人工推注灌注法输尿管软镜液体流量体外测定及影响因素

摘要

Objective:To measure the liquid flow of flexible ureteroscope under manual syringe infusion mode in vitro and influencing factors.Methods:The experiment was divided into group A and group B according to the lengths of extension tubes.In group A,1-m extension tube was connected to the flexible ureteroscope.Then physio-logical saline was extracted with 60 mL syringe and pushed in vitro in the diameter of 0.2 cm,0.5 cm,and 0.8 cm respectively.The flow rate per min was calculated.In group B,0.5-m extension tube was connected to the flexible ureteroscope.The rest procedures were same as group A.The data were analysed statistically.Results:In the group A,the liquid flow rate with the diameter of extension tube of 0.8 cm,0.5 cm and 0.2 cm was (70.59 ± 1.68), (65.45±1.50)and (60.1 6±1.27)mL/min respectively.In the group B,the liquid flow rate with the diameter of extension tube of 0.8 cm,0.5 cm and 0.2 cm was (76.59±1.56),(75.00±1.40)and (69.23±1.14)mL/min re-spectively.When the diameter of extension tube was same,the liquid flow rate of group B was statistically higher than that of group B.When the diameter of extension tube was 1 m,the larger the diameter of extension tube,the larger the liquid flow rate (P <0.001).The liquid flow rate of group B was statistically higher than that of group A. When the diameter of extension tube was 0.5 m,there was no statistically significant difference in the liquid flow rate between the diameter 0.8 cm and 0.5 cm (P =0.093),but the liquid flow rate was obviously higher than that of diameter 0.2 cm.Conclusions:The liquid flow rate of manual syringe infusion mode is not stable during flexible ureteroscope lithotripsy.The length and diameter of the extension tube can influence the liquid flow rate.Otherwise, different people have different power and it is difficult to control.The safety and rationality are doubtful when manu-al syringe infusion mode is applied to the clinic.%目的：：体外测定不同直径不同长度延长管下人工推注注射器灌注法输尿管软镜的液体流量,研究其稳定性及影响流量的因素.方法：根据延长管长度不同分为 AB 两组：A 组延长管长度为1 m,B 组延长管长度为0.5 m.60 ml 注射器抽取生理盐水后连接到直径分别为0.2、0.5、0.8 cm 的延长管,再连接到输尿管软镜人工推注,体外计算每分钟的流量.对AB 两组的体外液体灌注量进行多次重复测定,所测得的数据进行统计学比较.结果：A 组使用直径为0.8、0.5、0.2 cm 延长管人工推注液体的流速分别为(70.59±1.68)、(65.45±1.50)及(60.16±1.27)ml/min；B 组使用直径为0.8、0.5、0.2 cm 延长管推注的液体流速分别为(76.59±1.56)、(75.00±1.40)及(69.23±1.14)ml/min.对以上数据进行统计学比较分析可以发现,使用0.5 m 延长管流量明显大于使用1 m 延长管时的流量(P＜0.001)；当使用1 m 延长管时,三种不同直径的延长管之间的流量均差异有统计学意义(P ＜0.001)；而使用0.5 m 延长管时,直径为0.8 cm 和0.5 cm 的延长管之间的流量差异无统计学意义(P ＝0.093),而直径为0.2 cm延长管与其他两组相比,流量明显减少.结论：输尿管软镜碎石术中采用人工推注射器灌注法流量不稳定,受延长管长度和直径的影响,不同的人推注的力量不同,难以调控,浪费人力资源,应用到临床的安全性及合理性值得商榷.