CN1686067A - Cataract ultrasonic emulsification instrument - Google Patents

Abstract

A cataract phacoemulsification apparatus used in the technical field of medical equipment. Including: treatment needle section, throttling refrigeration section, operating handle, main engine, characterized in that the treatment needle section, throttling refrigeration section, and operating handle are integrated into a whole, respectively at the front end, middle end, and rear end of the whole body, and the main engine is set at The end of the integral rear end operating handle, the treatment needle section is composed of the front section of the treatment needle and a thermocouple, the treatment needle performs ultrasonic vibration, and a thermocouple is welded on the treatment needle section; the throttling treatment section includes: after the treatment needle section, cooling section protective sleeve, heat insulation material, throttling capillary, the rear section of the treatment needle is set in the center of the throttling treatment section, the throttling capillary is wrapped outside the rear section of the treatment needle, between the throttling capillary and the cooling section protective cover Fill with insulating material. The Joule-Thomson technique avoids possible thermal damage to the intraocular tissue during the operation, reduces the surgical incision to about 1mm, and speeds up the recovery speed of the patient after the operation.

Description

Cataract Phacoemulsification Apparatus

technical field

The invention relates to an instrument used in the technical field of medical instruments, in particular to a phacoemulsification instrument for ophthalmic medical surgery.

Background technique

The working principle of the phacoemulsification instrument to remove the cataract tissue in the patient's eye is: drive the ultrasonic transducer with a power ultrasonic signal source, convert the electrical energy into high-speed and small-amplitude mechanical energy, and produce "cutting effect" and "cavitation effect" on the cataract tissue in the eyeball. ", make it crushed, emulsified and sucked out of the body. Ultrasound technology has been used in clinical treatment for nearly 40 years. In the past 10 to 20 years, ultrasonic treatment equipment has developed rapidly. my country is still in its infancy in the development of ultrasonic treatment equipment. At present, when cataracts are removed with a phacoemulsification device, a small incision of about 3 mm is made on the outside of the eyeball, the treatment needle enters the eye, and the crystals are crushed by using the "cutting effect" and "cavitation effect" of ultrasonic waves. Suction the emulsified cataract fragments out of the eye, and then implant the artificial lens to restore the patient's vision.

After searching the literature of the existing technology, it is found that the patent number is: 97119026.7, and the name is: Cataract Phacoemulsification Apparatus, which uses ultrasonic waves with a frequency of 50kHz to treat cataracts. The technology reads: The whole machine uses a single-chip microcomputer to control the liquid crystal to display Chinese characters Human-machine interface, including a high-efficiency miniaturized ultrasonic transducer connected to a replaceable two-stage stepped amplitude and hyperboloid excessive horn (treatment needle), a circuit consisting of switching power amplifier circuit, automatic frequency tracking, constant Ultrasonic power supply composed of power control, and injection suction and backflow protection system composed of peristaltic pump, solenoid valve, and vacuum degree measurement circuit. The threat of thermal damage to the cornea caused by the high ultrasonic energy of this technology still exists, and with the increase of the ultrasonic frequency, this threat becomes more prominent. At present, the main factors causing corneal thermal injury include high-energy ultrasound, tight incision, and obstruction of the circulation of perfusate in the anterior chamber. Since the phacoemulsification device works on the principle of ultrasonic vibration, it is inevitable to vibrate and generate heat during the treatment process. Although the heat generation is not very large, because the volume of the treatment needle is small, the temperature of the needle is relatively high during treatment. It is much higher than the body temperature of the human body, which will cause a certain degree of surgical trauma to the affected area, and may even cause a certain degree of thermal damage. In addition, cataract surgery done with traditional phacoemulsification can lead to severe corneal astigmatism. With the improvement of cataract surgery technology, postoperative corneal astigmatism has become the main reason for affecting vision recovery. During cataract surgery, factors such as the position, size, suture, suture method of the surgical incision, and the healing of the incision after the operation will all cause changes in the corneal shape, resulting in distortion of the corneal curvature radius, making the curvature radii of the corneal meridians unequal. , The incident light is unequally refracted on each meridian of the cornea, and cannot be gathered on the retina at the same time, resulting in distortion and blurring of the patient's vision. This is postoperative corneal astigmatism. Under the condition of certain other factors, such as suitable incision position for cataract surgery, uniform, accurate and neat suture tension, and tight incision closure, it is very important to minimize the size of the incision. Currently, the incision for cataract surgery is about 3mm. Smaller surgical incisions can reduce the degree of postoperative corneal astigmatism, thereby improving the quality of surgery and shortening the recovery time of patients.

