本研究主要探討內視鏡治療術結合無針式內視鏡冷凍治療系統，藉由工作流體將組織抬升，將癌細胞與健康組織分開，進行冷凍治療術。冷凍治療術所使用的冷凍劑為液態二氧化碳，由於經過高壓瞬間降壓的效應，會產生氣固兩相的二氧化碳噴流，其低溫為-78℃能夠有效消滅癌細胞。為了增加內視鏡之功能，本研究以外掛的方式將內視鏡掛於自製的內視鏡套頭上，其目的在增加內視鏡系統之工作通道，可做為止血、抽氣等醫療用途。此套頭亦可應用於工業用內視鏡上，達到與醫用內視鏡相同效果。為了減少治療過程病人之不適感，本研究將雪花形成腔外徑縮小為5 mm，並改善其設計，以達成治療過程穩定提供二氧化碳雪花之要求。
本實驗主要探討雪花形成腔長度、雪花形成腔開口角度及第二側壁開口等，對於生物組織冷凍特性的影響。實驗工作包括量測生物組織上下表面之溫度變化，生物組織表面溫度分佈，組織縱剖面的溫度分佈，及3-5-3冷凍治療循環之效應等。實驗先以無針式注射系統將抬升溶液注入生物組織使其抬升，再進行冷凍治療實驗。實驗結果顯示雪花形成腔長度11 mm時冷凍溫度達-68℃±2.0℃，形成腔開口角度為15⁰時雪花冷凍溫度可達-78 ℃，若第二側壁口開口長度為10 mm與13 mm時不會影響系統之冷凍性能，但若第二側壁口開口長度增為至15 mm，則雪花冷凍溫度則改變為-38.0℃±11.3℃。吾人將冷凍治療術進一步應用於豬結腸的體外實驗，結果顯示二氧化碳雪花噴灑角度在30⁰與40⁰時，上表皮最終冷凍溫度皆可以達到-50℃以下且冷凍速率達200℃/min以上。若將冷凍治療術應用小里肌肉之體外實驗，在二氧化碳雪花噴灑角度在30⁰與40⁰時，在肌肉層深度為5mm與10mm處，溫度差為5℃。另外3分鐘冷凍、5分鐘解凍、3分鐘冷凍治療循環結果顯示，在第二循環時，上表面冷凍溫度無明顯變化，但下表面於第二循環時，在二氧化碳噴灑角度10⁰、20⁰、30⁰條件下，下表面冷凍溫度下降2℃。但當二氧化碳噴灑角度40⁰時，下表面冷凍溫度下降6.5℃，顯示在3-5-3冷凍治療循環進行過程中，組織下表面溫度皆有下降之趨勢。

This research investigates the characteristics of cryotherapy treatment on living organism by using carbon dioxide snow. Tissue elevation was performed before cryotherapy treatment to separate the cancer cells from the healthy tissue. Pressurized Liquid carbon dioxide was first injected into a formation chamber at room pressure. The pressure drop of carbon dioxide within the formation chamber results in a phase change and CO2 snow jet was injected on the tissue for cryotherapy treatment. CO2 snow is a gas-solid mixture with temperature low down to -78℃. It can be used to destroy the cancer cells by cryotherapy treatment. The working channels of endoscope were used for the supply of the liquid carbon dioxide as well as for air extracting and hemostasis. The outside diameter of the formation chamber of carbon dioxide was reduced for the patient’s comfort during the treatment. Design parameters investigated in this research are length and slit open angle of the formation chamber and the position of the side wall opening on the formation chamber. The evolution of temperatures of the upper and lower surfaces of biological tissue was recorded during the cryotherapy treatment. Results show that the temperature of the upper surface of the tissue is -68℃±2.0℃ as the length of formation chamber is 11 mm. The temperature of the upper surface is -78℃ as the slit open angle of the formation chamber is 15 degree. The temperature of the upper surface does not change as the position of the side wall opening is 10 mm and 13 mm. In the other hand, the temperature of the upper surface increase to -38℃ as the position of the side wall opening is 15 mm. We further applied cryotherapy technique on the freezing processes of porcine colon tissues. Results show that the temperature of upper surface decreases as the spray angle of carbon dioxide snow is increased. Freezing rate is up to 200℃/min and upper surface temperature is -50℃ as the spray angle of carbon dioxide snow is between 30⁰ and 40⁰in the test with porcine colon tissue . The freezing rate is up to 200℃/min and the freezing depth is 5 mm and 10 mm when the temperature difference and spray angle of carbon dioxide snow are 5℃ and 40⁰, respectively.
In the treatment of freeze-thaw-freeze processes, the temperature difference of the lower surface of small loin tissue is 2℃ between first cycle and second cycle under spray angle of carbon dioxide 10⁰、20⁰and 30⁰. The temperature diference of the lower surface of the small loin tissue is 6.5℃ between the first and second cycle if the spray angle of carbon dioxide is further increased to 40⁰. It indicates that the lower surface temperature of small loin tissue would be further decreased during the freezing and thawing cycles.

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