CN111359038A

CN111359038A - High-flow arteriovenous internal fistula current limiting device

Info

Publication number: CN111359038A
Application number: CN202010220758.1A
Authority: CN
Inventors: 周大勇; 沈平; 姚志超; 黄剑; 汤尧; 沈利明
Original assignee: Suzhou Municipal Hospital
Current assignee: Suzhou Municipal Hospital
Priority date: 2020-03-26
Filing date: 2020-03-26
Publication date: 2020-07-03

Abstract

The invention relates to a high-flow arteriovenous internal fistula flow limiting device, which comprises a C-shaped hoop, an infusion port and a liquid aspirator, wherein the C-shaped hoop is used for clamping and embracing a venous blood vessel or an artificial blood vessel for an internal fistula; the liquid suction device comprises a liquid suction pump, a suction tube and a puncture needle, wherein one end of the liquid suction pump, which is connected with a suction port, is connected with the other end of the suction tube, and the puncture needle is used for penetrating from the outside of the body and connecting with an infusion port. The blood flow limiting device has the advantages of ingenious structure, reasonable design and convenient use, the elastic sac on the C-shaped hoop holds the venous blood vessel or the artificial blood vessel tightly, the transfusion port is implanted into the body of a patient, the blood flow can be regulated by only simple puncture, the wound is small, the blood flow cannot be influenced by factors such as blood pressure and the like, and the accurate flow limitation can be realized.

Description

High-flow arteriovenous internal fistula current limiting device

Technical Field

The invention relates to an instrument for arteriovenous internal fistula, in particular to a high-flow arteriovenous internal fistula flow limiting device, and belongs to the technical field of design of medical instruments.

Background

Arteriovenous fistulas are "life lines" for uremic patients. However, the excessive flow of arteriovenous internal fistula of part of patients causes cardiac insufficiency or acrosteal blood syndrome, which is a serious complication of patients with hemodialysis. Clinically, a surgical current limiting method is adopted for high-flow arteriovenous internal fistula at present, namely, an arteriovenous anastomotic stoma is bound by using a suture or wrapped by using an artificial material, so that a lumen is reduced, and blood flow is reduced. However, this current limiting method has the following disadvantages: firstly, blood flow may be reduced due to the undersize lumen, and normal hemodialysis or fistula occlusion cannot be maintained; secondly, the blood flow is still large and the expected effect can not be achieved due to insufficient reduction of the lumen. Studies have suggested that color ultrasound can be used intraoperatively to assess blood flow, thereby allowing a more accurate "flow restriction". However, such an operation requires a wound in a state of surgical incision, and blood flow is affected by factors such as blood pressure, so that accurate "flow restriction" cannot be achieved in practice, and if the patient needs intervention, surgical incision is performed again, which causes pain to the patient.

Therefore, in response to the above-mentioned deficiencies of the prior art, there is a need to develop a device that can accurately adjust the blood flow of an internal fistula after surgery.

Disclosure of Invention

The invention aims to overcome the defects in the prior art, and provides the high-flow arteriovenous internal fistula flow limiting device which is ingenious in structure, reasonable in design and convenient to use, and can achieve the purpose of accurately adjusting the blood flow of the internal fistula after operation.

According to the technical scheme provided by the invention: high flow arteriovenous internal fistula current limiting device, its characterized in that: the artificial blood fistula catheter comprises a C-shaped hoop, an infusion port and a liquid aspirator, wherein the C-shaped hoop is used for being clamped on an intravenous blood vessel or an artificial blood vessel for an internal fistula, an elastic bag is arranged on the inner peripheral surface of the C-shaped hoop and is communicated with the infusion port, the infusion port is used for being placed in a human body, and the infusion port is communicated with the interior of the elastic bag through a catheter; the liquid suction device comprises a liquid suction pump, a suction tube and a puncture needle, wherein one end of the liquid suction pump, which is connected with a suction port, is connected with the other end of the suction tube, and the puncture needle is used for penetrating from the outside of the body and connecting with an infusion port.

