CN2053099U - Medical apparatus for treating piles - Google Patents
Medical apparatus for treating piles Download PDFInfo
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- CN2053099U CN2053099U CN88207129U CN88207129U CN2053099U CN 2053099 U CN2053099 U CN 2053099U CN 88207129 U CN88207129 U CN 88207129U CN 88207129 U CN88207129 U CN 88207129U CN 2053099 U CN2053099 U CN 2053099U
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- A61B1/31—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the rectum, e.g. proctoscopes, sigmoidoscopes, colonoscopes
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/32—Devices for opening or enlarging the visual field, e.g. of a tube of the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- A—HUMAN NECESSITIES
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1485—Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1402—Probes for open surgery
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- A—HUMAN NECESSITIES
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/0066—Sensing and controlling the application of energy without feedback, i.e. open loop control
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- A—HUMAN NECESSITIES
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- A61B2018/0091—Handpieces of the surgical instrument or device
- A61B2018/00916—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
- A61B2018/00928—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device by sending a signal to an external energy source
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
- A61B2018/1266—Generators therefor with DC current output
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Abstract
The utility model provides an apparatus for carrying out direct-current electrotherapeutics towards piles or illnesses similar to piles on the body of patients, comprising a direct-current generator, a grounding polar plate, a search unit on the highest peak of the electrode on the far end, which can penetrate into the pile, and a manual part, which is used to support the search unit and control the current intensity. The search unit is provided with one basal body and at least one electrode which is connected by the highest peak of the electrode on the far end. The manual part is provided with a handle below which is held by the doctor. The basal body of the pile combines with the manual part. The included angle between the axial line of the pile and the axial line of the handle below is an obtuse angle. The choze magnitude of the angle can allow the doctor to hold the apparatus without continuously and abnormally bending the doctor's wrist. And a front panel is usually arranged above the handle below.
Description
The present invention relates to be used for the treatment of the current therapeutic apparatus device of hemorrhoid or similar disease.
Hemorrhoid are a kind of modal of the mankind, make people disability and very painful disease.
Hemorrhoid are a kind of modal of the mankind, make people disability and very painful disease.Suggestion according to U.S. food and consultative committee of Drug Administration is defined as hemorrhoid that " unusual big or Symptomatic blood vessel agglomerate is supporting and topped the mucosa or the epidermis at anal orifice and rectal intestine position.
Suffer from the internal hemorrhoid of symptom in the U.S. population of estimation 1/3rd, the sickness rate in the time of 50 years old is 50%.Owing to worry the pain that special therapeutic method causes, hospitalization, medical care expenses and wounded or disabled reasons such as time, patient usually postpones inspection.This delay estimation can cause the development of hemorrhoid, or more serious colorectum disease just is diagnosed late.
The therapy that many treatment hemorrhoid are arranged.For example, doctor of medicine Wilbur.E.Keesey has illustrated the Direct current treatment to hemorrhoids disease in one piece of article delivering in 1934.At present, local suppository method is used for most patients, especially for those hemorrhoid is had especially sharply the patient of the cause of disease (for example, accidental violent diarrhoea outbreak), under certain conditions, may be necessary, only the method that can take.By putting a rubber ring at the root of hemorrhoidal vessels, also can make hemorrhoidal vessels downright bad and come off sometimes with a special utensil.This Therapeutic Method is applicable to those blood vessels above pectinate line, avoiding violent pain, (pain is the complication that 6%～10% patient suffers from).This treatment is not suitable for slight hemorrhoidal vessels to the moderate pathological changes.For less (1 grade and 2 grades) hemorrhage internal hemorrhoid, injection sclerotherapy is effective.In tela submucosa, injection sclerosant forms thrombosis with chemical method, and makes mucosa be bonded to following tissue.Injection sclerotherapy restriction is used for slightly to the moderate pathological changes, and supervenes following complication: to the reaction of injection material, above topped mucosa come off, downright bad and infect, comprising the tela submucosa abscess.Cryosurgery (promptly using the metal probe of a liquid nitrogen or cooled) can freezing hemorrhoid.Sometimes because pain needs local anesthesia.Complication may comprise can not accurately be controlled the histoclastic degree of depth, postoperative pain and rectum drain.The advantage of excision inflammation hemorrhoid is to excise all relevant unnecessary tissues, comprises the exterior portion of excising a kind of special internal hemorrhoid.But it is, restricted to the total amount that may excise in order not produce deleterious sequela.For many blood vessels the typical patient of pathological changes is arranged all, surgical operation only can be handled the most serious position of pathological changes symptom, and does not think that surgical operation just can treat resultful.The shortcoming of these methods comprises pain owing to need the hospitalization expense higher, wounded or disabled time, and the complication of potential generation, for example, those problems relevant with anesthesia, surgical operation to do thoroughly and comprise postoperative complication such as anal stenosis.
