CN106901827A - Urethra temperature preservation control device and method in tumor of prostate cryoablation - Google Patents
Urethra temperature preservation control device and method in tumor of prostate cryoablation Download PDFInfo
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- CN106901827A CN106901827A CN201710096225.5A CN201710096225A CN106901827A CN 106901827 A CN106901827 A CN 106901827A CN 201710096225 A CN201710096225 A CN 201710096225A CN 106901827 A CN106901827 A CN 106901827A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
- A61B2018/00041—Heating, e.g. defrosting
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00505—Urinary tract
- A61B2018/00517—Urinary bladder or urethra
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00547—Prostate
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00714—Temperature
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00791—Temperature
- A61B2018/00821—Temperature measured by a thermocouple
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Abstract
The present invention relates to the urethra temperature preservation control device and method that are used in a kind of prostate cryoablation, including electrical heating urethra attemperator, thermocouple, electrical heating wire, temperature switch, PID temperature controllers etc..Thermocouple is coated in silica gel protected coating or external three temperature thermocouples are on tube wall, and all circuits are all drawn from urethra attemperator inner chamber, and are connected with control panel.In the case where layer of silica gel thickness determines, the temperature of design temperature switch, when design temperature of the temperature that thermocouple is measured less than temperature switch, you can automatic switching on heater circuit, and using temperature on PID temperature controller fuzzy Control tube walls close to design temperature.The present invention not only causes that the temperature on urethral wall is precisely controlled; and the size of zone of ablation can be played as needed and be precisely controlled; expect in tumor of prostate cryoablation protect urethra while; tumor tissues are killed as far as possible and triggers Human immune responses, at utmost protect the normal physical function of patient.
Description
Technical field
The present invention relates to one kind for electrical heating urethra attemperator and control method in prostate cryoablation.
Background technology
Prostate cancer is to be diagnosed a kind of most malignant tumours in male in the world.About 1/6th male's meeting
Obtain this disease.Many treatment methods all be used to treat prostate cancer, such as surgical resection, chemotherapy radiotherapy etc..Nowadays disappear
Melt treatment, especially with cryoablation（Targeted Cryoablation of Prostate Cancer, TCAP）By low-temperature device
Tool, controlledly make lesion tissue experience lower the temperature, freeze, rewarming process, so as to cause tumour cell irreversible damage even
Necrosis, because it has registration, hemostatic analgesia, postoperative complications few, safe, the advantages of small to health tissues injury,
Deep favorable comment and favor by numerous doctors with patient.
Although TCAP is a kind of minimal invasive techniques, refer to 17% or so patient by prostate cryoablation in report
It is postoperative, the complication such as the relevant urinary incontinence, sex dysfunction, urethrorectal fistula can be caused, and easily draw after freezing necrosis tissue loss
Play acute or Delayed onset lower urinary tract obstruction.In recent years, many researchs are devoted to research and development thermel protection device to limit cryoablation
To the injury from low temperature of surrounding tissue, while with the protection devices such as urethra warm-up cycle, thermoprobe, imaging monitor, refrigerant skill
Art progress, operating technology is ripe and there occurs great changes.Clinical data shows that the probability of urethrorectal fistula is reduced to
0.4%, the urinary incontinence has been also reduced to 3.1%, thus urethra Insulation be prostate target cryoablation operation protection urethra and its
Urinary function necessary means；Although urethra attemperator protects urethra, peripheral cyclic remaining cancerous tissue is might have, increased
The research of cancer return probability, Perrotte etc. also demonstrates this point, so, can not replace full body of gland cold therapy at present
Method.Urethra heat insulation function, the simultaneously again as far as possible small effective freezing of factor influence of protection urethral tissue are quickly and accurately provided
Border is the key technology difficulty of urethra insulation.
During current country TCAP performs the operation, doctor's bimetallic tube hot water heat exchanger or common electric heater unit, heat source
To 37oC or so, maintains this temperature all the time in operation, is not controlled by, although protect the normal function of urethra, but
Reduce low temperature lethality of the cryoablation in Periurethral tumor tissues.
