CN111481261A - 一种输尿管镜尿道鞘 - Google Patents
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Abstract
本发明公开了一种输尿管镜尿道鞘，包括插入部、尿道鞘壁、输尿管镜插管、可压缩伸缩管、充气模块、测压模块；所述插入部固定在尿道鞘壁前端；所述可压缩伸缩管一端与尿道鞘壁后端相连，另一端与输尿管镜插管相连；所述输尿管镜插管用于输尿管镜从整个尿道鞘后端插入；所述插入部上设有用于监测膀胱内压力的测压模块；所述尿道鞘壁前端外壁设有充气模块，用于充气扩张后对尿道鞘的柔性固定。本发明测压模块可检测膀胱内压力，通过充气模块可避免通道鞘滑脱损伤尿道，可以有效提高手术成功率，降低严重手术并发症发生的风险。
Description
技术领域
本发明属于医疗器械领域，特别是一种输尿管镜尿道鞘。
背景技术
泌尿系结石是泌尿外科的常见病。近些年来，我国泌尿系结石的发病率有增加趋势，是世界上3大结石高发区之一。目前中国成人肾结石患病率为5.8％，约有6100万肾结石患者，其中男性约3470万人，女性约2650万人。随着腔内泌尿外科的发展，输尿管内窥软镜因具备微创、安全和有效的特点，已经作为治疗肾脏结石的主要手段被泌尿外科医生广泛使用。输尿管镜碎石操作过程中需通过尿道，并且在操作过程中需要来回推拉，容易易造成尿道损伤、感染、狭窄。为了减少患者尿道损伤，医生多在操作输尿管镜时使用输尿管通道鞘保护尿道。在进镜前先将输尿管镜通道鞘插入患者尿道，为输尿管镜提供通道，这样可以有效减少尿道与输尿管镜的摩擦，并且可以避免在取出较大结石时划伤尿道。
普通的通道鞘外表呈圆柱形，顶端的扩张器不可伸缩扩张范围有限，在尿道狭窄处容易遇到阻力，出现嵌顿，如果强行推入会造成患者黏膜或者全层损伤。由于个体差异性的存在，尿道的弯曲或狭窄都可能导致输尿管通道鞘放置失败。在手术过程中有很大比例的患者不能成功放置输尿管通道鞘。有研究结果显示，22％的患者术中未能成功放置输尿管导入鞘，而且由于通道鞘没有固定装置，放置成功后也很容易随着输尿管镜的运动滑脱。
输尿管碎石术中需要持续灌注冲洗液，冲洗液通过输尿管积蓄到膀胱内，容易造成膀胱和肾内压过大，可能会导致软镜碎石术后患者出现全身炎症反应综合征，甚至尿源性脓毒血症的发生。为了防止膀胱及肾脏受到损伤，需要医生在操作内镜一段时间后将内镜从通道鞘拔出，释放膀胱内积累的液体。由于缺乏术中膀胱压力监测设备，医生只能凭经验操作，增加了手术风险。如果可以通过设备实时监测膀胱内压力并在压力过大时提醒医生释放液体，就可以避免肾内压过高的情况发生。
综上所述，传统的通道鞘具有插入困难、易滑脱、不能监测膀胱压力等缺点，给输尿管镜碎石术带来较大困难。
发明内容
本发明的目的在于提供一种输尿管镜尿道鞘，具备膀胱压力监测和鞘体固定功能的可伸缩输尿管镜尿道鞘。
实现本发明目的的技术解决方案为：
一种输尿管镜尿道鞘，包括插入部、尿道鞘壁、输尿管镜插管、可压缩伸缩管、充气模块、测压模块；
所述插入部固定在尿道鞘壁前端；所述可压缩伸缩管一端与尿道鞘壁后端相连，另一端与输尿管镜插管相连；所述输尿管镜插管用于输尿管镜从整个尿道鞘后端插入；所述插入部上设有用于监测膀胱内压力的测压模块；所述尿道鞘壁前端外壁设有充气模块，用于充气扩张后对尿道鞘的柔性固定。
本发明与现有技术相比，其显著优点是：
(1)本发明在尿道鞘壁前端的环形空腔内设置气囊，气囊压缩状态位于尿道鞘壁环形空腔内，不影响尿道鞘的插入使用，扩张状态从气囊扩张通道引出体外，实现尿道鞘的固定，防止滑脱，减少尿道损伤的风险；同时在插入部上设有测压模块，可实现膀胱内压直接监测功能，以防止通道鞘放置不当和肾内压过高带来的手术并发症。
