CN109363654B - Noninvasive esophageal and gastric fundus varices venous pressure detector - Google Patents
Noninvasive esophageal and gastric fundus varices venous pressure detector Download PDFInfo
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- CN109363654B CN109363654B CN201811504260.7A CN201811504260A CN109363654B CN 109363654 B CN109363654 B CN 109363654B CN 201811504260 A CN201811504260 A CN 201811504260A CN 109363654 B CN109363654 B CN 109363654B
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/0215—Measuring pressure in heart or blood vessels by means inserted into the body
- A61B5/02152—Measuring pressure in heart or blood vessels by means inserted into the body specially adapted for venous pressure
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Abstract
The invention discloses an esophageal and gastric variceal venous pressure detector which comprises a front-end probe, a catheter and a handle, wherein the rear end of the front-end probe is connected with the catheter, the rear end of the catheter is connected with the handle, a control key is arranged on the handle, and a microprocessor is arranged in the handle; the control key is connected with the microprocessor, the front-end probe comprises a rebound probe head, a driving coil and a detection coil, the driving coil is connected with a power supply through a lead, and the detection coil is connected with the microprocessor; the rebound detecting head is arranged in a cylindrical area surrounded by the driving coil and the detecting coil in an alternating and surrounding manner, the rebound detecting head is a flexible permanent magnet, and the rebound detecting head reciprocates in the front-end probe; by adopting the detector, the pressure value of the esophageal and gastric varices vein can be quickly obtained, and when the pressure value of the esophageal and gastric varices vein under most conditions, namely the portal vein pressure value, regional portal hypertension, post-cutoff operation and other conditions is not equal to the portal vein pressure, the detector can also truly measure the pressure of the esophageal and gastric varices vein and reflect the bleeding risk of rupture of the varices vein.
Description
Technical Field
The invention belongs to the field of medical instruments, and particularly relates to an instrument for non-invasively detecting esophageal and gastric variceal venous pressure of a patient with portal hypertension through a gastroscope.
Background
The liver cirrhosis is a common disease in China, is often accompanied by portal hypertension characterized by elevated portal vein pressure, can cause various symptoms such as upper gastrointestinal hemorrhage, splenic hyperfunction, ascites and the like caused by esophageal and gastric varicose vein rupture, and seriously influences the life quality of patients and even threatens life. The portal vein pressure is an important index for diagnosing the portal vein hypertension and has an important guiding function for selecting a treatment method. But it is difficult to measure accurately because the portal vein is located between the capillaries of the gastrointestinal tract and the blood vessels of the liver sinus. The conventional measurement methods include the following methods:
1. the portal vein branch tube is used for direct pressure measurement in the operation, the method is most accurate, but the portal vein branch tube has large damage and can be obtained in the operation, and the method has limited guiding effect on diagnosis, bleeding prevention and treatment decision.
2. The method has certain prevention and treatment guiding values before treatment, but belongs to indirect pressure measurement, and the accuracy is not as good as that of direct pressure measurement; belongs to invasive examination, can not be repeatedly rechecked, and has higher material consumption and interventional operation cost and higher technical difficulty.
3. The method is estimated by combining the imaging with the fluid mechanics, although the method is non-invasive, the accuracy is inferior to the former two methods, and the method needs professional equipment and enhanced CT examination, has high cost and is still in the clinical experimental stage at present.
The method has the problems of large damage, high cost, difficulty in popularization, low accuracy, incapability of measuring pressure for multiple times and the like, so that the portal vein pressure of a patient cannot be easily obtained in the industry all the time, and the method becomes the bottleneck of diagnosis and treatment of portal hypertension.
Disclosure of Invention
In order to solve the problems in the prior art, the invention discloses an esophageal fundus varicose vein pressure detector which is placed on the surface of an esophageal fundus varicose vein through a gastroscope clamping channel, a probe lightly touches the surface of the varicose vein, the pressure of the varicose vein is measured by utilizing the rebound pressure measurement principle, the gastroscopy which is necessary for portal hypertension is selected for detection, and the pressure value of the esophageal fundus varicose vein can be quickly obtained.
