CN106473847A - The dilatancy local urinary tract intracavity stent system of degradable - Google Patents
The dilatancy local urinary tract intracavity stent system of degradable Download PDFInfo
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- CN106473847A CN106473847A CN201611032869.XA CN201611032869A CN106473847A CN 106473847 A CN106473847 A CN 106473847A CN 201611032869 A CN201611032869 A CN 201611032869A CN 106473847 A CN106473847 A CN 106473847A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0077—Special surfaces of prostheses, e.g. for improving ingrowth
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
- A61M29/02—Dilators made of swellable material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2002/047—Urethrae
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0061—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof swellable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0067—Means for introducing or releasing pharmaceutical products into the body
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Pulmonology (AREA)
- Gastroenterology & Hepatology (AREA)
- Anesthesiology (AREA)
- Hematology (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
The invention provides the dilatancy local urinary tract intracavity stent of a class degradable, in the postoperative local urinary tract effectively supporting diseased region of the narrow obstruction of urinary tract, prevention of postoperative scar hyperplasia, contracture lead to narrow obstruction recurrence;It is made by degradation material, after scar stability, degrades before attachment calculus, excretes with urine;Its form includes but is not only limited to bare bracket, bracket for eluting medicament or coating stent of medicine, overlay film frame etc..This type support is compressed in the less epitheca of caliber in course of conveying, discharges after reaching target urinary tract position, expands and becomes big, supports pathological changes urinary tract;Shelf inner diameter, length suitably can be adjusted according to clinical needs;Compare with catheter with traditional double J-type ureter bracket, avoid the interference damage to urinary tract normal beyond narrow positions, avoid the restriction to support lumen diameter for the urinary tract physiological stenosis position, thus ensure that support supports expansion effect, prevention of postoperative narrow obstruction recurrence effectively.
Description
Technical field
The present invention relates to medical instruments field and in particular to intracavitary therapy urinary tract narrow (include but be not only limited to kidney
Broad-mouthed receptacle for holding liquid urine output pipe jointing part is narrow, stricture of ureter, urethral stricture etc.) degradability, dilatancy Local stent system.
Background technology
Dead organ shows that the child that hydronephrotic sickness rate is 3.1%, 2%-2.5% suffers from hydronephrosis;Urinary tract obstruction
It is to lead to hydronephrotic Important cause of disease, and stricture of pyeloureteric junction, stricture of ureter and urethral stricture are clinically
Common urinary tract obstruction type.The classic treatment method of urinary tract obstruction is open or laparoscopic surgery excision narrow section urinary tract, so
Rear end-end coincide and rebuilds the integrity of urinary tract;With the progress of technology, urinary tract intracavitary therapy is gradually introducing clinic, and it has wound
Wound is little, recover advantage fast, that expense is low, is accepted by increasing doctor.
The intracavitary therapy method of UPJO and stricture of ureter includes narrow, the interior incision of region of obstruction
Otomy etc. in art, balloon dilatation, the electric lead with air bag;Multiple studies have shown that success rate of operation in 50%- both at home and abroad
70% about hence it is evident that be less than open or laparoscopic surgical procedure.In above-mentioned operation, postoperative need indwelling tube of double-J (i.e. traditional urine output
Pipe holder) support ureter, drainage of urine, limited by ureter physiological stenosis and tubal bladder opening, the pipe of double J pipe
Footpath is significantly less than the level being expanded to needed for narrow, region of obstruction;Diseased region is postoperative when there is cicatrix, narrow, contracture,
Double J pipe does not have obvious supporting role hence it is evident that reducing therapeutic effect.Additionally, as placed thicker double J pipe then to normally defeated
Catheter section produces obvious damaging action.Urethral stricture is often secondary to gonorrhea, wound, and intracavitary therapy method mainly includes sacculus
Expansion, cool spare system, laser therapy etc., but urethral stricture postoperative scar group is woven with the tendency of obvious centration growth, narrow again
Narrow probability is high;Postoperative short-term domestic demand indwelling catheter drainage of urine, supports narrow section, but indwelling catheter has damage normal urine
Road part, concurrent urinary tract infection, the problem of reduction patients ' life quality;Extract after catheter frequently with metal urethral probe in the ranks
Disconnected expansion of driving in the wrong direction, brings great pain to patient, and therapeutic effect is not good enough.
