CN203408155U - Mild hypothermia therapy-endovascular heat exchange temperature regulating and control device - Google Patents

Mild hypothermia therapy-endovascular heat exchange temperature regulating and control device Download PDF

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Publication number
CN203408155U
CN203408155U CN201320523653.9U CN201320523653U CN203408155U CN 203408155 U CN203408155 U CN 203408155U CN 201320523653 U CN201320523653 U CN 201320523653U CN 203408155 U CN203408155 U CN 203408155U
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China
Prior art keywords
heat exchange
temperature
temperature control
saline
sterile saline
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Withdrawn - After Issue
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CN201320523653.9U
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Chinese (zh)
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王磊
徐胜普
沙洪
胡勇
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Institute of Biomedical Engineering of CAMS and PUMC
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Institute of Biomedical Engineering of CAMS and PUMC
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Abstract

The utility model discloses a mild hypothermia therapy-endovascular heat exchange body temperature precision control device. The device is composed of an endovascular guide tube system, an extracorporeal saline circulation system and a heat exchange controller. The endovascular guide tube system is connected with the extracorporeal saline circulation system through a pipeline to form a closed saline flowing channel. A circulating water pump controls sterile saline to flow in the closed channel, a heat exchange coil is soaked in cooling agents, the temperature of the cooling agents can be changed through a heating cooling device, and therefore the temperature of the sterile saline is regulated. The heat exchange controller is composed of the heating cooling device, a temperature control system and a display operating unit, and the connection is achieved through circuits. The heat exchange controller can change the temperature of the saline in the extracorporeal saline circulation system, and therefore temperature control saline is obtained by the endovascular guide tube system, the temperature control saline and the blood of a patient carry out heat exchange through the ball surface of the guide tube system, and therefore the aim of regulating the core body temperature of patients with high-risk central nervous systems or patients with low body temperature is achieved.

