CN112353487A - Medical combined ablation needle capable of monitoring pressure and ablation method - Google Patents
Medical combined ablation needle capable of monitoring pressure and ablation method Download PDFInfo
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Abstract
The invention relates to the technical field of medical ablation needles and ablation methods, in particular to a medical combined ablation needle capable of monitoring pressure and an ablation method. The ablation needle has reasonable and compact structure and convenient use, can realize the combined use of a physical ablation method and a chemical ablation method, not only can realize the irrigation of physical ablation and chemical ablation, but also can realize the synchronous operation of the physical ablation and the chemical ablation; meanwhile, when the ablation needle jointly ablates the tumor, the physical ablation and the chemical ablation are cooperated, and the pressure in the tumor body is monitored in real time in the ablation process through the pressure monitoring element so as to adjust the proper ablation parameters, so that the ablation effect is obviously improved, and the treatment effect of 1+1 & gt 2 is realized.
Description
Technical Field
The invention relates to the technical field of medical ablation needles and ablation methods, in particular to a medical combined ablation needle capable of monitoring pressure and an ablation method.
Background
In clinic, many solid tumors are usually not suitable for surgical excision and other treatments due to many factors, ablation is usually adopted, the currently common ablation can be divided into physical ablation and chemical ablation, the common physical ablation methods include radio frequency ablation, microwave ablation, ultrasound confocal ablation, nanosecond pulsed electric field ablation and the like, and the chemical ablation includes absolute alcohol ablation, acetic acid ablation, hypertonic saline, sodium morrhuate and ethanol solution and the like. The most widely used in clinic is radio frequency ablation, which is most commonly used in solid tumors such as primary liver cancer or metastatic liver cancer; whereas chemical ablation is most commonly performed using absolute alcohol ablation.
The principle of radio frequency ablation is that high-frequency current is directly led into a tumor tissue, ions in the tissue around an electrode continuously change directions under the action of alternating current to generate heat through friction, water inside and outside the tumor tissue is vaporized by utilizing local high temperature to cause protein denaturation and final coagulation necrosis, and the ablation effect on the tumor is that the tumor cells directly generate coagulation necrosis due to the high temperature and simultaneously the high temperature affects various functions of cell membranes, mitochondria and lysosomes; the high temperature causes the blood vessels in the tumor to be coagulated and the blood vessels to be blocked; the tumor cell membrane antigen is exposed in the process of radiofrequency ablation, and the generation of specific antibodies by organisms is increased. However, radio frequency ablation inevitably has thermal damage to surrounding normal tissues, and due to the thermal damage, many tumors of organs located at special positions cannot be ablated, or after ablation, risks such as organ function damage, fever, organ function decompensation and the like occur. Meanwhile, due to the three-dimensional structure of the tumor, the radiofrequency ablation needle is easy to deviate from the spherical center of the tumor body under the guidance of ultrasound or CT during puncture, the ablation of the puncture center is sufficient, and the ablation of the edge of the tumor part is insufficient, so that the tumor is easy to relapse or even transfer after early postoperative ablation.
The principle of the absolute alcohol ablation is that the absolute alcohol is directly injected into a tumor body, so that the tumor cells are dehydrated, the protein is solidified, and small blood vessels in the tumor body are embolized, thereby inactivating the tumor. However, absolute alcohol injection still has many defects, and complications such as abdominal pain, fever, hemoglobinuria, drunkenness-like symptoms and the like are easy to occur during or after operation. In addition, the absolute alcohol amount of one injection is mostly limited to 20mL to 30mL, and the general poisoning symptom of ethanol is easy to appear, when the injection treatment is carried out on liver cancer, the dispersion of absolute alcohol is often limited due to the separation of fibrous tissues in the tumor, and the tumor is often required to be injected in multiple points, so the tolerance of a patient is reduced, the ethanol leakage is easy to appear in multiple injection in multiple times, severe abdominal pain is caused, the risk of tumor cell planting and transfer is increased in multiple injection, and due to the three-dimensional structure of the tumor body, even if the tumor is punctured in multiple points, the insufficient ablation or omission of tumor cells in partial positions is easy to appear, so the early relapse and transfer after the operation are easy to appear.
