超脉冲光纤铥激光碎石的研究进展

Research progress of super-pulse fiber thulium laser lithotripsy

DING Tianfu，HUANG Zhongyue，XU Zheng，LI Jianxing

（Department of Urology，Beijing Tsinghua Changgung Hospital，Tsinghua University School of Clinical Medicine，Beijing 102218，China）

ABSTRACT：Super-pulse thulium fiber laser （hereinafter referred to as thulium laser） has shown broad application prospects in medical research，especially in the treatment of urinary tract stones.Thulium laser has a thin fiber diameter，which reduces the occupation of the working channel and increases the irrigation water flow.Currently，the peak power reaches up to 500 W，the single pulse energy to 6 J，and the frequency to 2000 Hz.The stone-breaking mechanism of thulium laser is photothermal and photomechanical.Different combinations of energy and frequency will significantly affect the volume of stone fragments.“High energy and low frequency” is more suitable for “fragmentation” stone breaking，while “low energy and high frequency” is more suitable for “powderization” stone breaking.Some in vitro experiments have confirmed that thulium laser has higher stone-breaking efficiency，less stone displacement，and more obvious thermal effects compared to holmium laser.Clinically，thulium laser has been applied to ureteroscopic lithotripsy and percutaneous nephrolithotomy.，and the stone free rate and safety are relatively high.This article reviews the stone-breaking principles，in vitro experiments，and clinical applications of thulium laser，aiming to provide better theoretical support and practical experience for the development and application of super-pulse thulium fiber laser in the future.

KEY WORDS：super-pulse fiber thulium laser; stone; lithotripsy; temperature

摘要：超脉冲光纤铥激光（以下简称铥激光）作为新型激光在医学研究中展现出广阔的应用前景，尤其在处理泌尿系结石方面表现突出。（剩余9874字）