CN112022699A

CN112022699A - Reagent bottle of peritoneal dialysis chest abdomen developer

Info

Publication number: CN112022699A
Application number: CN202011042181.6A
Authority: CN
Inventors: 吕晶; 耿瀛洲; 马莹; 王晓培; 杨亚丽; 梁嫦娜; 靳引红; 毋欣桐; 钱宝; 李昭
Original assignee: First Affiliated Hospital of Medical College of Xian Jiaotong University
Current assignee: First Affiliated Hospital of Medical College of Xian Jiaotong University
Priority date: 2020-09-28
Filing date: 2020-09-28
Publication date: 2020-12-04
Anticipated expiration: 2040-09-28
Also published as: CN112022699B

Abstract

The invention discloses a reagent bottle of a peritoneal dialysis thoracoabdominal imaging agent, which comprises an upper shell, a connecting piece and a lower shell, wherein the lower end of the upper shell is provided with a first tapered abutting surface in a tapered shape, the upper end of the lower shell is provided with a second tapered abutting surface in a tapered shape, and the second tapered abutting surface is limited by the connecting piece and abuts against the first tapered abutting surface; the peritoneal dialysis device comprises a lower shell and an upper shell, and is characterized in that a moving rod is arranged in an inner cavity of the lower shell, a first stop block is arranged at the upper end of the moving rod, a second stop block is arranged at the lower end of the moving rod, a compression spring is further arranged on the moving rod and located between the second stop block and a second conical abutting surface, a diaphragm is arranged in the inner cavity of the upper shell, a plug body is arranged at an upper port of the upper shell, an upper cavity is formed between the diaphragm and the plug body, a liquid for sterilization and injection is filled in the upper cavity, a lower cavity is formed between the diaphragm and the first stop block, and peritoneal dialysis breast and abdomen imaging powder is.

Description

Reagent bottle of peritoneal dialysis chest abdomen developer

Technical Field

The invention relates to the field of peritoneal dialysis, in particular to a reagent bottle of a peritoneal dialysis chest and abdomen imaging agent.

Background

Peritoneal dialysis is an effective alternative mode for end-stage renal disease, and is characterized in that peritoneal dialysis solution is filled into an abdominal cavity through a peritoneal dialysis catheter by utilizing the characteristic that the peritoneal membrane is used as a semi-permeable membrane, and solute on the high-concentration side moves to the low-concentration side due to the concentration gradient difference of the solute on the two sides of the peritoneal membrane (diffusion effect); the water moves from the hypotonic side to the hypertonic side (osmosis). The peritoneal dialysis solution is continuously replaced to achieve the purposes of removing in vivo metabolites and toxic substances and correcting water and electrolyte balance disorder.

Thoraco-abdominal fistula and peritoneal leakage are one of the mechanical complications of peritoneal dialysis, and are seen in patients with weak abdominal wall, inguinal hernia and malnutrition after peritoneal dialysis catheterization. Mild abdominal wall leakage is often not easily discovered, while persistent and severe abdominal wall leakage can lead to reduced ultrafiltration volume, abdominal wall edema, and even leakage orifices that are not readily healed, and therefore early diagnosis, accurate positioning, and repair are critical to the ultimate complete healing and successful peritoneal dialysis. However, there is no reliable means to define the leakage orifice of the abdominal wall, which may lead to serious clinical symptoms by delaying the start time of dialysis, and if the leakage orifice cannot heal by itself, the leakage orifice may lead to the withdrawal of peritoneal dialysis and the change to hemodialysis treatment. Thoracoabdominal fistula is also a common complication of peritoneal dialysis, can cause a large amount of pleural effusion on the left side, and is an important reason for causing the failure of peritoneal dialysis technique to turn into hemodialysis due to repeated chest distress, short breath, cough and even incapability of lying down. The diagnosis of thoraco-abdominal fistulas is difficult. The diagnosis of the previous thoraco-abdominal fistula is established by adding methylene blue to the peritoneal dialysis solution, or by extracting the pleural effusion with a contrast agent, for example, to appear blue, or by the presence of a contrast agent component. However, after the melan enters the thoracic cavity from the abdominal cavity, the melan is difficult to distinguish by naked eyes, and the contrast agent has large irritation to the peritoneum and cannot be tolerated by many patients.

