CN111358604A

CN111358604A - Single-pigtail transplantation renal stent drainage catheter for renal transplantation of children

Info

Publication number: CN111358604A
Application number: CN202010186308.5A
Authority: CN
Inventors: 钱叶勇; 王振; 柏宏伟
Original assignee: Individual
Current assignee: Individual
Priority date: 2020-03-17
Filing date: 2020-03-17
Publication date: 2020-07-03

Abstract

The invention relates to a single pigtail transplantation kidney stent drainage catheter for kidney transplantation of children, which comprises a linear catheter part, a pigtail tube part and a screw interface, wherein the screw interface can be combined with a urine drainage bag. The length of the linear conduit part is 40cm-45cm, the linear conduit part is provided with scale marks and is divided into three parts with different inner diameters, the first part is connected with the pigtail tube part, the inner diameter of the first part is the same as that of the pigtail tube part and is 2.0mm-3.0mm, the inner diameter of the second part is 8mm, and the inner diameter of the third part is gradually increased to the inner diameter of the second part. The pigtail tube portion is made of a flexible material and comprises two spiral curls, the two spiral curls are in a spiral curling shape in a natural state, and the spiral curls become a straight shape when a linear guide wire is placed in the guide tube. The invention provides a drainage catheter which is firm in fixation, convenient for in vitro monitoring and removal and suitable for kidney transplantation stents for children.

Description

Single-pigtail transplantation renal stent drainage catheter for renal transplantation of children

Technical Field

The invention relates to a medical auxiliary instrument, in particular to a single-pigtail transplanted kidney stent drainage catheter for kidney transplantation of children.

Background

Kidney transplantation is the most effective means for treating chronic renal insufficiency uremia. The main steps of the surgical operation include that the renal artery and vein are respectively anastomosed with the iliac vessel of the receiver, and the renal ureter is anastomosed with the bladder of the receiver. Wherein the transplanted hydronephrosis caused by urine leakage and ureteral stenosis due to the anastomosis surgical technique of the ureter and the recipient or the ischemic injury of the ureter is a serious complication after the kidney transplantation. Practice proves that the indwelling stent tube in the kidney transplantation can provide effective support for the kidney after transplantation and effectively drain and transplant kidney urine, thereby reducing the complications.

The clinical classification is divided into an inner stent tube and an outer stent tube. The internal support is a commonly used double pigtail tube, two ends of the internal support are respectively arranged in the transplanted renal pelvis and bladder, the internal support is fixed on the renal pelvis and bladder by means of pigtail tubes at two ends, and the internal support tube needs to be pulled out by using a cystoscope after one month of operation. Since urine is still extracted from the urethra of the patient, the clinical evaluation of the transplanted kidney function after the operation cannot be influenced because the uremia patient still has urine before the transplantation cannot accurately distinguish whether the urine volume is from the transplanted kidney. The external support is a straight tube without a pigtail, one end of the external support is placed in the renal pelvis during operation, and the other end of the external support is placed outside the body and fixed in a suture binding mode. The external stent has the advantages that the external stent can be pulled out after operation, and the invasive examination operation of the cystoscope is reduced. Another advantage is that the external stent tube is directly connected to the transplanted renal pelvis, so that the change of the urine volume of the transplanted kidney can be directly observed, and the function of the transplanted kidney can be conveniently and timely evaluated. The main disadvantage of the outer stent tube is that the outer stent tube is bound and fixed by a suture, and the outer stent tube falls off accidentally due to the turning over, moving or loosening of the suture of a patient. In addition, the external support tube needs to be fixed every day and the like for maintenance and nursing, which consumes a great deal of medical care time. Moreover, the external stent tube has no scale marks, so that the external stent tube is placed in the transplanted renal pelvis by depending on the experience of a surgeon, the accurate measurement cannot be realized, and the stent drainage tube cannot be accurately placed in the transplanted renal pelvis, thereby influencing the operation effect. The external stent tube is commonly used in clinic without side holes, and the stent tube is blocked due to hematuria after kidney transplantation, so that the transplanted hydronephrosis is caused, and the recovery of the transplanted renal function is influenced.

Except for the living relatives for the kidney, the dead heart for the kidney is the main source of the kidney in China. To date, more than 6000 donors with age less than 6 years donate kidneys in China. As the kidney supply of children is still developing, the volume of the kidney supply is obviously smaller than that of adults, and the inner diameter of the ureter is obviously smaller than that of the ureter of adults. Therefore, the pipe diameter of the stent pipe in clinical application is larger than the inner diameter of the ureter for kidney delivery of children, which leads to the failure of pipe placement.

Therefore, there is a particular need for a new renal stent graft for renal use in children to solve the problems of the prior art.

