CN114259612A - Continuous drainage device for lumbar cisterna - Google Patents

Abstract

The invention belongs to the technical field of medical instruments, and particularly relates to a continuous drainage device for a lumbar cisterna, which comprises a drainage tube, wherein the right end of the drainage tube is movably connected with a thick-wall bag, the outer side of the drainage tube is sleeved with a hollow plug, the hollow plug is sleeved at the joint of the thick-wall bag and the drainage tube, the outer side of a body of the drainage tube is provided with a convection hole, the left end of the drainage tube is sealed, the right side of the sealed end of the drainage tube is connected with a traction line, the other end of the traction line penetrates through the inner cavity of the drainage tube and is connected with an O-shaped pull ring, the left side of the thick-wall bag is provided with a switching pull ring, and the switching pull ring is connected with the O-shaped pull ring Craniotomy, general anesthesia, lumbar anesthesia, etc.

Description

Continuous drainage device for lumbar cisterna

Technical Field

The invention relates to the technical field of medical instruments, in particular to a continuous drainage device for a lumbar cistern.

Background

Because of the blood-brain barrier (blood-brain barrier) between plasma and brain cells, the prevention, diagnosis and treatment of intracranial hypertension, traumatic craniocerebral hemorrhage, brain tumors, intracranial infection, etc. often require the establishment of physical channels between the central nervous system and the outside.

Such diseases include:

infectious diseases: cryptococcal meningitis, aspergillic meningitis, mucorales meningitis, tuberculous meningitis, bacterial meningitis (Staphylococcus aureus, Neisseria meningitidis, Brucella, Streptococcus pneumoniae), viral meningitis (herpes simplex virus, enterovirus, poliovirus, adenovirus, Japanese encephalitis virus, HIV virus), syphilitic meningitis (including other spirochetal meningitis), intracranial parasitic infections (encystus infections, etc.)

Neoplastic diseases: primary central nervous system tumors, such as primary central nervous system lymphoma (or secondary); waldenstrom's macroglobulinemia bee _ neel syndrome; other tumors, such as leukemia and lung cancer, have nervous system metastasis affecting the central nervous system. Of these, intrathecal injection of chemotherapeutic drugs is one of the most effective methods for the prevention and treatment of central nervous system leukemia (CNS).

Craniocerebral trauma: diagnosing and draining the bloody cerebrospinal fluid, controlling the intracranial pressure.

Central nervous system symptom control: cerebrospinal fluid leakage, intracranial hypertension, and the like.

The current surgical procedures commonly used for the above diseases include: 1) repeated lumbar puncture; 2) continuous lumbar cistern drainage; 3) lumbar cisterna abdominal drainage; 4) ommaya pouch, and the like.

1) Lumbar puncture: the operation method is that the patient bends on the bed lying on the side, and holds the knees with both hands, so that the lumbar kyphosis and the intervertebral space are widened. And (5) performing local conventional disinfection, and puncturing after infiltration anesthesia. Resistance exists when the needle is generally inserted into the needle for 4-5 cm, the resistance is suddenly reduced, then the needle core is pulled out, and cerebrospinal fluid can drip out when the needle tail is rotated. The cerebrospinal fluid is discharged and taken according to different purposes and specific conditions. Then the needle core is inserted, the puncture needle is pulled out, the puncture needle is fixed by a sterilized gauze piece, and the pillow is removed and the patient lies for 4 to 6 hours.

2) Continuous lumbar cistern drainage: through lumbar puncture, put into the drainage tube between the lumbar vertebrae, continuously drain cerebrospinal fluid, reach effects such as step-down, injection medicine, advantage: repeated lumbar puncture (for example, the treatment of cryptococcus meningitis, one puncture is needed for draining cerebrospinal fluid for 2 days sometimes), controllable flow rate and the like are avoided; the disadvantages are as follows: the seepage is more, and bacteria are easy to reversely enter cerebrospinal fluid to cause infection.