Indocyanine green (ICG) is a novel fluorescent body internal dye, and is characterized in that indocyanine green (ICG) is quickly removed from blood flow, is taken by liver dirt, is excreted into bile, has no enterohepatic circulation, and is not absorbed by other tissues, so that the indocyanine green (ICG) is used for checking liver functions and effective blood flow of liver, and judging the severity of liver diseases. On the other hand, the solar cell can absorb laser and efficiently convert light energy into heat energy, and is an ideal photothermal preparation for inducing breast cancer photothermal therapy.

In the diagnosis of abdominal wall leakage, the fluorescence imaging characteristic of indocyanine green is utilized, and a fluorescence imaging instrument is combined to irrigate abdominal cavity with indocyanine green mixed abdominal liquid, so that the abdominal wall is detected in real time, the first brightened part is the laceration, and the size of the laceration can be judged according to the fluorescence imaging time and the brightening range. Not only the location is accurate, but also it is non-invasive, convenient and reliable. And can be used for identifying inguinal hernia and providing basis for operation mode.

The indocyanine green is used as an imaging agent for safely and effectively imaging peritoneal dialysis thoracoabdominal fistula and abdominal wall leakage. Indocyanine green is powdery, and when the indocyanine green injection preparation is used, the indocyanine green powder 40mg needs to be prepared by 10ml of injection water, so that the imaging concentration is difficult to master, and the operation process is complex.

Disclosure of Invention

Aiming at the technical problems, the invention provides the reagent bottle for the peritoneal dialysis thoracoabdominal imaging agent, which integrates injection and indocyanine green powder on one structure, is additionally provided with a needle tube, does not need to use other needle tubes, and has the advantages of reasonable design, compact structure and good sealing property.

The technical scheme adopted by the invention is as follows:

a reagent bottle of peritoneal dialysis chest and abdomen developer,

the reagent bottle comprises an upper shell, a connecting piece and a lower shell which are sequentially arranged from top to bottom, wherein the lower end of the upper shell is provided with a first tapered abutting surface in a tapered shape, and the diameter of the first tapered abutting surface is increased towards the lower end part of the upper shell; the upper end of the lower housing is provided with a second tapered abutting surface of a tapered shape, the diameter of which is reduced toward the upper end portion of the lower housing, the second tapered abutting surface being restrained by a connecting member to abut on the first tapered abutting surface; the peritoneal dialysis machine comprises a lower shell, and is characterized in that a moving rod is arranged in an inner cavity of the lower shell, a first stop block is arranged at the upper end of the moving rod, the first stop block is positioned in an inner cavity of the upper shell and positioned at the upper end of a first conical abutting surface, a second stop block is arranged at the lower end of the moving rod, a compression spring is further arranged on the moving rod, the compression spring is positioned between the second stop block and a second conical abutting surface, a diaphragm is arranged in the inner cavity of the upper shell, a plug body is arranged at an upper port of the upper shell, an upper cavity is formed between the diaphragm and the plug body, a liquid for sterilization and injection is filled in the upper cavity, a lower cavity is formed between the diaphragm and the first stop block, and peritoneal dialysis.

Preferably, a plurality of puncture needles are arranged on the first stop block, the puncture needles are positioned on the surface facing the diaphragm, and the first stop block can move up and down in the inner cavity of the upper shell.

Preferably, the connecting piece is including the connecting cylinder that has the perforating hole, the lower extreme of the inner wall of connecting cylinder is provided with the convex surface that extends to the center pin, the convex surface inboard is provided with the first toper contact surface of convergent shape, be provided with on the casing down and keep off the ring along its radial, keep off the ring and be located the convex surface upper end, the lower extreme that keeps off the ring is provided with the second toper contact surface with first toper contact surface matched with, be provided with on the lateral wall of connecting cylinder along its radial arc and separate the dog, the arc separates the dog and runs through the connecting cylinder lateral wall and extend to the through hole inside, the arc separates the interior tip of dog and is located between the lower terminal surface and the convex surface of casing.

