CN111790050A

CN111790050A - Medical catheter structure for external bridging and application thereof

Info

Publication number: CN111790050A
Application number: CN202010696547.5A
Authority: CN
Inventors: 吴向阳
Original assignee: Individual
Current assignee: Individual
Priority date: 2020-07-20
Filing date: 2020-07-20
Publication date: 2020-10-20

Abstract

The invention belongs to the field of medical equipment, and relates to an in-vitro bridging medical catheter structure and application. The invention relates to an in vitro bridging medical catheter structure which mainly comprises a soft thick sleeve, a blood flow control device, two connecting ports, a blood flow detector and a pipeline. Meanwhile, the blood flow in the bridging tube can be gradually reduced until the bridging tube is removed along with the gradual compensation of the collateral blood vessels around the embolized blood vessel. After the invention is applied to treatment, intravascular embolectomy is not needed, and the invention has simple use method and can be widely applied to the medical field.

Description

Medical catheter structure for external bridging and application thereof

Technical Field

The invention belongs to the field of medical equipment, and relates to an in-vitro bridging medical catheter structure and application thereof.

Background

Causes of arterial vessel embolism

People with hypertension, hyperlipidemia, high (blood) viscosity, high craving for tobacco, coronary heart disease, especially those with myocardial and atrial fibrillation, atherosclerosis, and abdominal aortic aneurysm are highly motivated people. Many reports suggest that the most common cause of peripheral arterial embolization is cardiogenic: emboli are 94% from cardiac patients, 77% of whom are accompanied by atrial fibrillation; coronary heart disease including myocardial infarction, atrial fibrillation, congestive heart failure and ventricular aneurysms account for about 60%; rheumatic heart disease accounts for 20%; rheumatic heart disease and coronary heart disease, both of which have thrombosis in the left heart, are mainly the middle aged and the elderly.

Arterial spontaneous thrombus is mostly formed on the basis of atherosclerosis, and because of high blood flow velocity in the artery, sufficient thrombin cannot be accumulated locally even if the blood coagulation process is activated, and platelets can be adhered and aggregated only when atherosclerotic plaques are broken and endothelial cells are damaged, so that lumen stenosis is caused, thrombin with effective concentration is accumulated locally, and fibrinogen is converted into fibrin by the thrombin to form thrombus. In summary, the direct cause of arterial embolization can be several: such as thrombus falling from atrium of atrial fibrillation patient, tumor thrombus falling from left atrial myxoma patient, lipid and/or calcified plaque falling from aorta intima, thrombus formed spontaneously in artery, vessel lumen blockage by inner membrane torn from aortic dissection and the like.

Classification of arterial vascular embolisms and current treatment methods

The embolism position can be divided into visceral artery embolism and peripheral artery embolism, and the peripheral artery embolism can be divided into peripheral aorta embolism and peripheral arteriole embolism.

As for the treatment means, the visceral artery embolism is mainly the medication, the intervention, and the surgical operation. For peripheral arteriole embolism, the peripheral arteriole embolism can be relieved after being treated by medicaments mostly without surgical treatment. For peripheral aortic embolism, the peripheral aortic embolism is better to the femoral artery and the adjacent aortic blood vessels, and the disease course can be divided into acute occlusion and chronic occlusion: the chronic obliterator has slow illness, the collateral vascular network adjacent to the embolized blood vessel is gradually increased to compensate, and the patient does not need to amputate and generally does not threaten the life of the patient. The distal blood flow of the blood vessel of the criminal of the acute obliterator is suddenly lost, the tissue is acutely ischemic and anoxic, a large amount of inflammatory mediums such as cytokine and the like are released, the cells are disintegrated, the tissue is necrotic, the disease condition is rapidly progressed, and the treatment method comprises drug treatment, interventional embolectomy, amputation and the like.

