CN101239220A - Application of east-to-take-out peripheral nerve semi-implantation type electric stimulation system - Google Patents
Application of east-to-take-out peripheral nerve semi-implantation type electric stimulation system Download PDFInfo
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- CN101239220A CN101239220A CNA200810032909XA CN200810032909A CN101239220A CN 101239220 A CN101239220 A CN 101239220A CN A200810032909X A CNA200810032909X A CN A200810032909XA CN 200810032909 A CN200810032909 A CN 200810032909A CN 101239220 A CN101239220 A CN 101239220A
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Abstract
The present invention relates to an application of easy-taking peripheral nervous half-implantation type electrical stimulation system. The system is composed of functional output device, functional input device, data output device, information output device, electric power input device and contact device. The invention comprises applications of said system in peripheral nervous injured diseases, including: peripheral nerve denervated caused by violence trauma such as cutting, puncturing, breaking or indirect injury such as fracture, dislocation; peripheral nerve avulsion caused by draw-off; peripheral nerve destroyed caused by crush; peripheral nerve incidental injury caused by operation and neural inflammatory caused by various factors. The system enlarges application range of peripheral nervous half-implantation type electrical stimulation system in medical field, and takes the implanted electrical stimulation guide wire out directly or by assistant instrument monitoring after the treating course for nerve injured patient is finished, reduces tedious operation of taking out again and improves safety and practicality.
Description
Technical field
The invention belongs to biomedical engineering field, particularly relate to a kind of application of peripheral nerve semi-implantation type electric stimulation system of easy taking-up.
Background technology
Along with the fast development of China's industrial economy and communications, the high-energy trauma patient obviously increases, and the peripheral nerve injury very high based on this class disability rate of brachial plexus nerve become common clinical and frequently-occurring disease.To the regeneration behind the peripheral nerve injury, although it is neural to adopt meticulous microsurgical technique to repair at present, use medicine, hormone and nerve growth factor to promote its regeneration, neuranagenesis speed is still undesirable.Electricity irritation is as a kind of physiotherapy, be to utilize the promotion that is used for of electric current to damage peripheral nerve regeneration and prevent that flesh from withering, its effect extensively is subjected to certainly at academia, successively confirms that with a large amount of zooperies electricity irritation can promote obviously that the peripheral nerve regeneration that damages speeds up from Wilson, Pomeranz, Fakhouri, Politis etc. in 1976.Nineteen eighty-three Raji confirms that electric-impulse stimulation can promote Mus sciatic nerve functional rehabilitation, and can increase the diameter of nerve injury section and section regeneration aixs cylinder far away, and accelerator nerve damage section far away Wallerian degeneration improves neuranagenesis speed.Domestic many scholars have also carried out electricity irritation separately and have promoted perineural experiment of damage or clinical research.A large amount of experimentatioies confirms that electricity irritation has the effect that promotes peripheral nerve regeneration.Though electricity irritation at present promotes the damage peripheral nerve regeneration and prevents that the mechanism that flesh withers from not illustrating as yet that its effect is sure.
The stimulation mode of electricity irritation mainly contains two kinds at present: transcutaneous electrostimulation and implantation type electric stimulation.Both respectively have its pluses and minuses.The advantage of transcutaneous electrostimulation is to have avoided the loaded down with trivial details operation of body embedded set electrode and needed operation once more to take out, and the wound that causes of needle electrode, characteristics such as have conveniently, no pain and indication are extensive, also do not have the infection that semi-implantation type may bring and the hidden danger of damage simultaneously.But it has following shortcoming: (1) weak effect mainly is because stimulus intensity is limited, because higher stimulus intensity patient can not feel well, and the possibility of skin scald is arranged; (2) twice stimulus intervals are oversize, because percutaneous stimulation all is to carry out in hospital mostly; (3) patient's compliance is poor.Compare to transcutaneous electrostimulation, the advantage of implant electrode is can round-the-clock lasting stimulation, and because its direct stimulated muscle or nerve, its stimulus intensity can be than big many of transcutaneous electrostimulation, also can avoid inconvenience that transcutaneous electrostimulation brings, sense of discomfort and can not pinpoint defective (Osterman).Its shortcoming is the loaded down with trivial details operation of body embedded set electrode and needs operation once more to take out, and electrode itself damages the mechanics that nerve may cause.