At present, the urinary tract support clinically commonly used includes ureter bracket (referring mainly to double J pipe) and catheter, and material is rubber
Glue, latex, metal etc..Above-mentioned support tube is interim placement, and according to the difference of material and generation technique, double J pipe can indwelling 1
- 2 years moons, the general indwelling time of catheter is less than 2 weeks;Main reason is that its indwelling time is long and cause obvious urinary tract sense
Dye and attachment calculus (support tube can adsorb urine solute as foreign body and be allowed to precipitate, and then forms calculus).Additionally, it is defeated
Urinary catheter and urethra all have physiological stenosis position, lead to not insert the abundant double J pipe meeting expansion requirement and catheter;When for
Meet expansion to require and when the excessively thick double J pipe of indwelling or catheter, not only place difficult, normal urethra tube chamber caused damage;
Also huge misery can be brought to patient.
It is thus desirable to new urinary tract support, for the local urinary tract in urinary tract obstruction postoperative support effectively diseased region,
Prevention of postoperative scar hyperplasia, contracture lead to narrow, obstruction recurrence;It is right to reduce as far as possible during the indwelling of support or even avoid
The impact of normal urinary tract, avoids the urinary tract infection of secondary and attachment calculus because support exists simultaneously.
Content of the invention
It is an object of the invention to provide the dilatancy local urinary tract intracavity stent of a class degradable, for narrow in urinary tract
The postoperative local urinary tract effectively supporting diseased region of narrow, obstruction, prevention of postoperative scar hyperplasia, contracture lead to narrow, obstruction multiple
Send out;It is made by degradation material, after scar stability, degrades before attachment calculus, excretes with urine;
Its form includes but is not only limited to bare bracket, bracket for eluting medicament or coating stent of medicine, overlay film frame etc..
Above-mentioned urinary tract intracavity stent, the support that bare bracket is defined as being made by degradation material is key;Medicament elution
Support or coating stent of medicine are defined as by the certain ingredient of different technologies means cladding on bare bracket, ingredient
Play corresponding effect;Overlay film frame is defined as in support overlying thin film to prevent fibrous connective tissue, epithelial tissue from wearing
More standoff gap entrance support intracavity hypertrophy leads to support, urinary tract narrow.
Above-mentioned urinary tract intracavity stent, is made up of degradation material;Degradation material includes but is not only limited to degradable
Metal material (includes but is not only limited to Mg-Al-Zn Alloy, magnesium zinc calcium alloy, magnesium lithium aluminum zinc zirconium calcium strontium alloy, calcium kirsite, magnesium
Zinc yttrium neodymium alloy, iron base composite material etc., can be the combination of one or more of above-mentioned material) and degradable high polymer material
(include but be not only limited to PGA, polymeric polyglycolide-polylactide, polylactide, PPDO, polydactyl acid,
Copolymer of poly lactic acid, polyglycolic acid, poly-epsilon-caprolactone, PTMC, condensing model, polyamino acid derive carbonic acid
Ester, poe, shitosan, poly- hydroxyl alkane fat, poly- 4 hydroxybutyric acid fat, crospolyvinylpyrrolidone etc., can be above-mentioned material
The combination of one or more of material) etc., can be the combination of one or more of above-mentioned material;Preferably degradable metal material
Material.
Above-mentioned urinary tract intracavity bracket for eluting medicament or coating stent of medicine cladding ingredient, including but be not only limited to
Antiblastic, more wound repair materials, calculus formation inhibitor, antibiotics, developing agent etc.;It can be said medicine composition
One or more of combination.
