钬激光热效应的动物实验研究

An in vivo porcine model of the thermal efiect of holmium laser

目的探讨输尿管镜钬激光碎石中不同钬激光功率设置、灌注流量对钬激光热效应的影响。方法选取健康雌性家猪1只建立钬激光热效应动物模型,不同医用注射泵灌注流量设定四组,分别为A组(0 mL/min)、B组(10 mL/min)、C组(15 mL/min)、D组(20 mL/min),四组灌注流量下设置钬激光功率为0.4 J×20.0 Hz、0.8 J×20.0 Hz、0.8 J×30.0 Hz。记录并比较不同灌注流量下钬激光参数设置时的温度以及达43℃所需激发时间。结果同一灌注流量下,钬激光光纤周围温度随着钬激光功率的增加而升高,差异均有统计学意义(均P<0.001);同一钬激光功率下,最高温度随着灌注流量的增大而降低,差异均有统计学意义(均P<0.001)。同一钬激光功率下,灌注流量越大,达到43℃所需激发时间越长,差异均有统计学意义(均P<0.001)。同一灌注流量下,达43℃所需激发时间随着钬激光功率的增加而缩短,差异均有统计学意义(均P<0.001)。结论钬激光热效应与钬激光功率及灌注流量相关,临床工作中应间断激发钬激光并适当增加灌注流量以减少输尿管损伤。

Objective To study the effect of different power setting and perfusion flow on the thermal effect of holmium laser in ureteroscopic holmium laser lithotripsy.Methods The holmium laser thermal effect animal model was established in a healthy female domestic pig.The different flow rates of medical syringe pump were set into four groups:group A(O mL/min),group B(10 ml/min),group C(15 mL/min),and group D(20 mL/min).Under each flow rate,the holmium laser was set with 0.4 J×20.0 Hz,0.8 J×20.0 Hz and 0.8 J×30.0 Hz.The temperature of holmium laser parameters and the excitation time required to reach 43℃at different flow rates were recorded and compared.Results At the same flow rate,the temperature around the holmium laser fiber increased with the increase of holmium laser power,and the differences were statistically significant(all P<0.001).Under the same holmium laser power,the maximum temperature decreased with the increase of flow rate,and the differences were statistically significant(all P<0.001).Under the same holmium laser power,the larger the flow rate,the longer the excitation time needed to reach 43 C,and the differences were statistically significant(all P<0.001).At the same flow rate,the excitation time needed to reach 43 decreased with the increase of holmium laser power,and the differences were statistically significant(all P<0.001).Conclusions The thermal effect of holmium laser is related to the power of holmium laser and perfusion flow.It should stimulate holmium laser intermittently and increase perfusion flow properly to reduce ureteral injury in practice.