肾结石的超声波推进技术

Ultrasonic propulsion of kidney stones

超声推进是一种新型的技术,它利用短时间的聚焦超声脉冲在肾脏收集系统和输尿管上重新定位结石。本综述的目的是探讨效能与安全性的初步测试、技术的改进方向及临床应用的观点。临床前的研究已经证明了超声推进的可行性和一致性,并为特定的应用程序提供了更多的输出和改进。初步的可行性研究显示了其在临床方面的适用性,包括促进输尿管镜下残留碎片的通道,或冲击波碎石术,在肾盂输尿管连接部移动大结石从而减轻痛苦,把大结石与一堆小碎片区别开来。作为一种基于办公室内系统,超声推进显示了其良好的前景,可以将肾结石重新定位。潜在的应用包括:在输尿管镜检查或冲击波碎石后促进清除残留碎片,在治疗前重新定位结石,并重新定位从肾盂输尿管连接部进入肾脏的结石,以减轻急性肾绞痛。

Ultrasonic propulsion is a novel technique that uses short bursts of focused ultrasonic pulses to reposition stones transcutaneously within the renal collecting system and ureter. The purpose of this review is to discuss the initial testing of effectiveness and safety,directions for refinement of technology,and opinions on clinical application. Preclinical studies have demonstrated feasibility and consistent safety of ultrasonic propulsion with room for increased outputs and refinement toward specific applications. The initial feasibility study showed the applicability,including facilitating passage of residual fragments following ureteroscopy or shock wave lithotripsy,moving a large stone at the UPJ with relief of pain,and differentiating large stones from a collection of small fragments. Ultrasonic propulsion shows promise as an office-based system for transcutaneously repositioning kidney stones. Potential applications include facilitating expulsion of residual fragments following ureteroscopy or shock wave lithotripsy,repositioning stones prior to treatment,and repositioning obstructing UPJ stones into the kidney to alleviate acute renal colic.