Preferably, the upper end of the inner wall of the connecting cylinder is provided with an internal thread section, and the side wall of the lower shell is provided with an external thread section matched with the internal thread.

Preferably, the outer side wall of the arc-shaped baffle block is provided with two flexible belts, the two flexible belts are respectively positioned on two sides of the arc-shaped baffle block, and the two flexible belts are arranged around the outer wall of the connecting cylinder.

Preferably, the cock body is including setting up in the inside sealing of last casing to and be located the needle file of casing upper end, be provided with the needle tubing on the needle file, the needle tubing downwardly extending is to the inside and be close to terminal surface down of sealing, the outside of needle tubing is provided with flexible protective sheath, the lower extreme of flexible protective sheath is provided with along its radial flexible fixture block, flexible fixture block with draw-in groove on the needle file inlays establishes the cooperation.

Preferably, the lower end of the lower shell is provided with a bottom cover, the upper end of the bottom cover is provided with a sealing block extending to the inner cavity of the lower shell, and the sealing block is in contact with the second stopper.

The invention has the beneficial effects that: the reagent bottle of the peritoneal dialysis thoracoabdominal imaging agent comprises an upper shell, a connecting piece and a lower shell which are sequentially arranged from top to bottom, wherein a diaphragm in the upper shell is divided into an upper chamber and a lower chamber, a sterilization injection liquid is filled in the upper chamber, and peritoneal dialysis thoracoabdominal imaging powder is filled in the lower chamber; the internal carriage release device comprises a lower shell, wherein a movable rod is arranged in the lower shell, a first stop block is arranged at the upper end of the movable rod, the first stop block is positioned in an inner cavity of the upper shell and positioned at the upper end of a first conical abutment surface, a second stop block is arranged at the lower end of the movable rod, a compression spring is further arranged on the movable rod and positioned between the second stop block and a second conical abutment surface, the stop block is separated from an arc during use, at the moment, the upper end of the lower shell moves towards the upper shell, the first stop block moves upwards to extrude a diaphragm to be damaged, liquid for sterilization injection is mixed with peritoneal dialysis breast and abdomen development powder, a bottle body is slightly shaken, and the dissolving speed of the peritoneal dialysis breast. Secondly, be provided with the cock body at the last port of last casing, the cock body is including setting up in the inside sealing of last casing to and be located the needle file of casing upper end, be provided with the needle tubing on the needle file, the outside of needle tubing is provided with flexible protective sheath, the lower extreme of flexible protective sheath is provided with along its radial flexible fixture block, the needle tubing downwardly extending to the sealing inside and be close to terminal surface down, treat that peritoneal dialysis chest abdomen video picture powder dissolves the back completely, with the needle tubing downstream, wear to break the sealing lower extreme and communicate with each other with the last casing inner chamber, promote the carriage release lever, can inject peritoneal dialysis chest abdomen video picture agent into the peritoneal dialysis liquid through adding the medicine hole. Structural design is reasonable, and with needle tubing, the liquid for sterilization injection and peritoneal dialysis thorax abdomen video picture powder integration in a structure, convenient to use, and the leakproofness is good, has ensured the accuracy of peritoneal dialysis indocyanine green concentration and the security before the use in stomach wall seepage and thorax abdomen fistula diagnosis.

Drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to the drawings without creative efforts.

FIG. 1 is a schematic structural diagram of a reagent bottle of a peritoneal dialysis thoracoabdominal imaging agent according to the present invention;

FIG. 2 is a sectional view showing a coupling manner of an upper case and a lower case;

FIG. 3 is a cross-sectional view of the upper housing;

FIG. 4 is a cross-sectional view of the lower housing;

FIG. 5 is a cross-sectional view of the connector barrel;

FIG. 6 is a cross-sectional view of the manner in which the upper housing and plug body are connected;

figure 7 is a schematic view of a plug body.

