CN108310504B - Vena cava retrograde perfusion tube and use method thereof - Google Patents

Vena cava retrograde perfusion tube and use method thereof Download PDF

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CN108310504B
CN108310504B CN201810162115.9A CN201810162115A CN108310504B CN 108310504 B CN108310504 B CN 108310504B CN 201810162115 A CN201810162115 A CN 201810162115A CN 108310504 B CN108310504 B CN 108310504B
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tube
vena cava
perfusion
artery
pipe
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CN108310504A (en
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熊际月
谭赵霞
罗明
杜磊
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West China Hospital of Sichuan University
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West China Hospital of Sichuan University
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621—Extra-corporeal blood circuits
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621—Extra-corporeal blood circuits
    • A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
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Abstract

The invention discloses a vena cava retrograde perfusion tube, which belongs to the field of medical instruments and comprises an artery perfusion tube, wherein an artery perfusion branch tube A and an artery perfusion branch tube B are connected to the artery perfusion tube, the free end of the artery perfusion branch tube A is connected with one end of a vena cava drainage tube A, the free end of the artery perfusion branch tube B is connected with one end of a vena cava drainage tube B, the artery perfusion branch tube A and the vena cava drainage tube A are integrally formed, the artery perfusion branch tube B and the vena cava drainage tube B are integrally formed, the vena cava drainage tube A or the vena cava drainage tube B are connected with the artery perfusion tube through the retrograde perfusion tube, and the artery perfusion branch tube A, the artery perfusion branch tube B, the vena. The invention has the advantages of convenient operation, short preparation time and rapid conversion among various perfusion modes.