According to one object of the present invention, a kind of being used for comprises patient's hemorrhoid or similar disease instrument of carrying out direct current electrotherapy on one's body: a dc generator device; A ground connection pole plate pad that is used for patient; One pole probe, this one pole probe have the eletrode tip of a far-end to be used to penetrate hemorrhoid to play negative electrode; And the manual part of an instrument is used for supporting probe and controls galvanic intensity.Probe comprises a matrix and at least one the elongate probe electrode that is connected with the remote electrode tip that extends from matrix, and this tip is used for forming conduction with hemorrhoid and contacts.The instrument manual part comprises the handgrip parts below, and its size and structure are suitable for being hung on to by the doctor; Be used for the probe matrix is connected to the conduction way of contact engagement device of described manual part, the angle of cut between probe axis and the following handgrip component axes is the obtuse angle, the selection of this obtuse angle value should make the doctor need not its wrist of gryposis constantly when the treatment hemorrhoid, just can hold this instrument manual part; Top treatment monitors and control handgrip parts, the top of the common underlaid handgrip parts of these parts, and a front panel arranged, when the remote electrode tip of probe penetrates hemorrhoid, the doctor can see front panel, front panel comprises the device that is used for the various states of display instrument treatment condition, this remote electrode tip that is used for device shown and probe is placed in the doctor usually and holds following handgrip parts, when the probe electrode tip of far-end is penetrated hemorrhoid in same visual line of sight; And the device that is used to control unidirectional current intensity, so that the finger that makes the doctor can be used to hold that hand of the handgrip parts below described is operated this control device, therefore, when the doctor carries out hemorrhoid treating, he holds this instrument and operating control device with one and allows the empty hemorrhoid for the treatment of of another hands, and he can see therapentic part simultaneously and observe the treatment condition that is apparent in the display device this moment.
The most preferred embodiment of this purpose can comprise more than one according to the present invention, following parts.Be used to show the device of the state of this instrument treatment condition, comprise being used to show the device of for example treating the elapsed time, be used to show the state of this treatment condition of treatment unidirectional current intensity, and/or the device of treatment starting state.The device that is used to control, comprise first device that increases progressively current intensity, second device of current intensity that is used to successively decrease, and may further include and be used to interrupt galvanic the 3rd device, the 3rd device preferably by first device and second device time startup be activated.About 120 ° of obtuse angle value.Engagement device comprises that all one of matrix of probe gives the taper of sizing and shape and by the taper hole that size and dimension limited on the instrument manual part, so that insert this taper in the taper hole.Preferably the cross section common shape of this taper is square, has the angle, garden of the sizing of giving, corresponding to the size in taper hole, but slightly littler than the size in taper hole.Probe can be changed, and comprises at least two elongate probe electrodes that are arranged in parallel and lay, and departs from least two eletrode tips of elongate probe are preferably vertical each other.
According to another object of the present invention, a kind of for example being applicable to, adopt the employed probe of above-mentioned hemorrhoid treating instrument, comprise a matrix, with at least one the elongated one pole probe electrode that connects with the remote electrode tip that extends from matrix, being used for forming conduction with hemorrhoid contacts, this probe further comprises the engagement device that is used for the probe matrix is connected to the conduction way of contact manual part, the angle of cut between probe axis and the manual part axis is the obtuse angle, the selection of this obtuse angle value should make the doctor when the treatment hemorrhoid, need not its wrist of gryposis constantly and just can hold this instrument, this probe matrix comprises a taper that gives sizing and shape, and by the taper hole that size and dimension limited on the instrument manual part, so that in the taper hole, insert this taper, the cross section common shape of this taper is square, fillet with the sizing of giving, corresponding to the size in taper hole, but slightly littler than the size in taper hole.
