Karlsen S J, Smevik B, Hovig T
Institute of Surgical Research, University of Oslo, Norway.
Urol Res. 1991;19(2):105-15. doi: 10.1007/BF00368185.
The acute effects of extracorporeal shock waves on renal morphology were studied by light and electron microscopy in 14 dogs. One kidney received an average clinical number of exposures, the nonexposed, contralateral kidney serving as control. The original Dornier HM-3 generator was used in 3 animals, the modified version in 11. Intravascular radiographic contrast medium was administered in five animals. Damage was observed in all exposed kidneys, none in the contralateral control kidney. The effects were characterized by renal and perirenal hemorrhage and edema, parenchymal hemorrhagic foci with tissue destruction, often extending from cortex to medulla. In the nearby regions there was endothelial cell damage in arteries, veins and glomerular capillaries. Breaks in the wall of these vessels were detected with platelet plug formations and thrombi. In glomeruli, breaks of Bowman's capsule and epithelial cell damage with loss of foot processes were observed. A wide range of tubular cell damage was demonstrated, ranging from vacuolization to complete necrosis. Tubular lumina were filled with red cells, indicating renal origin of hematuria. The tissue damage was less pronounced in kidneys exposed to the modified lithotriptor than to the original. No difference in the quantity or quality of damage was detected whether radiographic contrast medium was administered or not.
通过光学显微镜和电子显微镜研究了14只狗体外冲击波对肾脏形态的急性影响。一侧肾脏接受平均临床次数的冲击波照射，未照射的对侧肾脏作为对照。3只动物使用原装多尼尔HM - 3发生器，11只使用改良版。5只动物注射了血管内造影剂。所有接受照射的肾脏均出现损伤，对侧对照肾脏未出现损伤。其影响表现为肾内及肾周出血和水肿，实质内有出血性病灶并伴有组织破坏，常从皮质延伸至髓质。在附近区域，动脉、静脉和肾小球毛细血管的内皮细胞受损。检测到这些血管壁破裂，伴有血小板栓形成和血栓。在肾小球中，观察到鲍曼囊破裂和上皮细胞损伤伴足突消失。显示出广泛的肾小管细胞损伤，从空泡化到完全坏死不等。肾小管管腔内充满红细胞，表明血尿源于肾脏。与原装碎石机相比，使用改良版碎石机照射的肾脏组织损伤较轻。无论是否注射造影剂，损伤的数量和质量均未检测到差异。