Wherein, 1-bottom cover; 2-a lower shell; 3-connecting the cylinder; 4-an upper shell; 5-a plug body; 501-sealing part; 502-a needle seat; 503-card slot; 6-needle tube; 7-a flexible protective sheath; 8-arc separating blocks; 9-a flexible band; 10-a second stop; 11-a compression spring; 12-arc separating blocks; 13-a moving rod; 14-a first stop; 15-a membrane; 16-a first tapered abutment surface; 17-a second tapered abutment surface; 18-a baffle ring; 19-peritoneal dialysis thoracoabdominal imaging powder; 20-peritoneal dialysis thoracoabdominal imaging powder; 21-external thread; 22-a needle; 23-a first conical contact surface; 24-a second tapered contact surface; 25-convexity; 26-flexible latch.

Detailed Description

In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, but not all, embodiments of the present invention. The components of embodiments of the present invention generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.

Thus, the following detailed description of the embodiments of the present invention, presented in the figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

The above description is only for the purpose of illustrating the technical solutions of the present invention and not for the purpose of limiting the same, and other modifications or equivalent substitutions made by those skilled in the art to the technical solutions of the present invention should be covered within the scope of the claims of the present invention without departing from the spirit and scope of the technical solutions of the present invention.

The invention specifically provides a reagent bottle of a peritoneal dialysis thoracoabdominal imaging agent, which comprises an upper shell 4, a connecting piece 3 and a lower shell 2 which are sequentially arranged from top to bottom as shown in figure 1.

Specifically, as shown in fig. 2 to 4, the lower end of the upper housing 4 is provided with a first tapered abutment surface 16 having a tapered shape, and the diameter of the first tapered abutment surface 16 increases toward the lower end of the upper housing 4; the upper end of the lower case 2 is provided with a tapered second tapered abutment surface 17, the diameter of the second tapered abutment surface 17 is reduced toward the upper end portion of the lower case 2, and the second tapered abutment surface 17 is restrained by a connecting member to abut on the first tapered abutment surface 16.

A moving rod 13 is arranged in the inner cavity of the lower shell 2, a first stopper 14 is arranged at the upper end of the moving rod 13, the first stopper 14 is positioned in the inner cavity of the upper shell 4 and positioned at the upper end of a first conical abutting surface 16, a second stopper 10 is arranged at the lower end of the moving rod 13, a compression spring 11 is further arranged on the moving rod 13, the compression spring 11 is positioned between the second stopper 10 and a second conical abutting surface 17, a diaphragm 15 is arranged in the inner cavity of the upper shell 4, a plug body 5 is arranged at the upper port of the upper shell 4, an upper cavity is formed between the diaphragm 15 and the plug body 5, sterile injection liquid is filled in the upper cavity, a lower cavity is formed between the diaphragm 15 and the first stopper 14, and peritoneal dialysis breast and abdomen imaging powder is filled in the lower cavity; the lower end of the lower shell 2 is provided with a bottom cover 1, the upper end of the bottom cover 1 is provided with a sealing block extending to the inner cavity of the lower shell 2, and the sealing block is in contact with the second stop block 10.

In this embodiment, the first stopper 14 is located in the upper casing 4 and above the first tapered abutment surface 16, and the diameter of the first stopper 14 is the same as the diameter of the inner cavity of the upper casing 4, so that when the first stopper 14 can move along the inner cavity of the upper casing 4, the first stopper 14 and the inner wall of the lower casing 2 can be kept sealed, and the peritoneal dialysis powder or the mixture of the peritoneal dialysis powder and the sterile injection solution above the first stopper 14 can be prevented from overflowing from the periphery of the barrier side of the priming coat. Therefore, the first block 14 is made of a middle-hardness polyester material or medical plastic, and a rim silicone material by extrusion molding.

