CN103111010A - Double-cavity sacculus tube and application thereof - Google Patents
Double-cavity sacculus tube and application thereof Download PDFInfo
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- CN103111010A CN103111010A CN2013100290175A CN201310029017A CN103111010A CN 103111010 A CN103111010 A CN 103111010A CN 2013100290175 A CN2013100290175 A CN 2013100290175A CN 201310029017 A CN201310029017 A CN 201310029017A CN 103111010 A CN103111010 A CN 103111010A
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Abstract
Provided is a double-cavity sacculus tube and application of the double-cavity sacculus tube. The purposes of the double-cavity sacculus tube and the application of the double-cavity sacculus tube are to provide convenience and to be practical, and are to be applied to surgical hemostasis and drainage of a cerebral hemorrhage patient in a serious illness. The double-cavity sacculus tube comprises a sacculus, an outer pipeline, an inner pipeline, a water injection pipe and a check valve, wherein the upper end of the inner pipeline is a flexible end which is obtuse-round-shaped, and the back end of the inner pipeline is a flaring which can be connected with an aseptic drainage bag. The outer pipeline is adhered to the wall of the inner pipeline, the sacculus is arranged at the position, close to the front end, of the outer pipeline, two pairs of drainage side holes are formed in the outer pipeline in two sides of the sacculus, and the number of each pair of drainage side holes is two. Each drainage side hole is communicated with the front end of the inner pipeline. Distance between the outer edge of the sacculus and the edge of the drainage side hole is 1cm-2cm. The water injection pipe is connected with the back end of the outer pipeline, and the check valve is installed on the water injection pipe. The double-cavity sacculus tube is applied to the surgical hemostasis and the drainage of the cerebral hemorrhage patient in the serious illness.
Description
Technical field
The present invention relates to a kind of Dual-chamber saccular pipe and the clinical practice in the intracerebral hemorrhage patients art thereof.
Background technology
The Dual-chamber saccular pipe was invented the sixties in last century, was mainly used at first Urology Surgery, was used for solving urine Xu and slipped and urinary incontinence.As the term suggests Dual-chamber saccular pipe two-chamber, an end is inserted urethra, and other end inflation can make an end of inserting urethra expand, and fixes this pipe with this, and an end of inserting urethra is also reserved opening so that drainage of urine.Facts have proved, the Dual-chamber saccular pipe can be slipped and urinary incontinence by fine solution Urinary by the other end drainage bag of plugging into.But also find simultaneously, if patient's life-time service should can cause inadequate drainage by pipe, the patient is uncomfortable, and urinary tract infection and ureter epithelial proliferation even occur.Three kinds of Dual-chamber saccular pipes that material is made have now been developed: be respectively the silicone sebific duct for this reason, silicone rubber tube and latex tubing, silicone adhesive tubing matter is softer, and the latex tubing material is also soft but opaque, the hard and proof of silicone rubber tube material can cause that the patient is uncomfortable, stimulates urothelium cell proliferation etc.So now widely used is silicone sebific duct (silicone Foley catheter balloons).In addition, in order to reduce untoward reaction, the coating that the silicone adhesive tube outer surface has also carried out unlike material is processed, used the alloying metal coating such as having, use in addition the Teflon to process.The former to bacteriuria and urinary tract infection significantly better than common silicone sebific duct, although the latter has not detected the Teflon in urine, but the ratio that the patient does not feel well increases, and experiment in vitro confirms that the Teflon may promote epithelial division growth, has potential danger.
Up till now, also mainly concentrate on urine drainage and the auxiliary treatment of Urology Surgery abroad about the application of Dual-chamber saccular pipe, except Urology Surgery, the Dual-chamber saccular pipe also is applied to vaginal reconstruction, anus shaping etc., external outline is that investigation Dual-chamber saccular pipe causes bacteriuria in urological applications of compounds, urinary tract infection, and the contact epithelial cell has or not hypertrophy etc.Domestic about the Dual-chamber saccular pipe except being applied to urological surgery, also have the Dual-chamber saccular pipe is applied to the posterula hemostasis, uterine cavity is hemorrhage, the hemostatic treatment of oral hemorrhage and archorrhagia etc., adopt the modes such as inflation in Dual-chamber saccular, injecting normal saline, residual cavity drain after the solution operation in patients, edge of a knife pain and wound surface hemostasis problem are especially obvious with haemostatic effect.
