CN111588523A

CN111588523A - Support drainage device for correcting biliary stricture

Info

Publication number: CN111588523A
Application number: CN202010373995.1A
Authority: CN
Inventors: 王红梅; 刘晓飞; 李月敏; 李虎城
Original assignee: 8th Medical Center of PLA General Hospital
Current assignee: 8th Medical Center of PLA General Hospital
Priority date: 2020-05-06
Filing date: 2020-05-06
Publication date: 2020-08-28

Abstract

The invention discloses a biliary stricture correcting and supporting drainage device, which comprises an outer tube, wherein a drainage channel, an air injection channel and a guide wire channel are arranged in the outer tube, a columnar air bag is further fixed at a position close to the far end of the outer tube, the columnar air bag is sleeved on the outer tube and is arranged along the length direction of the outer tube, the columnar air bag is hermetically connected with the outer wall of the outer tube, the air injection channel is communicated with the columnar air bag, the drainage channel penetrates through the columnar air bag, and a drainage inlet and a drainage outlet which are communicated with the drainage channel are respectively formed at the outer sides of two ends of the columnar air bag. The invention can realize long-time continuous support of the biliary tract stenosis part, has controllable strength and adjustable position, realizes long-term and non-slip support, is convenient to take out of the patient body, and avoids the defect that the biliary tract stenosis part is permanently kept in the patient body or taken out in an operation.

Description

Support drainage device for correcting biliary stricture

Technical Field

The invention relates to the technical field of medical treatment, in particular to a biliary stricture correcting and supporting drainage device which is used for correcting and expanding and supporting a biliary stricture part for a long time so as to restore the normal diameter of a biliary tract and the normal function of bile circulation.

Background

Biliary stricture is the stenosis of bile duct caused by repeated attack of bile duct injury and cholangitis, or congenital stenosis of bile duct cavity, which can be stimulated by iatrogenic injury, abdominal trauma, gall stone, bile duct inflammation and the like to cause hyperplasia of fibrous tissues on the wall of the bile duct, thickening of the wall of the bile duct, and gradual narrowing of the inner cavity of the bile duct. The clinical manifestations include abdominal pain, chills, high fever, intermittent jaundice, etc. At present, two treatment methods are generally adopted for the position of biliary tract stenosis, firstly, the scar lesion of the stenosis is removed, and the biliary tract is repaired and reconstructed in an operation mode, so that the biliary tract realizes the function of normally supplying bile; the other method is to expand the biliary stricture part and then put in the stent, and because the biliary stricture part is put in the affected part by means of a gastroscope or a duodenoscope, the biliary stricture support in the method can not support the affected part for a long time, and restenosis can occur along with the taking out of the stent. If the long-term support is realized, a metal bracket is required to be used, the metal bracket is always kept in the body of the patient and cannot be taken out, and if the metal bracket is taken out, the operation is required; if the patient becomes stenotic after taking out the stent, the stent needs to be put in again, which brings pain to the patient and burden of medical expenses. Metal stents are therefore principally only suitable for patients who cannot be operated and whose survival is to be expected to be around 12 months, and the placement of metal stents is principally not permitted for benign stenosis.

In order to avoid the retraction of the biliary tract after simple expansion or stent removal, the stricture portion needs to be supported for a long time to correct the stricture and restore the original function.

Chinese patent document CN 201611261267.1 discloses a leak-proof device for use after rectal anastomosis, which is characterized in that a balloon and a drainage tube are placed in the intestinal tract, the drainage tube is communicated to the outside of the body, the balloon is inflated to block the intestinal tract, so as to prevent the excrement from contacting with the anastomosis opening, and the drainage tube is used to suck the excrement out of the body to be healed and taken out. The balloon inflation mode is difficult to retain at the anastomotic opening for a long time, is easy to slide and the like, and is not beneficial to healing of the anastomotic opening.

