CN104473692A - High-voltage pulse human-body calculus therapeutic system based on plasmas and use method high-voltage pulse human-body calculus therapeutic system - Google Patents
High-voltage pulse human-body calculus therapeutic system based on plasmas and use method high-voltage pulse human-body calculus therapeutic system Download PDFInfo
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- CN104473692A CN104473692A CN201410839316.XA CN201410839316A CN104473692A CN 104473692 A CN104473692 A CN 104473692A CN 201410839316 A CN201410839316 A CN 201410839316A CN 104473692 A CN104473692 A CN 104473692A
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Abstract
The invention discloses a high-voltage pulse human-body calculus therapeutic system based on plasmas. The system comprises an endoscope device, a calculus crusher, an electrode probe and a foot switch, wherein the calculus crusher is used for generating high-voltage pulses; the electrode probe is connected with the calculus crusher through a transmission cable; the foot switch is connected with the calculus crusher through a wire cable; the electrode probe stretches into a human body, and directly touches calculi in the human body. According to the system, based on a touch type calculus crushing principle, after the electrode probe stretches into the human body, and directly touches the calculi, the calculi are crushed in a way that the calculus crusher generates high-voltage pulses, i.e. the calculi are intensively crushed in a way that the high-voltage pulses generate plasma explosion in the calculi; as the energy required for calculus crushing is on a lower level, little damage occurs to the human body; moreover, the calculus crushing energy can be precisely controlled every time; the system is safe and reliable to use, capable of efficiently and rapidly removing the calculi, wide in application prospect, and applicable for popularization.
Description
Technical field
The present invention relates to a kind of electromedical equipment for the treatment of calculosis, specifically, relate to a kind of high voltage pulse calculosis therapy system based on plasma and using method thereof.
Background technology
The solid mass that calculosis is in the catheter lumen in human body or formed in the chamber of chamber sexual organ (as kidney, ureter, gallbladder or bladder etc.).Be mainly seen in gallbladder and bladder, renal pelvis, also show in the chamber of pancreas conduit, salivary ducts etc.Calculus is made up of inorganic salt or Organic substance.Generally have a core in calculus, be made up of the epithelial cell come off, bacterial aggregate, parasitic ovum or polypide, excrement block or foreign body, inorganic salt or Organic substance deposit on core more layer by layer.Due to the difference of afflicted organ, the composition contained by lithogenous mechanism, shape, quality, all not identical on impact of body etc.Generally speaking, calculus can cause tube chamber to block, and affects the discharge of afflicted organ's liquid, produces the symptoms such as pain, hemorrhage or secondary infection.
At present, the type of medical stoner is mainly divided into extra chock wave lithotriptor and intracavitary stone breaker.Extracorporeal lithotiptor is mainly divided into electrohydraulic type, electromagnetic type, piezoelectric type.Intracavitary stone breaker is mainly divided into ultrasonic lithotrite, electrohydraulic lithotripsy machine, laser lithotripsy machine, endoscopy.
Extracorporeal shock-wave lithotripsy (ESWL) due to its non-invasively treating method, and accept by extensive patients.Have tissue injury little, the advantage that success rate is higher.But the crushing effect of extracorporeal shock-wave lithotripsy (ESWL) to incarceration formula and staghorn stone is not good enough, and during x-ray locating therapy, client need accepts X-radiation, causes additional injury to patient body.
Electrohydraulic type extracorporeal shock wave lithotrite has been widely used in clinical, but its shock wave energy is large, and noise is also large, sacrificial electrode, also larger to the injury of tissue, extracorporeal shock-wave lithotripsy (ESWL) needs to use supporting auxiliary device, need to take fixing room (about 30 square meter), invest larger.And the expenses such as plant maintenance are also considerable, virtually add medical treatment cost.It is strong that electrohydraulic lithotripsy machine produces stress ratio ultrasonic lithotrite, and the expense used is low, but, the shock wave that electrohydraulic lithotripsy machine produces, not through focusing on, shock wave is radially outwards propagated from eletrode tip, injury can be there is to calculus surrounding tissue, the energy that calculus obtains at every turn is unstable, if misoperation, also can damage endoscope.
