CN109350850B - Intracavity stimulating electrode for treating dysphagia - Google Patents

Intracavity stimulating electrode for treating dysphagia Download PDF

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Publication number
CN109350850B
CN109350850B CN201811469322.5A CN201811469322A CN109350850B CN 109350850 B CN109350850 B CN 109350850B CN 201811469322 A CN201811469322 A CN 201811469322A CN 109350850 B CN109350850 B CN 109350850B
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stimulating electrode
catheter
electrode
stimulating
stimulation
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CN109350850A (en
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兰月
徐光青
林拓
李婉萁
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Guangzhou First Peoples Hospital
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Guangzhou First Peoples Hospital
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36007Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of urogenital or gastrointestinal organs, e.g. for incontinence control
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0517Esophageal electrodes

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Electrotherapy Devices (AREA)

Abstract

The present invention relates to an endoluminal stimulating electrode for treating a swallowing disorder, comprising a catheter for nasal or oral insertion into a patient, the catheter comprising a catheter body having three pairs of stimulating electrodes mounted on or around the catheter body, the three pairs of stimulating electrodes being configured to receive a variable current to apply electrical stimulation to the oropharynx of the patient; and a switching device for controlling the stimulating electrode. The invention can realize direct noninvasive stimulation of the nerve muscles to the key muscles of the intracavity swallowing, has simple structure and convenient use, and can effectively ensure the accuracy of the placement position and the stimulation of the intracavity swallowing muscles.