Chinese patent document CN 110192932 discloses a degradable intestinal stent for rectal anastomotic stoma protection, which comprises an intestinal degradable support, anastomotic stoma protection sleeves with openings at two ends, a fixed support and a degradable suture of the protection sleeves; when the stent is in service, the stent is arranged at the front end of the anastomotic stoma by 5-10 cm and is completely arranged in the rectum, no hard part is exposed outside the body through the anus, the degradable support piece exerts circumferential support force on the inner wall of the intestinal tract and is tightly attached to the intestinal tract, and the two protective sleeves are made of magnesium-zinc alloy wires and are tightly attached to the intestinal wall at the fixed position and completely cover the anastomotic stoma. Although the above documents can avoid the injury of the secondary operation, the stent is always kept in the body, cannot be taken out, and is complicated to install.

Disclosure of Invention

In order to solve the technical problems, the invention provides a device which can correct biliary stricture and can support and drain for a long time at the same time, can realize long-time continuous support of biliary stricture parts, has controllable strength and adjustable position, realizes long-time and non-slip support, is convenient to take out of a patient body, and avoids the defect that the biliary stricture parts are permanently kept in the patient body or taken out in an operation.

The invention adopts the following technical scheme:

the utility model provides a correct biliary tract stenosis and support drainage device, the device includes an outer tube, the outer tube is inside to be equipped with drainage channel, gas injection passageway and seal wire channel, is being close to the position of outer tube distal end still fixes a column gasbag, column gasbag cover is arranged in on the outer tube, and along the length direction of outer tube sets up, the column gasbag with the outer wall of outer tube is sealing connection, the gas injection passageway with the column gasbag is linked together, drainage channel runs through the column gasbag, and the both ends outside of column gasbag form respectively with the drainage import and the drainage export that drainage channel is linked together.

Preferably, one end of the drainage channel extends out of the columnar balloon and is led out from the distal end of the outer tube to form the drainage outlet.

Further preferably, the drainage outlet is of equal diameter and remains straight through to the drainage channel.

And a side drainage outlet communicated with the drainage channel is further arranged on the side surface of the outer tube, which is close to the drainage outlet and positioned outside the columnar air bag.

The drainage inlet is provided with 3-5 drainage inlets, the aperture of each drainage inlet is 0.8-1.5 mm, and the diameter of each drainage inlet is preferably 1 mm.

The far end of outer tube is a taper structure, seal wire channel and drainage channel stretch out respectively the far end of outer tube.

The diameter of the columnar air bag formed after air injection is 6-10 mm, and the diameter of the drainage channel is 5-8.5 Fr; the guide wire channel can be used for a guide wire with the diameter of 0.035inch to pass through.

The outer diameter of the outer pipe is 8.5-12 Fr, and the air pressure borne by the columnar air bag is 0.8-1.2 MPa.

The technical scheme of the invention has the following advantages:

the invention sets a column air sac near the far end of the outer tube, the column air sac is sleeved on the outer tube, and supplies air to the column air sac through an air injection channel in the outer tube, the air pressure can reach 12 atmospheric pressures, the column air sac expands the narrow part of the biliary tract after being propped up, so that the narrow part of the biliary tract gradually recovers to the original size, bile in the biliary tract can be conveyed through a drainage channel in the outer tube, and the purposes of completely eliminating the stenosis and fully draining the bile can be achieved. The outer tube here can reach narrow department through percutaneous puncture method and carry out the expansion, the column gasbag can be arranged in the patient for a long time in, can realize taking out fast after deflating to the column gasbag, can not cause the injury to the patient, the column gasbag here is owing to have suitable sufficient atmospheric pressure, the column gasbag is closely laminated with the biliary tract wall realization atmospheric pressure completely, attached narrow position realizes long-term support and difficult emergence and slides, be favorable to correcting the narrow position of biliary tract for a long time, flexible column gasbag has solved the biliary tract stenosis and has corrected and bile drainage problem.

Drawings

In order to more clearly illustrate the embodiments of the present invention, the drawings which are needed to be used in the embodiments will be briefly described below, and it is apparent that the drawings in the following description are some embodiments of the present invention, and other drawings can be obtained from the drawings without inventive labor to those skilled in the art.