The domestic present electricity irritation clinical practice after the nerve injury around is less relatively, and based on transcutaneous electrostimulation, implantation type electric stimulation rarely has report.At present the snap ring electrodes (Agnew) that adopt are reported in the nerve trunk electricity irritation in the world.Circular snap ring electrode can be guaranteed the contact area with the nerve trunk maximum, thereby produce bigger field intensity in the part, yet its shortcoming be its cause easily press (too little) or sliding friction repeatedly (too big) to cause proliferation of fibrous tissue to the direct card of nerve as ring as ring after card press, with the infringement to neural blood confession, simultaneously it has operation complex operation and nerve is produced the risk of secondary damage when taking out electrode.Therefore, how reducing the damage of nerve when guaranteeing good effect of stimulation as far as possible and can successfully take out the electrode seal wire becomes the thorny problem that the restriction implantation type electric stimulation is able to extensive use.
Summary of the invention
Technical problem to be solved by this invention provides the application of a kind of peripheral nerve semi-implantation type electric stimulation system of easy taking-up in orthopaedics, hands surgery, neurosurgery, microsurgery, reconstruction surgery and rehabilitation section.
The technical solution adopted for the present invention to solve the technical problems is: a kind of application of peripheral nerve semi-implantation type electric stimulation system of easy taking-up is provided, this system is by the function output device, function input equipment, data output device, information output apparatus, power supply input equipment and contact device are formed, and it is characterized in that: described peripheral nerve semi-implantation type electric stimulation system comprises in the peripheral nerve injury disease to be cut, thorn, pound violence wound or fracture, the joint dislocation indirect injury causes peripheral nerve from disconnected, tractive causes the peripheral nerve avulsion, pressure is pounded and is caused peripheral nerve and roll over and to frustrate damage, peripheral nerve is accidentally injured in operation, the application of neural inflammation due to the various factors.
Described peripheral nervous electric stimulation is in the application of hands surgical field.
Described peripheral nervous electric stimulation is in the application in neurosurgery field.
Described peripheral nervous electric stimulation is in the application in rehabilitation section field.
Described peripheral nervous electric stimulation is in the application in orthopaedics field.
Described peripheral nervous electric stimulation is in the application in microsurgery field.
Described peripheral nervous electric stimulation is in the application of reconstruction surgical field.
A kind of peripheral nerve semi-implantation type electric stimulation system of easy taking-up comprises:
(1) function input equipment: be mainly operation push-button, be used for manipulating to function output setting;
(2) data output device: being mainly USB module and port, is by the related data output of USB port with storage;
(3) information output apparatus: be mainly LCD and show, be used for the actual displayed of function setting operation and to the monitoring of stimulus parameter;
(4) power supply input equipment: be mainly 9V battery power supply circuit part;
(5) function output device: be mainly electricity irritation generation module and outfan, be used to produce the corresponding treatment electrical stimulation signal, link to each other with the electrode seal wire by interface convertor;
(6) contact device: the end of electrode seal wire have one with neural directly electrodes in contact.
Described electrical stimulation parameters is: exchange output: frequency is 2-100Hz; Pulsewidth is 50-300us; Output current is 10-1000uA.Direct current is output as: 1-9uA.Output time is: 0:01 hour to 10:00 hour.
Described electrode seal wire is formed coated outside one deck insulated sleeve by inert metal element NiTi or the cobaltic alloy silk of nickel or stainless steel silk.
The electrode of described contact device comprises some electrodes in contact or arc electrodes in contact.
A kind of peripheral nerve semi-implantation type electric stimulation method of easy taking-up comprises the following steps:
(1) directly finds the position of damaged peripheral nerves wound and carry out micro-reparation by surgical operation;
(2) insert electrode seal wire and contact electrode respectively and be fixed in adjacent tissue in the nearly far-end of the nerve of repairing the position;
(3) cause the electrode seal wire external from skin;
(4) link to each other with electric-stimulation controller by interface convertor, implement electricity irritation.