Above-mentioned urinary tract intracavity bracket for eluting medicament or coating stent of medicine cladding in order to suppress scar tissue hypertrophy, prevention
The antiblastic of narrow recurrence, including but be not only limited to batimastat, inhibitors of metalloproteinase, 17 beta estradiols, NO
Donor, 2-CdA, 2- deoxycoformycin, FTY720, wheat examine phenol sodium, ciclosporin A and its derivant, Ai Saibu
Can, Zenapax, basiliximab, anti-thymus globulin, everolimuses, methotrexate, Nei Aolaer, cyclophosphamide, brequinar
Sodium, leflunomide, Mizoribine, heparin, rheum emodin, arsenicum, retinoic acid, rapamycin, dactinomycin, Radix Tripterygii Wilfordii and its derivative
Thing, paclitaxel etc., can be the combination of one or more of said medicine composition.
The more wound in order to promote wound repair of above-mentioned urinary tract intracavity bracket for eluting medicament or coating stent of medicine cladding is repaiied
Multiple material, including but be not only limited to cellulose and its derivates, hyaluronic acid, alginate, chondroitin sulfate, chitin and
Its derivant, Chitosan-phospholipid complex, fibroin albumen etc., can be the combination of one or more of mentioned component.
Above-mentioned urinary tract intracavity bracket for eluting medicament or coating stent of medicine cladding in order to pre- anti-adhesion lithogenous knot
Stone formed inhibitor, including but be not only limited to citrate, magnesia mixture, Portugal's amine polysaccharide, ammonia chloride, Methionine, acetyl hydroximic acid,
Hydroxyurea, Chinese herbal medicine (include but be not only limited to Rhizoma Alismatis, Semen Sterculiae Lychnophorae, Herba Lysimachiae, Stigma Maydis, Musa basjoo Sieb. Et Zucc. core etc.) etc., can be above-mentioned
The combination of one or more of composition.
Above-mentioned urinary tract intracavity bracket for eluting medicament or the antibiotic in order to prevent urinary tract infection of coating stent of medicine cladding
Class medicine, including but be not only limited to penicillins (include but be not limited merely to amoxicillin, mezlocillin, oxazacillin
Deng), cephalo-type (include but be not limited merely to ceftriaxone, cefoperazone, cefoxitin etc.), carbapenemss (include but
It is not limited merely to imipenum, meropenem, faropenem etc.), oxacephemss (include but are not limited merely to draw oxygen head
Spore, flomoxef etc.), monocyclic beta-lactam class (include but be not limited merely to aztreonam, carumonam etc.), beta lactamase presses down
Pharmacy (includes but is not limited merely to clavulanic acid, sulbactam, Tazobactam Sodium etc.), and aminoglycosides (include but not only limit to
In gentamycin, amikacin, streptomycin etc.), quinolones (include but be not limited merely to Ciprofloxacin, Levofloxacin,
How for husky magnitude), macrolide (includes but is not limited merely to erythromycin, Azithromycin, Roxithromycin etc.), lincomycin
Class (includes but is not limited merely to lincomycin, clindamycin etc.), and polypeptide antibiotics (includes but is not limited merely to through the ages
Mycin, norvancomycin, polymyxin, bacitracin etc.), Tetracyclines (include but are not only limited to tetracycline, how western ring
Element, minocycline etc.), chloromycetin (include but be not only limited to chloromycetin, thiamphenicol etc.), sulfonamides (include but not
It is limited only to sulfadiazine, Sulfamethoxazole, willow nitrogen sulphur arsenic pyridine etc.), antiviral agents (include but are not limited merely to ribavirin
Woods, Lamivudine, acyclovir, amantadine, zanamivir, neat Fu Duoding, zalcitabine, stavudine, valaciclovir, more
VCV, cytosine arabinoside, trifluridine, idoxuridine, adefovirdipivoxil, Oseltamivir, zanamivir, Entecavir), antifungal agent
(include but be not limited merely to Amphotericin B, nysfungin, griseoflavin, Ketoconazole, miconazole, econazole, clotrimazole, biphenyl
Benzyl azoles, Itraconazole, fluconazol, voriconazole, terbinafine, oxygen cytosine), antitubercular agent (includes but is not limited merely to
Isoniazid, rifampicin, ethambutol, streptomycin, pyrazinamide, sodium aminosalicylate, the different amide of second sulfur, capreomycin, ring
Serine, rifandin, rifapentine, Sparfloxacin etc.), nitrofurantoin, furazolidone, metronidazole, trimethoprim etc.) etc.;Can
Combination for one or more of said medicine composition.
