CN107184270A - 一种射频消融系统的贴壁反馈方法 - Google Patents

一种射频消融系统的贴壁反馈方法 Download PDF

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CN107184270A
CN107184270A CN201710313641.6A CN201710313641A CN107184270A CN 107184270 A CN107184270 A CN 107184270A CN 201710313641 A CN201710313641 A CN 201710313641A CN 107184270 A CN107184270 A CN 107184270A
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electrode
adherent
feedback method
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汪虔
秦杰
何俊德
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An Zhen Shanghai Medical Technology Co Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00214Expandable means emitting energy, e.g. by elements carried thereon
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00642Sensing and controlling the application of energy with feedback, i.e. closed loop control
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00875Resistance or impedance
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B2018/124Generators therefor switching the output to different electrodes, e.g. sequentially
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1467Probes or electrodes therefor using more than two electrodes on a single probe

Abstract

本发明公开了一种射频消融系统的贴壁反馈方法,涉及射频消融领域,包括以下步骤:将射频消融导管插入待消融的组织表面或内部;将消融电极伸出所述消融导管;测量所述消融电极与所述待消融的组织之间的阻抗值;判断所述阻抗值是否在预设阈值之内;若在阈值之外则说明贴合不好,需要调整所述消融电极的位置或单独增加这个消融电极的射频功率。本发明所述的射频消融系统的贴壁反馈方法将判断结果直接反馈给射频发生器,形成贴壁反馈控制,从客观的物理的角度测量电极导管与消融组织的贴合程度,消除医生经验对消融成功的影响。

Description

一种射频消融系统的贴壁反馈方法
技术领域
本发明涉及射频消融领域,尤其涉及一种射频消融系统的贴壁反馈方法。
背景技术
RITA射频消融术治疗的原理是在CT、彩色B超的引导下,将多极子母针消融电极准确刺入肿瘤部位,射频消融仪在电子计算机控制下将射频脉冲能量通过多极针传导到肿瘤组织中,使肿瘤组织产生局部高温(70℃-95℃),从而达到使肿瘤组织及其邻近的可能被扩散的组织凝固坏死的目的,坏死组织在原位被机化或吸收。在CT、彩色B超的引导下,将多极子母针消融电极准确刺入肿瘤部位,射频消融仪在电子计算机控制下将射频脉冲能量通过多极针传导到肿瘤组织中,集束电极射频电极发出高频率射频波,激发组织细胞进行等离子震荡,所产生的热量可使局部温度达到高温(70℃——95℃),从而使肿瘤组织及其邻近的可能被扩散的组织凝固坏死。RITA消融术对大小在7cm以内的肿瘤有显着的治疗效果。
RITA射频消融术是近年兴起的实体肿瘤微创治疗新技术,是中小型肿瘤的治疗方法。能使患者免除开刀之苦,与传统治疗相比具有疗效高、创伤小、痛苦小、恢复快、无后遗症、无风险、适应症广等优点。RITA射频消融术可用于人体器官良、恶性实体肿瘤,目前临床应用较多的是:肝癌、肺癌、乳腺癌。原发性肿瘤、转移性肿瘤、不能手术切除的晚期肿瘤、手术中探查发现不能完全切除的肿瘤、不能承受放疗化疗的肿瘤患者,均可接受射频消融治疗。
射频消融的速度或效果在很大程度上依赖电极导管和消融组织的贴合度,现有技术中,操作医生完全依赖各种腔镜带来的直接的视觉反馈,或则根据贴壁调节丝的力量感觉,来判断电极导管与消融组织的贴合程度。
因此,本领域的技术人员致力于开发一种检测射频消融导管的电极贴壁方法,从客观的物理的角度测量电极导管与消融组织的贴合程度,消除医生经验对消融成功的影响。
发明内容
有鉴于现有技术的上述缺陷,本发明所要解决的技术问题是如何从客观的物理的角度测量电极导管与消融组织的贴合程度。
为实现上述目的,本发明提供了一种射频消融系统的贴壁反馈方法,包括以下步骤:
步骤1、将射频消融导管插入待消融的组织中;
步骤2、将消融电极伸出所述消融导管;
步骤3、测量所述消融电极与所述待消融的组织之间的阻抗值;
步骤4、判断所述阻抗值是否在预设阈值之内;若在所述阈值之外则说明贴合不好;
步骤5、若在阈值之外则说明贴合不好,则调整所述消融电极的位置或单独增加这个消融电极的射频功率。
进一步地,所述预设阈值为225欧到250欧。
进一步地,所述消融电极为一个或多个。
进一步地,所述步骤4的判断结果直接反馈给射频发生器。
进一步地,所述步骤2中,所述消融电极伸出所述消融导管后呈伞状。
进一步地,在步骤5中,还包括,当接触不好的那个电极测到的阻抗比接触好的电极测到的阻抗明显高时,单独关闭接触不好的那个电极或调整位置。
本发明所述的检测射频消融导管的电极贴壁的方法,利用多个电极中的一个或多个电极实时测量电极导管与消融组织之间的阻抗值,或者通过承载电极的导丝的压力值,通过数学统计算法,客观地判断电极导管与消融组织之间的贴合程度,并可将判断结果,无需操作医生干预的情况下,反馈给射频发生器,形成贴壁反馈控制,增强了射频消融的速度和效果。
以下将结合附图对本发明的构思、具体结构及产生的技术效果作进一步说明,以充分地了解本发明的目的、特征和效果。
附图说明
图1是本发明的一个较佳实施例的贴壁反馈方法示意图。
具体实施方式
本发明所述的检测射频消融导管包括导管本体、导丝以及消融电极,导丝承载消融电极,导丝和消融电极共同穿设在导管本体内部。消融导管插入消融组织后,导丝承载着消融电极从导管本体中的远端伸出并展开成立体伞状。本发明所述的消融电极具有多个电极,可以在不同部位,多个角度与消融组织接触、贴合。
如图1所示,消融电极连接的检测装置可以发出激发电流,测量每一个消融电极与消融组织之间的阻抗值,若阻抗值在225欧到250欧之间则说明电极贴合情况良好,若有个别电极测得的阻抗特别大,则说明其与消融组织的贴合存在问题,需要调整位置或单独增大这个电极的射频输出功率。
另外一种实施例是在每个消融电极所附属的导丝上安装压敏传感器,压敏传感器可以采集每根导丝实时的压力值,当压力值在0.5牛到2牛之间,则说明电极贴合情况良好,若有个别电极测得的压力值特别小,则说明其与消融组织的贴合存在问题,需要调整位置或单独增大这个电极的射频输出功率。
判断结果无需操作医生干预的情况下反馈给射频发生器,形成贴壁反馈控制,增强了射频消融的速度和效果。
以上详细描述了本发明的较佳具体实施例。应当理解,本领域的普通技术无需创造性劳动就可以根据本发明的构思作出诸多修改和变化。因此,凡本技术领域中技术人员依本发明的构思在现有技术的基础上通过逻辑分析、推理或者有限的实验可以得到的技术方案,皆应在由权利要求书所确定的保护范围内。

