CN118079205A - 一类ecmo穿刺置管双腔导管 - Google Patents
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- 238000002618 extracorporeal membrane oxygenation Methods 0.000 title claims abstract description 43
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- 210000001631 vena cava inferior Anatomy 0.000 description 15
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- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 description 6
- 210000000591 tricuspid valve Anatomy 0.000 description 6
- 210000004731 jugular vein Anatomy 0.000 description 4
- 238000006213 oxygenation reaction Methods 0.000 description 4
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- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
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Abstract
本发明公开一类ECMO穿刺置管双腔导管,包括内腔导管和外腔导管,所述内腔导管包括头端、中端和尾端,所述外腔导管包覆内腔导管的中段并与内腔导管的外壁间形成外腔,内腔导管的尾端穿出外腔导管的侧壁并向外延伸;所述内腔导管的头端前部呈锥形,锥形尖端设有导管导丝开口,锥形面上开设有第一引流孔,所述外腔导管靠近内腔导管头端的侧壁上开设有第二引流孔。本发明通过对导管的独特设计,在一根导管内实现动、静脉血完全分隔,可避免两次血管穿刺,对大血管损伤较小。
Description
技术领域
本发明涉及医疗器械技术领域,具体涉及一类ECMO穿刺置管双腔导管。
背景技术
体外膜肺氧合,即ECMO(Extracorporeal Membrane Oxygenation),俗称“叶克膜”、“人工肺”,是一种医疗急救设备,用于对重症心肺功能衰竭患者提供持续的体外呼吸与循环,以维持患者生命。ECMO运转时,血液从患者静脉引出,通过膜肺氧合,排出二氧化碳,氧合血再通过静脉或动脉流回患者体内。ECMO的本质是一种改良的人工心肺机,其最核心的部分是膜肺和血泵,分别起人工肺和人工心的作用,可以对重症心肺功能衰竭患者进行长时间心肺支持,为危重症的抢救赢得宝贵的时间。
建立人工体外膜肺氧合,首先需要建立大的静脉通道,从体内引流出血液,经过氧合和排出二氧化碳,将血液输回到人体内,目前ECMO运转主要分为两种形式,第一、V/V通路ECMO支持形式;第二,V/A通路ECMO支持形式。对于静脉-静脉(V/V)通路ECMO支持形式,目前常规的V/V通路是从下腔静脉置管引出血液,再从颈内静脉置管输入上腔静脉,回流到右心房,进入肺循环,如图1所示,红色箭头为ECMO环路内的动脉血回输,蓝色剪头代表股静脉血引出体外。目前,用于体外膜肺氧合的置管存在诸多亟须解决的问题,比如用于体外膜肺氧合的静脉置管分为动脉引流管和静脉引流管,不能混用,而且由于静脉插管管径内径较大,从颈内静脉和股静脉穿刺两次,对血液管路损伤较大;此外,由于动、静脉置管引流之间没有分隔,从上腔静脉回输的动脉血一部分未进入右心房和肺循环,而直接经过下腔静脉引流出体外进入ECMO再循环,极大的分流了动脉血液,增加了ECMO血液的再循环,降低了ECMO输送氧和排出二氧化碳的交换运行效率,增大了ECMO治疗成本。因此,研发一种在ECMO运作过程中单管置入,能很好地引流静脉血液,同时尽可能避免动脉血再循环的ECMO置管导管,是亟待本领域科学技术人员解决的问题。
发明内容
为解决上述现有技术中的不足,本发明提供一类ECMO穿刺置管双腔导管,将穿刺置管合二为一,能很好地引流静脉血液,同时尽可能避免动脉血再循环。
为实现上述技术目的,本发明采用的技术方案是:
一类ECMO穿刺置管双腔导管,包括内腔导管和外腔导管,所述内腔导管包括头端、中端和尾端,所述外腔导管包覆内腔导管的中段并与内腔导管的外壁间形成外腔,内腔导管的尾端穿出外腔导管的侧壁并向外延伸;所述内腔导管的头端前部呈锥形,锥形尖端设有导管导丝开口,锥形面上开设有第一引流孔,所述外腔导管靠近内腔导管头端的侧壁上开设有第二引流孔。
进一步地,所述第二引流孔与第一引流孔之间的距离不超过5cm。
进一步地,所述内腔导管的头端外周位于第一引流孔与第二引流孔之间设有气囊,所述气囊外接充气装置。
进一步地,在内腔导管的中间段处,所述外腔导管与内腔导管同轴设置。
进一步地,用于经股静脉通路置入时,内腔导管外接ECMO的离心泵,外腔导管外接ECMO的人工膜肺。
进一步地,用于经颈静脉通路置入,内腔导管外接ECMO的人工膜肺,外腔导管外接ECMO的离心泵。
与现有技术相比,本发明的有益效果有:
本发明通过对导管的独特设计,在一根导管内实现动、静脉血完全分隔,可避免两次血管穿刺,对大血管损伤较小。
