Artificial nasolacrimal canal
Technical field
The invention belongs to medicine technology field, relate to a kind of treatment of ophthalmic diseases, particularly a kind of artificial nasolacrimal canal.
Background technology
To be tear enter two pipelines of nasal cavity from eyes with nasolacrimal duct, and nasolacrimal duct comprises nasolacrimal duct house steward and lacrimal ductule, and lacrimal ductule comprises superior canaliculus and lower lacrimal canaliculi.Excessive tear is a kind of commonly encountered diseases, the frequently-occurring disease of ophthalmology, mainly is to be caused by nasolacrimal passage obliteration.Main at present employing dacryocystorhinostomy or probing of lacrimal passage are treated.But the dacryocystorhinostomy operation is complicated, and damage is big, and intraoperative hemorrhage is many, and operating time is long, and the operation rear face leaves cicatrix, can not undergo surgery because of surgical contraindication sometimes; Operation has simultaneously changed the original anatomical passageway of lacrimal passage, in case postoperative anastomotic stoma fiber forms cicatrix or ossified, can cause anastomotic stoma to block so that cause that lacrimal passage blocks again.Probing of lacrimal passage exists the long-term effect instability, and the problem that relapse rate is high is not suitable for the treatment of chronic dacryocystitis especially, makes its application be subjected to certain limitation.
At the deficiency of existing operation method, so there is the people to design the kinds of artificial nasolacrimal duct, the surgical injury of implantable artificial nasolacrimal duct is little and do not change the original anatomical passageway of lacrimal passage.For example, Chinese patent literature once disclosed a kind of artificial nasolacrimal canal [China Patent No.: zl200820208980.4; Granted publication number: CN201370875Y], comprise drainage tube, the upper end of drainage tube is provided with a push pipe and plurality of fixed lobe, above-mentioned fixed lobes is made by the bar shaped sheet material, push pipe, fixed lobes, drainage tube are connected to integral structure, each fixed lobes is uniform distribution and the outwardly-bent lantern shape that surrounds along the circumferential direction, has breach between two adjacent fixed lobes.Though it is little that the artificial nasolacrimal canal of this structure has a relative surgical injury, postoperative is difficult for the advantage of recurrence, but this artificial nasolacrimal canal can only be implanted nose tear house steward, promptly only is suitable for the disease on the nose tear house steward, can't be used for the treatment of diseases such as lacrimal ductule obstruction, so exist certain limitation.
The head of this artificial nasolacrimal duct inner chamber to the diameter of bottom equates, only is fit to adopt the operation of guiding push-in type when this artificial nasolacrimal canal is implanted, and can't adopts guiding to draw in the formula operation.Each doctor has the modus operandi that self is accustomed to, if do not adopt aforesaid way may cause the operative failure rate to promote, the scope of application of this artificial nasolacrimal duct is influenced by doctor's the modus operandi of self being accustomed to also thus.
Summary of the invention
The objective of the invention is to have the problems referred to above, proposed a kind of artificial nasolacrimal canal that can treat diseases such as nose tear house steward and lacrimal ductule obstruction simultaneously at existing technology.
Purpose of the present invention can realize by following technical proposal: a kind of artificial nasolacrimal canal, comprise the drain person in charge, the top that drain is responsible for has some and is the flaky fixed lobes of bar shaped, the outwardly-bent camber of described every fixed lobes and have elasticity, it is characterized in that, described fixed lobes place is provided with the piped drain arm that can penetrate in the lacrimal ductule, and this drain arm is responsible for above-mentioned drain and is communicated.
The outwardly-bent camber of fixed lobes is from extremely maximum to end face direction natural expansion with drain person in charge connecting place, and then transition is drawn in to the place, axle center.When employing was performed the operation this in artificial nasolacrimal duct importing body, fixed lobes was opened just at the lachrymal sac place this artificial nasolacrimal duct is fixed in the body, can expand the lachrymal sac of contraction simultaneously.The drain arm penetrates in the lacrimal ductule just with the lacrimal ductule conducting; Drain is responsible for nose tear house steward conducting.Thereby the tear in the eye socket can enter lachrymal sac by the drain arm, and the tear in the lachrymal sac can flow into drain and be responsible for from the breach between two fixed lobes, and the end that drain is responsible for links to each other with nasal tube, so realize the mediation lacrimal passage.
