CN116269737A - Rhinitis treatment electrode assembly and rhinitis treatment device based on temperature control radio frequency ablation - Google Patents
Rhinitis treatment electrode assembly and rhinitis treatment device based on temperature control radio frequency ablation Download PDFInfo
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Abstract
The invention discloses a rhinitis treatment electrode assembly based on temperature control radio frequency ablation, which comprises: a delivery tube; the distal end of the conveying pipe is fixed at the proximal end of the cutter head so as to be communicated with the inner cavity of the cutter head, the cutter head is provided with an ablation end face, and an ablation channel is arranged on the ablation end face; the ablation electrode is partially and fixedly arranged in the inner cavity of the cutter head, an ablation part of the ablation electrode protrudes out of the ablation end surface of the cutter head through an ablation channel, and the ablation electrode is electrically connected with a power supply unit of the rhinitis treatment electrode assembly through a power cable; the temperature sensor is arranged on the ablation end face and is in signal connection with a control system of the rhinitis treatment electrode assembly through a signal cable; during the ablation operation, the ablation part protruding from the ablation end surface ablates the target tissue based on the temperature signal fed back by the temperature sensor, so as to reduce the bioactivity of the target tissue, and thus, rhinitis treatment is realized. Accurate treatment is performed by delivering energy to the nasal mucosa portion overlying the PNN region in the posterior middle nasal meatus and along the posterior inferior turbinate.
Description
Technical Field
The invention relates to the technical field of ablation treatment, in particular to a rhinitis treatment electrode assembly and a rhinitis treatment device based on temperature control radio frequency ablation.
Background
Chronic rhinitis affects about 20 million people worldwide. Symptoms include nasal discharge, nasal obstruction, itching nose, sneezing. Traditional treatments for rhinitis include the use of topical intranasal steroids, antihistamines and anticholinergic nasal sprays, etc. The symptoms difficult to treat by drug treatment need to be treated by surgery, and the modes of surgery mainly comprise two types: inferior turbinate arthroplasty, transnasal septum orthotics, and nerve block, which aim to reduce nasal mucosa hyperreactivity, are aimed at improving nasal ventilation function. Nerve blocking procedures include, for example, pterygoid-tube nerve excision and post-nasal nerve cutting.
The existing nerve blocking operation mainly comprises a pterygoid-tube nerve excision operation and a postnasal nerve cutting operation, wherein the operation modes are invasive operations, and the pterygoid-tube nerve cutting operation comprises the following steps: because the pterygoid canal is deep and is positioned outside and below the root sphenoid sinus of the pterygoid process, the inner side of the back wall of the maxillary sinus is equivalent to the back of the outer side wall of the nasal cavity and is parallel to the outer side wall of the nasal cavity, so that the pterygoid canal nerve excision operation is clinically performed, the operation is complex, the difficulty is high, and three methods of operation through the nasal cavity, the nasal septum and the maxillary sinus are mainly provided. In the operation process, the sphenoid sinus needs to be opened or the osseous structure is damaged, the operation wound is large, and postoperative infection is easy to cause. Post-nasal nerve cutting: the postnasal nerve (Posterior nasal nerve (PNN)) is derived from the pterygopalatine postganglion fibers of the pterygopalatine ganglion and the sensory fibers of the maxillary nerve, enters the nasal cavity mainly through the pterygopalatine holes, belongs to peripheral nerves distributed in the nasal cavity and is divided into an inner branch, an outer branch and a postnasal lower nerve of the postnasal upper nerve, runs under the nasal cavity mucosa, is relatively easy to be exposed relative to the pterygopalatine nerve, easily causes bleeding in the operation process, causes unclear vision, makes the operation progress slow, and often needs an electrocoagulation pteropalatine artery.
After the nerve blocking operation, partial nerves are completely cut off or cut off, and the partial nerves completely lose biological functions, so that complications such as nasal cavity dryness, hard palate numbness, dry eyes and the like are easy to occur, and particularly the incidence rate of dry eyes is high.
Disclosure of Invention
A first object of the present invention is to provide a rhinitis treatment electrode assembly based on temperature-controlled radio frequency ablation, which can perform accurate treatment on PNN (Posterior nasal nerve, postnasal nerve) regions in the covered posterior middle nasal meatus and delivery of energy along the nasal mucosa portion of the posterior inferior turbinate, so as to achieve partial destruction of the biological function of a target tissue, reduce the biological activity thereof, and not directly cause the partial target tissue to completely lose the biological function, thereby reducing the probability of adverse complications.
The second object of the present invention is to provide a rhinitis treatment device based on temperature control radio frequency ablation, which can accurately treat PNN (Posterior nasal nerve, postnasal nerve) regions in the covered posterior middle nasal meatus and the nasal mucosa portion along the posterior inferior turbinate, so as to achieve partial destruction of the biological function of the target tissue, reduce the biological activity of the target tissue, and not directly cause the partial target tissue to completely lose the biological function, thereby reducing the probability of adverse complications.