3) Lumbar cisterna abdominal drainage: through lumbar puncture, a drainage tube is placed between lumbar vertebrae, enters the abdominal cavity under the skin, and introduces cerebrospinal fluid into the abdominal cavity to be absorbed by the peritoneum. The operation is complicated.

4) Ommaya sac the Ommaya sac is a minimally invasive ventricular drainage tool, is invented by Pakistan neurosurgeon Ommaya in the course of continuous intracerebroventricular administration for treating fungal meningitis, is called as a chemotherapy sac, and is then applied to the ventricular drainage tool. The advantages are that: can repeatedly extract liquid, and can prevent tumor or infection spread caused by abdominal drainage by injecting chemotherapy (treating tumor) and antibiotics (reducing systemic drug administration) through the sac.

All the four operation modes have defects;

1) for the treatment of continuous intracranial hypertension, repeated lumbar puncture is needed, the pain of a patient is increased, the infection possibility is improved, fibrosis is caused after repeated operation of a puncture point, continuous lumbago, incontinence of urine and feces (nerve injury) and the like can be caused, pressure reduction and intrathecal injection are carried out through lumbar puncture, the cerebrospinal fluid pressure and the drug concentration change greatly, and cerebral hernia, chemical meningitis and the like can be caused;

2) the lumbar cisterna magna continuously drains, so that the puncture times are reduced, the blood pressure can be gradually reduced, but cerebrospinal fluid often flows out of a puncture port, so that external bacteria are easily reversely fed into the lumbar cisterna magna to cause central nervous system infection, and therefore the cerebrospinal fluid can be reserved for only 5-7 days, and the external drainage bag is fixed on a sickbed, so that a patient is inconvenient to move, and a drainage tube has no good fixing structure and is extremely easy to fall off;

3) lumbar cisterna abdominal drainage: the procedure must be performed under operating room conditions, requires anesthesia, is complicated and cannot be used in patients with infectious diseases (causing infectious peritonitis) and intolerance to anesthesia;

4) the Ommaya bag needs general anesthesia for craniotomy, needs a high-tech neurosurgeon to complete the operation under the assistance of a stereotactic operation planning system, damages the brain parenchyma in the operation process, and can cause hematoma and serious complications.

Therefore, an improved operation type and a matched medical apparatus thereof are needed, and intracranial lesion prevention, diagnosis and treatment which are simple to insert, small in wound, free of falling off, infection and blockage, painless to replace, capable of performing various diagnosis and treatment operations and convenient to nurse are realized.

Disclosure of Invention

The invention aims to provide a continuous drainage device for a lumbar cisterna magna, and aims to solve the problems of high cost and inconvenient operation of the existing lumbar cisterna magna drainage operation in the background art.

In order to achieve the purpose, the invention provides the following technical scheme: the utility model provides a last drainage device for big pond of waist, includes the drainage tube, the right-hand member swing joint of drainage tube has thick wall bag, the outside cover of drainage tube is equipped with the cavity stopper, the junction at thick wall bag and drainage tube is established to the cavity stopper cover, the convection hole has been seted up in the outside on the body of drainage tube, the left end of drainage tube is sealed, the sealed end right side of drainage tube is connected with the tractive line, the other end of tractive line runs through the inner chamber of drainage tube and is connected with O type pull ring, the left side of thick wall bag is provided with the switching pull ring, the switching pull ring is connected with O type pull ring.

Preferably, the hollow plug comprises an expansion plug column, the right end of the expansion plug column is connected with a fixing column, and a stitching plate is arranged on the outer side of the expansion plug column.

Preferably, the right side of the body of the fixing column is provided with a butt joint groove and a connecting groove, and the connecting groove is positioned on the outer side of the butt joint groove.

Preferably, the thick-walled capsule comprises a capsule body, and a connecting plate is arranged on the left side of the capsule body and corresponds to the connecting groove.