The problem of the existing treatment method for acute limb arterial vascular embolism

Acute arterial vascular embolism can occur due to different treatment methods and has the following three types of sequelae: when the part of the patient is not in time to open blood flow, serious ischemia and anoxia of the distal limb of the embolus occur, tissue necrosis occurs in the serious patient, and amputation is inevitable; some patients successfully complete the endovascular embolectomy, a large amount of blood is suddenly supplied, metabolic wastes accumulated on the lower limbs are quickly diluted to the whole body, a large amount of inflammatory factors are activated and released, an inflammation storm occurs, the patients suffer from the damage of important organs such as lung, kidney, liver, brain, heart and the like, meanwhile, after the far ends of the limbs obtain the blood supply again, tissues are swollen, the syndrome of the fascia bone compartment can occur, the treatment difficulty is high, the cost is high, and serious patients, particularly old patients, are easy to die; some patients who do not take amputation and do not have endovascular embolectomy have limb necrosis and serious infection in the later period, and finally die from septicemia.

Significance of the invention in the field of acute limb arterial vascular embolism

The invention economically and conveniently achieves the aim of rapidly recovering the blood circulation of the tissue with the far-end acute ischemia by an in-vitro bridging mode. Meanwhile, the blood flow in the bridging tube can be monitored and controlled, the most suitable blood flow of tissues at the far end of the embolized blood vessel can be maintained, and the aims of not only preventing ischemic tissues from necrosis, but also controllably releasing systemic inflammatory factors and necrotic tissues are achieved. The collateral vessel network of the embolization vessel gradually increases along with the time, the self compensation is realized, the blood flow in the bridging tube can be gradually reduced until the bridging tube is removed, and the aims of protecting the limbs and the life are finally realized. After the application of the invention for treatment, an intravascular embolectomy is not needed, and serious and even fatal threats to the whole body caused by uncontrollable release of inflammatory factors and a large amount of necrotic tissues after the embolectomy are avoided, so that the aim of safe, simple and effective treatment of arterial embolism is fulfilled.

Disclosure of Invention

In view of the above defects, the present invention provides an extracorporeal bridging medical catheter structure, which solves the problems of maintaining blood circulation to the tissue with far-end ischemia, maintaining the muscular tissue under thrombus without necrosis, enabling the blood flow to be monitored and controlled, and effectively preventing the serious complications after the existing embolectomy from occurring too much. In the later stage, the compensation is gradually realized by means of the blood vessels around the embolized blood vessels, the harmony and the harmony of the arterial thrombus and the human body are achieved, the limb protection and the life protection are realized, the operation is simplified, and the hospitalization cost is reduced, so that a new scheme for treating the arterial thrombus is realized.

In order to achieve the above purpose of the invention, the following technical scheme is adopted:

the invention provides an extracorporeal bridging medical catheter, which mainly comprises a soft thick sleeve I (1), a soft thick sleeve (8), a connecting port (3) and a pipeline (7), wherein the soft thick sleeve (1), the soft thick sleeve (8) and the pipeline (7) are connected through the connecting port (3).

Before being placed into a blood vessel, the puncture resistant sleeve bag comprises a puncture needle, a thin sleeve, a guide steel wire, an expander and a soft thick sleeve.

The inner walls of the soft thick sleeve and the pipeline are coated with an anticoagulant coating. Further, the anticoagulant coating is a heparin coating or a hirudin coating, and is preferably a heparin coating.

A blood flow control device can be additionally arranged on the pipeline (7). The external pressure type extrusion device adjusts the local diameter of the soft pipeline through a blood flow regulating valve, and the blood flow control device comprises a fixing device (2), a blood flow regulating valve (6) and a blood flow regulating head (11); further, the blood flow control device is of a tube wall external pressure type and is not in direct contact with the inner surface of the tube wall and blood therein.

Furthermore, the inner walls of the tube walls of the soft

thick sleeves

1 and 8 and the pipeline 7 are coated with an anticoagulant coating, wherein the anticoagulant coating is a heparin coating or a hirudin coating, and preferably a heparin coating.

Furthermore, the inner diameter of the pipeline 7 is 1-8 mm, and the length of the pipeline is 30-250 cm.

The pipeline 7 is provided with a blood flow control device 2, and the control valve is a three-way valve, a throttle valve and a speed regulating valve.

The blood flow detection meter (5) can be additionally arranged on the pipeline (7) and is connected with the pipeline (7) through the blood flow detection head (9) and the lead (4), the blood flow detection head (9) is in a clamping type with the pipe wall (7) and is not in direct contact with the inner surface of the pipe wall and blood in the pipe wall, and the blood flow detection meter can be removed from the pipeline (7) after the flow measurement is finished.