The first scheme provided by the invention is as follows: a rhinitis treatment electrode assembly based on temperature controlled radio frequency ablation, comprising: a hollow delivery tube configured to be capable of bending deformation under a predetermined strength external force; the distal end of the conveying pipe is fixed on a proximal end interface of the cutter head so as to be communicated with an inner cavity of the cutter head, the cutter head is provided with an ablation end face, and an ablation channel is arranged on the ablation end face; the ablation electrode is partially and fixedly arranged in the inner cavity of the cutter head, an ablation part of the ablation electrode protrudes out of the ablation end surface of the cutter head through the ablation channel, and the ablation electrode is electrically connected with the power supply unit of the rhinitis treatment electrode assembly through a power cable; the temperature sensor is arranged on the ablation end face and is in signal connection with a control system of the rhinitis treatment electrode assembly through a signal cable; during the ablation operation, the ablation part protruding out of the ablation end face ablates target tissues based on the temperature signals fed back by the temperature sensor so as to reduce the biological activity of the target tissues and further realize rhinitis treatment, wherein under the condition that the temperature signals fed back by the temperature sensor are lower than a preset threshold value, the electrical parameters of the ablation electrode are improved; and under the condition that the temperature signal fed back by the temperature sensor is higher than a preset threshold value, reducing the electrical parameter of the ablation electrode.
Preferably, the ablation electrode comprises a first electrode and a second electrode, the first electrode and the second electrode are arranged at intervals, the temperature sensor is arranged on an ablation end face between the first electrode and the second electrode, and an ablation part of the first electrode and the second electrode forms a current path through target tissue during ablation to perform tissue ablation.
Preferably, the ablation electrode is connected with a neutral electrode, and the distance between the temperature sensor and the neutral electrode in the ablation end face is within a preset threshold value.
Preferably, the plane of the ablation end face and the axis of the conveying pipe form an angle of 10-20 degrees, the plurality of ablation parts of the ablation electrode are arranged on the ablation end face in a matrix shape, when the ablation work is performed, the conveying pipe is subjected to preset deformation under the action of preset external force, and the ablation end face and the axis of the conveying pipe form an angle so that the ablation end face is attached to target tissue, and the ablation parts in the matrix shape accurately act on the target tissue.
Preferably, the temperature sensor is a thermocouple formed by twisting two wires with different thermoelectric voltages, so that a plurality of contact points exist between the two wires with different thermoelectric voltages of the thermocouple and target tissues during ablation, and the accuracy of the control system for obtaining temperature signals fed back by the thermocouple is improved based on the plurality of contact points during the ablation working process.
Preferably, the rhinitis treatment electrode assembly further comprises a cleaning unit, the cleaning unit comprises a water outlet hole and a water suction hole which are arranged on the ablation end face, and a water outlet connecting pipe and a water suction connecting pipe which penetrate through the conveying pipe and are respectively communicated with the water outlet hole and the water suction hole, during ablation operation, the water outlet connecting pipe conveys preset liquid to a target position through the water outlet hole so as to achieve the purposes of cleaning and/or reducing ablation impedance, and the water suction connecting pipe sucks the preset liquid through the water suction hole so as to achieve the purpose of cleaning.
Preferably, the conveying pipe is a metal pipe, and an insulating coating or an insulating film is deposited on the periphery of the metal pipe.
Preferably, the electrode assembly further comprises: a handle having a receiving cavity, a proximal end of the delivery tube being secured to a distal interface of the handle to communicate with the receiving cavity; the device comprises a handle accommodating cavity, a PCB unit arranged in the handle accommodating cavity, and an operation button arranged on the surface of the handle and electrically connected with the PCB unit, wherein the PCB unit is electrically connected with a control system of the rhinitis treatment electrode assembly, an ablation electrode is electrically connected with the PCB unit, and a temperature sensor is in signal connection with the PCB unit.
Preferably, the tool bit is ceramic material, the tool bit includes tool bit upper cover and the tool bit lower cover of mutual detachable connection, the ablation electrode set firmly in the tool bit upper cover with the inner chamber that the tool bit lower cover formed, the ablation terminal surface is located the tool bit lower cover.
Preferably, the distal end of the delivery tube has a first diameter and the proximal end of the delivery tube has a second diameter, the second diameter being greater than the first diameter.
Preferably, the distal end of the delivery tube has a first hardness and the proximal end of the delivery tube has a second hardness, the second hardness being greater than the first hardness.
The second scheme provided by the invention is as follows: the rhinitis treatment device based on the temperature control radio frequency ablation comprises the rhinitis treatment electrode assembly, and further comprises a control system host connected with the rhinitis treatment electrode assembly, wherein the control system host controls the rhinitis treatment electrode assembly to ablate target tissues based on a preset program.
Preferably, the water outlet connection pipe of the electrode assembly is connected with a flow regulator through a first hose to realize the regulation of the preset liquid delivery flow rate during cleaning.
Preferably, the water outlet connection pipe of the electrode assembly is connected with the first hose and connected with the supply device of the preset liquid through the dropping funnel.
Preferably, the first hose is connected to a peristaltic pump, and the peristaltic pump alternately extrudes and releases the first hose to achieve pumping of the preset liquid.
Preferably, the water suction connection pipe of the electrode assembly is connected with the water suction pipe of an aspirator through a second hose to realize suction of the preset liquid.