Therefore, a method for ablation of tumors by combining absolute alcohol and radio frequency is explored clinically at present, the combination method is also a simple superposition of the two ablation methods, namely, the tumors are ablated by absolute alcohol and then punctured again for radio frequency ablation, and the current research suggests that injection in the tumors of the absolute alcohol can cause vascular embolism perfused in tumor tissues. The formation of thrombus in tumor blood vessels promotes the necrosis and fibrosis of tumor cells, and the water protective belt formed by absolute alcohol also enhances the ablation effect of heat on tumors. Charring of the surrounding tissues of the electrode pins is delayed after the injection of the anhydrous alcohol in the tumor. The radio frequency ablation is carried out after the injection in the anhydrous alcohol tumor, the local temperature does not rise any more before the anhydrous alcohol is completely vaporized, the carbonization of tissues around the electrode needle is delayed, the heat energy can be further spread, the ablation range is enlarged, and the ablation effect is improved. Meanwhile, the heat resistance of cells can be reduced by causing the tumor cells to be damaged, so that the radio frequency effect is improved, the permeability of cell membranes is increased by the high-temperature effect of radio frequency ablation, and simultaneously, the tumor cells can be killed more efficiently by anhydrous alcohol by the high temperature, so that the two have a synergistic effect, namely, the radio frequency ablation is synergistic by the intratumoral injection of the anhydrous alcohol, and the radio frequency ablation is synergistic by the intratumoral injection of the anhydrous alcohol.
The problems of the current combined ablation are as follows: the mode of injection-radio frequency ablation in the anhydrous alcohol tumor is a two-step puncture method and sequential combination, the simultaneous combined ablation of physical ablation and chemical ablation is not really realized, the risk of increasing needle track planting transfer also exists, and in addition, the problems of insufficient ablation and the like exist due to inconsistent internal positions of the tumor body punctured twice. And the operation flow is more complicated, equipment and disposable consumables which are operated twice need to be prepared, and meanwhile, the risk of postoperative bleeding, pain and other complications in the operation is increased due to the two times of puncture. In addition, the ablation equipment is not improved, the mode free selection and the opportunity free combination of the two combined ablation cannot be realized, and the puncture ablation is not realized by a one-step puncture method.
In addition, in the current clinical ablation of solid tumors, preliminary calculation of the size of the tumor requires time and temperature for ablation, and for chemical ablation, preliminary calculation of the volume of fluid to be injected. However, during ablation, the tumor internal pressure is too high due to over-high local temperature or over-high injection pressure at the puncture site in the tumor during ablation, so that tumor cells drop into blood or are extruded into normal tissues, the ablation treatment effect is poor, and the tumor recurs and metastasizes in early postoperative period, so that the tumor internal pressure monitoring is also necessary besides the detection of the temperature during operation.
Disclosure of Invention
The invention provides a medical combined ablation needle capable of monitoring pressure and an ablation method, overcomes the defects of the prior art, and can effectively solve the problems that the conventional medical ablation needle is poor in ablation effect and combined ablation is not realized by a one-step puncture method.
One of the technical schemes of the invention is realized by the following measures: a medical combined ablation needle capable of monitoring pressure comprises an ablation needle body, an ablation needle tail interface box, a physical ablation part, a chemical ablation part and a pressure adjusting part, wherein the ablation needle body comprises an ablation working section and an ablation non-working section which are connected into a whole from left to right, the right end of the ablation non-working section is fixedly communicated with the left end of the ablation needle tail interface box, the left end of the ablation working section is provided with an ablation needle point, the ablation working section is fixedly provided with a pressure monitoring element, a chemical ablation channel and a pressure monitoring line channel which are mutually isolated are arranged in the ablation needle body, the chemical ablation channel and the pressure monitoring line channel both extend from the tail end of the ablation needle body to the ablation working section, at least two liquid outlets communicated with the left end of the chemical ablation channel are distributed along the side wall of the ablation needle body in the ablation working section, and the liquid outlet end of the chemical ablation part is communicated with the chemical ablation channel, a cooling circulation channel which can cool the medium in the chemical ablation catheter is arranged in the ablation needle tail interface box, the pressure regulating part is electrically connected with the pressure monitoring element, the physical ablation part is connected with the right end of the ablation needle body, and an insulating layer is arranged on the outer side of the ablation non-working section of the ablation needle body.
The following is a further optimization or/and improvement of one of the above-mentioned technical solutions of the invention:
the liquid outlet is spirally distributed at intervals on the side wall of the ablation needle body of the ablation working section.
