BASIC ASPECTS OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

体外冲击波碎石术已成为首选的治疗方法 泌尿系统结石最近，越来越多的新 已经开发了碎石机（第二代和第三代机器）。 然而，石头破碎的基本机制以及 对肾组织的潜在急性和长期有害影响， 功能尚未完全解释。需要进一步 基础冲击波物理学和动物研究。 我们建议继续进行调查，以便更好地了解 石组织波相互作用的力学，石的机制， 破碎和肾组织损伤，并进一步表征 碎石机能量源、机器设置和治疗的影响 临床冲击波碎石术有效性和安全性的策略。一 设计了一系列的实验和理论研究， 本项目分为四个目标：1）组织损伤的机制， 限制碎石过程中的损伤; 2）结石的计算机建模- 组织-冲击波相互作用; 3）肾脏的物理表征 结石和肾组织;和4）建立损害标准， 结石破碎和肾组织损伤。 该项目的总体目标是整合来自广泛的 一系列基本的物理和动物研究，以建立优化的 治疗参数，最大限度地有效粉碎结石， 肾组织损伤和功能改变。本项目的成果 为项目2的临床研究奠定基础 制定这些方案是为了优化治疗策略， 体外冲击波碎石术治疗肾结石

Extracorporeal shock wave lithotripsy has become the primary treatment modality for urinary stones. Recently, a growing number of new lithotripters (second and third generation machines) have been developed. Yet, the fundamental mechanisms for stone fragmentation as well as the potential acute and long term deleterious effects on renal tissue and function have not been completely explained. The need remains for further basic shock wave physics and animal studies. We propose to continue our investigations to better understand the mechanics of stone-tissue-wave interactions, the mechanisms of stone fragmentation and of renal tissue injury, and to further characterize the effects of lithotripter energy sources, machine settings, and treatment strategies on clinical shock wave lithotripsy efficacy and safety. A series of experimental and theoretical studies have been designed and are grouped into four aims of this project: 1) mechanisms of tissue injury and limitation of damage during lithotripsy; 2) computer modeling of stone- tissue-shock wave interaction; 3) physical characterization of renal calculi and renal tissues; and 4) establishment of damage criteria for stone fragmentation and renal tissue injury. The overall goal of this project is to integrate information from a broad range of basic physical and animal studies to establish optimized treatment parameters, with maximally efficient stone comminution, minimal renal tissue damage and functional changes. Results from this project shall lay the foundation for the clinical investigations in Project 2 which are formulated to optimize treatment strategies for the management of renal nephrolithiasis with extracorporeal shock wave lithotripsy.