Development of A New Type Extracorporeal Micro-explosive Lithotripter

新型体外微爆胆道碎石机研制研制了一种新型体外微爆冲击波碎石机，该碎石机采用椭球反射体，在人体与冲击波发生器之间隔有一层橡胶膜。接下来，我们成功地利用双曝光全息干涉术实现了冲击波聚焦的可视化。为了观察超声设备存在于激波路径上时激波是如何传导的，用超级计算机模拟了第二焦点周围的压力分布。压力分布没有明显的变化以破坏胆结石。从我们用明胶的实验来看，冲击波在气泡中诱导的微液体射流可能会损伤组织。采用人胆结石、肾结石和模型结石植入杂种狗胆囊，观察其在体内的破坏作用。然后每只动物微爆（AgNO3 10mg） 50 ~ 200次。每块胆结石都被破坏成一些碎片。尸检显示腹膜腔除轻度肺出血外未见异常。但在500例休克集中导致肝和肺出血的荚膜下轻度出血。也就是说，我们必须用最小和最有效的电击聚焦来摧毁胆结石。通过这些实验，该机器可用于一次治疗200次冲击波下胆结石的临床崩解。

Development of a New Type Extracorporeal Micro-explosive Biliary LithotripterWe developed a new type water-bath-free extracorporeal micro-explosive shock wave lithotripter having an ellipsoidal reflector with a rubber membrane between human body and shock wave generator. next, we successed the visualization of the shock wave focusing using double exposure hologaraphic interferometry. In order to see how shock wave may be conducted when the ultrasonography apparatus exists on the shock wave path, wa simulated the pressure distribution around the second focus by a supercomputer. There was no significant change in the pressure distribution in order to distroy gallstones. And from our experiment using gelatin, it applies that the micro-liquid jet induced in an air bubble by a shock wave may damage tissue. To investigate the gallstone destruction in vivo, human gallstones, kidney stones, or model calculi were implanted into the gallbladder of mongral dogs. Then the micro-explosion (AgNO3 10mg) was conducted 50-200 times for each animal. Each gallstone was desructed into some fragments. Autopsy revealed no abnormal findings in the peritoneal cavity except for mild lung bleeding. But in the case of 500 shockfocusings resulted subcapsular mild bleeding in the liver and lung bleeding. That is to say, we must apply minimal and most effective shock focusing to destroy gallstones.With these experiments, this machine may be useful for gallstone disingegration clinically under 200 shock wave applications in one treatment.