(5) after electricity irritation finished, closing controller was directly extracted the electrode seal wire out from skin.
Beneficial effect
Expanded the range of application of peripheral nerve semi-implantation type electric stimulation system at medical field, the patient who makes nerve damage is when treatment finishes the course of treatment, need not to take out the electric stimulation electrode seal wire by operation once more, but directly or by the supplementary instrument monitoring down the electricity irritation seal wire of implanting is extracted out, reduce the troublesome operation of operation taking-up once more, increased safety and practicality.
Description of drawings
Fig. 1 is a system schematic of the present invention.
Fig. 2 is system of the present invention sketch map in kind.
Among the figure: 1-portable therapeutic device 2-adapter 3-implants lead 4-experiment mouse
The specific embodiment
Below in conjunction with specific embodiment, further set forth the present invention.Should be understood that these embodiment only to be used to the present invention is described and be not used in and limit the scope of the invention.Should be understood that in addition those skilled in the art can make various changes or modifications the present invention after the content of having read the present invention's instruction, these equivalent form of values fall within the application's appended claims institute restricted portion equally.
The stimulus parameter that the present invention selects is for exchanging output, frequency: 20hz; Pulsewidth: 100us; Voltage: 9V, the electricity irritation of leaveing in first day continuous 20 day 30 minutes every day from postoperative.In actual stimulating course, it is stable that we observe embodiment object ordinary circumstance, the slight muscle contraction of visible whole back leg flesh, no spasm and lasting muscle tonus.In the light microscopic and electron microscopic section of nerve section, we do not observe " early stage aixs cylinder regression ", and (early axonal degeneration, any sign EAD) prove that the stimulus parameter that we select is feasible.
The alloy silk that the present invention adopts the electrode seal wire to be made up of inert metal element NiTi or nickel cobalt or rustless steel is made point-like or arc and neural directly electrodes in contact, seal wire coated outside one deck insulated sleeve at its end.Perusal is general glossy silver gray, this NiTi or nickel cobalt or stainless steel alloy seal wire not only have unique memory function, and have intensity height, nonmagnetic, wear-resisting, endurance, acid and alkali-resistance, the corrosive medium of anti-the human body, belong to good physics, chemical property such as extremely strong level.It is harmless, has excellent biological compatibility and lower biodegradability, and corrosion rate is widely used at medical domain less than 0.001 milligram/year in oral cavity and Physiological Medium.
When drawing materials after ten weeks in experience embodiment subject, we find that seal wire does not have obvious color and luster and changes, non-cracking, attenuate, evidence of corrosion, the obvious scar tissue adherent at no seal wire conduct position, the necrosis of festering of muscle skin in the embodiment subject.
The embodiment step: 36 of healthy male SD rats, body weight 300-350g is provided by the department of the Chinese Academy of Sciences of laboratory animal section of Fudan University.Be divided into four groups at random: the electrode seal wire a bit with 12 of sciatic nerve dry contact groups (experimental group P); Electrode seal wire arc contacts 12 of groups (matched group C) with 12 of sciatic nerve dry contact groups (experimental group Q) and electrodeless seal wire with sciatic nerve.Every group be divided into two subgroups (draw materials all around the group and drew materials in ten weeks the group each 6).Press 5ml/1000g to after the SD rats underwent intraperitoneal injection anesthesia with 1% pentobarbital sodium, the operating field sterile drape, longitudinal incision is made in the outside behind thigh, and spatium intermusculare appears sciatic nerve from buttocks thigh portion.From piriformis outlet 1cm place, cut off sciatic nerve with the sterilization razor, coincide in the descending bundle adventitia of microscope with the 9-0prolene microsutures immediately.Experimental group is placed NiTi or the nickel cobalt or the stainless steel alloy electrode of band seal wire at the nearly far-end 0.5cm of anastomotic stoma place, contact with nerve trunk row point respectively or the arc contact.Seal wire passes from the musculus glutaeocruralis gap, reserves suitable length and makes buffering after the back hypodermic tunnel passes from the rat napex, gives 5-0 and admires the silk ribbon needlework with seal wire and spatium intermusculare fascia and napex skin fixes simultaneously in case the seal wire slippage on every side.After marking the both positive and negative polarity of intending stimulating on the nearly distal guide wire of anastomotic stoma, intramuscular injection penicillin injection liquid is successively closed stitching.
