Méndez-Sánchez N, Uribe-Esquivel M, Bosques F, de la Mora G, Sánchez J M, Ponciano G
Clínica de Hígado del Instituto Nacional de la Nutrición Salvador Zubirán México, D.F.
Rev Invest Clin. 1990 Jul-Sep;42(3):231-9.
Extracorporeal shock waves lithotripsy is a new procedure discovered and applied in the present decade to treat urinary and biliary stones. Shock waves are acoustic waves similar to sonic waves which follow the acoustic laws and therefore the shock waves can be refracted or reflected depending on the medium interface. Due to the high water content, the human body can be crossed by shock waves which eventually may be focused on the target stone. There are several commercially available shock waves generators, i.e. the spark gap emisors which were the first ones, and the piezoceramic and electromagnetic emisors. To focus the shock waves on a biliary stone the machines are provided with fluoroscopic or ultrasound devices or with both in the most advanced machines. Using an electromagnetic emisor (Lithostar plus) our group has treated 78 patients with biliary stones without analgesia or anesthesia. Total stone fragmentation was achieved in 85% of the cases. In patients with cholesterol gallstones who undergo lithotripsy, an adjuvant treatment with oral cholesterol solvent is mandatory. Extracorporeal biliary lithotripsy is free of mortality, and the morbidity is less than 5%.
体外冲击波碎石术是近十年来发现并应用于治疗尿路结石和胆结石的一种新方法。冲击波是类似于声波的机械波，遵循声学定律，因此冲击波可根据介质界面发生折射或反射。由于人体含水量高，冲击波可以穿过人体，最终聚焦于目标结石。有几种市售的冲击波发生器，即最初的火花隙发生器、压电陶瓷发生器和电磁发生器。为了将冲击波聚焦于胆结石，这些机器配备了透视或超声设备，或者在最先进的机器中两者都配备。我们小组使用电磁发生器（Lithostar plus），在未进行镇痛或麻醉的情况下治疗了78例胆结石患者。85%的病例实现了结石完全破碎。对于接受碎石术的胆固醇结石患者，必须采用口服胆固醇溶剂进行辅助治疗。体外胆结石碎石术无死亡率，发病率低于5%。
