Abstract：
OBJECTIVE: To evaluate calyceal irrigation fluid temperature changes during flexible ureteroscopic Ho:YAG laser lithotripsy.
METHODS: Between May 2019 and January 2020, patients with kidney stones undergoing flexible ureteroscopic Ho:YAG laser lithotripsy were enrolled. A K-type thermocouple was applied for intraoperative temperature measurement. Laser was activated at different power (1 J/20 Hz and 0.5 J/20 Hz) and irrigation (0 ml/min, 15 ml/min and 30 ml/min) settings, temperature-time curve was drawn and time needed to reach 43 °C without irrigation was documented.
RESULTS: Thirty-two patients were enrolled in our study. The temperature-time curve revealed a quick temperature increase followed by a plateau. With 15 ml/min or 30 ml/min irrigation, 43 °C was not reached after 60 s laser activation at both 1 J/20 Hz and 0.5 J/20 Hz. At the power setting of 1 J/20 Hz and irrigation flow rate of 15 ml/min, the temperature rise was significantly higher than other groups. Without irrigation, the time needed to reach 43 °C at 1 J/20 Hz was significantly shorter than that at 0.5 J/20 Hz (8.84 ± 1.41 s vs. 13.71 ± 1.53 s).
CONCLUSIONS: Ho:YAG laser lithotripsy can induce significant temperature rise in calyceal fluid. With sufficient irrigation, temperatures can be limited so that a toxic thermal dose is not reached, when irrigation is closed, the temperature increased sharply and reached 43 °C in a few seconds.
METHODS: Between May 2019 and January 2020, patients with kidney stones undergoing flexible ureteroscopic Ho:YAG laser lithotripsy were enrolled. A K-type thermocouple was applied for intraoperative temperature measurement. Laser was activated at different power (1 J/20 Hz and 0.5 J/20 Hz) and irrigation (0 ml/min, 15 ml/min and 30 ml/min) settings, temperature-time curve was drawn and time needed to reach 43 °C without irrigation was documented.
RESULTS: Thirty-two patients were enrolled in our study. The temperature-time curve revealed a quick temperature increase followed by a plateau. With 15 ml/min or 30 ml/min irrigation, 43 °C was not reached after 60 s laser activation at both 1 J/20 Hz and 0.5 J/20 Hz. At the power setting of 1 J/20 Hz and irrigation flow rate of 15 ml/min, the temperature rise was significantly higher than other groups. Without irrigation, the time needed to reach 43 °C at 1 J/20 Hz was significantly shorter than that at 0.5 J/20 Hz (8.84 ± 1.41 s vs. 13.71 ± 1.53 s).
CONCLUSIONS: Ho:YAG laser lithotripsy can induce significant temperature rise in calyceal fluid. With sufficient irrigation, temperatures can be limited so that a toxic thermal dose is not reached, when irrigation is closed, the temperature increased sharply and reached 43 °C in a few seconds.
摘要：
目的：评估输尿管软镜Ho:YAG激光碎石术中肾盏冲洗液温度的变化。
方法：在2019年5月至2020年1月期间，纳入了接受输尿管软镜Ho:YAG激光碎石术的肾结石患者。采用K型热电偶进行术中温度测量。以不同功率（1J/20Hz和0.5J/20Hz）和冲洗（0ml/min，15ml/min和30ml/min）设置，绘制温度-时间曲线并记录达到43°C而不进行灌溉所需的时间。
结果：32例患者纳入本研究。温度-时间曲线显示温度快速升高，然后达到平稳状态。15毫升/分钟或30毫升/分钟冲洗，在1J/20Hz和0.5J/20Hz的60s激光激活后,均未达到43°C。在1J/20Hz的功率设置和15ml/min的冲洗流量下，温度上升明显高于其他组。没有灌溉,在1J/20Hz时达到43°C所需的时间明显短于0.5J/20Hz时（8.84±1.41svs.13.71±1.53秒)。
结论：Ho:YAG激光碎石术可引起泪液温度明显升高。有足够的灌溉，可以限制温度，这样就不会达到有毒的热剂量，当灌溉关闭时，温度急剧升高并在几秒钟内达到43°C。
方法：在2019年5月至2020年1月期间，纳入了接受输尿管软镜Ho:YAG激光碎石术的肾结石患者。采用K型热电偶进行术中温度测量。以不同功率（1J/20Hz和0.5J/20Hz）和冲洗（0ml/min，15ml/min和30ml/min）设置，绘制温度-时间曲线并记录达到43°C而不进行灌溉所需的时间。
结果：32例患者纳入本研究。温度-时间曲线显示温度快速升高，然后达到平稳状态。15毫升/分钟或30毫升/分钟冲洗，在1J/20Hz和0.5J/20Hz的60s激光激活后,均未达到43°C。在1J/20Hz的功率设置和15ml/min的冲洗流量下，温度上升明显高于其他组。没有灌溉,在1J/20Hz时达到43°C所需的时间明显短于0.5J/20Hz时（8.84±1.41svs.13.71±1.53秒)。
结论：Ho:YAG激光碎石术可引起泪液温度明显升高。有足够的灌溉，可以限制温度，这样就不会达到有毒的热剂量，当灌溉关闭时，温度急剧升高并在几秒钟内达到43°C。
