冲击波技术在医学领域的应用

APPLICATIONS OF SHOCK WAVE TO MEDICAL THERAPY

冲击波研究长期以来用于解决超音速飞行、宇宙飞船重返大气层等相关的高速气体动力学问题.近30年来,冲击波技术成功地应用于医学领域.本文从阐述体外冲击波碎石机的工作原理开始,对体外冲击波碎除肾结石和尿道结石的作用机制(如应力作用、空化效应)进行评述;在此基础上,重点介绍了冲击波治疗骨不连、假关节、肩周炎、网球肘及其他骨科疾病的临床疗效.通过认识气泡崩裂产生的微型水喷射的特点,综述了水中微爆炸、激光聚焦产生的微型水喷射和微型冲击波进行血运重建的理论和方法;通过认识基于冲击波的DNA/药物的定向转运技术,综述了液态DNA转运、粉末状药物转运、分子转移入胞的实验装置和实验结果.此外,还介绍了冲击波在兽医学中用于治疗马、犬等动物的跟腱、韧带和骨的损伤的疗效.最后,展望了今后值得研究的几个领域:冲击波的新波源、冲击波治疗的新设备、冲击波技术在脑血栓血运重建和癌症治疗中的应用.

Shock wave researches were traditionally developed as an element of high-speed gas dynamics supporting supersonic flights and atmospheric reentry of space vehicles.However,in the past thirty years shock waves have been successfully applied to medical therapy.This paper discusses firstly the operation principles of extracorporeal shock wave lithotripsy（ESWL） and its mechanisms（i.e.stress mechanism,and cavilation mechanism） of noninvasion removal of kidney and urthral stones.Then the effectiveness of ESWL treatment to nonunion bone fracture,false joint,tennis elbow etc.in orthopedic surgery are reviewed.The theories and methods of formation of microexplosion-and laser-induced microwater jets are briefly discussed with special attention paid on their applications to cerebral thrombosis revascularization.Relevant experimental setups are also enumerated for introducing DNA/drug and high-speed particles into cells and related results summarized.Besides,the idea underlying the application of shock wave to treat tendons,ligaments and bones on horses or dogs in veterinary medicine is presented.This review proposes finally the key research fields to be further explored,such as the new generation technology of medical shock wave,novel devices for shock wave therapy,and medical applications of shock wave to the cerebral embolism revascularization and gene therapy.