In above-mentioned artificial nasolacrimal canal, the quantity of described fixed lobes is 2~10.Fixed lobes is along circumferential uniform distribution, has breach between the per two adjacent fixed lobes.
In above-mentioned artificial nasolacrimal canal, described fixed lobes top is provided with locking cap, and the lower end of fixed lobes is connected with the upper surface that drain is responsible for, and the upper end of fixed lobes comes together in the locking cap place and fixed lobes is connected mutually with locking cap.The firmness that locking cap has improved the fixed lobes top greatly is set, has also increased the elasticity of fixed lobes simultaneously, make it fixing more firm.
In above-mentioned artificial nasolacrimal canal, the quantity of described drain arm is 1~2.Dacryocanalicular quantity has only two at most in the human body, but ill lacrimal ductule may be wherein one, a drain arm is set thus has more specific aim, has promptly avoided the dacryocanalicular loss of another root.
In above-mentioned artificial nasolacrimal canal, described drain is responsible on the upper surface and is fixed with a drain arm; The junction that drain arm and drain are responsible for is between above-mentioned two adjacent fixed lobes.
According to the physiological structure of human nasal lacrimal passage, when fixed lobes was positioned at lachrymal sac, the extended line of lower lacrimal canaliculi was positioned at fixed lobes place and close drain appropriate department, so fixing the person in charge on the upper surface with drain of drain arm meets the human physiological structure.This drain arm can penetrate lower lacrimal canaliculi, and the position that can guarantee after the drain arm penetrates lower lacrimal canaliculi to be deformed simultaneously and the drain arm is responsible for respect to drain does not change yet.Though the indentation, there of the junction that drain arm and drain are responsible between two adjacent fixed lobes only accounted for its less area, flows in the lachrymal sac normally so guaranteed tear.
In above-mentioned artificial nasolacrimal canal, has the through hole of axial perforation on the described locking cap, the diameter that the diameter of through hole is responsible for less than drain.The diameter of locking cap is less, and when lead passed locking cap and ties a knot in the end, locking cap can block and knot, and makes lead artificial nasolacrimal canal can be drawn desired location, thereby has increased the modus operandi that the doctor implants artificial nasolacrimal canal.
In above-mentioned artificial nasolacrimal canal, be fixed with a drain arm on the lower surface of described locking cap; The junction of drain arm and locking cap is between above-mentioned two adjacent fixed lobes.
According to the physiological structure of human nasal lacrimal passage, when fixed lobes was positioned at lachrymal sac, the extended line of superior canaliculus was positioned at the fixed lobes place and near the locking cap place, then the drain arm fixing with the locking cap lower surface on meet the human physiological structure.This drain arm can penetrate superior canaliculus, can guarantee after the drain arm penetrates superior canaliculus to be deformed and the drain arm is not also changed with respect to the position of locking cap simultaneously.Though the indentation, there of the junction that drain arm and drain are responsible between two adjacent fixed lobes only accounted for its less area, flows in the lachrymal sac normally so guaranteed tear.
In above-mentioned artificial nasolacrimal canal, be fixed with a drain arm one on the upper surface that described drain is responsible for; Be provided with a drain arm directly over drain arm one, the junction that drain arm one and drain are responsible for and the junction of drain arm two and locking cap are between identical above-mentioned two adjacent fixed lobes.
Have two drain arms in the above-mentioned artificial nasolacrimal canal, according to the physiological structure of human nasal lacrimal passage, when fixed lobes was positioned at lachrymal sac, the extended line of lower lacrimal canaliculi was positioned at fixed lobes place and close drain appropriate department; The extended line of superior canaliculus is positioned at fixed lobes place and close locking cap place; So drain arm one is fixing be responsible on the upper surface with drain and drain arm two fixing with the locking cap lower surface on meet the human physiological structure.Thus, drain arm one can penetrate lower lacrimal canaliculi, drain arm two can penetrate superior canaliculus, can guarantee after the drain arm penetrates lower lacrimal canaliculi, superior canaliculus to be deformed and the drain arm is not also changed with respect to the position of the drain person in charge, locking cap simultaneously.Though the junction that drain arm and drain are responsible for and the junction of drain arm and locking cap be the indentation, there between identical two adjacent fixed lobes all, but has only accounted for its less area, flow into normally in drain is responsible for so guaranteed tear.
