Teichman J M, Vassar G J, Glickman R D, Beserra C M, Cina S J, Thompson I M
Division of Urology, University of Texas Health Science Center and Brooke Army Medical Center, San Antonio, USA.
J Urol. 1998 Aug;160(2):320-4. doi: 10.1016/s0022-5347(01)62883-0.
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.
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.
Holmium:YAG lithotripsy of uric acid calculi in vitro produced cyanide consistently. Cyanide production correlated with total holmium:YAG energy (p <0.001).
Holmium:YAG lithotripsy of uric acid calculi risks production of cyanide. This study raises significant safety issues.
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。
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。
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）。
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。
