体外冲击波对肝和胆囊上皮细胞超微结构的影响

研究体外冲击波冲击对新西兰兔肝胆组织细胞超微结构的影响。冲击波冲击时间为０、１５、３０和４５ ｍｉｎ，冲击波能量储存读数分别为０、７．８、１５．６和２３．５。作用后立即处死动物，在透射电镜下观察。结果：胆囊上皮细胞不同程度变性，表现为内质网、线粒体肿胀及基质变淡；细胞侧面的连接结构消失，间隙增宽；有的细胞分离、脱落。肝细胞能观察到肿胀、核固缩和质膜破裂等改变．能量越强，改变越严重。冲击波作用后２、４、６和１４个月，上述改变和损伤大部分可逆变，在电镜下观察到损伤修复恢复正常的过渡细胞，在１４个月时，所有细胞恢复正常。结论：实验支持体外冲击波碎石术在临床应用，但应尽量避免对肝胆组织的过度冲击，以免产生严重的细胞损伤。

EFFECTS OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY ON THE CELL ULTRASTRUCTURE OF LIVER AND GALLBLADDER EPITHELIAL CELLS

The ultrastructural changes of gallbladder and liver cell induced by extracorporeal shock wave lithotripsy (ESWL) were observed to identify how serious the cell damage could be and whether it could be reversible.. METHODS The shock wave was firing focused on a definite area of gallbladder and liver, and lasted 0, 15, 30, and 45 min respectively. 8 rabbits were killed immediately after firing. The other & rabbits were killed at 2, 4, 6 and 14 months after 30 min firing. The shocked tissue point was taken out as the specimen and observed under a JEM 1200-EX transmission electron microscope. RESULTS Ultrastructural changes and damages of gallbladder and liver cells could be found after shock wave Firing. The longer firing period lasted, the more damages appeared. However, most of these damages could be reversed gradually to normal within 2- 14 months after firing. CONCLUSIONS The findings support: the clinical application of ESWL can not make severe damage to the patients, but excessive shock wave firing should be avoided to prevent the inreversible damages.