CN113925663A - Rectal anastomosis protection device and operation method - Google Patents
Rectal anastomosis protection device and operation method Download PDFInfo
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- CN113925663A CN113925663A CN202111268443.5A CN202111268443A CN113925663A CN 113925663 A CN113925663 A CN 113925663A CN 202111268443 A CN202111268443 A CN 202111268443A CN 113925663 A CN113925663 A CN 113925663A
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- 238000000034 method Methods 0.000 title claims abstract description 18
- 230000003872 anastomosis Effects 0.000 title claims description 17
- 230000000968 intestinal effect Effects 0.000 claims abstract description 96
- 230000010412 perfusion Effects 0.000 claims abstract description 38
- 239000012528 membrane Substances 0.000 claims abstract description 31
- 210000000664 rectum Anatomy 0.000 claims abstract description 17
- 239000007788 liquid Substances 0.000 claims description 29
- 210000004379 membrane Anatomy 0.000 claims description 28
- 210000003128 head Anatomy 0.000 claims description 23
- 210000000436 anus Anatomy 0.000 claims description 13
- 230000009471 action Effects 0.000 claims description 9
- 210000001072 colon Anatomy 0.000 claims description 9
- 239000003814 drug Substances 0.000 claims description 9
- 210000000056 organ Anatomy 0.000 claims description 9
- 238000001802 infusion Methods 0.000 claims description 8
- 210000004347 intestinal mucosa Anatomy 0.000 claims description 8
- 230000008569 process Effects 0.000 claims description 8
- 239000000126 substance Substances 0.000 claims description 7
- 238000007789 sealing Methods 0.000 claims description 6
- 229940079593 drug Drugs 0.000 claims description 5
- VYPSYNLAJGMNEJ-UHFFFAOYSA-N Silicium dioxide Chemical compound O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 claims description 4
- 239000000741 silica gel Substances 0.000 claims description 4
- 229910002027 silica gel Inorganic materials 0.000 claims description 4
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 claims description 3
- 238000007599 discharging Methods 0.000 claims description 3
- 238000005086 pumping Methods 0.000 claims description 3
- 210000005077 saccule Anatomy 0.000 claims description 3
- 238000004140 cleaning Methods 0.000 claims description 2
- 238000002347 injection Methods 0.000 claims description 2
- 239000007924 injection Substances 0.000 claims description 2
- 238000005406 washing Methods 0.000 claims 1
- 208000015181 infectious disease Diseases 0.000 abstract description 6
- 210000000683 abdominal cavity Anatomy 0.000 abstract description 2
- 230000009467 reduction Effects 0.000 abstract description 2
- 238000001356 surgical procedure Methods 0.000 abstract 1
- 210000000936 intestine Anatomy 0.000 description 10
- 238000011084 recovery Methods 0.000 description 5
- 238000011010 flushing procedure Methods 0.000 description 4
- 230000001681 protective effect Effects 0.000 description 4
- 206010056519 Abdominal infection Diseases 0.000 description 3
- 238000001179 sorption measurement Methods 0.000 description 3
- 210000003815 abdominal wall Anatomy 0.000 description 2
- 230000008602 contraction Effects 0.000 description 2
- 230000006870 function Effects 0.000 description 2
- 210000001035 gastrointestinal tract Anatomy 0.000 description 2
- 230000002093 peripheral effect Effects 0.000 description 2
- 230000035807 sensation Effects 0.000 description 2
- 238000007493 shaping process Methods 0.000 description 2
- 206010050456 Anastomotic leak Diseases 0.000 description 1
- 208000015634 Rectal Neoplasms Diseases 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 238000011109 contamination Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 230000003111 delayed effect Effects 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 230000002349 favourable effect Effects 0.000 description 1
- 210000003608 fece Anatomy 0.000 description 1
- 210000003405 ileum Anatomy 0.000 description 1
- 238000000338 in vitro Methods 0.000 description 1
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- 229920002635 polyurethane Polymers 0.000 description 1
- 239000004814 polyurethane Substances 0.000 description 1
- 230000008092 positive effect Effects 0.000 description 1
- 206010038038 rectal cancer Diseases 0.000 description 1
- 238000007467 rectal resection Methods 0.000 description 1
- 201000001275 rectum cancer Diseases 0.000 description 1
- 239000000243 solution Substances 0.000 description 1
- 210000003384 transverse colon Anatomy 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
- A61F5/44—Devices worn by the patient for reception of urine, faeces, catamenial or other discharge; Colostomy devices
- A61F5/445—Colostomy, ileostomy or urethrostomy devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
- A61M25/007—Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1018—Balloon inflating or inflation-control devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M3/00—Medical syringes, e.g. enemata; Irrigators
- A61M3/02—Enemata; Irrigators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/22—Valves or arrangement of valves
- A61M39/24—Check- or non-return valves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/22—Valves or arrangement of valves
- A61M39/28—Clamping means for squeezing flexible tubes, e.g. roller clamps
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- Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- General Health & Medical Sciences (AREA)
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Abstract
The invention relates to a rectum anastomotic stoma protection device and an operation method, which are characterized in that: the device comprises a drainage main pipe, an intestinal internal fixator, a perfusion head, a drainage sleeve membrane, an external drainage pipeline, an external fixing clamp, a collection container, a perfusion pipeline, an inflation pipeline and a negative pressure pipeline, wherein the intestinal internal fixator is arranged on the outer wall of the drainage main pipe, the drainage main pipe is provided with a drainage cavity, a perfusion cavity, an inflation cavity and a negative pressure cavity, the upper end of the perfusion cavity is connected with the perfusion head, the lower end of the perfusion cavity is connected with the perfusion pipeline, the upper end of the inflation cavity is of a closed structure, the lower end of the inflation cavity is connected with the inflation pipeline, the upper end of the negative pressure cavity is provided with a negative pressure side hole, the negative pressure side hole is communicated with the outer cavity of the intestinal internal fixator, the lower end of the negative pressure cavity is connected with the negative pressure pipeline, the lower end of the drainage cavity is connected with the drainage sleeve membrane, the external drainage pipeline is connected with the external drainage sleeve membrane, and the other end of the external drainage pipeline is connected with the collection container. The advantages are that: can effectively isolate the anastomotic stoma, avoid the abdominal cavity infection of the patient caused by the excrement contacting the surgical anastomotic stoma, avoid the need of the diversion and the secondary reduction surgery, and relieve the pain of the patient.