Contents of the invention

The purpose of the present invention is to overcome the deficiencies in the prior art and provide a phacoemulsification apparatus for cataract. It makes it possible to reasonably control the working temperature of the treatment needle through the Joule-Thomson (J-T) throttling refrigeration technology, so as to avoid possible thermal damage to the intraocular tissues (such as cornea, iris, etc.) during the operation and reduce the trauma to the affected area during the operation. And the surgical incision can be reduced from about 3mm to about 1mm; the stable, lower treatment needle temperature and smaller surgical incision will further reduce the impact of surgery on corneal astigmatism and speed up the recovery of patients after surgery.

The present invention is realized through the following technical proposals. The present invention includes: a treatment needle section, a throttling refrigeration section, an operating handle, a main engine, and the treatment needle section, a throttling refrigeration section, and an operating handle are integrated into a whole, respectively at the front end and the middle of the whole body. End, rear end, the host is set at the end of the overall rear end operating handle. The treatment needle section is composed of the front section of the treatment needle and a thermocouple. The treatment needle vibrates ultrasonically, and a thermocouple is welded on the treatment needle section: the throttling cooling section includes: the back section of the treatment needle, the cooling section protective cover, the heat insulation Material, throttling capillary, the rear part of the treatment needle is set in the center of the throttling refrigeration section, the throttling capillary is wrapped outside the rear section of the treatment needle, and the space between the throttling capillary and the protective sleeve of the refrigeration section is filled with heat insulating material.

The high-pressure gas flows in the throttling capillary, and the heat generated by the ultrasonic vibration of the treatment needle and the heat transferred from the eyeball to the treatment needle are taken away by the Joule-Thomson (J-T) cold effect generated by the high-pressure gas throttling. Silver plating or silver brazing ensures good heat conduction between the throttling capillary and the treatment needle, and the outside of the throttling cooling section is a protective cover for the cooling section.

The section of the treatment needle is partly wound with a throttling capillary near the operating handle.

The operating handle, the inlet pipe and outlet pipe of the throttling capillary, and the induction wire of the thermocouple pass through the operating handle.

The host computer includes a control display circuit composed of a liquid crystal display interface and a single-chip microcomputer control circuit, a control display circuit composed of a single-chip microcomputer control circuit, a temperature measurement circuit, an inlet pressure measurement circuit, an inlet pressure sensor, an outlet pressure measurement circuit, an outlet pressure sensor and a liquid crystal display. A temperature and pressure monitoring and display circuit composed of an interface, and a flow automatic adjustment system composed of a single-chip microcomputer control circuit, an opening driver of an inlet pressure regulating valve, an inlet pressure regulating valve, an opening driver of an outlet pressure regulating valve, and an outlet pressure regulating valve. The control circuit is further described below: the host is provided with a master switch, a button for setting the temperature of the treatment needle, etc., and the liquid crystal display can display parameters such as inlet pressure, outlet pressure, and temperature of the treatment needle. The temperature signal sensed by the thermocouple is transmitted to the single-chip microcomputer control circuit through the temperature measurement circuit. The opening degree driver of the inlet pressure regulating valve can adjust the opening degree of the inlet pressure regulating valve under the control of the single-chip microcomputer control circuit; the opening degree driver of the outlet pressure regulating valve can adjust the opening degree of the outlet pressure regulating valve under the control of the single-chip microcomputer control circuit. When the temperature of the treatment needle deviates from the preset temperature, the single-chip microcomputer control circuit sends an instruction to adjust the opening of the inlet pressure regulating valve and the outlet pressure regulating valve respectively through the driver of the opening of the inlet pressure regulating valve and the driver of the opening of the outlet pressure regulating valve. , so as to control the flow rate of high-pressure gas, and then control the temperature of the treatment needle at the preset temperature. An inlet pressure sensor is installed at the outlet of the inlet pressure regulating valve, and the inlet pressure sensor transmits the sensed inlet pressure signal to the single-chip microcomputer control circuit through the inlet pressure measurement circuit; an outlet pressure sensor is installed at the outlet of the outlet pressure regulating valve, and the outlet The pressure sensor transmits the sensed outlet pressure signal to the single-chip microcomputer control circuit through the outlet pressure measurement circuit. The various components in the main engine, according to the sequence of high-pressure gas flow, are: gas source master valve, filter, inlet pressure regulating valve, inlet pressure sensor, outlet pressure sensor, and outlet pressure regulating valve. The connection between the filter, the inlet pressure regulating valve and the outlet pressure regulating valve and the pipeline is threaded or welded, and the connection between the inlet pressure sensor and the outlet pressure sensor and the pipeline is welded.