The ultrasonic transducer of endo-luminal ultrasound lithotrite operationally can produce atomizating phenomenon, affects the effect of endoscope, and ultrasonic vibration produces less at the stress of calculus surfaces, and lithotrity effect is not good.
Laser lithotripsy machine is at present more novel a kind of rubble mode, and laser energy has the advantages such as pulse voltage is large, pulse frequency is stable, and lithotrity effect is better, can adapted flexible endoscope, and the rubble time is shorter than ultrasonic and electrohydraulic type.But this kind of laser equipment is expensive, energy output less stable, corrective maintenance difficulty is large, and need consumable goods optical fibers, operating cost is high.
Air pressure intracavitary stone breaker, it is not charged that its intracavity visits cup, and can not produce heat, impact bar directly contacts calculus and carries out calculus-smashing, and calculifragous efficiency is high, and treatment time is short.
The selection aspect of intracavity rubble endoscope, electric, the ultrasonic and vapour-pressure type of liquid can only carry out rubble by rigid endoscope, be restricted the use at some positions, laser lithotripsy machine can carry out rubble by flexible endoscope, and it is substantially unrestricted that endoscopically enters human body.
For high voltage pulse crushing technique, in mining industry, engineering machinery, oil drilling, sewage disposal, timber stoving, building machinery, be obtained for engineer applied at present.But to be applied in calculosis treatment field, also also exist as plasma electrion to the Crushing Problem of quasi-brittle material, high voltage safety problem, reduce energy level to reduce the damage problem to surrounding tissue organ, the adaptability problem to calculus type and to carry out the problems such as comprehensive Operation to patient part.
Summary of the invention
For overcoming prior art Problems existing, the invention provides a kind of calculus that can act on inner and accurately control rubble energy and the high voltage pulse calculosis therapy system based on plasma little to surrounding tissue organ damage.
To achieve these goals, the technical solution used in the present invention is as follows:
Based on the high voltage pulse calculosis therapy system of plasma, comprise endoscope apparatus, for generation of the calculus crusher of high-voltage pulse, by the electrode catheter that transmission cable is connected with calculus crusher, and by foot switch that cable is connected with calculus crusher, wherein, electrode catheter stretches into and directly contacts with the calculus in human body.
Further, described electrode catheter comprises the union joint with transmission cable grafting, the fexible conductor that one end is connected with union joint, be coated on the flexible insulating layer outside fexible conductor, and the flexible insulating layer being arranged at the fexible conductor other end keeps the metallic shield ring of certain intervals with fexible conductor, wherein, described fexible conductor mates with endoscope apparatus, and metallic shield ring one end of fexible conductor directly contacts with calculus.This electrode catheter is coaxial cable structure, and fexible conductor is formed centrally the high-field electrode of point-like therein, the ground electrode of the metallic shield annular ring formation shape in fexible conductor end.This metallic shield ring is both as the ground electrode of high voltage pulse electric discharge; simultaneously also as the shielding protection layer of high voltage pulse; the electromagnetic radiation that shielding high voltage pulse produces; the shock wave diffusion that restriction high voltage pulse produces; avoid the tissue around lesion electrode probe and calculus contact position, and only act on the calculus at its ends contact place.By appropriate design high voltage pulse parameter, high voltage pulse can be made at calculus internal discharge, and when the wavelength of the shock wave that it produces is less than a specific threshold, the shock wave being diffused into calculus outside can be decayed rapidly, within making energy be limited in secure threshold, do not injure the tissue of surrounding.
As preferably, in described electrode catheter, fexible conductor and the common diameter of flexible insulating layer are 0.5 ~ 3mm.According to difference, the difference of type of surgery, the difference of calculus character of operative site, select the electrode catheter of different-diameter.The sparking electrode design of this very small diameter makes electrode catheter arrive operative site smoothly.
