Soh J
Department of Urology, Kyoto Prefectural University of Medicine.
Nihon Hinyokika Gakkai Zasshi. 1998 Jan;89(1):23-8. doi: 10.5980/jpnjurol1989.89.23.
In our investigations to develop microexplosion lithotripsy (MEL), the detonation theory, which was proposed in industrial blasting, was proved to be tenable also in MEL with tiny explosives of a few mg. According to the theory, the peak pressure of shock wave generated by blasting was analyzed relating to the volume of calculi.
472 cases of renal urinary calculi to be disintegrated by ESWL were examined.
For the successful disintegration, the maximum length of calculi, which was employed conventionally, was a good predictor as for those less than 15 mm (disintegrated in 95%) and those more than 25 mm (disintegrated in 8%). However, the maximum length could not predict the successful result in calculi with intermediate maximum length between 15 and 25 mm. For this intermediate range of the maximum length, the volume of calculi was a very good indicator to show whether the integration was possible or not, because the large majority (90%) of calculi less than 6 cm3 was treated successfully, while none of calculi more than 6 cm3 was disintegrated. According to the theory, the peak pressure of shock wave generated by blasting, which was required to disintegrate a calculated of 6 cm3, was calculated as 80 MPa.
Since it is believed that the peak pressure generated by usual ESWL machines is between 80 and 120 MPa at the focussing point, the conclusion in this report that the maximum volume of calculi disintegrated by ESWL might be 6 cm3 was thought to be fairly reasonable.
在我们研发微爆炸碎石术（MEL）的研究中，工业爆破中提出的爆轰理论被证明在使用几毫克的微小炸药的MEL中也成立。根据该理论，分析了爆破产生的冲击波峰值压力与结石体积的关系。
对472例拟用体外冲击波碎石术（ESWL）碎石的肾尿石症患者进行检查。
对于成功碎石，传统上采用的结石最大长度对于小于15毫米的结石（95%可碎石）和大于25毫米的结石（8%可碎石）是一个很好的预测指标。然而，最大长度无法预测最大长度在15至25毫米之间的结石的碎石成功结果。对于这个最大长度的中间范围，结石体积是显示碎石是否可行的一个非常好的指标，因为绝大多数（90%）体积小于6立方厘米的结石治疗成功，而体积大于6立方厘米的结石无一碎石成功。根据该理论，将一块6立方厘米结石碎石所需的爆破产生的冲击波峰值压力计算为80兆帕。
由于人们认为普通ESWL机器在聚焦点产生的峰值压力在80至120兆帕之间，本报告得出的ESWL可碎石的最大结石体积可能为6立方厘米的结论被认为是相当合理的。
