CN107158549A - 用于调控左心室容量以改善心脏泵功能的辅助装置 - Google Patents
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- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
- A61M60/148—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
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Abstract
本发明公开了一种用于调控左心室容量以改善心脏泵功能的辅助装置，包括控制芯片，在控制芯片上连接有心电传感器、心脏压力传感器及反搏泵；在反搏泵上连接有球囊导管，在球囊导管的末端连接有左心室球囊。本发明能通过微创的方式进行使用，使用过程中能实现增加回心血量，减轻肺水肿的作用，而且不完全依赖于左心室射血功能就能进一步增加心排血量和主动脉压，改善冠状动脉和外周动脉的灌注，而且整体成本低廉，使用方便，效果理想。
Description
技术领域
本发明涉及医疗器具技术领域，尤其是一种用于调控左心室容量以改善心脏泵功能的辅助装置。
背景技术
主动脉内球囊反搏((Intra-aortic balloon pump或Intraaortic BalloonCounterppulsation简称：IABP)是最早以氧供氧耗理论为基础的辅助循环方式。1968年首次应用于临床，IABP早期主要用于心脏围术期血流动力学不稳定、心源性休克或心功能衰竭患者的循环支持，通常需要外科手术切开血管植入主动脉内球囊。20世纪80年代经皮穿刺技术的出现使IABP具有创伤小、并发症少以及操作简便等优点，目前已广泛应用于高危PCI患者的循环支持。
1968年，Kantrowitzz首次临床应用主动脉球囊反搏取得成功。1981年，Bregmen经多年精心研究，改进了(Datascope)球囊结构及置入动脉的方法。随着主动脉内球囊反搏的器械和装置不断更新，质量不断改善与提高，应用范围不断扩大，并发症显著下降，现已成为抢救心源性休克、心脏直视手术后不能脱离人工心肺机或术后发生地心排血量综合征等危重病人的有效手段，在心脏外科和心脏内科领域得到广泛应用。IABP工作原理：作为一种按反搏动原理设计的对衰竭的左心提供辅助的机械装置。通过股动脉穿刺途径将一个球囊放置在降主动脉锁骨下动脉以远1-2cm至肾动脉之间，并与主动脉球囊反搏泵相连接，在主动脉球囊反搏泵控制与驱动下，在心脏舒张期球囊充气，增加冠状动脉灌注压，改善冠状动脉血液循环；在心脏收缩期球囊排气，降低心脏射血后负荷，增加心排血量，使心脏残血量减少，同时降低了心脏的前负荷，从而达到减少心肌耗氧量，改善心脏功能的目的。IABP降低左室后负荷、减轻心脏做功，左室收缩压和射血阻力降低约10-20％，左心室舒张末容量下降20％，心排血量增加0.5L/min.m2,。提高舒张压，增加冠脉灌注；增加全身重要器官灌注，肾血流增加19.8％，肝脏血流增加35％，脾脏血流增加47％，循环稳定，微循环改善，尿量增加。降低右房压及肺动脉压，肺动脉压降低12％，肺血管阻力降低19％。对危重状态下或血流动力学不稳定的患者，争取时间手术。
IABP虽然通过减轻心脏后负荷增加前向心排血量，但其增加心排血量作用有赖于左心室的射血功能；严重主动脉瓣关闭不全患者安置主动脉内球囊反搏可能会加重心脏前负荷而不增加前向心排血量、严重主动脉疾病不适合主动脉内球囊反搏。IABP最大的局限性是不能主动辅助心脏，心输出量增加依赖自身心脏收缩及稳定的心脏节律，且支持程度有限，对严重左心功能不全者效果欠佳。
发明内容
本发明的目的是：提供了一种用于调控左心室容量以改善心脏泵功能的辅助装置，它在不完全依赖于左心室收缩功能的前提下实现增加心排血量减轻肺水肿的作用。
本发明是这样实现的：用于调控左心室容量以改善心脏泵功能的辅助装置，包括控制芯片，在控制芯片上连接有心电传感器、心脏压力传感器、反搏泵及操作模块；在反搏泵上连接有球囊导管，在球囊导管的末端连接有左心室球囊。
所述的球囊导管分为中央腔和外周腔。中央腔用于引导左心室球囊进入左心室，并在球囊植入后监测左心室压力，外周腔是氦气进出球囊的通道。中央腔的头端与左心室相通，尾端与反搏仪的压力传感器连接，另外球囊反搏是由固定在导管外面的的圆柱形气囊构成(附着在导管外圈)。
球囊的容积位30-40ml。
在控制芯片上连接有参数显示器。