Particularly, described calculus crusher comprises control unit, controlled unit controls the high-voltage dc power supply be connected with external power supply, the high voltage energy-storage units be connected with high-voltage dc power supply, be connected with high voltage energy-storage units and the high voltage pulse discharge circuit of controlled unit controls, the high voltage measuring unit be all connected with high voltage energy-storage units and high voltage pulse discharge circuit, and the display device be all connected with control unit, button and indicating device, wherein, electrode catheter is connected with high voltage pulse discharge circuit, high voltage measuring unit and control unit Two-way Feedback, foot switch is connected with control unit and discharges for controlling high voltage pulse discharge circuit.
Further, described control unit is also connected with the residual amount of energy leadage circuit be connected with electrode catheter.
In order to ensure safety, the voltage peak of described calculus crusher is lower than 9kV, and energy storage is lower than 5J.The problem of the safe peak value of this high voltage obtains through a large amount of clinical trial, can ensure in the energy level situation of effective rubble, makes rubble electric discharge damage very little to human body.It should be noted that, the electrostatic that people's clothes produces, its voltage peak can up to tens of kV.And in development process, design the diameter of the fexible conductor as sparking electrode as small as possible, reduce its energy level, so that the problem of comprehensive operation is carried out to sufferer part.
Particularly, described endoscope apparatus comprises the photoconduction line of built-in light guide fiber, be arranged at the cold light source camera lens of photoconduction line one end, be arranged at the image acquisition device of the photoconduction line other end, and the display module to be connected with image acquisition device, wherein, fexible conductor and flexible insulating layer mate with photoconduction line is integrated.
For the ease of the fixing of calculus and the contact with electrode catheter, prevent calculus from moving in shattering process and flicking, described electrode catheter has also been arranged side by side the calculus string bag, the extensible distance of this calculus string bag is greater than the extensible distance of electrode catheter.The calculus string bag is retractable into point-like or wire when stretching into, can manually make it expand or shrink during use, is convenient to the calculus granule after by fragmentation and takes human body out of.
Based on said structure, present invention also offers this using method based on the high voltage pulse calculosis therapy system of plasma, comprise the steps:
(1) endoscope apparatus is stretched into stone location together with electrode catheter;
(2) under the image-guidance of endoscope apparatus feedback, adjustment electrode catheter position, makes it effectively to contact with calculus;
(3) the calculus string bag by electrode catheter is arranged side by side catches calculus, makes electrode catheter and calculus contact stabilization;
(4) according to calculus situation, the relevant parameter of high voltage pulse is regulated by calculus crusher;
(5) start calculus crusher, by electrode catheter, electric discharge is carried out to calculus broken.
Further, after described step (5), the calculus fragment of fritter is taken out one by one by the calculus string bag, or it is broken to continue to carry out electric discharge to the calculus fragment of bulk, until calculus is all broken for fritter.
Rubble principle of the present invention is theoretical based on contact calculus-smashing: for the solid block (as lithangiuria) with certain characteristic be dipped in liquid, when applying the electric pulse of a nanosecond pulse width to it, in solid block inside, electrical breakdown occurs.Note, this is not, on solid block surface, electrical breakdown occurs, but inner in solid block.Puncture rear and form plasma channel in solid block inside, plasma channel is formed, generally at the joint face of uneven solid dielectric, when after power density to certain threshold value according to energy minimum principle, generation plasma explodes, and the blast effect that plasma blast produces causes solid block broken.
Because the shock wave wave source of this theory is inner in calculus (solid block), force localization, shock wave wavelength is short, and required energy level is lower, can reduce the injury to human body, and the energy of broken calculus accurately can be controlled by equipment each time.Therefore, as compared to other rubble modes (as air pressure and laser), the injury to surrounding tissue can be reduced, little to peripheral organs wound.Owing to realizing the principle of electrical breakdown in calculus inside, make the present invention unrestricted to the hardness of calculus, go for all kinds of calculus, as lithangiuria (hard calculus, inorganic calculus), cholelithiasis (soft calculus, organic calculus) etc.
