Nelson R C, Rowland G A, Torres W E, Baumgartner B R
Biliary Lithotripsy Center, Crawford W. Long Hospital, Emory University, Atlanta, GA 30322.
AJR Am J Roentgenol. 1990 Feb;154(2):291-4. doi: 10.2214/ajr.154.2.2105016.
We evaluated 30 gallstone lithotripsy procedures performed on 27 patients with the Dornier MPL-9000 Lithotripter to determine how time was spent in the lithotripsy suite and to evaluate the various technical reasons for interrupting the administration of shock waves during the treatment. The procedure averaged 98 +/- 32 min total time in the lithotripsy suite. This included an average of 22 +/- 6 min before the treatment, 70 +/- 28 min for administration of shock waves, and 6 +/- 2 min after the treatment. The time required to deliver the shock waves did not correlate with patient age, sex, or weight; the number of gallstones; or the number or date of the treatment. However, a trend was seen toward an association between shorter treatment times and larger stone volumes. On the average, the administration of shock waves was interrupted every 48 shock waves for various reasons. Electronically changing the imaging plane of the in-line sonographic transducer to retarget the stone in the focal zone was by far the most frequent reason for interrupting shock-wave delivery, averaging 56 shock waves between changes. We conclude that extracorporeal shock-wave lithotripsy of gallstones is a time consuming and technically demanding procedure that requires continuous monitoring and frequent interruption in order to optimize targeting and fragmentation of the stone(s) while maintaining the patient's comfort.
我们对使用多尼尔MPL - 9000碎石机为27例患者实施的30次胆结石碎石手术进行了评估，以确定在碎石室的时间分配情况，并评估治疗过程中中断冲击波发射的各种技术原因。在碎石室的手术总时间平均为98±32分钟。这包括治疗前平均22±6分钟、冲击波发射70±28分钟以及治疗后6±2分钟。发射冲击波所需的时间与患者年龄、性别、体重、胆结石数量或治疗次数及日期均无关联。然而，治疗时间较短与结石体积较大之间存在一种趋势性关联。平均而言，由于各种原因，每发射48次冲击波就会中断一次。通过电子方式改变在线超声换能器的成像平面以重新将结石定位在聚焦区是迄今为止中断冲击波发射最常见的原因，两次改变之间平均为56次冲击波。我们得出结论，胆结石体外冲击波碎石术是一项耗时且技术要求高的手术，需要持续监测并频繁中断，以便在保持患者舒适度的同时优化结石的定位和破碎。