The pressure adjusting part comprises a pressure signal adjuster and an optical fiber, the pressure signal adjuster is connected with the pressure monitoring element through the optical fiber, the optical fiber penetrates through a pressure monitoring line passing channel in the ablation needle body, the outer wall of the ablation needle body of the ablation working section is provided with a pressure monitoring channel with an opening facing the outside of the ablation needle body, the pressure monitoring element is fixedly installed in the pressure monitoring channel, and the pressure sensing end of the pressure monitoring element is located outside the pressure monitoring channel.
The pressure monitoring element adopts a miniature optical fiber pressure sensor.
The inlet end of the cooling circulation channel of the ablation needle tail connector box is communicated with a cooling water inlet container through a water inlet conduit, and the outlet end of the cooling circulation channel of the ablation needle tail connector box is communicated with a cooling water return container through a water outlet conduit.
The chemical ablation part comprises a push injection pump, and the liquid outlet end of the push injection pump is communicated with the chemical ablation channel through a chemical ablation catheter; the physical ablation part comprises a radio frequency ablation host, an ablation cathode and an ablation anode, the ablation anode and the ablation cathode are both arranged at the needle tail of the right end of the ablation needle body, and the radio frequency ablation host is respectively connected with the ablation cathode and the ablation anode through leads.
The left end of the ablation working section is provided with a sub-ablation needle tip surrounding the ablation needle tip, and the sub-ablation needle tip is in an umbrella shape after being opened.
The second technical scheme of the invention is realized by the following measures: the ablation method of the medical combined ablation needle capable of monitoring the pressure in one technical scheme comprises the following steps:
preparing various articles and equipment, and connecting corresponding equipment; according to the size of a solid tumor with ablation indication of a human body or a solid tumor model of an experimental animal except a brain tumor, selecting an ablation needle body with the appropriate thickness, under the guidance of ultrasound or CT, selecting an appropriate puncture path and puncture angle to puncture, injecting local anesthetic by using an injection pump while puncturing, after an ablation working section enters a tumor part, slowly pumping a chemical ablation preparation by using the injection pump according to the chemical ablation preparation required by preoperative calculation, simultaneously observing the pressure value of a pressure signal regulator, after the pumping of the chemical ablation preparation is finished, adjusting the ablation power, temperature and ablation time of a radio frequency ablation host according to the size of the tumor, performing radio frequency ablation, and simultaneously closely observing the pressure and temperature through the pressure signal regulator and the radio frequency ablation host respectively, if the pressure is too large, adjusting the ablation power of the radio frequency ablation host and increasing the circulation speed of cooling water, when the needle is to be withdrawn after the ablation is finished, the needle is withdrawn while the injection pump is used for injecting injection water or hypertonic saline water to ablate the needle channel so as to prevent the planting transfer.
The third technical scheme of the invention is realized by the following measures: the ablation method of the medical combined ablation needle capable of monitoring the pressure in one technical scheme comprises the following steps:
preparing various articles and equipment, and connecting corresponding equipment; according to the size of the solid tumor with ablation indication or the experimental animal solid tumor model. Except brain tumors, selecting an ablation needle with the appropriate thickness, selecting an appropriate puncture path and puncture angle for puncturing under the guidance of ultrasound or CT, injecting local anesthetic by using a push injection pump while puncturing, slowly pumping a chemical ablation preparation by using the push injection pump according to the chemical ablation preparation required by preoperative calculation after an ablation working section enters a tumor part, simultaneously adjusting the ablation power, temperature and ablation time of a radio frequency ablation host according to the size of the tumor, carrying out synchronous radio frequency ablation, simultaneously closely observing the pressure and temperature through a pressure signal regulator and the radio frequency ablation host respectively, reducing the ablation power of the radio frequency ablation host and increasing the circulation speed of cooling water if the pressure is too high, and injecting injection water or hypertonic saline for needle channel ablation while withdrawing the needle when the needle is planned to be withdrawn after ablation to prevent the implantation metastasis.