As a further improvement of the invention, the elastic bag is adhered and fixed on the C-shaped hoop, a through hole is arranged at the center of the C-shaped hoop, and the catheter penetrates into the C-shaped hoop through the through hole and is communicated with the interior of the elastic bag in a sealing way.

As a further improvement of the invention, the C-shaped hoop is further provided with a connecting member, and two ends of the C-shaped hoop can be connected with each other through the connecting member.

As a further improvement of the invention, the connecting member comprises an arc-shaped card, one end of the C-shaped hoop is provided with a connecting notch, one end of the arc-shaped card is rotatably installed in the connecting notch, the other end of the arc-shaped card is provided with a bending head, the inner surface of the bending head is a plane, the outer side surface of the other end of the C-shaped hoop is provided with a bayonet, and the center of the bayonet is concavely provided with a plane and can be matched and attached with the inner surface of the bending head.

As a further improvement of the invention, the inner side surfaces of the two ends of the arc-shaped card are provided with elastic transition pads, and one end of each elastic transition pad close to the C-shaped hoop is higher than one end far away from the C-shaped hoop.

As a further improvement of the invention, the transfusion port comprises a port seat, a puncture diaphragm and a pressure-maintaining anti-reflux mechanism, wherein the port seat is in a cone frustum shape, a cavity is arranged in the port seat, a puncture opening is formed in the center of the top of the port seat, and the puncture diaphragm is arranged at the puncture opening; the port seat side part is provided with an outlet communicated with the cavity, and the guide pipe is connected to the outlet; the pressure maintaining and backflow preventing mechanism is arranged in the cavity and comprises a bullet-shaped valve core and a return spring, the bullet-shaped valve core is arranged in the cavity in a sealing and sliding mode, the return spring is arranged below the bullet-shaped valve core, one end of the return spring is abutted against the inner surface of the bottom of the cavity, and the other end of the return spring is abutted against the outer surface of the bottom of the bullet-shaped valve core; the bullet-shaped valve core is of a hollow structure, a side hole is formed in the side face of the cylindrical portion of the bullet-shaped valve core, an annular groove is concavely formed in the inner peripheral surface of the cavity, a channel is arranged in the port seat, one end of the channel is communicated with the annular groove, and the other end of the channel is communicated with the outlet; when the bullet-shaped valve core is not pressed, the side hole on the bullet-shaped valve core and the annular groove are mutually staggered under the action of the return spring; when the bullet-shaped valve core is pressed and moves to abut against the inner surface of the bottom of the cavity, the side hole in the bullet-shaped valve core is communicated with the annular groove.

As a further improvement of the invention, the periphery of the puncture opening is provided with at least two positioning marks which protrude from the top surface of the port seat and are uniformly distributed in the circumferential direction, the positioning marks are used for matching with a positioning fixer outside the skin, the center of the positioning fixer is provided with a through hole, the shape and size of the through hole are the same as those of the puncture opening, and the positioning fixer is provided with a plurality of positioning holes which correspond to the positioning marks one to one.

As a further improvement of the invention, the front end of the puncture needle is round and closed, and a plurality of openings communicated with the inner hole of the puncture needle are arranged on the side part of the puncture needle.

As a further improvement of the invention, the liquid suction pump is a peristaltic pump.

Compared with the prior art, the invention has the following advantages:

1) the invention has the advantages of ingenious structure and reasonable design, the C-shaped hoop can be reliably fixed on the venous vessel or the artificial vessel for internal fistula by arranging the C-shaped hoop and the elastic bag, the elastic bag on the inner peripheral surface of the C-shaped hoop expands after being filled with liquid so as to hold the venous vessel or the artificial vessel tightly, the transfusion port can be implanted under the skin of a patient, the blood flow can be adjusted by only simple puncture, compared with the traditional method of adopting surgical incision to carry out current limiting, the invention has small wound and can not be influenced by factors such as blood pressure and the like, thereby realizing accurate current limiting.

2) When liquid is injected into the elastic bag, the pressure-maintaining and backflow-preventing mechanism can prevent the liquid in the elastic bag from flowing back into the port seat, so that the main pressure-maintaining effect is achieved, the blood flow in a vein vessel or an artificial blood vessel is accurately limited, and the puncture diaphragm can also achieve the second effect of preventing the liquid from flowing back, so that double insurance is formed.

