CN106510703A - 一种喉反神经实时监测仪及监测方法 - Google Patents
一种喉反神经实时监测仪及监测方法 Download PDFInfo
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- CN106510703A CN106510703A CN201611125127.1A CN201611125127A CN106510703A CN 106510703 A CN106510703 A CN 106510703A CN 201611125127 A CN201611125127 A CN 201611125127A CN 106510703 A CN106510703 A CN 106510703A
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- 238000012544 monitoring process Methods 0.000 title claims abstract description 17
- 210000002416 recurrent laryngeal nerve Anatomy 0.000 title claims abstract description 16
- 238000000034 method Methods 0.000 title claims abstract description 8
- 210000000867 larynx Anatomy 0.000 claims description 12
- 206010044565 Tremor Diseases 0.000 claims description 3
- 238000002679 ablation Methods 0.000 claims description 3
- 239000000523 sample Substances 0.000 claims description 3
- 230000005611 electricity Effects 0.000 claims description 2
- 210000005036 nerve Anatomy 0.000 abstract description 4
- 210000000534 thyroid cartilage Anatomy 0.000 abstract description 4
- 210000001260 vocal cord Anatomy 0.000 abstract description 4
- 210000004717 laryngeal muscle Anatomy 0.000 abstract 2
- 230000003183 myoelectrical effect Effects 0.000 abstract 2
- 206010002091 Anaesthesia Diseases 0.000 abstract 1
- 230000037005 anaesthesia Effects 0.000 abstract 1
- 230000004936 stimulating effect Effects 0.000 abstract 1
- 230000001537 neural effect Effects 0.000 description 7
- 238000002627 tracheal intubation Methods 0.000 description 5
- 210000000653 nervous system Anatomy 0.000 description 2
- 210000001685 thyroid gland Anatomy 0.000 description 2
- 210000003437 trachea Anatomy 0.000 description 2
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000002695 general anesthesia Methods 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 230000002232 neuromuscular Effects 0.000 description 1
- 210000000715 neuromuscular junction Anatomy 0.000 description 1
- 239000002858 neurotransmitter agent Substances 0.000 description 1
- 230000004962 physiological condition Effects 0.000 description 1
- 229920006395 saturated elastomer Polymers 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 210000001186 vagus nerve Anatomy 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/389—Electromyography [EMG]
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/296—Bioelectric electrodes therefor specially adapted for particular uses for electromyography [EMG]
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/40—Detecting, measuring or recording for evaluating the nervous system
- A61B5/4029—Detecting, measuring or recording for evaluating the nervous system for evaluating the peripheral nervous systems
- A61B5/4041—Evaluating nerves condition
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
- A61B2562/02—Details of sensors specially adapted for in-vivo measurements
- A61B2562/0209—Special features of electrodes classified in A61B5/24, A61B5/25, A61B5/283, A61B5/291, A61B5/296, A61B5/053
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Abstract
本发明公开了一种喉反神经实时监测仪及监测方法，所述检测仪包括主机、界面盒与分线盒，其特征在于，所述界面盒包括正电极针与负电极针，所述分线盒电连接有手术器械，所述主机通过界面盒电联接于分线盒，所述正电极针与负电极针连接于界面盒，所述监测方法，包括以下步骤：第一步，将正电极针与负电极针分别插入甲状软骨切迹的两侧，此时，会在声带肌与喉返神经之间形成回路；第二步，用带有弱电的手术器械刺激喉返神经，此时，声带肌颤动形成肌电信号，该肌电信号通过界面盒传入主机，经过分析即可实现喉返神经实时监测，本发明能在半麻醉的状态下实现实时的监测，而且在神经监测的同时不损伤声带。