When the method with other medicable treatment hemorrhoid compared, device of the present invention had some advantages that surpass present technical method, evident in efficacy comprising it, and safety and do not have pain relatively comparatively speaking, and its expense is that patient can bear.
From following present most preferred embodiment and accompanying drawing, will see these and other characteristic of the present invention and advantage significantly.
At first briefly accompanying drawing is illustrated.
Fig. 1 is the perspective view of Medical Instruments of the present invention.
Fig. 2 is the vertical view of the manual part among Fig. 1.
Fig. 3 is the side view of manual part among Fig. 1 and Fig. 2, and Fig. 3 A is a probe insertion plane graph on the manual part in Fig. 3 that the 3A-3A of Fig. 3 direction is got.
Fig. 4, Fig. 4 A is instrument of the present invention is taken from different perspective directions when treating hemorrhoid diagrammatic figure with Fig. 4 B.
Fig. 5 is the vertical view of instrument probe, and Fig. 5 A is the probe matrix section end-view of getting in the 5A-5A of Fig. 5 direction.
Fig. 5 B is the vertical view of another embodiment of instrument probe of the present invention, and Fig. 5 C is the partial end view of probe matrix section in Fig. 5 B that get at the 5C-5C place.
Fig. 6 is the probe locate mode table of selectable probe matrix section.
Fig. 7 is the vertical view of instrument ground pole plate (pad).
Fig. 8 is the side view of instrument base device.
Fig. 9 is the front view of another embodiment of instrument manual part, and Fig. 9 A is the partial side view with the manual part far-end at rotatable electrode tip of the present invention.
Figure 10 is the block diagram of equipment circuit.
Figure 11, Figure 12 and Figure 13 are the schematic diagrams of first embodiment of circuit among Figure 10.
Figure 14 to Figure 16 is the schematic diagram of second embodiment of circuit among Figure 10.
Referring to Fig. 1, Medical Instruments 10 of the present invention comprises a base unit 12 and a medical manual part 14.This instrument also comprises a unipolar removable probe 16(Fig. 5 in addition) and a ground pole plate 17(Fig. 7).
Referring to Fig. 2 and following each figure, manual part 14 comprises the handgrip parts 18 below, extend a connection cord 20 that is connected to base unit 12 from the handgrip parts, and the groove 22 that also contains a back as shown in Figure 3 is used to put into the forefinger of user so that hang on to manual part.On the flat front surface 23 superincumbent patient positions 24 of manual part, comprise and for example treat elapsed time (light emitting diode character display 26), treatment current's intensity (light emitting diode bar chart 28) and circuit state indicator display uniies such as (on/off display 30).Above the patient parts comprise also that in addition switch 32 and 34 is used for the DC current intensity that increment ground respectively increases progressively and successively decreases and flow through probe, and as described below when these two switches are started simultaneously by the doctor (for example pushing) with its thumb, be used for interruptive current.The front surface 23 of manual part seals, in case washing the time has liquid to flow into this manual part between the two treatments process.
