关键。本课题从Nd:YAG激光光凝术对激光参数最优化的迫切需求出发，创造性的发明了动态光热参数检测方法（Dynamic Optical and Thermal Detection Method, DOTD方法）以测量脉冲Nd:YAG激光照射血液所致光热凝固过程中的血液关键光热特性参数的动态变化。就项目组所知，我们的DOTD方法克服了传统积分球检测方法仅能检测血液在不同温度恒定状态下光学参数的不足，第一次获得了临床条件下激光照射指定厚度离体人静脉血层全过程的光热场实时检测数据。基于R语言数据可视化和回归分析、时间序列算法等人工智能技术对所获光热特性实时检测数据进行分析，本课题获得了两个重要结果：.（1）发现光热凝固模拟手术全过程静脉血的光热参数随时间的动态变化是可量化、重复和预测的过程。据此，本团队提出了“伞效应”和“空腔效应”动态平衡理论，实现了对1983年安德森所提出的选择性光热解理论在时域上的拓展，建立了与实验结果高度相符的动态光学参数表达式，实现了对血液光凝过程中激光能量分布随时间变化的精确估计。.（2）解出了修正朗伯比尔定律中未知几何尺寸因子G随血层厚度变化的表达式，实现了修正朗伯比尔精确计算混沌介质中激光能量空间分布的突破，进而为激光在生物组织乃至混沌介质中传播的研究提供了一种可用公式计算的理论模型。. 上述实验结果及使得我们针对激光光凝模拟手术全过程中光热场时空场分布问题建立起可靠的数学模型。其临床意义是满足项目计划书提出的Nd:YAG激光治疗口腔颌面部静脉畸形的副作用更小，更精准的临床需求，并进一步的对激光光热凝固手术光参数的选择起到指导和借鉴。而其科学意义是为混沌介质中光传播的时空分布解析解的获得提供了新的思路和方法，实现了生物医学光子学的理论原创。该理论将被应用于人工智能辅助激光手术训练预测评估等新技术中，从而进一步确立本团队在智能光医学方向的引领地位。

内容获取失败，请点击重试