研究：坐過山車能排出腎結(jié)石？

Just ask any one of the 300,000 Americans who develop kidney stones: What if the excruciating pain of passing one of those little devils could be prevented by strapping yourself into a make-believe runaway mine train, throwing your hands in the air and enduring G-forces as high as 2.5 for about three minutes? Would you do it?

從30萬患腎結(jié)石的美國人中去隨便找個患者問問：若乘坐一輛越礦飛車，飛車如逃離般飛馳而過時手在空中亂舞，還要承受高達2.5G的重力三分鐘，就能免去排出那些小個惡魔時的劇痛，你會去做嗎?

Hell yeah, they’d do it.

廢話，他們會的。

In a bit of medical research inspired by strange and remarkable patient accounts, a Michigan State University urologist reports that, yes, riding a medium-intensity roller coaster such as the Disney theme parks’ Big Thunder Mountain Railroad can result in the painless passing of small, and even a few large, kidney stones.

密歇根州立大學(xué)的泌尿?qū)＜易⒁獾搅艘恍┖币姴±?，受其啟發(fā)進行了醫(yī)學(xué)研究。他們得出報告說，是的，玩一趟中等刺激的過山車，比如迪士尼樂園的巨雷山過山車，能無痛排出小粒甚至是一些大顆腎結(jié)石。

For best results, ride in the back, where — roller coaster afficionados all seem to agree — the thrills are greatest. Independent of kidney stone volume and location, findings reported Sunday in the Journal of the American Osteopathic Assn. showed that sitting in the back of the roller coaster resulted in an average passage rate of 63.89%.

坐在過山車尾部效果最佳，過山車愛好者都知道坐在后面的座位是最刺激的。周日發(fā)表在《美國骨科協(xié)會雜志》上的調(diào)查報告表示，坐在過山車尾部平均排石率能達到63.89%。

Front-seat rides resulted in a far more modest passage rate of 16.67%.

而坐在頭部，排石率要低得多，只有16.67%。

In what magical kingdom, you may well ask, does someone think to conduct such research?

你完全可以問，得在什么魔法王國才做得出這種實驗?zāi)?

Dr. David D. Wartinger, a professor emeritus at Michigan State University’s College of Osteopathic Medicine, initiated the study after a series of patients reported something almost too strange to believe: In the wake of riding Big Thunder at Walt Disney World in Orlando, Fla., these patients said their kidney stones passed painlessly from the kidney through the narrow duct of the ureter and into the bladder. In one case, a patient told Wartinger that he passed one kidney stone after each of three consecutive rides on the roller coaster.

密歇根大學(xué)骨科醫(yī)學(xué)退休教授大衛(wèi)•沃汀格爾是研究發(fā)起者，之前有腎結(jié)石患者向他講述了樁樁難以置信的怪事：他們在佛羅里達州奧蘭多的迪士尼樂園玩了巨雷山過山車后，體內(nèi)的腎結(jié)石就毫無痛感地從腎臟經(jīng)由狹窄尿管排到了膀胱內(nèi)。有一個案例的病人告訴沃汀格爾，他連著坐了三次過山車，每次都有一顆結(jié)石排出。

Using a 3-D printed model of that patient’s kidney, Wartinger and his colleagues implanted three kidney stones of various sizes into the upper, middle or lower passageways of the clear silicone model. Two of those mineral clusters, which can form as the kidney filters waste from the bloodstream, were small-to-moderate size — 4.5 millmeters and 13.5 mm. Those might pass through the duct leading to the bladder without incident but could also cause considerable pain and discomfort as they passed unaided. But a third measured 64.6 mm, a size that would rarely pass without treatment — the administration of ultrasound shock waves, called lithotripsy, designed to break up the deposit and allow it to pass.

沃汀格爾和同事用3D打印機制造了這位患者腎臟的透明硅膠模型，并把三個大小不一的腎結(jié)石放入模型上中下的管道中。腎結(jié)石是腎臟在過濾血流垃圾時形成的礦物質(zhì)群。其中兩顆結(jié)石小的4.5mm，中等大小的13.5mm。這等大小的結(jié)石在經(jīng)由尿管向膀胱自然移動時，可以平安無事，但也能引起劇痛和不適感。第三顆結(jié)石64.6mm大，這種大小的結(jié)石只有借助超聲沖擊波治療，也即碎石術(shù)打碎結(jié)石，才能排出體外。

The researchers received permission from Walt Disney World first, then concealed the kidney model in a backpack and rode Big Thunder 20 times, varying their seat position between front and back.

實驗前，研究人員先征得了迪士尼樂園同意，然后把腎模型藏到背包中坐了20次巨雷山過山車，期間還變換位置，從頭部換到尾部。

After analyzing the location of those three kidney stones at the end of each ride, the researchers concluded that “findings support the anecdotal evidence that a ride on a moderate-intensity roller coaster could benefit some patients with small kidney stones,” Wartinger said. When the kidney stone was large, the initial position of the kidney stone affected the likelihood of its passing during the ride. But even those passed two in three times while the silicone model rode the thrill ride.

研究人員在每次坐完過山車后都會檢查三顆腎結(jié)石的位置，得出了如下結(jié)論。沃汀格爾說，“我們實驗所得驗證了病人所述情況，坐中等刺激的過山車可以幫助一些患者排出小塊結(jié)石。”大顆腎結(jié)石所處位置會影響坐過山車時結(jié)石排出的可能性，但排出結(jié)石時三次有兩次是在硅膠模型經(jīng)過刺激車程的時候。

“Many people in the United States probably live within a few hours’ drive of an amusement park containing a roller coaster with features capable of dislodging calyceal renal calculi,” wrote Wartinger and co-author Dr. Marc A. Mitchell of the Doctor’s Clinic in Poulsbo, Wash.

“很多美國人住在一家游樂園幾小時車程內(nèi)，這家游樂園有一輛過山車可以幫助人們排掉腎盞結(jié)石，”沃汀格爾和來自華盛頓州波爾斯波醫(yī)生診所的馬克•米切爾一同寫道。

Roller coaster therapy might be a good preventive treatment for people who are high risk of developing obstructive kidney stones, wrote Wartinger and Mitchell. They suggested that patients who have had kidney stones in the past, or women who have had kidney stones and are thinking of becoming pregnant, consider a thrill ride or two in a bid to clear tiny stones before the deposits grow larger. Kidney stone sufferers who have had their deposits broken up by lithotripsy might also consider a roller-coaster ride to finish the job, they said.

過山車療法對梗阻性腎結(jié)石易患人群可能是個很好的預(yù)防療法，沃汀格爾和米切爾在報告中說。他們建議過去長過腎結(jié)石的患者和有腎結(jié)石、正在準備開始妊娠的女性，考慮放開膽子坐一兩次過山車來把微小結(jié)石清出，以防長得更大。他們還說，已接受過碎石術(shù)治療的腎結(jié)石患者也可以考慮坐過山車，以把結(jié)石徹底排出體外。