The soft thick sleeve 1 enters the artery of the human body through the puncture needle 3.

The puncture needle 3 is 0.3-4 mm in diameter and 3-10 cm in length.

The second purpose of the invention is to provide a using method of the external bridging medical catheter, which comprises the following steps:

(1) soaking medical instruments such as catheters, guide wires, sheath tubes and the like in heparin sodium saline; and pre-flushing the catheter, the puncture needle and the guide wire by using heparin sodium saline;

(2) taking the puncture point of the superior radial artery as the center, performing spiral disinfection, and tying a tourniquet above the puncture point;

(3) arterial puncture: the needle with the sleeve punctures an artery at 30 degrees, after blood return is observed, the needle is pressed down to 15 degrees, the puncture needle is drawn out after the blood is sent into the artery by 3-5 mm, the guide wire is placed in the sleeve, the sleeve is withdrawn, the skin is expanded to a blood vessel cavity by the dilator through the guide wire, the dilator is withdrawn, the thick sleeve is placed in the guide wire, the guide wire is withdrawn, and the tail end of the sleeve is connected with a pipeline 7. The blocking forceps temporarily block the pipeline to prevent bleeding, the operation is repeated at the position where the far end of the lower limb artery thrombus is easy to puncture, such as the dorsalis pedis artery, the puncture of 8 is completed, the other end of the pipeline is connected with 8 after exhausting, the temporary blocking forceps are withdrawn, and the equipment starts to work.

(5) The pipeline 7 can be clamped into the blood flow monitoring discussion head, the blood flow in the pipeline can be detected through a lead and an external device (ultrasonic detection principle), and the detection devices can be withdrawn after the measurement is finished, so that the carrying and the activity of a patient are facilitated. The flow regulator is of an external pressure type and can be arranged outside the pipeline 7, and the cross-sectional area of the pipeline is adjusted through the bolt, so that the blood flow in the pipeline is adjusted. And after the flow is adjusted to a satisfactory flow, locking the bolt lock to finish one-time flow adjustment. When the flow needs to be adjusted next time, the flow lock is opened again, and the adjustment is performed again according to the data monitored by the flow meter and the clinical requirement.

The third purpose of the invention is the use of the in vitro bridging medical catheter in the invention for preparing a medical device for treating acute peripheral vascular arterial embolism or venous thrombosis.

The invention has scientific design, unique structure, convenient operation, easy implementation and obvious generated technical effect, and compared with the prior medical catheter equipment, the invention has the following substantive characteristics and progresses:

the invention can effectively ensure the blood supply of tissues behind the thrombus blockage part, is equivalent to that the extracorporeal collateral circulation connects the upper limb artery with the lower limb artery, and actually connects the far end and the near end of the embolism artery through an extracorporeal connecting pipeline. In order to facilitate the control of the blood flow, a control valve is arranged in the pipeline, and the flow meter realizes more accurate control, so that the amputation can be avoided, and the metabolic wastes and inflammatory factors can be orderly released, which is different from the traditional embolectomy, after the embolectomy, the blood flow cannot be detected or controlled, the periosteum syndrome is easy to occur, and a large amount of inflammatory factors and necrotic substances are easy to release suddenly, so that serious systemic damage is caused, and even death is caused. The indwelling needle is adopted to ensure that a patient can use several days for one-time needle insertion, the needle insertion part is not easy to infect, and the device can be removed after sufficient collateral blood vessel compensation appears around the embolism blood vessel. The invention has the advantages of good equipment safety, high reliability, convenient installation and good clinical application prospect.

Drawings

FIG. 1: structure schematic diagram of in-vitro bridging medical catheter

FIG. 2 is a drawing: puncture needle

FIG. 3: guide wire

FIG. 4 is a drawing: soft thick sleeve

Portion of an access artery

FIG. 5: dilating sheath

The scores in the figures are as follows: 1-soft thick sleeve I; 2-a fixing device; 3-a connection port; 4-a wire; 5-blood flow detector; 6-blood flow regulating valve; 7-a pipeline; 8-soft thick sleeve II; 9-blood flow volume detection head; 10-dilating the sheath; 11-a blood flow regulating head;

Detailed Description

The following examples further illustrate the benefits of the present invention, and the examples are for illustrative purposes only and do not limit the scope of the present invention, and variations and modifications apparent to those of ordinary skill in the art in light of the present disclosure are intended to be included within the scope of the present invention.