The ablation needle has reasonable and compact structure and convenient use, can realize the combined use of a physical ablation method and a chemical ablation method, not only can realize the irrigation of physical ablation and chemical ablation, but also can realize the synchronous operation of the physical ablation and the chemical ablation; meanwhile, when the ablation needle is used for jointly ablating tumors, the physical ablation and the chemical ablation are cooperated, and the pressure in the tumor body is monitored in real time in the ablation process through the pressure monitoring element so as to adjust proper ablation parameters, so that the ablation effect is obviously improved, and the treatment effect of 1+1 > 2 is realized; in addition, when the ablation needle is used for ablation, anesthesia and combined ablation treatment can be realized only by one-step puncture, compared with the existing ablation mode, the ablation needle has the advantage of reducing needle track planting metastasis, and simultaneously, the ablation is performed on the same puncture part of a tumor by one-step ablation, so that the ablation effect is improved, and complications such as bleeding, pain, injury and the like are reduced.
Drawings
Fig. 1 is a front view structural diagram of a medical combined ablation needle capable of monitoring pressure according to embodiment 1 of the invention.
Fig. 2 is a structural schematic diagram of the needle tail of the medical combined ablation needle capable of monitoring pressure.
FIG. 3 is an enlarged sectional view of the melting section A in FIG. 1.
Fig. 4 is a partially enlarged schematic view of the ablation stage of fig. 1.
The codes in the figures are respectively: 1 is melting needle tail interface box, 2 is melting the working section, 3 is melting the inoperative segment, 4 is melting the needle point, 5 is the pressure monitoring component, 6 is the chemical ablation passageway, 7 is the liquid outlet, 8 is the chemical ablation pipe, 9 is the pressure signal regulator, 10 is optic fibre, 11 is the pipe of intaking, 12 is cooling water inlet container, 13 is the water outlet pipe, 14 is cooling water return liquid container, 15 is the push pump, 16 is the radio frequency ablation host computer, 17 is the wire.
Detailed Description
The present invention is not limited by the following examples, and specific embodiments may be determined according to the technical solutions and practical situations of the present invention.
In the present invention, for convenience of description, the description of the relative positional relationship of the components is described according to the layout pattern of fig. 1 of the specification, such as: the positional relationship of front, rear, upper, lower, left, right, etc. is determined in accordance with the layout direction of fig. 1 of the specification.
The invention is further described with reference to the following examples and figures:
example 1: as shown in the attached drawings 1 to 4, the medical combined ablation needle capable of monitoring pressure comprises an ablation needle body, an ablation needle tail interface box 1, a physical ablation part, a chemical ablation part and a pressure regulating part, wherein the ablation needle body comprises an ablation working section 2 and an ablation non-working section 3 which are connected into a whole from left to right, the right end of the ablation non-working section 3 is fixedly communicated with the left end of the ablation needle tail interface box 1, the left end of the ablation working section 2 is provided with an ablation needle point 4, the ablation working section 2 is fixedly provided with a pressure monitoring element 5, the ablation needle body is internally provided with a chemical ablation channel 6 and a pressure monitoring line channel which are mutually isolated, the chemical ablation channel 6 and the pressure monitoring line channel both extend from the tail end (right end) of the ablation needle body to the working section 2, the ablation working section 2 is distributed with at least two liquid outlets 7 communicated with the left end of the chemical ablation channel 6 along the side wall of, the play liquid end that the part was ablated to chemistry passes through chemical ablation pipe 8 intercommunication with chemical ablation passageway 6, is provided with the cooling circulation channel that can melt the medium cooling in the pipe 8 to chemistry in ablating in ablation backshank interface box 1, and pressure regulation part is connected with pressure monitoring element 5 electricity, and the part is ablated with the right-hand member of ablating the needle body to physics, is provided with the insulating layer in the 3 outsides of ablating non-working sections of ablating the needle body:
(1) the ablation needle can realize the combined use of physical ablation and chemical ablation, not only can realize the irrigation continuation of the physical ablation and the chemical ablation, but also can realize the synchronous operation of the physical ablation and the chemical ablation;
the physical ablation method comprises radio frequency ablation, microwave ablation, ultrasonic confocal ablation, nanosecond pulsed electric field ablation and the like;