Disclosure of Invention

The invention aims to overcome the defects of the existing drainage tube and provides a renal stent graft drainage tube which has a simple structure and a good fixing effect, is convenient for monitoring the function of a transplanted kidney in vitro and is convenient to remove, and is suitable for children to supply the kidney.

In order to achieve the purpose, the technical scheme of the invention is as follows:

a kidney support drainage catheter for single pigtail transplantation for kidney transplantation of children comprises a linear catheter part 1, wherein length scale marks 2 are arranged on the outer wall of the linear catheter part 1, one end of the linear catheter part 1 is connected with a pigtail tube part 3, the other end of the linear catheter part 1 is provided with a screw connector 4, and the pigtail tube part 3 and the linear catheter part 1 are communicated; the inner diameter of the pigtail tube part 3 is 2.0mm-3.0mm, and the thickness of the tube wall is 0.2mm-0.3 mm; the length of the linear conduit part 1 is 40cm-45cm, the linear conduit part is divided into three parts, a first part 5 of the linear conduit part 1 is connected with the pigtail conduit part 3, the inner diameter of the linear conduit part is the same as the inner diameter of the pigtail conduit part 3, the bending starting point of the pigtail conduit part 3 is taken as a calibration starting point, the first part 5 of the linear conduit part 1 is taken as the calibration starting point to 20cm of a scale, a second part 6 of the linear conduit part 1 is taken as the end from 21cm of the scale, the inner diameter is 8mm, a third part 7 of the linear conduit part 1 is taken as the part from 20cm to 21cm of the scale, and the inner diameter of the third part is gradually increased from the inner diameter of the first part to the inner diameter of the second part; the pipe wall thickness of the linear pipe part 1 is uniform and is the same as that of the pigtail pipe part 3.

Preferably, the pigtail tube portion 3 is made of a flexible material, and is in a spiral coil shape in a natural state, including two spiral coils, wherein the diameter of the spiral coil is 10 mm-15 mm; the shape of the pigtail tube part 3 can be changed, when the linear guide wire is put in, the pigtail tube part 3 becomes linear, and after the linear guide wire is pulled out, the pigtail tube part 3 is reset to be in a natural state, namely, a spiral crimp shape.

Preferably, the pipe wall of the pigtail pipe part 3 is provided with liquid outlet holes 8 at intervals.

Preferably, the screw interface 4 can be completely combined with a screw of a urine drainage bag for clinical application.

The invention has the beneficial effects that: first, the pipe diameter of thinner portion more matches with children ureter internal diameter, goes out the liquid hole and more does benefit to the urine drainage with the pipe diameter of thicker portion. Secondly, the pigtail which is kept in the renal pelvis is spirally curled to have good fixing function, and the stent is fixed in the transplanted renal pelvis, thereby reducing the falling risk of the stent drainage tube. Third, the change in the urine volume of the draining transplanted kidney is directly monitored in vitro, thereby evaluating the change in the function of the transplanted kidney. Fourthly, the operation can be directly removed from the body after operation, thereby avoiding the invasive operation of the cystoscope. Fifthly, directly observing the scales on the skin of the drainage tube, evaluating the length of the drainage stent tube in the body, judging whether the drainage stent tube falls off or not, and improving the nursing efficiency of medical care.

Drawings

FIG. 1 is a schematic structural view of a single pigtail transplanted kidney stent drainage catheter for kidney transplantation of children.

FIG. 2 is a schematic structural view of a single-pigtail-transplanted kidney stent drainage catheter for kidney transplantation of children in a pigtail tube partially linear state

The reference numerals of the drawings have the following meanings:

1: a linear conduit portion; 2: length scale lines; 3: pigtail tubing section; 4: a screw interface; 5: a first portion of the in-line conduit portion; 6: a second portion of the in-line conduit portion; 7: a third portion of the in-line conduit portion; 8: and a liquid outlet hole.

