CN111601627A - 用于排出硬膜下血肿的系统和方法 - Google Patents
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Abstract
在一个实施例中,一种用于排出硬膜下血肿的系统包括:入口,其被配置为被放置成与硬膜下腔流体连通;冲洗贮存器,其与入口流体连通并被配置为向入口和硬膜下腔供应冲洗流体;出口,其与入口分开,并也被配置为被放置成与硬膜下腔流体连通;以及泵,其与出口流体连通并被配置为在硬膜下腔内产生负压,并从硬膜下腔排空流体。
Description
相关申请的交叉引用
本申请要求2017年12月14日提交的序列号为62/599,644的共同未决的美国临时申请的优先权,该序列号为62/599,644的美国临时申请在此通过引用以其整体并入本文。
背景
硬膜下血肿是一种通常与创伤性脑损伤有关的血肿,其中血液聚集在硬脑膜和大脑之间。硬膜下血肿可能导致颅内压(ICP)升高,从而对脆弱的脑组织造成压迫和损伤。因此,硬膜下血肿通常会危及生命。
目前,急性硬膜下血肿通常通过以下方式来治疗:在颅骨中形成到达硬膜下腔的一个或更多个相对较大的钻孔,以使收集的液体和其他物质能够从该腔排出。近来,微创技术得到了发展,在这种技术中,小的颅内螺栓被拧入颅骨,进入硬膜下腔,以便能够进行引流。
虽然这些技术可能是有效的,但它们通常是无效的,且硬膜下血肿的复发也相对常见。有鉴于此,可以理解的是,希望有用于排出硬膜下血肿的替代系统和方法。
附图说明
参考下面的图,本发明可以被更好地理解。在所有附图中,匹配的附图标记表示相对应的部分,附图不一定按比例绘制。
图1是用于排出硬膜下血肿的系统的实施例的框图。
图2是图1中示出的计算机系统的实施例的框图。
详细描述
如上所述,希望有用于排出硬膜下血肿的替代系统和方法。本文公开了这样的系统和方法的示例。在一些实施例中,用于排出硬膜下血肿的系统包括入口和分开的出口(separate outlet),冲洗液体(例如盐水)可通过所述入口输送到硬膜下腔,液体和其他物质(例如凝块物质和/或硬膜下血肿的其他副产物)可通过所述分开的出口被排出。在一些实施例中,入口和出口均包括相对小直径的颅内螺栓,该颅内螺栓具有内部通道,流体和其他物质可以通过该内部通道。入口与包含冲洗流体的冲洗贮存器流体连通,以及出口与泵流体连通,该泵在硬膜下腔内产生负压以从该腔抽出液体和其他物质。在某些情况下,负压也可以有助于将大脑重新扩张回到以前被血肿占据的硬膜下腔。泵的操作可以用泵控制器来控制,该泵控制器从与入口和出口相关联的压力传感器接收压力信号,使得可以保持期望的负压水平,并且如果出现意外后果(例如系统10中的堵塞或泄漏),则可以关停泵。在一些实施例中,该系统还包括一个或更多个监测传感器,所述一个或更多个监测传感器可以用于识别被排出的流体的一个或更多个参数,例如被排出的流体的成分。可以使用在相关联的计算机系统上执行的一个或更多个适当的算法来分析所获取的数据。
在以下公开中,描述了多种具体实施例。应当理解的是,这些实施例是所公开发明的示例实现方式,并且替代实施例是可能的。所有这样的实施例都被视为落在本公开的范围内。
图1示出了用于排出硬膜下血肿的系统的示例实施例。在图1中,示出了患者12。更具体地,示出了当患者仰卧时患者头部12的一部分。在该局部视图中可见的是覆盖在患者颅骨16上的患者头皮14,以及显示为与颅骨接触的硬脑膜18。在硬脑膜18和大脑20之间是硬膜下腔22,该硬膜下腔22被假定为包含硬膜下血肿。因此,参考数字22可以被称为标识(identify)硬膜下腔和硬膜下血肿。
又如图1所示,穿过头部12形成了两个间隔开的开口,以提供通向硬膜下腔22的通路。这些开口包括入口开口24和出口开口26,入口开口24可以例如位于头部的下部位置,出口开口26可以例如位于头部的上部位置。在这种布置中,出口开口26可以高于入口开口24,以便于从硬膜下腔22移除气体(例如,空气)。在一些实施例中,开口24、26可以沿着头部12彼此间隔大约2至4英寸的距离。开口24、26可以以任何合适的方式形成。举例来说,开口24、26可以通过穿过头皮14做一个刺伤切口并用麻花钻钻穿颅骨16和硬脑膜18来形成。如果硬脑膜没有被所述钻打开,则硬脑膜可以穿过麻花钻孔被锋利地或钝性(sharply orbluntly)打开。
一旦开口24、26已经被形成,则颅内螺栓可以被设置在开口中。更具体地,入口颅内螺栓28可以拧入入口开口24,而出口颅内螺栓30可以拧入出口开口26。从图1可以理解,每个螺栓28、30包括可以咬入颅骨16的骨中的外螺纹32。此外,每个螺栓28、30包括内部通道34,流体和其他物质可以通过该内部通道34。通过这些通道34,每个螺栓28、30被放置成与硬膜下腔22流体连通。虽然颅内螺栓在图1中被示出并在本文中被描述,但是应当注意,在替代实施例中,可以形成常规的钻孔,并且钻孔盖用于将硬膜下导管固定就位。
进一步参考图1,入口歧管36连接到入口颅内螺栓28,以及出口歧管38连接到出口颅内螺栓30。这些歧管36、38使得螺栓28、30能够分别连接到入口管40和出口管42。入口管40还连接到冲洗贮存器44,且因此,将冲洗贮存器放置成与入口歧管36和入口颅内螺栓28流体连通。这样,包含在冲洗贮存器44中的冲洗流体,例如盐水,可以在重力或泵(未示出)的作用下流到入口颅内螺栓28并进入硬膜下腔22。注意,入口颅内螺栓28和入口歧管36可以一起被称为系统10的“入口”,而出口颅内螺栓30和出口歧管38可以一起被称为系统的“出口”。