Description

Intracavity stimulating electrode for treating dysphagia
Technical Field
The invention relates to the technical field of medical equipment, in particular to a stimulation electrode for treating dysphagia.
Background
Neurogenic dysphagia is often accompanied by weakness in muscle contractions associated with swallowing. Neuromuscular electro-thorn is an important method for treating dysphagia. The current neuromuscular electrical stimulator for treating dysphagia mainly consists of an electrical stimulator, a current output lead and a stimulating electrode. During treatment, the stimulating electrode is first required to be in close contact with specific deglutition muscle group, then specific current generated by the electric stimulator is transmitted to the stimulating electrode through the current output wire, and the deglutition muscle group contacted with the electrode is directly stimulated, so that the purpose of improving the corresponding muscle function is achieved. Therefore, the stimulation electrode is a key to applying the power generated by the electric stimulator to the target muscle group.
The neuromuscular electrical stimulation electrode currently existing for the treatment of dysphagia is a surface stimulation electrode or a needle-shaped stimulation electrode. The surface stimulating electrode is convenient to use, but can only be stuck on the skin surface such as the facial surface of the mouth and the facial surface of the mandible to stimulate the muscles of the upper group and the lower group of the oral cavity and the hyoid bone, but can not be stuck on the surfaces of the muscles in the oral cavity, the pharyngeal cavity and the esophagus, and can not directly stimulate the deep swallowing muscles; the needle-shaped stimulation electrode is required to be inserted into the stimulation muscle, the patient is difficult to accept, the requirement on the operator is high, once the insertion depth or the needle insertion position is inaccurate, the target muscle is likely to be not stimulated, the muscle fibers contacted by the needle-shaped stimulation electrode are fewer, and the stimulation effect is relatively poor. In addition, each stimulation electrode is connected to one current output wire, and when stimulation is performed on a plurality of sites at the same time, errors are likely to occur due to the fact that the current output wires are more or the wires are wound.
Disclosure of Invention
The invention aims to provide an electric stimulation electrode capable of directly and noninvasively stimulating neuromuscular to an endoluminal swallowing key muscle. Furthermore, the invention can selectively stimulate one or more of three parts of the tongue root, the pharynx and the upper esophageal sphincter at the same time according to the specific situation of the patient.
The aim of the invention is achieved by the following technical scheme:
It is an object of the present invention to provide an endoluminal stimulating electrode for treating a swallowing disorder comprising a catheter for nasal or oral insertion into a patient, the catheter comprising a catheter body having at least one stimulating electrode mounted on or about the catheter body, the at least one stimulating electrode being configured to receive a variable current to apply electrical stimulation to the oropharynx of the patient; and switching means for controlling the stimulation electrode.
As a further refinement of the invention, the one stimulation electrode comprises a first stimulation electrode and a second stimulation electrode, which are configured as a pair of stimulation electrodes for stimulating one of the patient's upper sphincter of the tongue root, pharynx or esophagus.
As a still further optimization of the present invention, the at least one pair of stimulation electrodes includes three pairs of stimulation electrodes that stimulate the tongue root, pharynx and upper esophageal sphincter, respectively; the switching device is configured to selectively switch on one or more of the three pairs of stimulation electrodes.
As a further optimization of the present invention, the pair of tongue root stimulating electrodes includes a first tongue root stimulating electrode and a second tongue root stimulating electrode, the pair of pharynx stimulating electrodes includes a first pharynx stimulating electrode and a second pharynx stimulating electrode, and the pair of upper esophageal sphincter stimulating electrodes includes a first upper esophageal sphincter stimulating electrode and a second upper esophageal sphincter stimulating electrode; the distance between the first stimulation electrode and the second stimulation electrode is 1cm; the distance between the tongue root stimulating electrode II and the pharynx stimulating electrode I is 3cm; the distance between the pharyngeal stimulating electrode II and the upper esophageal sphincter stimulating electrode I is 5cm.
As a still further optimization of the present invention, the endoluminal stimulating electrode for treating dysphagia further comprises a balloon and a balloon inflation interface disposed on the catheter body, the balloon inflation interface for inflating the balloon; the inflated balloon may be in close contact with the esophageal wall, preventing the catheter from shifting during stimulation.
As a still further refinement of the present invention, the balloon is disposed proximate one end of the catheter body, and the balloon inflation interface is disposed proximate the other end of the catheter body; the distance between the balloon and the upper sphincter stimulating electrode II is 2cm.
As a still further refinement of the invention, the endoluminal stimulating electrode for treating a swallowing disorder further comprises graduations provided on the catheter.