Description
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to a rectal anastomosis protection device and an operation method.
Background
At present, rectal resection is generally adopted for clinically treating rectal cancer, complications such as rectal anastomotic stoma infection or anastomotic leakage of a patient easily occur after an operation, abdominal cavity infection of the patient is further caused, the patient is delayed to be discharged for a light patient, and the life of the patient is threatened for a heavy patient. To avoid contamination of the patient's rectal stoma with fecal matter, it is generally desirable to protect the stoma. The existing protection anastomotic stoma is common and effective: the last ileum or transverse colon of the patient is lifted out of the main abdominal wall, and then a protective enterostomy is made on the abdominal wall of the patient to form a temporary enterostomy for the diversion of excrement. After the anastomotic stoma of the rectal operation is healed, the intestinal tract reduction is carried out by performing a secondary operation. The method needs to carry out secondary operation on the patient, so that the patient is injured secondarily, the recovery period is longer, and the physical and mental pain and the medical expense of the patient are increased. In the known technology, although a method for plugging a rectal anastomosis stoma by using a balloon is clinically used, the expansion of the balloon can cause certain expansion and compression effects on the anastomosis stoma, and the balloon is smooth and easy to displace, so that the recovery of the anastomosis stoma is not facilitated and the defects of incomplete drainage of excrement exist.
Disclosure of Invention
The invention provides a rectal anastomotic stoma protection device and an operation method thereof for solving the technical problems in the prior art.
In the operation, an I-shaped structure combining positive pressure support and negative pressure adsorption of the rectum anastomotic stoma protection device is placed in the colon at the proximal end of the anastomotic stoma of a patient, the intestinal internal fixator is well attached to the intestinal wall of the patient through the inflation and exhaust operations of the inner cavity and the outer cavity of the intestinal internal fixator, and excrement is drained from the inside of the drainage main pipe to the outside of the body, so that the anastomotic stoma can be effectively isolated, and the excrement is thoroughly prevented from contacting the operation anastomotic stoma; when necessary, the liquid medicine can be infused into the intestinal cavity through the infusion head, so that the excrement can be smoothly discharged. The rectum anastomotic stoma protection device can effectively avoid the infection of the anastomotic stoma and the abdominal infection of a patient caused by the leakage of the anastomotic stoma, so that the anastomotic stoma of the patient has sufficient time to heal, the operation of diversion and secondary recovery is not needed, and the pain of the patient is relieved. After the anastomotic stoma of the patient is healed, the protective device can be directly taken out, and secondary damage to the patient is avoided.
The technical scheme adopted by the invention for solving the technical problems in the prior art is as follows:
rectum coincide mouthful protection device, its characterized in that: comprises a drainage main pipe, an intestinal internal fixator, an infusion head, a drainage sleeve membrane, an external drainage pipeline, an external fixation clamp, a collection container, an infusion pipeline, an inflation pipeline and a negative pressure pipeline, the outer wall of the middle part of the drainage main pipe is provided with an intestinal fixator, the drainage main pipe is provided with four independent cavities which are respectively a drainage cavity, a perfusion cavity, an inflation cavity and a negative pressure cavity, the upper end of the perfusion cavity of the drainage main pipe is connected with a perfusion head, the lower end of the perfusion cavity is connected with a perfusion pipeline, the upper end of the inflatable cavity of the drainage main pipe is of a closed structure, the lower end of the inflatable cavity of the drainage main pipe is connected with an inflation pipeline, the upper end of the negative pressure cavity of the drainage main pipe is provided with a negative pressure side hole which is communicated with the outer cavity of the intestinal internal fixator, the lower end of the negative pressure cavity is connected with a negative pressure pipeline, the lower end of the drainage cavity of the drainage main pipe is connected with a drainage mantle, the external end of the drainage sleeve membrane is connected with an external drainage pipeline, and the other end of the external drainage pipeline is connected with a collection container.
