超声刀及其在心脏手术的运用.ppt

* * * The three components of the Harmonic Scalpel System are high-frequency, computer-controlled generator, a hand piece which houses the ultrasonic transducer, and a variety of interchangeable blade configurations. A computer-controlled electrical signal causes the piezo-electric ceramics in the ultrasonic transducer in the Harmonic Scalpel Hand Piece to expand and contract, converting electrical energy to mechanical motion (ultrasound). The transducer, attached to the mount, transmits the ultrasonic vibration to the attached blade. To simplify, the electric signal sent to the transducer in the Harmonic Scalpel Hand Piece is converted to mechanical motion. The result is vibration of 55,500 cycles per second (ultrasonic motion) at the blade tip. * The blade vibrates longitudinally at 55,500 Hz per second. The blade travels from 50 to 100 microns per stroke. * The Harmonic Scalpel blade vibrates longitudinally at 55,500 Hz per second. The blade travels from 50 to 100 microns per stroke. Rapid acceleration of tissues moving with the blade breaks the hydrogen bonds that give protein structure, which results in a protein coagulum that seals coapted vessels. Deep coagulation of large vessels results when the effect is prolonged. * Hemostasis is achieved by denaturation of tissue protein and formation of coagulum; these effects occur at the operating tissue temperature of the Harmonic Scalpel - temperatures less than 100oC. The higher temperatures associated with electrosurgery and laser result in tissue dessication and eschar. 超声刀及其在心脏手术的运用 主机（GEN04） 手柄 (HP054) 超声刀头 转换帽(HSA06，ADP15) 脚控装置 (FSW01) 主机 车架 脚控装置 手柄 主机 (GEN04) 电源开关 声音调节钮 可调档位工作指示器 高档位工作指示器 手控激发键 测试键 档位提高键 待机键 工作指示灯 显示器 档位降低键 警报指示器 手柄插口 在手柄中，主机中的电能转换成机械能 变频器 座架 导电陶 机架 刀头以55,500 (Hz) 速度震动 活动刀头 组织垫 Ultrasonic Energy 电流传导至手柄 手柄内压电陶瓷片激活工作 陶瓷片将电能转换成机械能 产生纵向机械振动并在传导轴节点处扩大 传导至刀头达到最大 55,500 Hz高频振动 刀头以 55,500 Hz（次/秒）振动 刀头与组织蛋白接触 使组织内的水分子汽化， 蛋白氢键断裂和组织蛋白变性形成粘滞凝固物 蛋白凝固闭合管腔 达到切割和止血效果（5mm以下血管） 空化效应——液体中的微小气泡称为空