Detailed Description

Firstly, the difference between the sizes of the kidney for the children and the kidney for the adults is found in clinical kidney transplantation, and the pipe diameter of the part, in which the kidney-transplantation stent drainage catheter for the kidney for the children is placed, is determined. 130 kidneys for patients in 2016 to 2018 in 10 months are taken as study objects in the transplantation center, and the study objects are divided into two groups according to the age of donors, wherein the age of the donors is more than or equal to 18 years, and the adult kidneys for patients are taken as adult kidneys, and the age of recipients is less than 6 years, and the children kidneys for patients are taken as children. Before the transplantation after the removal and trimming of the donor kidney, the major diameter and the transverse diameter of the donor kidney and the inner diameter of the ureter are measured and recorded. Of the 130 kidneys, 100 adult kidney groups and 30 child kidney groups, the two groups were recorded as mean ± standard deviation, and the statistical differences of the two groups were examined using the group t. The length of the donor kidney group of the children is (6.5 +/-2.0) cm, the length of the donor kidney of the adult is (11.3 +/-1.6) cm, the length of the donor kidney of the children is obviously shorter than the length of the donor kidney of the adult, and the difference has the statistical significance P of less than 0.05. The transverse diameter of the donor kidney group of the child is (4.1 +/-1.0) cm, the transverse diameter of the donor kidney of the adult is (6.8 +/-1.4) cm, the transverse diameter of the donor kidney of the child is obviously shorter than the transverse diameter of the donor kidney of the adult, and the difference has statistical significance P < 0.05. The inner diameter of the ureter of the children kidney supply group is (2.5 +/-0.9) mm, the inner diameter of the ureter of the adult kidney supply group is (4.8 +/-1.4) mm, the inner diameter of the ureter of the children kidney supply group is obviously shorter than that of the ureter of the adult kidney supply group, and the difference has statistical significance P < 0.05. Therefore, the pipe diameter of the implantation part of the transplanted kidney stent drainage catheter for the kidney of the children is designed to be 2.0mm-3.0 mm.

Secondly, measuring the lengths of the ureter and the bladder to the body surface in clinical kidney transplantation, and determining the lengths and the sections of the renal stent graft drainage catheters for children to supply kidneys. From 2016 for 1 month to 2018 for 10 months, the transplantation center completed 300 clinical kidney transplants. The clinical finding shows that the length of ureter required to meet successful kidney transplantation is (14.5 + -3.9) cm. Meanwhile, the distance from the bladder to the skin surface was (9.3. + -. 3.6) cm. Therefore, the length of the transplanted kidney support drainage catheter is designed to be 40cm-45cm, wherein 20cm can meet the implantation length of the transplanted kidney ureter, and the remaining 20 cm-25 cm can meet the drainage length from the bladder to the body surface.

Thirdly, according to the clinical research result, the specific structure of the single-pigtail transplanted kidney stent drainage catheter for kidney transplantation of children is explained. As shown in fig. 1, a kidney stent drainage catheter for single pigtail transplantation for kidney transplantation of children comprises a linear catheter part 1, wherein the outer wall of the linear catheter part 1 is provided with length scale marks 2, one end of the linear catheter part 1 is connected with a pigtail tube part 3, the other end of the linear catheter part 1 is provided with a screw connector 4, and the pigtail tube part 3 and the linear catheter part 1 are communicated; the inner diameter of the pigtail tube part 3 is 2.0mm-3.0mm, and the thickness of the tube wall is 0.2mm-0.3 mm; the length of the linear conduit part 1 is 40cm-45cm, the linear conduit part is divided into three parts, a first part 5 of the linear conduit part 1 is connected with the pigtail conduit part 3, the inner diameter of the linear conduit part is the same as the inner diameter of the pigtail conduit part 3, the bending starting point of the pigtail conduit part 3 is taken as a calibration starting point, the first part 5 of the linear conduit part 1 is taken as the calibration starting point to 20cm of a scale, a second part 6 of the linear conduit part 1 is taken as the end from 21cm of the scale, the inner diameter is 8mm, a third part 7 of the linear conduit part 1 is taken as the part from 20cm to 21cm of the scale, and the inner diameter of the third part is gradually increased from the inner diameter of the first part to the inner diameter of the second part; the pipe wall thickness of the linear pipe part 1 is uniform and is the same as that of the pigtail pipe part 3. The design aims at judging the length of the transplanted renal pelvis after the catheter is inserted into the renal pelvis by marking scales, and is beneficial to quickly and accurately positioning the stent tube on the transplanted renal pelvis; and the length of the kidney-shaped implant is about 10-15cm longer than the length of the transplanted renal pelvis to the body surface, thereby being convenient for the clinical nursing requirement. The inner diameters of different parts of the linear catheter part 1 are different, the design aim is to ensure that the circumference of the catheter for the kidney ureter section of a child is more suitable for the diameter of the kidney ureter of the child, and the diameter of the rear section of the catheter is enlarged to be beneficial to urine drainage.

The pigtail tube portion 3 is made of flexible material, is spirally curled naturally, and comprises two spirally curls, and the diameter of the spirally curls is 10-15 mm. The design is aimed at a crimp diameter of 10 mm-15 mm to accommodate the size of the renal pelvis supply of the child. The shape of the pigtail tube part 3 can be changed, when the linear guide wire is placed in the pigtail tube part 3, the pigtail tube part 3 becomes linear, and after the linear guide wire is pulled out, the pigtail tube part 3 is reset to be in a natural state, namely, a spiral curling shape; the design aims at ensuring that the bracket drainage tube is in a linear state when a guide wire is inserted into a pigtail tube and is easy to be inserted into a ureter; after the guide wire is pulled out, the pigtail tube 3 is curled, so that the drainage stent tube is fixed on the transplanted renal pelvis to prevent falling off.

