CAJ | 학술논문

目的：探讨软性输尿管镜碎石术液体流量最佳的灌注方式。方法根据液体灌注方式不同分为三组：A 组，采用高度悬吊灌注法，灌注水袋液体平面距离操作镜体的平面高度为60 cm；B 组，采用压力灌注泵恒压灌注法，调节灌注泵的压力和流量为恒定值，使自软镜流出的水流呈自然抛物线；C 组，采用手推注射器灌注法，60 ml 注射器连续推注液体。分别使用 A、B、C 三种液体灌注方法对内径为3．6F 的软性输尿管镜在无光纤置入和内置入200μm 光纤两种情况下进行液体灌注，体外重复6次测定每分钟液体的灌注流量，并对这三组所测得的数据行统计学分析。结果①软性输尿管镜在无光纤置入情况下，三组的液体灌注量分别为 A 组（20．60±1．70）ml／min；B 组（39．23±2．34）ml／min；C 组（75．55±11．26）ml／min。各组之间比较，差异有统计学意义（P ＜0．001）。②软性输尿管镜内置入200μm 光纤后，测定的液体灌注量分别 A 组（12．10±1．53） ml／min；B 组（22．22±1．38）ml／min；C 组（64．68±3．87）ml／min，三组之间比较，差异有统计学意义（P ＜0．001）。另外，在无光纤置入和内置入200μm 光纤两种情况下，C 组均明显高于 A 组、B 组。结论软性输尿管镜碎石术中采用压力灌注泵恒压灌注是一种安全可靠的灌注方法。
목적：탐토연성수뇨관경쇄석술액체류량최가적관주방식。방법근거액체관주방식불동분위삼조：A 조，채용고도현조관주법，관주수대액체평면거리조작경체적평면고도위60 cm；B 조，채용압력관주빙항압관주법，조절관주빙적압력화류량위항정치，사자연경류출적수류정자연포물선；C 조，채용수추주사기관주법，60 ml 주사기련속추주액체。분별사용 A、B、C 삼충액체관주방법대내경위3．6F 적연성수뇨관경재무광섬치입화내치입200μm 광섬량충정황하진행액체관주，체외중복6차측정매분종액체적관주류량，병대저삼조소측득적수거행통계학분석。결과①연성수뇨관경재무광섬치입정황하，삼조적액체관주량분별위 A 조（20．60±1．70）ml／min；B 조（39．23±2．34）ml／min；C 조（75．55±11．26）ml／min。각조지간비교，차이유통계학의의（P ＜0．001）。②연성수뇨관경내치입200μm 광섬후，측정적액체관주량분별 A 조（12．10±1．53） ml／min；B 조（22．22±1．38）ml／min；C 조（64．68±3．87）ml／min，삼조지간비교，차이유통계학의의（P ＜0．001）。령외，재무광섬치입화내치입200μm 광섬량충정황하，C 조균명현고우 A 조、B 조。결론연성수뇨관경쇄석술중채용압력관주빙항압관주시일충안전가고적관주방법。
Objective To investigate the best reperfusion mode for flexible ureteroscopic litho-tripsy.Methods According to different perfusion modes,three groups were divided into different modes, including suspension perfusion mode(Group A)with 60 cm of liquid height,constant pressure perfusion mode(Group B)using pressure infusion pump,and manual syringe infusion mode(Group C).The liquid of the three groups were perfused by flexible ureteroscope (diameter 3.6F)with or without inserted fiber (200μm).Irrigation fluid volume per minute was repeatedly tested for six times in vitro and then recorded for statistical analysis.Result In the condition without the fiber,irrigation fluid volumes of Group A,B and C were(20.60 ±1.70)ml/min,(39.23 ±2.34)ml/min and(75.55 ±11.26)ml/min,respectively. There were significantly differences between the three groups(P <0.001).In the condition with inserted fiber(200μm),irrigation fluid volumes of Group A,B and C were(12.10 ±1.53)ml/min,(22.22 ± 1.38)ml/min and(39.68 ±3.87)ml/min,respectively.There were significantly differences among the three groups(P <0.001).Furthermore,irrigation fluid volume in Group C was obviously higher than those in Group A and B no matter the fiber was inserted or not.Conclusion Constant pressure perfusion mode using pressure infusion pump is safe and reliable during flexible ureteroscopic lithotripsy.