Twenty Years of Shock Wave Research at the Institute for Surgical Research
Twenty Years of Shock Wave Research at the Institute for Surgical Research
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外科研究所二十年的冲击波研究
DOI：
10.1159/000048884
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发表时间：
2002
影响因子：
1.6
通讯作者：
M. Delius
中科院分区：
文献类型：
--
作者：
M. Delius
冲击波是一种声压波脉冲，持续时间仅为1微秒，压力可达数百至1,000个大气压（图1）。它们在体外产生，并通过皮肤在相对较大的区域上耦合到体内，在组织中传播并通过超声波聚焦在结石上。慕尼黑大学外科研究所的历史与体外冲击波碎石术的发展、输尿管和其他部位结石的破碎紧密相连。它的前任主任沃尔特·布伦德尔在60年代建立了该研究所，并一直领导到1989年去世。他在七十年代中期开始研究冲击波的临床应用。下面的简要回顾从对结石清除的历史根源的评论开始，并描述了体外冲击波碎石术的发展。像任何其他治疗一样，冲击波产生的副作用促使研究人员仔细研究。出现了空化的因果作用的想法，这是一个涉及流体中气泡的产生和运动的过程。这一机制得到了许多实验的支持。图1。碎石机冲击波的压力记录。峰值压力在y轴上显示为正向上冲程，并且超过90 MPa。正压力波之后是低于基线且在10 MPa范围内的拉伸波。X轴上的时间标度以Is为单位。阅读是用光纤探头水听器进行的，这是今天提供强拉伸压力的无失真检测的唯一方法。这个原理是由Eisenmenger和Staudenraus发明的[32]。
Shock waves are acoustic pressure wave pulses which last only a microsecond and reach a pressure of several hundred up to over 1,000 atmospheres (fig. 1). They are produced outside the body and are coupled on a relatively large area through the skin into the body, propagated in tissue and focused on a stone by means of ultrasound. The history of the Institute for Surgical Research of the University of Munich is tightly linked with the development of extracorporeal shock wave lithotripsy, the fragmentation of stones in the ureteric tract and other locations. Its former director Walter Brendel set up the Institute in the sixties and directed it till his death in 1989. He started research on the clinical application of shock waves in the mid seventies. The following brief review starts with a remark on the historical roots of stone removal and describes the evolution of extracorporeal shock wave lithotripsy. Like any other treatment, shock waves generated side effects which stimulated researchers to take a closer look at. The idea of a causative role of cavitation emerged, a process involving the generation and movement of bubbles in a fluid. This mechanism was supported by a number of experiments. It Fig. 1. Pressure registration of a shock wave of a lithotripter. The peak pressure is shown as positive upstroke on the y-axis and exceeds 90 MPa. The positive pressure wave is followed by a tensile wave which is below the baseline and is in the range of 10 MPa. The time scale on the x-axis is in Is. The reading was made with a fibre-optic probe hydrophone which is today the only way to provide an undistorted detection of strong tensile pressures. The principle was invented by Eisenmenger and Staudenraus [32].