经腹壁ESWL治疗输尿管上段结石对胰腺的生物学效应  

The Biological Effect on the Pancreas in Upper Ureteral Calculi Treated by ESWL ThroughAbdominal Wall

作　　者：林友岳[1] 王玉珠[1] 蔡邦联[1] 陈嗣平[1] 

机构地区：[1]温州医学院附属第三医院碎石中心,浙江瑞安325200

出　　处：《临床泌尿外科杂志》2010年第2期123-125,共3页Journal of Clinical Urology

摘　　要：目的:探讨医用冲击波会否对胰腺诱发不良的生物学效应。方法:收集输尿管上段结石192例,经腹壁ESWL,术后1天(20～30 h)常规检测血、尿淀粉酶,采用B超检查胰腺及周围脏器。对术后腹痛且血、尿淀粉酶增高者加以CT检查,并积极对症支持治疗;术后1周、3周、3个月、1年复查KUB、腹部B超和(或)CT及血清淀粉酶。结果:192例输尿管上段结石ESWL后1天6例出现上腹部疼痛并有血、尿淀粉酶增高,B超有2例提示为急性胰腺炎(水肿型)可能,CT有3例提示为急性胰腺炎可能,上述6例给予积极对症支持治疗后症状消失,1周、3周腹部B超和CT均未见胰腺异常影像,血清淀粉酶、尿淀粉酶逐渐恢复到正常范围,168例随访3个月、1年,腹部B超、KUB和(或)CT均未见胰腺及周围脏器异常,血清淀粉酶、尿淀粉酶均在正常范围。结论:经腹壁ESWL治疗输尿管上段结石安全有效,无严重并发症,可作为ESWL重要的补充手段之一。Objective：To investigate whether the medical wave induced adverse biological effects on the pancre as. Methods：192 cases of upper ureteral calculi with ESWL through abdominal wall, postoperative day （20 30 hours） we carried out routine examination of blood amylase and urine amylase, using B-ultrasound for checking pancreas and the surrounding organs, the postoperative having abdominal pain , blood and urine amylase to be increased had to be added CT examination, and had to he required to actively support the treatment of symptomatic; after one week, three weeks ,three months and one year reviewed KUB, abdominal B-ultrasound and / or CT and serum amylase. Results： 192 cases of upper ureteral calculi after ESWL, in the day, there were 6 cases had upper abdominal pain and serum amylase and urine amylase increased, there are 2 cases of B-mode ultrasound showed the possibility of acute pancreatitis （edema）, there are 3 cases of CT examinations showed the possibility of acute pan creatitis. The above-mentioned six cases were given active support treatment, and then the symptoms disappear. In one week, three weeks, the abdominal B-ultrasonography and CT examination showed no abnormal pancreatic imaging, and the serum amylase, urine amylase gradually returned to normal range. The remaining 168 patients were followed up for three months, one year, their abdominal B-mode ultrasound, KUB and/or CT showed the pancreas and surrounding organs no abnormal, serum amylase, urine amylase were within normal range. Conclu- sions：Extracorporeal shock wave lithotripsy through the abdominal wall on upper ureteral calculi was safe and effective, with no serious complications, it could be used as an important complementary means.

关 键 词：经腹壁ESWL 胰腺 生物学效应 

分 类 号：R693[医药卫生—泌尿科学]