Preferably, the control system host further comprises a control switch, and the control switch is used for controlling start and stop of ablation.
Compared with the prior art, the invention has the following advantages:
1. according to the technical scheme, the temperature sensor is arranged on the ablation end face, the temperature of the treatment area is continuously monitored in the ablation operation process, so that the ablation electrode maintains the target temperature to ablate and treat the target tissue area, the effect of conveying radio frequency energy to the PNN area in the covered middle nasal meatus and the nasal mucosa part along the lower nasal turbinate and continuously monitoring the temperature of the treatment area is achieved, accurate treatment is achieved, and obvious damage to mucous membranes on the nasal surfaces and adjacent tissues can not be caused.
2. According to the technical scheme, the cleaning unit is arranged, nasal secretions are flushed in time, and the influence of the secretions on the thawing effect is reduced. Meanwhile, the visual field in the operation is guaranteed to be clearly visible, misjudgment on the ablation position is reduced, and accurate ablation is realized. The water absorption holes and the water absorption connecting pipes in the cleaning unit can timely recycle waste water, waste liquid and the like, so that secondary injury to patients is prevented. The device has the advantages that the device has a cleaning function and can reduce the impedance of an ablation part, so that the ablation range can be enlarged, namely, after the ablation range is enlarged under the specific condition of the ablation energy, the ablation energy received by the tissue to be ablated in unit area in unit time is reduced, and the device is favorable for the refined control of operators. In addition, the preset liquid conveyed by the cleaning unit can provide a cooling effect under certain conditions, for example, a tissue region after the ablation can be washed by normal saline or other liquid in a gap between two ablations to play a role of quickly cooling, the overlapping part is prevented from being excessively ablated due to the overlapping of the two ablations, and the operation safety is improved and the operation time is also shortened.
3. According to the technical scheme, in order to enable the cutter head to conveniently extend into the nasal cavity, the technical scheme of the embodiment sets the included angle between the ablation end face and the axis of the conveying pipe to be 10-20 degrees, and meanwhile the ablation end face is beneficial to fully contacting target tissues, so that accurate ablation and accurate acquisition of the temperature of a target area by the sensor are facilitated.
4. The temperature sensor adopted in the technical scheme of the invention is a thermocouple formed by twisting two metal wires of copper and nickel, and the most contact points can be obtained for the copper, copper and nickel and target tissues due to the twisting form of the two metal wires of copper and nickel, so that the temperature sensor has more accurate acquisition effect. The thermocouple is formed by twisting two metal wires of positive (TP) pure copper and negative (TN) copper-nickel alloy, namely a Peltier+ effect and a Seebek effect, when the temperature t1 at one end changes according to the difference of heat conductivity of two different materials, a potential difference can be generated between the electrodes, and the potential difference u can be converted into a corresponding temperature value t through a measuring and calculating unit. Wherein DeltaU-oc (t 1-t 2), and the potential difference is proportional to the temperature difference across. The host machine automatically maintains the target temperature of the knife end of the radio frequency temperature control rhinitis treatment electrode according to the feedback temperature of the thermocouple by real-time adjustment, and the sensor can be of other types or shapes, for example, copper wires and nickel wires are parallel and then coiled in an S shape.
Drawings
FIG. 1 is a schematic view of one embodiment of a rhinitis treatment electrode assembly of the present invention;
FIG. 2 is a cross-sectional view of a rhinitis treatment electrode assembly of the present invention;
FIG. 3 is an enlarged schematic view of a mechanism diagram and a temperature sensor of the tool bit of the present invention;
FIG. 4 is a schematic view of a tool tip according to the present invention;
FIG. 5 is a schematic view of an embodiment of a delivery tube of the present invention;
FIG. 6 is a schematic diagram showing the components of the rhinitis treatment apparatus according to the present invention;
fig. 7 shows a nasal structure of a human body.
Reference numerals illustrate:
001-posterior superior lateral nasal nerve; 002-posterior inferior lateral nasal nerve; 101-a cutter head upper cover; 102-a cutter head lower cover; 1021-ablating an end face; 1022-ablation channel; 1023-water outlet holes; 1024-water absorbing holes; 103-an ablation electrode; 1031-a first electrode; 1032-a second electrode; 2-a conveying pipe; 201-an insulating film; 301-a water outlet connecting pipe; 302-a water absorption connecting pipe; 303-a first hose; 304-a second hose; 305-a flow regulator; 306-a dropping funnel; 401-handle upper cover; 402-a handle lower cover; 403-PCB units; 404-operating a button; 405-a power line; 5-a control system host; 501-pedal; 6-peristaltic pump; 7-aspirator.
Detailed Description
Other advantages and effects of the present invention will become apparent to those skilled in the art from the following disclosure, which describes the embodiments of the present invention with reference to specific examples. The invention may be practiced or carried out in other embodiments that depart from the specific details, and the details of the present description may be modified or varied from the spirit and scope of the present invention. It is to be understood that the terms "center," "longitudinal," "transverse," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," and the like are directional or positional relationships as indicated based on the drawings, merely to facilitate describing the invention and simplify the description, and do not indicate or imply that the devices or elements referred to must have a particular orientation, be constructed and operated in a particular orientation, and thus are not to be construed as limiting the invention. Furthermore, the terms "first," "second," and the like, are used for descriptive purposes only and are not to be construed as indicating or implying a relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defining "a first", "a second", etc. may explicitly or implicitly include one or more such feature. In the description of the present invention, unless otherwise indicated, the meaning of "a plurality" is two or more.