Above-mentioned urinary tract intracavity bracket for eluting medicament or coating stent of medicine cladding in order to make what support develop under x-ray to show
Shadow agent, including but be not only limited to barium sulfate, iodide, the metal material of degradable, ordinary metallic material powder, bismuth compound
Deng can be the combination of one or more of mentioned component.
The covering material of above-mentioned urinary tract intracavity overlay film frame is made by degradable high polymer material, including but not only office
Be limited to PGA, polymeric polyglycolide-polylactide, polylactide, PPDO, polydactyl acid, copolymer of poly lactic acid,
Polyglycolic acid, poly-epsilon-caprolactone, PTMC, condensing model, polyamino acid derive carbonic ester, poe, shell
Polysaccharide, poly- hydroxyl alkane fat, poly- 4 hydroxybutyric acid fat, crospolyvinylpyrrolidone etc., can be one of above-mentioned material or several
The combination planted.
Above-mentioned urinary tract intracavity stent, before release, need to be placed in outer intrathecal in compressed form;After release, expand and become big,
In order to support diseased region ureter;This requires that its structure possesses compressibility, including but be not only limited to rhombus, W shape etc.,
It can be the combination of one or more of said structure.The one of value is mentioned that, support release after expand mode, including but not only
It is confined to rely on natural resiliency to expand, balloon expandable secondary expansion, memory material excites expansion etc. by temperature or other factors, can
Combination for one or more of aforesaid way.
Above-mentioned urinary tract intracavity stent, after release, its shape need to adapt to local urinary tract form, including but be not only limited to Lou
Bucket type, T-shaped, cylindrical shape etc., can be the combination of one or more of above-mentioned shape;The length of support is equal to or is suitably larger than narrow
Narrow section of urinary tract length, the internal diameter of support is equal to or is suitably larger than narrow section urinary tract need to expand the internal diameter level reaching.For avoiding releasing
After putting because of urinary tract motion (ureteral peristalsises and external urethra passive activity) stent migration that causes it may be considered that multiple fixation
Scheme, including but be not only limited to:Suitably increase stent length, suitably increase support lumen diameter, stent outer edge designs hair
Thorn or barb, support two ends or centre substantially expand to support fixation etc., can be the group of one or more of above-mentioned design
Close.Wherein it should be noted that the urinary tract support due to finally giving needs to be adapted with urinary tract inwall, therefore ensureing this
While frame is adaptable with the interior wall construction of urinary tract, the dimensions of support can design according to clinical demand, for difference
Clinical demand and design the structure of support, shape, dimensions etc. is all in the protection domain of invention.
The processing mode of above-mentioned urinary tract intracavity stent include but be not only limited to braiding, cutting, engraving, natural molding, two
Secondary machine-shaping etc., can be the combination of one or more of said method.
The release device of above-mentioned urinary tract intracavity stent is mainly made up of epitheca and inner core, and support is placed in epitheca with compressive state
Interior, support and inner core contact but are not connected with fixing, between epitheca and support and inner core can relative slidably;Will during use
Stent pushing, to the diseased regions such as narrow, obstruction, fixing inner core, epitheca of dropping back, accurately discharges support, and stent expansion, internal diameter increase
Big support ureter;It is also possible to use suitable balloon expandable stent so as to fully expanding and being close to urinary tract inwall.
After above-mentioned urinary tract intracavity stent is retained in pathological changes urinary tract position, also can be used according to the needs of patient's practical situation
Special solution lavation reaches dissolving support, but does not damage the purpose of urinary tract tissue.