Referring to Fig. 4, Fig. 4 A, Fig. 4 B, Fig. 5 and Fig. 5 A, probe comprises a pair of elongated conductive electrode 36 and 38, conductive electrode extends to the remote electrode tip of point from taper fixture 41.For example, taper fixture 41 cross sections are square and angle, garden (Fig. 5 A) are arranged, its size pack in the hole 40 that has in the far-end 44 of manual part 14 (Fig. 4) just right, and then the banana plug 43 of taper fixture 41 is contained in probe 16 on the manual part 14 securely.Probe electrode is enclosed in nonconducting sleeve pipe (46) lining, and clad is lived its distal portions, in case contact tissue unintentionally, but will be reduced to bottom line to the obstruction to doctor's the therapentic part visual field.The neighbouring part of each electrode is installed in as in the sleeve pipe made from injected-formative plastic 48.Probe matrix section is made into to insert a Kong Shineng 4 kinds of locate modes (half-twist between every kind of location).Quadrant section according to the rectum that will be treated is selected the location by the doctor.Use another kind of method, probe 16 ' (Fig. 5 B) can have matrix section 41 ' (Fig. 5 C) of an octagonal cross-section to be contained on the probe matrix section.(alternative probe locate mode table has been shown among Fig. 6).The eletrode tip parts of an electrode 36 extend beyond the eletrode tip parts of another electrode 38 in the vertical in the pair of electrodes, and therefore in therapeutic process, these two eletrode tips can not penetrate tissue simultaneously, so that alleviated patient's discomfort.Easy in order to make, probe 16 ' can make with another kind of method, the neighbouring part of two electrodes pack into a simple smooth sleeve pipe 48 ' in, and the functional part of matrix section and banana plug coupling be assembled in octagonal coupling components 41 ' in.
The axis P of the probe that fits together with manual part is that the direction of A is extended along the angle of cut with this manual part front surface plane 23, angle A preferably is about 120 ° (Fig. 4), adopt this mode, when the treatment hemorrhoid, the remote electrode tip member of probe contacts with hemorrhoidal tissue 50, with important display part on the patient parts of manual part the two all simultaneously along doctor 52 sight line L, make the doctor can constantly monitor treatment parts 54 and treatment parameter, need not sight line is left patient 56.
Referring to Fig. 1 and Fig. 8, base unit 12 is useful on the feed cable 58 that this instrument is connected to alternating current power supply, and is useful on the socket 60 and the cable 64(Fig. 7 that is used to be connected grounding device 17 that connects the manual part cable) socket 62.There is one logical one to disconnect the light-emitting components 68 that 66 and one of passes are used for the indicating instrument startup on the front surface of base unit 12.A pair of carriage 70 extends out from the side of pedestal, is used to lay manual part.
Grounded parts 17(Fig. 7) be made of the adsorption plate in the fluid-tight shell 74 (or pad) 72, feed cable 64 is connected to grounding device on the socket 62 of base unit.
Referring to Figure 10, Medical Instruments is made up of three electric components, and these three electric components are base units 12, (this is a main device) manual part 14 and pole plate (claiming polar cushion again) 17.Base unit is made up of power supply 80 and current feedback circuit 84.Power supply 80 is to gauge tap 32,34, and the logic circuit of time and magnitude of current display 26,28 and ground connection pole plate 17 provides DC voltage.Current feedback circuit 84 is connected to probe 16, and is used to control the DC current that is delivered to probe 16 from pole plate 17 by patient 56.In manual part 14, be connected on the current feedback circuit 84 at the switch 32 and 34 that is positioned on the probe handgrip, be used for the electric current that up regulation is transmitted by patient 56.The digital circuit part that is connected to current feedback circuit 84 and is positioned on the probe handgrip makes visual display unit 26 and 28 can show the current value and the treatment elapsed time of transmission.
Referring to Figure 11, power supply 80 comprises 2 110 volts-25.2V step-down transformer T that are connected in series
1And T
2 Common junction 93 ground connection of primary side, when two remaining secondary wire 92 and 94 are used together, the interchange total voltage 50.4V that they can provide, and provide the alternating voltage 25.2V(identical to ground wire with the situation of a single 110V～50.4V centre-tapped transformer from each root lead).By using a bridge rectifier 96 that alternating voltage is converted to direct current, and 1000 μ f capacitor C by two ground connection
1And C
2Carry out filtering.This circuit provides positive 35.6V and minus 35.6V supply voltage on lead 92 and 94, and is counted as the fraction voltage source.The increasing of voltage (from 25.2V to 35.6V) is that the reason owing to circuit arranged and its capacitor causes.Three voltage adjusters (REG) are used to provide voltage source+15V ,-15V and the 5V of three kinds of adjustment.Each adjustor all passes through the capacitor C of one 0.1 μ f
3Carry out filtering.+ 15V voltage is used for pole plate 17, and+5V voltage is used for below with the electronic circuit that illustrates.
