BASIC ASPECTS OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

体外冲击波碎石术已成为主要治疗方法 治疗尿路结石的方法。最近，越来越多的新的 碎石机(第二代和第三代碎石机)已经开发出来。 然而，结石破碎的基本机制以及 对肾组织和肾脏的潜在急性和长期有害影响 功能尚未完全解释。仍然有必要进一步 基础冲击波物理学和动物研究。 我们建议继续进行调查，以更好地了解 结石-组织-波相互作用的力学，结石的机制 碎裂和肾组织损伤，并进一步表征 碎石机能量来源、机器设置和治疗的影响 临床冲击波碎石术的疗效和安全性策略。一个 已经设计了一系列的实验和理论研究，并 归纳为本项目的四个目标：1)组织损伤机制和 碎石过程中损伤的限制；2)结石的计算机模拟- 组织-冲击波相互作用；3)肾脏的物理特性 结石和肾组织；以及4)建立损害标准 结石碎裂和肾组织损伤。 该项目的总体目标是将来自广泛的 建立优化的基础物理和动物研究范围 处理参数，最高效率的石料粉碎，最小 肾组织损伤和功能改变。本项目的成果 将为项目2的临床研究奠定基础 这些都是为管理层优化治疗策略而制定的 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.