3) The C-shaped hoop can be further provided with a connecting component, and two ends of the C-shaped hoop can be connected with each other through the connecting component, so that the C-shaped hoop is stably held on the venous blood vessel or artificial blood vessel for internal fistula, and the accuracy of flow limiting is higher.

Drawings

Fig. 1 is a schematic view of the overall structure of embodiment 1 of the present invention.

Fig. 2 is a schematic view of an installation application of the C-shaped band of fig. 1.

Fig. 3 is an enlarged sectional view of the configuration of the port and the puncture needle of fig. 1.

Fig. 4 is a front view of the installation structure of the C-shaped band, the elastic bag and the arc-shaped card in embodiment 2 of the present invention.

Fig. 5 is a perspective view showing the installation structure of the C-shaped band, the elastic bag and the arc-shaped clip in embodiment 2 of the present invention.

Description of reference numerals: 1-C-shaped hoop, 1 a-through hole, 2-transfusion port, 3-liquid aspirator, 4-elastic sac, 5-catheter, 6-liquid aspirator, 7-aspirator, 8-puncture needle, 9-port seat, 9 a-cavity, 9 b-puncture opening, 9C-annular groove, 9 d-channel, 10-puncture diaphragm, 11-bullet-shaped valve core, 11 a-side hole, 12-reset spring, 13-positioning mark, 14-positioning fixer, 14 a-through hole, 14 b-positioning hole, 15-arc card, 16-bending head, 17-bayonet and 18-elastic transition pad.

Detailed Description

The invention is further illustrated by the following specific figures and examples.

Example 1

As shown in fig. 1 to 3, embodiment 1 discloses a high-flow arteriovenous internal fistula flow limiting device, which comprises a C-shaped hoop 1, an infusion port 2 and a liquid aspirator 3, wherein the C-shaped hoop 1 is used for clamping on a venous blood vessel or an artificial blood vessel for internal fistula, an elastic bag 4 is arranged on the inner peripheral surface of the C-shaped hoop 1, the elastic bag 4 is communicated with the infusion port 2, the infusion port 2 is used for being placed in a human body, and the infusion port 2 is communicated with the inside of the elastic bag 4 through a catheter 5; the fluid aspirator 3 includes a fluid suction pump 6, a suction tube 7 and a puncture needle 8, one end of the fluid suction pump 6 to which a suction port is connected, the other end of the suction tube 7 to which the puncture needle 8 is connected, the puncture needle 8 being used for penetrating and connecting the port 2 from the outside of the body.

When the artificial blood vessel is used, firstly, the venous blood vessel or the artificial blood vessel for the internal fistula is exposed in a surgical incision mode, then the C-shaped hoop 1 is installed on the venous blood vessel or the artificial blood vessel for the internal fistula, and the elastic bag 4 on the inner peripheral surface of the C-shaped hoop 1 is tightly held on the outer surface of the venous blood vessel or the artificial blood vessel; then the transfusion port 2 is implanted under the skin of the patient body, and the installation of the high-flow arteriovenous internal fistula flow limiting device is completed. When the blood flow volume of the arteriovenous internal fistula of a patient is too large and the flow needs to be limited, the liquid aspirator 3 is firstly connected with the transfusion port 2 [ firstly, the position of the transfusion port 2 is determined, then the skin is disinfected, then the local skin is wiped by using a dry cotton ball or gauze, finally the puncture needle 8 of the liquid aspirator 3 is inserted into the transfusion port 2 ], the liquid aspirator 3 is started, the elastic bag 4 is filled with liquid through the transfusion port 2, and at the moment, the elastic bag 4 is expanded and the vein or artificial blood vessel is tightened to play a role in limiting the flow; conversely, when the blood flow is reduced too much to maintain normal hemodialysis or fistula occlusion, the fluid aspirator 3 can draw the fluid out of the elastic balloon 4 to reduce the degree of restriction. Because the transfusion port 2 is implanted in the body of a patient, the blood flow can be adjusted only by simple puncture, compared with the prior art of adopting surgical incision to carry out flow limitation, the wound is small, and the blood flow cannot be influenced by factors such as blood pressure and the like, thereby realizing accurate flow limitation.