出口管42还连接到泵46(例如蠕动泵),使得出口歧管38和出口颅内螺栓30被放置成与泵流体连通。泵46操作以经由出口颅内螺栓30和出口歧管38从硬膜下腔22抽取流体,以及在该腔内产生负压条件。在一些实施例中,泵46的操作由从系统10的压力传感器接收反馈的泵控制器48控制。在一些实施例中,压力传感器包括与入口相关联的入口压力传感器50和与出口相关联的出口压力传感器52。在图1的示例中,入口压力传感器50被设置在入口歧管36内,以及出口压力传感器52设置在出口歧管38内。不管它们的位置如何,入口压力传感器50和出口压力传感器52经由信号线54和56向泵控制器48提供压力信号,并且泵控制器可以响应这些信号调节泵46,以确保在硬膜下腔22内保持期望的负压。在一些实施例中,在手术过程中,硬膜下腔22内的压力被保持在大约-1至-8mmHg。如上所述,这种负压不仅有助于移除血肿中的流体和其他物质,而且还有助于重新扩张大脑20以填充硬膜下腔22。
当使用泵46从硬膜下腔22排出流体和其他物质时,该流体/物质可以被沉积在排放贮存器60中。该贮存器60可以包括观察镜或观察管(sight glass or tube)(未示出),通过该观察镜或观察管,系统的用户(例如,医生或医生助理)可以观察已经从硬膜下腔22被排出的流体/物质。此外,安全阀62可以与排放贮存器60相关联,以使气体(例如,空气)能够离开贮存器。又如图1所示,抗菌过滤器64可以被设置在排放贮存器60和安全阀62之间,以防止在气体排放期间污染封闭系统。
从上述讨论中可以理解,系统10是无菌的封闭系统,其中硬膜下血肿可以用冲洗流体代替,并且其中空气到硬膜下腔的引入可以完全或几乎被消除。防止空气到硬膜下腔的引入是很重要的,因为它可能与术后混乱(post-operative confusion)相关联,并可能使患者易于病理膜形成和/或慢性硬膜下血肿复发。
在一些实施例中,可以监测从硬膜下腔22排出的流体以确定其成分。此外,这种监测可以提供何时可以终止排出过程(即何时从硬膜下腔22排出的流体主要是冲洗流体)的指示。因此,系统10还可以包括一个或更多个监测传感器66。例如,一个这样的传感器58可以包括分光光度计,该分光光度计被配置成测量出口管42中的流体的光谱。这种测量可以向用户和系统10提供流体的成分的指示,包括流体是否包含气体(例如,空气)。可以提供其他传感器66来评估流体是否存在病理物质,例如血液、血液分解产物、蛋白质、核酸、或离子。
不管由一个或更多个监测传感器66收集的数据的性质如何,由传感器生成的信号可以被提供给数据采集单元68,数据采集单元68可以例如在信号被提供给计算机系统70之前放大和/或修改信号(例如,将信号从模拟信号转换成数字信号),计算机系统70包括被配置成分析信号的软件和/或固件。这样的分析可以包括分析由一个或更多个监测传感器测量的光谱,以向系统的用户提供排出过程结束的指示。在这种情况下,冲洗流体向硬膜下腔22的流动可以被停止,并且硬膜下腔22中的剩余流体可以使用泵46来被排出。在其他实施例中,计算机系统70可以被配置成自动关闭系统。还应注意,计算机系统70上的软件和/或固件可用于从泵控制器48接收压力数据并且也分析该数据。此外,在一些实施例中,计算机系统70可以被配置成控制泵控制器48的操作。
图2是计算系统70的示例实施例的框图。计算系统70通常包括均被连接到系统总线80的处理设备72、存储器74、用户接口76、和一个或更多个输入/输出(I/O)设备78。处理设备72可以例如包括能够执行存储在存储器74中的计算机可执行指令的中央处理单元(CPU)。存储器74可以包括易失性存储器元件(例如,RAM、闪存等)和非易失性存储元件(例如,硬盘、ROM等)中的任何一者或其组合。用户接口76可以包括能够将用户输入加入到计算设备70中的一个或更多个设备(例如键盘和鼠标)以及能够向用户传达信息的一个或更多个设备(例如显示器)。I/O设备78可以包括使得计算设备70能够与其他设备通信的部件(诸如网络适配器)。
存储器74(非暂时性计算机可读介质)存储包括操作系统82和流体分析程序84的软件应用(程序),流体分析程序84至少可用于分析从监测传感器66接收的数据,以提供被评估液体的成分的指示。又如图2中所示,存储器74还可以包括数据库86,在数据库86中可以存储这种分析的结果。
所公开的系统和方法是微创的,并且可以在手术室或床边被执行。现有技术不包括排出慢性硬膜下血肿的定量终点,而所公开的系统和方法提供了定量测量,使得临床医生能够知道硬膜下血肿是否已经完全排空,并且增加了时间窗以实现病理物质从硬膜下腔的完全清除。这可与常规成像(如计算机断层扫描)相结合,以估算在脑再扩张的情况下硬膜下血肿的完全排出。此外,所公开的系统和方法最小化或消除了气颅和张力性气颅及其相关的风险和所需的治疗。
现有技术依赖于被动的大脑再膨胀来恢复硬膜下腔,而所公开的系统和方法对硬膜下腔施加负压,这可以导致随着大脑再扩张而更快速地恢复硬膜下腔,这将导致改善由大脑压迫和/或刺激(irritation)引起的神经缺陷的恢复。此外,更快治愈慢性硬膜下血肿可能会降低因脑压迫或刺激引起的癫痫发作的风险。
作为进一步的问题,所公开的系统和方法将有可能降低早期进行深静脉血栓形成(DVT)化学预防(例如,皮下肝素)的风险。化学预防已被证明是复发的一个危险因素,且这可以通过持续引流由化学DVT预防产生的任何少量血液产物(blood products)来缓解。这有望降低DVT的风险。