Liquid outlet holes 8 are arranged on the pipe wall of the pigtail pipe part 3 at intervals. The design aims to better drain urine and reduce the transplanted hydronephrosis caused by blood clot obstruction.

The screw interface 4 can be completely combined with a screw of a urine drainage bag for clinical application. The design is intended to improve clinical care efficiency.

And fourthly, the clinical application process of the kidney transplantation operation is described by taking one kidney transplantation operation as an example. In the kidney transplantation, after the renal blood vessels are matched with the blood vessels of a recipient, the transplanted renal ureter is trimmed according to the position of the kidney and the height of the patient, and the length of the renal ureter is measured by using the linear catheter part 1. The wall of the bladder is separated, and the wall of the bladder at the site of vesicoureteral anastomosis is incised, and a sharp opening is made in the anterior wall of the bladder. Placing a clinically common hydrophilic coating guide wire into the inner cavity of the drainage tube to enable the spiral section of the pigtail tube to be linear, wherein the pigtail tube part 3 is in a linear state; the pigtail tube part 3 of the bracket drainage tube is taken as the front end, the bracket drainage tube is placed into the bladder through a sharp opening on the front wall of the bladder, then the bladder is pulled out by cutting the bladder wall at the anastomotic position of the vesicoureteral tract, then the bracket drainage tube is placed into the transplanted renal pelvis in a retrograde direction, after the bracket drainage tube pigtail tube part 3 is completely placed into the transplanted renal pelvis, the hydrophilic coating guide wire in the bracket drainage tube is pulled out, so that the pigtail tube part 3 is spirally restored to be curled, and the drainage tube is fixed in the transplanted renal pelvis. And (4) visually observing the length scale mark 2 of the drainage stent tube, judging whether the length of the drainage stent tube is matched with the length of the transplanted nephroureter, and adjusting the length according to the condition. The implanted kidney ureter is matched with the bladder of a recipient in sequence, the position of the implanted kidney is placed, the stent drainage tube is pulled out of the body from the incision, the length scale mark 2 scale value of the stent drainage tube outside the incision skin is recorded, and the incision is sutured. The screw connector 4 of the bracket drainage tube is connected with the urine drainage bag. The daily drainage tube nursing can be completed by visually observing the length scale mark 2 scale values of the stent drainage tube after the operation, and the stent drainage tube is directly pulled out in vitro after 4 weeks after the operation.

Claims

1. The single-pigtail transplantation renal stent drainage catheter for renal transplantation of children is characterized by comprising a linear catheter part (1), wherein length scale marks (2) are arranged on the outer wall of the linear catheter part (1), one end of the linear catheter part (1) is connected with a pigtail tube part (3), the other end of the linear catheter part is provided with a screw connector (4), and the pigtail tube part (3) and the linear catheter part (1) are communicated; the inner diameter of the pigtail tube part (3) is 2.0mm-3.0mm, and the thickness of the tube wall is 0.2mm-0.3 mm; the length of the linear conduit part (1) is 40cm-45cm and is divided into three parts, a first part (5) of the linear conduit part (1) is connected with the pigtail conduit part (3), the inner diameter of the first part is the same as that of the pigtail conduit part (3), the bending starting point of the pigtail conduit part (3) is taken as a calibration starting point, the first part (5) of the linear conduit part (1) is taken as the calibration starting point to 20cm from the scale, a second part (6) of the linear conduit part (1) is taken as the scale from 21cm to the tail end, the inner diameter is 8mm, a third part (7) of the linear conduit part (1) is taken as the scale from 20cm to 21cm, and the inner diameter of the third part is gradually increased from the inner diameter of the first part to the inner diameter of the second part; the pipe wall thickness of the linear pipe part (1) is uniform and is the same as that of the pigtail pipe part (3).

2. A children's single pigtail-transplanted renal stent drainage catheter for renal transplantation according to claim 1, wherein the pigtail tube section (3) is made of a flexible material, and is in a spiral coil shape in a natural state, comprising two spiral coils, and the diameter of the spiral coil is 10 mm-15 mm; the shape of the pigtail tube part (3) can be changed, when the linear guide wire is placed in the pigtail tube part (3) becomes linear, and after the linear guide wire is pulled out, the pigtail tube part (3) is reset to be in a natural state, namely, a spiral winding shape.

3. The single pigtail-transplanted renal stent drainage catheter for children according to claim 2, wherein: liquid outlet holes (8) are arranged on the pipe wall of the pigtail pipe part (3) at intervals.

4. The single pigtail transplant renal stent drainage catheter for children according to claim 1, wherein the screw port (4) can be completely combined with a screw of a urine drainage bag for clinical application.