逆行性肾内手术中的激光安全、警告和限制。
Laser safety, warnings, and limits in retrograde intrarenal surgery.
作者信息
Corrales M, Panthier F, Solano C, Candela L, Traxer O
机构信息
GRC n.° 20, Grupo de Investigación Clínica Litiasis Urinaria, Hospital Tenon, Universidad de La Sorbona, París, France; Servicio de Urología, Universidad de La Sorbona, Hospital Tenon (AP-HP), Paris, France.
GRC n.° 20, Grupo de Investigación Clínica Litiasis Urinaria, Hospital Tenon, Universidad de La Sorbona, París, France; Servicio de Urología, Universidad de La Sorbona, Hospital Tenon (AP-HP), Paris, France.
出版信息
Actas Urol Esp (Engl Ed). 2024 Jan-Feb;48(1):19-24. doi: 10.1016/j.acuroe.2023.06.009. Epub 2023 Jun 23.
OBJECTIVE
To analyze the current information about laser safety in retrograde intrarenal surgery (RIRS), focusing on the two main laser technologies that we use in urology, the holmium:yttrium-aluminum-garnet (Ho:YAG) laser, and the thulium fiber laser (TFL).
METHODS
Narrative overview of the most relevant articles published in MEDLINE and Scopus databases about this subject.
RESULTS
TFL and Ho:YAG laser at similar settings (0.2 J/40 Hz) have similar volume-averaged temperature increase and the average heating rate increase proportionally to laser power, especially when high frequencies are used. Recent preclinical data, comparing both laser technologies at different laser settings, agreed that when the delivered energy increases in expenses of higher frequencies, the thermal damage increases too. Higher frequencies, despite of the rise of temperature in the irrigation medium, can cause accidental thermal lasering lesions.
CONCLUSION
The use of low frequency settings and a proper irrigation is critical to avoid thermal injury in endoscopic laser lithotripsy. In addition, the use of laser safety eyeglasses is recommended in Ho:YAG and TFL ELL.
目的
分析逆行性肾内手术（RIRS）中激光安全的现有信息，重点关注我们在泌尿科中使用的两种主要激光技术，即钬：钇铝石榴石（Ho：YAG）激光和掺铥光纤激光（TFL）。
方法
对 MEDLINE 和 Scopus 数据库中关于该主题的最相关文章进行叙述性综述。
结果
TFL 和 Ho：YAG 激光在相似设置（0.2 J/40 Hz）下具有相似的体积平均温升，并且平均加热速率与激光功率成比例增加，尤其是在使用高频率时。最近的临床前数据比较了两种激光技术在不同激光设置下的情况，一致认为当以更高的频率增加传递的能量时，热损伤也会增加。尽管在灌流介质中温度升高，但高频率仍可能导致意外的热激光损伤。
结论
在进行内窥镜激光碎石术时，使用低频设置和适当的灌流至关重要，以避免热损伤。此外，建议在 Ho：YAG 和 TFL ELL 中使用激光安全眼镜。
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