Description

Heat exchange temperature control set for adjusting in mild hypothermia therapy-blood vessel
Technical field
This utility model is the key technology about medical instruments field, relates in particular to heat exchange temperature control set for adjusting in a kind of mild hypothermia therapy-blood vessel.
Background technology
Mild hypothermia therapy refers to by controlled reduction patient core temperature avoids the method for damage influence with armour.The method for multiple brain injury disease, and finds also may have certain protective effect when other organ injury as a kind of brain guard method gradually.Mild hypothermia therapy method is listed in recommend method in the cardio-pulmonary resuscitation of American Heart Association and the cerebral trauma guide of blood vessel first aid guide (American Heart Association guideline for CPR and ECC) and U.S. neurosurgery association (American Association of Neurological Surgeons.Guidelines for the management of severe traumatic brain jury).Nearest questionnaire survey shows that the , U.S. has 61% emergency authorities to adopt sub-cryotherapy.Research find sub-low temperature to cerebral blood flow have regulating action, reduce CMRO2 and improve cellular energy metabolism, reduce the release of excitatory amino acid, reduce oxygen-derived free radicals generation, reduce intracellular calcium overload, reduce the recovery of neuronal necrosis and apoptosis, the conduction of promotion intercellular signal, reduce cerebral infarction area, alleviate cerebral edema and reduce intracranial pressure etc.Research also find sub-low temperature on blood pressure, blood oxygen pressure, partial pressure of carbon dioxide, blood pH value and blood glucose without impact, the laboratory animal heart, lung, kidney, small intestinal are also had no to pathologic lesion, illustrate that sub-low temperature does not increase the infringement of other histoorgan.From the nineties, confirmed first that in the world sub-low temperature can significantly reduce the dead residual rate of experimental brain injury in rats animal, at present, domestic and international hospital with good conditionsi has classified mild hypothermia therapy method as the conventional therapy of Severe Craniocerebral Injury Undergoing.Sub-cryotherapy has significant effect, but conventional cool-down method has run into many problems in clinical use procedure at present.At present clinically, the most frequently used mild hypothermia therapy method mostly is surface cooling method, as passed through ice blanket, alcohol bath, ice bag, circulate cold air processing etc.Although these sub-low temperature induction methods can reach target temperature, its operating process is comparatively loaded down with trivial details, Induction Process is longer, and even the longer time just can reach target temperature mostly to need 3~8 hours.In addition also there is larger difficulty maintaining and control aspect target temperature in above-mentioned cool-down method, conventionally occurs the situations such as temperature fluctuation range is larger.The time that the average induced low temperature of surface cooling method reaches 33 degree is 3.5 hours, has part to occur cooling over-education phenomenon simultaneously.And perfusion cool-down method in another kind of blood vessel reaches the object that reduces core temperature by a large amount of cooling liquids of quick infusion.This cool-down method is effective fast, but can form huge challenge to patient's the heart, lung and renal function, and the adjustment process of temperature maintains comparatively very complicated in addition, so its clinical practice is very limited.These traditional methods are restricting the universal of mild hypothermia therapy.
Utility model content
For above-mentioned prior art, this utility model provides heat exchange temperature control set for adjusting in a kind of mild hypothermia therapy-blood vessel, by hot swapping in blood vessel, regulates temperature to realize the accurate control to patient's core temperature.Be mainly used in treating in cardiovascular and cerebrovascular disease operation process and brain injury post-operative recovery process that cerebral trauma produces in, this utility model by heat exchange in blood vessel lower the temperature rapidly, program rewarming, can reach the accurate patient of control core temperature.
In order to solve the problems of the technologies described above, heat exchange temperature control set for adjusting in this utility model mild hypothermia therapy-blood vessel, comprise catheter in blood vessel system, external brine circulation system and heat exchange controller, described catheter in blood vessel system comprises body inner catheter and body temperature trans; Described external brine circulation system comprises Sterile Saline bag, water circulating pump, air trap and cryogen vessel, in described refrigerator container, is provided with heat exchange coil, and described heat exchange coil is immersed in cold-producing medium; Described heat exchange controller comprises heating and cooling device, temperature control system and demonstration and operating unit; Described Sterile Saline bag, water circulating pump are connected by pipeline in turn with air trap, and one end of described heat exchange coil is connected to described air trap, and the other end of described heat exchange coil is connected to one end of described body inner catheter by inflow catheter; Described Sterile Saline bag is connected to the other end of described body inner catheter by flowing out conduit, the circulation that has formed thus Sterile Saline is closed circuit, described outflow conduit is provided with current meter, and it is 1000-3000 ml/hour at the closed circuit flow velocity of circulation that described water circulating pump is controlled Sterile Saline; Air during described air trap is closed circuit in order to removal circulation; Described temperature sensor, described temperature control system and described water circulating pump are electrically connected to, and described temperature control system and described heating and cooling device and described demonstration and operating unit are electrically connected to, thus formation temperature control loop.