The invention can also adopt the following technical scheme:
preferably, the upper end of the main drainage pipe is designed into a structure of a non-equal-diameter wide-mouth bulge, and the lower end of the main drainage pipe is of an equal-diameter pipe body structure.
Preferably, the appearance of the intestinal internal fixator is in an organ shape, a wide-mouth bulge is arranged at a lower port, the upper end and the lower end of the intestinal internal fixator are respectively sealed with the drainage main pipe, a closed space is formed in the periphery of the outer wall of the drainage main pipe and serves as an inner cavity of the fixator, the diameter of the wide-mouth bulge at the lower end of the intestinal internal fixator corresponds to that of the wide-mouth bulge at the upper end of the drainage main pipe, and the diameter of the wide-mouth bulge is 25-35 mm and is 5-10 mm larger than that of a middle fold.
Preferably, the pouring head is a flexible hose, the head of the pouring head is provided with a smooth and closed pouring head end, and the side wall of the pouring head is provided with a plurality of pouring side holes.
Preferably, the filling pipeline comprises a filling pipe and a liquid non-return one-way valve, a silica gel one-way valve for preventing liquid from flowing back is arranged in the liquid non-return one-way valve, and the outer diameter of the filling pipe is smaller than 3 mm.
Preferably, the inflation pipeline comprises an inflation tube, an inflation indicating saccule and an inflation one-way valve, and the outer diameter of the inflation tube is 1.5-1.8 mm.
Preferably, the negative pressure pipeline comprises a negative pressure pipe, a negative pressure indicating saccule and a negative pressure one-way valve, and the outer diameter of the negative pressure pipe is 1.5-1.8 mm.
Preferably, the drainage covering membrane adopts a thin-wall flexible hose which can be curled and folded, the wall thickness of the drainage covering membrane is less than 0.5mm, the upper end of the drainage covering membrane is fixedly bonded with the drainage main pipe, and the lower end of the drainage covering membrane is fixedly connected with the external fixing clamp.
Preferably, the external fixation clamp is fixedly connected with the drainage sleeve membrane and the external drainage pipeline, and the external fixation clamp is provided with a drainage hole, a catheter fixing groove and a human body fixing hole.
An operation method of a rectal anastomotic stoma protection device is characterized in that: comprises the following steps of (a) carrying out,
s1, after the rectum operation of the patient is anastomosed, the drainage main pipe and the intestinal fixator part of the device are placed in the colon at the proximal end of the anastomotic stoma through the special conveying sleeve, the anastomotic stoma is kept below the intestinal fixator and positioned in the middle of the drainage sleeve, and the wide-mouth protruding part at the lower end of the intestinal fixator and the wide-mouth protruding part at the upper end of the drainage main pipe are attached to the intestinal wall to form a sealing structure similar to an I shape.
S2, filling a certain amount of gas into the inflation pipeline, expanding the organ-shaped intestinal fixator main body to the outer periphery under the action of positive pressure, pumping negative pressure through the negative pressure pipeline, exhausting air at the periphery of the intestinal fixator, forming negative pressure between the wide-mouth bulge at the lower end of the intestinal fixator and the wide-mouth bulge at the upper end of the drainage main pipe, and attaching the intestinal mucosa of a patient to the periphery of the intestinal fixator main body under the action of negative pressure, thereby playing multiple fixing and sealing roles.
S3, extending the perfusion tube, the inflation tube and the negative pressure tube out of the anus of the patient along with the drainage sleeve film, adjusting the position after leading out the anus and clamping the perfusion tube, the inflation tube and the negative pressure tube in corresponding catheter fixing grooves on the external fixing clamp, fixing the external fixing clamp outside the anus of the patient through a human body fixing hole, adjusting the positions of an external drainage pipeline and a collection container, wearing and hanging the drainage pipeline and the collection container, keeping the drainage channel smooth, and then conducting drainage on the enteric-coated substance.
S4, when a patient needs to wash the intestinal lumen or dilute the enteric-coated substance, injecting normal saline or other medicines into the colon of the patient through the injection tube, so that the enteric-coated substance is smoothly led out of the body of the patient through a channel formed by the drainage lumen and the drainage sleeve membrane in the device after being diluted; the excrement generated in the processes of perfusion, flushing and drainage sequentially enters a collection container through a drainage cavity, a drainage sleeve membrane and an external drainage pipeline of a drainage main pipe, and the excrement in the operation process is guaranteed not to contact with an operation anastomosis port.