Found through retrieving prior art literature, at present in terms of for the operation thermometric insulation of prostate cryoablation, on
In application Chinese patent in 2007, " CN200710036336.3 urethra for ablation of prostate temperature multi-point monitorings were led for extra large university of communications
Pipe ", and Shanghai Daoxiang Medical System Co., Ltd. was in Chinese patent " a kind of prostatitis of CN201510553498.9 of application in 2016
Urethra attemperator in adenoncus knurl cryoablation ", these patents be mainly used for urethra prostate section inner wall temperature multiple spot,
Real-time monitoring, heating and thermal insulation and the transformation to normal catheter is carried out to urethra, but heater has not been controlled.
Can also well solve cryoablation Post operation cancer without a effective heating and heat-insulating device in the market
Disease Problems Concerning Their Recurrence.
The content of the invention
The present invention is directed to during existing prostate cancer cryosurgery, though urethra attemperator reduces the injury to urethra,
But also increase post-surgical cancer recurrence rate this situation, there is provided a kind of tumor of prostate of the control of intelligent program its heating behavior is cold
Freeze urethra temperature preservation control device and method in ablation, so as to control the size of Periurethral zone of ablation, the apparatus structure is simple,
Facilitate easy-to-use, the cryoablation for tumour provides different control methods.The true temperature on urethral wall can be measured, together
When information can be given in time and feed back, realize that intelligent program controls heating starting temperature and intensification, and electrical heating wire and thermoelectricity
Even temperature inductor is all placed in insulating tube, farthest reduces patient's inconvenience over the course for the treatment of and pain.
In order to solve the above-mentioned technical problem, the technical scheme of use of the invention is：A kind of tumor of prostate cryoablation
Urethra temperature preservation control device in art, including electrical heating urethra insulating tube, thermocouple, electrical heating wire, temperature switch, PID temperature controllers,
Man-machine interface, AC power, dc source, the electrical heating wire and thermocouple are knitted to the urethral catheterization in electrical heating urethra insulating tube
Guan Shang, built-in electrical heating wire and thermocouple are drawn in electrical heating urethra insulation tube cavity, are connected with PID temperature controllers, feed back in
In man-machine interface, for real-time displays temperature；The PID temperature controllers, temperature switch and thermocouple collectively constitute control circuit, use
Heating, heating-up temperature, heat time in electrical heating urethra insulating tube is controlled；The temperature signal that the thermocouple is collected
Compare with the design temperature of temperature switch after treatment, for whether controlling current flowing in attemperator on electrical heating wire, together
When the signal that collects of thermocouple compare with the design temperature in PID temperature controllers, prevent the temperature on urethral wall too high, pass through
PID temperature controllers automatically adjust heating voltage and reach and precisely controllable heat；Thermocouple is processed into temperature letter with PID temperature controllers
Number compare with the design temperature of temperature switch, thus the circulation of Cutoff current whether；Temperature signal that the thermocouple is collected,
Temperature switch has the design temperature of design temperature and PID temperature controllers, voltage, heat time parameter to be shown in man-machine interface,
The temperature of real-time monitoring tissue.
The man-machine interface is directly connected with AC power, the electric current of the PID temperature controllers and electrical heating urethra insulating tube
It is converted as being connected with man-machine interface after dc source.
The electrical heating wire 3 is segmented helical arrangement in the wall of urethra insulating tube 1, meets segmentation and selectively heats and protect
The requirement of urethra, the thermocouple 2 is knitted to centre outside the electrical heating wire 3 in silica-gel coating nearby or external three
Root, for accurate temperature measurements.
Described thermocouple is copper-constantan thermocouple, and copper wire wraps up by insulated paint respectively with constantan wire, temperature-measuring range is-
200~100 DEG C, the external diameter of built-in thermocouple is 0.5 mm for the external diameter of 0.1mm or external thermocouples, outside external thermocouple with
Stainless steel outer tube is coated, if thermocouple is arranged in silica-gel coating, the temperature that thermocouple is measured, automatic amendment is obtained on tube wall
Temperature.
