JP6326995B2 - Blood flow regulator - Google Patents

Description

  The present invention relates to a blood flow adjustment device that adjusts the blood flow of a blood vessel.

  Hemodialysis is known as a treatment for renal failure. In hemodialysis, waste and water that should be removed from the blood by the kidney are removed by passing the blood through an artificial kidney having a hollow fiber and filtering it. In order to supply a sufficient amount of blood from the patient undergoing hemodialysis to the artificial kidney, an inner shunt in which an artery and a vein are anastomosed is formed in the patient's arm or the like. Since blood flows from the artery to the vein by the inner shunt, the amount of blood in the vein through which the injection needle is punctured increases. On the other hand, blood flow to the peripheral side in the artery decreases, necrosis due to malnutrition occurs on the peripheral side, and the burden on the heart increases.

  In order to solve the above-described problem, a blood flow control device is known in which a pair of clamping members that sandwich an inner shunt is provided, and the clamping member is adjusted by a lock mechanism that includes a claw and a recess (patent) Reference 1).

JP-A-11-76248

  However, the blood flow control device described above needs to operate the lock mechanism embedded in the body with the skin or the like interposed from outside the body, so that the operability is poor, and the state of the lock mechanism, that is, the inner shunt There is a problem that it is difficult to determine whether the folder is closed or open.

  The present invention has been made in view of the above-described circumstances, and an object of the present invention is to provide means capable of easily opening and closing an internal shunt embedded in the body.

  (1) A blood flow control device according to the present invention is arranged so that a blood vessel can be sandwiched between a first member having a magnetic body and the first member, and a second member having a magnet, and the magnetic A guide member that supports a body and the magnet so as to be movable in a direction in which the first member or the second member contacts or separates from the other of the first member or the second member. It has.

  The blood flow control device is embedded in the body, and the other of the first member and the second member or the guide member is fixed to subcutaneous fat tissue or the like in the body. One of the first member or the second member moves to the first position or the second position by the magnetic force from the other of the first member or the second member or from the outside. Since the other of the first member or the second member or the guide member is fixed to the subcutaneous fat tissue or the like, only one of the first member or the second member moves by the external magnetic force when an external magnetic force acts. To do. When the external magnetic force is not acting, one of the first member or the second member is occluded by sandwiching the blood vessel at a position closest to the other of the first member or the second member (first position). When an external magnetic force stronger than the magnet of the second member acts, one of the first member or the second member circulates blood through the blood vessel at a position away from the other of the first member or the second member (second position). Open as much as possible. Thereby, a blood vessel can be opened and closed using magnetic force from the outside.

  (2) Preferably, the guide member includes a first position where the first member and the second member abut or approach each other, a second position where the first member and the second member are separated from each other, The first member and the second member are movably supported, and have a stopper that restricts the first member and the second member from being further away from the second position.

  Even if a magnetic force acts from the outside, one of the first member or the second member that is moved by the stopper does not move away from the other of the first member or the second member than the second position.

  (3) Preferably, the guide member extends from one of the first member and the second member, and is inserted into a hole formed in the other of the first member or the second member. It has a bar.

  (4) Preferably, the blood flow control device is configured such that the magnetic body is attracted by the magnet and exerts a larger magnetic force than the magnet on the first member and the second member at the first position. And a magnetic member for moving one of the first member and the second member at the first position to the second position.

  (5) Preferably, the magnetic member has an electromagnet.

  According to the blood flow control device according to the present invention, a blood vessel embedded in a body can be opened and closed by an external magnetic force.

FIG. 1 is a perspective view schematically showing an arm 91 of a patient. FIG. 2 is a perspective view schematically showing the mounting member 20 and the inner shunt 90. FIG. 3 is a cross-sectional view showing a state where the second member 22 is in the first position in the blood flow rate adjusting device 10 in which the first member 21 is stitched. FIG. 4 is a cross-sectional view showing a state where the second member 22 is in the second position in the blood flow rate adjusting device 10 in which the first member 21 is stitched. FIG. 5 is a cross-sectional view showing a state in which the second member 22 is in the first position in the blood flow rate adjusting device 10 in which the guide member 23 is sewn. FIG. 6 is a cross-sectional view showing a state when the second member 22 is in the second position in the blood flow rate adjusting device 10 in which the guide member 23 is sewn. FIG. 7 is a cross-sectional view illustrating a state when the second member 22 is in the first position in the blood flow rate adjusting device 10 according to the modification. FIG. 8 is a cross-sectional view showing a state when the second member 22 is in the second position in the blood flow rate adjusting device 10 according to the modification.