与现有的技术相比，本发明能通过微创的方式进行使用，使用过程中能实现增加回心血量，减轻肺水肿的作用，而且不完全依赖于左心室射血功能就能进一步增加心排血量和主动脉压，改善冠状动脉和外周动脉的灌注，对于顽固性心力衰竭、急性心肌梗死(AMI)合并心源性休克(CS)、难治性不稳定型心绞痛、血流动力学不稳定的高危PCI患者(左主干病变、严重多支病变、重度左心功能不全)以及PCI失败需过渡到外科手术等情况均可适用，而且整体成本低廉，使用方便，效果理想。
附图说明
图1为本发明的结构示意图。
具体实施方式
本发明的实施例：用于调控左心室容量以改善心脏泵功能的辅助装置，包括控制芯片1，在控制芯片1上连接有心电传感器2、心脏压力传感器3、反搏泵4及操作模块8；在反搏泵4上连接有球囊导管5，在球囊导管5的末端连接有左心室球囊6；所述的球囊导管5分为中央腔和外周腔；球囊的容积位30-40ml；在控制芯片1上连接有参数显示器7。
控制芯片1作用是接受心电传感器2及心脏压力传感器3的参数，以及控制反搏泵4的工作情况，至于如何将心电传感器2及心脏压力传感器3的参数与控制芯片1内预设数据结合对反搏泵4的工作情况进行实时控制，这是现有技术所常用的技术手段，也可根据需要自行进行设计调整，此处就不再赘述，也非本发明的保护点。同样，至于电路接口连接等方案也为现有技术。
操作模块8采用机械键盘、触摸式控制屏或智能终端(如智能平板电脑或智能手机)，其作用是对控制芯片1的进行参数修改或对反搏泵4的工作进行实时干预，保证紧急情况时的安全性。
参数显示器7对控制芯片1接收到的各项参数进行直观显示。
球囊导管5由高分子材料聚氨酯类制成，具有较好的抗血栓性能和生物组织相容性。
由反搏泵4、控制芯片1及相关的接口与电路组成反搏仪。
为了便于理解，本发明还具体提供一种具体使用时的操作方案：
植入步骤：绝大多数经股动脉置入，将反搏泵4与气源连接。
1.在无菌操作下，穿刺股动脉，送入导丝至左心室，经血管扩张器扩张后送球囊导管5。
2.将球囊导管5的中央腔穿过导丝，在X透视下沿导丝将气囊导管缓慢送至左心室内，撤出导丝。
3.采用无鞘气囊导管时，先用血管扩张器扩张血管，再用止血钳扩张皮下组织，经导丝直接送入球囊导管5。
4.固定鞘管和球囊导管5，经三通接头将球囊导管5的前端连接反搏仪的反搏泵4，调整各种参数后开始反搏。
5.连接心电传感器2，获取心电信号。
6.连接球囊导管5的中央腔至心脏压力传感器3获取压力信号；球囊导管5的外周腔连接反搏泵。
7.选择触发模式(心电或压力触发)。
8.根据反搏波调整左心室球囊6的充气放气时间。
9.调节反搏比例及强度。
Claims (4)
1.一种用于调控左心室容量以改善心脏泵功能的辅助装置，包括控制芯片(1)，其特征在于：在控制芯片(1)上连接有心电传感器(2)、心脏压力传感器(3)、反搏泵(4)及操作模块(8)；在反搏泵(4)上连接有球囊导管(5)，在球囊导管(5)的末端连接有左心室球囊(6)。
2.根据权利要求1所述的辅助装置，其特征在于：所述的球囊导管(5)分为中央腔和外周腔。
3.根据权利要求1所述的辅助装置，其特征在于：球囊的容积位30-40ml。
4.用于调控左心室容量以改善心脏泵功能的辅助装置，其特征在于：在控制芯片(1)上连接有参数显示器(7)。
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109316641A (zh) * | 2018-11-06 | 2019-02-12 | 曾建新 | 一种人工心脏装置 |
| CN109966575A (zh) * | 2019-05-05 | 2019-07-05 | 北京安生生物技术有限责任公司 | 一种单球囊反搏式左心辅助装置 |
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| CN1195561A (zh) * | 1997-04-07 | 1998-10-14 | 李凤翥 | 辅助循环导流反搏急救装置 |
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| CN209005003U (zh) * | 2017-06-29 | 2019-06-21 | 吴强 | 用于调控左心室容量以改善心脏泵功能的辅助装置 |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN109316641A (zh) * | 2018-11-06 | 2019-02-12 | 曾建新 | 一种人工心脏装置 |
| CN109966575A (zh) * | 2019-05-05 | 2019-07-05 | 北京安生生物技术有限责任公司 | 一种单球囊反搏式左心辅助装置 |
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