according to the current thermal ablation theory, when the tumor is jointly ablated, the chemical ablation dispersity at the edge of the tumor is increased due to the chemical ablation when the radiofrequency ablation is performed, and meanwhile, when the tumor is jointly ablated, liquid around the ablation working section 2 of the ablation needle forms a liquid spherical zone under the action of the radiofrequency thermal ablation, so that the thermal injury to peripheral normal tissues caused by the radiofrequency ablation is limited, and the thermal ablation effect in the liquid spherical zone is increased; in addition, the peripheral liquid spherical zone fully ablates peripheral tumor tissues, limits the chance of shedding, transferring and relapse of tumor cells under thermal ablation, and increases the sensitivity of radio frequency ablation, namely, the ablation needle realizes the treatment effect of 1+1 > 2 due to the combination of physical ablation and chemical ablation;
(2) when the ablation needle is used, a chemical ablation preparation can reach the ablation working section 2 through the chemical ablation channel 6 and then is discharged through the liquid outlet 7. The chemical ablation preparation for combination is selected more, and common absolute alcohol, water for injection or hypertonic saline, acetic acid and the like can be selected during chemical ablation, the dispersity of the absolute alcohol is easily influenced by tumor interstitial separation, but the dispersity of the absolute alcohol can be obviously increased under the thermal ablation of radio frequency ablation; the injection water and the hypertonic saline water are less affected by the dosage, the postoperative complications are lower, the heated chemical ablation preparation can be directly used to increase the treatment effect, and the injection water and the hypertonic saline water are injected to ablate the needle track to reduce the chance of needle track planting transfer when the ablation is finished;
(3) in the ablation process of the ablation needle, the anesthetic can be synchronously injected, the anesthetic is sent to the ablation working section 2 through the chemical ablation channel 6 and then discharged through the liquid outlet 7, so that the pain of a patient in the ablation process and the waste of materials are reduced;
(4) in the ablation process, the pressure in the tumor body is monitored in real time through the pressure monitoring element 5, the pressure is monitored during ablation, the radio frequency ablation is adjusted according to the pressure change, and the falling, planting, transferring and recurrence of tumor cells are reduced;
(5) when the ablation needle is used for ablation, anesthesia and combined ablation treatment can be realized only by one-step puncture, compared with the existing ablation mode, the ablation needle has the advantage of reducing needle track planting metastasis, and simultaneously, the ablation is performed on the same puncture part of a tumor by one-step ablation, so that the ablation effect is increased, and complications such as bleeding, pain, injury and the like are reduced.
The insulating layer is arranged on the outer side of the ablation non-working section 3, so that only the ablation working section 2 and the ablation needle tip 4 can be ensured to exert an ablation effect.
The material of the ablation needle body is the same as that of the existing ablation needle body, and is generally a metal material.
The medical combined ablation needle capable of monitoring the pressure can be further optimized or/and improved according to the actual needs:
as shown in fig. 4, in order to make the ablation preparation surround the ablation object (solid tumor for ablation indication) as much as possible and improve the ablation effect, the chemical liquid outlets 7 are spirally and alternately distributed on the side wall of the ablation needle body of the ablation working section 2.
Meanwhile, the chemical liquid outlet 7 is arranged in a spiral shape, so that the anesthesia speed around the ablation object can be accelerated when the anesthetic is pumped through the chemical ablation channel 6.
As shown in fig. 1 and 4, the pressure regulating component includes a pressure signal regulator 9 and an optical fiber 10, the pressure signal regulator 9 is connected with the pressure monitoring element 5 through the optical fiber 10, the optical fiber 10 passes through the pressure monitoring line passing channel in the ablation needle body, a pressure monitoring channel with an opening facing the outside of the ablation needle body is arranged on the outer wall of the ablation needle body of the ablation working section 2, the pressure monitoring element 5 is fixedly installed in the pressure monitoring channel, and the pressure sensing end of the pressure monitoring element 5 is located outside the pressure monitoring channel.
In order to make the pressure monitoring effect better, the pressure sensing end of the pressure monitoring element 5 is arranged outside the pressure monitoring channel.
The pressure monitoring element 5 is a miniature optical fiber pressure sensor as required.
The miniature optical fiber pressure sensor can adopt the optical fiber sensor with the model number of single channel (general) or fpi-hr (scientific application) or fop-m (standard) provided by Shenzhen European Shenshen opto-electronic technology Limited.
As shown in fig. 1 and 2, the inlet end of the cooling circulation channel of the ablation needle tail connector box 1 is communicated with a cooling water inlet container 12 through a water inlet conduit 11, and the outlet end of the cooling circulation channel of the ablation needle tail connector box 1 is communicated with a cooling water return container 14 through a water outlet conduit 13.
