CN110638558A

CN110638558A - Medical semi-open type blocking device

Info

Publication number: CN110638558A
Application number: CN201911091353.6A
Authority: CN
Inventors: 郑哲; 彭博; 于存涛; 王强; 孙晓刚
Original assignee: Fuwai Hospital of CAMS and PUMC
Current assignee: Fuwai Hospital of CAMS and PUMC
Priority date: 2019-11-10
Filing date: 2019-11-10
Publication date: 2020-01-03

Abstract

The invention relates to the field of medical instruments, and particularly discloses a medical semi-open blocking device which comprises a shell, wherein a support passage for a support to pass through, a pressure cavity for containing fluid and an elastic film for separating the support passage from the pressure cavity are arranged in the shell; the pressure chamber is filled with fluid to promote the elastic membrane to expand towards the direction of the support channel and block the support channel. The invention can complete the operation without adopting deep low temperature stop circulation under the condition of placing the bracket in an antegrade way, thereby reducing postoperative complications and improving the operation effect.

Description

Medical semi-open type blocking device

Technical Field

The invention relates to the field of medical instruments, in particular to a medical semi-open type blocking device.

Background

The aortic full-arch replacement and stent trunk operation is widely applied to the treatment of thoracic aortic aneurysm, acute and chronic type A aortic dissection and other diseases, and the near-mid-term and long-term operation curative effect of the aortic full-arch replacement and stent trunk operation is accepted by more and more experts at home and abroad. No matter the stent is placed in a retrograde motion manner or the stent is placed in a anterograde manner, the operation needs to adopt a deep low temperature circulation stopping technology, namely, the whole body is required to be cooled in the operation, when the temperature of nasopharynx is reduced to 18-20 ℃, unilateral selective cerebral perfusion is performed through axillary artery or innominate artery intubation, at the moment, the lower half body stops circulation, namely, no blood is perfused in organs perfused by descending aorta, including spinal cord, liver, kidney, digestive tract and the like, after the stent blood vessel is implanted in the descending aorta vacuum cavity, the anastomosis of the descending aorta proximal end and the arch part distal end is completed by adopting an open anastomosis technology, then the lower half body perfusion is recovered, and the time of the circulation stopping is generally controlled to be about 20-30 min. However, the deep hypothermia stopping circulation can cause a series of difficult-to-avoid problems such as internal environment disorder, blood coagulation function damage, acute liver and kidney insufficiency, gastrointestinal tract dysfunction, spinal cord injury and the like, and leads to poor recovery, serious complications and even death of patients after the operation. Therefore, how to shorten the cycle time of the deep hypothermia stop has important clinical application value.

In the case of antegrade stent placement, deep hypothermia arrest is required because blood cannot flow through the artificial blood vessel when the stent is implanted in the descending aorta through the artificial blood vessel (a four-branched artificial blood vessel or a three-branched artificial blood vessel, the same applies hereinafter).

This technical problem is urgently needed to be solved.

Disclosure of Invention

In view of the above, the present invention is directed to a medical semi-open blocking device, which can complete an operation without a deep hypothermia stop cycle when a stent is placed anterograde, thereby reducing postoperative complications and improving an operation effect.

The invention provides a medical semi-open blocking device, which comprises a shell, wherein a support passage for a support to pass through, a pressure cavity for accommodating fluid and an elastic film for separating the support passage from the pressure cavity are arranged in the shell; the pressure chamber is filled with fluid to promote the elastic membrane to expand towards the direction of the support channel and block the support channel.

As a further improvement to the technical scheme, the shell is of a revolving body structure, the bracket channel is arranged along the axial direction of the shell and forms a left end opening and a right end opening, and the right end opening is used for being connected with the artificial blood vessel.

As a further improvement to the above technical solution, the elastic membrane is arranged along the radial direction of the shell and takes the axis of the shell as the symmetry axis.

As a further improvement to the technical scheme, the medical semi-open blocking device further comprises a guide cylinder I, wherein a guide channel I is arranged in the guide cylinder I, the guide cylinder I coaxially extends into the support channel from the left end opening of the shell and is fixedly connected with the support channel, and the guide channel I is axially arranged along the guide cylinder and is communicated with the support channel.

As a further improvement to the technical scheme, the guide cylinder I is connected with the shell through a thread pair or in an interference fit mode.

As a further improvement to the above technical scheme, the medical semi-open blocking device further comprises a guide cylinder II provided with a guide channel II therein, the guide cylinder II coaxially extends into the bracket channel from the right end opening of the shell and is fixedly connected with the bracket channel, and the guide channel II is arranged along the axial direction of the guide cylinder and is communicated with the bracket channel; a transition blood vessel is fixedly sleeved outside the guide cylinder II and is used for being sewn with the artificial blood vessel.