In above-mentioned artificial nasolacrimal canal, the described drain person in charge, drain arm, fixed lobes and locking cap all adopt plastics or elastomeric material to make.Specifically, artificial nasolacrimal canal adopts the macromolecule medical material in plastics or the elastomeric material to make, and it has higher flexibility.After the artificial nasolacrimal duct of basis implanted, the drain person in charge in the artificial nasolacrimal canal can be out of shape back identical in the human physiological structure with the drain arm.
In above-mentioned artificial nasolacrimal canal, be integral structure between the described drain person in charge, drain arm, fixed lobes and the locking cap.Integral structure has been stopped part and has been separated situation about dropping, and has increased fastness simultaneously and has improved safety coefficient and service life.
In above-mentioned artificial nasolacrimal canal, the head of described drain arm is tapered.The tube wall that tube head is propped up in drain dwindles gradually towards the front end face direction and makes this position littler and slick and sly than the diameter at all the other positions, thereby makes things convenient for the drain arm to import in the tiny lacrimal ductule and reduce dacryocanalicular damage.
In above-mentioned artificial nasolacrimal canal, described drain is responsible for and is provided with several vertically and the locating hole that circumferentially all is dislocatedly distributed.Locating hole is determined with respect to the position of drain arm, only need determine the position relation of locating hole with respect to nasal meatus thus when operation, the drain arm can be directed in the lacrimal ductule accurately.Fail accurately to arrive assigned address if import the back artificial nasolacrimal canal, then available traveller hook is pulled out artificial nasolacrimal canal in the locating hole place.Locating hole is set thus can make operation more convenient, safe, accurate.
Compared with prior art, this artificial nasolacrimal duct has solved lacrimal ductule jointly and has stopped up the problem that the disease that causes can't be treated when treatment nose tear house steward and the lachrymal sac place disease.
This artificial nasolacrimal duct has simple, convenient, the safety of implant surgery, can adopt the modus operandi multiformity, and indication is wide, the advantage that curative effect is sure.
This artificial nasolacrimal duct adopts integral structure to increase fastness and has improved safety coefficient and service life.
Description of drawings
Fig. 1 is the sectional structure sketch map of this artificial nasolacrimal duct embodiment one.
Fig. 2 is the sectional structure sketch map of A-A among Fig. 1.
Fig. 3 is the structural representation at B visual angle among Fig. 1.
Fig. 4 is the structural representation at C visual angle among Fig. 1.
Fig. 5 is the plan structure sketch map of this artificial nasolacrimal duct embodiment two.
Fig. 6 is the sectional structure sketch map of this artificial nasolacrimal duct embodiment three.
Fig. 7 is the structural representation at D visual angle among Fig. 5.
Fig. 8 is the structural representation at E visual angle among Fig. 6.
Among the figure, 1, drain is responsible for; 1a, locating hole; 2, fixed lobes; 3, locking cap; 3a, through hole; 4, drain arm; 41, the drain arm one; 42, the drain arm two.
The specific embodiment
Below be specific embodiments of the invention and in conjunction with the accompanying drawings, technical scheme of the present invention is further described, but the present invention be not limited to these embodiment.
Embodiment one
As shown in Figures 1 to 4, artificial nasolacrimal canal comprises the drain person in charge 1, fixed lobes 2, locking cap 3, drain arm 4.
Specifically, as depicted in figs. 1 and 2, it is 1 cylindrical that drain is responsible for, and its underpart has locating hole 1a.Locating hole 1a determines with respect to the position of drain arm 4, only need determine the position relation of locating hole 1a with respect to nasal meatus thus when operation, drain arm 4 can be directed in the lacrimal ductule accurately.Fail accurately to arrive assigned address if import the back artificial nasolacrimal canal, then available traveller hook is pulled out artificial nasolacrimal canal in locating hole 1a place.Locating hole 1a is set thus can make operation more convenient, safe, accurate.
The quantity of above-mentioned locating hole 1a is two, and all is dislocatedly distributed at axial and circumferential.
