体外冲击波对兔输尿管形态及组织学影响的研究

The effect of extracorporeal shock wave on the morphology of rabbit ureter

目的 :探讨冲击波 (SW )对输尿管形态的影响。方法 :将 4 2只成年兔随机分为 7组 ,每组 6只。第 1组为正常对照组 ;第 2～ 6组为液电式SW组 ;第 7组为电磁式SW组。各组接受冲击并在冲击后不同时间取材。全部标本行常规病理检查并予评分。结果 :第 2～ 5组和第 7组 ,肉眼可见焦点周围组织有出血、水肿等改变 ,输尿管直径较冲击前显著增加 (P <0 .0 1 )。光镜下可见平滑肌细胞变性及管腔狭窄 ,病理量化评分显著高于正常组 (P <0 .0 5 ) ;电镜下则有肌细胞线粒体破坏等改变。第 6组形态改变不明显 ,病理评分和正常组的区别无显著性意义。结论 :临床剂量的冲击波能导致输尿管多种病理变化。冲击后第 5天 ,输尿管形态已基本恢复正常。

Purpose:To investigate the effect of shock wave on the morphology of rabbit ureter.Methods:A total of 42 mature rabbits were randomly divided into seven groups, each of which contains 6 ones. Group 1 acted as control and the rest as treatment groups. Group 2 to group 6 were treated with electrohydraulic shock wave and group 7 with electromagnetic shock wave. Each group received different amounts of shock energy and their ureteral segments were taken out at different time after the treatment. All samples were examined pathologically and graded under light microscopy.Results:In groups 2, 3, 4, 5 and 7, hemorrhage and edema were seen on the ureter, muscle and periureteric soft tissue adjacent to the focus (F 2). Ureters exposed to shock wave were swollen and their diameters were significantly increased after shock wave treatment (P< 0.01 ). Cellular degeneration or luminal stricture of ureters were found on light microscopy. The pathological scores of the above groups were statistically significantly higher than that of the control group (P< 0.05 ). Under the electron microscopy, smooth muscle cells had mitochondrial destructive alterations. In group 6, these changes almost did not exist. There was no statistical difference between the scores of group 6 and 1.Conclusions:Clinical doses of shock waves could result in injury to some extent in the ureter and periureteric space. After the application, ureteral morphology would recover within 5 days in the main. There was no significant difference between the acute ureteral morphological abnormality induced by electrohydraulic and electromagnetic shock waves.