As shown in fig. 3, in the present embodiment 1, the infusion port 2 includes a port seat 9, a puncture membrane 10 and a pressure-maintaining anti-backflow mechanism, the port seat 9 is in a truncated cone shape, a cavity 9a is formed inside the port seat 9, a puncture opening 9b is formed in the center of the top of the port seat 9, and the puncture membrane 10 is installed in the puncture opening 9 b; the port seat 9 is provided at its side with an outlet communicating with the cavity 9a, the duct 5 being connected to said outlet; the pressure maintaining and backflow preventing mechanism is arranged in the cavity 9a and comprises a bullet-shaped valve core 11 and a return spring 12, the bullet-shaped valve core 11 is arranged in the cavity 9a in a sealing and sliding mode, the return spring 12 is arranged below the bullet-shaped valve core 11, one end of the return spring 12 is abutted against the inner surface of the bottom of the cavity 9a, and the other end of the return spring 12 is abutted against the outer surface of the bottom of the bullet-shaped valve core 11; the bullet-shaped valve core 11 is of a hollow structure, a side hole 11a is formed in the side face of the cylindrical portion of the bullet-shaped valve core 11, an annular groove 9c is formed in the inner peripheral surface of the cavity 9a in a concave mode, a channel 9d is formed in the port seat 9, one end of the channel 9d is communicated with the annular groove 9c, and the other end of the channel 9d is communicated with the outlet; when the bullet-shaped valve core 11 is not pressed, the side hole 11a on the bullet-shaped valve core 11 and the annular groove 9c are staggered with each other under the action of the return spring 12; when the bullet spool 11 is pressed and moved into abutment with the bottom inner surface of the cavity 9a, the side hole 11a in the bullet spool 11 and the annular groove 9c communicate with each other. With the arrangement, when liquid is injected into the elastic bag 4, the pressure maintaining and backflow preventing mechanism can prevent the liquid in the elastic bag 4 from flowing back into the harbor seat 9, so as to play a main pressure maintaining role and accurately limit the flow of blood in a vein vessel or an artificial blood vessel; in addition, the puncture membrane 10 also has a second function of preventing liquid from flowing backwards, thereby forming double insurance.

As shown in fig. 3, in this embodiment 1, two positioning marks 13 protruding from the top surface of the port seat 9 and evenly distributed in the circumferential direction are disposed on the periphery of the puncture opening 9b, the positioning marks 13 are used for being matched with a positioning fixer 14 outside the skin, a through hole 14a is disposed in the center of the positioning fixer 14, the shape and size of the through hole 14a are the same as those of the puncture opening 9b, and two positioning holes 14b corresponding to the positioning marks 13 one to one are disposed on the positioning fixer 14. When in operation, the positioning fixer 14 is firstly placed on the skin surface and is attached to the top of the port seat 9, and a plurality of positioning marks 13 are uniformly distributed on the surface of the outer peripheral part of the top of the transfusion port 2; thus, the positioning hole 14b on the positioning fixer 14 is correspondingly embedded with the positioning mark 13 of the port seat 9 one by rotating and moving the positioning fixer 14, at the moment, the puncture opening 9b on the port seat 9 is defined by the through hole 14a on the positioning fixer 14, the medical staff can press the positioning fixer 14 with one hand to avoid the movement of the positioning fixer 14 and the transfusion port 2 and puncture with the other hand, thereby greatly improving the puncture accuracy and the puncture efficiency. In the present invention, the positioning mark 13 may be a light emitting lamp, a color point, or other recognizable object harmless to the human body.

As shown in fig. 2, in this embodiment 1, the elastic bag 4 is adhered and fixed on the C-shaped hoop 1, a through hole 1a is formed at the center of the C-shaped hoop 1, and the catheter 5 penetrates through the C-shaped hoop 1 through the through hole 1a and is in sealed communication with the inside of the elastic bag 4. So set up, can install C-shaped hoop 1 to internal fistula on with vein blood vessel or artificial blood vessel more conveniently, optimize the pipeline and arrange.