FIG. 1 is a longitudinal cross-sectional view of a supporting drainage device provided by the present invention;

FIG. 2 is a schematic sectional view taken along line A-A of FIG. 1;

FIG. 3 is a schematic structural view of the biliary stricture site before supporting and draining;

fig. 4 is a schematic structural view of the biliary stricture portion after supporting and draining.

Description of reference numerals:

1-an outer tube; 2-drainage channel, 21-drainage inlet, 22-drainage outlet and 23-side drainage outlet; 3-a gas injection channel; 4-a guide wire channel; 5-a columnar air bag; 6-stenosis; 7-biliary tract wall.

Detailed Description

The technical solutions of the present invention will be described clearly and completely with reference to the accompanying drawings, and it should be understood that the described embodiments are some, but not all embodiments of the present invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments of the present invention without making any creative effort, shall fall within the protection scope of the present invention.

As shown in fig. 1 and 2, the invention provides a biliary stricture supporting and drainage device, which comprises an outer tube 1, a drainage channel 2, an air injection channel 3 and a guide wire channel 4 are arranged inside the outer tube 1, the outer tube is a solid tube, each channel is formed in the outer tube, a columnar air bag 5 is further fixed at a position close to the far end of the outer tube 1, the columnar air bag 5 is sleeved on the outer tube 1 and arranged along the length direction of the outer tube 1, the columnar air bag 5 is hermetically connected with the outer wall of the outer tube 1, the air injection channel 3 is communicated with the columnar air bag 5, a drainage inlet 21 and a drainage outlet 22 which are communicated with the drainage channel 2 are arranged on the outer tube 1 outside the two ends of the columnar air bag 5, and preferably, one end of the drainage channel 2 extends out of the columnar air bag 5 and is led out from the far end of the outer tube 1 to form the. The columnar air bag 5 is of an elastic structure, the air pressure borne by the columnar air bag 5 is 0.8-1.2 MPa, the air injection pressure in the columnar air bag 5 can be adjusted according to actual conditions, when air is injected into the columnar air bag 5 through the air injection channel 3, the elastic columnar air bag 5 forms a columnar surface which is completely and hermetically attached to the inner wall of the biliary tract, slippage does not occur, the correction effect on the inner wall of the biliary tract is generated after long-term support, any infection on a wound cannot be generated, meanwhile, the two ends of a narrow part can be communicated, smooth conveying of bile is achieved, the outer tube can directly enter the biliary tract through a percutaneous puncture mode, when the affected part needs to be expanded for a long time, air can be injected into the columnar air bag according to specific conditions of the affected part, and complete attachment is achieved. When the air bag needs to be taken out, the air bag only needs to discharge the air in the columnar air bag, and is quick and convenient.

The distal end of the outer tube 1 is a tapered structure, which facilitates the shuttle in the biliary tract, as shown in fig. 1, the guide wire channel 4 and the drainage channel 2 respectively extend out of the distal end of the outer tube 1, and the drainage inlet 21 is located at the end of the outer tube 1. Meanwhile, a side drainage outlet 23 is arranged on the side wall of the outer tube 1 close to the far end of the columnar air bag 5, so that the bile drainage efficiency is improved.

The diameter of the drainage channel 2 is 5-8.5 Fr; the diameter of the columnar air bag 5 is 6-10 mm; the guide wire channel 4 can penetrate through the guide wire with the diameter of 0.035inch to pass through, and the large-diameter drainage channel can realize smooth conduction of the bile.

According to the invention, the columnar air bag 5 is arranged at the far end of the outer tube 1, the columnar air bag 5 can be completely attached to the biliary tract wall 7, and the columnar air bag 5 has enough attaching surface, so that the columnar air bag 5 is not easy to slide when an affected part is expanded, and the flexible columnar air bag 5 solves the problems of biliary tract stenosis and bile drainage.

In order to smooth the bile transportation, the present invention preferably maintains the cross-sectional area of the drainage outlet 22 to be identical to the cross-sectional area of the drainage channel 2. Certainly, the side drainage outlet 23 is also arranged on the side wall of the outer tube 1, which is more beneficial to dredging the bile.