The resistor R of one one megaohm
1Capacitor C with one 18 μ f
4Serial connection exchanges 25.2V voltage thereby draw one, so that provide 60 hertz signal to one minute timer part 98.Timing circuit 98 divided by 3600, just sends pulse signal 99 of per minute to 60 hertz signals to drive circuit sheet 122, can count up to 7 from 0 like this.Drive circuit sheet 122 turns on and off seven light-emitting diodes pipeline sections that light emitting diode (LED) shows, and (on display 124), this light emitting diode indicator can digitized the number of minutes that indicates treatment time.As current feedback circuit 84(Figure 10) be reset, or once new treatment is when starting, and light emitting diode indicator is reset, and character display is " 0 " (following will explanation).
Referring to Figure 12, current feedback circuit 84 comprises: pulse generator 100, logic gates 1-6, counting circuit 102 and 104, numeral---aanalogvoltage circuit 116 and current driver 120.
1. instruction counter increases progressively counting (gate circuit 1)
Instruction counter countdown (gate circuit 1 and 2) or
3. make enumerator reset (gate circuit 3 and 4)
In other words, when push switch 32 makes it to form when electrically contacting with+5V voltage source, increase progressively counting by gate circuit 1 instruction counter.When push switch 34, by gate circuit 1 and 2 instruction counter countdowns.When simultaneously when depressing switch 32 and 34, enumerator 102 and 104 is resetted, when switch 32 and 34 is pressed simultaneously, intervalometer 124(Figure 11) preferably also reset.When this device is opened, the resistor R of 1 megohm
2, R
3With with the capacitor C of itself and the 0.1 μ f that connects
5, C
6, they be connected across each switch 32 and 34 and ground wire between, be used for sending pulse by the reset terminal 106 and 108 of gate circuit 3 and 4 on enumerator.
Enumerator has outfan 0
1-0
8, their co-operation are to provide nearly 256 digital counting.The output of enumerator is added to one eight input numeral---analog converter 116.When its counting of enumerator increasing or decreasing, the output counting that numeral---analog converter 116 is proportional to enumerator increases or reduces its output voltage 114.Numeral---analog converter 116 output voltages 114 are sent to operational amplifier 118, and operational amplifier 118 is as a buffer and amplify this output voltage 114, to drive a npn transistor 120.The current sink that transistor 120 constitutes from patient to the ground wire.In other words, probe can be used as the current loop from pole plate 17 that positive voltage source can be provided to this system's ground wire (GND).By the placed in-line 131 ohmic resistor R of the emitter E of transistor 120
4Limit this electric current.
Can provide the bulb (not shown) of a 12V at the eletrode tip place of probe, so that for checking that patient provides illumination.This bulb can drive by 15V negative supply (Figure 11), so that high intensity illumination is provided.
In order to prevent that patient is applied big DC current suddenly, the output of enumerator also is added on one the eight input nor gate 6, this nor gate (with gate circuit 5 and gate circuit 2 together) forbid continuing contrary counting to 00000000 the time when the enumerator meter.
Referring to Figure 11, the output of nor gate (Figure 12) is used to control the green LED 30 of one a minute intervalometer and an indicating device electric state again.When the counting of enumerator 102 and 104 equaled 00000000, a positive voltage was added on the transistor 112 by line 113 from gate circuit 6, makes transistor turns.Because logic gates 7-9, drive circuit sheet 122 resets, and green LED 30 is lighted.
Referring to Figure 13, current indicator 28 is connected to the emitter E of transistor 120 by line 115.Be connected across 131 ohmic resistor R by measurement
4On voltage (Figure 12), the current value that the indication of current indicator utilization Ohm's law transmits by patient.The current value that transmits by patient is shown by the bar chart row.Indicator 28 is preferably passed through 10000 ohm rheostat R
5Be calibrated to 20 milliamperes of maximum scales.