The dilatancy local urinary tract intracavity stent of degradable of the present invention has advantages below:
1. this support degradable, after narrow, region of obstruction scar stability, degrades before attachment calculus, both rose
Arrive temporary transient support dilating effect, turn avoid attachment this complication of calculus.
2. this support is local, expansiveness urinary tract support, before being delivered to target site, is compressed in caliber less
Outer intrathecal, after reaching target site, release from epitheca expands, and shelf inner diameter can be equal to or be suitably larger than narrow urinary tract and need to expand
Open the internal diameter level reaching, its length is equal to or is suitably larger than narrow section urinary tract length;With traditional double J-type ureter bracket and leading
Urinary catheter is compared, it is to avoid interference damage to urinary tract normal beyond narrow positions, avoid urinary tract physiological stenosis position to
The restriction of frame lumen diameter, thus ensure that support supports expansion effect, prevention of postoperative narrow obstruction recurrence effectively.
3. this support can coat antiblastic, more wound repair materials, calculus inhibitor, antibiotic etc., can press down
Diseased region scar tissue hypertrophy processed, reduces narrow, obstruction relapse rate, promotes wound repair, calculus are adhered in suppression, and
The incidence rate of urinary tract infection can be reduced.
Brief description
Fig. 1 is the dilatancy local urinary tract intracavity stent structural representation of degradable;
Fig. 2 be degradable dilatancy local urinary tract intracavity stent urinary tract intracavity release after schematic shapes.
Description of reference numerals
The support that the support 4 of 1 epitheca, 2 inner core 3 compression expands
Specific embodiment
In conjunction with accompanying drawing, the present invention is described in detail.
The present invention devises the dilatancy urinary tract support of a class degradable, and support by degradable metal material and/or can drop
Solution macromolecular material is made, and is allowed to degrade in urinary tract system and (after the scar stability of target lesion urinary tract position, adheres to
Before calculus), excrete with urine, play the temporary transient effect supporting expansion.Support can coat multi-medicament and become distribution
Wave respective action, including but be not only limited to antiblastic, more wound repair materials, calculus inhibitor, antibiotic, development
The combination of one or more of agent etc., play suppression scar tissue hypertrophy, wound healing, suppression attachment calculus,
Prevention is infected, is made support effect such as visible under x-ray.In order to avoid wound surface fibrous connective tissue and/or epithelial tissue pass through and prop up
Space on frame is in support intracavity hypertrophy, and then causes that support, urinary tract be narrow, obstruction, and support can cover film barrier fibrous connective
Tissue and/or epithelial tissue pass through;Film is made by degradable high polymer material.Simple high by degradable metal or degradable
The support that molecular material is made is bare bracket, and the support of coating medicine composition is bracket for eluting medicament or coating stent of medicine,
Overlay film for overlay film frame on frame;Bare bracket, bracket for eluting medicament or coating stent of medicine, overlay film frame are this kind of urinary tract supports
Three kinds of principal modes.
Support need to be placed in the less epitheca of internal diameter and be delivered to target site, and then discharges, expands, and play support expansion
The purpose of target urinary tract;This requires that the structure of support possesses compressibility, and after compression, volume, internal diameter diminish, after uncompression,
Volume, internal diameter become big, restore to the original state (Fig. 1 a, 1b, 1c);Therefore support Design be compressible structure, including but be not only limited to
Rhombus (Fig. 1 d), W shape (Fig. 1 e) etc..Urinary tract system includes renal pelvis, ureter, bladder and urethra, the different parts of urinary tract system
There are different forms;And in the case of narrow obstruction, obstruction near-end urinary tract Chang Jishui expansion, form generation substantially changes;
This require design support shape need to adapt to different shape under different situations for the urinary tract, including but be not only limited to funnel
Shape, T-shaped, cylindrical shape etc. (Fig. 2), can be the combination of one or more of above-mentioned shape.The length of support is equal to or suitably big
In narrow section urinary tract length, the internal diameter of support is equal to or is suitably larger than narrow section urinary tract need to expand the internal diameter level reaching.Urine output
Pipe smooth muscle has the characteristics that to wriggle from the top down, and the outer body mobility of male urethra is big;These all may make to place
Support be subjected to displacement it is therefore desirable to there be special support Fixed Design scheme, including but be not only limited to proper extension support
Length, suitably increases support lumen diameter, stent outer edge design burr or barb, support two ends or centre substantially expand in order to
Support fixing etc., can be the combination of one or more of above-mentioned design.For making the urinary tract intracavity stent meeting above-mentioned condition,
Selectable processing mode includes but is not only limited to braiding, cutting, engraving, natural molding, secondary operations molding etc., can be upper
State the combination of one or more of method.
