复式脉冲对组织损伤的实验研究
韩见知 陈忠兴 杨 信 李 斌 高绍青 黄长青
指导: 郭应禄 梁丽莉
【摘要】复式脉冲与单次脉冲相比，可以提高碎石效率。
但是复式脉冲对组织的损伤程度是否随碎石效率的提高而增加未见文献报道。为此，我们采用活体猪作了系列液电式复式脉冲与单式脉冲以及电磁式脉冲对组织损伤的实验研究。研究表明，在相同的能量和冲击次数的条件下，肉眼所见的复式脉冲比单式脉冲的损伤范围更小。显微病理检查也证明，复式和单式脉冲对肾脏及输尿管的各层结构都可造成以出血为特征的、可逆性的损伤，很少产生瘢痕组织。与电磁式脉冲的对比研究也证明，复式脉冲在碎石效果更好的条件下，对组织的损伤并不增加。结论：与液电式单式脉冲和电磁式脉冲相比，复式脉冲并不增加对肾和输尿管组织的损伤。
【关键词】 复式脉冲 单次脉冲 双空化效应 碎石 组织损伤
【Abstract】Compared the
unitary impulse , double impulse could improve the efficiency of
the lithotripsy. But it is not clearly that whether the tissue injury could be increased
by the double impulse when it improved the efficiency of the lithotripsy. So, we made a series
of experiment study on the tissue injury of the vivo pigs with the double impulse and unitary impulse as well as the electromagnetic
impulse. The results show that the injury focus, which induced by the double impulse or by the
unitary impulse, is a similar. Under the same energy and the impulsion, the
injury focus, which induced by the double impulse, is small
than the focus, which induced by the unitary impulse.
Microstructure pathology shows that the character of focus, which
on the renal artery, vein, glumeruli, renal tubules and the ureter, are similarity. Conclusion: comparison
with the focus induced by the single impulse or by the electromagnetic impulse, the
focus on the tissue of the renal and the ureter induced by the duplicated impulse is a smaller.
【 Key words】 double impulse double cavitation unitary
impulse lithotripsy tissue injury
复式脉冲是在特定的时间范围内连续产生两个脉冲波,达到双空化效应(double cavitation),使冲击波的能量更集中指向靶区中心，从而增强冲击波碎石的效果。我们作了大量的体外实验证明，复式脉冲与单次脉冲相比，在冲击次数、冲击能量及结石性状都同的条件下，可以提高碎石效率达40~60%（另文介绍）。但是复式脉冲对活体组织的损伤程度是否随碎石效率的提高而增加未见文献报道。为此，我们采用活体猪作了系列液电式复式脉冲与单式脉冲以及电磁式脉冲对组织损伤的对比实验研究，报告如下。
一、材料与方法
1、采用湛江海滨医疗器械公司生产的液电式HB -VG型碎石机和在此机型基础上研制的复式脉冲碎石机以及电磁式碎石机（德国DONIER COMPACT S "小巨人"）；作单式和复式脉冲以及电磁式脉冲对组织损伤的实验研究。
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