Description

Vena cava retrograde perfusion tube and use method thereof
Technical Field
The invention relates to the field of medical instruments, in particular to a vena cava retrograde perfusion tube and a use method thereof.
Background
Extracorporeal circulation is a technique of temporarily replacing the human heart and lungs with a special device to perform blood circulation and gas exchange. Such devices are referred to as artificial hearts (pumps) and artificial lungs (oxygenators), also known collectively as artificial heart-lungs, artificial heart-lung devices, or extracorporeal circulation devices. During extracorporeal circulation, venous blood is led into the blood storage tank through the superior vena cava cannula and the inferior vena cava cannula, the artificial heart (pump) pumps the venous blood into the artificial lung for oxygenation and discharges carbon dioxide, and the oxygenated blood is pumped into an internal artery system through the artificial heart under certain pressure, so that the silence and clear operation field during operation are ensured, the blood supply of other important organs except the heart is also ensured, and the blood storage tank is an important guarantee measure for the development of great cardiac vessel surgery.
Currently, in total aortic arch replacement, "deep hypothermia-arrest-cycle selective brain perfusion (ACP + DHCA)" techniques are commonly used. However, this technique is performed with complete ischemia of the lower body, low temperature and long extracorporeal circulation, which all cause severe organ damage and coagulation dysfunction, and therefore these patients are typically characterized by a height of 4: i.e., high mortality, high incidence of organ dysfunction, high blood transfusion rate, and high blood volume transfusion.
The continuous maintenance of systemic perfusion is critical to improve the adverse effects of ACP + DHCA on patients. Therefore, when the selective cerebral perfusion is combined with the inferior vena cava intubation retrograde perfusion (ACP + RIVP) to replace ACP + DHCA in the total aortic arch replacement surgery, the whole body blood perfusion can be continuously maintained, so that the lower half body has no ischemia time, and the patient does not need deep hypothermia any more. These changes would avoid damage to the body from cryogenic arrest and improve patient prognosis.
However, the existing extracorporeal circulation device can only implement deep hypothermia arrest circulation selective cerebral perfusion (ACP + DHCA) and cannot implement selective cerebral perfusion combined with inferior vena cava retrograde perfusion (ACP + RIVP), and a product directly used for the ACP + RIVP is urgently needed. Shorten the preparation time, shorten the operation time and improve the prognosis of patients.
Disclosure of Invention
The invention aims to provide a vena cava retrograde perfusion tube and a using method thereof, which can rapidly perform superior vena cava and/or inferior vena cava retrograde perfusion without an auxiliary device.
In order to achieve the purpose, the technical scheme adopted by the invention is as follows: the utility model provides a vena cava retrograde perfusion tube, includes the artery perfusion tube, is connected with artery perfusion branch pipe A, artery perfusion branch pipe B on the artery perfusion tube, and artery perfusion branch pipe A free end is connected with vena cava drainage tube A one end, and artery perfusion branch pipe B free end is connected with vena cava drainage tube B one end, vena cava drainage tube B or vena cava drainage tube A fill the union coupling through retrograde perfusion tube and artery, artery perfusion branch pipe A, artery perfusion branch pipe B, vena cava drainage tube A, vena cava drainage tube B are the hose.
Preferably, the arterial perfusion branch pipe A and the vena cava drainage pipe A, and the arterial perfusion branch pipe B and the vena cava drainage pipe B are integrally formed.
Preferably, the retrograde perfusion tube is connected with a piezometric tube.
Preferably, an arterial microembolus filter is arranged on the arterial perfusion tube.
Furthermore, the free end of the vena cava drainage tube A and the free end of the vena cava drainage tube B are both connected with a main vein blood return tube, and the main vein blood return tube is a flexible tube.
A method of using a vena cava retrograde perfusion tube, comprising the steps of:
step 1, connecting an arterial perfusion tube to the outlet end of an oxygenator, connecting a vena cava drainage tube A and a vena cava drainage tube B to a blood storage tank, arranging a pump A between the blood storage tank and the inlet end of the oxygenator, and arranging a pump B on a retrograde perfusion tube;
step 2, filling the whole perfusion system with sterile liquid under the driving of a pump A and a pump B;
step 3, cutting off the artery perfusion branch pipe A and the vena cava drainage pipe A, and cutting off the artery perfusion branch pipe B and the vena cava drainage pipe B, respectively connecting the artery perfusion branch pipe A and the artery perfusion branch pipe B to a main artery intubation tube of a human body, and respectively connecting the vena cava drainage pipe A and the vena cava drainage pipe B to a lower vena cava intubation tube and an upper vena cava intubation tube of the human body;
step 4, closing one section of the vena cava drainage tube A flowing to the blood storage tank through the flow stopping clamp, performing cerebral perfusion under the drive of the pump A, performing retrograde perfusion of the inferior vena cava under the drive of the pump B, simultaneously closing the arterial perfusion branch tube A through the flow stopping clamp, and stopping perfusion of the aorta supplying blood to the lower half body; or the retrograde perfusion tube 7 is only sealed by the flow stopping clamp, the pump B does not work, the aorta is perfused under the drive of the pump A, and the normal venous drainage of the vena cava drainage tube is realized.
Another method for using a vena cava retrograde perfusion tube comprises the following steps:
step 1, connecting an arterial perfusion tube to the outlet end of an oxygenator, connecting a venous return main trunk tube to a blood storage tank, arranging a pump A between the blood storage tank and the inlet end of the oxygenator, and arranging a pump B on a retrograde perfusion tube;
step 2, filling the whole perfusion system with sterile liquid under the driving of a pump A and a pump B;
step 3, cutting off the artery perfusion branch pipe A and the vena cava drainage pipe A, and cutting off the artery perfusion branch pipe B and the vena cava drainage pipe B, respectively connecting the artery perfusion branch pipe A and the artery perfusion branch pipe B to a main artery intubation tube of a human body, and respectively connecting the vena cava drainage pipe A and the vena cava drainage pipe B to a lower vena cava intubation tube and an upper vena cava intubation tube of the human body;
and 4, controlling the opening and closing of different parts of the vena cava drainage tube B, the vena cava drainage tube A and the vein blood return main tube through the flow stopping clamp, and realizing the retrograde perfusion and normal vein drainage of the vena cava on one side or two sides.
In step 4, the following four perfusion methods are included:
1. sealing one section of the vena cava drainage tube A flowing to a main venous return blood trunk through a flow stopping clip, performing cerebral perfusion under the drive of a pump A, performing inferior vena cava retrograde perfusion under the drive of a pump B, simultaneously sealing an arterial perfusion branch tube A through the flow stopping clip, and stopping perfusion of an aorta supplying blood to a lower half body;
2. the venous return main trunk is sealed by the flow stopping clamp, the retrograde perfusion of the superior vena cava and the retrograde perfusion of the inferior vena cava are simultaneously carried out under the driving of the pump A, and the perfusion of the aorta is stopped by sealing the arterial perfusion tube by the flow stopping clamp;
