钬激光：尿酸结石的碎石术

Holmium:YAG lithotripsy of uric acid calculi.

作者信息

Teichman J M, Champion P C, Wollin T A, Denstedt J D

机构信息

Division of Urology, University of Texas Health Science Center, San Antonio, USA.

出版信息

J Urol. 1998 Dec;160(6 Pt 1):2130-2.

PMID:9817338

Abstract

PURPOSE

Holmium:YAG lithotripsy of uric acid calculi produces cyanide. We review our experience with holmium:YAG lithotripsy of uric acid calculi to determine if there is any clinical evidence of cyanide toxicity.

MATERIALS AND METHODS

A retrospective analysis of all of our cases of holmium:YAG lithotripsy of uric acid calculi was done. Anesthetic and postoperative data were reviewed.

RESULTS

A total of 18 patients with uric acid calculi were treated with holmium:YAG lithotripsy by ureteroscopy (5), retrograde nephroscopy (2), percutaneous nephrolithotomy (5) or cystolithotripsy (6). No patient had increased end-tidal carbon dioxide, changes in electrocardiogram or significant decrease in postoperative serum bicarbonate. An 84-year-old woman had decreased diastolic pressure of 30 mm. Hg while under general anesthesia. No cyanide related neurological, cardiac or respiratory complications were noted.

CONCLUSIONS

There were no obvious cyanide related complications from holmium:YAG lithotripsy of uric acid calculi. These data suggest no significant cyanide toxicity from holmium:YAG lithotripsy of uric acid calculi in typical clinical settings. Animal studies are warranted to characterize the risk.

摘要

目的

钬激光碎石治疗尿酸结石会产生氰化物。我们回顾了我们使用钬激光碎石治疗尿酸结石的经验，以确定是否有氰化物中毒的临床证据。

材料与方法

对我们所有使用钬激光碎石治疗尿酸结石的病例进行回顾性分析。回顾麻醉和术后数据。

结果

共有18例尿酸结石患者接受了钬激光碎石治疗，治疗方式包括输尿管镜检查（5例）、逆行肾镜检查（2例）、经皮肾镜取石术（5例）或膀胱碎石术（6例）。没有患者出现呼气末二氧化碳增加、心电图改变或术后血清碳酸氢盐显著降低。一名84岁女性在全身麻醉下舒张压下降了30毫米汞柱。未观察到与氰化物相关的神经、心脏或呼吸并发症。