S5, when the collecting container needs to be replaced or cleaned, the flow stopping clamp on the external drainage pipeline is closed, the joint on the collecting container is unscrewed and taken down, the suspended collecting container is picked off, after the collecting container is cleaned or replaced by a new collecting container, the joint is remounted, connected and screwed down, when the excrement in the collecting container needs to be discharged, the joint can be directly picked off without being detached, the suspended collecting container is opened, the liquid drainage switch is closed after the drainage, and then the collecting container is hung and fixed.
S6, after the anastomotic stoma of the patient is healed, exhausting the air in the inner cavity of the intestinal fixator through the air charging pipeline, enabling the organ main body of the intestinal fixator to contract inwards, simultaneously charging air to the negative pressure pipeline, separating the intestinal mucosa of the patient from the periphery of the intestinal fixator under the action of positive pressure, detaching the external fixing clamp, and then directly taking out the rectal anastomotic stoma protecting device.
The invention has the advantages and positive effects that: according to the technical scheme, the intestinal fixator of the protection device is of an organ type structure, the lower end of the intestinal fixator is provided with the wide-mouth protruding part, the upper end of the drainage main pipe is of a wide-mouth protruding part structure, and the size of the wide-mouth protruding part at the upper end of the drainage main pipe is consistent with that of the wide-mouth protruding part at the lower end port of the intestinal fixator, so that the intestinal fixator and the drainage main pipe can be combined to form an I-shaped appearance, the intestinal fixator can be well fixed in intestinal tracts of patients without displacement, and the intestinal fixator can adapt to intestinal cavities of different sizes, effectively collect intestinal cavity contents, is free of residue and leakage, and is safe to use. The inner cavity between the intestinal internal fixator and the drainage main pipe is inflated and sucked through the inflation cavity of the protection device, so that the peripheral size of the organ pipe main body of the intestinal internal fixator can be adjusted to a certain degree, the shaping of the intestinal internal fixator is assisted, and the protection device is favorably placed, fixed and taken out. The negative pressure cavity inhales and inflates air to the outer cavity between the intestinal internal fixator and the intestinal wall of the patient, so that the intestinal internal fixator and the intestinal wall can be fully attached and separated, and when the air is inhaled, negative pressure is formed between the intestinal wall of the patient and the intestinal internal fixator, so that the intestinal mucosa is attached to the outer wall of the intestinal internal fixator, and the drainage is ensured to be free of leakage; when the protection device is inflated, the intestinal mucosa is separated from the outer wall of the intestinal internal fixator, and the protection device is convenient to take out. The perfusion channel formed by the perfusion cavity of the drainage main pipe and the perfusion pipeline can inject liquid such as flushing liquid and medicines into the intestines of the patient, so that the drainage of excrement is smooth and has no detention, and the non-return one-way valve can prevent the leakage of objects in the intestines. The drainage sleeve film is thin and flexible, can be contracted, has good compliance, and can be expanded to discharge excrement smoothly when the excrement is in the drainage sleeve film; when no excrement exists, the whole body is reduced, the occupied space is small, the foreign body sensation in the intestines is reduced, and the influence on the anus contraction function is reduced. The external fixation clamp can fix the drainage mantle and the external drainage pipeline outside the anus of the patient to prevent the drainage mantle from shifting or deforming due to external force traction, and meanwhile, the external fixation clamp is provided with a catheter fixing groove and a positioning hole, so that the perfusion tube, the inflation tube and the negative pressure tube are fixed, smooth pipelines are ensured, and the patient can move conveniently. The drainage main pipe, the drainage sleeve membrane, the external drainage pipeline and the collection container form a smooth and closed drainage channel, so that excrement is not contacted with the anastomotic stoma in the whole drainage process, and the rectum anastomotic stoma of a patient is effectively protected. The external drainage pipeline is provided with a flow stopping clip and a detachable joint which are matched with the joint on the collecting container for use, so that the collecting container can be detached and cleaned. In addition, the lower end of the collecting container is provided with a liquid outlet, and the patient can automatically adjust the discharge of the liquid in the collecting container according to the use condition.
In the operation, an I-shaped structure combining positive pressure support and negative pressure adsorption of the rectum anastomotic stoma protection device is placed in the colon at the proximal end of the anastomotic stoma of a patient, the intestinal internal fixator is well attached to the intestinal wall of the patient through the inflation and exhaust operations of the inner cavity and the outer cavity of the intestinal internal fixator, and excrement is drained from the inside of the drainage main pipe to the outside of the body, so that the anastomotic stoma can be effectively isolated, and the excrement is thoroughly prevented from contacting the operation anastomotic stoma; when necessary, the liquid medicine can be infused into the intestinal cavity through the infusion head, so that the excrement can be smoothly discharged. The rectum anastomotic stoma protection device can effectively avoid the infection of the anastomotic stoma and the abdominal infection of a patient caused by the leakage of the anastomotic stoma, so that the anastomotic stoma of the patient has sufficient time to heal, the operation of diversion and secondary recovery is not needed, and the pain of the patient is relieved. After the anastomotic stoma of the patient is healed, the protective device can be directly taken out, and secondary damage to the patient is avoided.
