不同能量冲击波对猪肾近期病理损伤实验研究.docVIP

不同能量冲击波对猪肾近期病理损伤的实验研究 实验完成单位：1华中科技大学同济医学院附属同济医院泌尿外科 2 湛江海滨医用冲击波研究所 周惜才1 严泽军1 陈志强1 陈忠兴2 郑连伟2 实验参与讨论单位：北京大学泌尿外科研究所 2 湛江海滨医用冲击波研究所 周惜才1 严泽军1 陈志强1 陈忠兴2 郑连伟2 实验参与讨论单位：北京大学泌尿外科研究所An experimental study on the short-term pathologic injury of different extracorporeal shock wave energy on swines kidney Abstract Objectives: To investigated the correlation between the degree of swine renal injury and the applied extracorporeal shock wave (ESW) energy. Methods: Electrohydraulic lithotripter and electromagnetic lithotripter were adopted, each lithotripter shocked 36 swines, which weighted 28-35kg were randomly divided into 5 groups (A、B、C、D and E) according to different discharge voltage, and group E as a normal control. Each group was divided into 4 subgroups according to the time schedule, the subgroups were sacrificed respectively at immediately, the 1st, 2nd and 3rd weeks，resection of bilateral kidneys for gross appearance observation and histological examination. Results: All of the kidneys have morphologic changes after ESW shocked, the severity of the damage was increasing with the rise of voltage, but gradually recovering with time. Once the pressure of focal spot exceeded 25.45MPa, the damage caused by ESW was irreversible (at least in short-term). There was no obvious abnormality in the control group. Conclusion: The injury of kidneys recovered well within 1 to 3 weeks when the pressure of focal spot was no higher than 25.45MPa, but irreversible pathological changes were observed when the pressure exceeded 25.45MPa. The research provides the experimental foundation for the selection of energy parameter in clinical ESWL. Key words Electrohydraulic lithotripter; Electromagnetic lithotripter; Extracorporeal shock wave; Swine; Kidney; Injury 自Chaussy等人首次应用Dornier HM1型体外冲击波碎石机成功地治疗肾结石以来，肾结石的治疗发生了革命性的变化。经过短短20多年的发展，体外冲击波碎石术（ESWL）已经成为肾结石治疗的主要方法。但是，大量的临床观察表明，由于能量参数选择不当，高能冲击波（HESW）在 ESWL过程中对肾脏组织会造成急性和慢性损伤[1]。为了探讨体外冲击波能量大小与