Before inserting target site, support and inner core are placed in epitheca, and support and inner core contact but be not connected with
Fixing, between epitheca and support and inner core can relative slidably;When (Fig. 1 a) uses, by stent pushing to narrow, obstruction etc.
Diseased region, fixing inner core, epitheca of dropping back, accurately discharge support, stent expansion, internal diameter become big and support ureter, exit inner core
And epitheca;(Fig. 1 b, 1c) it is also possible to use suitable balloon expandable stent so as to fully expanding and being close to urinary tract inwall.Above-mentioned urinary tract
After intracavity stent is retained in pathological changes urinary tract position, also can be reached using special solution lavation according to the needs of patient's practical situation
Dissolving support, but do not damage the purpose of urinary tract tissue.
Claims (10)
1. a class degradable dilatancy local urinary tract intracavity stent it is characterised in that:It is made by degradation material, in scar
Trace stably after, attachment calculus before degrade, excrete with urine;Its form include but be not only limited to bare bracket,
Bracket for eluting medicament or coating stent of medicine, overlay film frame etc..
2. urinary tract intracavity stent according to claim 1 it is characterised in that:Bare bracket is defined as being made by degradation material
Support key;Bracket for eluting medicament or coating stent of medicine are defined as the medicine certain by different technologies means cladding
On bare bracket, ingredient plays corresponding effect to composition;Overlay film frame is defined as in support overlying thin film to prevent
Fibrous connective tissue, epithelial tissue pass through standoff gap entrance support intracavity hypertrophy and lead to support, urinary tract narrow.
3. urinary tract intracavity stent according to claim 1 it is characterised in that:It is made up of degradation material, degradation material
Including but be not only limited to degradable metal material (include but be not only limited to Mg-Al-Zn Alloy, magnesium zinc calcium alloy, magnesium lithium aluminum zinc
Zirconium calcium strontium alloy, calcium kirsite, magnesium zinc yttrium neodymium alloy, iron base composite material etc., can be one or more of above-mentioned material
Combination) and degradable high polymer material (include but be not only limited to PGA, polymeric polyglycolide-polylactide, polylactide, gather
Lanthanum Isopropoxide, polydactyl acid, copolymer of poly lactic acid, polyglycolic acid, poly-epsilon-caprolactone, PTMC,
Condensing model, polyamino acid derive carbonic ester, poe, shitosan, poly- hydroxyl alkane fat, poly- 4 hydroxybutyric acid fat, crosslinked poly- second
Alkene pyrrolidone etc., can be the combination of one or more of above-mentioned material) etc., can be one or more of above-mentioned material
Combination;Preferably degradable metal material.
4. urinary tract intracavity bracket for eluting medicament according to claim 1 or coating stent of medicine it is characterised in that:Its cladding
Ingredient include but be not only limited to antiblastic, more wound repair materials, calculus formation inhibitor, Tri-Biocin
Thing, developing agent etc.;It can be the combination of one or more of said medicine composition.