Drawings
FIG. 1 is a schematic structural view of the present invention;
FIG. 2 is a cross-sectional view A-A of FIG. 1;
FIG. 3 is a cross-sectional view B-B of FIG. 1;
FIG. 4 is a view from direction K of FIG. 1;
FIG. 5 is a cross-sectional view of a main drainage pipe C-C of the present invention;
FIG. 6 is a schematic structural view of an extracorporeal fixation clamp of the present invention;
fig. 7 is an enlarged partial cross-sectional view of the main drainage tube and the intestinal anchor of fig. 2.
In the figure: 1. a drainage main pipe; 1-1, a wide opening part at the upper end of the drainage main pipe; 1-2 parts of drainage cavity, 1-3 parts of negative pressure cavity; 1-4, inflating the cavity; 1-5, filling the cavity; 1-6, negative pressure side holes; 1-7, inflating side holes; 2. an enteral fixator; 2-1, a wide opening part at the lower end of the fixer; 2-2, an inner cavity of the fixer; 2-3, an outer cavity of the fixer; 3. a filling head; 3-1, filling the head end; 3-2, pouring side holes; 4. drainage covering film; 5. an in vitro fixation clamp; 5-1, drainage holes; 5-2, human body fixing holes; 5-3, a conduit fixing groove; 6. an extracorporeal drainage line; 6-1, a flow stopping clip; 6-2, a drainage pipeline joint; 7. a collection container; 7-1, collecting container joint; 7-2, a liquid drainage switch; 8. a filling pipeline; 8-1, filling a pipe; 8-2, a liquid non-return one-way valve; 9. an inflation pipeline; 9-1, inflating a tube; 9-2, an inflation indicating balloon; 9-3, inflating a one-way valve; 10. a negative pressure pipeline; 10-1, a negative pressure pipe; 10-2, a negative pressure indicating balloon; 10-3, a negative pressure one-way valve.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is further described in detail with reference to the following embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.
Referring to figures 1-7 of the drawings,
the rectum anastomotic stoma protecting device comprises a drainage main pipe 1, an intestinal internal fixator 2, a perfusion head 3, a drainage sleeve membrane 4, an external drainage pipeline 6, an external fixing clamp 5, a collecting container 7, a perfusion pipeline 8, an inflation pipeline 9 and a negative pressure pipeline 10. The drainage is responsible for the middle part outer wall and is equipped with intestines internal fixation ware, the drainage is responsible for and is equipped with four independent chambeies, is drainage chamber 1-2, fills chamber 1-5, aerifys chamber 1-4 and negative pressure chamber 1-3 respectively, the drainage is responsible for fills the chamber upper end and connects filling head 3, connects the pipeline 8 that fills at the lower extreme that fills the chamber, the drainage is responsible for and fills the chamber upper end and be closed structure, and the inflation line is connected to the lower extreme, the negative pressure chamber upper end system that the drainage was responsible for has the negative pressure side opening, the negative pressure side opening communicates with each other with intestines internal fixation ware exocoel, negative pressure pipeline 9 is connected to the negative pressure chamber lower extreme, drainage is responsible for the lower extreme connection drainage mantle 4 of drainage chamber 1-2, the external drainage pipeline 6 is connected to the external end of drainage mantle, collection container 7 is connected to the external drainage pipeline other end. The drainage main pipe, the drainage sleeve membrane, the external drainage pipeline and the collection container form a smooth and closed drainage channel, so that excrement is not contacted with the anastomotic stoma in the whole drainage process, and the rectum anastomotic stoma of a patient is effectively protected.
Specifically, the upper end of the drainage main pipe is designed into a structure of a non-equal-diameter wide-mouth protruding part, and the lower end of the drainage main pipe is of an equal-diameter pipe body structure. The drainage is responsible for the upper end wide-mouth bulge and is unanimous with intestines internal fixation ware lower port wide-mouth bulge size, can make intestines internal fixation ware and drainage be responsible for the appearance after the combination like this and be "worker" font, is favorable to keeping well fixed can not shifting in patient's intestinal, and the intestinal chamber of adaptable not unidimensional in addition effectively collects the intestinal chamber content, does not have to remain and leak, and is safe in utilization.
Specifically, the appearance of the intestinal internal fixator 2 is in an organ shape, a wide-mouth protruding part is arranged at the lower end port, the upper end and the lower end of the intestinal internal fixator are respectively sealed with the drainage main pipe, a closed space is formed in the periphery of the outer wall of the drainage main pipe and serves as an inner cavity of the fixator, the diameter of the wide-mouth protruding part at the lower end of the intestinal internal fixator corresponds to that of the wide-mouth protruding part at the upper end of the drainage main pipe, and the diameter of the wide-mouth protruding part at the lower end of the intestinal internal fixator is 25-35 mm and is 5-10 mm larger than that of a middle fold. The inner cavity between the intestinal internal fixator and the drainage main pipe is inflated and sucked through the inflation cavity of the protection device, so that the peripheral size of the organ pipe main body of the intestinal internal fixator can be adjusted to a certain degree, the shaping of the intestinal internal fixator is assisted, and the protection device is favorably placed, fixed and taken out.
