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钬激光碎石术:光热机制将尿酸结石转化为氰化物。

Holmium:YAG lithotripsy: photothermal mechanism converts uric acid calculi to cyanide.

作者信息

Teichman J M, Vassar G J, Glickman R D, Beserra C M, Cina S J, Thompson I M

机构信息

Division of Urology, University of Texas Health Science Center and Brooke Army Medical Center, San Antonio, USA.

出版信息

J Urol. 1998 Aug;160(2):320-4. doi: 10.1016/s0022-5347(01)62883-0.

Abstract

PURPOSE

Holmium:YAG lithotripsy fragments stones through a photothermal mechanism. Uric acid when heated is known to be converted into cyanide. We test the hypothesis that holmium: YAG lithotripsy of uric acid calculi produces cyanide.

MATERIALS AND METHODS

Human calculi of known uric acid composition were irradiated with holmium:YAG energy in water. Stones received a total holmium:YAG energy of 0 (control), 0.1, 0.25, 0.5, 0.75, 1.0 or 1.25 kJ. The water in which lithotripsy was performed was analyzed for cyanide concentration. A graph was constructed to relate holmium:YAG energy to cyanide production.

RESULTS

Holmium:YAG lithotripsy of uric acid calculi in vitro produced cyanide consistently. Cyanide production correlated with total holmium:YAG energy (p <0.001).

CONCLUSIONS

Holmium:YAG lithotripsy of uric acid calculi risks production of cyanide. This study raises significant safety issues.

摘要

目的

钬激光碎石术通过光热机制破碎结石。已知尿酸受热会转化为氰化物。我们检验尿酸结石钬激光碎石术会产生氰化物这一假设。

材料与方法

将已知尿酸成分的人体结石在水中用钬激光能量照射。结石接受的钬激光总能量为0(对照)、0.1、0.25、0.5、0.75、1.0或1.25千焦。对进行碎石术的水中的氰化物浓度进行分析。绘制图表以显示钬激光能量与氰化物产生量的关系。

结果

体外尿酸结石钬激光碎石术始终会产生氰化物。氰化物产生量与钬激光总能量相关(p<0.001)。

结论

尿酸结石钬激光碎石术有产生氰化物的风险。本研究提出了重大的安全问题。

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