Further, this utility model device also comprises warning system, described warning system comprises vascular pressure detection part and alarm controller, described vascular pressure detection part is transferred to alarm controller by the vascular pressure value detecting, described alarm controller is by the described vascular pressure value detecting and default threshold value comparison, whether the vascular pressure value detecting with judgement is abnormal, if so, and by showing and operating unit warning indication.
Compared with prior art, the beneficial effects of the utility model are:
This utility model adopts Endovascular Heat Exchange Cooling (endovascular heat exchange cooling) can effectively avoid shortcoming of the prior art.In this utility model mild hypothermia therapy-blood vessel, heat exchange temperature control set for adjusting is comprised of catheter in blood vessel system, external brine circulation system and heat exchange controller three parts.Wherein catheter in blood vessel system is connected with external brine circulation system; form the closed cycle of a Sterile Saline; and heat exchange controller can change the mesohalobic temperature of external brine circulation system; thereby the saline of temperature control is input in catheter in blood vessel system; make it to carry out heat exchange by balloon surface and the blood samples of patients of body inner catheter, thereby be reached for the object that cental system high-risk patient or hypothermia patient carry out core temperature adjusting.
Advantage of the present utility model is:
(1) in blood vessel the speed of cooling be 3-4 degree Celsius per hour, faster compared with traditional method, within average more than 80 minutes, reach target temperature;
(2) can maintain preferably target temperature range, avoid the fluctuation up and down of temperature, guarantee therapeutic effect;
(3), even if patient is clear-headed, can quick and precisely not reach target temperature during tracheal intubation yet.Rewarming process carries out accurately controlling simultaneously;
(4) amyostasia incidence rate and occurrence degree reduce, and principle is the temperature receptor (temperature receptor can " be cheated " in the application of insulation blanket simultaneously) that skin below has been avoided in cooling from inside to outside.Reduced the use of sedation anesthesia medicine and muscle relaxant, then reduced the use of respirator, the incidence rate of pulmonary infection is reduced greatly;
(5) apparatus structure is advanced, and controls simple.
Accompanying drawing explanation
Accompanying drawing is heat exchanger temperature precise control device structural representation in mild hypothermia therapy blood vessel described in the utility model
In figure: 1-catheter in blood vessel system, 11-body inner catheter, 12-body temperature trans, the external brine circulation system of 2-, 21-Sterile Saline bag, 22-current meter, 23-water circulating pump, 24-air trap, 25-cryogen vessel, 26-heat exchange coil, 3-heat exchange controller, 31-heating and cooling device, 32-temperature control system, 33-demonstration and operation, 41-flows out conduit, 42-inflow catheter.
The specific embodiment
Below in conjunction with the specific embodiment, this utility model is described in further detail.
In order to make those skilled in the art better understand the technical solution of the utility model, below in conjunction with the drawings and the specific embodiments, technical scheme described in the utility model is described in further detail.
As shown in the figure, this utility model, for heat exchange temperature control set for adjusting in mild hypothermia therapy blood vessel, comprises catheter in blood vessel system 1, external brine circulation system 2 and heat exchange controller 3.
Described catheter in blood vessel system 1 comprises body inner catheter 11 and body temperature trans 12, and body temperature trans 12 is positioned over patient's catheter, and rectum or esophagus can be measured patient's body temperature.
Described external brine circulation system 1 comprises Sterile Saline bag 21, water circulating pump 23, air trap 24 and cryogen vessel 25, described Sterile Saline bag 21 adopts medical Sterile Saline bag, in described refrigerator container 25, be provided with heat exchange coil 26, described heat exchange coil 26 is immersed in cold-producing medium, described heat exchange coil 26 is for the cold and hot transmission of Sterile Saline, when Sterile Saline flows through heat exchange coil 26, with cold-producing medium generation heat exchange.Heat exchange coil 26 should adopt the metal parts with better heat conductivility.
Described Sterile Saline bag 21, water circulating pump 23 and air trap 24 are connected in turn by pipeline, one end of described heat exchange coil 26 is connected to described air trap 24, and the other end of described heat exchange coil 26 is connected to one end of described body inner catheter 11 by inflow catheter 42; Described Sterile Saline bag 21 is connected to the other end of described body inner catheter 11 by flowing out conduit 41, the circulation that has formed thus Sterile Saline is closed circuit, described outflow conduit 41 is provided with current meter 22, and it is 1000-3000 ml/hour at the closed circuit flow velocity of circulation that described water circulating pump 23 is controlled Sterile Saline; This utility model adopts Sterile Saline as conduction of heat medium, is because Sterile Saline has good biocompatibility, if body inner catheter 11 leaks, can reduce the injury to patient as far as possible.Described water circulating pump 23, when making Sterile Saline mobile in the circulation of Sterile Saline is closed circuit, may produce some air in pipeline, by air trap 24, can remove ducted air.Air trap 24 is plastic containers.