It should be noted that, unless explicitly stated or limited otherwise, the terms "mounted," "connected," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; can be directly connected or indirectly connected through an intermediate medium, and can be communication between two elements. The specific meaning of the above terms in the present invention can be understood by those of ordinary skill in the art in a specific case.
First embodiment
The present embodiment provides a rhinitis treatment electrode assembly based on temperature-controlled radio frequency ablation, comprising: a hollow delivery tube 2 configured to be capable of undergoing bending deformation under a predetermined strength external force; the distal end of the conveying pipe 2 is fixed on a proximal end interface of the cutter head so as to be communicated with an inner cavity of the cutter head, the cutter head is provided with an ablation end surface 1021, and an ablation channel 1022 is arranged on the ablation end surface 1021; the ablation electrode 103 is partially and fixedly arranged in the inner cavity of the cutter head, an ablation part of the ablation electrode 103 protrudes out of an ablation end surface 1021 of the cutter head through the ablation channel 1022, and the ablation electrode 103 is electrically connected with a power supply unit of the rhinitis treatment electrode assembly through a power cable; the temperature sensor is arranged on the ablation end surface 1021 and is in signal connection with a control system of the rhinitis treatment electrode assembly through a signal cable; during the ablation operation, the ablation part protruding out of the ablation end surface 1021 ablates the target tissue based on the temperature signal fed back by the temperature sensor, so as to reduce the bioactivity of the target tissue and realize rhinitis treatment, wherein under the condition that the temperature signal fed back by the temperature sensor is lower than a preset threshold value, the electrical parameter of the ablation electrode 103 is improved; in case the temperature signal fed back by the temperature sensor is higher than a preset threshold, the electrical parameter of the ablation electrode 103 is reduced.
According to the technical scheme, the temperature sensor is arranged on the ablation end face 1021, the temperature of the treatment area is continuously monitored in the ablation operation process, so that the ablation electrode 103 maintains the target temperature to ablate and treat the target tissue area, the effect of conveying radio frequency energy to the PNN area in the middle nasal meatus after coverage and the nasal mucosa part along the lower nasal turbinate after coverage and continuously monitoring the temperature of the treatment area is achieved, and accurate treatment is performed, and obvious damage to the nasal surface mucosa and adjacent tissues is avoided. Preferably, the ablation electrode 103 is a radio frequency ablation electrode 103, the control system sends out high-frequency radio current, and the radio current generates a magnetic field in the electrode blade of the electrode knife head, so that molecules in target tissues covered by the magnetic field move, rub and generate heat, and thermally coagulate and destroy the target region tissues. Of course, the ablation electrode 103 may also be a plasma electrode, an ultrasonic element, a freezing element, a microwave element, a laser element or chemical ablation according to actual needs, and the system is adaptively changed. The above-mentioned electrical parameters may be parameters such as voltage, current, or power, and in any case, the purpose is to achieve constant temperature ablation, and changing the relevant parameters for achieving constant temperature should be within the scope of the present technical solution.
As an alternative embodiment, the temperature sensor may collect a temperature signal of the tissue in contact with the temperature sensor, or may be a temperature of a contact portion between the ablation end surface 1021 and the temperature sensor, or may be a temperature provided by an environment in which the temperature sensor is located.
Proteins are known to begin to denature at temperatures around 60℃and the biological activity gradually decreases. Thus, in one embodiment, the rf current provided by the ablation electrode 103 loops through the target tissue, which passes through the tissue, creating a constantly changing electric field that exerts a force on the electrolyte ions in the tissue, causing them to move back and forth at a rapid rate. The ion current rubs and impinges in the tissue to generate a magnetic field/heat which manifests itself in the tissue as a field/heat effect, thereby heating the target tissue to 50-70 ℃ to produce thermal ablation. I.e. the part of the nasal mucosa covering the PNN area in the posterior middle nasal meatus and along the posterior inferior turbinates, is heated, so that this part of the nerves starts to denature and reduce the bioactivity. Preferably, the heating may be performed for a period of 10 seconds to 15 seconds to reduce the biological activity of the portion of the nerve to the desired level.
Preferably, the ablation electrode 103 includes a first electrode 1031 and a second electrode 1032, the first electrode 1031 and the second electrode 1032 are spaced apart, the temperature sensor is disposed on an ablation end surface 1021 between the first electrode 1031 and the second electrode 1032, and an ablation portion of the first electrode 1031 and the second electrode 1032 forms a current path through a target tissue during ablation to perform tissue ablation.
In the technical solution of the present embodiment, referring to fig. 1 and 3, the ablation electrode 103 includes a first electrode 1031 and a second electrode 1032, which are respectively connected to two ends of the power supply unit, and when the power switch is turned on and the ablation electrode 103 is made to fully contact the target treatment area to start working, a current path is formed by means of the target tissue so as to perform tissue ablation. The temperature sensor is disposed on the ablation end surface 1021 between the first electrode 1031 and the second electrode 1032, so that the temperature sensor can monitor the temperature of the target area better, thereby being beneficial to realizing constant temperature ablation.