Example 1: in-vitro bridging medical catheter and use method thereof

A patient is 75 years old, and is admitted into the hospital after the right lower limb is cool and pale for 20 hours, the pale skin, the cool skin and the vascular collapse below the thigh of the lower limb are examined, the thrombosis of the femoral artery and the external iliac artery at the end of the vein is shown by ultrasound, the lumen is blocked, the blood flow at the far end is very little, and the venous system of the lower limb is not abnormal. The prior art has the history of cerebral hemorrhage, chronic obstructive pulmonary disease, hypertension and diabetes. If thrombolysis is selected in treatment, the risk of hemorrhage of important organs, especially cerebral hemorrhage, is extremely high, and if the hemorrhage occurs, the disease can cause disability or be bedridden for a long time, and finally the disease can die from lung infection; if the femoral artery embolectomy is carried out, a large amount of periosteum syndrome and inflammatory factors are activated and released quickly after the operation, so that important organs such as lung, kidney and liver insufficiency are caused, and finally death is caused due to multi-organ insufficiency; the other option is the high amputation of the right lower limb, but the patient and family members can not receive the treatment mode causing disability; without any of the above active treatments, the patient's lower limbs would experience necrosis and eventually death from systemic infection. If the invention is applied, the curative effects of amputation prevention, life saving, simple treatment method, low cost and small wound can be achieved.

An extracorporeal bridging medical catheter comprising: 1-soft thick sleeve I; 2-a fixing device; 3-a connection port; 4-a wire; 5-blood flow detector; 6-blood flow regulating valve; 7-a pipeline; 8-soft thick sleeve II; 9-blood flow volume detection head; 10-dilating the sheath; 11-a blood flow regulating head;

firstly, the wrist of the patient is lifted up to keep the wrist joint in a hyperextension state. Before puncture, a proper amount of anesthetic is injected subcutaneously, and the index finger, the middle finger and the ring finger of the left hand of a puncture person are lightly placed at the most powerful position of the radial artery of a patient from far to near from the puncture position in sequence to indicate the running direction of the radial artery of the patient. The position pointed by the forefinger is the 'target point' of puncture, the line pointed by the three fingers is the direction of needle insertion, the angle of needle insertion is generally 30-45 degrees, if the tail part of the needle flows out, the needle can be pressed down by about 15 degrees, then the soft thin cannula is sent forward to be completely inserted into the blood vessel, the rigid needle core is slowly removed, the soft cannula is reserved, the tail part of the cannula is visible to spray blood, and the soft guide wire is sent in. During the above operation, if blood returning from the tail part of the needle is not seen after the needle is inserted, the puncture needle is not required to be retracted urgently, the position relation between the puncture needle and the radial artery at the moment can be judged by using the index finger of the left hand, the puncture needle is retracted to the subcutaneous part, the needle is inserted again after the needle tip direction is adjusted, and if the blood spraying from the tail end of the puncture needle is good, the rest operation is completed, and the soft guide wire is placed. The needle handle can be fixed by the index finger and the thumb of the left hand to ensure that the puncture needle is immovable, the guide wire can be fed by the right hand, the action is gentle, once resistance is met, the guide wire is immediately stopped being fed, and after the guide wire can be partially withdrawn, the guide wire is fed to a proper position after the angle of the puncture needle is changed or the advancing direction of the guide wire is adjusted by rotating the puncture needle. Slightly enlarging the skin puncture point by using a steel needle tip or a small sharp knife, placing an expansion element into the blood vessel along the guide wire to reduce the resistance when the thick sheath tube is fed, withdrawing the expansion element, feeding the thick sheath tube into the blood vessel along the guide wire, withdrawing the guide wire, connecting the tail end of the thick sheath tube with a soft connecting pipe through a connecting port 3, and temporarily blocking the soft catheter for later use by using a flow control valve. The thick sleeve 8 enters the distal end of the occlusion artery (usually selected from dorsalis pedis artery or popliteal artery) in the same way, and is connected with the thick sleeve 8 and a soft outer pipeline, so that the gas in the pipeline and the puncture needle needs to be removed, and the pipeline is opened and temporarily blocked, so that the application connection of the pipeline to the human body is completed. The mode of connecting the two arteries ensures blood supply of tissues behind the thrombus blockage part, namely, the collateral circulation in vitro connects the hand artery with the foot artery, in order to prevent blood from coagulating in an extracorporeal pipeline, the pipeline is a plastic pipe adopting an anticoagulant coating (such as a heparin coating), a patient uses anticoagulant drugs such as heparin and the like for the whole body, and blood is intermittently drawn to detect the anticoagulant strength such as APTT and the like so as to guide the dosage of the anticoagulant drugs. In addition, in order to control the blood flow, the pipe is provided with a control valve which is an external pressure type extrusion device, and the local diameter of the soft pipe is adjusted through the blood flow regulating valve, thereby achieving the purpose of controlling the blood flow in the soft pipe. To allow the flow of blood in the tubing to be measured, the flexible tubing can be snapped into a flow probe and the flow of blood in the tubing measured by ultrasound techniques and equipment. The application of the device can rapidly open blood circulation for the limb with far-end ischemia step by step to prevent amputation, and simultaneously, because the blood flow in the bridging tube can be measured and controlled, inflammatory factors and necrotic substances of the limb with ischemia can be slowly released to the whole body, so that acute damage to other important organs of the whole body caused by rapid and large-scale release is avoided, and the purpose of life preservation is achieved. After 1 week of treatment, the patient can be in better state, the connecting pipeline can be adhered to the upper limbs, the trunk and the lower limbs by the adhesive tapes, the patient gown can be worn after the patient gown is properly fixed, the daily life of the patient is not affected by the device, the patient can move on the ground, after half a month, the blood flow in the device can be gradually reduced along with the gradual establishment of the circulation of the lateral branches of the patient, until the patient can be completely removed, the puncture needle is removed, and the patient is wrapped by the bandage gauze pad after partial compression for half an hour. The patient gradually recovers and is discharged from the hospital.