In order to achieve the purpose, the invention adopts the technical scheme that the device comprises a front-end probe, a catheter and a handle, wherein the rear end of the front-end probe is connected with the catheter, the rear end of the catheter is connected with the handle, a control key is arranged on the handle, and a microprocessor is arranged in the handle; the front-end probe connected with the microprocessor by the control key comprises a rebound probe head, a driving coil and a detection coil, wherein the driving coil is connected with a power supply through a lead, and the detection coil is connected with the microprocessor through a lead; the drive coil and the detection coil are alternately surrounded, the rebound detection head is arranged in a cylindrical area surrounded by the drive coil and the detection coil, the rebound detection head is a flexible permanent magnet, and the rebound detection head can reciprocate in the front-end probe.
The inner core body of the rebound detecting head is a segment-shaped permanent magnet, the outer part of the permanent magnet is wrapped with silica gel, and the whole rebound detecting head is flexible.
The front end of the rebound probe is hemispherical.
The tip of front end probe is provided with a nut, and the nut center is equipped with the trompil, and the rear end of resilience detecting head is provided with a retaining ring, and the diameter of retaining ring is greater than the trompil at nut center.
The pipe adopts the hose, and the surface of pipe sets up rubber as the protective layer, and the pipe is whole waterproof can wash the disinfection.
The conducting wire connected with the driving coil and the detection coil is arranged in the catheter, and the conducting wire is connected with the driving coil and the detection coil through standard interfaces.
The front end probe is fixedly connected with the catheter in a gluing way, and the catheter is detachably connected with the handle.
The handle is provided with a display screen which is connected with the microprocessor.
The handle is provided with a USB interface, the handle is also internally provided with a rechargeable battery, the rechargeable battery is connected with the USB interface, and the rechargeable battery supplies power for the driving coil, the detection coil, the display screen, the indicator light and the microprocessor.
The handle is also provided with a standby indicator light, a maintenance indicator light, a completion indicator light and a battery power indicator light.
Compared with the prior art, the invention has at least the following beneficial effects: the driving coil provides ejection force for the ejection probe; detecting the change of the electric signals of the detection coil when the rebound detection head rebounds after the driving coil stops supplying power, and transmitting the electric signals of the detection coil to a microprocessor in the handle through a lead in the conduit; the microprocessor judges the resilience force applied to the resilience detecting head according to the change of the electric signal of the detecting coil; the front probe is arranged on the surface of a varicose vein at the fundus of the esophagus and the stomach through a gastroscope clamping channel, the rebound probe lightly touches the surface of the varicose vein, the pressure of the varicose vein is measured by utilizing the rebound pressure measurement principle, and the varicose vein is a portal vein branch and represents the portal vein pressure;
the method has the advantages that gastroscopy which must be done by patients with portal hypertension is selected for detection, the esophageal and gastric varices pressure value can be rapidly obtained, the portal vein system has no valve, and the esophageal and gastric varices are patients with hepatic cirrhosis, namely the portal vein pressure value; for regional portal hypertension caused by spleen vein occlusion, pancreas occupation and the like, portal vein pressure in the spleen and stomach area is increased, and gastric fundus varicosity may exist; while the mesenteric region and the portal vein trunk pressure are normal; at the moment, the portal vein trunk and the hepatic vein wedge pressure are not high, and the patient still has rupture bleeding of the varicose veins of the stomach fundus; in addition, for patients after the peripheral splenectomy cardia vascular cutoff, the esophageal and gastric varices venous pressure is lower than the portal vein pressure, the meaning of the patients who measure the portal vein pressure or hepatic vein wedging pressure is not large, and the risk of varicose vein bleeding can be reflected more truly by directly measuring the esophageal and gastric varices venous pressure; this is also one of the advantages of the solution of the invention over other detection means.
Drawings
FIG. 1 is a schematic diagram of the present invention.
Fig. 2 is a schematic view of the detection state of the contact between the front probe and the esophageal varices vein mucosa wall.
FIG. 3 is a schematic diagram of a front end probe.
In the attached figure, 1-front probe, 2-catheter, 3-handle, 4-control key, 5-screw cap, 6-rebound probe, 7-gastroscope, 8-gastroscope front transparent cap and 9-varicose vein.
Detailed Description
The invention is further illustrated, but not limited, by the following description and drawings.
A noninvasive esophageal and gastric varices venous pressure detector comprises a front-end probe 1, a catheter 2 and a handle 3, wherein the catheter 2 is connected with the front-end probe 1 and the handle 3, the front end of the handle 3 is connected with the catheter 2, the handle 3 is also provided with a control key 4, and a microprocessor is arranged inside the handle 3; the control key 4 is connected with the microprocessor, the front-end probe 1 comprises a rebound probe head 6, a driving coil and a detection coil, the driving coil is connected with a power supply through a lead, and the detection coil is connected with the microprocessor through a lead; the drive coil and the detection coil are alternately encircled, the rebound detection head 6 is arranged in a cylindrical area encircled by the drive coil and the detection coil, the rebound detection head 6 is a flexible permanent magnet, and the rebound detection head 6 reciprocates in the front-end probe 1.