可以对所公开的系统进行各种修改。例如,多个入口和/或出口颅内螺栓可用于具有混合密度的硬膜下血肿或者具有由一个或更多个膜分开的多于一个成分的硬膜下血肿(形成离散的血肿区域),如在混合密度硬膜下血肿的情况下。此外,该系统还可以包括用于打开硬脑膜以能够移除流体的工具。
Claims (20)
1.一种用于排出硬膜下血肿的系统,所述系统包括:
入口,所述入口被配置为被放置成与硬膜下腔流体连通;
冲洗贮存器,所述冲洗贮存器与所述入口流体连通并被配置为向所述入口和所述硬膜下腔供应冲洗流体;
出口,所述出口与所述入口分开,并且还被配置为被放置成与所述硬膜下腔流体连通;和
泵,所述泵与所述出口流体连通,并被配置为在所述硬膜下腔内产生负压,并从所述硬膜下腔排出流体。
2.根据权利要求1所述的系统,其中,所述入口包括第一颅内螺栓,以及所述出口包括第二颅内螺栓,每个颅内螺栓包括流体能够通过的内部通道。
3.根据权利要求2所述的系统,其中,所述入口还包括连接到所述第一颅内螺栓的入口歧管,以及所述出口还包括连接到所述第二颅内螺栓的出口歧管。
4.根据权利要求1所述的系统,其中,所述泵包括蠕动泵。
5.根据权利要求1所述的系统,还包括至少一个压力传感器,所述至少一个压力传感器被配置成测量在所述入口、所述出口、或所述硬膜下腔内的压力。
6.根据权利要求5所述的系统,其中,所述至少一个压力传感器包括与所述入口相关联的第一压力传感器和与所述出口相关联的第二压力传感器。
7.根据权利要求6所述的系统,其中,所述第一压力传感器被集成到所述入口中,并且所述第二压力传感器被集成到所述出口中。
8.根据权利要求5所述的系统,还包括泵控制器,所述泵控制器与所述至少一个压力传感器通信,并且被配置为响应于所测量的压力来控制所述泵的操作。
9.根据权利要求5所述的系统,还包括排放贮存器,通过所述至少一个泵从所述硬膜下腔排出的流体被收集在所述排放贮存器中。
10.根据权利要求1所述的系统,还包括与所述出口流体连通的监测传感器,所述监测传感器被配置为测量从所述硬膜下腔排出的流体的参数。
11.根据权利要求10所述的系统,其中,所述监测传感器包括分光光度计,所述分光光度计被配置为测量所述排出的流体的光谱。
12.根据权利要求11所述的系统,还包括被配置成分析由所述监测传感器测量的数据的计算机系统。
13.根据权利要求1所述的系统,其中,所述系统包括多个入口和多个出口,所述多个入口和多个出口被配置为与所述硬膜下腔流体连通。
14.一种用于排出硬膜下血肿的方法,所述方法包括:
在患者的颅骨中形成入口开口,以进入所述硬膜下血肿所位于的硬膜下腔;
在所述颅骨中形成与所述入口开口间隔开的进入所述硬膜下腔的出口开口;
穿过所述入口开口向所述硬膜下腔供应冲洗流体;和
同时用与所述出口开口相关联的泵向所述硬膜下腔施加负压并从所述硬膜下腔排出流体。
15.根据权利要求14所述的方法,还包括测量在所述硬膜下腔内的压力,并响应于所测量的压力控制所述负压。
16.根据权利要求15所述的方法,其中,施加负压包括将所述硬膜下腔保持在大约-1至-8mmHg的压力。
17.根据权利要求14所述的方法,还包括监测从所述硬膜下腔经由所述出口排出的流体。
18.根据权利要求17所述的方法,其中,监测所述流体包括用分光光度计监测所述流体。
19.根据权利要求18所述的方法,还包括分析由所述分光光度计收集的数据以确定所述流体的成分。
20.根据权利要求14所述的方法,包括在所述颅骨中形成多个入口开口和多个出口开口,以便进入混合密度的硬膜下血肿的不同区域。
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Citations (14)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5029584A (en) * | 1989-09-21 | 1991-07-09 | Cornelius Smith | Method and apparatus for measuring patient blood loss |
WO1997048425A2 (en) * | 1996-06-18 | 1997-12-24 | Paes Newton | Double lumen catheter for draining and irrigating of the intraventricular system and monitoring and controlling of the intracranial pressure |
US20030181824A1 (en) * | 2002-03-22 | 2003-09-25 | Odland Rick Mathew | System for treating tissue swelling |
US20040133149A1 (en) * | 2002-07-19 | 2004-07-08 | W.O.M. World Of Medicine Ag | Device for rinsing a body cavity |
US20040147871A1 (en) * | 2002-02-25 | 2004-07-29 | Burnett Daniel R. | Implantable fluid management system for the removal of excess fluid |
