摘要
目的利用3D肾模型模拟体内输尿管环境碎石,研究超脉冲铥光纤激光(TFL)在不同功率、碎石模式及灌注速度下的热效应情况。方法构建体外热效应模型,在实验室温度、设备固定等相同条件下,测量并比较采用不同光纤直径、功率、碎石模式、灌注速度等进行TFL模拟碎石时的光纤周围温度。结果两种不同直径的光纤在相同条件下所引起的光纤周围温度变化比较,差异具有统计学意义(P<0.05)。在同等条件下,不同的碎石模式所产生的光纤周围温度不同,“高能低频”的温度要低于“低能高频”,数据分别进行组间比较,差异具有统计学意义(P<0.05)。随着灌注速度的增加,光纤周围的温度逐渐下降,数据分别进行了组内多重比较,差异具有统计学意义(P<0.05)。当碎石功率为10 W,灌注速度最小为10 mL/min,平台期温度未达到安全阈值(43℃)。当碎石功率为20 W时,灌注速度最小为10 mL/min,平台期温度超过安全阈值,而灌注速度为20 mL/min时,平台期的温度未达到安全阈值。结论在体外输尿管模型碎石研究中,激光的碎石功率、碎石模式、灌注速度、光纤直径等是TFL热效应的影响因素。无论哪种碎石模式、光纤直径,当碎石功率≤10 W,灌注速度≥10 mL/min时,光纤周围温度是安全的,当碎石功率≤20 W,灌注速度≥20 mL/min时,光纤周围温度是安全的。
Objective The thermal effects of super-pulsed thulium fiber laser(TFL)at different powers,lithotripsy modes and irrigation rates were studied using a 3D kidney model to simulate ureteral lithotripsy in vivo.Methods A thermal effect model was established in vitro.Under the same conditions of laboratory temperature and equipment,the temperature around the optical fiber was measured and compared when different optical fiber diameters,powers,lithotripsy modes and irrigation rates were used to simulate lithotripsy by TFL.Results There was significant difference in the temperature around the optical fiber caused by two fibers with different diameters under the same conditions(P<0.05).Under the same conditions,different lithotripsic modes produced different temperatures,and the temperature of“high energy and low frequency”was lower than that of“low energy and high frequency”(P<0.05).When the power was 10 W and the minimum irrigation rate was 10 mL/min,the plateau temperature did not reach the safety threshold(43℃).When the power was 20 W and the minimum irrigation rate was 10 mL/min,the platform temperature exceeded the safety threshold.When the irrigation rate was 20 mL/min,the platform temperature did not reach the safety threshold.Conclusion In the study of ureteral lithotripsy in vitro,the power,mode,irrigation rate and optical fiber diameter are factors affecting the thermal effects of TFL.No matter what kind of lithotripsy mode and fiber diameter,the temperature around the fiber is safe when the lithotripsy power is≤10 W and the irrigation rate is≥10 mL/min;when the lithotripsy power is≤20 W and the irrigation rate is≥20 mL/min,the temperature around the fiber is safe.
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,Tsinghua University,Beijing 102218,China)
出处
《现代泌尿外科杂志》
CAS
2023年第11期993-997,共5页
Journal of Modern Urology
关键词
超脉冲铥光纤激光
输尿管碎石术
热效应
安全阈值
super-pulsed thulium laser
ureteral lithotripsy
thermal effect
safety threshold