In order to suppress scar tissue hypertrophy, prevent narrow recurrence antiblastic, including but be not only limited to batimastat, gold
Proteases inhibitor, 17 beta estradiols, NO donor, 2-CdA, 2- deoxycoformycin, FTY720, wheat are examined
Phenol sodium, ciclosporin A and its derivant, Ai Saibu can, Zenapax, basiliximab, anti-thymus globulin, everolimuses, first ammonia
Pterin, Nei Aolaer, cyclophosphamide, brequinar sodium, leflunomide, Mizoribine, heparin, rheum emodin, arsenicum, retinoic acid, thunder
Handkerchief mycin, dactinomycin, Radix Tripterygii Wilfordii and its derivant, paclitaxel etc., can be the group of one or more of said medicine composition
Close.
In order to promote the more wound repair materials of wound repair, including but be not only limited to cellulose and its derivates, hyaluronic acid,
Alginate, chondroitin sulfate, chitin and its derivant, Chitosan-phospholipid complex, fibroin albumen etc., can be mentioned component
One or more of combination.
In order to pre- anti-adhesion lithogenous calculus inhibitor, including but be not only limited to citrate, magnesia mixture, Portugal's amine gather
Sugar, ammonia chloride, Methionine, acetyl hydroximic acid, hydroxyurea, Chinese herbal medicine (include but be not only limited to Rhizoma Alismatis, Semen Sterculiae Lychnophorae, Herba Lysimachiae,
Stigma Maydis, Musa basjoo Sieb. Et Zucc. core etc.) etc., can be the combination of one or more of mentioned component.
In order to prevent the antibiotics of urinary tract infection, including but be not only limited to penicillins (include but and not only limit to
In amoxicillin, mezlocillin, oxazacillin etc.), cephalo-type (includes but is not limited merely to ceftriaxone, cefoperazone, head
Western fourth of spore etc.), carbapenemss (include but are not limited merely to imipenum, meropenem, faropenem etc.), oxacephem
Class (includes but is not limited merely to latamoxef, flomoxef etc.), and monocyclic beta-lactam class (includes but is not limited merely to ammonia
Qu Nan, carumonam etc.), and beta-lactam enzyme inhibitor (include but be not limited merely to clavulanic acid, sulbactam, Tazobactam Sodium
Deng), aminoglycosides (include but be not only limited to gentamycin, amikacin, streptomycin etc.), quinolones (include but simultaneously
It is not only limited to Ciprofloxacin, Levofloxacin, how to replace husky magnitude), macrolide (includes but is not limited merely to red mould
Element, Azithromycin, Roxithromycin etc.), lincomycin class (includes but is not limited merely to lincomycin, clindamycin etc.), many
Peptide antibiotics (includes but is not limited merely to vancomycin, norvancomycin, polymyxin, bacitracin etc.), tetracycline
Class (include but be not only limited to tetracycline, doxycycline, minocycline etc.), chloromycetin (includes but to be not only limited to chlorine mould
Element, thiamphenicol etc.), sulfonamides (include but are not limited merely to sulfadiazine, Sulfamethoxazole, willow nitrogen sulphur arsenic pyridine etc.), resist
Viral medicine (includes but is not limited merely to ribavirin, Lamivudine, acyclovir, amantadine, zanamivir, Qi Fuduo
Fixed, zalcitabine, stavudine, valaciclovir, ganciclovir, cytosine arabinoside, trifluridine, idoxuridine, adefovirdipivoxil, Ao Sita
Wei, zanamivir, Entecavir), antifungal agent (includes but is not limited merely to Amphotericin B, nysfungin, griseoflavin, ketone
Health azoles, miconazole, econazole, clotrimazole, Bifonazole, Itraconazole, fluconazol, voriconazole, terbinafine, oxygen born of the same parents are phonetic
Pyridine), antitubercular agent (include but be not limited merely to isoniazid, rifampicin, ethambutol, streptomycin, pyrazinamide, to amino
Sodium salicylate, the different amide of second sulfur, capreomycin, Cycloserine, rifandin, rifapentine, Sparfloxacin etc.), nitrofurantoin, furan
Mutter oxazolone, metronidazole, trimethoprim etc.) etc.;It can be the combination of one or more of said medicine composition.
