CN109432510A - Teflon pressure drop materials and operation gasket for microvascular decompression - Google Patents

Teflon pressure drop materials and operation gasket for microvascular decompression Download PDF

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Publication number
CN109432510A
CN109432510A CN201811000072.0A CN201811000072A CN109432510A CN 109432510 A CN109432510 A CN 109432510A CN 201811000072 A CN201811000072 A CN 201811000072A CN 109432510 A CN109432510 A CN 109432510A
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gasket
pressure drop
teflon
drop materials
operation gasket
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CN201811000072.0A
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CN109432510B (en
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李心远
应婷婷
浦奔放
华春晖
李桀
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Shanghai tongren hospital
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L31/00Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/04Macromolecular materials
    • A61L31/048Macromolecular materials obtained by reactions only involving carbon-to-carbon unsaturated bonds
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L31/00Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/14Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02ATECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A50/00TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
    • Y02A50/30Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Epidemiology (AREA)
  • Vascular Medicine (AREA)
  • Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Materials For Medical Uses (AREA)

Abstract

The invention discloses a kind of Teflon pressure drop materials, which has the flocculence fibre structure being made of polytetrafluoroethylene fibre, density 0.001-0.002g/cm3, the diameter of polytetrafluoroethylene fibre is 0.1~0.2mm.The present invention also provides the application of the Teflon pressure drop materials and the operation gaskets being prepared by it.Teflon pressure drop materials provided by the invention and operation gasket can reduce the probability that operation is invalid and recurs, and improve the curative effect of microvascular decompression.Operation gasket provided by the invention may be designed to the shape and size of the standardization of plurality of specifications, meet the various situations of different thicknesses blood vessel in microvascular decompression, above-mentioned size-normalized gasket can be directly used when operation, without manually tearing adjustment outer dimension, the uncertainty of operation is reduced.