Description
技术领域
本发明涉及医疗领域，尤其涉及一种喉反神经实时监测仪及监测方法。
背景技术
在甲状腺消融手术中，喉反神经的实时监测尤为重要，也是手术的难点所在，现有技术中均采用将电极放置于神经气管插管，将神经气管插管连接于接线盒，然后将神经气管插管插入患者体内，最后通过接线盒连接的手术器械发出微刺激电流刺激神经获得肌电信号，主机将信号放大记录肌电图和发出警报声，达到术中实时监测神经功能的目的，但是此技术方案必须在患者全麻醉的状态下，而且在实施的时候，要求实施者必须准确掌握插入的深度，过深或过浅都会导致喉返神经实时监测的失败，在不同患者不同的生理条件下，实施者很难准确的控制带有电极的神经气管插管的插入深度，而且带有电极的神经气管插管在监测时，由于电极裸露在外，容易对患者的声带造成损伤，故而，一种可以在半麻醉状态下实现喉反神经实时监测，并且不损伤人体声带的监测仪及监测方法亟需研究。
发明内容
为解决上述问题，本发明提出以下技术方案：
一种喉反神经实时监测仪，包括主机、界面盒与分线盒，所述界面盒包括正电极针与负电极针，所述分线盒电连接有手术器械，所述主机通过界面盒电联接于分线盒，所述正电极针连接于界面盒，所述负电极针连接于界面盒；
一种喉反神经实时监测方法，包括以下步骤：
第一步，将正电极针与负电极针分别插入甲状软骨切迹的两侧，此时，会在声带肌与喉返神经之间形成回路；
第二步，用带有弱电的手术器械刺激喉返神经，此时，声带肌颤动形成肌电信号，该肌电信号通过界面盒传入主机，经过分析即可实现喉返神经实时监测；
优选地，所述手术器械为消融针或探针；
优选地，所述正电极针与负电极针均呈圆柱形；
本发明对比现有技术可实现以下有益效果：相比现有技术中采用带有电极的神经气管插管实现喉返神经监测，本发明对操作者的要求不高，能在半麻醉的情况下实现对喉返神经的实时监测；
本发明通过将正负电极插入于甲状软骨的切迹两侧，利用甲状软骨上的声带肌与喉返神经形成回路来实现喉返神经的实时监测，从而避免带带电极的神经气管插管直接插入而导致声带受损。
附图说明
图1为本发明的结构示意图；
其中，1-主机、2-界面盒、3-分线盒、201-正电极针、202-负电极针、301-手术器械。
具体实施方式
如图1，本发明包括主机1，电联接于主机的界面盒2，该界面盒2包括正电极针201与负电极针202，所述界面盒2电联接有一分线盒3，该分线盒3包括若干个手术器械301，所述正电极针201与负电极针202均电联接于界面盒2，在手术中，将正电极针201与负电极针202分别插入甲状软骨切迹的两侧，此时正电极针201与负电极针202会产生两种回路，其一，附着于甲状软骨上的声带肌与喉返神经产生回路，其二，附着于甲状软骨上的神经肌接头与迷走神经产生回路，然后利用电联接于分线盒3上的手术器械301刺激喉返神经或迷走神经，电流通过神经肌接头释放神经递质引起声带肌颤动形成肌电信号、通过正电极针201与负电极针202将肌电信号传入界面盒2，界面盒2再将信号传输至主机1，主机1将肌电信号放大显示肌电图和报警声而实现术中神经功能实时监测，所述手术器械301为探针或消融针。
Claims (4)
1.一种喉反神经实时监测仪，包括主机、界面盒与分线盒，其特征在于，所述界面盒包括正电极针与负电极针，所述分线盒电连接有手术器械，所述主机通过界面盒电联接于分线盒，所述正电极针连接于界面盒，所述负电极针连接于界面盒。
2.一种喉反神经实时监测方法，其特征在于，包括以下步骤：
第一步，将正电极针与负电极针分别插入甲状软骨切迹的两侧，此时，会在声带肌与喉返神经之间形成回路；
第二步，用带有弱电的手术器械刺激喉返神经，此时，声带肌颤动形成肌电信号，该肌电信号通过界面盒传入主机，经过分析即可实现喉返神经实时监测。
3.根据权利要求1所述的一种喉返神经实时检测仪，其特征在于，所述手术器械为消融针或探针。
4.根据权利要求1所述的一种喉返神经实时检测仪，其特征在于，所述正电极针与负电极针均呈圆柱形。
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106955103A (zh) * | 2017-05-03 | 2017-07-18 | 彭德科 | 一次性面神经监测电极装置 |
| CN108113673A (zh) * | 2018-01-29 | 2018-06-05 | 唐华松 | 一种神经肌电信号接收电极装置 |
| CN108309296A (zh) * | 2018-02-27 | 2018-07-24 | 江苏百宁盈创医疗科技有限公司 | 一种无神经监护气管插管的神经监护电极装置 |
| CN109528297A (zh) * | 2018-10-29 | 2019-03-29 | 四川大学华西医院 | 一种可进行喉返神经监测的消融针及监测系统 |
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| CN205268163U (zh) * | 2015-12-23 | 2016-06-01 | 中国医学科学院肿瘤医院 | 一种免肌松干扰型喉返神经监测仪 |
| CN207400735U (zh) * | 2016-12-09 | 2018-05-25 | 肖玉根 | 一种喉返神经实时监测仪 |
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Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
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| WO2016038490A1 (de) * | 2014-09-12 | 2016-03-17 | Dr. Langer Medical Gmbh | Ableitelektrode |
| CN205268163U (zh) * | 2015-12-23 | 2016-06-01 | 中国医学科学院肿瘤医院 | 一种免肌松干扰型喉返神经监测仪 |
| CN207400735U (zh) * | 2016-12-09 | 2018-05-25 | 肖玉根 | 一种喉返神经实时监测仪 |
Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106955103A (zh) * | 2017-05-03 | 2017-07-18 | 彭德科 | 一次性面神经监测电极装置 |
| CN108113673A (zh) * | 2018-01-29 | 2018-06-05 | 唐华松 | 一种神经肌电信号接收电极装置 |
| CN108113673B (zh) * | 2018-01-29 | 2024-02-20 | 上海倍可达医疗科技有限公司 | 一种神经肌电信号接收电极装置 |
| CN108309296A (zh) * | 2018-02-27 | 2018-07-24 | 江苏百宁盈创医疗科技有限公司 | 一种无神经监护气管插管的神经监护电极装置 |
| CN109528297A (zh) * | 2018-10-29 | 2019-03-29 | 四川大学华西医院 | 一种可进行喉返神经监测的消融针及监测系统 |
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