不同灌注方式下软性输尿管镜液体流量的体外测定  

Effects of different perfusion modes of irrigation fluid volume on flexible ureteroscope in vitro

作　　者：柯芹 杨嗣星[1] 廖文彪[1] 宋超[1] 刘凌琪[1] 

机构地区：[1]武汉大学人民医院泌尿外科,430060

出　　处：《临床外科杂志》2014年第11期808-809,814,共3页Journal of Clinical Surgery

摘　　要：目的：探讨软性输尿管镜碎石术液体流量最佳的灌注方式。方法根据液体灌注方式不同分为三组：A 组，采用高度悬吊灌注法，灌注水袋液体平面距离操作镜体的平面高度为60 cm；B 组，采用压力灌注泵恒压灌注法，调节灌注泵的压力和流量为恒定值，使自软镜流出的水流呈自然抛物线；C 组，采用手推注射器灌注法，60 ml 注射器连续推注液体。分别使用 A、B、C 三种液体灌注方法对内径为3．6F 的软性输尿管镜在无光纤置入和内置入200μm 光纤两种情况下进行液体灌注，体外重复6次测定每分钟液体的灌注流量，并对这三组所测得的数据行统计学分析。结果①软性输尿管镜在无光纤置入情况下，三组的液体灌注量分别为 A 组（20．60±1．70）ml／min；B 组（39．23±2．34）ml／min；C 组（75．55±11．26）ml／min。各组之间比较，差异有统计学意义（P ＜0．001）。②软性输尿管镜内置入200μm 光纤后，测定的液体灌注量分别 A 组（12．10±1．53） ml／min；B 组（22．22±1．38）ml／min；C 组（64．68±3．87）ml／min，三组之间比较，差异有统计学意义（P ＜0．001）。另外，在无光纤置入和内置入200μm 光纤两种情况下，C 组均明显高于 A 组、B 组。结论软性输尿管镜碎石术中采用压力灌注泵恒压灌注是一种安全可靠的灌注方法。Objective To investigate the best reperfusion mode for flexible ureteroscopic litho-tripsy.Methods According to different perfusion modes,three groups were divided into different modes, including suspension perfusion mode（Group A）with 60 cm of liquid height,constant pressure perfusion mode（Group B）using pressure infusion pump,and manual syringe infusion mode（Group C）.The liquid of the three groups were perfused by flexible ureteroscope （diameter 3.6F）with or without inserted fiber （200μm）.Irrigation fluid volume per minute was repeatedly tested for six times in vitro and then recorded for statistical analysis.Result In the condition without the fiber,irrigation fluid volumes of Group A,B and C were（20.60 ±1.70）ml/min,（39.23 ±2.34）ml/min and（75.55 ±11.26）ml/min,respectively. There were significantly differences between the three groups（P 〈0.001）.In the condition with inserted fiber（200μm）,irrigation fluid volumes of Group A,B and C were（12.10 ±1.53）ml/min,（22.22 ± 1.38）ml/min and（39.68 ±3.87）ml/min,respectively.There were significantly differences among the three groups（P 〈0.001）.Furthermore,irrigation fluid volume in Group C was obviously higher than those in Group A and B no matter the fiber was inserted or not.Conclusion Constant pressure perfusion mode using pressure infusion pump is safe and reliable during flexible ureteroscopic lithotripsy.

关 键 词：软性输尿管镜 灌注方式 体外测定 

分 类 号：R693[医药卫生—泌尿科学]