国产超脉冲铥光纤激光碎石体外实验研究  

Preliminary exploration of domestic super-pulsed thulium fiber laser lithotripsy energy setting

作　　者：丁天福 肖博 黄忠月 曾雪 梁磊 姬超岳 李建兴 DING Tianfu;XIAO Bo;HUANG Zhongyue;ZENG Xue;LIANG Lei;JI Chaoyue;LI Jianxing(Department of Urology,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]北京清华长庚医院泌尿外科,清华大学临床医学院,北京102218

出　　处：《现代泌尿外科杂志》2022年第11期917-921,共5页Journal of Modern Urology

摘　　要：目的研究国产超脉冲铥光纤激光的最佳“碎块化”“粉末化”激光参数设置。方法将BegoStone结石放入一个上下直径相同的试管内,试管之间放置一个粗细可调节的筛网,由泌尿外科医师手持激光光纤,在规定时间内,激发激光进行碎石,实验结束后收集筛网上下两侧的结石碎块及粉末,再次使用筛网人工筛选符合“碎块化”“粉末化”的结石后进行称重,记录每次碎石的总重量、大小等,最后进行分析,计算出符合“碎块化”“粉末化”的结石重量及所占比重,每次实验在同样的条件下重复5次,最后记录平均值。结果在超脉冲铥光纤激光碎石过程中,当频率或激光能量其中之一固定不变时,碎石效率随着另一个条件的增加而增加。在“硬结石”碎石时,当碎石能量与频率为0.8 J×20 Hz时,碎石速率为(94.20±25.42)mg/min,“碎块化”效率最高约为82.1%(P<0.05),碎块化速率为(77.34±15.06)mg/min。当碎石能量与频率为0.2 J×120 Hz时,碎石速率为(63.99±5.05)mg/min,“粉末化”效率最高约为84.3%(P<0.05),粉末化速率为(53.93±3.69)mg/min。在“软结石”碎石时,当碎石能量与频率为0.8 J×20 Hz时,碎石速率为(107.15±1.89)mg/min,“碎块化”效率最高约为85.6%(P<0.05),碎块化速率为(91.59±7.86)mg/min。当碎石能量与频率为0.2 J×120 Hz时,碎石速率为(92.69±5.07)mg/min,“粉末化”效率最高约为87.5%(P<0.05),粉末化速率为(81.10±8.72)mg/min。结论在体外超脉冲铥光纤激光碎石中,其“碎块化”最佳参数设置为0.8 J×20 Hz,“粉末化”最佳参数设置为0.2 J×120 Hz。Objective To explore the optimal laser energy settings for domestic super-pulsed thulium laser in the fragmentation and pulverization of renal stones.Methods The BegoStone stones were put into a test tube with the same diameter from the bottom to the upper part,a thickness-adjustable screen was placed between the test tubes,and a urologist held the laser device to crush the stones within the specified time.After the experiment was completed,the stone fragments and powder on both sides of the screen were collected.The fragmented and pulverized stones were manually screened again and weighed.The total weight and size of fragments were recorded,and finally analyzed to calculate the weight and percentage of fragmented and pulverized stones.The experiments were repeated 5 times under the same condition,and the average value was recorded.Results In super-pulsed thulium fiber laser lithotripsy,the efficiency increased with the increase of frequency and energy.When the energy and frequency to crush hard stones were 0.8 J×20 Hz,and velocity was(94.20±25.42)mg/min,the maximum efficiency and rate of fragmentation were 82.1%(P<0.05)and(77.34±15.06)mg/min,respectively.When the energy and frequency were 0.2 J×120 Hz,and velocity was(63.99±5.05)mg/min,the maximum efficiency and rate of pulverization were 84.3%(P<0.05)and(53.93±3.69)mg/min,respectively.When the energy and frequency to crush soft stones were 0.8 J×20 Hz,and velocity was(107.15±1.89)mg/min,the maximum efficiency and rate of fragmentation were 85.6%(P<0.05)and(91.59±7.86)mg/min,respectively.When the energy and frequency were 0.2 J×120 Hz,and velo-city was(92.69±5.07)mg/min,the maximum efficiency and rate of pulverization were 87.5%(P<0.05)and(81.10±8.72)mg/min,respectively.Conclusions In vitro super-pulsed thulium fiber laser crushing,the best parameters for fragmentation and pulverization are 0.8 J×20 Hz and 0.2 J×120 Hz,respectively.

关 键 词：超脉冲铥光纤激光 激光碎石手术 碎块化 粉末化 

分 类 号：R691.4[医药卫生—泌尿科学]