The working process of the present invention: before the operation, the doctor sets the temperature of the treatment needle on the host according to the specific conditions of the operation, connects the high-pressure gas source (take high-pressure nitrogen as an example) with the host, and the high-pressure nitrogen passes through the filter and the imported pressure regulating valve. Entering the throttling capillary, the high-pressure nitrogen gas is throttled and depressurized in the throttling capillary, which produces the Joule-Thomson cooling effect, and takes away the heat generated by the ultrasonic vibration of the treatment needle and the heat transferred from the eyeball to the treatment needle, and the throttled gas passes through The outlet pressure regulating valve discharges the main engine. A thermocouple is welded on the treatment needle, and the single-chip microcomputer control circuit controls the opening driver of the inlet pressure regulating valve and the opening driver of the outlet pressure regulating valve according to the temperature signal of the treatment needle sensed by the thermocouple, and automatically adjusts the inlet pressure regulating valve and the outlet regulator. The opening of the pressure valve is used to adjust the flow of high-pressure nitrogen gas entering the throttling capillary of the refrigeration section, and to control the temperature of the treatment needle to the required temperature range. The liquid crystal display interface can display the temperature of the treatment needle, the inlet pressure of the throttling capillary, the outlet pressure and other parameters, so that the doctor can monitor the operation of the throttling refrigeration system at any time during the operation, so as to adjust the temperature of the treatment needle according to the specific conditions of the operation. and make corresponding adjustments.

Compared with the traditional cataract phacoemulsification apparatus, the phacoemulsification apparatus of the present invention has the following advantages: (1) the temperature-controllable phacoemulsification treatment needle completely avoids possible thermal damage to intraocular tissues during cataract surgery, The doctor can set the temperature of the phacoemulsification treatment needle according to the specific situation of the operation to ensure the best operation effect. (2) The phacoemulsification needle adopts a sleeveless design, which will neither block the gap around the incision due to the thermal deformation of the heat insulation sleeve during the phacoemulsification process, resulting in reduced perfusion fluid leakage; nor will the heat insulation sleeve be pressed by the front and rear lips of the incision. Obstruction of fluid perfusion in the anterior chamber. Perfusion and phacoemulsification are separated, and even if the phacoemulsification needle is blocked by lens nucleus fragments during the operation, it will not cause perfusate circulation disturbance in the anterior chamber. In this way, good perfusate circulation can play a vital role in maintaining the normal function of intraocular tissues during surgery. (3) The surgical incision is smaller, the outer diameter of the new type of phacoemulsification treatment needle is smaller, and the width of the surgical incision can be reduced to about 1.0 mm, which can further reduce the impact of postoperative corneal astigmatism (corneal astigmatism affects postoperative uncorrected vision). One of the important reasons for recovery, and the most important factor affecting the degree of corneal astigmatism is the incision width). (4) Less damage to corneal nerves, smaller corneal incisions have less damage to corneal nerves, and have little negative impact on postoperative corneal perception. (5) The operation is simpler and more flexible. Because the new type of phacoemulsification needle is lighter and lighter, the operating space in the anterior chamber is relatively increased.