Description

Teflon pressure drop materials and operation gasket for microvascular decompression
Technical field
The present invention relates to the polytetrafluoroethylene (PTFE) pressure drop materials of a kind of shape and density criterion, prepare shape, scale topography The polytetrafluoroethylene (PTFE) pressure drop materials controllable with density, can reduce prevents from falling off, shift, to improve the treatment of microvascular decompression Effect.
Background technique
Microvascular decompression (MVD) is treatment encephalic metastasis, such as trigeminal neuralgia, facial spasm, glossopharyngeal neuralgia Maximally efficient method, the whole world have tens of thousands of patients to receive " microvascular decompression " every year.Shanghai Communications University's medicine at present The attached Beijing Tongren Hospital's neurosurgery of institute is more than more than 1000 examples using the patient of the above-mentioned disease of neural treated by microvascular decompression.The hand Art principle is to use Teflon (Teflon) gasket (Teflon pressure drop materials) by pressuring nerve at cranial nerve in/out brain stem end Compressing vessels are separated with cranial nerve, release compressing of the blood vessel to nerve, to reach the mesh alleviated clinical symptoms, treat disease 's.The still ununified specification of existing Teflon gasket is temporarily to be fabricated to size, fluffy degree, density not when using in art One it is spherical, it is random larger, be 0.0007-0.008g/cm through random detection density3Differ.Although microvascular decompression is The approval of vast domestic and international doctor and patient are obtained, but the operation still has invalid and recurrence probability in various degree, both at home and abroad It is reported in 3%-15% and does not wait and (recur the operative treatment China neurosurgery magazine of trigeminal neuralgia after microsurgical vascular decompression .2006,22(9):538-540.).The main reason for its invalid and recurrence includes: (1) postoperative arachnoid adhesion;(2)Teflon Gasket falls off or shifts, and compressing vessels is caused to reset, and enters and leaves the compressing of brain stem section to trigeminal neuralgia again;(3) Teflon gasket Size is improper, crosses substantially trigeminal neuralgia bend by pressure, the too small impulse conduction for leading to compressing vessels to nerve root;(4) it depressurizes Material selects improper (such as gelfoam), is absorbed after long-time by body.Wherein focal adhesion, gasket such as fall off/shift at the originals It is a main cause for leading to recurrence that the compressing vessels because caused by are oppressed again.The case of postoperative recurrence detects hair through re-treatm ent It is existing, 22% there are the adhesion of Teflon gasket, falls off or shift.Also having some cases is the Teflon due to having used thickness blocked up Compressing Roots of trigeminal nerve forms apparent impression after gasket or the hardening of Teflon gasket, and distortion stimulation trigeminal neuralgia is to draw Play recurrence.
Currently, Teflon pressure drop materials used in microvascular decompression are substantially in fine and close and thin pad both at home and abroad Piece sample product, but there are no unified standards for size, shape, size etc., also without the matured product of a variety of different sizes for doctor Raw selection.The densification and thin Teflon gasket are directly used in isolation compressing vessels and the surgical effect of nerve is bad.According to hair The many years of experience of bright people, in use, needing that Teflon gasket is temporarily torn into fluffy ball not of uniform size with haemostatic clamp in art Shape, then the spherical Teflon pressure drop materials are implanted into, such surgical effect can be better.However, these be temporarily made into it is spherical Teflon pressure drop materials have very big randomness, it is difficult to comply fully with specification required for operation, usually occur because facing in art When be made into Teflon pressure drop materials size, shape, fluffy degree, the uniformity be not suitable for and have to remake, be implanted into again Cotton piece, this operation repeatedly not only extend operating time, also virtually increase the risk of blood vessel and neurotrosis, increase The uncertainty for having added operation directly influences the probability that operation is invalid and recurs.Also patient selects gelfoam as art Middle pressure drop materials, but often will appear and fall off and absorbed situation.
Therefore, a kind of novel Teflon pressure drop materials are badly in need of in this field, can effectively prevent falling off after being implanted into and move Position reduces the probability that operation is invalid and recurs, improves the curative effect of microvascular decompression.
Summary of the invention
Technical problem to be solved by the present invention lies in provide a kind of novel Teflon (Teflon) pressure drop materials, drop Low invalid and recurrence probability of performing the operation, improves the curative effect of microvascular decompression.
In order to solve the above technical problems, the present invention provides a kind of novel Teflon pressure drop materials, which has The flocculence fibre structure being made of polytetrafluoroethylene fibre, density 0.001-0.002g/cm3, polytetrafluoroethylene fibre Diameter is 0.1~0.2mm.Further, the fluffy degree of the pressure drop materials is 915-1830.
The present invention also provides the novel Teflon pressure drop materials to be used to prepare into the operation being implanted into microvascular decompression The application of gasket.
A kind of operation gasket for microvascular decompression has the flocculence fiber knot being made of polytetrafluoroethylene fibre Structure, density 0.001-0.002g/cm3, the diameter of polytetrafluoroethylene fibre is 0.1~0.2mm.Further, the operation pad The fluffy degree of piece is 915-1830.
A kind of specific specification of the operation gasket are as follows: the global shape of the operation gasket is shuttle-type, and the entirety of gasket is long Spending (L) is 4mm, and maximum width (W) is 1.2mm, and maximum height (H) is 0.8mm.
A kind of specific specification of the operation gasket are as follows: the global shape of the operation gasket is shuttle-type, and the entirety of gasket is long Spending (L) is 2mm, and maximum width (W) is 0.6mm, and maximum height (H) is 0.4mm.
A kind of specific specification of the operation gasket are as follows: the global shape of the operation gasket is c-type, the interior diameter of gasket It (d) is 1mm, overall diameter (D) is 3mm, and chord length (l) is 0.8mm, and width (h) is 2mm.
A kind of specific specification of the operation gasket are as follows: the global shape of the operation gasket is c-type, the interior diameter of gasket It (d) is 2mm, overall diameter (D) is 4mm, and chord length (l) is 1.6mm, and width (h) is 2mm.
The beneficial effects of the present invention are:
1) material of the invention uses polytetrafluoroethylene fibre, can be applied to human body, has good histocompatbility, Nonabsorable.
2) material of the invention has flocculence fibre structure, density 0.001-0.002g/cm3, fluffy degree 915- 1830, density and fluffy degree are moderate, can effectively mitigate compressing of the art medium vessels beating to nerve, will not be excessively high really up to the mark because of density Or it is blocked up to generate new compressing, the probability that operation is invalid and recurs can be reduced, the curative effect of microvascular decompression is improved.
3) shuttle-type gasket and c-type gasket provided by the invention, the both ends of gasket are relatively fine, convenient for being placed to nerve in operation Between blood vessel.And c-type gasket can wrap around nerve or blood vessel, and gasket is effectively prevent to fall off.
