摘要
目的 研制出一种操作简易、安全且能够提供稳定的灌注压力的恒压灌注泵,通过精准控制术中灌注压力,以提高输尿管镜碎石手术的安全性和有效性。方法 采用体外测试与离体猪肾模型(n=12)相结合的验证设计。体外测试中,观察组采用恒压灌注泵(基于电机驱动注射器推力原理,设置流速1.35、2.70、5.40mm/s),对照组采用自然连续灌注(悬挂500mL生理盐水于180cm高度)。利用尿流动力仪连续5min记录不同操作条件(空通道、钬激光光纤、导丝占用)下的流速与压力。在离体猪肾实验中,将7.5F输尿管镜置入离体猪肾盂下1cm处,通过BL-420S生物信号系统实时监测肾盂内压。观察指标包括肾盂内压变化,流速稳定性及压力波动范围。结果 体外测试中,与自然连续灌注相比,恒压灌注泵在不同灌注速度下均能提供恒定的灌注压力,且不同灌注模式下的流速差异有统计学意义(P<0.001)。在空通道条件下,不同灌注模式的平均流速分别为(76.00±0.71)、(86.20±0.84)和(96.20±0.84)mL/min。即使工作通道被光纤和2.67F导丝占据,恒压灌注泵的灌注速度仍保持稳定。离体猪肾模型测试中,恒压灌注泵在不同灌注速度下,肾盂内压力均保持在安全范围内(<30mmHg),且各猪模型之间的肾盂内压力差异无统计学意义(P>0.05)。而重力灌注组和手动灌注组的肾盂内压力波动较大,且最大压力均超过30mmHg。结论 恒压灌注泵具有不同于自然连续灌注的显著优势。无论输尿管镜工作通道是否被占用,均能提供恒定的灌注压力且能保持肾盂内压力的在安全范围内。
Objective To develop a user-friendly and safe constant pressure infusion pump capable of maintaining stable irrigation pressure,and to evaluate its efficacy in precisely controlling intraoperative perfusion pressure during ureteroscopic lithotripsy for enhanced surgical safety and effectiveness.Methods The study combined in vitro testing with an ex vivo porcine kidney model(n=12).In the in vitro fests,the experimental group used a constant pressure infusion pump(driven by a motorized syringe,with flow rates set at 1.35,2.70,and 5.40 mm/s),while the control group used gravity-based continuous irrigation(500 mL saline hung at 180 cm height).A urodynamic system was used to continuously record irrigation flow rates and pressures over 5 minutes under various operating conditions(open channel,presence of holmium laser fiber,and 2.67F guidewire).In the ex vivo porcine kidney model,a 7.5F ureteroscope was inserted 1 cm into the renal pelvis,and intrapelvic pressure was continuously monitored using a BL-420S biological signal acquisition system.Key outcomes included intrapelvic pressure levels,flow rate stability,and pressure fluctuation range.Results In vitro testing demonstrated that the constant pressure infusion pump maintained stable pressure under all flow rate settings,with significantly different flow rates between modes(P<0.001).Average flow rates under open channel conditions were(76.00±0.71),(86.20±0.84),and(96.20±0.84)mL/min for increasing speed levels.Even when the working channel was occupied by a laser fiber or guidewire,the pump ensured steady flow.In the porcine kidney model,the constant pressure infusion pump consistently maintained intrapelvic pressures below 30 mmHg across all settings,with no significant variation between kidneys(P>0.05).In contrast,gravity and manual infusion groups showed greater pressure fluctuations,with peak pressures exceeding 30 mmHg.Conclusion The constant pressure infusion pump offers significant advantages over traditional gravity-based irrigation by ensuring stable infusion pressure and maintaining intrapelvic pressure within a safe range,regardless of ureteroscope channel occupancy.
作者
谢露光
吕世栋
郑莉
李亚东
周春兰
XIE Lu-guang;LYU Shi-dong;ZHENG Li;Li Ya-dong;ZHOU Chun-lan(School of Nursing,Nanfang Hospital,SouthernMedical University,Guangzhou 510515,Guangdong,China;不详)
出处
《广东医学》
2025年第5期666-671,共6页
Guangdong Medical Journal
基金
广东省基础与应用基础研究项目(2024A1515010331)。
关键词
输尿管镜
恒压灌注
肾盂内压
上尿路结石
ureteroscopy
constant-pressure irrigation
intrarenal pelvic pressure
upper urinary tract stones
