Gutiérrez Jorge, Alvarez Ulises M, Mues Enrique, Fernández Francisco, Gómez Gustavo, Loske Achim M
Nuevo Hospital Civil de Guadalajara, Universidad de Guadalajara, C.P. 44340 Guadalajara, Jalisco, Mexico.
Urol Res. 2008 Feb;36(1):67-72. doi: 10.1007/s00240-007-0132-2. Epub 2008 Jan 10.
Intracorporeal lithotripsy is used to treat a high percentage of urinary calculi. Urinary calculi may contain bacteria, which might cause septicemia after lithotripsy; however, little is known about the effects of lithotripters on the viability of microorganisms inside renal calculi. The objectives of this study were to evaluate the bactericidal effect, and the potential effect on intra-bacterial protein release of four different intracorporeal lithotripters on Escherichia coli (E. coli) inoculated inside artificial kidney stones. An electrohydraulic, a pneumatic, an ultrasonic, and a holmium-laser lithotripter were used to pulverize a set of infected kidney stones inside a test tube containing a saline solution. Two different energy levels were tested per lithotripter. The stones were manufactured by mixing gypsum cement and Vel-mix-stone with a suspension containing E. coli. Results were analyzed by analysis of variance. The release of intracellular protein was measured with a spectrophotometer. Bacteria inactivation was observed with all lithotripters. The highest percentage of inactivated bacteria was obtained with the electrohydraulic lithotripter. The smallest effect was observed using the holmium-laser lithotripter. A relatively high amount of intracellular protein was released into the saline solution after stone pulverization. Intracorporeal lithotripters inactivate a high percentage of bacteria during stone comminution; however, intracellular protein is released, increasing the probability of septicemia.
体内碎石术用于治疗大部分尿路结石。尿路结石可能含有细菌，碎石术后可能导致败血症；然而，关于碎石器对肾结石内微生物生存能力的影响知之甚少。本研究的目的是评估四种不同的体内碎石器对接种于人工肾结石内的大肠杆菌的杀菌效果以及对细菌内蛋白质释放的潜在影响。使用一种液电碎石器、一种气动碎石器、一种超声碎石器和一种钬激光碎石器在装有盐溶液的试管内粉碎一组感染性肾结石。每种碎石器测试两种不同的能量水平。通过将石膏水泥和Vel - mix - stone与含有大肠杆菌的悬浮液混合来制造结石。结果采用方差分析进行分析。用分光光度计测量细胞内蛋白质的释放。所有碎石器均观察到细菌失活。液电碎石器使细菌失活的百分比最高。使用钬激光碎石器观察到的效果最小。结石粉碎后，相对大量的细胞内蛋白质释放到盐溶液中。体内碎石器在结石粉碎过程中使大部分细菌失活；然而，细胞内蛋白质会释放出来，增加了败血症的发生概率。