Description of drawings

Fig. 1 working schematic diagram of the present invention

Fig. 2 structural representation of the present invention

Fig. 3 Schematic diagram of the structure of the treatment needle section of the present invention

Fig. 4 structural schematic diagram of throttling refrigeration section of the present invention

Fig. 5 schematic diagram of control circuit of the present invention

Among them, the treatment needle section 1, the throttling refrigeration section 2, the operating handle 3, the main engine 4, the inlet pressure regulating valve 5, the filter 6, the main air source valve 7, the high pressure air source 8, the outlet pressure regulating valve 9, and the treatment needle 10 , Thermocouple 11, refrigeration section protective cover 12, heat insulating material 13, throttling capillary 14.

Detailed ways

As shown in Fig. 1, the treatment needle section 1, the throttling refrigeration section 2 and the operating handle 3 of the present invention are integrated into a whole, respectively at the front end, the middle end, and the rear end of the whole body, and the host machine 4 is arranged at the rear end of the whole body operating handle 3. end. A thermocouple 11 is welded on the treatment needle section 1, a throttling capillary 14 is arranged in the throttling refrigeration section 2, an inlet pipe and an outlet pipe of the throttling capillary 14 are arranged in the operating handle 3, and induction lines of the thermocouple 11, etc. Handle 3 through. The main engine 4 is the control center of the phacoemulsification apparatus described in the present invention, and parameters such as the temperature of the cooling needle 10 can be set on a friendly man-machine interface, and the temperature and inlet of the cooling needle 10 of the throttling refrigeration system can be monitored through the display window. Pressure, outlet pressure and other parameters.

As shown in Fig. 2, it is a structural schematic diagram of the present invention. The main components of the present invention include a treatment needle section 1 , a throttling refrigeration section 2 and an operating handle 3 . The treatment needle section 1, the throttling refrigeration section 2, and the operating handle 3 are integrated into a whole, respectively at the front end, the middle end, and the rear end of the whole. Operating handle 3 is about 10mm with diameter, and wall thickness is about 0.5mm (Φ 10 * 0.5) medical stainless steel tube (X2CrNi 18-9) is made, and shape is convenient to hold by the doctor. The connection type of the treatment needle section 1 and the throttling refrigeration section 2, and the throttling refrigeration section 2 and the operating handle 3 is welding.

As shown in FIG. 3 , it is a schematic diagram of the structure of the treatment needle section of the present invention. The treatment needle section 1 includes a treatment needle 10 and a thermocouple 11. The treatment needle 10 is made of a medical stainless steel tube (X2CrNi 18-9) with a diameter of 1.0mm and a wall thickness of 0.1mm (Φ1.0×0.1), and the treatment needle extends all the way To the junction of throttling refrigeration section 2 and operating handle 3. A thermocouple 11 is welded at the rear end of the treatment needle 10 , and the thermocouple 11 is used for sensing the temperature of the treatment needle 10 .

As shown in FIG. 4 , it is a schematic structural diagram of the throttling refrigeration section of the present invention. The throttling treatment section 2 includes: a treatment needle 10 , a cooling section protective cover 12 , a thermal insulation material 13 , and a throttling capillary 14 . The throttling capillary 14 is formed by bending a capillary (X2CrNi 18-9) with a diameter of 0.5 mm and a wall thickness of 0.08 mm (Φ0.5×0.08) into a spiral shape with a mold, and the treatment needle 10 is formed along the formed spiral capillary 14 Insert axially, and then achieve permanent connection between the treatment needle 10 and the capillary 14 and ensure good heat conduction between the throttling capillary 14 and the treatment needle 10 by silver plating or silver brazing. It is characterized in that the Joule-Thomson (J-T) throttling refrigeration technology is applied to the phacoemulsification apparatus of the present invention, that is, the throttling capillary 14 is wound on the part of the treatment needle 10 close to the operating handle 3, and the high-pressure gas flows therein. The heat generated by the ultrasonic vibration of the treatment needle 10 and the heat transmitted to the treatment needle 10 by the eyeball are taken away by the Joule-Thomson (J-T) cooling effect generated by the throttling of the high-pressure gas. The outside of the throttling refrigerating section 2 is a protective cover 12 for the refrigerating section (because high-pressure gas flows in the capillary to prevent accidental leakage from harming the human body), between the throttling capillary 14 and the refrigerating section protecting cover 12 Filled with heat insulating material 13 for reducing cold loss.