Stimulating course: postoperative rose in first day, and three groups of rats are all at the same descending nerve electric stimulation of intraperitoneal anesthesia, 30 minutes every days, continued stimulus 20 days.After the continued stimulus through 20 day 30 minutes every day, end and we find when drawing materials for the tenth weekend around the: put stimulating group, the arc stimulating group all has slight adhesion at nearly far-end of sciatic nerve anastomotic stoma and surrounding tissue, all do not have and obviously infect sign, each stimulating electrode is all on the throne, there is not obvious seal wire slippage, point stimulates the electrode seal wire convenient to remove, and epineurium is still smooth; Arc stimulating electrode seal wire takes out no difficulty, but at electrode place epineurium light impression is arranged.
The present invention not only can reach gratifying effect of stimulation, and can guarantee the extraction of safe ready ground, need not implement operation once more and draw materials.
Electricity physiology and histology result when around the table one draw materials in the end
| Project | Matched group (C) | Point electrode group (P) | Arc-shaped electrode group (Q) |
| AMP(mV) | 4.72±1.90 | 7.28±1.13 | 6.30±0.70 |
| MNCV(m/s) | 31.57±5.04 | 45.23±7.18 | 40.17±4.19 |
| Muscle wet weight (g) | 1.2202±0.0072 | 1.4798±1.0072 | 1.3898±0.0078 |
| Far-end aixs cylinder number (individual/high power field) | 119±19 | 177±21 | 145±11 |
| Nerve fiber percent of pass (%) | 43.67±3.45 | 61.45±3.24 | 53.18±4.30 |
| Vascular counts under the adventitia (bar) | 19.8±1.2 | 30±1.3 | 27.3±1.0 |
Electricity physiology and histology result when table two is drawn materials for ten weekends
| Project | Matched group (C) | Point electrode group (P) | Arc-shaped electrode group (Q) |
| AMP(mV) | 6.03±1.44 | 9.15±0.64 | 6.98±1.51 |
| MNCV(m/s) | 38±3.90 | 50±4.86 | 48±4.05 |
| Muscle wet weight (g) | 1.7164±0.0102 | 2.2304±0.0072 | 2.1702±0.0092 |
| Far-end aixs cylinder number (individual/high power field) | 176±29 | 257±27 | 206±14 |
| Nerve fiber percent of pass (%) | 60.44±8.13 | 87.85±4.53 | 73.70±5.06 |
| Vascular counts under the adventitia (bar) | 27.5±1.5 | 39.5±2.4 | 34.8±1.7 |
The present invention is identical with above-mentioned zoopery at the application principle of orthopaedics, hands surgery, neurosurgery, microsurgery, reconstruction surgery and rehabilitation section.
Claims (12)
1. the application of a peripheral nerve semi-implantation type electric stimulation system that easily takes out, this system is by the function output device, function input equipment, data output device, information output apparatus, power supply input equipment and contact device are formed, it is characterized in that: described peripheral nerve semi-implantation type electric stimulation system comprises and cutting in the peripheral nerve injury disease, thorn, pound violence wound or fracture, the joint dislocation indirect injury causes peripheral nerve from disconnected, tractive causes the peripheral nerve avulsion, pressure is pounded and is caused peripheral nerve and roll over and to frustrate damage, the application of neural inflammation due to operation accidental injury peripheral nerve and the various factors.
2. the application of the peripheral nerve semi-implantation type electric stimulation system of a kind of easy taking-up according to claim 1 is characterized in that: described peripheral nervous electric stimulation is in the application of hands surgical field.
3. the application of the peripheral nerve semi-implantation type electric stimulation system of a kind of easy taking-up according to claim 1 is characterized in that: described peripheral nervous electric stimulation is in the application in neurosurgery field.
4. the application of the peripheral nerve semi-implantation type electric stimulation system of a kind of easy taking-up according to claim 1 is characterized in that: described peripheral nervous electric stimulation is in the application in rehabilitation section field.
