大功率医用钬激光治疗机治疗犬膀胱结石的组织安全性评价

Organize Safety Evaluation of High Power Medical Holmium Laser Therapeutic Machine on Canine Bladder Lithotripsy

为了评价钬激光治疗膀胱结石的安全性,以6只雌性Beagle犬为医学实验对象,提出了利用膀胱镜镜鞘通过犬的尿道将人体结石直接植入到犬膀胱内的新方法,建立了一种用时较短、对膀胱组织无损伤的犬膀胱结石新模型,并采用输出功率为100 W的HANS-H100医用钬激光治疗机进行了碎石,对钬激光治疗膀胱结石开展了组织安全性评价方面的医学实验研究。实验结果表明:碎石后6只犬精神状态良好,摄食饮水正常,呼吸及对外界反应均未见明显异常;碎石后观察到尿道或膀胱有一定的损伤,引起动物血尿,但该损伤是可逆性的,碎石后14 d尿液恢复正常;碎石后24 h观察到膀胱黏膜有不同程度的损伤,主要表现为黏膜上皮细胞变性坏死、黏膜固有层水肿、大量炎性细胞浸润,肌层内肌纤维间水肿、少量炎性细胞浸润等变化;碎石后7 d主要表现为黏膜上皮细胞脱落、黏膜固有层内水肿,固有层肉芽结缔组织增生等改变;碎石后14 d膀胱组织学结构恢复正常,说明该损伤是可逆性的变化。该实验证明大功率医用钬激光治疗机用于治疗膀胱结石是安全有效的。

To evaluate the safety of treating bladder calculi with holmium laser, we set up a bladder calculus model, which is low time-consuming and has no damage to the bladder tissue, by using cystoscope sheath to implant human stones into the bladders of six female Beagle dogs. Then we performed bladder lithotripsy using a medical holmium laser therapeutic machine（HANS-H100）, which had output power of 100 W and worked in cooperation with cystoscope, and hence conducted medical experiments for organize safety evaluation. After the treatment, all the six dogs behaved normally and showed no abnormity in eating, drinking, breathing, and external reactions after lithotripsy, though there was damage to either urethra or bladder according to the hematuria observed. However, this damage was reversible, since the dogs＇ urine returned to normal 14 days after the lithotripsy. Different degrees of injuries appeared in the bladder mucosa in the 24 th hour after treatment, such as degeneration of epithelial cell necrosis, mucosal edema, inflammatory cells infiltration, muscle layer edema between muscle fibers, and inflammatory cell infiltration. In addition, mucosal epithelial cell shedding, mucosal edema, lamina propria connective tissue hyperplasia of granulation became the main symptoms in the 7th day. The bladder tissue structure recovered in the 14 th day after the lithotripsy, indicating that the damage was also reversible. The experiments proved that the high-power medical holmium laser therapy machine was safe and effective for treating bladder stones.