Fernández Francisco, Fernández Gilberto, Loske Achim M
Departamento de Nanotecnología, Centro de Física Aplicada y Tecnología Avanzada, Universidad Nacional Autónoma de México, Querétaro, México.
J Endourol. 2009 Aug;23(8):1247-53. doi: 10.1089/end.2009.0071.
Reducing extracorporeal shockwave lithotripsy (SWL) time by increasing the shockwave rate of the lithotripter has been tested in the past; however, basic research and treatment outcomes revealed that this is not convenient. The purpose of this study was to use an animal model to demonstrate that SWL treatment time can be reduced significantly without sacrificing stone fragmentation efficiency using tandem shockwaves.
A tandem research lithotripter was used to treat 50 artificial kidney stones implanted into the kidneys of 50 rabbits. Standard single-pulse and tandem shockwaves were compared in two different scenarios: Without a fluid-filled expansion chamber and with a fluid-filled expansion chamber surrounding the stone.
The presence of fluid surrounding the stone enhances fragmentation in both the standard and tandem modes. No significant difference in fragmentation efficiency was recorded between the standard and tandem SWL with stones surrounded by fluid; however, the treatment time with tandem shockwaves was reduced by 50%.
Significantly shorter SWL treatments may be possible in the future using tandem shockwaves on urinary stones that are surrounded by fluid.
过去曾尝试通过提高碎石机的冲击波频率来缩短体外冲击波碎石术（SWL）的时间；然而，基础研究和治疗结果表明这种方法并不方便。本研究的目的是使用动物模型证明，采用串联冲击波在不牺牲结石破碎效率的情况下可显著缩短SWL治疗时间。
使用一台串联研究用碎石机治疗植入50只兔子肾脏内的50颗人造肾结石。在两种不同情况下比较标准单脉冲和串联冲击波：无充满液体的扩张室以及结石周围有充满液体的扩张室。
结石周围存在液体可增强标准模式和串联模式下的结石破碎效果。结石被液体包围时，标准SWL和串联SWL在破碎效率上无显著差异；然而，串联冲击波的治疗时间缩短了50%。
未来对于被液体包围的尿路结石，使用串联冲击波可能会显著缩短SWL治疗时间。