As an optional embodiment of the invention, the inner core body of the rebound probe 6 is a segment-shaped permanent magnet, and the outer part of the permanent magnet is wrapped with silica gel; the segment-shaped permanent magnet is divided into a plurality of segments, silica gel wraps the segments, and all the segments are connected by the silica gel, so that the rebound probe 6 is flexible and can move in the soft lens clamping passage.
A display screen is arranged on the handle 3 and is connected with the microprocessor; the handle 3 is provided with a USB interface, the handle 3 is also internally provided with a rechargeable battery, the rechargeable battery is connected with the USB interface, and the rechargeable battery supplies power for the driving coil, the detection coil, the display screen and the microprocessor.
As shown in fig. 3, the front end of the rebound probe 6 is hemispherical; the resilience detecting head 6 is flexible, the end part of the front end probe 1 is provided with a nut 5, the center of the nut 5 is provided with an opening, the rear end of the resilience detecting head 6 is provided with a check ring, the diameter of the check ring is larger than the opening at the center of the nut 5, a lead for connecting the driving coil and the detection coil is arranged in the guide pipe 2, and the lead is connected with the driving coil and the detection coil through standard interfaces.
The front end probe 1 and the catheter 2 are fixedly connected through socket gluing; two coils which are mixed and wound are arranged in the front-end probe 1, the front-end probe 1 is flexible and made of plastic, the coil indicated by a solid line is a driving coil, and the electromagnetic effect provides ejection force for the rebound probe head 6; the coil indicated by the dotted line is a detection coil, the electric signal of the detection coil changes when the rebound detection head 6 rebounds after the power supply of the driving coil is stopped, and the electric signal of the detection coil is transmitted to the microprocessor in the handle 3 through a lead in the catheter 2; the microprocessor judges the resilience force of the resilience detecting head 6 according to the electric signal change of the detecting coil, and the driving coil is connected with reverse current after the detection is finished, so that the resilience detecting head 6 retracts into the front-end probe 1 and is in a standby state for secondary detection. The driving coil and the detection coil are respectively connected with the conducting wires in the catheter 2 through conducting wire connectors; the front probe 1 is of a closed structure to prevent digestive juice from entering the guide tube 2, the front probe 1 and the guide tube 2 can be used for unscrewing the screw cap 5 and taking out the resilience probe 6 for cleaning and disinfection after a patient is done, and the disposable consumable can also be used.
The conduit 2 adopts a hose, and the outer surface of the conduit 2 is provided with rubber or plastic as a protective layer; the front end probe 1 and the catheter 2 can also be connected in a detachable mode, and the catheter 2 and the handle 3 are detachably connected.
The connecting part of the catheter 2 and the front-end probe 1 is a conical surface, the conical surface means that a step is arranged at the connecting part of the catheter 2 and the front-end probe 1, the outer diameter of the catheter 2 at the connecting part of the catheter 2 and the front-end probe 1 is gradually reduced towards the front end direction, and the inner diameter of the front-end probe 1 is gradually reduced.
The rebound probe 6 can be formed by pressing neodymium iron boron iron powder and silica gel in addition to a segmental neodymium iron boron magnet, and is magnetized to form a flexible permanent magnet after being manufactured; the semicircular front end contacts the varicose vein, and the rear end of the resilience probe 6 is provided with a bulge to prevent the bulge from falling off.
A screw cap 5 is arranged at the front end of the front-end probe 1, an opening is formed in the center of the screw cap 5, and the screw cap 5 is made of plastic or silica gel; the opening in the center of the screw cap 5 can allow the probe body to be ejected, and the protrusion on the tail part of the probe can enable the tail part of the probe to be clamped at the opening in the center of the screw cap 5 to prevent the probe from falling off. The resilience probe head 6 and the screw cap 5 can be cleaned, the screw cap 5 is unscrewed after each use, and digestive juice permeating into the probe channel is cleaned; as an alternative embodiment, the resilience probe 6 can be beneficial to carry out resilience manometry operation perpendicular to the wall of the varicose vein by sleeving a transparent cap 8 at the front end of the gastroscope 7.