The control method of urethra temperature preservation control device in a kind of application tumor of prostate cryoablation, first, adds in electricity
Three thermocouples are knitted on hot urethra insulating tube, on the same line, spacing is 5 or 8 mm to thermocouple temperature measurement point, is marked
The position of thermocouple, after insertion urethra, the position of the position adjustment electrical heating urethra insulating tube inserted according to cryoprobe so that thermoelectricity
Even point for measuring temperature can measure minimum temperature in art；The heating starting temperature of design temperature switch, when one of thermocouple is measured
When temperature is the startup heating-up temperature of temperature switch setting, start heating, set the control temperature of PID temperature controllers, work as temperature
During less than the control temperature for setting, then heating continues；Higher than setting and controlling temperature, if heating stops temperature, and intelligently
Program can provide different heating powers according to the different position of urethral tissue to heat demand difference, it is ensured that its temperature is setting
In fixed control range.
The heating starting temperature that the temperature switch sets is 10 o -20oTemperature that what C, PID temperature controller set control as
37o-43oWhen C, PID temperature controller and temperature switch link, the heating tasks of setting, and precise control urethra are automatically performed
Temperature on wall makes its not heat damage and low temperature injury between -20~43 DEG C.
The beneficial effects of the invention are as follows：The present invention can not only accurately thermometric, and can be heated as needed, protection urine
Road tissue, expands zone of ablation, reduces the probability of the postoperative recurrence of tumor of prostate cryoablation, while at utmost protecting patient just
Normal physical function.
The present invention is allowed to zone of ablation on the premise of original urethra attemperator real time temperature measurement, the function of intelligent temperature control
More accurately control, increase zone of ablation, reduce influence of the urethra attemperator to cryoablation, reduce the general of post-surgical cancer recurrence
Rate, i.e., obtain maximum freezing ablation range on the premise of urethral tissue is protected.
The best advantage is that, the access of temperature switch so that heating behavior obtains more accurately controlling, insulation
Influence of the device to ablation can be largely reduction, while attemperator also can Real-time Feedback temperature change, to the greatest extent
Amount reduces the pain of patient, reduces complication, protects the function of patient body.
Brief description of the drawings
Fig. 1 is urethra temperature preservation control device schematic diagram in tumor of prostate cryoablation of the invention；
Fig. 2 is the placement location and electricity of thermocouple in urethra temperature preservation control device in tumor of prostate cryoablation of the invention
Resistance silk and silica-gel coating schematic diagram.
Specific embodiment
Below in conjunction with the accompanying drawings 1 and specific embodiment, the present invention is expanded on further.These embodiments are interpreted as being only used for
It is bright the present invention rather than limit the scope of the invention.After the content for having read record of the present invention, art technology
Personnel can make various changes or modifications to the present invention, and these equivalence changes and modification equally fall into the claims in the present invention and limited
Fixed scope.
Such as Fig. 1, shown in 2, urethra temperature preservation control device in tumor of prostate cryoablation of the invention, including electrical heating
Urethra insulating tube 1, thermocouple 2, electrical heating wire 3, temperature switch 4, PID temperature controllers 5, man-machine interface 6, power supply 7.Electrical heating wire 3
Segmentation helical arrangement meets the requirement that segmentation is selectively heated and protects urethra in the wall of urethra insulating tube 1, and thermocouple 2 is compiled
The centre being woven in outside the electrical heating wire 3 in silica-gel coating is nearby or external three, is marked according on pipe shaft during operation, adjusts
Its position is saved, the minimum temperature of urethral tissue is monitored as much as possible, be easy to regulation voltage to carry out heating and thermal insulation to target area.It is interior
The electrical heating wire 3 and thermocouple 2 put are drawn in the inner chamber of urethra insulating tube 1, are connected with PID temperature controllers 5, are fed back in man-machine interface 6
On, for real-time displays temperature.PID temperature controllers 5, temperature switch 4 and thermocouple 2 collectively constitute control circuit, for controlling electricity
Heating, heating-up temperature, heat time in heating urethra insulating tube 1；After the processes temperature signal that the thermocouple 2 is collected
Design temperature with temperature switch 4 compares, for whether controlling current flowing in attemperator on electrical heating wire 3, while hot
The signal that galvanic couple 2 is collected compares with the design temperature in PID temperature controllers 5, prevents the temperature on urethral wall too high, passes through
PID temperature controllers 5 automatically adjust heating voltage and reach and precisely controllable heat；Thermocouple 2 is processed into temperature with PID temperature controllers 5
Signal compares with the design temperature of temperature switch 4, thus the circulation of Cutoff current whether；The temperature that the thermocouple 2 is collected
It is man-machine that signal, temperature switch 4 have the design temperature of design temperature and PID temperature controllers 5, voltage, heat time parameter to be shown in
On interface 6, the temperature of real-time monitoring tissue.Man-machine interface 6 is directly connected with AC power 7, and the PID temperature controllers 5 and electricity add
The electric current of hot urethra insulating tube 1 is converted as being connected with man-machine interface 6 after dc source 8.