As shown in fig. 3, in the present embodiment 1, the tip of the puncture needle 8 is rounded and closed, and a plurality of openings communicating with the inner hole of the puncture needle 8 are provided on the side of the puncture needle 8. So configured, because the puncture needle 8 front end is round and closed, this has enough structural strength to move inward against the bullet valve core 11.

As shown in FIG. 2, in the present embodiment 1, the liquid suction pump 6 is preferably a peristaltic pump. With the arrangement, the peristaltic pump has accurate and stable liquid conveying capacity, liquid can be conveyed in two directions, suction is realized, and the operation is very convenient. In addition, the liquid in the peristaltic pump is isolated in the pump tube, and the pump tube can be quickly replaced, so that the clinical requirement is met. Of course, other products having a function of sucking liquid that are available in the related art may be used as the liquid suction pump 6.

Example 2

As shown in fig. 4 and 5, the embodiment 2 discloses a high-flow arteriovenous internal fistula flow limiting device, which is different from the embodiment 1 in that a connecting member is further arranged on the C-shaped hoop 1, and two ends of the C-shaped hoop 1 can be connected with each other through the connecting member. So set up, the connecting element can let C-shaped hoop 1 hold on internal fistula is with vein blood vessel or artificial blood vessel more steadily, lets the accuracy of current-limiting higher. Moreover, when the C-shaped hoop 1 is provided with the connecting component, the C-shaped hoop 1 does not need to be made of hard materials, but can be made of materials with better softness, so that the C-shaped hoop can be more conveniently arranged on the venous vessel or artificial vessel for internal fistula.

As shown in fig. 4 and 5, in this embodiment 2, the connecting member includes an arc card 15, one end of the C-shaped hoop 1 is provided with a connecting slot, one end of the arc card 15 is rotatably installed in the connecting slot, the other end of the arc card 15 is provided with a bending head 16, the inner surface of the bending head 16 is a plane, the outer side surface of the other end of the C-shaped hoop 1 is provided with a bayonet 17, the center of the bayonet 17 is concavely provided with a plane and can be matched and attached with the inner surface of the bending head 16. So arranged, the two ends of the C-shaped hoop 1 can be reliably connected through the arc-shaped clamps 15.

As shown in fig. 4 and 5, in this embodiment 2, the inner sides of the two ends of the arc-shaped card 15 are provided with elastic transition pads 18, and one end of the elastic transition pad 18 close to the C-shaped hoop 1 is higher than one end far from the C-shaped hoop 1. So set up, can protect internal fistula effectively and use vein blood vessel or artificial blood vessel. The flexible transition pad 18 is preferably made of medical grade silicone that can be implanted into the body.

The above description is only for the preferred embodiment of the present invention, and the above specific embodiments are not intended to limit the present invention. Various modifications and alterations may occur to those skilled in the art without departing from the spirit and scope of the invention, and such modifications and alterations should be accorded the broadest interpretation so as to encompass all such modifications and alterations.

Claims

1. High flow arteriovenous internal fistula current limiting device, its characterized in that: the artificial fistula catheter comprises a C-shaped hoop (1), a transfusion port (2) and a liquid aspirator (3), wherein the C-shaped hoop (1) is used for being clamped on an internal fistula vein or artificial blood vessel, an elastic bag (4) is arranged on the inner peripheral surface of the C-shaped hoop (1), the elastic bag (4) is communicated with the transfusion port (2), the transfusion port (2) is used for being placed into a human body, and the transfusion port (2) is communicated with the interior of the elastic bag (4) through a catheter (5); the liquid aspirator (3) comprises a liquid suction pump (6), a suction pipe (7) and a puncture needle (8), one end of a suction opening of the liquid suction pump (6) is connected, the other end of the suction pipe (7) is connected with the puncture needle (8), and the puncture needle (8) is used for penetrating from the outside of the body and connecting with the transfusion port (2).

2. The high flow arteriovenous internal fistula flow limiting device of claim 1 wherein: the C-shaped hoop (1) is further provided with a connecting component, and two ends of the C-shaped hoop (1) can be connected with each other through the connecting component.

