Moon P O, Scheeres D E, Mills K
Department of Surgery, Michigan State University/Butterworth Hospital, Grand Rapids.
J Stone Dis. 1993 Apr;5(2):77-82.
The relationship between acoustic energy, stone burden, and stone clearance in biliary extracorporeal shock wave therapy (ESWL) is unclear. We hypothesized that there is a consistent relationship between these parameters that enables gallstone clearance to be predicted. Using a porcine model and various gallstone burdens, we performed biliary ESWL with varying energy levels and number of shock waves. The acoustic energy/stone burden ratio (AE/SB) was calculated that incorporated these variables. Stone clearance increased with higher energy settings and fewer stones present (p less than 0.005). The relationship between AE/SB ratio and stone clearance was logarithmic (r 2 = 0.82). The plateau of this curve showed optimal stone clearance at approximately 20 joules/g, beyond which point the benefit of further ESWL may not outweigh the risks. This relationship between AE/SB ratio and stone clearance may be able to predict the optimal energy required and probable outcome of biliary ESWL prior to the procedure.
在胆道体外冲击波碎石术（ESWL）中，声能、结石负荷和结石清除率之间的关系尚不清楚。我们假设这些参数之间存在一种一致的关系，能够预测胆结石的清除情况。我们使用猪模型和各种胆结石负荷，以不同的能量水平和冲击波次数进行了胆道ESWL。计算了纳入这些变量的声能/结石负荷比（AE/SB）。结石清除率随着能量设置的提高和结石数量的减少而增加（p小于0.005）。AE/SB比与结石清除率之间的关系呈对数关系（r² = 0.82）。该曲线的平台期显示，在约20焦耳/克时结石清除效果最佳，超过这一点，进一步进行ESWL的益处可能不会超过风险。AE/SB比与结石清除率之间的这种关系可能能够在手术前预测胆道ESWL所需的最佳能量和可能的结果。