As a further optimization of the invention, the catheter body is coated with silica gel.
As a further optimization of the invention, the stimulating electrode is annular and made of a metal material.
As a further optimization of the invention, the other end of the catheter main body is also provided with a catheter connector connected with the electric stimulator, and the switching device is arranged on the catheter connector.
Compared with the prior art, the technical scheme provided by the invention has the following beneficial effects: (1) The stimulating electrode is arranged on the same catheter, a current transmission wire connected with the stimulating electrode is coated in the catheter, the outer surface of the catheter is covered by materials which are insulated by silica gel and the like and harmless to human bodies (the surface of the stimulating electrode is exposed), so that the stimulating electrode can pass through a nasal cavity or an oral cavity to enter the pharyngeal cavity and the esophagus along with the electrode catheter, and the direct noninvasive nerve muscle electric stimulating electrode for swallowing key muscles in the cavity can be realized; (2) Further, one or more of three parts of the tongue root, the pharyngeal portion and the upper esophageal sphincter can be stimulated at the same time selectively; (3) The accurate placement position of the stimulation electrode can be ensured by a method of marking scales on the electrode catheter; (4) The inflatable balloon is arranged on the electrode catheter, so that the catheter can be prevented from shifting in the stimulation process, and the stimulating electrode is ensured to be in close contact with the inner surface of the muscle in the stimulation process; and (5) the operation is convenient, simple and easy to use.
Drawings
Fig. 1 is a schematic structural view of an endoluminal stimulating electrode for treating a swallowing disorder according to a first embodiment of the present invention;
FIG. 2 is a schematic structural view of an endoluminal stimulating electrode for treating a swallowing disorder according to a second embodiment of the present invention;
Fig. 3 is a schematic view showing the use state of the endoluminal stimulating electrode for treating dysphagia of the present invention.
In the figure, a catheter adapter 1, a balloon inflation interface 2, a scale 3, a catheter main body 4, a first tongue root stimulating electrode 5, a second tongue root stimulating electrode 6, a first pharynx stimulating electrode 7, a second pharynx stimulating electrode 8, a first esophageal upper sphincter stimulating electrode 9, a second esophageal upper sphincter stimulating electrode 10, a balloon 11, a tongue root stimulating electrode switch 12, a pharynx stimulating electrode switch 13, a esophageal upper sphincter stimulating electrode switch 14, a nasal cavity 15, an oral cavity 16, a tongue root 17, a pharynx 18, a esophageal upper sphincter muscle 19, an air tube 20, an esophagus 21, a switching device A, a stimulating electrode B and a stimulating electrode C.
Detailed Description
The invention is described in further detail below with reference to the accompanying drawings.
Fig. 1 shows an endoluminal stimulating electrode for treating a swallowing disorder comprising a catheter having a catheter body 4, the catheter body 4 being elongate with a diameter of about 3mm; at least one stimulation electrode is mounted on or around the catheter body 4, said at least one stimulation electrode being receptive to a variable current from an electrical stimulator for applying electrical stimulation to the oropharynx of the patient, and switching means a for controlling the switching on and off of said stimulation electrode.
An electrode catheter connector 1 is arranged at one end of the catheter, and the stimulating electrode is directly connected with the electric stimulator through the electrode catheter connector 1. The outer surface of the catheter is covered with an insulating material and a material harmless to the human body, such as silica gel; the surface of the stimulating electrode can be exposed in a conductive way, and a current transmission wire connected with the stimulating electrode is wrapped in the catheter. The catheter is inserted into the oropharyngeal cavity and the upper esophageal portion of a patient through one nasal cavity 15 or oral cavity 16, and can directly stimulate the tongue root 17, the pharynx 18 and the upper esophageal sphincter 19.
The catheter may be single-use or reusable.
As an improvement of the first embodiment of the present invention, the at least one stimulation electrode may be a pair of stimulation electrodes including a first stimulation electrode B and a second stimulation electrode C, which receive a variable current from an electrical stimulator to electrically stimulate one of the tongue root portion 17, the pharynx portion 18, or the esophageal sphincter 19 of the patient. The distance between the first stimulating electrode B and the second stimulating electrode C is 1cm, and the electric stimulation treatment can be effectively carried out on muscles in a certain cavity of the oropharyngeal cavity, the esophagus and the like of a patient through the arrangement of the pair of stimulating electrodes.
As an improvement of the first embodiment of the present invention, the stimulating electrode may be a metal ring-shaped stimulating electrode, which is shaped to ensure contact of the stimulating electrode with the muscles in the cavity.
