Hofmann R, Olbert P, Weber J, Wille S, Varga Z
Department of Urology and Paediatric Urology, Medicl School, Phillipps Universität Marburg, Germany.
BJU Int. 2002 Jul;90(1):16-9. doi: 10.1046/j.1464-410x.2002.02814.x.
To assess a new lithotripter for intracorporal lithotripsy, which combines the mechanically driven pneumatic LithoClast (Electro-Medical Systems, Nyon, Switzerland) and a new ultrasonic device (Electro-Medical Systems), for use in percutaneous nephrolitholapaxy (PNL).
The new lithotripter consists of a LithoClast Master with 12 Hz repetition rate and a new ultrasonic device. The 1.0 mm LithoClast probe is advanced off-centre through the hollow 3.3 mm ultrasonic probe and protrudes about 1 mm. A new irrigation system with a pinch valve compressing the irrigation tube, a foot-switch for activating the ultrasound, the LithoClast and both together, and a stone bucket at the outlet tube are new features. Between February 1999 and August 2001, 68 patients were treated by PNL with the new device; 35 had complete and 33 had partial staghorn calculi. PNL was administered under fluoroscopic control and with the patient prone.
The mean (range) duration of surgery was 61 (42-119) min. The complete stone-free rate was 66% after the first PNL; of the 68 patients, 16 received a second PNL, giving a final stone-free rate of 76% and 80%. The stone was composed of calcium oxalate monohydrate (COM) in 13%, COM with uric acid in 35%, apatite in 20% and cystine in 11%. Clinically the new lithotripter was very effective, producing smaller stone particles and thus fewer residual stone fragments after PNL than with the LithoClast or ultrasonic fragmentation alone.
The new lithotripter provides easily managed and highly effective stone fragmentation of all stones, regardless of their composition.
评估一种用于体内碎石术的新型碎石机，该碎石机结合了机械驱动的气动碎石器（瑞士尼翁的电子医疗系统公司生产的LithoClast）和一种新型超声设备（电子医疗系统公司生产），用于经皮肾镜取石术（PNL）。
新型碎石机由重复频率为12Hz的LithoClast Master和一种新型超声设备组成。1.0mm的LithoClast探头偏心穿过3.3mm的空心超声探头，并伸出约1mm。具有夹管阀压缩冲洗管的新型冲洗系统、用于启动超声、LithoClast以及两者同时启动的脚踏开关，以及出液管处的结石收集桶都是新特点。1999年2月至2001年8月期间，68例患者接受了使用该新型设备的PNL治疗；35例为完全鹿角形结石，33例为部分鹿角形结石。PNL在荧光透视控制下进行，患者俯卧位。
手术平均（范围）时长为61（42 - 119）分钟。首次PNL后完全无石率为66%；68例患者中，16例接受了第二次PNL，最终无石率为76%和80%。结石成分中，一水草酸钙（COM）占13%，COM伴尿酸占35%，磷灰石占20%，胱氨酸占11%。临床上，新型碎石机非常有效，与单独使用LithoClast或超声碎石相比，PNL后产生的结石颗粒更小，残留结石碎片更少。
新型碎石机能够轻松实现对所有结石的高效碎石，无论结石成分如何。
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