Delius M, Jordan M, Liebich H G, Brendel W
Institute of Surgical Research, University of Munich, Federal Republic of Germany.
Ultrasound Med Biol. 1990;16(5):459-66. doi: 10.1016/0301-5629(90)90168-c.
The effect of extracoporeal shock waves on the liver and the gallbladder wall was compared in two groups of dogs exposed to 1500 shock waves generated in an electrohydraulic lithotripter with 15 kV and 80 nF. The waves were focused on the gallbladder wall. In the experimental group, a shock wave burst of 10 consecutive waves with an interval of 10 ms between the waves was administered each second; in the control group, single shocks were released each second. The day following shock wave exposure, the dogs were anaesthetized, killed and then dissected. In the liver, subcapsular and intraparenchymal focal haemorrhages occurred in the high pressure field and venous thrombi in portal veins. There was a nonsignificant trend towards an increased number of venous thrombi after burst application. The gallbladder wall was haemorrhagic and oedematous, the mucosa was ulcerated in the focal area; blood clots were found in nearly all gallbladders. No differences were detected between the groups. The free plasma haemoglobin was only increased after fast shock wave administration. Increased haemolysis and the trend towards an increased number of thrombi favour cavitation as a mechanism of shock wave damage. The similar extent of tissue damage suggests that shock wave bursts can be applied for gallstone destruction in humans if the major liver vessels are kept out of the high pressure field.
在两组犬中比较了体外冲击波对肝脏和胆囊壁的影响，这两组犬均暴露于由一台电压15 kV、电容80 nF的液电碎石机产生的1500次冲击波下。冲击波聚焦于胆囊壁。在实验组，每秒给予一组10次连续的冲击波，波与波之间间隔10毫秒；在对照组，每秒释放单个冲击波。在冲击波暴露后的第二天，将犬麻醉、处死并进行解剖。在肝脏中，高压区域出现包膜下和实质内局灶性出血以及门静脉内静脉血栓形成。在给予冲击波群后，静脉血栓数量有增加的趋势，但差异无统计学意义。胆囊壁出血且水肿，局部区域黏膜溃疡；几乎在所有胆囊中均发现血凝块。两组之间未检测到差异。仅在快速给予冲击波后，游离血浆血红蛋白才升高。溶血增加以及血栓数量增加的趋势支持空化作用作为冲击波损伤的一种机制。组织损伤程度相似表明，如果主要肝血管避开高压区域，冲击波群可用于人体胆结石的破坏。
