本研究使用自製之無針式內視鏡冷凍治療系統，結合組織抬升技術與二氧化碳雪花進行生物體之內視鏡冷凍治療術之研究。此系統包含壓力供應與儲存、自製控制器、無針式噴注器、冷凍治療系統四個子系統，並利用Joule-Thomson effect，當液態二氧化碳於常溫時由高壓突降至常壓所產生之固態氣態混合噴流為冷凍劑進行生物組織之冷凍實驗，探討生物組織於二氧化碳雪花噴流下之冷凍特性。實驗用之生物組織為約六個月大之豬隻大腸，透過控制雪花形成腔腔體長度、側壁孔面積、側壁孔位置等參數量測二氧化碳雪花在組織表面的溫度變化、冷凍速率、溫度場範圍等。實驗首先透過自製之無針式內視鏡注射系統，以有機纖維溶液為工作流體進行組織抬升，標的二氧化碳雪花之冷凍目標，同時藉由抬升部位保護肌肉層與其下的組織(如血管與神經等)不會因雪花冷凍而受損，再以二氧化碳雪花噴流噴灑於上，並使用紅外線熱影像儀及熱電偶等測量組織表面的溫度場與溫度變化。實驗結果顯示，當雪花形成腔腔體長度較短、較大的側壁孔面積時可得到較佳的冷凍效果，其組織表面溫度可低於攝氏零下60度左右。實驗結果另顯示較小的形成腔長度與較小的側壁孔面積可達成較大的冷凍面積，因此在臨床治療上可依照病灶組織的大小決定使用何種雪花形成腔設計進行治療。本研究另將上述之冷凍治療系統結合工業用內視鏡，進行冷凍治療在內視鏡應用上的模擬測試。實驗結果顯示此冷凍治療系統可與內視鏡系統結合並成功進行組織抬升技術與冷凍治療術的觀察、操作、後續追蹤等步驟。此研究結果可提供未來於臨床應用上可供參考的數據資料。

This study investigates the freezing mechanism and the performance of carbon dioxide snow jet on organism tissue by an endoscopic needle-free cryogenic system. This system includes four units such as the pressure supply unit, the controller, the needle-free micro injector, and the cryogenic unit. CO2 snow is used as the refrigerant. The testing material is porcine colon of six-months-old pigs. The freezing rate, the freezing temperature, the freezing field of tissue surface are investigated by various formation chamber designs, include various formation chamber lengths, sidewall holes areas, and locations of sidewall holes. The first step of the experiments is using organic fiber solution as working fluid to make tissue elevation by the needle-free injection system for marking the location of tumors or lesions. At the second step, CO2 snow spray is used to freeze the elevated portion and determine the surface temperature, the freezing rate, and the freezing area by IR thermal-images and thermocouples. According to the results, the tissue surface temperature is lower when a shorter formation chamber and smaller sidewall holes are applied, and the surface temperature can reach below -60 ℃. The freezing area increases when formation chamber lengths and sidewall holes decrease. Considering the size of tumors, surgeons can choose a right formation chamber design making the best performance in clinical treatments. This study combines the cryotherapy system with an industrial endoscope to simulate the performance of an endoscopic cryotherapy system, and the results demonstrate there are no problems on observation and operation during experiments.

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