The embodiments described herein are merely illustrative of the spirit of the invention. Various modifications or additions may be made to the described embodiments or alternatives may be employed by those skilled in the art without departing from the spirit or ambit of the invention as defined in the appended claims.

Claims

1. An in vitro bridging medical catheter is characterized by comprising a soft thick sleeve I (1), a soft thick sleeve II (8), a connecting port (3) and a pipeline (7), wherein the soft thick sleeve (1) and the soft thick sleeve (8) are connected with the pipeline (7) through the connecting port (3).

2. Catheter according to claim 1, characterized in that the inner walls of said soft thick sleeve and tubing are coated with an anticoagulant coating.

3. Catheter according to claim 2, wherein the anticoagulant coating is any one of a heparin coating, a hirudin coating, preferably a heparin coating.

4. The conduit according to claim 1, wherein the inner diameter of the conduit (7) is 1-8 mm, and the length thereof is 30-250 cm.

5. Catheter according to claim 1, wherein said line (7) is externally provided with a blood flow control means, further preferably a pressure squeezing means.

6. The catheter as claimed in claim 1, characterized in that the line (7) is externally provided with a blood flow meter (5) which is connected with the line (7) through a blood flow measuring head (9) and a lead (4), the blood flow measuring head (9) is in a snap-in type of the tube wall (7) and is not in direct contact with the inner surface of the tube wall and blood therein, and the blood flow measuring head can be removed from the line (7) after completing the flow measurement.

7. The catheter as claimed in claim 1, characterized in that the line (7) is externally provided with a blood flow meter (5) which is connected with the line (7) through a blood flow measuring head (9) and a lead (4), the blood flow measuring head (9) is in a snap-in type of the tube wall (7) and is not in direct contact with the inner surface of the tube wall and blood therein, and the blood flow measuring head can be removed from the line (7) after completing the flow measurement.

8. The catheter according to claim 1, characterized in that the puncture needle is contained in the soft thick sleeve (1).

9. The catheter of claim 8, wherein said needle has a diameter of 0.3 to 4mm and a length of 3 to 10 cm.

10. Use of a catheter comprising any one of claims 1-9 in the manufacture of a medical device for the treatment of arterial or venous thrombosis.