As shown in Fig. 5, it is a schematic diagram of the control circuit of the present invention. The control circuit is structurally included in the host. The control circuit includes: a control display circuit composed of a single-chip microcomputer control circuit 21 and a liquid crystal display 20 interface, a single-chip microcomputer control circuit 21, a temperature measurement circuit 22, an inlet pressure measurement circuit 25, an outlet pressure measurement circuit 26, an inlet pressure sensor 27, A temperature and pressure monitoring and display circuit composed of an outlet pressure sensor 28 and a liquid crystal display 20 interface, a single-chip microcomputer control circuit 21, an inlet pressure regulating valve opening driver 23, an inlet pressure regulating valve 5, an outlet pressure regulating valve opening driver 24 and an outlet A flow automatic adjustment system composed of pressure regulating valve 9. The single-chip microcomputer control circuit 21 is provided with a main switch, a temperature setting button of the treatment needle 10, etc., and the liquid crystal display 20 can display parameters such as inlet pressure, outlet pressure, and temperature of the treatment needle 10. The temperature signal sensed by the thermocouple 11 is transmitted to the single-chip microcomputer control circuit 21 through the temperature measurement circuit 22 . The inlet pressure regulating valve opening driver 23 can adjust the opening of the inlet pressure regulating valve 5 under the control of the single-chip microcomputer control circuit 21; the outlet pressure regulating valve opening driver 24 can adjust the outlet pressure regulating valve under the control of the single-chip microcomputer control circuit 21. The opening of valve 9. When the temperature of the treatment needle 10 deviates from the preset temperature, the single-chip microcomputer control circuit 21 issues an instruction to adjust the inlet pressure regulating valve 5 and the outlet pressure regulating valve 5 through the inlet pressure regulating valve opening driver 23 and the outlet pressure regulating valve opening driver 24 respectively. The opening of the pressure valve 9 is controlled to control the flow rate of the high-pressure gas, and then the temperature of the treatment needle 10 is controlled to a preset temperature. An inlet pressure sensor 27 is provided at the outlet of the inlet pressure regulating valve 5, and the inlet pressure sensor transmits the sensed inlet pressure signal to the single-chip microcomputer control circuit 21 through the inlet pressure measuring circuit 25; The outlet pressure sensor 28 , the outlet pressure sensor transmits the sensed outlet pressure signal to the single-chip microcomputer control circuit 21 through the outlet pressure measurement circuit 26 .

Claims (3)

1, a kind of cataract ultrasonic emulsification instrument, comprise: treatment syringe needle section (1), throttling refrigeration section (2), operating grip (3), main frame (4), it is characterized in that, treatment syringe needle section (1), throttling refrigeration section (2), operating grip (3) become an integral body, respectively in front end, middle-end, the rear end of integral body, main frame (4) is arranged on the end of whole rear end operating grip (3), described treatment syringe needle section (1) is made up of treatment syringe needle (10) leading portion and thermocouple (11), treatment syringe needle (10) is done supersonic vibration, is welded with thermocouple (11) on the treatment syringe needle section (1); Described throttling refrigeration section (2) comprising: treatment syringe needle (10) back segment, refrigerating section protective sleeve (12), adiabator (13), throttle capillary tube (14); the back segment of treatment syringe needle (10) is arranged on the interior center of throttling refrigeration section (2); throttle capillary tube (14) wraps outside treatment syringe needle (10) back segment, filling heat insulator (13) between throttle capillary tube (14) and the refrigerating section protective sleeve (12).

2, cataract ultrasonic emulsification instrument as claimed in claim 1 is characterized in that, described treatment syringe needle section (1) is being located part winding throttle capillary tube (14) near operating grip (3).

3, cataract ultrasonic emulsification instrument as claimed in claim 1 is characterized in that, described operating grip (3), and the sensor wire of the inlet tube of throttle capillary tube (14), outlet, thermocouple (11) passes from operating grip (3).

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