  Hereinafter, preferred embodiments of the present invention will be described. In addition, this embodiment is only one embodiment of this invention, and it cannot be overemphasized that an embodiment can be changed in the range which does not change the summary of this invention.

[Blood flow control device 10]
The blood flow control device 10 according to the present embodiment includes a mounting member 20 shown in FIG. 2 and a magnetic member 50 shown in FIG. The mounting member 20 is mounted on an inner shunt 90 (see FIGS. 1 and 2), which is a blood vessel created by anastomosing the artery 92 and the vein 93 in the patient's arm 91 or the like. The magnetic member 50 is a member that acts on the mounting member 20 by being disposed outside the patient's body and at a position close to the mounting member 20 mounted in the body.

[Mounting member 20]
As shown in FIG. 2, the mounting member 20 includes a first member 21, a second member 22, and a guide member 23.

  As shown in FIGS. 2 and 3, the first member 21 includes a cover body 24 having an internal space and a magnetic body 25 disposed in the internal space of the cover body 24. The cover body 24 has a thin plate shape. The material of the cover body 24 is a material suitable for medical use such as silicon resin. The material of the magnetic body 25 is a metal such as iron. The periphery of the magnetic body 25 is completely covered by the cover body 24. For this reason, the magnetic body 25 does not come into contact with the surrounding tissue at the position where the mounting member 20 is mounted.

  Two circular holes 26 are formed on one surface 27 of the cover body 24. A guide bar 36 of the guide member 23 described later is inserted into the circular hole 26. Here, the inner diameters of the two circular holes 26 are slightly smaller than the diameter of the guide bar 36. Thereby, the guide bar 36 inserted into the circular hole 26 and the cover body 24 are fitted and fixed to each other. As a result, the guide bar 36 is extended from the first member 21. The interval between the two circular holes 26 is set to such a size that the inner shunt 90 can be disposed between the two circular holes 26.

  The cover body 24 is fixed by the other surface 28 on the back side of the one surface 27 being sewn to the subcutaneous adipose tissue 94 of the patient's arm 91 with a suture 29. The cover body 24 may be fixed to the subcutaneous adipose tissue 94 by means other than the suture 29, such as an adhesive.

  As shown in FIGS. 2 and 3, the second member 22 includes a cover body 30 having an internal space, and a magnet 31 disposed in the internal space of the cover body 30. The cover body 30 has a thin plate shape. The material of the cover body 30 is a material suitable for medical use such as silicone resin. The periphery of the magnet 31 is completely covered by the cover body 30. For this reason, the magnet 31 does not contact the surrounding tissue at the position where the mounting member 20 is mounted.

  Two through holes 32 (corresponding to holes) are formed in the cover body 30. A guide bar 36 is inserted through the through hole 32. Here, the inner diameters of the two through holes 32 are larger than the diameter of the guide bar 36. Thus, the second member 22 is movable along the axial direction of the guide bar 36 in a state where the guide bar 36 is inserted through the cover body 30. The interval between the two through holes 32 is set to be approximately the same as the interval between the two circular holes 26. Accordingly, the inner shunt 90 can be disposed between the two through holes 32, and the guide bar 36 can be inserted into both the through hole 32 and the circular hole 26.

  As shown in FIGS. 2 and 3, the guide member 23 is fixed to the plate-like member 34 (corresponding to a stopper) made of a material suitable for medical use such as silicon resin, and the plate-like member 34. And two guide bars 36 protruding from one surface 35 of the cage plate member 34.

  The first member 21 is supported by the guide member 23 when the guide bar 36 is inserted into the circular hole 26. The second member 22 is supported by the guide member 23 so as to be movable along the axial direction of the guide bar 36 when the guide bar 36 is inserted into the through hole 32. The second member 22 is disposed between the first member 21 and the guide member 23. Thus, the guide member 23 supports the first member 21 and the second member 22 in a state where the magnetic body 25 and the magnet 31 are opposed to each other.

  Of the members constituting the mounting member 20 described above, the surfaces of the members (the cover body 24, the cover body 30, and the guide member 23) that may come into contact with the surrounding tissue are curved or chamfered. It is preferable that treatments such as these have been performed. This is because it is possible to reduce the possibility that the surrounding tissue is damaged by the contact of each member with the surrounding tissue.

  Hereinafter, the procedure for mounting the mounting member 20 on the inside of the patient's arm 91 will be described in detail. First, the inner shunt 90 is produced by anastomosing the artery 92 and the vein 93 by a known means. Next, the first member 21 is disposed at a position opposite to the skin 95 of the arm 91 with respect to the inner shunt 90. At this time, the first member 21 is disposed so that the one surface 27 faces the inner shunt 90.