Described heat exchange controller 3 comprises heating and cooling device 31, temperature control system 32 and demonstration and operating unit 33.
Described temperature sensor 12, described temperature control system 32 and described water circulating pump 23 are electrically connected to, and described temperature control system 32 and described heating and cooling device 31 and described demonstration and operating unit 33 are electrically connected to, thus formation temperature control loop.The temperature of the body inner catheter 11 that described temperature control system 32 reception temperature sensors 12 collect, and according to the target temperature of setting by the temperature of described heating and cooling device 31 and the closed circuit middle Sterile Saline of water circulating pump 23 controlled circulation, this temperature control system 32 is according to the body temperature of current patient and the target body temperature of default that are recorded by body temperature trans 12, control heating and cooling device 31 to regulate the temperature of Sterile Saline, the information that temperature control system 32 shows according to current meter 22 is controlled described circulating pump 23 to regulate the flow velocity of Sterile Saline.
Described heat exchange controller 3 in this utility model adopts advanced semiconductor refrigerating technology, accurately to control Sterile Saline temperature.Described heat exchange controller 3 can be controlled the change of the temperature of Sterile Saline in described external brine circulation system 2; and the Sterile Saline of temperature control is input in described catheter in blood vessel system 2; make it to carry out heat exchange by balloon surface and the blood samples of patients of body inner catheter 11, be reached for the object that cental system high-risk patient or hypothermia patient carry out core temperature adjusting.
This utility model device also comprises warning system, in whole process, regularly detects vascular pressure, finds fortuitous event and alarm, with the adverse consequences that prevents from causing because of system itself or other reasons.Described warning system comprises vascular pressure detection part and alarm controller, described vascular pressure detection part is transferred to alarm controller by the vascular pressure value detecting, described alarm controller is by the described vascular pressure value detecting and default threshold value comparison, whether the vascular pressure value detecting with judgement is abnormal, if so, by showing and operating unit warning indication.
Described demonstration and operating unit 33 are a panel computer, and described demonstration is connected with described temperature control system 32 with operating unit 33.Described demonstration and operating unit 33 are for user's operation and demonstration, and this demonstration and operating unit 33 can be achieved as follows function: power supply indication; Report to the police and indicate; Start/stop; Real-time displays temperature change curve; Target setting temperature, this target temperature is 31-38 degree; Refrigerating/heating speed is set; Pressure detecting, is connected with serial ports of computers.
Connection in this utility model between all parts adopts plastic conduit, the closed circuit disposable material that all uses of circulation of whole saline flow.
Adopt heat exchange temperature control set for adjusting in this utility model mild hypothermia therapy-blood vessel to carry out lowering the temperature in blood vessel to 20 routine hypertensive cerebral hemorrhage postoperative patients, and observe the curative effect.Right lateral thigh retaining venipuncture, to postcava (the lower location of perspective), links condensation pipe, and temperature sensor probe is as for anus, for keeping nutrition and water-electrolyte balance, prevent complication, adopt and fall cranium pressure-controlled cerebral edema, steadily blood pressure, promotes brain cell metabolism.Mild hypothermia therapy persistent period 48~72h, without skull pressure rising high is 48h, that have skull pressure rising high is 72h, target temperature is 33-35 degree, indices in patient's temperature-fall period: cooling fore-anus temperature: 38.7 ± 0.5 ℃, there is reduction time: 30 ± 8min in anus temperature, average cooling rate: 2 ± 0.2 ℃/h, reach target temperature time: 140 ± 30min.Rewarming is to determine that whether mild hypothermia therapy is successfully crucial, and progressively slow and steady rewarming, controls rewarming and be approximately 0.5 degree per hour, rewarming to 36.5 degree left and right.By clinical observation, find: in blood vessel, the generation of cooling amyostasia and degree significantly reduce with respect to surface cooling, can effectively avoid Secondary brain edema, cerebral hernia and centra failure.
Although this utility model is described in conjunction with figure above; but this utility model is not limited to the above-mentioned specific embodiment; the above-mentioned specific embodiment is only schematic; rather than restrictive; those of ordinary skill in the art is under enlightenment of the present utility model; in the situation that not departing from this utility model aim, can also make a lot of distortion, within these all belong to protection of the present utility model.