Claims (6)

1.一种射频消融系统的贴壁反馈方法,其特征在于,包括以下步骤:
步骤1、将射频消融导管插入待消融的组织中;
步骤2、将消融电极伸出所述消融导管;
步骤3、测量所述消融电极与所述待消融的组织之间的阻抗值;
步骤4、判断所述阻抗值是否在预设阈值之内;若在所述阈值之外则说明贴合不好;
步骤5、若在阈值之外则说明贴合不好,则调整所述消融电极的位置或单独增加这个消融电极的射频功率。
2.如权利要求1所述的贴壁反馈方法,其特征在于,所述预设阈值为225欧到250欧。
3.如权利要求1所述的贴壁反馈方法,其特征在于,所述消融电极为一个或多个。
4.如权利要求1所述的贴壁反馈方法,其特征在于,所述步骤4的判断结果直接反馈给射频发生器。
5.如权利要求1所述的贴壁反馈方法,其特征在于,所述步骤2中,所述消融电极伸出所述消融导管后呈伞状。
6.如权利要求1所述的贴壁反馈方法,其特征在于,在步骤5中,还包括,当接触不好的那个电极测到的阻抗比接触好的电极测到的阻抗明显高时,单独关闭接触不好的那个电极或调整位置。
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Cited By (4)

* Cited by examiner, † Cited by third party
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CN109793568A (zh) * 2019-01-30 2019-05-24 苏州信迈医疗器械有限公司 一种多极消融装置
WO2022141691A1 (zh) * 2020-12-31 2022-07-07 杭州堃博生物科技有限公司 射频操作提示方法、电子装置及计算机可读存储介质
WO2022148159A1 (zh) * 2021-01-08 2022-07-14 北京迈迪顶峰医疗科技股份有限公司 电极组件、消融装置和射频消融设备
WO2022148151A1 (zh) * 2021-01-08 2022-07-14 北京迈迪顶峰医疗科技股份有限公司 电极组件、消融装置和射频消融设备

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CN104023663A (zh) * 2011-12-29 2014-09-03 圣犹达医疗用品电生理部门有限公司 用于最优化耦合消融导管至身体组织以及评估由导管形成的损伤的系统

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US5935079A (en) * 1994-03-31 1999-08-10 Ep Technologies, Inc. Systems and methods for positioning multiple electrode structures in electrical contact with the myocardium
CN104023663A (zh) * 2011-12-29 2014-09-03 圣犹达医疗用品电生理部门有限公司 用于最优化耦合消融导管至身体组织以及评估由导管形成的损伤的系统

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109793568A (zh) * 2019-01-30 2019-05-24 苏州信迈医疗器械有限公司 一种多极消融装置
CN109793568B (zh) * 2019-01-30 2020-12-01 苏州信迈医疗器械有限公司 一种多极消融装置
CN112155712A (zh) * 2019-01-30 2021-01-01 苏州信迈医疗器械有限公司 一种具有能量传递/反馈控制机制的射频消融仪
WO2022141691A1 (zh) * 2020-12-31 2022-07-07 杭州堃博生物科技有限公司 射频操作提示方法、电子装置及计算机可读存储介质
WO2022148159A1 (zh) * 2021-01-08 2022-07-14 北京迈迪顶峰医疗科技股份有限公司 电极组件、消融装置和射频消融设备
WO2022148151A1 (zh) * 2021-01-08 2022-07-14 北京迈迪顶峰医疗科技股份有限公司 电极组件、消融装置和射频消融设备

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