Positive top of the drain person in charge 1 has two and is bar shaped lamellar and rubber-like fixed lobes 2, and fixed lobes 2 is responsible for 1 circumferential uniform distribution along drain, has breach between two fixed lobes 2.Fixed lobes 2 tops are provided with locking cap 3, the lower end of fixed lobes 2 is connected with the drain person in charge 1 upper surface, it is extremely maximum to locking cap 3 direction natural expansion that 1 connecting place is responsible in fixed lobes 2 and drain, and then transition comes together in locking cap 3 places and fixed lobes 2 is connected mutually with locking cap 3.
As shown in Figures 1 to 4, one of them indentation, there between two fixed lobes 2 is provided with a piped drain arm 4 that can penetrate in the lacrimal ductule.Lacrimal ductule comprises superior canaliculus and little lacrimal ductule; According to the physiological structure of human nasal lacrimal passage, when fixed lobes 2 was positioned at lachrymal sac, the extended line of lower lacrimal canaliculi was positioned at fixed lobes 2 places and is responsible for 1 place near drain.So in order to make above-mentioned drain arm 4 can penetrate lower lacrimal canaliculi, after simultaneously drain arm 4 penetrates lower lacrimal canaliculi is deformed and make drain arm 4 be responsible for 1 position and do not change with respect to drain, then the rear end of this drain arm 4 is connected on the drain person in charge 1 the upper surface, and the front end of drain arm 4 is positioned at away from drain is responsible for the axis normal of 1 place and drain arm 4 in the drain person in charge 1 axis.Drain arm 4 is connected with the drain person in charge 1 by the gap and/or the breach of fixed lobes 2.Junction one of them indentation, there between two fixed lobes 2 of 1 is responsible in drain arm 4 and drain, but has only accounted for its less area, flows in the lachrymal sac normally so guaranteed tear.
After importing this artificial nasolacrimal duct in the body, fixed lobes 2 is positioned at lachrymal sac and is in open configuration, and fixed lobes 2 is fixed in this artificial nasolacrimal duct in the body, when lachrymal sac has as diseases such as dacryocystisises, fixed lobes 2 can be with dacryocystectasia, thereby reaches the purpose of treatment simultaneously.The drain house steward is positioned at nose tear house steward, and the drain house steward can conducting lachrymal sac nasal meatus.Drain arm 4 can be positioned at lower lacrimal canaliculi separately and can play the conducting lower lacrimal canaliculi, thereby makes tear enter lachrymal sac by drain arm 4.Drain arm 4 in this artificial nasolacrimal duct is used for treating separately lower lacrimal canaliculi, and is pointed, promptly avoided the loss to superior canaliculus.
The head of drain arm 4 is tapered, and promptly the tube wall of drain arm 4 heads dwindles gradually towards the front end face direction and makes this position littler and slick and sly than the diameter at all the other positions, thereby makes things convenient for drain arm 4 to import in the tiny lacrimal ductule and reduce dacryocanalicular damage.
The through hole 3a that has axial perforation on the locking cap 3, the diameter of through hole 3a are responsible for 1 internal diameter less than drain.Because the diameter of locking cap 3 is less, when lead passed locking cap 3 and ties a knot in the end, locking cap 3 can block and knot, and makes lead artificial nasolacrimal canal can be drawn desired location, thereby has increased the modus operandi that the doctor implants artificial nasolacrimal canal.
The drain person in charge 1, drain arm 4, fixed lobes 2 and locking cap 3 all adopt the macromolecule medical material to make and are integral structure between four.This macromolecule medical material has higher flexibility after this artificial nasolacrimal duct implants, drain in the artificial nasolacrimal canal be responsible for 1 and drain arm 4 can be along with the human physiological structure be out of shape, thereby improved comfortableness and safety greatly.Integral structure has been stopped part and has been separated situation about dropping, and has increased fastness simultaneously and has improved safety coefficient and service life.