As a further improvement to the technical scheme, the guide cylinder II is connected with the shell through a thread pair.

As a further improvement of the above technical solution, the medical semi-open blocking device further comprises a pressure reducer connected with the flow port through a communication pipe and used for filling or extracting fluid into or from the pressure chamber.

As a further improvement to the above technical solution, the pressure reducer is of an injector structure.

As a further improvement of the above technical solution, a connection valve is arranged between the communication pipe and the pressure reducer, one end of the connection valve is connected with the communication pipe, the other end of the connection valve is connected with the pressure reducer, and the end of the connection valve connected with the pressure reducer is connected with a sealing cover which is fastened on the connection valve through a tether.

Compared with the prior art, the invention has the following beneficial technical effects:

the invention provides a medical semi-open blocking device, which is characterized in that firstly, a proximal port of an artificial blood vessel is connected with a shell and communicated with a bracket channel to finish preparation work; during operation, after the heart stops beating, the right innominate artery is treated, the forceps are blocked between the right innominate artery and the left common carotid artery, the right innominate artery supplies blood, the left common carotid artery and the left subclavian artery also supply blood through the femoral artery, the blood vessel main body is matched with the blocking forceps, the branch blood vessels of the artificial blood vessel are respectively clamped by the forceps, fluid is filled into the pressure cavity through the flow opening, the elastic membrane gradually expands towards the direction of the stent channel under the action of fluid pressure, the elastic membrane blocks the stent channel when the fluid pressure reaches a set value, the near-end mouth part of the blood vessel main body is in a closed state, then the forceps are opened, circulation is opened, blood flows in the descending aorta, and the stent can be partially opened when the delivery device drives the stent to pass through the stent, the stent is delivered to the descending aorta through the stent channel and implanted to expand the true cavity, the conveying device is withdrawn after implantation, the elastic film returns to a fully closed state, at the moment, the blood in the blood vessel main body is blocked, the connection between the blood vessel main body and the semi-open blocking device is disconnected, the operation is completed after the near-end mouth part of the trimmed blood vessel main body is matched with the root part of the aorta, and the medical semi-open blocking device can be reused.

Therefore, the medical semi-open blocking device is creatively used, so that the operation can be completed without adopting deep low temperature stop circulation under the condition of forward placement of the stent, the postoperative complications are reduced, and the operation effect is improved.

Drawings

FIG. 1 is a schematic structural view of the present invention;

FIG. 2 is a schematic structural diagram of the housing of the present invention;

fig. 3 is a state diagram of the present invention in use.

Detailed Description

In order to make the technical solutions of the present invention better understood, the following detailed description of the present invention is provided with reference to the accompanying drawings and specific embodiments; of course, the drawings are simplified schematic drawings, and the scale of the drawings does not limit the patented products.

As shown in fig. 1 to 3: the embodiment provides a semi-open type blocking device, which comprises a shell 2, wherein a support passage 21 for a support to pass through, a pressure chamber 22 for accommodating fluid and an elastic film 23 for separating the support passage 21 from the pressure chamber 22 are arranged in the shell 2, and a flow port 24 communicated with the pressure chamber 22 and used for allowing the fluid to enter and exit is arranged on the shell 2; the pressure chamber 22 is filled with fluid, which causes the elastic membrane 23 to expand in the direction of the support channel 21 and blocks the support channel 21.

Before the operation, the proximal port of the artificial blood vessel 1 needs to be connected to the housing 2 and communicated with the stent passage 21, thereby completing the preparation. Taking the artificial blood vessel 1 with a four-branch structure as an example, the artificial blood vessel 1 is provided with four branch blood vessels 11, wherein a first branch blood vessel of the four branch blood vessels 11 is anastomotic with a brachiocephalic artery, a second branch blood vessel is anastomotic with a left internal jugular vein, a third branch blood vessel is anastomotic with a left subclavian artery, and a fourth branch blood vessel is used for perfusion or exhaust. The artificial blood vessel 1 is hermetically connected with the shell 2, so that the blood is prevented from seeping.

The stent is a self-elastic stent structure implanted in the descending aorta to enlarge the true lumen, is also consistent with the prior art, and the structure and the principle of the stent are not described again; the stent is delivered by a special delivery device, such as the structure shown in CN2933337Y, or an existing delivery device for interventional therapy.