Preferably, the left side of the vesicle is provided with a butt joint, the butt joint is movably connected with the drainage tube, and a connection point of the butt joint and the drainage tube is positioned on the inner side of the butt joint groove.

Preferably, the outer side of the drainage tube is provided with a detachable puncture tube which is a three-way tube, and the length of the drainage tube is greater than that of the puncture tube.

Preferably, the drainage tube comprises a self-remaining tube, and a detachable disposal tube is connected to the right end of the self-remaining tube.

Preferably, the outer side of the thick-wall bag is provided with a handle, and the outer side of the hollow plug is provided with a positioning plate.

Compared with the prior art, the invention has the beneficial effects that:

1) the invention changes the surgical operation into the internal operation, the product can be installed only by lumbar puncture, theoretically, all ordinary doctors and anaesthetists master the lumbar puncture (the lumbar puncture is a project which is necessary to be examined by medical practitioners), the requirement of the operation on the operators is reduced, the operations such as incision and suture, craniotomy, general anesthesia, lumbar anesthesia and the like are not involved, the professional operation of neurosurgery is not needed, in the prior art, the saccule enters the upper abdomen from the skin of the lumbar through a tunnel in the body, and the replacement device needs to be incised and sutured again, so that the pain of a patient can be caused;

2) the device has low requirements on operation implementation sites, can be operated beside a bed without sterile environment, operating room and the like, has low requirements on personnel, can be developed in non-tertiary hospitals, and is convenient to popularize and apply in other laggard countries and regions in the world;

3) after the device is used for operation, the nursing is simple, no incision and continuous seepage exist after the operation, and the nursing is almost not needed;

4) the device has strong operability, can carry out repeated diagnostic cerebrospinal fluid collection, continuous drainage, repeated intrathecal injection, long-term pressure measurement, micro-pump drainage or injection and retention of a slow release agent, so that the intracranial drug concentration is slowly increased, and the side effect of a drug with toxicity can be further reduced;

5) the anti-blocking;

6) the replacement of the technique only needs to be simply guided by using a special soft cannula, does not need to perform lumbar puncture again, does not need anesthesia, and hardly causes pain, so that certain diseases for hospitalization can be followed and treated regularly in an outpatient clinic, and the whole medical expense is reduced;

7) the survival rate of the patient is improved, the patient who has poor state and can not tolerate general anesthesia or lumbar anesthesia can be treated, obvious trauma (only small puncture holes) does not exist in the first placement and replacement, and in addition, the device avoids craniotomy, repeated lumbar puncture and retention, does not influence normal life and sleep, and further does not cause spiritual impact on the patient;

8) the device has the advantages of no power supply, simple structure, no special material and very low production cost.

Drawings

FIG. 1 is a schematic structural view of the present invention;

FIG. 2 is a front view cross-sectional structural schematic of the thick-walled bladder of the present invention;

FIG. 3 is a schematic sectional view of the hollow plug according to the present invention;

FIG. 4 is a schematic sectional view of a puncture tube according to the present invention.

In the figure: 1 drainage tube, 11 self-remaining tube, 12 disposal tube, 13 convection hole, 2 pulling wire, 3 hollow plug, 31 expanding plug column, 32 fixed column, 33 butt joint groove, 34 connecting groove, 35 suture plate, 36 positioning plate, 4 thick-wall sac, 41 vesicle, 42 handle, 43 connecting plate, 44 switching pull ring, 45 butt joint, 5 puncture tube and 6O type pull ring.

Detailed Description

The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

In the description of the present invention, it is to be understood that the terms "upper", "lower", "front", "rear", "left", "right", "top", "bottom", "inner", "outer", and the like, indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, are merely for convenience in describing the present invention and simplifying the description, and do not indicate or imply that the device or element being referred to must have a particular orientation, be constructed and operated in a particular orientation, and thus, should not be construed as limiting the present invention.