Compared with prior art, the present invention has following beneficial effect:
(1) the present invention utilizes contact rubble principle, after electrode catheter stretches into and contacts with calculus, produce high voltage pulse by calculus crusher and fragmentation is carried out to calculus, make high-voltage pulse produce plasma blast in calculus inside, concentrate and make the broken calculus of land used, needed for it, energy level is lower, little to human injury, and accurately can control each rubble energy, safe and reliable, remove calculus efficient quick, be with a wide range of applications, be applicable to applying.
(2) the present invention determines the crest voltage problem of high voltage safety by clinical trial, controls at below 9kV by the voltage peak of calculus crusher, and energy storage is lower than 5J, in the lower situation of energy level, minimum to human injury.
(3) the present invention also remains on less state by the diameter controlled as the fexible conductor of sparking electrode, reduces the energy level of electric discharge further, also solves the problem of patient part being carried out to comprehensive operation.
(4) the present invention is arranged side by side the calculus string bag on electrode catheter, mating reaction is carried out with electrode catheter, ensure that the fixing of in rubble process calculus position, what make calculus fragment can not eject endoscope apparatus realizes scope, solve the matching problem with flexible endoscope lens device, and create a further reduction energy level.
(5) the present invention is by the high voltage pulse of nanosecond, achieve and cause plasma to explode in calculus inside, form shock wave source, reduce energy level by a larger margin, achieve calculus thoroughly to remove, achieve the calculus-smashing to different hardness, composition and structure, make the suitability of the present invention wider; And can binding plasma cutting, melt, stop blooding and the technology such as medical effect such as shrinkage, realize the probability that calculus-smashing and patient part can be treated simultaneously, thus make the present invention carry out omnibearing operative treatment.
Accompanying drawing explanation
Fig. 1 is structural representation of the present invention.
Fig. 2 is the structured flowchart of calculus crusher in the present invention.
Fig. 3 is the structural representation of electrode probe in the present invention.
Fig. 4 is the partial schematic diagram of electrode probe when stone location rubble in the present invention.
Detailed description of the invention
Below in conjunction with drawings and Examples, the invention will be further described, and embodiments of the present invention include but not limited to the following example.
Embodiment
As shown in Figures 1 to 4, based on the high voltage pulse calculosis therapy system of plasma, comprise endoscope apparatus 10, for generation of the calculus crusher 1 of high-voltage pulse, the electrode catheter 3 be connected with calculus crusher by transmission cable 2, and by the foot switch 4 that cable is connected with calculus crusher, wherein, electrode catheter stretches into and directly contacts with the calculus 11 in human body.
Particularly, described electrode catheter comprises the union joint 5 with transmission cable grafting, the fexible conductor 6 that one end is connected with union joint, be coated on the flexible insulating layer 7 outside fexible conductor, and the flexible insulating layer being arranged at the fexible conductor other end keeps the metallic shield ring 8 of certain intervals with fexible conductor, wherein, described fexible conductor mates with endoscope apparatus, and metallic shield ring one end of fexible conductor directly contacts with calculus.As preferably, in described electrode catheter, fexible conductor and the common diameter of flexible insulating layer are 0.5 ~ 3mm.
Particularly, described calculus crusher comprises control unit, controlled unit controls the high-voltage dc power supply be connected with external power supply, the high voltage energy-storage units be connected with high-voltage dc power supply, be connected with high voltage energy-storage units and the high voltage pulse discharge circuit of controlled unit controls, the high voltage measuring unit be all connected with high voltage energy-storage units and high voltage pulse discharge circuit, and the display device be all connected with control unit, button and indicating device, wherein, electrode catheter is connected with high voltage pulse discharge circuit, high voltage measuring unit and control unit Two-way Feedback, foot switch is connected with control unit and discharges for controlling high voltage pulse discharge circuit.Further, described control unit is also connected with the residual amount of energy leadage circuit be connected with electrode catheter.In order to ensure safety, the voltage peak of described calculus crusher is lower than 9kV, and energy storage is lower than 5J.This calculus crusher also should comprise the part that other realize corresponding function, and because these parts all belong to prior art, those skilled in the art in conjunction with these parts of electronic circuit general knowledge assembly on basis described herein, therefore can repeat no more herein.