As shown in figure 1, 3-5 drainage inlets 21 are preferably arranged on the side wall of the outer pipe, the aperture of each drainage inlet is 0.8-1.5 mm, and the diameter of each drainage inlet is preferably 1mm, so that bile can smoothly enter the drainage channel 2 from the drainage inlets 21 and then is discharged from a drainage outlet and/or a side drainage outlet at the far end.

As shown in figure 3, the invention is inserted into the narrow part 6, so that the biliary tract narrow part 6 is positioned in the middle of the columnar air bag 5, gas is injected into the columnar air bag 5 through the gas injection channel 3 from the outside, as shown in figure 4, the biliary tract narrow part 6 is gradually restored to the state before biliary tract lesion through the continuous expansion of the supporting and drainage device, bile in the biliary tract flows as shown by arrows in figure 4, enters the drainage channel 2 from the biliary tract through the drainage inlet 21 and the side drainage inlet 22, then enters the biliary tract after being output from the drainage outlet 22, so that the normal circulation of the bile is realized, meanwhile, the infection risk at the surgical anastomotic site is avoided, the long-time continuous flexible support on the biliary tract narrow part is realized, the support strength is controllable, the guide wire movement is controlled after the pressure of the columnar air bag is released, the position of the columnar air bag is conveniently adjustable, and the long-time continuous flexible support on the biliary tract narrow part can be realized, Has no sliding support, is convenient to be taken out from the body of the patient, and avoids the defect that the medical instrument is permanently kept in the body of the patient or taken out in an operation.

It should be understood that the above examples are only for clarity of illustration and are not intended to limit the embodiments. Other variations and modifications will be apparent to persons skilled in the art in light of the above description. And are neither required nor exhaustive of all embodiments. And obvious variations or modifications therefrom are intended to be within the scope of the invention.

Claims

1. A biliary stricture correcting and supporting drainage device, characterized in that it comprises an outer tube (1), a drainage channel (2), an air injection channel (3) and a guide wire channel (4) are arranged in the outer tube (1), a columnar air bag (5) is fixed at a position close to the far end of the outer tube (1), the columnar air bag (5) is sleeved on the outer tube (1), and is arranged along the length direction of the outer tube (1), the columnar air bag (5) is hermetically connected with the outer wall of the outer tube (1), the gas injection channel (3) is communicated with the columnar air bag (5), the drainage channel (2) penetrates through the columnar air bag (5), and a drainage inlet (21) and a drainage outlet (22) which are communicated with the drainage channel (2) are respectively formed at the outer sides of the two ends of the columnar air bag (5).

2. The biliary stricture correcting and supporting drainage device according to claim 1, wherein one end of the drainage channel (2) extends out of the cylindrical balloon (5) and is guided out of the distal end of the outer tube (1) to form the drainage port (22).

3. The correcting and supporting drainage device according to claim 2, characterized in that said drainage outlet (22) is of equal diameter and remains straight through with said drainage channel (2).

4. The biliary stricture correcting and supporting drainage device according to claim 3, wherein a lateral drainage port (23) communicating with the drainage channel (2) is further provided on the side of the outer tube (1) adjacent to the drainage port (22) and outside the cylindrical balloon (5).

5. The biliary stricture correcting and supporting drainage device according to any one of claims 1 to 4, wherein the number of the drainage inlets (21) is 3 to 5, and the diameter of each drainage inlet (21) is 0.8 to 1.5 mm.

6. The biliary stricture correction and drainage device according to claim 5, wherein the distal end of the outer tube (1) is a tapered structure, and the guide wire channel (4) and the drainage channel (2) respectively extend out of the distal end of the outer tube (1).

7. The biliary stricture correcting and supporting drainage device according to claim 1, wherein the columnar balloon (5) has a diameter of 6-10 mm after gas injection, and the drainage channel (2) has a diameter of 5-8.5 Fr; the guide wire channel (4) can be used for a guide wire with the diameter of 0.035inch to pass through.

8. The biliary stricture correcting and supporting drainage device according to claim 7, wherein the outer diameter of the outer tube (1) is 8.5-12 Fr, and the pressure of the air borne by the cylindrical balloon (5) is 0.8-1.2 MPa.