Coleman A J, Saunders J E
Medical Physics Department, St Thomas' Hospital, London, UK.
Ultrasonics. 1993;31(2):75-89. doi: 10.1016/0041-624x(93)90037-z.
Extracorporeal shockwave lithotripsy (ESWL) has now been used for more than a decade in the treatment of urinary stone disease. During this period there has been a wide range of studies on the physical properties of the high-amplitude focussed fields used in ESWL and the biological effects of exposure to such fields, including their ability to fragment hard concretions. These studies form a distinct body of knowledge whose relevance to the broader literature on biological effects from lower amplitude exposures has yet to be fully evaluated. This review attempts to present the main results of biological-effects studies in ESWL along with what is known of the physical properties of lithotripsy fields with the aim of assisting this evaluation. In general, the reported biological effects of lithotripsy fields are compatible with those that have been observed at those lower amplitudes of focussed pulsed ultrasound in which transient cavitation is the dominant mechanism of interaction. The relatively large amplitudes and low frequencies in ESWL, however, make it a more potent generator of transient cavitation than most other forms of medical ultrasound. Biological-effects studies with lithotripsy fields may, therefore, be expected to extend our understanding of the nature of transient cavitation and, in particular, its effects in mammalian tissue.
体外冲击波碎石术（ESWL）用于治疗尿路结石病已有十多年。在此期间，针对ESWL中使用的高振幅聚焦场的物理特性以及暴露于此类场的生物学效应开展了广泛研究，其中包括其破碎坚硬结石的能力。这些研究形成了一个独特的知识体系，其与关于较低振幅暴露的生物学效应的更广泛文献的相关性尚未得到充分评估。本综述试图呈现ESWL生物学效应研究的主要结果以及关于碎石场物理特性的已知情况，旨在助力这一评估。总体而言，所报道的碎石场生物学效应与在较低振幅聚焦脉冲超声中观察到的效应相符，在这种超声中，瞬态空化是主要的相互作用机制。然而，ESWL中相对较大的振幅和较低的频率使其成为比大多数其他形式的医学超声更强大的瞬态空化发生器。因此，对碎石场的生物学效应研究有望扩展我们对瞬态空化本质的理解，尤其是其在哺乳动物组织中的效应。