Example (b):

referring to fig. 1-4, the present invention provides a technical solution: the utility model provides a continuous drainage device for big pond of waist, including drainage tube 1, the left end of drainage tube 1 is inserted in the cerebrospinal fluid, the right-hand member swing joint of drainage tube 1 has thick wall bag 4, the cerebrospinal fluid can flow into in thick wall bag 4 through drainage tube 1, the outside cover of drainage tube 1 is equipped with cavity stopper 3, cavity stopper 3 is used for pressing from both sides tight drainage tube 1 on the one hand, on the other hand is used for closely laminating with the skin, and then prevent that the cerebrospinal fluid from overflowing along drainage tube 1, the junction of thick wall bag 4 and drainage tube 1 is established to cavity stopper 3 cover, the outside has seted up convection current hole 13 on the body of drainage tube 1, the left end of drainage tube 1 is sealed, the sealed end right side of drainage tube 1 is connected with and draws line 2, draw and draw line 2, draw line 2 can follow convection hole 13 and bend this moment, can be to drawing line 2 and draw the silted pipe wall in drainage tube 1 because of fungus group, Emboli such as thrombus dredge, the other end that draws line 2 runs through drainage tube 1's inner chamber and is connected with O type pull ring 6, the left side of thick wall bag 4 is provided with switching pull ring 44, switching pull ring 44 is connected with O type pull ring 6, rotatory thick wall bag 4, thick wall bag 4 drives O type pull ring 6 through switching pull ring 44 and rotates, O type pull ring 6 drives and draws line 2 to remove and adds the wrench movement, draw line 2 round the pipe wall rotation of drainage tube 1, form the pigtail structure, thereby further dredge to the deposit in the drainage tube 1.

The cavity stopper 3 is including bloated stopper post 31, and the subcutaneous tissue is filled in to bloated stopper post 31, extrudees carrying out cavity stopper 3 through subcutaneous tissue, can compress tightly drainage tube 1 on the one hand to avoid drainage tube 1 to roll back, on the other hand also can avoid cerebrospinal fluid to spill over along drainage tube 1, and the right-hand member of bloated stopper post 31 is connected with fixed column 32, and the outside of bloated stopper post 31 is provided with sews up plywood 35, sews up board 35 and is used for sewing up with skin, and then fixed cavity stopper 3.

The right side of the body of the fixing column 32 is provided with a butt joint groove 33 and a connecting groove 34, the connecting groove 34 is positioned on the outer side of the butt joint groove 33, the thick-wall sac 4 comprises a sac body 41, the left side of the sac body 41 is provided with a connecting plate 43, the connecting plate 43 corresponds to the connecting groove 34, the connecting plate 43 can still rotate after being plugged in the connecting groove 34, the left side of the sac body 41 is provided with a butt joint 45, the butt joint 45 is movably connected with the drainage tube 1, the connecting point of the butt joint 45 and the drainage tube 1 is positioned on the inner side of the butt joint groove 33, and after the butt joint 45 is connected with the drainage tube 1, the drainage tube 1 fixed by the hollow plug 3 cannot rotate when the butt joint 45 rotates.

The handle 42 is arranged on the outer side of the thick-wall bag 4, the positioning plate 36 is arranged on the outer side of the hollow plug 3, and the twisting condition of the traction line 2 is judged according to the relative distance between the handle 42 and the positioning plate 36.

The outside of drainage tube 1 is provided with puncture tube 5 that can dismantle, and puncture tube 5 sets up to the three-way pipe, and the length of drainage tube 1 is longer than the length of puncture tube 5 by 7cm and more than, and drainage tube 1 includes from staying pipe 11, and the right-hand member of staying pipe 11 is connected with detachable and abandons pipe 12.