What embodiment was provided has 6 kinds using urethra temperature preservation control device to the control mode that urethra carries out heating and thermal insulation,
This is only given in three kinds of modes and briefly described.
Mode one：
Three thermocouples are knitted on used urethra insulating tube, on the same line, spacing is 5 mm to thermocouple temperature measurement point,
The position of thermocouple has been marked, after insertion urethra, the position of the position adjustment insulating tube inserted according to cryoprobe so that thermocouple is surveyed
Warm spot can measure minimum temperature in art, and it is 20 to set temperature switchoC（Thermocouple measure temperature it is calibrated after the temperature that obtains
Degree, is the temperature on tube wall）, it is 20 when one of thermocouple measures temperatureoWhen C, start heating, set PID temperature
The temperature that controls of controller is 37oC, when temperature is less than design temperature, then heating continues；If temperature is higher than design temperature,
Heating stops, and intelligent program can provide different heating work(according to the different position of urethral tissue to heat demand difference
Rate, it is ensured that its temperature is -20 ~ 37oBetween C.
Mode two：
Three thermocouples are knitted on used urethra insulating tube, on the same line, spacing is 8 mm to thermocouple temperature measurement point,
The position of thermocouple has been marked, after insertion urethra, the position of the position adjustment insulating tube inserted according to cryoprobe so that thermocouple is surveyed
Warm spot can measure minimum temperature in art, and it is 10 to set temperature switchoC（Thermocouple measure temperature it is calibrated after the temperature that obtains
Degree, is the temperature on tube wall）, it is 10 when one of thermocouple measures temperatureoWhen C, start heating, set PID temperature controls
The temperature that controls of instrument is 43oC, when temperature is less than design temperature, then heating continues；If temperature is higher than design temperature, heat
Stop, and intelligent program can provide different heating powers according to the different position of urethral tissue to heat demand difference,
Ensure its temperature -20 ~ 43oBetween C.
Mode three：
Three thermocouples are inserted outside used urethra insulating tube, on the same line, spacing is 8 mm to thermocouple temperature measurement point,
After insertion urethra, the position of the position adjustment insulating tube inserted according to cryoprobe so that thermocouple temperature measurement point can be measured in art most
Low temperature, it is 10 to set temperature switchoC, is 10 when one of thermocouple measures temperatureoWhen C, start heating, setting
The temperature that controls of PID temperature controllers is 43oC, when temperature is less than design temperature, then heating continues；If temperature is higher than design temperature,
Then heating stops, and intelligent program can provide different heating according to the different position of urethral tissue to heat demand difference
Power, it is ensured that its temperature is -20 ~ 43oBetween C.
Claims (6)
1. a kind of urethra temperature preservation control device in tumor of prostate cryoablation, including electrical heating urethra insulating tube（1）, thermoelectricity
It is even（2）, electrical heating wire（3）, temperature switch（4）, PID temperature controllers（5）, man-machine interface（6）, AC power（7）, dc source
（8）, it is characterised in that：The electrical heating wire（3）And thermocouple（2）It is knitted to electrical heating urethra insulating tube（1）Interior catheter
On, built-in electrical heating wire（3）And thermocouple（2）In electrical heating urethra insulating tube（1）Inner chamber is drawn, with PID temperature controllers（5）Even
Connect, feed back in man-machine interface（6）On, for real-time displays temperature；The PID temperature controllers（5）, temperature switch（4）And thermocouple
（2）Control circuit is collectively constituted, for controlling electrical heating urethra insulating tube（1）In heating, heating-up temperature, heat time；Institute
State thermocouple（2）With temperature switch after the processes temperature signal for collecting（4）Design temperature compare, for control insulation dress
Put interior electrical heating wire（3）On current flowing whether, while thermocouple（2）The signal for collecting and PID temperature controllers（5）Interior
Design temperature compares, and prevents the temperature on urethral wall too high, by PID temperature controllers（5）Automatically adjust heating voltage and reach essence
Really, controllably heat；Thermocouple（2）With PID temperature controllers（5）It is processed into temperature signal and temperature switch（4）Design temperature ratio
Compared with, thus the circulation of Cutoff current whether；The thermocouple（2）Temperature signal, the temperature switch for collecting（4）There is setting temperature
Degree and PID temperature controllers（5）Design temperature, voltage, heat time parameter be shown in man-machine interface（6）On, real-time monitoring group
The temperature knitted.