Claims (4)

1. a heat exchange temperature control set for adjusting in mild hypothermia therapy-blood vessel, comprises catheter in blood vessel system (1), external brine circulation system (2) and heat exchange controller (3), it is characterized in that,
Described catheter in blood vessel system (1) comprises body inner catheter (11) and body temperature trans (12);
Described external brine circulation system (2) comprises Sterile Saline bag (21), water circulating pump (23), air trap (24) and cryogen vessel (25), in described refrigerator container (25), be provided with heat exchange coil (26), described heat exchange coil (26) is immersed in cold-producing medium;
Described heat exchange controller (3) comprises heating and cooling device (31), temperature control system (32) and demonstration and operating unit (33);
Described Sterile Saline bag (21), water circulating pump (23) and air trap (24) are connected in turn by pipeline, one end of described heat exchange coil (26) is connected to described air trap (24), and the other end of described heat exchange coil (26) is connected to one end of described body inner catheter (11) by inflow catheter (42); Described Sterile Saline bag (21) is connected to the other end of described body inner catheter (11) by flowing out conduit (41), the circulation that has formed thus Sterile Saline is closed circuit, described outflow conduit (41) is provided with current meter (22), and it is 1000-3000 ml/hour at the closed circuit flow velocity of circulation that described water circulating pump (23) is controlled Sterile Saline; Air during described air trap (24) is closed circuit in order to removal circulation;
Described temperature sensor (12), described temperature control system (32) and described water circulating pump (23) are electrically connected to, described temperature control system (32) and described heating and cooling device (31) and described demonstration and operating unit (33) are electrically connected to, thus formation temperature control loop.
2. heat exchange temperature control set for adjusting in mild hypothermia therapy-blood vessel according to claim 1, it is characterized in that, described temperature control system (32) receives the temperature of the body inner catheter (11) that temperature sensor (12) collects, and according to the target temperature of setting by the temperature of described heating and cooling device (31) and the closed circuit middle Sterile Saline of water circulating pump (23) controlled circulation; Described demonstration and operating unit are a panel computer, and described demonstration is connected with described temperature control system (32) with operating unit.
3. heat exchange temperature control set for adjusting in mild hypothermia therapy-blood vessel according to claim 1, is characterized in that, described demonstration and operating unit for start/stop system, target setting temperature, the speed of refrigerating/heating is set; Power supply indication and in real time display body indoor duct temperature change curve.
4. according to heat exchange temperature control set for adjusting in the mild hypothermia therapy-blood vessel described in any one in claims 1 to 3, it is characterized in that, this device also comprises warning system, described warning system comprises vascular pressure detection part and alarm controller, described vascular pressure detection part is transferred to alarm controller by the vascular pressure value detecting, described alarm controller is by the described vascular pressure value detecting and default threshold value comparison, whether the vascular pressure value detecting with judgement is abnormal, if so, by showing and operating unit warning indication.
CN201320523653.9U 2013-08-26 2013-08-26 Mild hypothermia therapy-endovascular heat exchange temperature regulating and control device Withdrawn - After Issue CN203408155U (en)

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103417325A (en) * 2013-08-26 2013-12-04 中国医学科学院生物医学工程研究所 Mild hypothermia therapy-endovascular heat exchange temperature adjustment control device
CN105287095A (en) * 2015-11-23 2016-02-03 邹秀丽 Intravascular sub-hypothermia therapeutic instrument for intensive care unit
CN109394415A (en) * 2018-12-07 2019-03-01 张玉婷 A kind of intravascular sub-low-temperature therapeutic equipment of severe medicine section
CN113855379A (en) * 2015-04-01 2021-12-31 佐尔循环服务系统公司 Working fluid cartridge with hinged chamber or housing for connecting a heat exchanger to an intravascular temperature management catheter

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103417325A (en) * 2013-08-26 2013-12-04 中国医学科学院生物医学工程研究所 Mild hypothermia therapy-endovascular heat exchange temperature adjustment control device
CN103417325B (en) * 2013-08-26 2015-04-01 中国医学科学院生物医学工程研究所 Mild hypothermia therapy-endovascular heat exchange temperature adjustment control device
CN113855379A (en) * 2015-04-01 2021-12-31 佐尔循环服务系统公司 Working fluid cartridge with hinged chamber or housing for connecting a heat exchanger to an intravascular temperature management catheter
CN105287095A (en) * 2015-11-23 2016-02-03 邹秀丽 Intravascular sub-hypothermia therapeutic instrument for intensive care unit
CN109394415A (en) * 2018-12-07 2019-03-01 张玉婷 A kind of intravascular sub-low-temperature therapeutic equipment of severe medicine section
CN109394415B (en) * 2018-12-07 2021-08-06 张玉婷 Intravascular sub-low temperature therapeutic instrument for severe medical science

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