Preferably, the ablation electrode 103 is connected to a neutral electrode, and the distance between the temperature sensor and the neutral electrode in the ablation end surface 1021 is within a preset threshold value.
Preferably, in consideration of the narrow nasal cavity space, the ablation electrode 103 is connected with a neutral electrode, and another signal for capturing the neutral electrode connected with the ablation electrode 103 is arranged at other parts of the human body, such as the shoulder, so as to form a loop, and when the operation button 404 is turned on, the neutral electrode can ablate the target tissue. The temperature sensor is arranged within a preset distance from the neutral electrode, so that accurate acquisition of temperature signals is facilitated. Of course, the temperature sensor may be preferably disposed around the neutral electrode, or may be disposed at one or more points around the neutral electrode. The temperature sensor may be one or a plurality of temperature sensors. So as to obtain more accurate temperature information and control the temperature more accurately.
Referring to fig. 7, showing the nasal structures of the human body, the electrode assembly of the present embodiment is required to act on the rear upper outer nasal nerve 001 and the rear lower outer nasal nerve 002 for ablation so that the activity of the rear upper outer nasal nerve 001 and the rear lower outer nasal nerve 002 is reduced. In the process of ablation, the nasal valve is the narrowest part of the nasal cavity and is the position with the largest resistance to the airflow of the nasal cavity, and the nasal valve consists of an inner nasal valve and an outer nasal valve. The internal nasal valve accounts for about 50% of the total airway resistance, about 1.3. 1.3 cm from the anterior nares, and is generally considered to be the nasal septum on the medial side, the lateral cartilage caudal margin on the nasal side, the inferior nasal concha head on the lateral side, and the nasal bottom on the inferior side. The angle formed between the tail of the nasal outside cartilage and the nasal septum is called the nasal valve angle. The average angle of the nasal valve angles of caucasians is 10-15, while asians and african americans are more blunt, with asians at about 17-25. Considering that the conveying pipe 2 in the technical scheme of the embodiment is internally provided with a water pipe, a cable and the like, large-angle bending cannot be performed, and in order to enable the cutter head to reach a preset area, a certain angle is preset between the ablation end face 1021 of the cutter head and the conveying pipe 2, so that accurate ablation is realized.
Preferably, the plane of the ablation end surface 1021 and the axis of the delivery tube 2 form an angle of 10 ° to 20 °, the plurality of ablation portions of the ablation electrode 103 are arranged in a matrix on the ablation end surface 1021, and when the ablation works, the delivery tube 2 is subjected to preset deformation under the action of a preset external force, and the ablation end surface 1021 and the axis of the delivery tube 2 form an angle so that the ablation end surface 1021 is attached to a target tissue, and the matrix-shaped ablation portions accurately act on the target tissue.
In order to facilitate the cutter head to extend into the nasal cavity, the technical scheme of the embodiment sets the included angle between the ablation end surface 1021 and the axis of the conveying pipe 2 to be 10-20 degrees, and is beneficial to enabling the ablation end surface 1021 to fully contact with target tissues, so that the sensor can accurately obtain the temperature of the target area. Preferably, referring to fig. 4, the cutter head of the present invention is schematically shown, and the angle may be set at 15 °. The ablation parts are arranged in a matrix shape in the ablation end face 1021, and under the condition of uniform impedance, the ablation scope of the ablation electrode is determined by an operator, so that accurate ablation is realized.
Preferably, the temperature sensor is a thermocouple formed by twisting two wires with different thermoelectric voltages, so that a plurality of contact points exist between the two wires with different thermoelectric voltages of the thermocouple and target tissues during ablation, and the accuracy of the control system for obtaining temperature signals fed back by the thermocouple is improved based on the plurality of contact points during the ablation working process.
In one embodiment, both copper and copper nickel wires may be used. The temperature sensor adopted in the embodiment is a thermocouple formed by twisting two metal wires of copper and nickel, and as shown in fig. 3, the two metal wires of copper and nickel are twisted, so that the most contact points can be obtained for the copper, copper and nickel and a target tissue, and the temperature sensor has a more accurate acquisition effect. The thermocouple is formed by twisting two metal wires of positive (TP) pure copper and negative (TN) copper-nickel alloy, namely a Peltier+ effect and a Seebek effect, when the temperature t1 at one end changes according to the difference of heat conductivity of two different materials, a potential difference can be generated between the electrodes, and the potential difference u can be converted into a corresponding temperature value t through a measuring and calculating unit. Wherein DeltaU-oc (t 1-t 2), and the potential difference is proportional to the temperature difference across. The host machine automatically maintains the target temperature of the knife end of the radio frequency temperature control rhinitis treatment electrode according to the feedback temperature of the thermocouple by real-time adjustment, and the sensor can be of other types or shapes, for example, copper wires and nickel wires are parallel and then coiled in an S shape. Of course, the particular materials and particular shapes of the wires of the present embodiment are not limiting on the inventive concept.
