胆囊结石甲基叔丁醚溶石联合超声助溶的研究  

Experimental Gallstone Dissolution with Methyi-Tert-Butyl Ether (MTBE) and Therapeutic Ultrasound Energy

作　　者：陈伟民[1] 胡海 张圣道[3] 姜志宏[3] 杨小妹[3] 蔡杏兴[3] 施瑞庭 

机构地区：[1]上海第二医科大学附属仁济医院,200001 [2]江苏省张家港市胆石病防治研究中心 [3]上海第二医科大学附属瑞金医院普外科

出　　处：《中华实验外科杂志》1996年第4期193-194,共2页Chinese Journal of Experimental Surgery

基　　金：上海市卫生局基金

摘　　要：18份胆囊结石,每份4枚,按结石外形、重量配对分组。每份中1枚作CT分型、生化分析、剖面结构观察;另3枚分别溶石:超声助溶、灌注助溶,静置对照。结果表明:①超声可以促进非钙化石的溶解,结石完全溶解,溶石时间明显缩短。超声组与灌注组比较,有显著性差异(P<0.05);与静置组比较,有非常显著性差异(P<0.001)。减时比分别为29%±17.97%和96%±2.32%;②超声可提高钙化结石减重率。超声组与灌注组比较,无显著性差异(P>0.05);与静置组比较,有显著性差异(P<0.05),所有钙化结石均不能完全溶解,残砾直径均>3mm。In the present paper, a Gallstone Dissolution Ultrasound Device(GDUD) has been developed and its in vitro effectiveness was evaluated. Eighteen sets of four gallstones matched for weight and appearance were selected from 18 surgically resected gallbladders. One stone from each set was analyzed for its density pattern by computed tomography(CT), for cholesterol content by bio chemical technique and for section-structure by macroscopical observation. The three other stones were subjected to dissolution with MTBE, with one being examined by simultaneous sonification via GDUD, one with manual stirring and one serving as control without treatment. The results showed that: 1) Ultrasound could help to dissolve non-calcified gallstones, producing encouraging reduction dissolution time by 96%±2.32%. Difference(P<0.05) was found between ultrasound and manual infusion group and significant difference(P<0.0001) was revealed between ul trasound group and control; 2) Ultrasound could enhance the percentage reduction in calcified gallstone. A difference (P<0.05) were detected between ultrasound group and control and no difference(P<0.05) was found between ultrasound group and manual infusion. All the residuals were>3mm in size. These data indicate that ultrasound is a effective mean of accelerating non-calcified gallstone dissolution in MTBE and it could be a alternative techniques for the treatment of cholelithiases.

关 键 词：胆囊结石 甲基叔丁醚 超声助溶 灌注助溶 

分 类 号：R657.420.5[医药卫生—外科学]