For cerebral hemorrhage severe cerebral hemorrhage particularly, surgical operation therapy is comparatively effectively to treat rescuing scheme.Medical practice for many years shows that Craniocerebral Surgery can effectively remove hemorrhagely, reduces intracranial pressure and prevents the Secondary cases cerebral hernia, saves patient's life.But the conventional drainage tube that postoperative is put tends to cause inadequate drainage, and secondary oozing of blood and hematoma form, and the secondary secondary is hemorrhage, might increase the weight of patient's the state of an illness and the length of patient stay is extended, and increases the weight of undoubtedly spirit and the financial burden of patient and family.Based on this, attempt to improve drainage system and drainage method after craniocerebral operations, to reaching comparatively satisfied therapeutic effect.Yet there are no up to now the report that the Dual-chamber saccular pipe is applied to the drain of severe cerebral hemorrhage surgical hemostasis.
Summary of the invention
The present invention seeks to overcome the deficiency of above-mentioned prior art, a kind of convenient and practical Dual-chamber saccular pipe is provided, and the application of Dual-chamber saccular pipe in the drain of severe cerebral hemorrhage surgical hemostasis.
Dual-chamber saccular pipe of the present invention is the two-chamber bimetallic tube, comprises sacculus, Outer Tube, interior conduit, water injection pipe and check valve; The interior conduit front end is the softness end of blunt round, and the interior conduit rear end is enlarging, is convenient to connect aseptic drainage bag; Sacculus is positioned on Outer Tube near the front end place, is arranged with two pairs of drain side openings on the Outer Tube of sacculus both sides, and every pair of drain side opening is two, so that the drain of liquid under the dura mater of sacculus top; Each drain side opening all is communicated with the interior conduit front end; The sacculus outer rim is 1-2cm apart from drain side opening Edge Distance, shortens the sacculus outer rim after drainage tube side opening distance, and drainage effect is constant, but can reduce stimulation and secondary damage to normal cerebral tissue; Rear end of pipeline is connected with water injection pipe outside, and check valve is housed on water injection pipe; Outer Tube invests on the wall of interior conduit, can be by check valve water filling in the sacculus;
The material of sacculus, Outer Tube, interior conduit, water injection pipe all adopts transparent silicone to make, and appearance is without any coating material.The interior conduit pipe range is 40cm approximately.
The Dual-chamber saccular pipe of the present invention silicone tubing that is formed in one, sacculus after the outer catheter saline injection expands and is spherical, shape according to hematoma, that sacculus can be shaped to is cylindric, olive shape, heart etc., volume is controlled between 10-20ml, select to use in the patient of different quantity of hematoma and shape, more be conducive to the compressing to the tiny blood vessels oozing of blood of hematoma rubble.
In operation process, drainage-fluid advances the drain side opening, and the Outer Tube of flowing through connects aseptic drainage bag at the expansion pipeline place of rear end.Normal saline injects through check valve, the water injection pipe of flowing through, along outer tube to arrival sacculus position, sacculus is enlarged into spherical, volume is controlled between 10-20ml, and the tube chamber of outer catheter is closed in the rear end, and outer catheter is one-way pipeline, the normal saline that postoperative discharges in sacculus needs to extract liquid out by check valve, and the Dual-chamber saccular pipe can recover the tubulose before not water filling.Be positioned at the center of haematoma cavity after sacculus expands, drainage-fluid can be by the drain side opening of balloon proximal, and the interior conduit of flowing through carries out drain in external aseptic drainage bag.