The cooling circulation medium for cooling can be physiological saline. When the ablation needle is used for ablation, when the pressure or the temperature of an ablation object is too high, the circulation speed of the cooling circulation medium can be increased, so that the pressure or the temperature of the ablation object is reduced. The circulation rate can be controlled by connecting a pumping device to the inlet end of the inlet conduit 11 or/and the outlet end of the outlet conduit 13.
The cooling water inlet container 12 and the cooling water return container 14 can adopt physiological saline bottles.
The cooling circulation channel is generally a circulation coil or a hose.
As shown in fig. 1, the chemical ablation part comprises a push injection pump 15, and the liquid outlet end of the push injection pump 15 is communicated with the chemical ablation channel 6 through a chemical ablation catheter 8; the physical ablation part comprises a radio frequency ablation host machine 16, an ablation cathode and an ablation anode, the ablation anode and the ablation cathode are both arranged at the needle tail of the right end of the ablation needle body, and the radio frequency ablation host machine 16 is respectively connected with the ablation cathode and the ablation anode through a lead 17.
Chemical ablation agents are injected into the chemical ablation channel 6 through the push injection pump 15 and then are discharged through the liquid outlet 7, so that chemical ablation is carried out on an ablation object. The ablation frequency, the ablation temperature and the ablation time can be controlled by the radiofrequency ablation host 16.
The chemical ablation preparation can be one of absolute alcohol, water for injection, and hypertonic saline or heated preparation thereof.
The bolus pump 15 is typically a digital bolus pump.
According to the requirement, the left end of the ablation working section 2 is provided with a sub-ablation needle tip surrounding the ablation needle tip 4, and the sub-ablation needle tip is in an umbrella shape after being unfolded.
After the sub-ablation needle points are added to the ablation needle, a multi-pole combined ablation needle is formed. The multi-pole combined ablation needle is suitable for ablation of larger tumors.
Example 2: the ablation method using the medical combined ablation needle capable of monitoring pressure in the embodiment 1 is carried out as follows:
preparing various articles and equipment, and connecting corresponding equipment; according to the size of a solid tumor (except brain tumor) with ablation indication of a human body or a solid tumor model of an experimental animal, an ablation needle body with the appropriate thickness is recommended to be selected according to the current clinical treatment guideline, under the guidance of ultrasound or CT (ablation can be carried out in open abdomen or laparoscopic surgery) after the sterilization and the drape, the appropriate puncture path and puncture angle are selected for puncture, local anesthetic is injected by a digital injection pump while puncture, after an ablation working section 2 enters a tumor part, the chemical ablation preparation is slowly pumped by the digital injection pump according to the chemical ablation required by preoperative calculation, the pressure value of a pressure signal regulator 9 is observed at the same time, after the chemical ablation preparation is injected by the pump, the ablation power, the temperature and the ablation time of a radio frequency ablation host computer 16 are regulated according to the tumor size for radio frequency ablation, and the pressure and the temperature are closely observed through the pressure signal regulator 9 and the radio frequency ablation host computer 16 respectively, if the pressure is too large, the ablation power of the radio frequency ablation host machine 16 is reduced, the speed of cooling water circulation is increased, when the needle is about to withdraw after ablation, the needle is withdrawn, and injection water or hypertonic saline is injected by a digital injection pump to ablate the needle channel to prevent the implantation transfer, and the operation is finished. Vital signs and other treatments were closely observed post-surgery.
The ablation method described in this example 2 is a chemical-physical combination irrigation ablation method.
Example 3: the ablation method using the medical combined ablation needle capable of monitoring pressure in the embodiment 1 is carried out as follows:
preparing various articles and equipment, and connecting corresponding equipment; according to the size of a solid tumor (except a brain tumor) with ablation indication of a human body or a solid tumor model of an experimental animal, the selection of an ablation needle with the appropriate thickness is recommended according to the current clinical treatment guideline, under the guidance of ultrasound or CT (ablation can also be carried out in open abdomen or laparoscopic surgery) after the disinfection and the drape, the selection of an appropriate puncture path and puncture angle for puncture is carried out, local anesthetic is injected by a digital injection pump while puncture is carried out, after an ablation working section 2 enters a tumor part, the chemical ablation preparation required by preoperative chemical ablation is slowly pumped by the digital injection pump according to the chemical injection pump, the ablation power, the temperature and the ablation time of a radio frequency ablation host computer 16 are adjusted according to the tumor size for synchronous radio frequency ablation, and the pressure and the temperature are closely observed through a pressure signal regulator 9 and the radio frequency ablation host computer 16 respectively, if the pressure is too large, the ablation power of the radiofrequency ablation host machine 16 is reduced and the speed of cooling water circulation is increased, when needle withdrawal is planned after ablation is completed, the needle is withdrawn, and injection water or hypertonic saline is injected by a digital injection pump to ablate the needle channel to prevent the planting transfer, and the operation is finished. Vital signs and other treatments were closely observed post-surgery.