As an improvement of the first embodiment of the present invention, as shown in fig. 1, the present invention further comprises a balloon 11 and a balloon inflation port 2, which are disposed on the catheter main body 4, wherein when the electrode catheter is inserted and the stimulation electrode is in place, the balloon 11 can be inflated through the balloon inflation port 2, and the inflated balloon is in close contact with the esophageal wall, so as to prevent the catheter from being displaced during the stimulation process. Wherein, the distance between the balloon 11 and the stimulating electrode C is preferably 2cm.
Graduations 3 are marked on the surface of the catheter, and when the electrode catheter is inserted, the graduations 3 can accurately reach the insertion depth of the catheter so as to ensure the correct placement position of the electrode.
The endoluminal stimulating electrode disclosed by the embodiment can realize direct noninvasive stimulation of nerve muscles to endoluminal deglutition critical muscles, has a simple structure and is convenient to use, and the accuracy of a placement position and the accuracy and effectiveness of stimulation to endoluminal deglutition muscles can be effectively ensured.
Fig. 2 shows a second embodiment of an endoluminal stimulating electrode for treating a swallowing disorder according to the present invention as a second embodiment modified on the basis of the above embodiment, including all the components of the above embodiment, and the following modifications are made on the basis of the above embodiment (only the second embodiment is described below as differing from the first embodiment).
The catheter body 4 is provided with a first tongue root stimulating electrode 5, a second tongue root stimulating electrode 6, a first pharyngeal stimulating electrode 7, a second pharyngeal stimulating electrode 8, a first esophageal sphincter stimulating electrode 9 and a second esophageal sphincter stimulating electrode 10 on or around, wherein the distance between the second tongue root stimulating electrode 6 and the first pharyngeal stimulating electrode 7 is 3cm, the distance between the second pharyngeal stimulating electrode 8 and the first esophageal sphincter stimulating electrode 9 is 5cm, and the distance between the stimulating electrodes A and the stimulating electrodes B at all positions is 1cm. The switching device a at the electrode catheter interface 1 comprises 3 switches: the three corresponding pairs of stimulating electrodes are respectively controlled by a tongue root stimulating electrode switch 12, a pharynx stimulating electrode switch 13 and an upper esophageal sphincter stimulating electrode switch 14, and one or more pairs of the three pairs of stimulating electrodes can be selected to be stimulated simultaneously according to the specific situation of dysphagia of a patient through the three switching devices 12, 13 and 14.
Wherein, the distance between the balloon 11 and the upper esophageal sphincter stimulating electrode II 10 is 2cm; three pairs of metal annular stimulating electrodes are arranged on a catheter wrapped with silica gel, the diameter of the catheter is about 3mm, and the catheter is inserted into the pharyngeal cavity and the upper part of the esophagus through one side nasal cavity or oral cavity 16, so that the tongue root part 17, the pharyngeal part 18 and the upper esophageal sphincter 19 can be stimulated directly.
When the device is used, the endoluminal stimulating electrode catheter of the embodiment of the invention is inserted from one nostril (also from the oral cavity), after two stimulating electrodes at the upper esophageal sphincter 19 pass through the upper esophageal sphincter 19, a small amount of gas is filled into the balloon 11, the catheter is pulled outwards until the balloon 11 abuts against the lower esophageal sphincter (the electrode is placed in place at the moment), a sufficient amount of gas is filled into the balloon 11, the balloon 11 is tightly contacted with the wall of the esophagus 21, the endoluminal stimulating electrode catheter is prevented from being displaced, and finally the non-inserted end of the endoluminal stimulating electrode catheter is fixed on the nasal wings of a patient by using adhesive tape.
The invention integrates three pairs of metal annular stimulating electrodes 5-10 and a saccule 11 on the same catheter, a current transmission wire connected with the stimulating electrodes is coated in the catheter, and the outer surface of the catheter is covered by materials which are insulated by silica gel and the like and harmless to human bodies (the surface of the stimulating electrodes is exposed) so that the stimulating electrodes can be accessed into the pharyngeal cavity and the esophagus. The catheter connector is provided with 3 switches for respectively controlling the three pairs of stimulating electrodes, and can selectively directly stimulate the key muscles of the swallowing in the cavities of the tongue root 17, the pharynx 18 and the upper esophageal sphincter 19. The catheter connector 1 is provided with a balloon inflation interface 2, so that the position of the electrode catheter is fixed to prevent the catheter from displacement.
The foregoing is merely exemplary of the present application and the details of construction and/or the general knowledge of the structures and/or characteristics of the present application as it is known in the art will not be described in any detail herein. It should be noted that modifications and improvements can be made by those skilled in the art without departing from the structure of the present application, and these should also be considered as the scope of the present application, which does not affect the effect of the implementation of the present application and the utility of the patent. The protection scope of the present application is subject to the content of the claims, and the description of the specific embodiments and the like in the specification can be used for explaining the content of the claims.