The application of Dual-chamber saccular pipe of the present invention is applied to the drain of severe cerebral hemorrhage surgical hemostasis; Concrete steps are:
(1) to meeting the patient of cerebral hemorrhage operation condition, adopt the small bone flap craniotomy clearance of intracerebral hematoma under general anesthesia, under Wicresoft's condition, the brain parenchymal hematoma is done large section or removed fully, large or cortex withers significantly to residual cavity in Rhizoma Atractylodis Macrocephalae, prevents the hemorrhage risk again that underbalance effect that the postoperative residual cavity causes greatly causes;
(2) stick hemostatic gauze in side and the bottom of operation residual cavity, reach the effect of protection wound surface;
(3) strut operation and insert the Dual-chamber saccular pipe after residual cavity, to the sacculus saline injection, sacculus is placed in hematoma residual cavity center, be expanded to 10-20ml volume size, specifically should decide according to the residual cavity size, general balloon volume is the 1/3-1/4 of volume of hematoma, sacculus produces suitable pressure so that diapire and sidewall are slightly exerted pressure as appropriate, compressing is not exaggerated to cerebral tissue, forms the occupy-place effect, causes cerebral edema;
(4) art finishes fixedly drainage tube, and the drainage bag of plugging into reaches drainage to the residual cavity oozing of blood;
(5) clinical follow drainage flow is reduced to limpidly as Extubation indications to drainage flow, should extract in advance normal saline in sacculus out, and drainage tube recovers tubulose, can smooth tube drawing.
Dual-chamber saccular pipe of the present invention is convenient and practical, and is applied to the drain of severe cerebral hemorrhage surgical hemostasis; The Dual-chamber saccular pipe is positioned over the hematoma residual cavity, and the sacculus that volume expands can play direct hemostasis by compression effect to the pathologic vessels wall, reduces again hemorrhage incidence rate.Take the emptying decompression of degression type that the cerebral tissue of pressurized is resetted gradually, avoid removing the hemorrhage incidence rate again that hematoma postoperative underbalance effect may cause.Sacculus is placed in the hematoma residual cavity, makes the haematoma cavity can not quick-make, guarantees that the drain of postoperative residual cavity is unobstructed, and can act on hematoma by drug targeting, guarantees the unobstructed of drain.
Studies show that: the serious symptom Patients with Cerebral Hemorrhage is improved conventional hemostasis and drainage way in operation process, introduce the Dual-chamber saccular pipe, after operation, hemorrhage rate reduction again, obviously reduce nearly medical expense at a specified future date, shortens the average time in hospital cycle, and effect is remarkable.Easily occur again hemorrhage for present intracerebral hemorrhage patients postoperative, thereby conditions of patients is worsened, increase the situation of economy and burden on society, improve conventional drainage way, carry out the applied research of Dual-chamber saccular pipe in the intracerebral hemorrhage patients art, severe cerebral hemorrhage is improved modus operandi, reach effective reduction cerebral hemorrhage again, complication.
Description of drawings
Fig. 1 is Dual-chamber saccular tubular construction schematic diagram of the present invention.
In figure: 1 sacculus, 2, Outer Tube, 3, interior conduit, 4, water injection pipe, 5 drain side openings, 6, check valve.
The specific embodiment
The Dual-chamber saccular pipe adopts latex and silica gel to make in addition.It is yellow, opaque that the drainage tube entire body of latex material is, and be unfavorable for observing the drain situation, and matter is tough, and pliability is poor, and is strong to normal cerebral tissue's zest; Traditional silica gel drainage tube tube chamber is monolayer, can not form sacculus, the effect that there is no hemostasis by compression, the drainage tube of silica gel material experiment simultaneously shows the hypertrophy of its composition possibility irritation cell and the untoward reaction that causes the patient, and cost of manufacture is higher extensively to be promoted at present although improved on coating now.In use also find, silica gel tube is placed in the hematoma residual cavity situation of inadequate drainage may occur due to the swelling of cerebral tissue.
But consider safety, convenience and the patient's of use ability to bear, select to make the Dual-chamber saccular pipe with the transparent silicone material.According to the size of caliber, select the drainage tube of 14 Fr/Ch calibers, not only can reach the unobstructed effect of drain, can reduce the stimulation of normal tissue simultaneously.
