ESWL对肾、输尿管影响的动物实验及临床观察  

Effects of ESWL on kidney and ureter; An experimental study and clinical observation

作　　者：申鹏飞[1] 余大敏[1] 张时纯[1] 黄福溥[1] 谢志光[1] 齐范[1] 齐琳[1] 

机构地区：[1]湖南医科大学湘雅医院泌尿外科

出　　处：《中华泌尿外科杂志》1994年第4期295-298,共4页Chinese Journal of Urology

摘　　要：动物实验分为幼兔ＥＳＷＬ组、对照组及成年兔ＥＳＷＬ组，于ＥＳＷＬ后２４ｈ及３个月，分别观察分肾功能，肾生长发育，分肾静脉血及外周血肾素水平（ＰＲＡ）的变化。结果２４ｈ后冲击侧肾功能下降。３个月后肾功能已恢复，肾生长发育不受影响，冲击侧肾静脉血及外周血ＰＲＡ与对照组及未冲击侧相比未发现升高，肾内有灶性纤维化等改变，其中１只幼兔冲击肾发生萎缩，广泛纤维化。临床观察１６９２例ＥＳＷＬ患者中有３例输尿管结石ＥＳＷＬ后肾积水加重，血肌酐升高，３例冲击肾发生萎缩，其中１例功能丧失，１例伴肾周巨大血肿。认为一般情况下ＥＳＷＬ的危害不大，但个别情况可发生肾萎缩、功能丧失，故行ＥＳＷＬ时仍应谨慎为妥。To study the effects of ESWL on kidney and ureter, 36 immature (2￣3 months old) and 18 mature rabbits were evaluated for renal function, renal growth and renin level at 24 hours and 3 months after ESWLrespectively. A group without ESWL was also observed as controls.Each experimental rabbit received ESWL of 3 000 shock waves at 11￣14kv with domestic JTESWL device. The renal function declined at 24 hours after ESWL and returned to normal at 3 months.Pathological changes in kidney including focal fibrosis,epithelial atrophy of tubules, dilatation of tubular cavity, thickened glomerular capsule and forcal fibrosis of lineal cicartrization in parenchyma were observed.There were no significant changes in total renal growth,renal function and renin level in split renal and peripheral blood as compared with the controls.The morphology of kidney was all normal except one immature kidney which was atrophied with extensive fibrosis after ESWL. From 1988 to 1992, 1692 patients were treated with ESWL fot urinary stones. Hydronephrosis became worse and creatmine elevated in 3 cases after ESWL for ureteral stones. In 3 cases after ESWL for renal stones,renal atrophy was noted with loss of renal function in one and a huge perirenal humatoma in another.

关 键 词：体外震波碎石 肾脏 动物实验 

分 类 号：R691.4[医药卫生—泌尿科学]