3. the vena cava drainage tube A is closed through the flow stopping clamp to flow to a section of human body, a vein blood return main trunk tube is closed, the superior vena cava retrograde perfusion is carried out under the driving of the pump A, and meanwhile, the artery perfusion tube is closed through the flow stopping clamp to stop the perfusion of the aorta;
4. the reverse perfusion tube is closed by the flow stopping clamp, and the aorta is perfused under the drive of the pump A, so that the normal venous drainage of the vena cava drainage tube is realized.
The invention has simple structure and reasonable design, can carry out retrograde perfusion of the superior vena cava or the inferior vena cava without additionally establishing a passage, and has the advantages of convenient operation, short preparation time and rapid conversion among various perfusion modes.
Drawings
FIG. 1 is a schematic structural diagram of an embodiment of the present invention;
FIG. 2 is a schematic structural diagram of a second embodiment of the present invention;
FIG. 3 is a schematic view of a perfusion method according to the first embodiment;
FIG. 4 is a schematic view of another perfusion method according to the first embodiment;
FIG. 5 is a schematic view of a perfusion method according to the second embodiment;
FIG. 6 is a schematic view of another perfusion method according to the second embodiment;
FIG. 7 is a schematic view of another perfusion method according to the second embodiment;
fig. 8 is a schematic view of another perfusion method according to the second embodiment.
In the figure: 1-arterial perfusion tube, 2-arterial perfusion branch tube A, 3-arterial perfusion branch tube B, 4-vena cava drainage tube B, 5-vena cava drainage tube A, 6-vein blood return main tube, 7-retrograde perfusion tube and 8-flow stopping clamp.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is further described in detail below with reference to the accompanying drawings.
The first embodiment is as follows:
as shown in fig. 1, a vena cava retrograde perfusion tube comprises an arterial perfusion tube 1, one end of the arterial perfusion tube 1 is connected with an arterial perfusion branch tube a2 and an arterial perfusion branch tube B3, the free end of the arterial perfusion branch tube a2 is connected with one end of a vena cava drainage tube a5, the free end of the arterial perfusion branch tube B3 is connected with one end of a vena cava drainage tube B4, the arterial perfusion branch tube a2 is integrally formed with the vena cava drainage tube a5, the arterial perfusion branch tube B3 is integrally formed with the vena cava drainage tube B4, the vena cava drainage tube B4 or the vena cava drainage tube a5 is connected with the arterial perfusion tube 1 through a retrograde perfusion tube 7, preferably, in this embodiment, the vena cava drainage tube a5 is; the arterial perfusion branch pipe A2, the arterial perfusion branch pipe B3, the vena cava drainage pipe A5 and the vena cava drainage pipe B4 are all flexible pipes.
The retrograde perfusion tube 7 is connected with a piezometric tube.
An arterial microembolus filter is arranged on the arterial perfusion tube 1.
The use method of the vena cava retrograde perfusion tube comprises the following steps:
step 1, connecting an arterial perfusion tube 1 to the outlet end of an oxygenator, connecting a vena cava drainage tube A5 and a vena cava drainage tube B4 to a blood storage tank, arranging a pump A between the blood storage tank and the inlet end of the oxygenator, and arranging a pump B on a retrograde perfusion tube 7;
step 2, filling the whole perfusion system with sterile liquid under the driving of a pump A and a pump B;
step 3, cutting off the artery perfusion branch pipe A2 and the vena cava drainage pipe A5, and the artery perfusion branch pipe B3 and the vena cava drainage pipe B4, respectively connecting the artery perfusion branch pipe A2 and the artery perfusion branch pipe B3 to a main artery intubation tube of a human body, and respectively connecting the vena cava drainage pipe A5 and the vena cava drainage pipe B4 to a lower vena cava intubation tube and a upper vena cava intubation tube of the human body;
step 4, closing one section of the vena cava drainage tube A5 flowing to the blood storage tank through the flow stopping clip 8, performing cerebral perfusion under the drive of the pump A, performing retrograde perfusion of the inferior vena cava under the drive of the pump B, simultaneously closing the arterial perfusion branch tube A2 through the flow stopping clip 8, and stopping perfusion of the aorta supplying blood to the lower half of the body, as shown in fig. 4; or the retrograde perfusion tube 7 is only sealed by the flow stopping clamp 8, the pump B does not work, the aorta is perfused under the driving of the pump A, and the normal venous drainage of the vena cava drainage tube is realized, as shown in figure 3.
Example two:
the difference from the first embodiment is that: the free end of the vena cava drainage tube A5 and the free end of the vena cava drainage tube B4 are both connected with one end of a main vein blood return tube 6, and the main vein blood return tube 6 is a flexible tube, as shown in figure 2.
The use method of the vena cava retrograde perfusion tube comprises the following steps:
step 1, connecting an arterial perfusion tube 1 to the outlet end of an oxygenator, connecting a venous return main trunk tube 6 to a blood storage tank, arranging a pump A between the blood storage tank and the inlet end of the oxygenator, and arranging a pump B on a retrograde perfusion tube 7;
step 2, filling the whole perfusion system with sterile liquid under the driving of a pump A and a pump B;
step 3, cutting off the artery perfusion branch pipe A2 and the vena cava drainage pipe A5, and the artery perfusion branch pipe B3 and the vena cava drainage pipe B4, respectively connecting the artery perfusion branch pipe A2 and the artery perfusion branch pipe B3 to a main artery intubation tube of a human body, and respectively connecting the vena cava drainage pipe A5 and the vena cava drainage pipe B4 to a lower vena cava intubation tube and a upper vena cava intubation tube of the human body;
and 4, controlling the opening and closing of different parts of the vena cava drainage tube B4, the vena cava drainage tube A5 and the vein blood return main tube 6 through the flow stopping clamp 8, and realizing the retrograde perfusion and normal vein drainage of the vena cava on one side or two sides.
In step 4, the following four perfusion methods are included:
1. the vena cava drainage tube A5 is sealed by the flow stopping clip 8 to flow to a section of the main venous return blood trunk 6, the brain perfusion is carried out under the drive of the pump A, the inferior vena cava retrograde perfusion is carried out under the drive of the pump B, and simultaneously the artery perfusion branch tube A2 is sealed by the flow stopping clip 8, the perfusion of the aorta supplying blood to the lower half of the body is stopped, as shown in figure 6;
2. the venous return main trunk 6 is sealed by the flow stopping clamp 8, the pump B does not work, the retrograde perfusion of the superior vena cava and the retrograde perfusion of the inferior vena cava are simultaneously carried out under the driving of the pump A, and the arterial perfusion tube 1 is sealed by the flow stopping clamp 8 to stop the perfusion of the aorta, as shown in figure 7;
3. the vena cava drainage tube A5 is sealed by the flow stopping clip 8 to flow to a section of human body to seal the vein blood return main trunk tube 6, the pump B does not work, the superior vena cava retrograde perfusion is carried out under the driving of the pump A, and simultaneously the artery perfusion tube 1 is sealed by the flow stopping clip 8 to stop the perfusion of the aorta, as shown in figure 8;
4. the reverse perfusion tube 7 is sealed by the flow stopping clamp 8, all the sections of the vena cava drainage tube B4, the vena cava drainage tube A5 and the vein blood return main tube 6 are completely unblocked, the pump B does not work, the aorta is perfused under the driving of the pump A, and the normal vein drainage of the vena cava drainage tube is realized, as shown in figure 5.
The present invention is capable of other embodiments, and various changes and modifications may be made by one skilled in the art without departing from the spirit and scope of the invention.