As shown in FIG. 4, a plurality of needles 22 are arranged on the first block 14, a plurality of needles 22 are arranged on the surface facing the diaphragm 15, and the first block 14 can move up and down in the inner cavity of the upper shell 4. When the peritoneal dialysis device is used, a medical worker pushes the lower shell 2, at the moment, the second conical abutting surface 17 moves towards the inner cavity of the upper shell 4 along the first conical abutting surface 16 until the puncture needle 22 punctures the diaphragm 15, the sterilization injection liquid meets the peritoneal dialysis breast and abdomen development powder, at the moment, the baffle ring 18 clamps the lower end face of the upper shell 4, the lower shell 2 stops moving upwards, and the medical worker slightly shakes the bottle body to fully mix the peritoneal dialysis breast and abdomen development powder with the sterilization injection liquid, so that the dissolution of the peritoneal dialysis breast and abdomen development powder is accelerated. Then, the medical staff removes the knob of the bottom cover 1, and presses the second stopper 10 manually or by means of tweezers or other auxiliary tools, so that the second stopper 10 continues to move upwards along the inner wall of the upper shell 4.

As shown in fig. 5, the connecting member includes a connecting cylinder 3 having a through hole, a convex surface 25 extending toward a central axis is provided at a lower end of an inner wall of the connecting cylinder 3, a first tapered contact surface 23 having a tapered shape is provided inside the convex surface 25, a stopper ring 18 is provided on the lower housing 2 along a radial direction thereof, the stopper ring 18 is located at an upper end of the convex surface 25, a second tapered contact surface 24 matching with the first tapered contact surface 23 is provided at a lower end of the stopper ring 18, an arc-shaped stopper 8 is provided on a side wall of the connecting cylinder 3 along the radial direction thereof, the arc-shaped stopper 8 penetrates through the side wall of the connecting cylinder 3 and extends into the through hole, and an inner end of the arc-shaped stopper 8 is located between a lower end surface of the upper housing 4 and the convex surface; the lateral wall that the arc separates dog 8 is provided with flexible area 9, flexible area 9 is provided with two and is located the arc respectively and separates the both sides of dog 8, two flexible area 8 arranges around connecting cylinder 3 outer wall.

The connecting cylinder 3 is used as a structure for connecting the upper shell 4 and the lower shell 2, the stability of the connection between the upper shell 4 and the lower shell 2 is ensured, the upper end of the connecting cylinder 3 is connected with the lower end of the upper shell 4 through threads, the upper end of the lower shell 2 is embedded and clamped in the connecting cylinder 3, the baffle ring 18 on the side wall of the lower shell 2 is clamped on the convex surface 25 of the inner wall of the connecting cylinder 3, so as to limit the downward movement of the lower shell 2, thus maintaining the first tapered abutment surface 16 and the second tapered abutment surface 17 in a state of always being in abutment, in order to avoid the lower shell 2 being urged by an external force to move towards the inner cavity of the upper shell 4, the side wall of the connecting cylinder 3 is provided with an arc-shaped baffle block 8, the inner end surface of the arc-shaped baffle block 8 is an inclined plane, and engages the second tapered abutment surface 17 between the stopper ring 18 and the lower end surface of the upper housing 4, thereby inhibiting the lower housing 2 from moving toward the upper housing inner cavity. When in use, medical staff takes off the arc-shaped baffle block 8 through the flexible belt 9 and pushes the lower shell 2 to move upwards.

As shown in fig. 6 and 7, the stopper body 5 includes a sealing portion 502 disposed inside the upper housing 4 and a needle seat 501 disposed at the upper end of the upper housing 4, a needle tube 6 is disposed on the needle seat, the needle tube 6 extends downward into the sealing portion 502 and is close to the lower end face, a flexible protection sleeve 7 is disposed outside the needle tube 6, a flexible fixture block 26 along the radial direction of the flexible protection sleeve 7 is disposed at the lower end of the flexible protection sleeve 7, and the flexible fixture block 26 is fitted with a clamping groove 503 on the needle seat 501.