Specifically, the pouring head 3 is a flexible hose, the head of the pouring head is provided with a smooth and closed pouring head end 3-1, and the side wall of the pouring head is provided with a plurality of pouring side holes 3-2. When the operation is needed, the liquid medicine can be infused into the intestinal cavity through the infusion head, so that the excrement can be smoothly discharged.
Specifically, the drainage covering membrane 4 adopts a thin-wall flexible hose which can be curled and folded, the wall thickness of the drainage covering membrane is smaller than 0.5mm, the upper end of the drainage covering membrane is fixedly bonded with the drainage main pipe 1, and the lower end of the drainage covering membrane is fixedly connected with the external fixing clamp 5. The drainage sleeve film is thin and flexible, can be contracted, has good compliance, and can be expanded to discharge excrement smoothly when the excrement is in the drainage sleeve film; when no excrement exists, the whole body is reduced, the occupied space is small, the foreign body sensation in the intestines is reduced, and the influence on the anus contraction function is reduced.
Specifically, the upper end of the external fixing clamp 5 is fixedly connected with the drainage sleeve 4, the lower end of the external fixing clamp is fixedly connected with the external drainage pipeline 6, and the external fixing clamp is provided with a drainage hole 5-1, a catheter fixing groove 5-2 and a human body fixing hole 5-3. The external fixation clamp can fix the drainage mantle and the external drainage pipeline outside the anus of the patient to prevent the drainage mantle from shifting or deforming due to external force traction, and meanwhile, the external fixation clamp is provided with a catheter fixing groove and a positioning hole, so that the perfusion tube, the inflation tube and the negative pressure tube are fixed, smooth pipelines are ensured, and the patient can move conveniently.
Specifically, the external drainage pipeline 6 is provided with a flow stopping clamp 6-1 and a detachable joint 6-2 which are matched with a joint on the collecting container 7 for use, so that the collecting container can be detached and cleaned.
Specifically, the collection container 7 is a flexible container for storing drainage liquid, and is provided with a connecting joint 7-1 and a drainage switch 7-2. The lower end of the collecting container is provided with a liquid outlet, and the patient can automatically adjust the discharge of the liquid in the collecting container according to the use condition.
Specifically, the filling pipeline 8 comprises a filling pipe 8-1 and a liquid non-return one-way valve 8-2, a silica gel one-way valve for preventing liquid backflow is arranged in the liquid non-return one-way valve, and the outer diameter of the filling pipe is smaller than 3 mm. The perfusion channel formed by the perfusion cavity of the drainage main pipe and the perfusion pipeline can inject liquid such as flushing liquid and medicines into the intestines of the patient, so that the drainage of excrement is smooth and has no detention, and the non-return one-way valve can prevent the leakage of objects in the intestines.
Specifically, the inflation pipeline 9 comprises an inflation tube 9-1, an inflation indicating balloon 9-2 and an inflation one-way valve 9-3, and the outer diameter of the inflation tube is 1.5-1.8 mm.
Specifically, the negative pressure pipeline 10 comprises a negative pressure pipe 10-1, a negative pressure indicating balloon 10-2 and a negative pressure one-way valve 10-3, and the outer diameter of the negative pressure pipe is 1.5-1.8 mm.
Specifically, the drainage main pipe, the intestinal fixator, the perfusion head and the drainage mantle can be made of medical silica gel or polyurethane materials with good biocompatibility.
An operation method of a rectum anastomotic stoma protection device comprises the following steps,
s1, after the rectum operation of the patient is anastomosed, the drainage main pipe 1 and the intestinal fixator 2 of the device are placed in the colon at the proximal end of the anastomotic stoma through the special conveying sleeve, the anastomotic stoma is kept below the intestinal fixator and positioned in the middle of the drainage sleeve 4, and the wide-mouth protruding part at the lower end of the intestinal fixator and the wide-mouth protruding part at the upper end of the drainage main pipe are attached to the intestinal wall to form a sealing structure similar to an I shape.
S2, filling a certain amount of gas into the inflation tube 9-1 of the inflation pipeline 9, expanding the organ-shaped intestinal fixator main body to the outer periphery under the action of positive pressure, then pumping negative pressure through the negative pressure pipeline 10, discharging air at the periphery of the intestinal fixator, forming negative pressure between the wide-mouth bulge at the lower end of the intestinal fixator and the wide-mouth bulge at the upper end of the drainage main tube, and attaching the intestinal mucosa of a patient to the periphery of the intestinal fixator main body under the action of negative pressure, thereby playing multiple fixing and sealing roles.