  Next, the other surface 28 of the first member 21 is sutured to the subcutaneous adipose tissue 94 opposite to the skin 95 of the arm 91 with respect to the inner shunt 90. As a result, the first member 21 is fixed to the subcutaneous fat tissue 94. Here, the first member 21 is fixed at a position where the inner shunt 90 is between the two circular holes 26.

  Next, the protruding tip of the guide bar 36 of the guide member 23 is inserted into the circular hole 26 of the first member 21. Here, the guide bar 36 is inserted through the through hole 32 of the second member 22 in advance. When the protruding tip portion of the guide bar 36 is inserted into the circular hole 26, the second member 22 is disposed on the opposite side of the first member 21 with respect to the inner shunt 90. Thereby, the inner shunt 90 is sandwiched between the second member 22 and the first member 21 in a state where the guide bar 36 and the first member 21 are fitted.

  In this state, the second member 22 is movable along the axial direction of the guide bar 36 to the first position shown in FIG. 3 and the second position shown in FIG. Thereby, the 2nd member 22 and the 1st member 21 can mutually contact / separate. The movement of the second member 22 in the direction from the second position to the first position is restricted by the first member 21. Thereby, it is controlled that the 2nd member 22 approaches the 1st member 21 side further than the 1st position. On the other hand, the movement of the second member 22 in the direction from the first position to the second position is restricted by the plate-like member 34 of the guide member 23. Thereby, it is controlled that the 2nd member 22 leaves | separates further from the 1st member 21 rather than a 2nd position.

  In the first position, the second member 22 is close to the first member 21. At this time, the inner shunt 90 is sandwiched while being pressed by the second member 22 and the first member 21 and is completely or substantially closed. Thereby, the blood flow rate in the inner shunt 90 is suppressed to zero or a small amount.

  In the second position, the second member 22 is farther from the first member 21 than in the first position. At this time, the inner shunt 90 is located between the second member 22 and the first member 21, but the pressing force is smaller than that in the first position. Therefore, the inner shunt 90 is opened. Thereby, the blood flow rate in the inner shunt 90 becomes larger than when the second member 22 is in the first position.

[Magnetic member 50]
As shown in FIG. 3, the magnetic member 50 includes an electromagnet 51, a power source 52 connected to the electromagnet 51, and a switch 53 disposed between the electromagnet 51 and the power source 52. The electromagnet 51 includes a magnetic body 54 made of iron or the like, and a coil 55 wound around the magnetic body 54. Both ends of the coil 55 are connected to the positive electrode and the negative electrode of the power source 52, respectively. A switch 53 is disposed between one end of the coil 55 and the positive electrode of the power source 52. The switch 53 may be disposed between the other end of the coil 55 and the negative electrode of the power source 52.

  The magnetic force generated in the electromagnet 51 is set so as to satisfy the condition that the magnet 31 is larger than the magnetic force that attracts the magnetic body 25. Specifically, the number of turns of the coil 55, the magnitude of the current flowing through the coil 55, the magnetic permeability and cross-sectional area of the magnetic body 54, and the like are set to satisfy the above conditions.

  When hemodialysis is not performed on the patient, the magnetic member 50 is not disposed near the position where the mounting member 20 is mounted outside the patient's body. Alternatively, even if the magnetic member 50 is disposed in the vicinity of the position, the switch 53 is turned off. In this case, no magnetic force is generated in the electromagnet 51. At this time, when the magnetic body 25 is attracted to the magnet 31, the second member 22 moves to the first position (see FIG. 3). Thereby, the inner shunt 90 is closed, and the blood flow rate in the inner shunt 90 is suppressed to zero or a small amount.

  On the other hand, when hemodialysis is performed on the patient, the magnetic member 50 is disposed in the vicinity of the position and the switch 53 is turned on. In this case, a magnetic force is generated in the electromagnet 51, and the magnetic force acts on the magnet 31 and the magnetic body 25. As described above, the magnetic force is larger than the magnetic force with which the magnet 31 attracts the magnetic body 25. At this time, since the cover body 24 covering the magnetic body 25 is stitched to the subcutaneous fat tissue 94, the first member 21 does not move. Therefore, the magnet 31 is separated from the fixed magnetic body 25 and is drawn toward the magnetic member 50 side.

  When the magnet 31 is attracted toward the magnetic member 50, the second member 22 moves from the first position to the second position (see FIG. 4). Thereby, the inner shunt 90 is opened, and the blood flow rate in the inner shunt 90 is increased.

