钬激光被广泛应用于泌尿系结石的微创治疗,影响钬激光碎石效率和效果的因素,除了外科医生的手术技巧,还有许多可优化调节的细节问题.激光的参数设置,包括激光脉冲能量、频率、脉宽等,不同的参数调节模式会产生不同的碎石效果.激光光纤的直径、涂层鞘、尖端修剪方式、对软镜弯曲度及灌流的影响,以及最近提出的“安全距离”概念等也会影响碎石效率及手术效果.本文将对这些影响钬激光碎石效率的细节问题进行简要综述.“,”Holmium:YAG laser lithotripsy has been widely used in mini-invasive treatment of urinary stone disease.There are several adjustable parameters setting that can also influence the laser fragmentation efficiency in addition to surgeon\'s personal skill.Different pulse energies,frequencies,and pulse durations may have different ablation efficiencies.In terms of laser fiber,the fiber diameter,fiber sheath,stripping and cleaving methods of laser fibers,and its impact on scope deflection and irrigation,as well as the recently proposed safety distance concept can also affect the laser lithotripsy performance.We give a brief summary on these factors in this review.