This calculus crusher connects externally fed power supply, its control panel has two on and off switch, respectively corresponding externally fed power supply and high-voltage dc power supply; High-voltage dc power supply can not be opened in the No operation time.During use, after determining stone location and calculus feature, arrange corresponding energy parameter and pulse parameter by control panel, control unit performs these parameters by control high voltage energy-storage units and high voltage pulse discharge cell, and by high voltage measuring unit inspection and feedback.High voltage energy-storage units adopts capacitance energy storage mode, after its energy storage completes, can feed back acousto-optic hint to operator.Then control high voltage pulse discharge circuit by operator by foot switch to discharge, make electrode catheter send pulse and then fragmentation to calculus.And having discharged after at every turn, control residual amount of energy leadage circuit by control unit and the residual amount of energy on electrode catheter is released, to protect safety and the accuracy of electric discharge next time.Process high voltage appearance measuring unit is measured and is recorded the Wave data of each pulse, feeds back to control unit.The corresponding parameter modification of control unit prompting operation is arranged.Because electrode catheter needs directly to enter inside of human body, therefore electrode catheter is disposable for operation process, and what its life-span needed guarantee once to perform the operation completes, and its life-span needs to be greater than 1000 pulses usually.
Particularly, described endoscope apparatus comprises the photoconduction line of built-in light guide fiber, be arranged at the cold light source camera lens of photoconduction line one end, be arranged at the image acquisition device of the photoconduction line other end, and the display module to be connected with image acquisition device, wherein, fexible conductor and flexible insulating layer mate with photoconduction line is integrated.
For the ease of the fixing of calculus and the contact with electrode catheter, prevent calculus from moving in shattering process and flicking, described electrode catheter has also been arranged side by side the calculus string bag 9, the extensible distance of this calculus string bag is greater than the extensible distance of electrode catheter.
Based on said structure, present invention also offers this using method based on the high voltage pulse calculosis therapy system of plasma, comprise the steps:
(1) endoscope apparatus is stretched into stone location together with electrode catheter;
(2) under the image-guidance of endoscope apparatus feedback, adjustment electrode catheter position, makes it effectively to contact with calculus;
(3) the calculus string bag by electrode catheter is arranged side by side catches calculus, makes electrode catheter and calculus contact stabilization;
(4) according to calculus situation, the relevant parameter of high voltage pulse is regulated by calculus crusher;
(5) start calculus crusher, by electrode catheter, electric discharge is carried out to calculus broken.
Further, after described step (5), the calculus fragment of fritter is taken out one by one by the calculus string bag, or it is broken to continue to carry out electric discharge to the calculus fragment of bulk, until calculus is all broken for fritter.
Above-described embodiment is only the preferred embodiments of the present invention, not limiting the scope of the invention, as long as adopt design principle of the present invention, and the change carried out non-creativeness work on this basis and make, all should belong within protection scope of the present invention.
Claims (10)
1. based on the high voltage pulse calculosis therapy system of plasma, comprise endoscope apparatus, it is characterized in that, also comprise the calculus crusher for generation of high voltage pulse, by the electrode catheter that transmission cable is connected with calculus crusher, and by the foot switch that cable is connected with calculus crusher, wherein, electrode catheter stretches into and directly contacts with the calculus in human body.
2. the high voltage pulse calculosis therapy system based on plasma according to claim 1, it is characterized in that, described electrode catheter comprises the union joint with transmission cable grafting, the fexible conductor that one end is connected with union joint, be coated on the flexible insulating layer outside fexible conductor, and the flexible insulating layer being arranged at the fexible conductor other end keeps the metallic shield ring of certain intervals with fexible conductor, wherein, described fexible conductor mates with endoscope apparatus, and metallic shield ring one end of fexible conductor directly contacts with calculus.
3. the high voltage pulse calculosis therapy system based on plasma according to claim 2, is characterized in that, in described electrode catheter, fexible conductor and the common diameter of flexible insulating layer are 0.5 ~ 3mm.