In this embodiment, the plug body 5 is made of medical silica gel or polyester material and has a certain flexibility, the needle tube 6 is already arranged on the needle seat 501 during production, the needle tube 6 extends downwards into the sealing portion 502 and is close to the lower end face, and does not penetrate through the sealing portion 502, the lower end of the needle tube 6 is designed into an inclined face, when in use, a medical worker takes down the needle tube protective sleeve 7, slightly pushes the needle tube 6, the bottom of the needle tube 6 can penetrate through the sealing portion 502 and extend into the inner cavity of the upper shell 4, then the end of the needle tube 6 is inserted into the drug adding hole on the peritoneal dialysis solution injection bag, the peritoneal dialysis breast and abdomen developer in the upper shell is injected into the peritoneal solution bag through the peritoneal solution drug adding hole by pushing the second stopper, the peritoneal dialysis breast and abdomen developer and the peritoneal solution are fully mixed, and the peritoneal dialysis breast and abdomen developer is mixed according to the mass ratio of 1: 200.

Indocyanine green is used to track imaging agents that localize thoraco-abdominal fistulas, and is more sensitive than melan as evidence of tracking of thoraco-abdominal fistulas. The green indocyanine is green, clear and recognizable with naked eyes, convenient observation and confirmation, no stimulation to peritoneum, and obviously superior to meland, and the technology is used for performing the test on all peritoneal dialysis objects combined with pleural effusion to identify the peritoneal fistula for early diagnosis and the pleural effusion caused by other reasons, so that the method has guiding significance.

The peritoneal dialysis thoracoabdominal imaging agent has the characteristics of high sensitivity and high specificity, and the accuracy is obviously superior to the biochemical indexes of methylene blue and hydrothorax and ascites. The technology is used for positioning abdominal wall leakage, is sensitive, can accurately position a leakage part, and can be used for identifying inguinal hernia so as to determine operation indication and mode. The technology can improve the diagnosis level of thoraco-abdominal fistula and abdominal wall leakage, greatly reduce the abdominocentesis recession rate, and is the first domestic and international initiative especially for peritoneal dialysis patients by using a fluorescence imaging technology. The indocyanine green has no stimulation, high safety and simple and convenient operation method, and is worthy of popularization.

The clinical application is as follows:

13 cases of peritoneal dialysis are combined with pleural effusion, a pleural drainage tube is firstly placed, the pleural effusion is completely placed, a patient is ordered to lie in a position, a peritoneal dialysis thoracoabdominal developer is filled into an abdominal cavity, whether the pleural drainage tube has pleural effusion flowing out or not is observed, if the pleural effusion flows out, the pleural drainage tube is bright green, the peritoneal dialysis thoracoabdominal developer is immediately detected by a fluorescent probe, if the peritoneal dialysis thoracoabdominal fistula exists, the peritoneal dialysis thoracoabdominal fistula is diagnosed, 9 patients with the peritoneal fistula are diagnosed, and 4 patients with the peritoneal fistula are excluded.

In addition, after the nephrology department peritoneal dialysis catheterization of the first subsidiary hospital of the western-style university of transport at 12 months in 2017 and 1 month to 2018, left pleural effusion and suspected thoraco-abdominal fistula are selected, and 10 patients with peritoneal dialysis combined pleural effusion are tested, wherein 8 male patients, 2 female patients, the average age of 49.30 +/-32.33 years and the dialysis time of 10.49 +/-8.33 months are selected. Firstly, the thoracic drainage tube is placed, and the pleural effusion is discharged. Carrying out biochemical examination of hydrothorax. Order the patient to lie down, fill 2000ml of peritoneal dialysis thoracoabdominal imaging agent into the abdominal cavity, observe whether the pleural drainage tube has pleural effusion flowing out, if yes, the pleural drainage tube is bright green, immediately detect with a fluorescence probe, if yes, the thoracoabdominal fistula can be diagnosed.