5. the application of the peripheral nerve semi-implantation type electric stimulation system of a kind of easy taking-up according to claim 1 is characterized in that: described peripheral nervous electric stimulation is in the application in orthopaedics field.
6. the application of the peripheral nerve semi-implantation type electric stimulation system of a kind of easy taking-up according to claim 1 is characterized in that: described peripheral nervous electric stimulation is in the application in microsurgery field.
7. the application of the peripheral nerve semi-implantation type electric stimulation system of a kind of easy taking-up according to claim 1 is characterized in that: described peripheral nervous electric stimulation is in the application of reconstruction surgical field.
8. the peripheral nerve semi-implantation type electric stimulation system of a kind of easy taking-up according to claim 1 comprises:
(1) function input equipment: comprise operation push-button, be used for manipulating to function output setting;
(2) data output device: comprise USB module and port, by the related data output of USB port with storage;
(3) information output apparatus: comprise that LCD shows, be used for the actual displayed of function setting operation and to the monitoring of stimulus parameter;
(4) power supply input equipment: comprise 9V battery power supply circuit part;
(5) function output device: comprise electricity irritation generation module and outfan, be used to produce the corresponding treatment electrical stimulation signal, link to each other with the electrode seal wire by interface convertor;
(6) contact device: the end of electrode seal wire have one with neural directly electrodes in contact.
9. a kind of peripheral nerve semi-implantation type electric stimulation system according to claim 8 is characterized in that: described electrical stimulation parameters is: exchange output: frequency is 2-100Hz; Pulsewidth is 50-300us; Output current is 10-1000uA; Direct current is output as: 1-9uA; Output time is: 0:01 hour to 10:00 hour.
10. the peripheral nerve semi-implantation type electric stimulation system of a kind of easy taking-up according to claim 8 is characterized in that:
Described electrode seal wire is formed coated outside one deck insulated sleeve by inert metal element NiTi or the cobaltic alloy silk of nickel or stainless steel silk.
11. according to Claim 8 or the peripheral nerve semi-implantation type electric stimulation system of 9 or 10 described a kind of easy taking-ups, it is characterized in that: the electrode of described contact device comprises some electrodes in contact or arc electrodes in contact.
12. the peripheral nerve semi-implantation type electric stimulation method of a kind of easy taking-up according to claim 1 comprises the following steps:
(1) directly finds the position of damaged peripheral nerves wound and carry out micro-reparation by surgical operation;
(2) insert electrode seal wire and contact electrode respectively and be fixed in adjacent tissue in the nearly far-end of the nerve of repairing the position;
(3) cause the electrode seal wire external from skin;
(4) link to each other with electric-stimulation controller by interface convertor, implement electricity irritation.
(5) after electricity irritation finished, closing controller was directly extracted the electrode seal wire out from skin.
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| CNA200810032909XA CN101239220A (en) | 2008-01-22 | 2008-01-22 | Application of east-to-take-out peripheral nerve semi-implantation type electric stimulation system |
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107661572A (en) * | 2013-03-15 | 2018-02-06 | 罗切斯特大学 | Spinal nerve stimulating ring for the rehabilitation with spinal cord injuries receptor and the patient of apoplexy |
| CN109363780A (en) * | 2018-10-29 | 2019-02-22 | 复旦大学附属华山医院 | Maincenter paralysis row is good for seven transposition of side neck nerve root shift length measuring tool |
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2008
- 2008-01-22 CN CNA200810032909XA patent/CN101239220A/en active Pending
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107661572A (en) * | 2013-03-15 | 2018-02-06 | 罗切斯特大学 | Spinal nerve stimulating ring for the rehabilitation with spinal cord injuries receptor and the patient of apoplexy |
| CN109363780A (en) * | 2018-10-29 | 2019-02-22 | 复旦大学附属华山医院 | Maincenter paralysis row is good for seven transposition of side neck nerve root shift length measuring tool |
| CN109363780B (en) * | 2018-10-29 | 2024-06-07 | 复旦大学附属华山医院 | Nerve root displacement length measuring tool for central paralysis walking and cervical seven-displacement operation |
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Open date: 20080813 |