The handle 3 is also provided with a standby indicator light, a maintenance indicator light, a completion indicator light and a battery power indicator light; if the standby indicator light is on, the probe is displayed to be in a standby state after being successfully installed; the completion of the lighting of the indicator light indicates the end of one-time detection, and the lighting of the maintenance indicator light indicates the fault inside the handle 3; the battery charge indicator is used to indicate whether the charge of the rechargeable battery is sufficient or insufficient.
The front end probe 1 is internally provided with a driving coil, instantaneous current generates an instantaneous magnetic field, homopolar repulsion enables the permanent magnet probe to move outwards towards the wall of the varicose vein, the probe decelerates and rebounds after striking the front surface of the wall of the varicose vein, the rebound probe 6 causes current change of the detection coil, signals enter a microprocessor in the handle 3 through a data line in the catheter 2 to calculate the deceleration of the rebound probe 6 after striking the wall of the varicose vein, and finally the signals are converted into readings of the varicose vein pressure, if the pressure of the varicose vein is higher, the deceleration of the rebound probe 6 after striking is increased, the duration of striking is shortened, and higher pressure readings are obtained after calculation.
The guide pipe 2 adopts corrosion-resistant rubber or plastic material as a sheath; the catheter 2 can be cleaned and sterilized for multiple uses.
The USB interface is used for power charging and data transmission.
The front probe 1 is placed on the surface of the esophageal and gastric varices through a gastroscope 7 clamp channel, the front probe 1 lightly touches the surface of the varices 9, the pressure of the varices 9 is measured by utilizing the rebound pressure measurement principle, and the varices 9 represent the pressure of the portal vein because the varices 9 belong to the portal vein.
The invention is connected with a handle 3 during operation, and a catheter 2 is provided with a front-end probe 1; the outer diameter of the catheter is 2.8 mm-3.2 mm, and the catheter can pass through a gastroscope channel; insert this subassembly in gastroscope 7's operation clamp way, gastroscope 7's front end sets up gastroscope front end transparent cap 8 that plastics made, gastroscope 7 gets into behind the esophagus, select comparatively outstanding varicose vein 9, gastroscope front end transparent cap 8 slightly presses the bellied varicose vein 9 esophagus mucosa wall, make front end probe 1 perpendicular and as far as possible with the esophagus mucosa and press close to esophagus mucosa surface as far as possible, auxiliary operation personnel opens operating button this moment, drive coil drive resilience detecting head 6 stretches out and accomplishes once touch resilience process, can directly read out the pressure data of varicose vein 9 by the display screen, or connect the computer and derive the pressure data of varicose vein 9 in batches. After the detection is finished, the drive coil is electrified with reverse current, the rebound probe head 6 is retracted into the front-end probe head 1, and the equipment enters a standby state to carry out next detection.
The rebound detecting head 6 rebounds after contacting the wall of the varicose vein, the driving coil is not electrified during rebounding, the detecting coil is electrified, the rebounding speed of the rebound detecting head 6 is influenced by the pressure in the varicose vein 9, the rebounding speed is higher when the pressure is higher, and the voltage signal in the detecting coil is higher. When the device is debugged, a rebound current signal generated by the esophageal variceal vein 9 of a patient with portal hypertension is detected and recorded before an operation, portal vein pressure is measured in the operation, a correlation formula of the portal vein pressure and the rebound current signal is established, the algorithm is retained in a microprocessor, and the corresponding portal vein pressure can be directly calculated by the current detected again.
Claims (9)
1. A noninvasive esophageal and gastric variceal venous pressure detector is characterized by comprising a front-end probe (1), a catheter (2) and a handle (3), wherein the rear end of the front-end probe (1) is connected with the catheter (2), the rear end of the catheter is connected with the handle (3), a control key (4) is arranged on the handle (3), and a microprocessor is arranged inside the handle (3); the control key (4) is connected with the microprocessor, the front-end probe (1) comprises a rebound probe head (6), a driving coil and a detection coil, the driving coil is connected with a power supply through a lead, and the detection coil is connected with the microprocessor through a lead; the drive coil and the detection coil are alternately encircled, the rebound detection head (6) is arranged in a cylindrical area encircled by the drive coil and the detection coil, the rebound detection head (6) is a flexible permanent magnet, and the rebound detection head (6) can reciprocate in the front-end probe (1); the end part of the front end probe (1) is provided with a screw cap (5), the center of the screw cap (5) is provided with an opening, the rear end of the rebound probe (6) is provided with a check ring, and the diameter of the check ring is larger than the opening at the center of the screw cap (5).