Instructions for use:

firstly, how to put in;

a. the patient bends on a lateral lying bed, holds knees with both hands to widen the lumbar kyphosis and the intervertebral space, is locally disinfected conventionally, after infiltration anesthesia, generally punctures in the 5 th lumbar intervertebral space, punctures a double-end lumbar puncture needle (meaning a puncture tube 5+ a hard metal puncture needle) into 4-5 cm under the skin to have resistance, feels the resistance to reduce suddenly, pulls out a needle core slowly (without withdrawing completely), rotates the needle tail to see that cerebrospinal fluid drips out from a side hole of the double-end lumbar puncture needle, and pushes the needle core into the puncture needle again immediately to avoid that the intracranial pressure changes too fast;

b. slowly pulling out the needle core, pushing in the drainage tube 1 at the side hole, allowing visible cerebrospinal fluid to flow out of the drainage tube 1, further pushing in the drainage tube 1, pulling out the puncture tube 5 (in the process, the drainage tube 1 is prevented from falling off), after the puncture tube 5 is completely pulled out, slightly forcibly cutting off the drainage tube 1 from the middle broken line (at the moment, the self-remaining tube 11 is separated from the waste tube 12), exposing the drainage tube 1 and the pull line 2, abandoning the waste tube 12, and keeping the self-remaining tube 11 remained in the human body;

c. the traction line 2 is buckled at the head end of the drainage tube 1 for fixing, the drainage tube 1 passes through the hollow plug 3, the traction line 2 is drawn out, and the O-shaped pull ring 6 is fixedly connected with the switching pull ring 44 on the left side of the thick-wall sac 4;

d. after the thick-wall sac 4, the hollow plug 3 and the drainage tube 1 are firmly connected, the thick-wall sac 4 is pressurized, the hollow plug 3 and the drainage tube 1 are pressed into the subcutaneous part, and the hollow plug 3 and the skin are fixed by knotting through suture lines;

e. rotating the thick-wall bag 4, and guiding the traction line 2 to wind the drainage tube 1, so that the tail end of the drainage tube 1 in the lumbar cisterna forms a coiled structure;

secondly, treating blockage of the drainage tube 1;

a. the thick-walled sac 4 is rotated reversely and forwardly repeatedly, so that the pulling wire 2 moves up and down in the drainage tube 1 to cut thrombus and fungus mass to cause falling off;

b. taking a fixed amount of normal saline, pushing in the normal saline through a non-wound needle, extracting an equivalent amount of liquid after verifying that the drainage tube 1 is smooth, and performing inspection when necessary;

three, replace new thick wall bag 4 suit

a. Reversely rotating the thick-wall bag 4, sequentially removing the thick-wall bag 4, the hollow plug 3 (cutting off suture lines) and other structures, pulling out the O-shaped pull ring 6 at the head of the pulling line 2, and then hooking the broken end of the self-remaining tube 11 by using the head end of the part of the disposal tube 12 of the new drainage tube 1;

b. the puncture tube sequentially goes along the self-remaining tube 11 part of the new drainage tube 1, the head end of the tube 12 part is abandoned, the self-remaining tube 11 part of the old drainage tube 1 enters the large waist pool, the head end of the old drainage tube 1 is kept to exceed the puncture tube 5, the new drainage tube 1 and the old drainage tube 1 are separated, the pull wire 2 of the old drainage tube 1 is loosened, and the curled pigtail structure of the large waist pool part of the drainage tube 1 is straightened so as to be conveniently taken out;

c. when the old drainage tube 1 is slowly withdrawn, a new drainage tube 1 is quickly placed in the side hole of the puncture tube 5, and the subsequent operation is the same as the 'one';

fourthly, measuring cerebrospinal fluid pressure, drainage, intrathecal injection and the like;

a. after the thick-wall sac 4 is fixed, a non-damaged needle (a thin injection needle) is inserted into the thick-wall sac 4, cerebrospinal fluid flows out of the non-damaged needle, the non-damaged needle is connected with a capillary glass piezometer tube, the long edge of the piezometer tube is vertical to the ground, the liquid level height is read, and the cerebrospinal fluid pressure can be reflected;