US20050043673A1 (en) * | 2003-08-22 | 2005-02-24 | Lieberman Daniel M. | Method and apparatus for irrigation and drainage of the brain's subdural space using a percutaneous approach |
US20050124943A1 (en) * | 2003-10-21 | 2005-06-09 | Lin-Hsue Yang | Medical bi-directional in-out switchable irrigation-drainage system for intracranial surgery |
US20060052737A1 (en) * | 2004-07-20 | 2006-03-09 | Medtronic, Inc. | Implantable cerebral spinal fluid drainage device and method of draining cerebral spinal fluid |
US20080033400A1 (en) * | 2005-08-02 | 2008-02-07 | Manfred Holper | Drainage system for cerebrospinal fluid |
US20110282263A1 (en) * | 2008-11-20 | 2011-11-17 | Branch Jr Charles L | Subdural Drainage Catheter with Flow Restoration Mechanism |
US20120053506A1 (en) * | 2010-08-26 | 2012-03-01 | New York University | Apparatus and Method for Periodic Fluid-Delivery/Fluid-Removal Cycles in the Cranial Subarchnoid Space to Treat Cerebral Cortical Disorders |
US20140330286A1 (en) * | 2013-04-25 | 2014-11-06 | Michael P. Wallace | Methods and Devices for Removing Obstructing Material From the Human Body |
US20140364821A1 (en) * | 2011-02-25 | 2014-12-11 | The Research Foundation For The State University Of New York | System and method for draining fluids |
US20150094644A1 (en) * | 2013-10-01 | 2015-04-02 | Md Start Sa | Systems and methods for moving and circulating fluid to treat alzheimer's disease |
-
2018
- 2018-12-14 JP JP2020532882A patent/JP2021506411A/ja active Pending
- 2018-12-14 AU AU2018385714A patent/AU2018385714A1/en not_active Abandoned
- 2018-12-14 CA CA3085776A patent/CA3085776A1/en active Pending
- 2018-12-14 WO PCT/US2018/065818 patent/WO2019118910A1/en unknown
- 2018-12-14 US US16/954,106 patent/US11865285B2/en active Active
- 2018-12-14 KR KR1020207019491A patent/KR20200100678A/ko not_active Application Discontinuation
- 2018-12-14 BR BR112020011994-6A patent/BR112020011994A2/pt unknown
- 2018-12-14 CN CN201880086685.2A patent/CN111601627A/zh active Pending
- 2018-12-14 EP EP18889473.7A patent/EP3723824A4/en active Pending
-
2020
- 2020-06-15 IL IL275403A patent/IL275403A/en unknown
-
2023
- 2023-12-21 US US18/393,045 patent/US20240115841A1/en active Pending
Patent Citations (14)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5029584A (en) * | 1989-09-21 | 1991-07-09 | Cornelius Smith | Method and apparatus for measuring patient blood loss |