As a result: among 10 patients, 5 patients were diagnosed with thoraco-abdominal fistula, and had shorter dialysis time (5.02 ± 3.99vs13.94 ± 8.61 month p ═ 0.034), significantly higher pleural glucose (24.88 ± 9.36mmol vs3.48 ± 1.31mmol/L p ═ 0.007), lower pleural leukocyte count (33.26 ± 10.35vs1899.72 ± 379.49/ul p ═ 0.000), higher serum albumin (34.47 ± 21.22vs30.84 ± 17.88g/L p ═ 0.025), significantly higher dialysis adequacy TKt/v (2.02 ± 1.39vs1.73 ± 0.99p ═ 0.021), blood pressure, creatinine, urea nitrogen, and no significant difference in protein. Turning to: patients diagnosed with thoraco-abdominal fistulas, 4 cases were changed to hemodialysis treatment, and 1 case was passed after thoraco-adhesion, and low-dose peritoneal dialysis was continued. In 5 cases, the thoraco-abdominal fistula is eliminated, infection resistance is given, nutrition is improved, dialysis is strengthened, and peritoneal dialysis treatment is continued.

9 suspected abdominal wall leakage, after the peritoneal dialysis thoracoabdominal imaging agent is filled into the abdominal cavity, the patient is ordered to change the body position to the self-standing position, the fluorescence probe is used for clearly probing fluorescence imaging on the abdominal wall, 5 patients with thoracoabdominal fistula are diagnosed through the fluorescence imaging, the site of the fluorescence imaging is firstly located as the leakage site, and 4 abdominal wall hernias are diagnosed. The details are shown in the following table.

In addition, the peritoneal dialysis catheterization of the nephrology department of the first subsidiary hospital of the university of western medicine was selected, and suspected peritoneal dialysis patients with abdominal wall leakage (after the peritoneal dialysis catheterization, especially for the patients with catheterization under a laparoscope, the drainage amount of the peritoneal fluid was significantly less than the infusion amount, the peritoneal fluid entered and exited smoothly, and whether abdominal wall edema exists or not) were treated with the peritoneal standing sheets to remove the peritoneal dialysis displacement. After 1000ml of peritoneal dialysis thoracoabdominal imaging agent is filled into the abdominal cavity, the patient is ordered to change the body position to a self-standing position, the fluorescence probe is used for definitely probing the fluorescence imaging on the abdominal wall, and the imaging diagnosis is the abdominal wall leakage. The site of the fluoroscope was first located as the leak site. The clinical manifestations, age, blood pressure, change of ultrafiltration volume, treatment method and clinical outcome of the patients were observed. As a result: the diagnosis of 7 cases of peritoneal dialysis was completed, wherein 6 cases of men and 1 case of women had an average age of 48.81 + -34.39 years, an ultrafiltration volume of-839.20 + -422.73 ml (-340-1100 ml), abdominal wall edema of 71.4% (5/7), scrotal edema of 57.1% (4/7), edema of both lower limbs of 14.3% (1/7), and blood pressure of 132.48 + -120.32 mmHg. The incidence of hypertension was 28.6% (2/7). The first time of fluorescence imaging is 11.48 +/-9.31 minutes on average. Of all patients, 5 cases were diagnosed with abdominal wall leakage, 3 cases (60%) were healed after surgical suturing at the site, 2 cases were self-healed after a small dose (1000 ml per infusion) of lying dialysis for 1 week, and 5 cases were treated by peritoneal dialysis. The inguinal hernia was diagnosed in 2 cases, hemodialysis treatment was changed to 1 case, and peritoneal dialysis treatment was continued after surgical repair in 1 case.

The peritoneal dialysis thoracoabdominal imaging agent is adopted to determine that abdominal wall leakage and thoracoabdominal fistula have high reliability and sensitivity, and the leakage part can be completely cured after surgical suture due to accurate positioning, so that the abdominal penetration and withdrawal rate is reduced, and particularly, the fluorescence imaging technology is initiated domestically and internationally. It is simple and convenient, and is worth popularizing. In addition, the method is popularized to diagnosis and positioning of incisional hernia and abdominal wall leakage after a peritoneal dialysis operation, and peritoneal dialysis complications are determined and treated in time.

The invention utilizes the new fluorescent staining agent to diagnose abdominal wall leakage and thoraco-abdominal fistula at an early stage, is beneficial to timely and successfully treating peritoneal dialysis complications, further improves the peritoneal dialysis treatment technology, reduces the peritoneal dialysis withdrawal rate, and fills the blank in the field.