2. The non-invasive esophageal gastric fundus variceal vein pressure detector according to claim 1, characterized in that the inner core of the rebound probe (6) is a segment-shaped permanent magnet, and the outer part of the permanent magnet is wrapped by silica gel.
3. The non-invasive esophageal fundoplication varicose vein pressure detector according to claim 1, wherein the front end of the rebound probe (6) is hemispherical.
4. The non-invasive esophageal fundoplication varicose vein pressure detector according to claim 1, characterized in that the catheter (2) is a flexible tube, and the outer surface of the catheter (2) is made of plastic or rubber as a protective layer.
5. The non-invasive esophageal fundoplication varicose vein pressure detector according to claim 1, characterized in that a lead wire connecting the driving coil and the detection coil is arranged in the catheter (2), and the lead wire is connected with the driving coil and the detection coil through standard interfaces.
6. The non-invasive esophageal fundoplication varicose vein pressure detector according to claim 1, wherein the front end probe (1) is detachably connected with the catheter (2), and the catheter (2) is detachably connected with the handle (3).
7. The non-invasive esophageal fundoplication varicose vein pressure detector according to claim 1, wherein a display screen is arranged on the handle (3), and the display screen is connected with the microprocessor.
8. The instrument according to claim 7, wherein the handle (3) is provided with a USB interface, and the handle (3) is further provided with a rechargeable battery therein, the rechargeable battery is connected with the USB interface, and the rechargeable battery supplies power to the driving coil, the detecting coil, the display screen and the microprocessor.
9. The esophageal fundus varicose vein pressure detector according to claim 1, wherein the handle (3) is further provided with a standby indicator light, a maintenance indicator light, a completion indicator light and a battery level indicator light.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201811504260.7A CN109363654B (en) | 2018-12-10 | 2018-12-10 | Noninvasive esophageal and gastric fundus varices venous pressure detector |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201811504260.7A CN109363654B (en) | 2018-12-10 | 2018-12-10 | Noninvasive esophageal and gastric fundus varices venous pressure detector |
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| CN109363654A CN109363654A (en) | 2019-02-22 |
| CN109363654B true CN109363654B (en) | 2020-03-31 |
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| WO1999013768A1 (en) * | 1997-09-12 | 1999-03-25 | Polar Electro Oy | Method and arrangement for measuring venous pressure |
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| CN105228515A (en) * | 2013-03-12 | 2016-01-06 | 引导介入公司 | Comprise the system of the seal wire for test fluid pressure |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US7279664B2 (en) * | 2005-07-26 | 2007-10-09 | Boston Scientific Scimed, Inc. | Resonator for medical device |
| US10688278B2 (en) * | 2009-11-30 | 2020-06-23 | Biosense Webster (Israel), Ltd. | Catheter with pressure measuring tip |
| WO2012109039A1 (en) * | 2011-01-30 | 2012-08-16 | Warnking Reinhard J | System for detection of blood pressure using a pressure sensing guide wire |
| US9924903B2 (en) * | 2012-12-27 | 2018-03-27 | Volcano Corporation | Pressure-sensing guide wire with sliding pressure sensor |
| CN106037697A (en) * | 2016-07-06 | 2016-10-26 | 河南驼人医疗器械集团有限公司 | Central venous catheter with pressure monitoring function |
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2018
- 2018-12-10 CN CN201811504260.7A patent/CN109363654B/en active Active
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO1999013768A1 (en) * | 1997-09-12 | 1999-03-25 | Polar Electro Oy | Method and arrangement for measuring venous pressure |
| CN1390524A (en) * | 2002-07-26 | 2003-01-15 | 湖南省肝硬化门脉高压症治疗研究中心 | Method and device for measuring esophageal varicose vein pressure without wound |
| CN104619247A (en) * | 2012-09-17 | 2015-05-13 | 波士顿科学西美德公司 | Pressure sensing guidewire |
| CN102908133A (en) * | 2012-11-12 | 2013-02-06 | 合肥优尔电子科技有限公司 | Esophagus vein blood pressure measuring instrument |
| CN105228515A (en) * | 2013-03-12 | 2016-01-06 | 引导介入公司 | Comprise the system of the seal wire for test fluid pressure |
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