(2)所述可压缩伸缩管4采用软性波纹管，既可以通过压缩改变长度，能够在输尿管镜不能顺利推进时，实现输尿管镜的顺利推进，也可以通过夹持实现管道的接通或关闭，从而实现导尿或者液体注入。
附图说明
图1为本发明输尿管镜尿道鞘总体结构示意图。
具体实施方式
下面结合附图及具体实施例对本发明做进一步的介绍。
结合图1，本发明的一种输尿管镜尿道鞘，包括插入部1、尿道鞘壁2、输尿管镜插管3、可压缩伸缩管4、充气模块、测压模块；
所述插入部1固定在尿道鞘壁2前端，所述插入部1呈空心子弹头状，便于整个尿道鞘插入尿道；所述可压缩伸缩管4一端与尿道鞘壁2后端相连，另一端与输尿管镜插管3相连；所述输尿管镜插管3用于输尿管镜从整个尿道鞘后端插入；所述插入部1上设有测压模块，用于监测膀胱内压力；所述尿道鞘壁2前端外壁设有充气模块，用于充气扩张后对尿道鞘的柔性固定。
进一步的实施方式中，所述尿道鞘壁2为由内管和外管构成的双管结构，内管作为输尿管镜的插入管道，内管与外管之间的环形空腔作为充气模块的通气通道以及测压模块3的接电通道。
进一步的实施方式中，所述充气模块包括充气接口5、通气管6及气囊7；所述气囊7设置在尿道鞘壁2前端的环形空腔内，尿道鞘壁2前端外管上设有气囊扩张通道，气囊7压缩状态位于尿道鞘壁2环形空腔内，气囊7扩张状态从气囊扩张通道引出体外；所述通气管6内置于尿道鞘壁2的环形空腔，一端与气囊7相连，另一端从尿道鞘壁2引出与充气接口5相连。
进一步的实施方式中，所述测压模块包括测压探头接口8、测压探头数据线9及测压探头10；所述测压探头10嵌入插入部1外壁，与外界物理接触，实现测压功能；所述测压探头数据线9内置于尿道鞘壁2的环形空腔，一端与测压探头10相连，另一端从尿道鞘壁2引出与测压探头接口8相连。
进一步的实施方式中，所述可压缩伸缩管4为软性波纹管，既可以通过压缩改变长度，也可以在可压缩伸缩管4外部通过夹持，实现管道的接通或关闭。通过压缩改变长度，能够在输尿管镜不能顺利推进时，通过压缩可压缩伸缩管4长度，实现输尿管镜的顺利推进，此外，也可以通过夹持，实现管道的接通或关闭，从而实现导尿或者液体注入。
优选的，所述可压缩伸缩管4采用波纹硅胶管；所述插入部1采用柔性医用硅胶管内加钢丝衬，医用硅胶管具有良好的生物相容性并且外表柔软光滑，可以减少对尿道的损伤，内加钢丝衬，保证了插入部1的刚度。
本发明的尿道鞘使用方法，具体如下：
将本发明输尿管镜尿道鞘通过尿道插入体内，将充气接口5与充气装置相连接，通过通气管6，迅速实现气囊7的充气，从而通过扩张的气囊7实现尿道鞘的固定，防止滑脱。此外，充气接口5与充气装置连接的管道上设有压力计，当气囊7内压力达到设定值时，充气装置停止对气囊7的充气。将测压模块与上位机连接，打开测压模块，实时监测膀胱内压力，测压探头10通过测压探头数据线9将检测电信号通过导线发送到体外的AD模块，AD模块与监测报警系统相连。监测报警系统采用ARM芯片和高清液晶屏的方式实现，监测到压力过大(超过设定值)时，液晶屏可以以醒目的信号进行提示，压力过大时可提醒医生释放液体。此外，测压探头10采用能在1s内对压力变化做出响应，并且具有100Pa以内的测量精度的压力传感器。将输尿管镜从输尿管镜插管3插入，进行医学操作。
以上实施例仅用以说明本发明的技术方案而非限定，参照较佳实施例对本发明进行了详细说明。本领域的普通技术人员应当理解，可以对本发明的技术方案进行修改或等同替换，而不脱离本发明技术方案的精神和范围，均应涵盖在本发明的权利要求范围内。
