激光治疗泌尿系结石的再思考  

Rethinking of laser treatment for urinary calculi

作　　者：姜声明 孙畅 杨嗣星[1] JIANG Shengming;SUN Chang;YANG Sixing(Department of Urology,Renmin Hospital of Wuhan University,Wuhan,430060,China)

机构地区：[1]武汉大学人民医院泌尿外科,武汉430060

出　　处：《临床泌尿外科杂志》2023年第6期471-476,共6页Journal of Clinical Urology

基　　金：中央引导地方科技发展专项(No:ZYYD2020000158);湖北省卫健委面上项目(No:WJ2021M254)。

摘　　要：钬激光用于腔内激光碎石近三十年,已成为治疗尿路结石的首选激光平台。但现有钬激光无法完全粉末化结石,激光发射后结石位移、直接或间接导致组织热损伤给临床医生带来诸多困扰。超脉冲铥光纤激光的问世吸引了研究人员的广泛关注,其通过激光器的创新与限制脉冲能量、拓宽脉冲频率带来了高效的粉尘化碎石效果,但仍未彻底解决激光的热效应、术中结石位移等问题。本文综述钬激光、超脉冲铥光纤激光的研究现状与新进展,从现有碎石用激光器的发展脉络中思考其物理参数的选择,探索激光粉碎尿路结石更为广阔的前景。The holmium laser has been used for intracavitary laser lithotripsy for nearly three decades and has become the preferred method for the treatment of urinary calculi.However,the existing holmium laser cannot completely powder the stone,so the retropulsion of the stone after laser emission and direct or indirect thermal damage to the tissue cause many problems to the clinicians.The emergence of superpulse thulium fiber laser has attracted wide attention of researchers,and it brings highly efficient dusting lithotripsy effect through laser innovation,limiting pulse energy and broadening pulse frequency,but the thermal effect of laser and stone retropulsion are still not completely solved.This paper reviews the research status and new progress of holmium laser and superpulse thulium fiber laser,considers the selection of physical parameters of existing lasers from their development,and explores the broader prospect of comminution of urinary calculi by laser.

关 键 词：尿路结石 激光碎石术 输尿管狭窄 钬 铥 

分 类 号：R693[医药卫生—泌尿科学]