Preferably, the rhinitis treatment electrode assembly further comprises a cleaning unit, the cleaning unit comprises a water outlet 1023 and a water suction hole 1024 which are arranged on the ablation end surface 1021, and a water outlet connecting pipe 301 and a water suction connecting pipe 302 which penetrate through the conveying pipe 2 and are respectively communicated with the water outlet 1023 and the water suction hole 1024, during the ablation operation, the water outlet connecting pipe 301 conveys preset liquid to a target position through the water outlet 1023 so as to achieve the purposes of cleaning and/or reducing ablation impedance, and the water suction connecting pipe 302 sucks the preset liquid through the water suction hole 1024 so as to achieve the purpose of cleaning.
According to the technical scheme, the cleaning unit is arranged to timely wash nasal secretion, so that the influence of the secretion on the thawing effect is reduced. Meanwhile, the visual field in the operation is guaranteed to be clearly visible, misjudgment on the ablation position is reduced, and accurate ablation is realized. The water absorbing holes 1024 and the water absorbing connecting pipes 302 in the cleaning unit can timely recycle waste water, waste liquid and the like, so that secondary damage to patients is prevented. In addition, the preset liquid conveyed by the cleaning unit can provide a cooling effect under certain conditions, for example, a tissue region after the ablation can be washed by normal saline or other liquid in a gap between two ablations to play a role of quickly cooling, the overlapping part is prevented from being excessively ablated due to the overlapping of the two ablations, and the operation safety is improved and the operation time is also shortened.
From another aspect, the cleaning unit not only plays a role of cleaning after delivering the preset liquid (such as physiological saline), but also can reduce the impedance of the part to be ablated, so that the ablation range can be enlarged, that is, after the ablation range is enlarged under the specific condition of the ablation energy, the ablation energy received by the tissue to be ablated in unit area in unit time is reduced, which is beneficial to the fine control of the operator.
Preferably, the delivery pipe 2 is a metal pipe, and an insulating coating or an insulating film 201 is deposited on the outer periphery of the metal pipe 2.
Because the metal material has good plasticity, the delivery tube 2 is made of metal in this embodiment, and the nasal structures of different patients may have slight differences, and before the delivery tube 2 stretches into the nasal cavity, a therapist can adjust the shape and/or angle of the delivery tube 2 according to the nasal structures of the patients, so that the delivery tube 2 can stretch into the nasal cavity better.
Preferably, the electrode assembly further comprises a handle having a receiving cavity, the proximal end of the delivery tube 2 being secured to the distal interface of the handle to communicate with the receiving cavity; the device comprises a PCB unit 403 arranged in the handle accommodating cavity and an operation button 404 arranged on the surface of the handle and electrically connected with the PCB unit 403, wherein the PCB unit 403 is electrically connected with a control system of the rhinitis treatment electrode assembly, the ablation electrode 103 is electrically connected with the PCB unit 403, and the temperature sensor is in signal connection with the PCB unit 403.
Referring to fig. 1 and 2, in this embodiment, the handle has a handle upper cover 401 and a handle lower cover 402, the handle upper cover 401 and the handle lower cover 402 form a containing cavity, the PCB unit 403 is fixedly disposed in the containing cavity, the PCB unit 403 is electrically connected to the ablation electrode 103 through a power line (not shown in the drawing) to realize transmission of ablation energy, and the PCB unit 403 is electrically connected to the temperature sensor through a signal line (not shown in the drawing) to realize collection of a temperature signal.
Preferably, the tool bit is made of ceramic, the tool bit includes a tool bit upper cover 101 and a tool bit lower cover 102 which are detachably connected with each other, the ablation electrode 103 is fixedly arranged in an inner cavity formed by the tool bit upper cover 101 and the tool bit lower cover 102, and the ablation end surface 1021 is positioned on the tool bit lower cover 102.
Because the ceramic has good insulativity and lower thermal conductivity, the cutter head is made of ceramic materials, so that a good insulation effect can be obtained, and abnormal ablation areas or scalding of other tissues in the nasal cavity can be prevented.
Preferably, the distal end of the delivery tube 2 has a first diameter and the proximal end of the delivery tube 2 has a second diameter, the second diameter being greater than the first diameter.
The delivery tube 2 adopts the reducing design, and distal end diameter is less than proximal end diameter, and distal end minor diameter is favorable to reducing the interference to the nasal endoscope, and the nasal endoscope of being convenient for stretches into the nasal cavity, reduces the electrode tube simultaneously and to the foreign matter invasion sense that brings at the nasal cavity, electrode tube proximal end major diameter, when guaranteeing electrode security, is favorable to improving the flexibility of operation. Of course, the delivery tube 2 may be provided in a gradually increasing diameter from the distal end to the proximal end, or may be of a two-stage design, as shown in fig. 5, which is a schematic representation of one embodiment of the delivery tube of the present invention.
Preferably, the distal end of the delivery tube 2 has a first hardness, and the proximal end of the delivery tube 2 has a second hardness, which is greater than the first hardness, so that the safety of the electrode is ensured while the operation flexibility is improved.