WO1997048425A2 (en) * | 1996-06-18 | 1997-12-24 | Paes Newton | Double lumen catheter for draining and irrigating of the intraventricular system and monitoring and controlling of the intracranial pressure |
US20040147871A1 (en) * | 2002-02-25 | 2004-07-29 | Burnett Daniel R. | Implantable fluid management system for the removal of excess fluid |
US20030181824A1 (en) * | 2002-03-22 | 2003-09-25 | Odland Rick Mathew | System for treating tissue swelling |
US20040133149A1 (en) * | 2002-07-19 | 2004-07-08 | W.O.M. World Of Medicine Ag | Device for rinsing a body cavity |
US20050043673A1 (en) * | 2003-08-22 | 2005-02-24 | Lieberman Daniel M. | Method and apparatus for irrigation and drainage of the brain's subdural space using a percutaneous approach |
US20050124943A1 (en) * | 2003-10-21 | 2005-06-09 | Lin-Hsue Yang | Medical bi-directional in-out switchable irrigation-drainage system for intracranial surgery |
US20060052737A1 (en) * | 2004-07-20 | 2006-03-09 | Medtronic, Inc. | Implantable cerebral spinal fluid drainage device and method of draining cerebral spinal fluid |
US20080033400A1 (en) * | 2005-08-02 | 2008-02-07 | Manfred Holper | Drainage system for cerebrospinal fluid |
US20110282263A1 (en) * | 2008-11-20 | 2011-11-17 | Branch Jr Charles L | Subdural Drainage Catheter with Flow Restoration Mechanism |
US20120053506A1 (en) * | 2010-08-26 | 2012-03-01 | New York University | Apparatus and Method for Periodic Fluid-Delivery/Fluid-Removal Cycles in the Cranial Subarchnoid Space to Treat Cerebral Cortical Disorders |
US20140364821A1 (en) * | 2011-02-25 | 2014-12-11 | The Research Foundation For The State University Of New York | System and method for draining fluids |
US20140330286A1 (en) * | 2013-04-25 | 2014-11-06 | Michael P. Wallace | Methods and Devices for Removing Obstructing Material From the Human Body |
US20150094644A1 (en) * | 2013-10-01 | 2015-04-02 | Md Start Sa | Systems and methods for moving and circulating fluid to treat alzheimer's disease |
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US20200353134A1 (en) | 2020-11-12 |
JP2021506411A (ja) | 2021-02-22 |
IL275403A (en) | 2020-07-30 |
EP3723824A1 (en) | 2020-10-21 |
BR112020011994A2 (pt) | 2020-11-17 |
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