2. urethra temperature preservation control device in tumor of prostate cryoablation according to claim 1, it is characterised in that：Institute
State man-machine interface（6）Directly and AC power（7）It is connected, the PID temperature controllers（5）With electrical heating urethra insulating tube（1）Electricity
Flow through and be converted into dc source（8）Afterwards with man-machine interface（6）It is connected.
3. urethra temperature preservation control device in tumor of prostate cryoablation according to claim 1, it is characterised in that：Institute
State electrical heating wire 3 and be segmented helical arrangement in the wall of urethra insulating tube 1, meet segmentation and selectively heat and protect wanting for urethra
Ask, the centre that the thermocouple 2 is knitted to outside the electrical heating wire 3 in silica-gel coating is nearby or external three, for essence
True measurement temperature.
4. urethra temperature preservation control device in tumor of prostate cryoablation according to claim 1, it is characterised in that：Institute
The thermocouple stated（2）It is copper-constantan thermocouple, copper wire is wrapped up by insulated paint respectively with constantan wire, temperature-measuring range is -200~100
DEG C, the external diameter of built-in thermocouple is 0.5 mm for the external diameter of 0.1mm or external thermocouples, outside external thermocouple with stainless steel outside
Pipe is coated, if thermocouple（2）It is arranged in silica-gel coating, then the temperature that thermocouple is measured, automatic amendment obtains the temperature on tube wall
Degree.
5. in a kind of any described tumor of prostate cryoablations of application claim 1-4 urethra temperature preservation control device control
Method processed, it is characterised in that：First, in electrical heating urethra insulating tube（1）On be knitted into three thermocouples（2）, thermocouple（2）Survey
On the same line, spacing is 5 or 8 mm to warm spot, has marked thermocouple（2）Position, after insertion urethra, inserts according to cryoprobe
Position adjustment electrical heating urethra insulating tube（1）Position so that thermocouple（2）Point for measuring temperature can measure minimum temperature in art；
Design temperature is switched（4）Heating starting temperature, when one of thermocouple measures temperature for temperature switch（4）The startup of setting
When heating-up temperature, start heating, set PID temperature controllers（5）Control temperature, when temperature less than setting control temperature when,
Then heating continues；If higher than setting and controlling temperature, heating stops temperature, and intelligent program can be different according to urethral tissue
Position it is different to heat demand and different heating powers are provided, it is ensured that its temperature is in the control range of setting.
6. control method according to claim 5, it is characterised in that：The temperature switch（4）The heating starting temperature of setting
Spend is 10 o -20oC, PID temperature controller（5）What is set controls temperature as 37o-43oC, PID temperature controller（5）And temperature switch（4）Connection
When dynamic, the temperature on the heating tasks of setting, and precise control urethral wall is automatically performed between -20~43 DEG C,
Make its not heat damage and low temperature injury.
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Cited By (5)
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| CN110464444A (en) * | 2019-08-14 | 2019-11-19 | 心诺普医疗技术（北京）有限公司 | A kind of Cryoablation system of temperature-controllable |
| CN111067616A (en) * | 2019-12-19 | 2020-04-28 | 华中科技大学同济医学院附属协和医院 | Electric knife capable of absorbing smoke and control method thereof |
| CN113081230A (en) * | 2021-03-23 | 2021-07-09 | 上海导向医疗系统有限公司 | Temperature measurement and rewarming integrated device and cryotherapy system |
| WO2022077313A1 (en) * | 2020-10-15 | 2022-04-21 | 山前（珠海）医疗科技有限公司 | Cryoballoon catheter having heating function |
| WO2022078505A1 (en) * | 2020-10-15 | 2022-04-21 | 山前（珠海）医疗科技有限公司 | Cryogenic balloon catheter having heating function |
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