The distal end hardness of the conveying pipe 2 is lower than that of the proximal end, so that a doctor can bend the operation pipe by hand according to actual conditions, and the operation pipe can be adjusted to a proper angle and/or shape.
Second embodiment
The embodiment provides a rhinitis treatment device based on temperature control radio frequency ablation, which comprises any one of the rhinitis treatment electrode assemblies, and further comprises a control system host 5 connected with the rhinitis treatment electrode assemblies, wherein the control system host 5 controls the rhinitis treatment electrode assemblies to ablate target tissues based on a preset program.
The control system host 5 is used for delivering energy to the rhinitis treatment component, the temperature sensor feeds back a temperature signal to the control system host 5, and the control system host 5 controls the ablation electrode 103 based on the temperature signal so as to realize constant-temperature ablation. The rhinitis treatment electrode assembly is connected with the control system host 5 through a plug so as to realize signal and energy transmission.
Preferably, the outlet connection pipe 301 of the electrode assembly is connected to a flow regulator 305 through a first hose 303 to achieve the regulation of the preset liquid delivery flow rate during cleaning.
Referring to fig. 1, by providing the flow regulator 305, the adjustment of the preset liquid delivery flow can be realized, nasal secretions can be flushed timely and accurately, and the influence of the secretions on the thawing effect is reduced. Meanwhile, the visual field in the operation is guaranteed to be clearly visible, misjudgment on the ablation position is reduced, and accurate ablation is realized.
Preferably, the water outlet connection pipe 301 of the electrode assembly is connected to the first hose 303 through the drip chamber 306 to be connected to the supply device of the preset liquid.
In an actual application scenario, the rhinitis treatment device of the present embodiment may be directly used in an outpatient service, where the outpatient service may not have a specific preset liquid supply device, and then the drip chamber 306 provided in the present embodiment may be directly connected to a preset liquid supply device, where the preset liquid may be physiological saline or a preset medicament solvent, and then the supply device may be directly a common infusion container.
Preferably, the first hose 303 is connected to a peristaltic pump 6, and the peristaltic pump 6 alternately squeezes and releases the first hose 303 to pump the preset liquid.
As shown in fig. 6, the peristaltic pump 6 is configured to alternately squeeze and release the first hose 303, thereby pumping a predetermined liquid.
Preferably, the suction connection pipe 302 of the electrode assembly is connected to a suction pipe of a suction device 7 through a second hose 304 to achieve suction of a predetermined liquid.
Referring to fig. 6, the water suction connection pipe 302 is connected with a water suction pipe of the aspirator 7, and negative pressure is generated in the aspirator 7 to suck and store the preset liquid, so that nasal secretions are flushed in time, and the influence of the secretions on the thawing effect is reduced. Meanwhile, the visual field in the operation is guaranteed to be clearly visible, misjudgment on the ablation position is reduced, and accurate ablation is realized. The water absorbing holes 1024 and the water absorbing connecting pipes 302 in the cleaning unit can timely recycle waste water, waste liquid and the like, so that secondary damage to patients is prevented. Preferably, both the first hose 303 and the second hose 304 may be PVC hoses, and may be hoses made of other materials.
Preferably, the control system host 5 further comprises a control switch, and the control switch is used for controlling start and stop of ablation.
Referring to fig. 6, the control switch may be a pedal 501, in some cases, the operator's hand is inconvenient to operate the switch, and then a pedal 501 switch connected in parallel with the operation button 404 is provided, so that the ablation operation is completed under the synchronous cooperation of hands and feet, and the operation is more reliable and convenient.
Application example
The patient is seated and the operator applies ablative treatment to the patient covering the PNN area in the posterior middle nasal meatus and along the nasal mucosa portion of the posterior inferior turbinate.
Step 1: the mixed solution of the tetracaine and the ephedrine is sprayed into the nasal cavity of the patient to perform the function of surface anesthesia and contraction of the nasal cavity.
Step 2: submucosally injecting not less than 1ml of local anesthetic into the patient near the root of the turbinate, for example: anesthesia was performed with 0.5% lidocaine.
Step 3: the tool bit of the radio frequency temperature control rhinitis treatment electrode assembly extends into nostrils, the treatment part is accurately positioned under the cooperation of the nasal endoscope, and the tool bit is fully contacted with the treatment position.
Step 4: clicking on the operating button 404 on the handle and/or the foot rest 501 initiates the treatment.
Step 5: the control system host 5 can automatically maintain the target temperature of the radiofrequency temperature control rhinitis treatment electrode knife end so as to achieve the treatment purpose.
Step 6: after the single ablation is completed, nasal mucus is washed by a water outlet pipe, a small amount of bleeding is washed, and meanwhile, waste water is collected in time by a water suction pipe.
Step 7: and (5) repeating the steps 3 to 6 to ablate the postnasal nerve plexus.
The embodiments of the present invention have been described in detail with reference to the drawings, but the present invention is not limited to the above embodiments. Even if various changes are made to the present invention, it is within the scope of the appended claims and their equivalents to fall within the scope of the invention.