4) the present invention provides the size of a variety of standardization is available, meet different thicknesses blood vessel in microvascular decompression Various situations, when operation can directly use above-mentioned size-normalized gasket, no longer need to tear gasket with haemostatic clamp to adjust The form and dimension of whole gasket reduces unnecessary operation, reduces the uncertainty of operation, to improve operative effect, reduces Recurrence rate.
Detailed description of the invention
Fig. 1 is the top view of shuttle shape operation gasket.
Fig. 2 is the front view of Fig. 1.
Fig. 3 is the perspective view of C-shaped operation gasket.
Fig. 4 is the flocculence fibre structure microscopical view that the polytetrafluoroethylene fibre of operation gasket is constituted.
Sign flag illustrates in attached drawing:
Length L;
Maximum width W;
Maximum height H;
Interior diameter d;
Overall diameter D;
Chord length l;
Width h.
Specific embodiment
Clear, complete description will be carried out to technical solution of the present invention below, it is clear that described embodiment is this hair Bright a part of the embodiment, instead of all the embodiments.Based on the embodiments of the present invention, those of ordinary skill in the art exist Every other embodiment obtained under the premise of creative work is not made, shall fall within the protection scope of the present invention.
It as depicted in figs. 1 and 2, is the top view and front view of shuttle shape operation gasket, the observation visual angle of two figures is vertical. Performing the operation in top view, gasket is oval, and the long axis and short axle of the ellipse correspond respectively to length L and maximum width W;It faces Performing the operation in figure, gasket is also oval, and the long axis and short axle of the ellipse correspond respectively to length L and maximum height H.Shuttle-type The both ends of gasket are comparatively fine compared to middle part, convenient for being implanted between neural blood vessel in operation.For convenient for microvascular decompression Operation, the present invention provide the shuttle shape operation gasket of two kinds of specifications, are respectively: L=4mm, W=1.2mm, H=0.8mm;L=2mm, W=0.6mm, H=0.4mm.
As shown in figure 3, it is overall diameter D that the outer profile of C-shaped operation gasket, which is diameter, for the perspective view of C-shaped operation gasket Circular a part, Internal periphery be diameter be interior diameter d circular a part, C-shaped perform the operation gasket width be h, foreign steamer The wide notch that C-shaped operation gasket is formed with Internal periphery meet, the gap width are chord length l.The c-type operation gasket can wrap around Nerve or blood vessel, more effectively can prevent gasket from falling off.For the operation convenient for microvascular decompression, the present invention provides two kinds of specifications C-shaped perform the operation gasket, be respectively: D=3mm, d=1mm, h=2mm, l=0.8mm;D=4mm, d=2mm, h=2mm, l= 1.6mm。
Above-mentioned operation gasket is fashioned into prepared by distinctive appearance using Teflon pressure drop materials, which depressurizes material Material uses polytetrafluoroethylene fibre, and polytetrafluoroethylene fibre constitutes flocculence fibre structure, wherein polytetrafluoroethylene fibre Diameter is 0.1~0.2mm, and the density of the Teflon pressure drop materials is 0.001-0.002g/cm3.Further detected, it is fluffy Looseness is 915-1830.
Teflon pressure drop materials provided by the invention and operation gasket can reduce the probability that operation is invalid and recurs, and improve The curative effect of microvascular decompression.Experimental program is as follows:
One, method
(1) experimental animal is grouped
It selects healthy adult SD rat (SPF grades) totally 120,256 ± 22g of average weight, male.According to random grouping Experimental animal is grouped: 1. blank control group (n=20), sham-operation group by method at random;2. traditional group (n=20), when operation, are implanted into Traditional Teflon gasket, when implantation, make at random;3. improveing shuttle-type group (n=20), when operation, is implanted into shuttle-type pad of the invention Piece;4. improveing c-type group (n=20), when operation, is implanted into c-type gasket of the invention;5. control group one (n=20), when operation, are implanted into Compare a gasket;6. control group two (n=20), two gaskets of implantation control when operation.
(2) SD rat trigeminal REZ area's gasket is placed in
With ketalar 0.2ml/kg, intraperitoneal injection is anaesthetized, and maintains body temperature, fixed head, conventional before and after ear to shave Hair preserved skin disinfection, giving abrasive drilling, slowly carefully mill opens skull one diameter about 8mm, exposure trigeminal neuralgia intracranial segment trunk, in trident Artery intimate contact with it is detected around neural, 2. five kinds of merging is different types of between nerve and artery to 6. group Teflon pressure drop materials.Stringent hemostasis, sutures muscle, skin.It goes again to every group of 10 rats respectively after postoperative 60 days, 90 days Trigeminal neuralgia and angiosynizesis situation and pressure drop materials position are detected in operation of opening cranium.
Wherein, the traditional Teflon gasket 2. organized is random production immediately, is 0.0007-0.008g/ through detection density cm3Differ;3. 4. two groups of improvement gasket is density 0.001-0.002g/cm3, fluffy degree 915-1830, polytetrafluoroethylene fibre 0.1~0.2mm of diameter;5. one gasket of control organized is density 0.0005-0.0008g/cm3, it is fluffy degree 2288-3660, poly- 0.1~0.2mm of diameter of tetrafluoroethylene fiber;6. two gasket of control organized is density 0.005-0.01g/cm3, fluffy degree 183- 366,0.1~0.2mm of diameter of polytetrafluoroethylene fibre;
Two, experimental result
Find when operations research at postoperative 60 days: 1. sham-operation group does not occur neural blood vessel adhesion, 2. tradition Teflon group Pressure drop materials fall off/shift 12, discovery neural blood vessel adhesion, and 3. 4. two groups of improvement gaskets do not find that pressure drop materials are de- Fall/shift and adhesion, 5. compare one group of discovery and fall off/shift 2, adhesion 1,6. compare two groups of discoveries fall off/shift 0, Adhesion 2.
Postoperative 90 days, find altogether when operations research again: 1. sham-operation group does not occur neural blood vessel adhesion, and 2. traditional group is sent out Now fall off/shift 36, discovery adhesions, 3. improves shuttle-type group and finds fall off/shift 11, discovery adhesion, 4. improves C Type group does not find to fall off/shift, and finds adhesion 1,5. compare one group of discovery it is de-/displacement falls 7, adhesion 2,6. compare two groups It was found that fall off/shift adhesion 61, discovery (table 1).
Traditional group pressure drop materials fall off/shift 6 (30%) totally, and one group of control falls off/shifts 7 (35%), improve shuttle Type falls off/shifts 1 (10%), and two groups of control falls off/shifts 1 (10%), traditional group and compares one group and other each groups Pressure drop materials fall off/and displacement rate is compared to there were significant differences (P < 0.05).Traditional group has 3 adhesions (15%), improvement shuttle-type group and Improvement c-type group respectively has 1 adhesion, and one group of control has 2 neural blood vessel adhesions (10%), and two groups of control has 6 neural blood vessels viscous Even (30%), sham-operation group does not find adhesion.Improvement shuttle-type group, the adhesion rate for improveing c-type group are below other groups, and with it is right According to there is significant difference (P < 0.05) between two groups.
There are pressure drop materials and falls off and the case where neural blood vessel adhesion in each group at table 1 postoperative 90 day.
In conclusion the various embodiments described above are only presently preferred embodiments of the present invention, it is not of the invention to limit Protection scope, all within the spirits and principles of the present invention, any modification, equivalent substitution, improvement and etc. done should be all included in In protection scope of the present invention.