The ablation method described in this example 3 is a chemical-physical combined synchronous ablation method.
In conclusion, the ablation needle can realize the combined use of the physical ablation method and the chemical ablation method, not only can realize the irrigation continuation of the physical ablation and the chemical ablation, but also can realize the synchronous operation of the physical ablation and the chemical ablation; meanwhile, when the ablation needle is used for jointly ablating tumors, physical ablation and chemical ablation are cooperated, and the pressure in the tumor body is monitored in real time in the ablation process through the pressure monitoring element 5 so as to adjust proper ablation parameters, so that the ablation effect is obviously improved, and the treatment effect of 1+1 > 2 is realized; in addition, when the ablation needle is used for ablation, anesthesia and combined ablation treatment can be realized only by one-step puncture, compared with the existing ablation mode, the ablation needle has the advantage of reducing needle track planting metastasis, and simultaneously, the ablation is performed on the same puncture part of a tumor by one-step ablation, so that the ablation effect is improved, and complications such as bleeding, pain, injury and the like are reduced.
The above technical features constitute a preferred embodiment of the present invention, which has strong adaptability and better implementation effect, and unnecessary technical features can be increased or decreased according to actual needs to meet the requirements of different situations.
Claims (10)
1. A medical combined ablation needle capable of monitoring pressure is characterized by comprising an ablation needle body, an ablation needle tail interface box, a physical ablation part, a chemical ablation part and a pressure regulating part, wherein the ablation needle body comprises an ablation working section and an ablation non-working section which are connected into a whole from left to right, the right end of the ablation non-working section is fixedly communicated with the left end of the ablation needle tail interface box, the left end of the ablation working section is provided with an ablation needle point, the ablation working section is fixedly provided with a pressure monitoring element, a chemical ablation channel and a pressure monitoring line channel which are mutually isolated are arranged in the ablation needle body, the chemical ablation channel and the pressure monitoring line channel both extend from the tail end of the ablation needle body to the ablation working section, at least two liquid outlets communicated with the left end of the chemical ablation channel are distributed on the side wall of the ablation working section along the ablation needle body, and the liquid outlet end of the chemical ablation part is communicated with the chemical ablation channel, a cooling circulation channel which can cool the medium in the chemical ablation catheter is arranged in the ablation needle tail interface box, the pressure regulating part is electrically connected with the pressure monitoring element, the physical ablation part is connected with the right end of the ablation needle body, and an insulating layer is arranged on the outer side of the ablation non-working section of the ablation needle body.
2. A medical combination ablation needle capable of monitoring pressure according to claim 1, wherein the liquid outlet ports are spirally spaced at the side wall of the ablation needle body of the ablation working section.
3. The medical combined ablation needle capable of monitoring pressure according to claim 1 or 2, wherein the pressure regulating component comprises a pressure signal regulator and an optical fiber, the pressure signal regulator is connected with the pressure monitoring element through the optical fiber, the optical fiber passes through a pressure monitoring line passing channel in the ablation needle body, a pressure monitoring channel with an opening facing the outside of the ablation needle body is arranged on the outer wall of the ablation needle body of the ablation working section, the pressure monitoring element is fixedly arranged in the pressure monitoring channel, and a pressure sensing end of the pressure monitoring element is positioned outside the pressure monitoring channel.
4. A medical united ablation needle capable of monitoring pressure according to claim 3, wherein the pressure monitoring element is a miniature optical fiber pressure sensor.
5. The medical combined ablation needle capable of monitoring pressure according to claim 1, 2 or 4, wherein the inlet end of the cooling circulation channel of the ablation needle tail interface box is communicated with a cooling water inlet container through a water inlet conduit, and the outlet end of the cooling circulation channel of the ablation needle tail interface box is communicated with a cooling water return container through a water outlet conduit; or/and a sub-ablation needle tip surrounding the ablation needle tip is arranged at the left end of the ablation working section, and the sub-ablation needle tip is in an umbrella shape after being unfolded.
