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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 medical shock wave will induce adverse biological effects on the pancreas. Methods: 192 cases of upper ureteral calculi were collected. The blood and urine amylases were detected routinely by ESWL in the abdominal wall and 1 day (20 ~ 30 hours) after surgery. The pancreas and surrounding organs were examined by B ultrasound. Postoperative abdominal pain and blood, urine amylase increased CT examination, and positive symptomatic supportive treatment; 1 week, 3 weeks, 3 months, 1 year review KUB, abdominal B and / or CT and serum starch Enzymes. Results: Sixty-one patients with upper ureteral calculi ESWL had upper abdominal pain and blood and urinary amylase in one day. Two cases of B-ultrasonography suggested acute pancreatitis (edematous type), CT showed three cases of acute pancreatic Inflammation may be, the above 6 cases given symptomatic symptomatic supportive treatment disappeared, 1 week, 3 weeks abdomen B ultrasound and CT showed no abnormal pancreatic abnormalities, serum amylase, urinary amylase gradually returned to normal range, 168 cases were followed up 3 Month, 1 year, abdomen B ultrasound, KUB and (or) CT were no pancreatic and peripheral organs abnormalities, serum amylase, urinary amylase are in the normal range. Conclusion: The treatment of upper ureteral calculi by ESWL is safe and effective, without serious complications, which can be used as an important supplementary means of ESWL.