In the semi-open type blocking device, the elastic membrane 23 blocks the stent passage 21 under the action of fluid pressure (the fluid acts on the inner surface of the elastic membrane 23) to prevent blood from flowing out of the stent passage 21 when the artificial blood vessel 1 is engorged with blood; the term "semi-open" means that, due to the elastic action of the elastic membrane 23, the outer surface of the elastic membrane can be deformed adaptively even when the outer surface is subjected to an acting force greater than the fluid pressure, and at this time, although the elastic membrane 23 cannot block the stent passage 21, if the conduction can be filled by an object generating the acting force, the stent passage 21 is still in a blocking state (this may occur when the stent is delivered by the delivery device, and the outer tube of the delivery stent may cause the elastic membrane 23 to be deformed and always adhere to the outer surface of the elastic membrane 23 to fill the gap generated by the deformation when the outer tube of the delivery stent is inserted).

The elastic membrane 23 may be made of flexible silicone; the fluid may be a gas or a liquid, as long as it can cause the elastic membrane 23 to deform; the housing 2 may be made of hard rubber; the support channel 21 and the pressure cavity 22 are separated by an elastic film 23 and are not communicated with each other all the time; the proximal orifice of the vascular prosthesis 1, i.e. the end thereof close to the heart, is the left end in fig. 1.

Before the operation, the proximal port of the artificial blood vessel 1 is connected to the housing 2 and communicated with the stent passage 21, thereby completing the preparation. In operation, after the heart is stopped, the right innominate artery is treated, the forceps are blocked between the right innominate artery and the left common carotid artery, the right innominate artery supplies blood, the left common carotid artery and the left subclavian artery also supply blood through the femoral artery, the positions of the artificial blood vessel 1 and the blocking forceps are matched, the four branch blood vessels 11 are respectively clamped by the forceps, fluid is filled into the pressure chamber 22 through the through opening 24, the elastic membrane 23 gradually expands towards the direction of the stent channel 21 under the action of the fluid pressure, the elastic membrane 23 blocks the stent channel 21 when the fluid pressure reaches a set value, the proximal mouth part of the artificial blood vessel 1 is in a closed state, then the forceps are opened, circulation is opened, blood flows in the descending aorta, the elastic membrane 23 can be partially opened when the delivery device drives the stent to pass through, the stent is delivered to the descending aorta through the stent channel 21 and implanted to expand the true lumen, after the artificial blood vessel 1 is cut off, the proximal mouth part of the artificial blood vessel 1 is anastomosed with the aortic root to complete the operation, and the medical semi-open blocking device can be reused.

In this embodiment, the housing 2 is a revolving structure, the stent channel 21 is disposed along the axial direction of the housing 2 and forms a left end opening and a right end opening (the left and right are shown in fig. 1 and 2), and the right end opening is used for connecting with the artificial blood vessel 1; the housing 2 may be cylindrical or other suitable structure; the bracket channel 21 is straight, so that the bracket is convenient to convey; at this time, the elastic membrane 23 is arranged along the radial direction of the shell 2 and takes the axis of the shell 2 as a symmetry axis, so that the elastic membrane 23 can be uniformly pressed, and the sealing effect of the elastic membrane is enhanced; the elastic film 23 is fixedly connected to the housing 2 at both axial ends, for example, by bonding, integral molding, or riveting.

In this embodiment, the medical semi-open blocking device further comprises a guide cylinder i 3 provided with a guide channel i 31 therein, the guide cylinder i 3 coaxially extends into the support channel 21 from the left end opening of the housing 2 and is fixedly connected, and the guide channel i 31 is axially arranged along the guide cylinder and is communicated with the support channel 21; the guide cylinder I3 is beneficial to guiding the conveying of the bracket; the guide cylinder I3 can be composed of two sections of cylinders, and the longitudinal section of the guide cylinder I is T-shaped; the guide cylinder I3 and the shell 2 can be connected through a thread pair (the wall surface of the bracket channel 21 is connected with the outer surface of the guide cylinder I3) or in an interference fit mode; the guide cylinder I3 can also be used for pressing and fixing the elastic film 23, thereby improving the connection stability of the elastic film 23.

In this embodiment, the medical semi-open blocking device further comprises a guide cylinder ii 4 provided with a guide channel ii 41 therein, the guide cylinder ii 4 coaxially extends into the support channel 21 from the right end opening of the housing 2 and is fixedly connected, and the guide channel ii 41 is axially arranged along the guide cylinder and is communicated with the support channel 21; the guide cylinder II 4 is also beneficial to guiding the conveying of the bracket; the guiding cylinder II 4 is connected with the artificial blood vessel 1, specifically, a transition blood vessel 5 is fixedly sleeved outside the guiding cylinder II 4, and the transition blood vessel 5 is the same as the existing artificial blood vessel, so that the transition blood vessel 5 can be spliced with the artificial blood vessel 1, after the implantation of the stent is completed, only the redundant part of the artificial blood vessel 1 needs to be cut off, and the artificial blood vessel 1 is disconnected with the shell 2; preferably, the guide cylinder II 4 is connected with the shell 2 through a thread pair (the wall surface of the support channel 21 is connected with the outer surface of the guide cylinder II 3), the guide cylinder II 4 is detached in a spiral mode, and the rest part of the semi-open type blocking device can be reused, so that resources are saved.