Application Example one:
Zhao, man, 50 years old, admission number 245058.Main cause " disturbance of consciousness was accompanied the right side limb adynamia 4 hours " is admitted to hospital in emergency treatment on January 19 in 2011, head CT " left side intracerebral hemorrhage in basal nuclei, amount of bleeding is 70ml approximately ".before operation, Hemorrhagic location and quantity of hematoma are determined in whole head CT inspections, tracheal intubation under balanced anesthesia, the visual area routine disinfection, operative incision adopts " small bone flap craniotomy clearance of intracerebral hematoma " art formula, sphenotresia, bone window diameter 3cm, the radial cerebral dura mater of opening, under operating microscope, the brain parenchymal hematoma is done large section or removed fully, the secondary that may cause for various pathologic blood vessel wall is hemorrhage, side and bottom at the operation residual cavity stick hemostatic gauze (absorbable hemostatic gauze), reach the effect of protection wound surface, insert the Dual-chamber saccular pipe after strutting the operation residual cavity, operative incision one side is fixed in interior conduit and Outer Tube rear end, be convenient to drain and water filling in the sacculus, sacculus is positioned at the drainage tube front end, interior conduit connects, the drain side opening of front end is positioned over bottom the hematoma residual cavity, sacculus by outer tube body far-end saline injection is placed in hematoma residual cavity center, make volumetric expansion to 10～15ml, the volume size should be decided according to the residual cavity size, general balloon volume is the 1/3-1/4 of volume of hematoma, sacculus produces suitable pressure can effectively oppress small arterial hemorrhage, the surgical wound surface oozing of blood is reduced, after the sacculus saline injection, volume can support simultaneously, compressing wound surface hemostatic material (as: gelfoam, the vertical yarns of speed etc.) hematoma residual cavity wall is pasted closely, wound surface equally adequately protects, again breaking of prevention tiny blood vessels.
After clearance of intracerebral hematoma, the operation residual cavity is emptying rapidly, cerebral tissue subsides obviously, the cranial cavity negative pressure is increased, balloon tube is placed in haematoma cavity and is full of the normal saline dilatation balloon to proper volume, not only can effectively prevent blood oozing from the wound surface, and the emptying decompression of degression type after surgery adapts to gradually the cerebral tissue of pressurized to reset and avoids the again hemorrhage of tiny blood vessels, and the fracture of raise vein is hemorrhage, and the cerebral tissue tractive peels off that to cause remote part hemorrhage.Another effect of Dual-chamber saccular pipe is to guarantee after surgery that the residual cavity drain is unobstructed, and conventional drainage tube often easily causes obstruction, makes inadequate drainage.And use Dual-chamber saccular Tube Drain, because sacculus is placed in the hematoma residual cavity, make the haematoma cavity can not quick-make, the drain that can give drainage tube provides certain intracranial space, courageous and upright CSF or a little oozing of blood can accompany drainage tube to draw smoothly, and drainage effect is better than the general drainage device, even residual hematoma is arranged in haematoma cavity, also can be by injecting urokinase, repeatedly rinse by double lumen tube and make the hematoma dissolving be easy to draw.
Art finishes fixedly drainage tube, and interior conduit connects aseptic drainage bag, can reach drainage effect to a small amount of oozing of blood of residual cavity, Outer Tube far-end sterile dressing.Whether second day after operation check head CT is observed the hematoma clearance situation and has secondary hemorrhage.Simultaneously, postoperative close observation drainage flow and color, to the interior conduit drainage flow obviously reduce, drainage-fluid is limpid as Extubation indications, gradually takes out normal saline in most sacculus by Outer Tube, drainage tube reverts to tubulose, can smooth tube drawing.
Application Example two:
Hu, man, 54 years old, admission number 243812.Main cause " gradual stupor was accompanied the right side limb adynamia 4 hours " is admitted to hospital in December in 2010 emergency treatment on the 13rd, head CT " left side intracerebral hemorrhage in basal nuclei; amount of bleeding is 65ml approximately ", operation row " small bone flap craniotomy evacuation of hematoma ", the hematoma residual cavity is inserted the Dual-chamber saccular pipe, second day after operation check head CT, have no again hemorrhage, in postoperative the 3rd day, the more limpid rear Dual-chamber saccular pipe of extracting smoothly of drainage-fluid, patient's recovery situation is good, leaves hospital on January 5th, 2011, length of stay 23 days, 22271.07 yuan of hospitalization costs.The enforcement that the Dual-chamber saccular pipe is inserted drainage is to the severe cerebral hemorrhage early diagnosis, Operation in early stage adopts the small bone flap craniotomy clearance of intracerebral hematoma, improves conventional hemostasis and drainage way in operation process, introduce the Dual-chamber saccular pipe, hemorrhage rate reduction again after operation.The Dual-chamber saccular pipe can effectively prevent again hemorrhage generation, and is simple to operate, damages littlely, and few intercurrent disease is better than the drainage effect that simple hematoma residual cavity routine is put pipe.Utilize Dual-chamber saccular pipe auxiliary treatment can significantly shorten being in hospital the cycle of patient, alleviate patient's hospitalization cost.