S3, extending the perfusion tube 8-1, the inflation tube 9-1 and the negative pressure tube 10-1 to the outside of the anus of the patient along the drainage sleeve, adjusting the position after leading out the anus and clamping the perfusion tube, the inflation tube and the negative pressure tube in the corresponding catheter fixing groove 5-2 on the external fixing clamp 5, fixing the external fixing clamp outside the anus of the patient through the human body fixing hole 5-3, adjusting the positions of the external drainage pipeline 6 and the collection container 7 and hanging the drainage pipeline, keeping the drainage channel smooth, and performing enteric drainage at the moment;
s4, when a patient needs to wash the intestinal lumen or dilute the enteric-coated substance, injecting normal saline or other medicines into the colon of the patient through the perfusion pipeline 8, so that the enteric-coated substance is smoothly led out of the body of the patient through a channel formed by the drainage lumen and the drainage sleeve membrane in the device after being diluted; the excrement generated in the processes of perfusion, flushing and drainage sequentially enters a collection container through a drainage cavity, a drainage sleeve membrane and an external drainage pipeline of a drainage main pipe, and the excrement in the operation process is guaranteed not to contact with an operation anastomosis port.
S5, when the collecting container 7 needs to be replaced or cleaned, closing the flow stopping clamp 6-1 on the external drainage pipeline 6, unscrewing the joint 7-1 on the collecting container, taking off the suspended collecting container, after cleaning or replacing a new collecting container, reinstalling, connecting and screwing the joint, when the excrement in the collecting container needs to be discharged, directly taking off the suspended collecting container without disassembling the joint, opening the liquid discharge switch, closing the liquid discharge switch after discharging, and then suspending and fixing.
S6, after the anastomotic stoma of the patient is healed, exhausting the air in the inner cavity of the intestinal fixator through the air charging pipeline 9, enabling the organ pipe main body of the intestinal fixator 2 to contract inwards, simultaneously charging air to the negative pressure pipeline, separating the intestinal mucosa of the patient from the periphery of the intestinal fixator under the action of positive pressure, removing the external fixation clamp, and then directly taking out the rectal anastomotic stoma protection device.
The I-shaped structure combining the positive pressure support and the negative pressure adsorption of the rectum anastomotic stoma protection device is placed in the colon at the proximal end of the anastomotic stoma of a patient, the intestinal internal fixator is well attached to the intestinal wall of the patient through the inflation and deflation operation of the inner cavity and the outer cavity of the intestinal internal fixator, and excrement is drained from the inside of the drainage main pipe to the outside of the body, so that the anastomotic stoma can be effectively isolated, and the excrement is thoroughly prevented from contacting the operation anastomotic stoma; when necessary, the liquid medicine can be infused into the intestinal cavity through the infusion head, so that the excrement can be smoothly discharged. The rectum anastomotic stoma protection device can effectively avoid the infection of the anastomotic stoma and the abdominal infection of a patient caused by the leakage of the anastomotic stoma, so that the anastomotic stoma of the patient has sufficient time to heal, the operation of diversion and secondary recovery is not needed, and the pain of the patient is relieved. After the anastomotic stoma of the patient is healed, the protective device can be directly taken out, and secondary damage to the patient is avoided.
The embodiments of the invention that are illustrated in the drawings are exemplary only and should not be taken as limiting the invention.
Claims (10)
1. A rectum anastomotic stoma protection device is characterized in that: comprises a drainage main pipe, an intestinal internal fixator, an infusion head, a drainage sleeve membrane, an external drainage pipeline, an external fixation clamp, a collection container, an infusion pipeline, an inflation pipeline and a negative pressure pipeline, the outer wall of the middle part of the drainage main pipe is provided with an intestinal fixator, the drainage main pipe is provided with four independent cavities which are respectively a drainage cavity, a perfusion cavity, an inflation cavity and a negative pressure cavity, the upper end of the perfusion cavity of the drainage main pipe is connected with a perfusion head, the lower end of the perfusion cavity is connected with a perfusion pipeline, the upper end of the inflatable cavity of the drainage main pipe is of a closed structure, the lower end of the inflatable cavity of the drainage main pipe is connected with an inflation pipeline, the upper end of the negative pressure cavity of the drainage main pipe is provided with a negative pressure side hole which is communicated with the outer cavity of the intestinal internal fixator, the lower end of the negative pressure cavity is connected with a negative pressure pipeline, the lower end of the drainage cavity of the drainage main pipe is connected with a drainage mantle, the external end of the drainage sleeve membrane is connected with an external drainage pipeline, and the other end of the external drainage pipeline is connected with a collection container.
2. The rectal anastomosis protection device of claim 1, wherein: the upper end of the drainage main pipe is designed into a structure of a non-equal-diameter wide-mouth bulge, and the lower end of the drainage main pipe is of an equal-diameter pipe body structure.
3. The rectal anastomosis protection device of claim 1, wherein: the appearance of the intestinal internal fixator is in an organ shape, a wide-mouth protruding part is arranged at a lower port, the upper end and the lower end of the intestinal internal fixator are respectively sealed with the drainage main pipe, a closed space is formed in the periphery of the outer wall of the drainage main pipe and serves as an inner cavity of the fixator, the diameter of the wide-mouth protruding part at the lower end of the intestinal internal fixator corresponds to that of the wide-mouth protruding part at the upper end of the drainage main pipe, and is 25-35 mm and 5-10 mm larger than that of a middle fold.