Claims (9)

1. a kind of Teflon pressure drop materials for microvascular decompression, which is characterized in that the material has by polytetrafluoroethyl-ne The flocculence fibre structure that alkene fiber is constituted, density 0.001-0.002g/cm3, the diameter of polytetrafluoroethylene fibre is 0.1~ 0.2mm。
2. material as described in claim 1, which is characterized in that the fluffy degree of the material is 915-1830.
3. Teflon pressure drop materials as claimed in claim 1 or 2 are used to prepare into the operation pad being implanted into microvascular decompression The application of piece.
4. a kind of operation gasket for microvascular decompression, which is characterized in that have the cotton being made of polytetrafluoroethylene fibre Wadding fibrous structure, density 0.001-0.002g/cm3, the diameter of polytetrafluoroethylene fibre is 0.1~0.2mm.
5. operation gasket as claimed in claim 4, which is characterized in that the fluffy degree of the operation gasket is 915-1830.
6. operation gasket as described in claim 4 or 5, which is characterized in that the global shape of the operation gasket is shuttle-type, pad The entire length of piece is 4mm, maximum width 1.2mm, maximum height 0.8mm.
7. operation gasket as described in claim 4 or 5, which is characterized in that the global shape of the operation gasket is shuttle-type, pad The entire length of piece is 2mm, maximum width 0.6mm, maximum height 0.4mm.
8. operation gasket as described in claim 4 or 5, which is characterized in that the global shape of the operation gasket is c-type, pad The interior diameter of piece is 1mm, overall diameter 3mm, chord length 0.8mm, width 2mm.
9. operation gasket as described in claim 4 or 5, which is characterized in that the global shape of the operation gasket is c-type, pad The interior diameter of piece is 2mm, overall diameter 4mm, chord length 1.6mm, width 2mm.
CN201811000072.0A 2018-08-30 2018-08-30 Teflon decompression material for microvascular decompression and operation pad Active CN109432510B (en)

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Cited By (1)

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Publication number Priority date Publication date Assignee Title
CN111097094A (en) * 2019-12-06 2020-05-05 泰升医疗有限公司 Micro-catheter for microvascular nerve decompression

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Publication number Priority date Publication date Assignee Title
CN111097094A (en) * 2019-12-06 2020-05-05 泰升医疗有限公司 Micro-catheter for microvascular nerve decompression

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