Claims (4)

1. A vena cava retrograde perfusion tube, characterized in that: the arterial perfusion branch pipe comprises an arterial perfusion pipe (1), wherein an arterial perfusion branch pipe A (2) and an arterial perfusion branch pipe B (3) are connected to the arterial perfusion pipe (1), the free end of the arterial perfusion branch pipe A (2) is connected with one end of a vena cava drainage pipe A (5), the free end of the arterial perfusion branch pipe B (3) is connected with one end of a vena cava drainage pipe B (4), the vena cava drainage pipe B (4) or the vena cava drainage pipe A (5) is connected with the arterial perfusion pipe (1) through a retrograde perfusion pipe (7), and the arterial perfusion branch pipe A (2), the arterial perfusion branch pipe B (3), the vena cava drainage pipe A (5) and the vena cava drainage pipe B (4; the artery perfusion branch pipe A (2) and the vena cava drainage pipe A (5), the artery perfusion branch pipe B (3) and the vena cava drainage pipe B (4) are integrally formed.
2. The vena cava retrograde perfusion tube of claim 1, wherein: the retrograde perfusion tube (7) is connected with a piezometric tube.
3. The vena cava retrograde perfusion tube of claim 1, wherein: an arterial microembolus filter is arranged on the arterial perfusion tube (1).
4. The vena cava retrograde perfusion tube of any one of claims 1-3, wherein: the free end of the vena cava drainage tube A (5) and the free end of the vena cava drainage tube B (4) are both connected with a main venous return blood main tube (6), and the main venous return blood main tube (6) is a hose.
CN201810162115.9A 2018-02-27 2018-02-27 Vena cava retrograde perfusion tube and use method thereof Active CN108310504B (en)

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US6110139A (en) * 1997-10-21 2000-08-29 Loubser; Paul Gerhard Retrograde perfusion monitoring and control system
CN201189206Y (en) * 2008-01-25 2009-02-04 天津市第一中心医院 Liver and kidney combination cutting and taking priming line
CN202105220U (en) * 2011-04-15 2012-01-11 广西医科大学第一附属医院 Aorta shunting retrograde perfusion device
US9084857B2 (en) * 2012-04-16 2015-07-21 W. L. Gore & Associates, Inc. Single access flow-reversal catheter devices and methods
CN204563087U (en) * 2015-03-17 2015-08-19 张金霞 The two-way blood back hemodialysis pipeline of not termination of pumping bridging closed arteriovenous
CN106039429A (en) * 2016-06-23 2016-10-26 柳州市人民医院 Left heart gas exhausting device

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