Claims (6)

1. An endoluminal stimulating electrode for treating a swallowing disorder, the endoluminal stimulating electrode comprising:
a catheter for nasal or oral insertion into a patient, the catheter comprising a catheter body having three pairs of stimulation electrodes mounted on or about the catheter body, the three pairs of stimulation electrodes configured to receive a variable current to apply electrical stimulation to the oropharynx of the patient; the three pairs of stimulation electrodes stimulate the tongue root part, the pharyngeal part and the upper esophageal sphincter respectively;
The pair of tongue root stimulating electrodes comprises a tongue root stimulating electrode I and a tongue root stimulating electrode II, the pair of pharynx stimulating electrodes comprises a pharynx stimulating electrode I and a pharynx stimulating electrode II, and the pair of upper esophageal sphincter stimulating electrodes comprises an upper esophageal sphincter stimulating electrode I and an upper esophageal sphincter stimulating electrode II;
The distance between the first stimulation electrode and the second stimulation electrode is 1cm;
the distance between the tongue root stimulating electrode II and the pharynx stimulating electrode I is 3cm;
the distance between the pharyngeal stimulating electrode II and the upper esophageal sphincter stimulating electrode I is 5cm;
Switching means for controlling the stimulation electrode; the switching device is configured to selectively switch on one or more of the three pairs of stimulation electrodes;
the catheter also comprises a balloon and a balloon inflation interface which are arranged on the catheter main body, wherein the balloon inflation interface is used for inflating the balloon;
The inflated balloon may be in close contact with the esophageal wall and in abutment with the lower esophageal sphincter opening to achieve accurate positioning of the catheter and prevent displacement of the catheter during stimulation.
2. An endoluminal stimulating electrode for treating a swallowing disorder as claimed in claim 1 wherein the balloon is disposed adjacent one end of the catheter body and the balloon inflation interface is disposed adjacent the other end of the catheter body; the distance between the balloon and the upper sphincter stimulating electrode II is 2cm.
3. An endoluminal stimulating electrode for treating a swallowing disorder as defined in claim 1, further comprising graduations disposed on the catheter.
4. An endoluminal stimulating electrode for treating a swallowing disorder as claimed in claim 1 wherein the catheter body is encased in silicone.
5. An endoluminal stimulating electrode for use in the treatment of dysphagia according to claim 1, wherein the stimulating electrode is annular in shape and is made of a metallic material.
6. An endoluminal stimulating electrode for treating a swallowing disorder as claimed in claim 1 wherein a catheter hub connected to an electrostimulator is also provided on the other end of the catheter body, the switching means being provided on the catheter hub.
CN201811469322.5A 2018-11-29 2018-11-29 Intracavity stimulating electrode for treating dysphagia Active CN109350850B (en)

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Publication number Priority date Publication date Assignee Title
CN109350850B (en) * 2018-11-29 2024-04-19 广州市第一人民医院(广州消化疾病中心、广州医科大学附属市一人民医院、华南理工大学附属第二医院) Intracavity stimulating electrode for treating dysphagia
CN114053583A (en) * 2021-11-16 2022-02-18 深圳市理康医疗器械有限责任公司 Direction adjustable pharyngeal cavity pipe electrode
CN117563129B (en) * 2024-01-17 2024-04-19 四川锦江生命科技有限公司 Stimulating electrode with directivity and device

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WO2004028433A2 (en) * 2002-09-27 2004-04-08 The Government Of The United States Of America, Represented By The Secretary, Department Of Health And Human Services Methods and devices for intramuscular stimulation of upper airway and swallowing muscle groups
WO2008028078A2 (en) * 2006-08-30 2008-03-06 Med-El Elektromedizinische Geraete Gmbh System, apparatus, and method for facilitating interface with laryngeal structures
CN200960346Y (en) * 2006-10-13 2007-10-17 赵子文 Unwound positive and negative pressure respiratory assistance device
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