Claims (10)
1.一种输尿管镜尿道鞘，其特征在于，包括插入部(1)、尿道鞘壁(2)、输尿管镜插管(3)、可压缩伸缩管(4)、充气模块、测压模块；
所述插入部(1)固定在尿道鞘壁(2)前端；所述可压缩伸缩管(4)一端与尿道鞘壁(2)后端相连，另一端与输尿管镜插管(3)相连；所述输尿管镜插管(3)用于输尿管镜从整个尿道鞘后端插入；所述插入部(1)上设有用于监测膀胱内压力的测压模块；所述尿道鞘壁(2)前端外壁设有充气模块，用于充气扩张后对尿道鞘的柔性固定。
2.根据权利要求1所述的输尿管镜尿道鞘，其特征在于，所述尿道鞘壁(2)为由内管和外管构成的双管结构，内管作为输尿管镜的插入管道，内管与外管之间的环形空腔作为充气模块的通气通道以及测压模块(3)的接电通道。
3.根据权利要求2所述的输尿管镜尿道鞘，其特征在于，所述充气模块包括充气接口(5)、通气管(6)及气囊(7)；所述气囊(7)设置在尿道鞘壁(2)前端的环形空腔内，尿道鞘壁(2)前端外管上设有气囊扩张通道，气囊(7)压缩状态位于尿道鞘壁(2)环形空腔内，气囊(7)扩张状态从气囊扩张通道引出体外；所述通气管(6)内置于尿道鞘壁(2)的环形空腔，一端与气囊(7)相连，另一端从尿道鞘壁(2)引出与充气接口(5)相连。
4.根据权利要求2所述的输尿管镜尿道鞘，其特征在于，所述测压模块包括测压探头接口(8)、测压探头数据线(9)及测压探头(10)；所述测压探头(10)嵌入插入部(1)外壁，与外界物理接触，实现测压功能；所述测压探头数据线(9)内置于尿道鞘壁(2)的环形空腔，一端与测压探头(10)相连，另一端从尿道鞘壁(2)引出与测压探头接口(8)相连。
5.根据权利要求1所述的输尿管镜尿道鞘，其特征在于，所述可压缩伸缩管(4)为软性波纹管。
6.根据权利要求1所述的输尿管镜尿道鞘，其特征在于，所述可压缩伸缩管(4)采用波纹硅胶管。
7.根据权利要求1所述的输尿管镜尿道鞘，其特征在于，所述插入部(1)采用柔性医用硅胶管内加钢丝衬。
8.根据权利要求1所述的输尿管镜尿道鞘，其特征在于，所述插入部(1)呈空心子弹头状。
9.根据权利要求1所述的输尿管镜尿道鞘，其特征在于，所述充气接口(5)与充气装置连接的管道上设有压力计。
10.根据权利要求1-9任意一项所述的输尿管镜尿道鞘的使用方法，其特征在于，将输尿管镜尿道鞘插入到位，将充气接口(5)与充气装置相连接，对气囊(7)进行充气实现尿道鞘的固定，将测压模块与上位机连接，打开测压模块进行压力监测，将输尿管镜从输尿管镜插管(3)插入。
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| CN116269643A (zh) * | 2023-03-16 | 2023-06-23 | 杭州好克光电仪器有限公司 | 可测量腔内压力的灌流吸引装置及使用方法 |
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| CN116269643A (zh) * | 2023-03-16 | 2023-06-23 | 杭州好克光电仪器有限公司 | 可测量腔内压力的灌流吸引装置及使用方法 |
| CN116269643B (zh) * | 2023-03-16 | 2023-10-03 | 杭州好克光电仪器有限公司 | 可测量腔内压力的灌流吸引装置 |
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