Claims (6)
1. a Dual-chamber saccular pipe, is characterized in that comprising sacculus, Outer Tube, interior conduit, water injection pipe and check valve; The interior conduit front end is the soft end of blunt round, and the interior conduit rear end is for connecting the enlarging of aseptic drainage bag; Outer Tube invests on inner duct wall, and sacculus is positioned on Outer Tube near the front end place, is arranged with two pairs of drain side openings on the Outer Tube of sacculus both sides, and every pair of drain side opening is two; Each drain side opening all is communicated with the interior conduit front end; The sacculus outer rim is 1-2cm apart from drain side opening Edge Distance; Water injection pipe is connected to the Outer Tube rear end, and check valve is housed on water injection pipe.
2. Dual-chamber saccular pipe as claimed in claim 1, is characterized in that the material of sacculus, Outer Tube, interior conduit, water injection pipe all adopts transparent silicone to make, and appearance is without any coating material.
3. Dual-chamber saccular pipe as claimed in claim 1, is characterized in that interior conduit pipe range 40cm.
4. the application of Dual-chamber saccular pipe as claimed in claim 1 is characterized in that being applied to the drain of severe cerebral hemorrhage surgical hemostasis.
5. the application of Dual-chamber saccular pipe as claimed in claim 4 is characterized in that:
(1) to meeting the patient of cerebral hemorrhage operation condition, adopt the small bone flap craniotomy clearance of intracerebral hematoma under general anesthesia, under Wicresoft's condition, the brain parenchymal hematoma is done large section or removed fully, large or cortex withers significantly to residual cavity in Rhizoma Atractylodis Macrocephalae, prevents the hemorrhage risk again that underbalance effect that the postoperative residual cavity causes greatly causes;
(2) stick hemostatic gauze in side and the bottom of operation residual cavity, reach the effect of protection wound surface;
(3) strut operation and insert the Dual-chamber saccular pipe after residual cavity, to the sacculus saline injection, sacculus is placed in hematoma residual cavity center, be expanded to 10-20ml volume size, specifically should decide according to the residual cavity size, balloon volume is generally the 1/3-1/4 of volume of hematoma, sacculus produces suitable pressure so that diapire and sidewall are slightly exerted pressure as appropriate, compressing is not exaggerated to cerebral tissue, forms the occupy-place effect, causes cerebral edema;
(4) art finishes fixedly drainage tube, and the drainage bag of plugging into reaches drainage to the residual cavity oozing of blood;
(5) clinical follow drainage flow is reduced to limpidly as Extubation indications to drainage flow, should extract in advance normal saline in sacculus out, and drainage tube recovers tubulose, can smooth tube drawing.
6. Dual-chamber saccular pipe as claimed in claim 5 is characterized in that being after sacculus expands cylindric, olive shape or heart, and balloon volume is controlled between 10-20ml.
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| CN106390212B (en) * | 2016-06-17 | 2019-03-26 | 四川大学华西第二医院 | Built-in obstetric vaginal bleeding negative pressure drainage measuring device |
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| CN108607151B (en) * | 2018-05-21 | 2021-06-01 | 青岛杰圣博生物科技有限公司 | Antibacterial catheter and preparation method thereof |
| CN110141761A (en) * | 2019-06-14 | 2019-08-20 | 深圳市慧极创新医疗科技有限公司 | A kind of extradural hemorrhage remove device |
| CN111134653A (en) * | 2020-01-20 | 2020-05-12 | 青岛大学附属医院 | Intracranial pressure automatic slow-descending pressure regulating device after intracranial giant tumor operation |
| CN111528995A (en) * | 2020-05-07 | 2020-08-14 | 南阳市中心医院 | A device for eliminating liver and gallstones |
| CN112843446A (en) * | 2021-03-18 | 2021-05-28 | 阳泉煤业（集团）有限责任公司总医院 | Self-used enema administration device |
| CN112843446B (en) * | 2021-03-18 | 2023-06-06 | 阳泉煤业（集团）有限责任公司总医院 | Self-usable enema feeder |
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Application publication date: 20130522 |