In this embodiment, the medical semi-open blocking device further includes a pressure reducer 6, and the pressure reducer 6 is connected to the communication port 24 through the communication pipe 7 and is used for filling or extracting fluid into or from the pressure chamber 22; the communicating pipe 7 is a medical rubber pipe; the pressure of the fluid in the pressure cavity 22 can be controlled by the pressure booster 6, so that the opening and closing of the bracket channel 21 are controlled; preferably, the pressure increasing and reducing device 6 is of an injector structure, has strong universality and can be configured independently.

In this embodiment, a connection valve 8 is disposed between the communication pipe 7 and the pressure reducer 6, one end of the connection valve 8 is connected to the communication pipe 7, the other end is connected to the pressure reducer 6, and one end of the connection valve 8 connected to the pressure reducer 6 is connected to a sealing cover 81, and the sealing cover 81 is fastened to the connection valve 8 by a tether 82; the connecting valve 8 can be a two-way valve structure or a three-way valve structure; both ends of the communicating pipe 7 can be connected to the circulation port 24 and the connecting valve 8 by hot melting; in an idle state, the sealing cover 81 covers one end of the sealing cover connected with the pressure increasing and reducing device 6 to prevent pollution and facilitate the storage of products; the tether 82 prevents the loss of the sealing cap 81.

Finally, the principle and embodiments of the present invention are explained by using specific examples, and the above descriptions of the examples are only used to help understand the core idea of the present invention, and the present invention can be modified and modified without departing from the principle of the present invention, and the modified and modified examples also fall into the protection scope of the present invention.

Claims

1. A medical semi-open blocking device is characterized in that: the support device comprises a shell, wherein a support channel for a support to pass through, a pressure cavity for containing fluid and an elastic film for separating the support channel from the pressure cavity are arranged in the shell, and a circulation port communicated with the pressure cavity and used for allowing the fluid to enter and exit is formed in the shell; the proximal port of the blood vessel main body is connected with the shell and communicated with the bracket channel; the pressure chamber is filled with fluid to promote the elastic membrane to expand towards the direction of the support channel and block the support channel.

2. The medical semi-open occlusion device of claim 1, wherein: the shell is of a revolving body structure, the bracket channel is arranged along the axial direction of the shell and forms a left end opening and a right end opening, and the right end opening is used for being connected with an artificial blood vessel.

3. The medical semi-open occlusion device of claim 2, wherein: the elastic film is arranged along the radial direction of the shell and takes the axis of the shell as a symmetry axis.

4. The medical semi-open occlusion device of claim 2, wherein: the medical semi-open blocking device further comprises a guide cylinder I, wherein a guide channel I is arranged in the guide cylinder I, the guide cylinder I coaxially extends into the support channel from the left end opening of the shell and is fixedly connected with the support channel, and the guide channel I is axially arranged along the guide cylinder and is communicated with the support channel.

5. The medical semi-open occlusion device of claim 4, wherein: the guide cylinder I is connected with the shell through a thread pair or in an interference fit mode.

6. The medical semi-open occlusion device of claim 4, wherein: the medical semi-open blocking device further comprises a guide cylinder II which is internally provided with a guide channel II, the guide cylinder II coaxially extends into the bracket channel from the right end opening of the shell and is fixedly connected with the bracket channel, and the guide channel II is arranged along the axial direction of the guide cylinder and is communicated with the bracket channel; a transition blood vessel is fixedly sleeved outside the guide cylinder II and is used for being sewn with the artificial blood vessel.

7. The medical semi-open occlusion device of claim 6, wherein: and the guide cylinder II is connected with the shell through a thread pair.

8. The medical semi-open occlusion device of any one of claims 1 to 7, wherein: the medical semi-open blocking device further comprises a pressure booster, and the pressure booster is connected with the circulation port through a communication pipe and used for filling or pumping fluid into or out of the pressure cavity.

9. The medical semi-open occlusion device of claim 8, wherein: the pressure increasing and reducing device is in an injector structure.

10. The medical semi-open occlusion device of claim 8, wherein: a connecting valve is arranged between the communicating pipe and the pressure reducing and increasing device, one end of the connecting valve is connected with the communicating pipe, the other end of the connecting valve is connected with the pressure reducing and increasing device, one end of the connecting valve, which is connected with the pressure reducing and increasing device, is connected with a sealing cover, and the sealing cover is tied on the connecting valve through a tether.