  The magnetic member 50 is not limited to the configuration described above as long as it can generate a magnetic force that moves the second member 22 from the first position to the second position. For example, the magnetic member 50 may be a magnet that can generate a larger magnetic force than the magnet 31.

[Effect of the embodiment]
The mounting member 20 of the blood flow control device 10 is embedded in the body, and the first member 21 and the guide member 23 fixed to the first member 21 are fixed to the subcutaneous fat tissue 94 in the body. The second member 22 moves to the first position or the second position by the magnetic force from the first member 21 or the outside. Since the first member 21 and the guide member 23 are fixed to the subcutaneous fat tissue 94, when the external magnetic force acts, only the second member 22 moves by the external magnetic force. When the magnetic force from the outside is not acting, the second member 22 is closed by sandwiching the inner shunt 90 at a position closest to the first member 21 (first position). When an external magnetic force stronger than the magnet 31 of the second member 22 acts, the second member 22 opens the inner shunt 90 so that blood can flow at a position (second position) away from the first member 21. Thereby, the inner shunt 90 can be opened and closed using magnetic force from the outside.

  Even if a magnetic force acts from the outside, the second member 22 is not separated from the first member 21 by the plate-like member 34 from the second position.

[Modification]
In the above-described embodiment, the first member 21 is sutured to the subcutaneous fat tissue 94. However, members other than the first member 21 may be sutured to the subcutaneous fat tissue 94. For example, as shown in FIGS. 5 and 6, the guide member 23 may be sewn to the skin 95.

  In the above-described embodiment, the first member 21 is supported in a state of being fixed to the guide member 23, the second member 22 is disposed between the first member 21 and the guide member 23, and the first position. And the second position are supported by the guide member 23 so as to be movable.

  However, the first member 21 and the second member 22 may be disposed at opposite positions. That is, the second member 22 is supported in a state of being fixed to the guide member 23, the first member 21 is disposed between the second member 22 and the guide member 23, and the first position and the second position. It may be supported by the guide member 23 so as to be movable. In this case, the through hole 32 is formed in the first member 21 and the guide bar 36 is penetrated. Further, the protruding tip end portion of the guide bar 36 is fitted with the second member 22.

  In the above-described embodiment, the guide member 23 includes the single plate-like member 34 and the two guide bars 36 that protrude from the plate-like member 34. It is not restricted to a simple configuration. For example, the guide member 23 may be configured by two plate-like members and a total of two guide bars 36 that protrude one by one from each of the plate-like members.

  In the above-described embodiment, two guide bars 36 are provided, but the number of guide bars 36 is not limited to two. In this case, it goes without saying that the numbers of the circular holes 26 and the through holes 32 are determined according to the number of the guide bars 36.

  In the above-described embodiment, the second member 22 is close to the first member 21 in the first position, but is not in contact therewith. However, the second member 22 may be in contact with the first member 21 in the first position.

  For example, as shown in FIGS. 7 and 8, the second member 22 may be curved, and magnets 31 may be incorporated at both ends thereof. The first member 21 may incorporate a magnetic body 25 at a position facing both ends of the second member 22. With this configuration, both end portions of the second member 22 are in contact with the first member 21 by attracting the magnetic body 25 facing the magnet 31 at the first position shown in FIG. .

DESCRIPTION OF SYMBOLS 10 Blood flow control apparatus 21 1st member 22 2nd member 23 Guide member 32 Through-hole 34 Plate-shaped member 36 Guide bar 50 Magnetic force member 51 Electromagnet

Claims (5)

A first member having a magnetic body;
A second member which is disposed so as to be able to sandwich a blood vessel between the first member and has a magnet;
A guide member that faces the magnetic body and the magnet and supports one of the first member and the second member so as to be movable in a direction in which the first member or the second member is in contact with or separated from the other of the first member or the second member; A blood flow regulating device comprising:   The guide member is movably movable between a first position where the first member and the second member abut or approach each other and a second position where the first member and the second member are separated from each other. The blood flow rate adjusting device according to claim 1, further comprising a stopper that supports one member and the second member and restricts the first member and the second member from being further separated from the second position.   The guide member has a guide bar that extends from one of the first member and the second member and is inserted into a hole formed in the other of the first member or the second member. The blood flow regulating device according to claim 2.   The magnetic member is attracted to the magnet, and a magnetic force larger than the magnet is applied to the magnetic body with respect to the first member and the second member at the first position, and the first member at the first position is applied. The blood flow rate adjusting device according to claim 1, further comprising a magnetic member that moves one of the second members to the second position. The blood flow control device according to claim 4, wherein the magnetic member has an electromagnet.

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