4. The rectal anastomosis protection device of claim 1, wherein: the pouring head is a flexible hose, the head part of the pouring head is provided with a smooth and closed pouring head end head, and the side wall of the pouring head is provided with a plurality of pouring side holes.
5. The rectal anastomosis protection device of claim 1, wherein: the filling pipeline comprises a filling pipe and a liquid non-return one-way valve, a silica gel one-way valve for preventing liquid from flowing back is arranged in the liquid non-return one-way valve, and the outer diameter of the filling pipe is smaller than 3 mm.
6. The rectal anastomosis protection device of claim 1, wherein: the inflation pipeline comprises an inflation tube, an inflation indicating saccule and an inflation one-way valve, and the outer diameter of the inflation tube is 1.5-1.8 mm.
7. The rectal anastomosis protection device of claim 1, wherein: the negative pressure pipeline comprises a negative pressure pipe, a negative pressure indicating balloon and a negative pressure one-way valve, and the outer diameter of the negative pressure pipe is 1.5-1.8 mm.
8. The rectal anastomosis protection device of claim 1, wherein: the drainage covering membrane is a thin-wall flexible hose which can be curled and folded, the wall thickness of the drainage covering membrane is less than 0.5mm, the upper end of the drainage covering membrane is fixedly bonded with the drainage main pipe, and the lower end of the drainage covering membrane is fixedly connected with the external fixing clamp.
9. The rectal anastomosis protection device of claim 1, wherein: the external fixation clamp is fixedly connected with the drainage sleeve membrane and the external drainage pipeline, and a drainage hole, a catheter fixing groove and a human body fixing hole are arranged on the external fixation clamp.
10. An operation method of a rectal anastomotic stoma protection device is characterized in that: comprises the following steps of (a) carrying out,
s1, after the rectum operation of the patient is anastomosed, firstly, the drainage main pipe and the intestinal fixator part of the device are placed in the colon at the proximal end of the anastomotic stoma through the special conveying sleeve, the anastomotic stoma is kept below the intestinal fixator and positioned in the middle of the drainage sleeve membrane, and the wide-mouth protruding part at the lower end of the intestinal fixator and the wide-mouth protruding part at the upper end of the drainage main pipe are attached to the intestinal wall to form a sealing structure similar to an I shape;
s2, filling a certain amount of gas into the inflation pipeline, expanding the organ-shaped intestinal fixator main body to the outer periphery under the action of positive pressure, then pumping negative pressure through the negative pressure pipeline, exhausting air at the periphery of the intestinal fixator, forming negative pressure between the wide-mouth bulge at the lower end of the intestinal fixator and the wide-mouth bulge at the upper end of the drainage main pipe, and attaching the intestinal mucosa of a patient to the periphery of the intestinal fixator main body under the action of negative pressure, thereby playing multiple fixing and sealing roles;
s3, extending the perfusion tube, the inflation tube and the negative pressure tube out of the anus of the patient along with the drainage sleeve film, adjusting the position after leading out the anus and clamping the perfusion tube, the inflation tube and the negative pressure tube in corresponding catheter fixing grooves on an external fixing clamp, fixing the external fixing clamp outside the anus of the patient through a human body fixing hole, adjusting the positions of an external drainage pipeline and a collection container, wearing and hanging the external drainage pipeline and the collection container, keeping the drainage channel smooth, and then performing enteric drainage;
s4, when a patient needs to wash the intestinal lumen or dilute the enteric-coated substance, injecting normal saline or other medicines into the colon of the patient through the injection tube, so that the enteric-coated substance is smoothly led out of the body of the patient through a channel formed by the drainage lumen and the drainage sleeve membrane in the device after being diluted; excrement generated in the processes of perfusion washing and drainage sequentially passes through a drainage cavity of a drainage main pipe, a drainage sleeve membrane and an external drainage pipeline and enters a collection container, so that the excrement in the operation process is ensured not to contact an anastomosis stoma;
s5, when the collection container needs to be replaced or cleaned, closing the flow stopping clamp on the external drainage pipeline, unscrewing and taking off the joint on the collection container, detaching the suspended collection container, after cleaning or replacing a new collection container, reinstalling, connecting and screwing down the joint, when the excrement in the collection container needs to be discharged, directly detaching the suspended collection container without detaching the joint, opening the liquid discharge switch, closing the liquid discharge switch after discharging, and then suspending and fixing;
s6, after the anastomotic stoma of the patient is healed, exhausting the air in the inner cavity of the intestinal fixator through the air charging pipeline, enabling the organ main body of the intestinal fixator to contract inwards, simultaneously charging air to the negative pressure pipeline, separating the intestinal mucosa of the patient from the periphery of the intestinal fixator under the action of positive pressure, detaching the external fixing clamp, and then directly taking out the rectal anastomotic stoma protecting device.
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