Dretler S P
Massachusetts General Hospital, Boston.
J Urol. 1993 Nov;150(5 Pt 1):1402-4. doi: 10.1016/s0022-5347(17)35790-7.
The electromechanical impactor is a 3.0F electrohydraulic electrode within a stainless steel sheath attached to a distal compression spring with a conical titanium tip. Each electrical discharge causes a 2.7 mm. tip extension and a kinetic impact energy of 900 bar. It is 5F, flexible and placed within the straight working port of a 9.5F to 10.0F rigid or semirigid ureteroscope. A clinical trial was performed and 15 patients (16 ureters with calculi) were treated with this device. An upper ureteral stone partially fragmented and migrated cephalad, 1 stone failed to break and was basket extracted, and there was 1 machine failure. The 13 other calculi were successfully broken to fragments less than 5 mm. In 2 patients baskets were also used to remove the larger monohydrate fragments. A secondary procedure was required to basket a 4 mm. calcium oxalate monohydrate fragment in a patient with 3 ureteral calculi. The average size of the calculi was 14 mm. in largest diameter. Excluding the machine failure, the average number of pulses required for fragmentation was 764. The life of each device was 600 to 800 pulses. Of the 15 cases 1 electrode was used in 10, 2 in 3 and 3 in 2. There was no evidence of ureteral wall injury, abrasion or perforation. The electromechanical impactor is a safe and effective method of ureteral stone fragmentation.
机电冲击器是一个3.0F的电液压电极，位于不锈钢护套内，通过一个带有锥形钛尖的远端压缩弹簧连接。每次放电会使尖端延伸2.7毫米，产生900巴的动能冲击力。它为5F，具有柔韧性，可放置在9.5F至10.0F的刚性或半刚性输尿管镜的直工作通道内。进行了一项临床试验，15例患者（16条输尿管有结石）接受了该装置治疗。一枚上段输尿管结石部分破碎并向头侧移位，1枚结石未破碎，通过套石篮取出，还有1次机器故障。其他13枚结石成功破碎成小于5毫米的碎片。2例患者还使用套石篮取出较大的一水合物碎片。一名有3枚输尿管结石的患者需要进行二次手术，用套石篮取出一枚4毫米的草酸钙一水合物碎片。结石的平均最大直径为14毫米。排除机器故障，破碎所需的平均脉冲数为764次。每个装置的使用寿命为600至800次脉冲。15例病例中，10例使用1个电极，3例使用2个电极，2例使用3个电极。没有输尿管壁损伤、擦伤或穿孔的证据。机电冲击器是一种安全有效的输尿管结石破碎方法。