4. the high voltage pulse calculosis therapy system based on plasma according to claim 2, it is characterized in that, described calculus crusher comprises control unit, controlled unit controls the high-voltage dc power supply be connected with external power supply, the high voltage energy-storage units be connected with high-voltage dc power supply, be connected with high voltage energy-storage units and the high voltage pulse discharge circuit of controlled unit controls, the high voltage measuring unit be all connected with high voltage energy-storage units and high voltage pulse discharge circuit, and the display device be all connected with control unit, button and indicating device, wherein, electrode catheter is connected with high voltage pulse discharge circuit, high voltage measuring unit and control unit Two-way Feedback, foot switch is connected with control unit and discharges for controlling high voltage pulse discharge circuit.
5. the high voltage pulse calculosis therapy system based on plasma according to claim 4, it is characterized in that, described control unit is also connected with the residual amount of energy leadage circuit be connected with electrode catheter.
6. the high voltage pulse calculosis therapy system based on plasma according to claim 4, it is characterized in that, the voltage peak of described calculus crusher is lower than 9kV, and energy storage is lower than 5J.
7. the high voltage pulse calculosis therapy system based on plasma according to claim 2, it is characterized in that, described endoscope apparatus comprises the photoconduction line of built-in light guide fiber, be arranged at the cold light source camera lens of photoconduction line one end, be arranged at the image acquisition device of the photoconduction line other end, and the display module to be connected with image acquisition device, wherein, fexible conductor and flexible insulating layer mate with photoconduction line is integrated.
8. the high voltage pulse calculosis therapy system based on plasma according to any one of claim 2 ~ 7, it is characterized in that, described electrode catheter has also been arranged side by side the calculus string bag, and the extensible distance of this calculus string bag is greater than the extensible distance of electrode catheter.
9. the using method of the high voltage pulse calculosis therapy system based on plasma as described in any one of claim 1 ~ 8, is characterized in that, comprise the steps:
(1) endoscope apparatus is stretched into stone location together with electrode catheter;
(2) under the image-guidance of endoscope apparatus feedback, adjustment electrode catheter position, makes it effectively to contact with calculus;
(3) the calculus string bag by electrode catheter is arranged side by side catches calculus, makes electrode catheter and calculus contact stabilization;
(4) according to calculus situation, the relevant parameter of high voltage pulse is regulated by calculus crusher;
(5) start calculus crusher, by electrode catheter, electric discharge is carried out to calculus broken.
10. the using method of the high voltage pulse calculosis therapy system based on plasma according to claim 9, it is characterized in that, after described step (5), the calculus fragment of fritter is taken out one by one by the calculus string bag, or it is broken to continue to carry out electric discharge to the calculus fragment of bulk, until calculus is all broken for fritter.
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| CN105534565A (en) * | 2015-12-07 | 2016-05-04 | 沈阳彼得康医疗科技有限公司 | High-voltage pulse generating device for calculus smashing |
| CN105748147A (en) * | 2016-02-22 | 2016-07-13 | 沈阳彼得康医疗科技有限公司 | Staghorn calculus smashing device |
| CN106821494A (en) * | 2017-03-28 | 2017-06-13 | 成都美创医疗科技股份有限公司 | A kind of Plasma surgical electrode |
| CN107374696A (en) * | 2017-05-05 | 2017-11-24 | 浙江荣信医疗科技有限公司 | Lithotripter and its application method in a kind of endoscope-use body |
| CN113081244A (en) * | 2021-05-14 | 2021-07-09 | 江苏邦士医疗科技有限公司 | Instrument is smashed to internal calculus |
| CN114948081A (en) * | 2022-05-18 | 2022-08-30 | 西安远鸿科技有限责任公司 | Oral intelligent stone breaking method and intelligent stone breaking equipment |
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| CN105534565A (en) * | 2015-12-07 | 2016-05-04 | 沈阳彼得康医疗科技有限公司 | High-voltage pulse generating device for calculus smashing |
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| CN114948081A (en) * | 2022-05-18 | 2022-08-30 | 西安远鸿科技有限责任公司 | Oral intelligent stone breaking method and intelligent stone breaking equipment |
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