Referring to Figure 14, Figure 15 and Figure 16 there is shown the schematic diagram of another scheme.Power supply 80 is by transformator T
3With two bridge network B
1And B
2Constitute, this power supply is the interchange 115V that comes from electrical outlets or exchange 230V and be transformed into and be denoted as+the 30V dc source of the 5V dc source of 5V and being denoted as+30V.The 5V dc source (+5V) adjust by voltage adjuster 129, be used for the power logic circuitry of using in this Medical Instruments.The 30V dc source is also adjusted by voltage adjuster 126, and being used for provides positive voltage to earthing pole plate 17.In general, adjustor 126 can prevent that power surge from influencing patient, but for for the purpose of the significant care, fuse F
2Be concatenated in the supervisory circuit 131.(Figure 14) fuse preferably can be restricted to 1/32 peace to electric current, if on the 30V power line voltage surge is arranged, supervisory circuit 131 just makes fuse blow.Zener diode D at that time
2Conducting then causes supervisory circuit to trigger silicon controlled rectifier (SCR), thereby handle+30V power supply and blows this fuse to earth short, and supervisory circuit 131 equally can be by photo-coupler OC(Figure 15) detect overcurrent by line 82 by the probe transmission.
Referring to Figure 15, be applied to patient's DC current values on one's body and control by current feedback circuit 84.Current feedback circuit 84 comprises 8 bit digital enumerators 139, and this enumerator drives by pulse generator (PG) increment ground.The display circuit that will illustrate below pulse generator also drives.The numeral output counting of enumerator 139 is sent to digital-analog convertor 132, this transducer directly is proportional to the output voltage 133 of the output counting of enumerator 139, output voltage 133 is added to the base stage (B) of transistor 135 then, this transistor constitutes the current sink from patient to the ground wire, by the magnitude of voltage on the base stage (B) that is added to transistor 135 current value that is transmitted by probe is controlled.Therefore, when digital counting increased, the DC current that transmits by probe just increased.
Be provided with the circuit that restriction is added to the magnitude of voltage on the transistor 135 base stage B.The output of NAND gate 134 of two highest significant positions that is connected to enumerator is by diode (D
3) present back enumerator 139, in order to determine the final value counting.When enumerator calculates when being over being recycled to its minima from its maximum between an order period, this final value counting prevents from patient is produced unexpected electric current drop, if do not stipulate the final value counting, the rapid drop that applies electric current can make patient feel under the weather.
, by " increasing progressively " switch 32 and " successively decreasing " switch 34 on the probe handgrip voltage on the Digital To Analog Converter outfan is controlled referring to Figure 16.One end of switch 32 and switch 34 all is connected to the 5V output voltage power supply of sign+5V.At the other end, switch 32 and 34 is connected to logic gates 136,134 and 138(Figure 15 by line 88 and 89 respectively).Disconnect and connect switch 32 and 34 and produce the output signal that control counter 139 outputs are counted.By push switch 32 only, instruction counter 139 increases progressively the final value that count down to by predetermined and counts determined maximum count.By push switch 34 only, instruction counter is successively decreased and is counted to the least count 00000000 of digital zero counting.As mentioned above, prevented that like this enumerator is circulated back to maximum count, caused transmitting maximum current value by probe and be circulated back to the maximum count meeting.When two switches were pushed simultaneously, enumerator 139 was reset.By being positioned at the bar chart display 28 on the probe handgrip, indication is applied to patient's magnitude of current show value.The bar chart display drives by analogue-to-digital converters 144, and this transducer is by the voltage on the emitter E of line 143 detection transistors 135.A-D converter produces the digital signal that is proportional to detected voltage on emitter E.The output that best A-D converter 144 is provided for lighting eight independent light emitting diodes (LED), each light emitting diode is represented 2 milliamperes on the bar chart display.Therefore, when all light emitting diodes are all lighted, just represent 16 milliamperes or full scale.
