自制激光碎石固定钳碎石效果的体外研究

In vitro lithotripsy experiment of a newly calculi anchoring forceps

目的评价一种自行设计的碎石固定钳在体外实验时的碎石效率。方法2010年10月选取结石替代品48颗，成分为碳酸钙，大致加工成椭圆形，质量0．5～0．7g，直径约1cm。随机分成两组，每组各24颗，第1组使用自制激光碎石固定钳，第2组不使用碎石固定钳，两组均采用钬激光碎石。在钬激光能量消耗2kJ时记录碎石时间及碎除结石质量，至彻底击碎结石后再记录碎石时间及消耗能量。比较两组碎石时间、消耗能量、残余结石的差异。结果钬激光能量消耗2kJ时碎石时间，第1组为（4．7±0．9）min，第2组为（4．2±0．9）min，差异无统计学意义（P〉0．05）；能量消耗2kJ时所碎除结石质量第1组为（0．14±0．04）g，第2组为（0．13±0．06）g，差异无统计学意义（P〉0．05）；剩余结石碎石时间第1组为（4．5±1．2）min，第2组为（9．2±2．6）min，差异有统计学意义（P〈0．05）；剩余结石碎石消耗能量第1组为（1．7±0．5）kJ，第2组为（2．6±0．4）kJ，差异有统计学意义（P〈0．05）；第1组总碎石时间为（9．2±1．7）min，总能量消耗为（3．7±0．5）kJ，第2组总碎石时间为（13．4±2．7）min，总能量消耗为（4．6±0．5）kJ，差异均有统计学意义（P〈0．05）。结论体外实验中，自制激光碎石固定钳能明显提高碎石效率，对于直径〈1cm结石的碎石效率提高更明显。

Objective To evaluate the lithotripsy efficiency of a newly calculi anchoring forceps in vitro. Methods Compared the efficiency with or without calculi anchoring forceps in the circumstances imitate percutaneous nephrolithotomy. There are 24 calculus for each group in random selection. The litho- tripsy was completed by one people, the time, energy and retained calculus were compared by T-test. Results When the energy expenditure reaches 2 k J, the operating time was （4.7 ± 0. 9） min in group 1 and （4.2 ± 0.9） rain in group 2 （P 〉 0. 05 ）. The removal calculus showed no differences between the two groups （P 〉 0.05）. After the energy used over 2 k J, the operating time of the remained calculus were （4.5 ± 1.2） min in group 1 and （9.2 ± 2.6） rain in group 2 respectively （P 〈 0.05 ） , and the energy con- sumed （ 1.7 ± 0. 5 ） kJ and （2.6 ± 0. 4） kJ respectively （P 〈 0.05 ）. Total energy consumed in group 1 and group2 was （3.7±0.5） kJ and （4.6±0.5） kJ （P〈0.05）. And the cumulate time used was （9.2± 1.7） min and （13.4±2.7） min in group 1 and group 2 respectively （P 〈0.05）. Conclusions The calculi anchoring forceps can improve the efficiency of lithotripsy in vitro. The improvement was significant for the calculus whose diameter was smaller than 1cm.