6. The medical combined ablation needle capable of monitoring pressure according to claim 3, wherein the inlet end of the cooling circulation channel of the ablation needle tail interface box is communicated with a cooling water inlet container through a water inlet conduit, and the outlet end of the cooling circulation channel of the ablation needle tail interface box is communicated with a cooling water return container through a water outlet conduit; or/and a sub-ablation needle tip surrounding the ablation needle tip is arranged at the left end of the ablation working section, and the sub-ablation needle tip is in an umbrella shape after being unfolded.
7. The medical pressure-monitored united ablation needle according to claim 1, 2, 4 or 6, wherein the chemical ablation component comprises a push-injection pump, and the liquid outlet end of the push-injection pump is communicated with the chemical ablation channel through a chemical ablation catheter; or/and the physical ablation part comprises a radio frequency ablation host, an ablation cathode and an ablation anode, the ablation anode and the ablation cathode are both arranged at the needle tail of the right end of the ablation needle body, and the radio frequency ablation host is respectively connected with the ablation cathode and the ablation anode through leads.
8. The medical pressure-monitored united ablation needle according to claim 3 or 5, wherein the chemical ablation component comprises a bolus pump, and a liquid outlet end of the bolus pump is communicated with the chemical ablation channel through a chemical ablation catheter; or/and the physical ablation part comprises a radio frequency ablation host, an ablation cathode and an ablation anode, the ablation anode and the ablation cathode are both arranged at the needle tail of the right end of the ablation needle body, and the radio frequency ablation host is respectively connected with the ablation cathode and the ablation anode through leads.
9. An ablation method using the pressure-monitorable medical combined ablation needle according to any one of claims 1 to 8 and characterized by the following steps:
preparing various articles and equipment, and connecting corresponding equipment; according to the size of a solid tumor with ablation indication of a human body or a solid tumor model of an experimental animal except a brain tumor, selecting an ablation needle body with the appropriate thickness, under the guidance of ultrasound or CT, selecting an appropriate puncture path and puncture angle to puncture, injecting local anesthetic by using an injection pump while puncturing, after an ablation working section enters a tumor part, slowly pumping a chemical ablation preparation by using the injection pump according to the chemical ablation preparation required by preoperative calculation, simultaneously observing the pressure value of a pressure signal regulator, after the pumping of the chemical ablation preparation is finished, adjusting the ablation power, temperature and ablation time of a radio frequency ablation host according to the size of the tumor, performing radio frequency ablation, and simultaneously closely observing the pressure and temperature through the pressure signal regulator and the radio frequency ablation host respectively, if the pressure is too large, adjusting the ablation power of the radio frequency ablation host and increasing the circulation speed of cooling water, when the needle is to be withdrawn after the ablation is finished, the needle is withdrawn while the injection pump is used for injecting injection water or hypertonic saline water to ablate the needle channel so as to prevent the planting transfer.
10. An ablation method using the pressure-monitorable medical combined ablation needle according to any one of claims 1 to 8 and characterized by the following steps:
preparing various articles and equipment, and connecting corresponding equipment; selecting ablation needles with the corresponding thickness according to the size of a solid tumor with ablation indication in a human body or a solid tumor model of an experimental animal except brain tumors, under the guidance of ultrasound or CT, selecting proper puncture path and puncture angle for puncture, injecting local anesthetic by using a push injection pump while puncturing, and after the ablation working section enters the tumor part, according to the chemical ablation preparation required by the preoperative calculation for chemical ablation, a push injection pump is used for slowly pumping the chemical ablation preparation, meanwhile, the ablation power, the temperature and the ablation time of the radio frequency ablation host machine are adjusted according to the size of the tumor, the synchronous radio frequency ablation is carried out, meanwhile, the pressure and the temperature are respectively and closely observed through the pressure signal regulator and the radio frequency ablation host, if the pressure is overlarge, the ablation power of the radiofrequency ablation host machine is reduced and the speed of cooling water circulation is increased, when needle withdrawal is planned after ablation is completed, the needle is withdrawn while the injection pump is used for injecting water for injection or hypertonic saline water to melt the needle channel so as to prevent the planting transfer.
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