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Development of the system for extracorporeal stone disintegration using microexplosion;Disintegration of renal and gall stone.

开发微爆炸体外碎石系统；肾结石和胆结石的崩解。

基本信息

批准号：
61870061
负责人：
KUWAHARA Masa-aki
金额：
$ 16.64万
依托单位：
TOHOKU UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Developmental Scientific Research
财政年份：
1986
资助国家：
日本
起止时间：
1986 至 1987
项目状态：
已结题

项目摘要

We have developed the extracorporeal shock wave lithotriper using chemical explosives(silver azide, 10mg) as an energy source of shock wave generation. This method(mESWL) was applied clinically since March 1985. Up to may 1987 a total of 229 cases was treated with 96% of clinical success rate. Renal function estimated by 99mTC-dimercaptosuccinic acid renal uptake-rate revealed no sighnificant deleterious effect on the renal function. As the complication, 1 case of bactgeremia, 1 case of gastro-intestinal bleeding and 2 cases of subcapsular renal hematoma were observed. The occurrence rate of complication was almost equivalent to Dornier System. All these complicated cases were Lreated conservatively, except 1 case of percutaneous drainage in the subcapsular hematomas. The results indicated that mESWL is safe and effective for the tratment on the upper urinary tract calculi. We belive tghat our system can sufficiently apply to the clinacal usage, however, it has also several disadvantages, such as an explosion sound and the use of water-tub. As the noise level in the explosion has been proved to be almost same compared to the Dornier System(HM-1), so the noise seems to be not a great probelm. From a point of efficienty of shock wave propagation, it is preferable that no interpolated material betwee a shock wave reflecter and a human body. Nonetheless, the adoption of a water-tub make the whole system complex. in this regard, we are trying a tgub-less sytem in mESWL, and study on another energy source, such as piezoceramics. in order to evaluate our system, not only from the efficicency in the clinical treatment and the easiness in the manipulation, but also form the economical point of view, we need more detailed information about other lithotripters. However, the development of a original made-in-japan lithotripter stimulates the researach on shock waves, and makes another step to apply the method widely to biomedical fields in this country.

我们用化学炸药(叠氮化银，10 mg)作为产生冲击波的能源，研制了体外冲击波碎石机。该方法(MESWL)自1985年3月开始临床应用。截至1987年5月，共治疗229例，临床成功率96%。用99mTc-二硫代丁二酸肾摄取率评价肾功能，对肾功能无明显不良影响。并发症：细菌血症1例，消化道出血1例，肾被膜下血肿2例。并发症发生率与Dornier系统基本相当。除1例包膜下血肿经皮引流外，其余均保守治疗。结果表明，mESWL治疗上尿路结石安全有效。我们相信我们的系统可以很好地应用于临床，但它也有一些缺点，如爆炸声和使用水桶。由于爆炸中的噪音水平已被证明与多尼尔系统(HM-1)几乎相同，因此噪音似乎不是一个大问题。从冲击波传播效率的角度来看，在冲击波反射器和人体之间最好不插入任何材料。尽管如此，采用浴缸使整个系统变得复杂。在这方面，我们正在尝试在mESWL中使用无TGUB系统，并研究另一种能源，如压电陶瓷。为了对我们的系统进行评估，不仅从临床治疗的有效性和易操作性，而且从经济的角度来看，我们还需要更详细的信息来了解其他碎石机。然而，日本原创碎石机的研制促进了冲击波的研究，为该方法在我国生物医学领域的广泛应用又迈出了一步。