Embodiment two
As Fig. 5 and shown in Figure 7, present embodiment is basic identical with structure and the principle of embodiment one, different place is: according to the physiological structure of human nasal lacrimal passage, when fixed lobes 2 was positioned at lachrymal sac, the extended line of superior canaliculus was positioned at fixed lobes 2 places and close locking cap 3 places.So in order to make above-mentioned drain arm 4 can penetrate superior canaliculus, after simultaneously drain arm 4 penetrates superior canaliculus is deformed and drain arm 4 is not changed with respect to the position of locking cap 3, then the rear end of this drain arm 4 is connected on the lower surface of locking cap 3.The junction of drain arm 4 and locking cap 3 one of them indentation, there between two fixed lobes 2, but only accounted for its less area, flow in the lachrymal sac normally so guaranteed tear.
Drain arm 4 can be positioned at superior canaliculus separately and can play the conducting superior canaliculus, thereby makes tear enter lachrymal sac by drain arm 4.Drain arm 4 in this artificial nasolacrimal duct is used for treating separately superior canaliculus, and is pointed, promptly avoided the loss to lower lacrimal canaliculi.
The through hole 3a that does not have axial perforation on the locking cap 3, but the internal diameter of drain arm 4 also is responsible for 1 internal diameter less than drain.When lead passed drain arm 4 and ties a knot in the end, drain arm 4 can block and knot, and makes lead artificial nasolacrimal canal can be drawn desired location, thereby has increased the modus operandi that the doctor implants artificial nasolacrimal canal equally.
Embodiment three
As Fig. 6 and shown in Figure 8, present embodiment is basic identical with structure and the principle of embodiment one, different place is: one of them indentation, there between two fixed lobes 2 is provided with the two piped drain arms 4 that can penetrate in the lacrimal ductule, i.e. drain arm 1 and drain arms 2 42.
Lacrimal ductule comprises superior canaliculus and little lacrimal ductule; According to the physiological structure of human nasal lacrimal passage, when fixed lobes 2 was positioned at lachrymal sac, the extended line of lower lacrimal canaliculi was positioned at fixed lobes 2 places and is responsible for 1 place near drain, and the extended line of superior canaliculus is positioned at fixed lobes 2 places and close fixed lobes 2 places.So in order to make above-mentioned drain arm 1 can penetrate lower lacrimal canaliculi, drain arm 2 42 can penetrate superior canaliculus, after simultaneously drain arm 4 penetrates lower lacrimal canaliculi is deformed and make drain arm 4 with respect to drain be responsible for 1 and the position of locking cap 3 do not change, then the rear end of this drain arm 1 is connected on the drain person in charge 1 the upper surface, and the rear end of drain arm 2 42 is connected on the lower surface of locking cap 3.The drain arm 1 and the drain person in charge's 1 the junction and the junction of drain arm 2 42 and locking cap 3 all are located at one of them indentation, there between two fixed lobes 2, but has bigger spacing between drain arm 1 and the drain arm 2 42, the sectional area of drain arm 1 and drain arm 2 42 has only accounted for the breach less area simultaneously, so guaranteed that effectively tear flows in the lachrymal sac normally.
Drain arm 1 can be positioned at lower lacrimal canaliculi and can play the conducting lower lacrimal canaliculi, and drain arm 2 42 can be positioned at superior canaliculus and can play the conducting superior canaliculus, thereby makes tear enter lachrymal sac by drain arm 4.
The through hole 3a that does not have axial perforation on the locking cap 3, but the internal diameter of drain arm 4 also is responsible for 1 internal diameter less than drain.When lead passed drain arm 2 42 and ties a knot in the end, drain arm 2 42 can block and knot, and makes lead artificial nasolacrimal canal can be drawn desired location, thereby has increased the modus operandi that the doctor implants artificial nasolacrimal canal equally.
Specific embodiment described herein only is that the present invention's spirit is illustrated.The technical staff of the technical field of the invention can make various modifications or replenishes or adopt similar mode to substitute described specific embodiment, but can't depart from spirit of the present invention or surmount the defined scope of appended claims.
Although this paper has used drain to be responsible for 1 morely; Locating hole 1a; Fixed lobes 2; Locking cap 3; Through hole 3a; Drain arm 4; Drain arm 1; Drain arm 2 42 terms such as grade, but do not get rid of the probability of using other term.Using these terms only is in order to describe and explain essence of the present invention more easily; They are construed to any additional restriction all is contrary with spirit of the present invention.