本发明中,第一引流孔与第二引流孔之间的距离设定,可以避免下腔静脉血引流不畅、抖管的问题,第一引流孔或第二引流孔正对右心房的三尖瓣,有助于动脉血回流更顺畅;气囊位在右心房和下腔静脉衔接处,充气以后防止动脉血进入下腔静脉,最大程度得减少动脉血再循环。
本发明中,双腔导管采用同轴的环形设计,可确保血液成层流状态流动,避免血栓形成。
附图说明
为了更清楚地说明本申请实施例的技术方案,下面将对实施例中所需要使用的附图作简单地介绍,应当理解,以下附图仅示出了本申请的某些实施例,因此不应被看作是对范围的限定,对于本领域普通技术人员来讲,在不付出创造性劳动的前提下,还可以根据这些附图获得其他相关的附图。
图1是现有技术中V/V通路ECMO支持形式的动、静脉血流向示意图;
图2是本发明的结构示意图;
图3是本发明在经股静脉通路置入时的应用示意图;
图4是本发明在经颈静脉通路置入时的应用示意图。
附图标记:1-内腔导管,11-前端,12-中间段,13-尾端,14-第一引流孔,2-外腔导管,21-第二引流孔,3-气囊。
具体实施方式
为使本申请实施例的目的、技术方案和优点更加清楚,下面将结合本申请实施例中的附图,对本申请实施例中的技术方案进行清楚、完整地描述,显然,所描述的实施例是本申请一部分实施例,而不是全部的实施例。通常在此处附图中描述和示出的本申请实施例的组件可以以各种不同的配置来布置和设计。因此,以下对在附图中提供的本申请的实施例的详细描述并非旨在限制要求保护的本申请的范围,而是仅仅表示本申请的选定实施例。基于本申请中的实施例,本领域普通技术人员在没有作出创造性劳动前提下所获得的所有其他实施例,都属于本申请保护的范围。
一类ECMO穿刺置管双腔导管,如图2所示,包括内腔导管1和外腔导管2,所述内腔导管1包括头端11、中端12和尾端13,所述外腔导管2包覆内腔导管1的中段并与内腔导管1的外壁间形成外腔,内腔导管1的尾端13穿出外腔导管2的侧壁并向外延伸;所述内腔导管1的头端11前部呈锥形,锥形尖端设有导管导丝开口,锥形面上开设有第一引流孔14,所述外腔导管2靠近内腔导管1头端11的侧壁上开设有第二引流孔21。所述第二引流孔21与第一引流孔14之间的距离不超过5cm。进一步地,所述内腔导管1的头端11外周位于第一引流孔14与第二引流孔21之间设有气囊3,所述气囊3外接充气装置。
进一步地,在内腔导管1的中间段12处,所述外腔导管2与内腔导管1同轴,可确保在内腔与外腔的血液呈层流状态流动,避免形成血栓。
本发明的双腔导管,可用于经股静脉通路置入。如图3所示,经股静脉通路置入后第一引流孔14正对右心房和三尖瓣,第二引流孔21位于下腔静脉内,内腔导管1外接ECMO的离心泵,内腔导管内为动脉血,从第一引流孔14进入右心房、三尖瓣,外腔导管2内为从下腔静脉引流的静脉血,外接ECMO的人工膜肺。置管时,使用超声对导管尖端位置进行定位,使第一引流孔14位于右心房、正对三尖瓣,第一引流孔14距离第二引流孔21不超过5厘米,第二引流孔21在下腔静脉内,方便通畅引流下腔静脉血,气囊3位于右心房和下腔静脉衔接处,充气以后防止第一引流孔14流出的动脉血进入第二引流孔21,最大程度得减少动脉血再循环,可以更充分顺畅回输入动脉血,进入肺循环。
本发明的双腔导管,也可用于经颈静脉通路置入。如图4所示,经颈静脉通路置入后,第一引流孔14位于下腔静脉内,第二引流孔21对准右心房和三尖瓣,内腔导管内为从下腔静脉引流的静脉血,外接ECMO的人工膜肺,外腔导管2内为动脉血,外接ECMO的离心泵;置管时,使用超声对导管尖端位置进行定位,使第一引流孔14在下腔静脉内,第二引流孔21位于右心房、正对三尖瓣,第一引流孔14距离第二引流孔21不超过5厘米,方便通畅引流下腔静脉血,气囊3位于右心房和下腔静脉衔接处,充气以后防止第二引流孔21流出的动脉血进入第一引流孔14,最大程度得减少动脉血再循环,可以更充分顺畅回输入动脉血,进入肺循环。
当然,本发明还可有其它多种实施例,在不背离本发明精神及其实质的情况下,熟悉本领域的技术人员可根据本发明作出各种相应的改变和变形,但这些相应的改变和变形都应属于本发明所附的权利要求的保护范围。
Claims (6)
1.一类ECMO穿刺置管双腔导管,其特征在于:包括内腔导管(1)和外腔导管(2),所述内腔导管(1)包括头端(11)、中端(12)和尾端(13),所述外腔导管(2)包覆内腔导管(1)的中段并与内腔导管(1)的外壁间形成外腔,内腔导管(1)的尾端(13)穿出外腔导管(2)的侧壁并向外延伸;所述内腔导管(1)的头端(11)前部呈锥形,锥形尖端设有导管导丝开口,锥形面上开设有第一引流孔(14),所述外腔导管(2)靠近内腔导管(1)头端(11)的侧壁上开设有第二引流孔(21)。
2.根据权利要求1所述的ECMO穿刺置管双腔导管,其特征在于:所述第二引流孔(21)与第一引流孔(14)之间的距离不超过5cm。
3.根据权利要求1所述的ECMO穿刺置管双腔导管,其特征在于:所述内腔导管(1)的头端(11)外周位于第一引流孔(14)与第二引流孔(21)之间设有气囊(3),所述气囊(3)外接充气装置。
4.根据权利要求1所述的ECMO穿刺置管双腔导管,其特征在于:在内腔导管(1)的中间段(12)处,所述外腔导管(2)与内腔导管(1)同轴设置。
5.根据权利要求1所述的ECMO穿刺置管双腔导管,其特征在于:用于经股静脉通路置入时,内腔导管(1)外接ECMO的离心泵,外腔导管(2)外接ECMO的人工膜肺。
6.根据权利要求1所述的ECMO穿刺置管双腔导管,其特征在于:用于经颈静脉通路置入,内腔导管(1)外接ECMO的人工膜肺,外腔导管(2)外接ECMO的离心泵。
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