Claims (10)
1. A rhinitis treatment electrode assembly based on temperature controlled radio frequency ablation, comprising:
a hollow delivery tube configured to be capable of bending deformation under a predetermined strength external force;
the distal end of the conveying pipe is fixed on a proximal end interface of the cutter head so as to be communicated with an inner cavity of the cutter head, the cutter head is provided with an ablation end face, and an ablation channel is arranged on the ablation end face;
the ablation electrode is partially and fixedly arranged in the inner cavity of the cutter head, an ablation part of the ablation electrode protrudes out of the ablation end surface of the cutter head through the ablation channel, and the ablation electrode is electrically connected with the power supply unit of the rhinitis treatment electrode assembly through a power cable;
the temperature sensor is arranged on the ablation end face and is in signal connection with a control system of the rhinitis treatment electrode assembly through a signal cable;
during the ablation operation, the ablation part protruding out of the ablation end face ablates target tissues based on the temperature signals fed back by the temperature sensor so as to reduce the biological activity of the target tissues and further realize rhinitis treatment, wherein under the condition that the temperature signals fed back by the temperature sensor are lower than a preset threshold value, the electrical parameters of the ablation electrode are improved; and under the condition that the temperature signal fed back by the temperature sensor is higher than a preset threshold value, reducing the electrical parameter of the ablation electrode.
2. The rhinitis treatment electrode assembly based on temperature control radio frequency ablation according to claim 1, wherein the ablation electrode comprises a first electrode and a second electrode, the first electrode and the second electrode are arranged at intervals, the temperature sensor is arranged on an ablation end face between the first electrode and the second electrode, and an ablation part of the first electrode and the second electrode forms a current path through target tissue for tissue ablation during ablation.
3. The rhinitis treatment electrode assembly based on temperature controlled radio frequency ablation according to claim 1, wherein the ablation electrode is connected to a neutral electrode, and the distance between the temperature sensor and the neutral electrode in the ablation end face is within a preset threshold.
4. The rhinitis treatment electrode assembly based on temperature control radio frequency ablation according to claim 1, wherein the plane of the ablation end face and the axis of the delivery tube form an angle of 10-20 degrees, a plurality of ablation parts of the ablation electrode are arranged on the ablation end face in a matrix shape, when the ablation work is performed, the delivery tube is subjected to preset deformation under the action of preset external force, and the ablation end face and the axis of the delivery tube form an angle in a superimposed manner, so that the ablation end face is attached to target tissue, and the ablation parts in the matrix shape accurately act on the target tissue.
5. The rhinitis treatment electrode assembly based on temperature control radio frequency ablation according to claim 4, wherein the temperature sensor is a thermocouple formed by twisting two wires with different thermoelectric potentials, so that a plurality of contact points exist between the two wires with different thermoelectric potentials of the thermocouple and target tissues during ablation, and the accuracy of obtaining temperature signals fed back by the thermocouple by the control system is improved based on the plurality of contact points during the ablation operation.
6. The rhinitis treatment electrode assembly based on temperature control radio frequency ablation according to claim 1, further comprising a cleaning unit, wherein the cleaning unit comprises a water outlet hole and a water suction hole which are arranged on the ablation end face, and a water outlet connecting pipe and a water suction connecting pipe which are respectively communicated with the water outlet hole and the water suction hole and penetrate through the conveying pipe, and during ablation operation, the water outlet connecting pipe conveys preset liquid to a target position through the water outlet hole so as to achieve the purposes of cleaning and/or reducing ablation impedance, and the water suction connecting pipe sucks the preset liquid through the water suction hole so as to achieve the purposes of cleaning.
7. The rhinitis treatment electrode assembly based on temperature-controlled radio frequency ablation according to claim 1, wherein the delivery tube is a metal tube, and an insulating coating or an insulating film is deposited on the outer periphery of the metal tube.
8. The rhinitis treatment electrode assembly based on temperature-controlled radio frequency ablation of claim 1, wherein the electrode assembly further comprises:
a handle having a receiving cavity, a proximal end of the delivery tube being secured to a distal interface of the handle to communicate with the receiving cavity;
the device comprises a handle accommodating cavity, a PCB unit arranged in the handle accommodating cavity, and an operation button arranged on the surface of the handle and electrically connected with the PCB unit, wherein the PCB unit is electrically connected with a control system of the rhinitis treatment electrode assembly, an ablation electrode is electrically connected with the PCB unit, and a temperature sensor is in signal connection with the PCB unit.
9. The rhinitis treatment electrode assembly based on temperature control radio frequency ablation according to claim 1, wherein the cutter head is made of ceramic materials, the cutter head comprises a cutter head upper cover and a cutter head lower cover which are detachably connected with each other, the ablation electrode is fixedly arranged in an inner cavity formed by the cutter head upper cover and the cutter head lower cover, and the ablation end face is positioned on the cutter head lower cover.
10. A rhinitis treatment device based on temperature control radio frequency ablation, comprising the rhinitis treatment electrode assembly according to any one of claims 1 to 9, and further comprising a control system host connected to the rhinitis treatment electrode assembly, wherein the control system host controls the rhinitis treatment electrode assembly to ablate target tissue based on a preset program.
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| CN116807607A (en) * | 2023-08-29 | 2023-09-29 | 北京先瑞达医疗科技有限公司 | Implanted ablation device |
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