不同能量冲击波对猪肾近期病理损伤的实验研究

目的探讨体外冲击波能量大小与肾脏损伤的关系。方法将体重28—35kg的白猪36头，根据冲击电压的不同，随机分为A、B、C、D、E组，其中E组为对照组。每组按观察时间不同又分为4个亚组，分别于冲击后即刻、1周、2周和3周取双侧肾脏，肉眼和光镜下观察其形态的改变。结果所有受冲击的肾脏均有损伤性改变，且损伤随电压的增加而加重，随时间的推移而逐渐恢复，当电压超过13kV后，所引起的损伤是不可逆的（至少短期内）。结论当冲击电压≤13kV时，冲击波所引起的损伤在1—3周内基本可以恢复，而一旦超过13kV，则会造成肾脏不可逆性病理改变。本实验结果为临床ESWL能量参数的选择提供了参考依据。

An experimental study on the short-term pathologic injury of different extracorporeal shock wave energy on swine kidney

Objective To investigate the correlation between the degree of swine renal injury and the applied extracorporeal shock wave （ESW） energy. Methods 36 swines weighted 28-35kg were randomly divided into 5 groups （A, B, C, D and E） according to different discharge voltage, and group E was normal control. Each group was divided into 4 subgroups. According to thc time schcdule, the subgroups were sacrificed immediately, the 1st, 2nd and 3rd wcek after they rcceived ESW. Bilateral kidneys of thc swines werc taken out for gross observation and histological examination. Results All of the kidneys had morphologic changes, the severity of the damage increasing with the rise of voltage, but they gradually recovcred with time. Once the voltagc exceeded 13 kV, the damage caused by ESW was irreversible （at least in short-term）. Conclusion The injury of kidneys recovered well within 1 to 3 weeks when the impulse voltage was no higher than 13 kV, but irreversible pathological changes were observed when the voltage exceeded 13 kV. The research provides the experimental foundation for the selection of energy parameter in clinical extracorporeal shock wave lithotripsy.