Claims

1. The reagent bottle for the peritoneal dialysis thoracoabdominal imaging agent is characterized by comprising an upper shell, a connecting piece and a lower shell which are sequentially arranged from top to bottom, wherein the lower end of the upper shell is provided with a first tapered abutting surface in a tapered shape, and the diameter of the first tapered abutting surface is increased towards the lower end part of the upper shell; the upper end of the lower housing is provided with a second tapered abutting surface of a tapered shape, the diameter of which is reduced toward the upper end portion of the lower housing, the second tapered abutting surface being restrained by a connecting member to abut on the first tapered abutting surface; the peritoneal dialysis machine comprises a lower shell, and is characterized in that a moving rod is arranged in an inner cavity of the lower shell, a first stop block is arranged at the upper end of the moving rod, the first stop block is positioned in an inner cavity of the upper shell and positioned at the upper end of a first conical abutting surface, a second stop block is arranged at the lower end of the moving rod, a compression spring is further arranged on the moving rod and positioned between the second stop block and a second conical abutting surface, a diaphragm is arranged in the inner cavity of the upper shell, a plug body is arranged at an upper port of the upper shell, an upper cavity is formed between the diaphragm and the plug body, a liquid for sterilization and injection is filled in the upper cavity, a lower cavity is formed between the diaphragm and the first stop block, and peritoneal dialysis breast and abdomen.

2. The reagent bottle for the peritoneal dialysis imaging agent for the thoracoabdominal membrane of claim 1, wherein the first stopper is provided with a plurality of puncture needles, a plurality of the puncture needles are positioned on the side facing the membrane, and the first stopper can move up and down in the inner cavity of the upper housing.

3. The reagent bottle of peritoneal dialysis thoracoabdominal imaging agent according to claim 1, wherein the connecting piece comprises a connecting cylinder having a through hole, the lower end of the inner wall of the connecting cylinder is provided with a convex surface extending towards the central axis, the inner side of the convex surface is provided with a first tapered contact surface in a tapered shape, the lower housing is provided with a baffle ring along the radial direction of the lower housing, the baffle ring is located at the upper end of the convex surface, the lower end of the baffle ring is provided with a second tapered contact surface matched with the first tapered contact surface, the side wall of the connecting cylinder is provided with an arc-shaped baffle block along the radial direction of the connecting cylinder, the arc-shaped baffle block penetrates through the side wall of the connecting cylinder and extends into the through hole, and the inner end of the arc-shaped baffle block is located between the lower end surface.

4. The reagent bottle for the peritoneal dialysis thoracoabdominal imaging agent according to claim 3, wherein the upper end of the inner wall of the connecting cylinder is provided with an internal thread section, and the side wall of the lower shell is provided with an external thread section matched with the internal thread.

5. The reagent bottle of peritoneal dialysis thoracoabdominal imaging agent according to claim 3, wherein the outer side wall of the arc-shaped stop block is provided with two flexible belts, the two flexible belts are respectively located at two sides of the arc-shaped stop block, and the two flexible belts are arranged around the outer wall of the connecting cylinder.

6. The reagent bottle of peritoneal dialysis thoracoabdominal imaging agent according to claim 1, wherein the stopper body comprises a sealing part arranged inside the upper housing and a needle seat located at the upper end of the upper housing, the needle seat is provided with a needle tube, the needle tube extends downwards to the inside of the sealing part and is close to the lower end face, the outer side of the needle tube is provided with a flexible protective sleeve, the lower end of the flexible protective sleeve is provided with a flexible clamping block along the radial direction of the flexible protective sleeve, and the flexible clamping block is embedded and matched with a clamping groove on the needle seat.

7. The reagent bottle for the peritoneal dialysis imaging agent for the chest and abdomen, according to claim 1, wherein the lower end of the lower housing is provided with a bottom cover, the upper end of the bottom cover is provided with a sealing block extending to the inner cavity of the lower housing, and the sealing block is in contact with the second stopper.