3. The high flow arteriovenous internal fistula flow limiting device of claim 2 wherein: connecting elements includes arc card (15), C shape hoop (1) one end is equipped with the connection notch, arc card (15) one end is rotated and is installed in the connection notch, arc card (15) other end is equipped with the head of buckling (16), the internal surface of buckling head (16) is established to the plane, the lateral surface of C shape hoop (1) other end is equipped with bayonet socket (17), bayonet socket (17) central concave be equipped with the plane and can with the laminating is matchd to the internal surface of buckling head (16).

4. The high flow arteriovenous fistula flow limiting device of claim 3, wherein: the inner side faces of two ends of the arc-shaped clamp (15) are provided with elastic transition pads (18), and one end, close to the C-shaped hoop (1), of each elastic transition pad (18) is higher than one end, far away from the C-shaped hoop (1). So set up, can protect internal fistula effectively and use vein blood vessel or artificial blood vessel.

5. The high flow arteriovenous internal fistula flow limiting device of any one of claims 1 to 4, wherein: the transfusion port (2) comprises a port seat (9), a puncture diaphragm (10) and a pressure-maintaining anti-reflux mechanism, wherein the port seat (9) is in a cone frustum shape, a cavity (9a) is formed in the port seat (9), a puncture opening (9b) is formed in the center of the top of the port seat (9), and the puncture diaphragm (10) is installed at the puncture opening (9 b); the side part of the port seat (9) is provided with an outlet communicated with the cavity (9a), and the conduit (5) is connected at the outlet; the pressure-maintaining anti-reflux mechanism is arranged in the cavity (9a), the pressure-maintaining anti-reflux mechanism comprises a bullet-shaped valve core (11) and a return spring (12), the bullet-shaped valve core (11) is arranged in the cavity (9a) in a sealing and sliding mode, the return spring (12) is arranged below the bullet-shaped valve core (11), one end of the return spring (12) is abutted to the inner surface of the bottom of the cavity (9a), and the other end of the return spring (12) is abutted to the outer surface of the bottom of the bullet-shaped valve core (11); the bullet-shaped valve core (11) is of a hollow structure, a side hole (11a) is formed in the side face of the cylindrical portion of the bullet-shaped valve core (11), an annular groove (9c) is formed in the inner peripheral surface of the cavity (9a) in a concave mode, a channel (9d) is formed in the port seat (9), one end of the channel (9d) is communicated with the annular groove (9c), and the other end of the channel (9d) is communicated with the outlet; when the bullet-shaped valve core (11) is not pressed, the side hole (11a) on the bullet-shaped valve core (11) and the annular groove (9c) are staggered with each other under the action of the return spring (12); when the bullet-shaped valve core (11) is pressed and moved to abut against the inner surface of the bottom of the cavity (9a), the side hole (11a) on the bullet-shaped valve core (11) and the annular groove (9c) are communicated with each other.

6. The high flow arteriovenous internal fistula flow limiting device of claim 5 wherein: the periphery of puncture opening (9b) is equipped with at least two protrusions in harbour seat (9) top surface and be positioning mark (13) of circumference evenly distributed, positioning mark (13) are used for cooperating with extradermal location fixer (14), the center of location fixer (14) is equipped with through-hole (14a), the shape size of through-hole (14a) with puncture opening (9b) are the same, are equipped with locating hole (14b) of a plurality of and positioning mark (13) one-to-one on location fixer (14).

7. The high flow arteriovenous internal fistula flow limiting device of claim 1 wherein: the elastic bag (4) is adhered and fixed on the C-shaped hoop (1), a through hole (1a) is formed in the center of the C-shaped hoop (1), and the catheter (5) penetrates into the C-shaped hoop (1) through the through hole (1a) and is communicated with the elastic bag (4) in an internal sealing mode.

8. The high flow arteriovenous internal fistula flow limiting device of claim 1 wherein: the front end of the puncture needle (8) is round and closed, and a plurality of openings communicated with the inner hole of the puncture needle (8) are formed in the side part of the puncture needle (8).

9. The high flow arteriovenous internal fistula flow limiting device of claim 1 wherein: the liquid suction pump (6) adopts a peristaltic pump.