b. the pulling wire 2 ensures that the tail end of the drainage tube 1 presents a 'pigtail' structure and is not easy to fall off;

c. a hollow plug 3 is sleeved along the drainage tube 1, and the hollow plug 3 is connected with a thick-wall sac 4;

d. the thick-wall sac 4 is pressed with force, so that the hollow plug 3 enters into the subcutaneous part for fixation, and the pulling wire 2 is fixed on the thick-wall sac 4;

e. the infusion patch is fixed on the skin, or the suture is fixed on the skin;

f. the operation of drainage, sheath injection and the like is also performed through a non-wound needle, which is similar to an ommaya sac.

While there have been shown and described the fundamental principles and essential features of the invention and advantages thereof, it will be apparent to those skilled in the art that the invention is not limited to the details of the foregoing exemplary embodiments, but is capable of other specific forms without departing from the spirit or essential characteristics thereof; the present embodiments are therefore to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein, and any reference signs in the claims are not intended to be construed as limiting the claim concerned.

Although embodiments of the present invention have been shown and described, it will be appreciated by those skilled in the art that changes, modifications, substitutions and alterations can be made in these embodiments without departing from the principles and spirit of the invention, the scope of which is defined in the appended claims and their equivalents.

Claims (8)

1. A continuous drainage device for a lumbar cistern, comprising a drainage tube (1), characterized in that: the right-hand member swing joint of drainage tube (1) has thick wall bag (4), the outside cover of drainage tube (1) is equipped with cavity stopper (3), the junction of thick wall bag (4) and drainage tube (1) is established to cavity stopper (3) cover, convection hole (13) have been seted up in the outside on the body of drainage tube (1), the left end of drainage tube (1) is sealed, the sealed end right side of drainage tube (1) is connected with and pulls off line (2), the other end that pulls off line (2) runs through the inner chamber of drainage tube (1) and is connected with O type pull ring (6), the left side of thick wall bag (4) is provided with switching pull ring (44), switching pull ring (44) are connected with O type pull ring (6).

2. A continuous drainage device for the lumbar cistern as claimed in claim 1, wherein: the hollow plug (3) comprises an expansion plug column (31), the right end of the expansion plug column (31) is connected with a fixing column (32), and a sewing plate (35) is arranged on the outer side of the expansion plug column (31).

3. A continuous drainage device for the lumbar cistern as claimed in claim 2, wherein: the right side of the body of the fixing column (32) is provided with a butt joint groove (33) and a connecting groove (34), and the connecting groove (34) is located on the outer side of the butt joint groove (33).

4. A continuous drainage device for the lumbar cistern as claimed in claim 3, wherein: the thick-wall capsule (4) comprises a capsule body (41), a connecting plate (43) is arranged on the left side of the capsule body (41), and the connecting plate (43) corresponds to the connecting groove (34).

5. A continuous drainage device for the lumbar cistern as claimed in claim 4, wherein: the left side of the vesicle (41) is provided with a butt joint connector (45), the butt joint connector (45) is movably connected with the drainage tube (1), and the connection point of the butt joint connector (45) and the drainage tube (1) is positioned on the inner side of the butt joint groove (33).

6. A continuous drainage device for the lumbar cistern as claimed in claim 1, wherein: the drainage tube is characterized in that a detachable puncture tube (5) is arranged on the outer side of the drainage tube (1), the puncture tube (5) is arranged into a three-way tube, and the length of the drainage tube (1) is greater than that of the puncture tube (5).

7. A continuous drainage device for the lumbar cistern as claimed in claim 6, wherein: the drainage tube (1) comprises a self-remaining tube (11), and the right end of the self-remaining tube (11) is connected with a detachable disposal tube (12).

8. A continuous drainage device for the lumbar cistern as claimed in claim 1, wherein: the outer side of the thick-wall bag (4) is provided with a handle (42), and the outer side of the hollow plug (3) is provided with a positioning plate (36).

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