In order to the developing agent making support develop under x-ray, including but be not only limited to the metal of barium sulfate, iodide, degradable
Material, ordinary metallic material powder, bismuth compound etc., can be the combination of one or more of mentioned component.
5. urinary tract intracavity overlay film frame according to claim 1 it is characterised in that:Covering material is by degradable macromolecule material
Material is made, including but be not only limited to PGA, polymeric polyglycolide-polylactide, polylactide, PPDO,
Polydactyl acid, copolymer of poly lactic acid, polyglycolic acid, poly-epsilon-caprolactone, PTMC, condensing model, poly- amino
Acid derivative carbonic ester, poe, shitosan, poly- hydroxyl alkane fat, poly- 4 hydroxybutyric acid fat, crospolyvinylpyrrolidone etc.,
It can be the combination of one or more of above-mentioned material.
6. urinary tract intracavity stent according to claim 1 it is characterised in that:Support before release, need to be with the shape of compression
Formula is placed in outer intrathecal;After release, expand and become big, in order to support diseased region ureter;It is compressible that this requires that its structure possesses
Property, including but be not only limited to rhombus, W shape etc., can be the combination of one or more of said structure.The one of value is mentioned that,
Support release after expand mode, include but be not only limited to rely on natural resiliency expand, balloon expandable secondary expansion, memory material
Material excites expansion etc. by temperature or other factors, can be the combination of one or more of aforesaid way.
7. urinary tract intracavity stent according to claim 1 it is characterised in that:Its shape need to adapt to office to support after discharge
Portion's urinary tract form, including but be not only limited to funnel type, T-shaped, cylindrical shape etc., can be the group of one or more of above-mentioned shape
Close;The length of support is equal to or is suitably larger than narrow section urinary tract length, and the internal diameter of support is equal to or is suitably larger than narrow section urinary tract
The internal diameter level reaching need to be expanded.For avoiding making because of urinary tract motion (ureteral peristalsises and external urethra passive activity) after release
The stent migration becoming it may be considered that multiple fixed solution, including but be not only limited to:Suitably increase stent length, suitably increase
Support lumen diameter, stent outer edge design burr or barb, support two ends or centre substantially expand to support fixation etc., can
Combination for one or more of above-mentioned design.Wherein it should be noted that due to the urinary tract support that finally gives need with
Urinary tract inwall is adapted, and therefore while ensureing that the interior wall construction that this support is with urinary tract is adapted, the dimensions of support can
To be designed according to clinical demand, the structure of the support designing for different clinical demands, shape, dimensions etc. are all being sent out
In bright protection domain.
8. urinary tract intracavity stent according to claim 1 it is characterised in that:Its processing mode includes but is not only limited to compile
Knit, cut, carving, natural molding, secondary operations molding etc., can be the combination of one or more of said method.
9. urinary tract intracavity stent according to claim 1 it is characterised in that:The release device of support is mainly by epitheca and interior
Core forms, and support is placed in outer intrathecal with compressive state, and support and inner core contact but be not connected with fixing, epitheca and support and interior
Can relatively slidably between core;By stent pushing to the diseased regions such as narrow, obstruction during use, fixing inner core, epitheca of dropping back,
Accurately release support, stent expansion, internal diameter increase support ureter;It is also possible to use suitable balloon expandable stent so as to fully swollen
Swollen and be close to urinary tract inwall.
10. urinary tract intracavity stent according to claim 1 it is characterised in that:After support is retained in pathological changes urinary tract position, also
Dissolving support can be reached using special solution lavation, but do not damage the purpose of urinary tract tissue according to the needs of patient's practical situation.
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CN109893682A (en) * | 2019-04-16 | 2019-06-18 | 东北大学 | A kind of degradable metal ureter bracket and preparation method with composite construction |
CN111714260A (en) * | 2020-07-17 | 2020-09-29 | 上海浦瑞通医疗科技有限公司 | Support and application thereof |
CN111714260B (en) * | 2020-07-17 | 2024-05-17 | 上海浦瑞通医疗科技有限公司 | Bracket and application thereof |
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