On the probe handgrip, also be provided with and be used to indicate the character display 26 that patient is applied electric current institute elapsed time.The digital dock driver 146 that can be an enumerator is by from pulse generator PG(Figure 15) 10 hertz signals by line 143 carry out timing.The output counting of enumerator 146 is used to drive three seven piece of digital and shows, their representatives divide and second.During treating, 7 piece of digital show that the record patient accepts the time of DC current.If the electric current that transmits by probe reduces to zero, being added to numeral---the signal 145 of the designation number zero count of analog converter 132 also is added to enumerator 146, in order to latch the time that shows, in other words, when electric current is reduced to zero, the time that shows on timer will stop, and indication treatment elapsed time.When electric current is applied to patient once more, the time that shows on timer will be continued timing.
Referring to Fig. 9, manual part 14 ' another embodiment in, for the time on the display is resetted, a reset switch 76 can be set.In addition, in the present embodiment, " increasing progressively " switch 32 ' and " successively decreasing " switch 34 ' settle side by side.
Insert in the hole 40 of manual part 14 by matrix section 41, assemble this instrument a new probe 16.The plug cable 20 of manual part and ground connection pole plate and 64 inserts their sockets 60 and 62 separately, and by cable 58 base unit is connected on the alternating current power supply.
The time of each treatment generally can surpass 5 minutes or 10 minutes, but the configuration (preferably referring to Fig. 4, Fig. 4 A and Fig. 4 B) of handgrip parts and probe axis makes the doctor can cosily set his wrist on the hand control part, need not the gryposis wrist.In addition, as mentioned above, the demonstration of treatment condition and probe electrode tip member make the doctor can monitor patient's the situation and the condition of treatment simultaneously with respect to the corresponding configuration of doctor's sight line.
Treated 42 patients that suffer from the symptom hemorrhoid with device of the present invention.The treatment group comprises 28 men and 14 woman, and average year order is 47 years old (make in year scope is 21 years old to 70 years old).
All curers all stand traditional inspection, and visual examination and finger are checked, and carried out anoscopy with the Hinkle-James rectal speculum.Those other source of disease of suffering from except that hemorrhoid cause that the curer of its symptom all is not included among the object of study.
When carrying out anoscopy, patient adopts the right side position, and eight fan-shaped section are carried out visualization, and first fan-shaped section is at patient's left, and the 6th fan-shaped section is in patient's right front.Be divided into from 0 to 4 these several levels according to people's hemorrhoid inflammatory lesions such as Banov.0 grade of representative is not unusual.1 grade of representative has clump tissue or interior hemorrhoidal tissue, but does not prolapse from the pipe of anus.2 grades of representatives produce prolapsus when exerting oneself, and organize and can withdraw after defecation just.1 grade and 2 grades of hemorrhoid may be hemorrhage.Hemorrhoidal tissue prolapsus when 3 grades of representatives are discharged feces just, and hemorrhoid are stayed the outside.Patient need they reset with handgrip.3 grades of hemorrhoid may be hemorrhage, or be attended by pain.4 grades of irreducible prolapse of hemorrhoid of representative have mucus and blood flow to go out when often following defecation.
Each patient stands the treatment to all internal hemorrhoid with inflammatory lesion.Most of hemorrhoid only need seance, are recorded as the number of minutes (ma * min) that the milliampere number that is applied multiply by operation.In general, make an appointment at every turn and carry out seance, but in the one-time continuous treatment, more than one little hemorrhoidal vessels is treated sometimes.If seance fails to make hemorrhoid to come off fully before finding when further consultation, the treatment that will add this hemorrhoidal vessels.Current treatment just is recorded as the milliampere number that adds and the time of treatment.
Typical treatment comprises uses the Hinkle-James rectal speculum that the hemorrhoid that will treat are carried out visual examination.Therapeutic equipments is aimed at the position, the top of hemorrhoid, along the longitudinal axis of hemorrhoidal vessels, and is a very little angle with rectal tube.If desired, can dip in 4% lignocaine (Xylocaine) with a Cotton Gossypii swab local anesthesia is carried out at this position.Probe is steadily penetrated tube chamber.Then electric current is opened greatly gradually, needed electric current increased to 10 to 15 milliamperes in 2 to 3 minutes.Under the situation of the probe of the most advanced and sophisticated head of use bipolar electrode, need carry out the treatment of 60 to 100 milliampere-seconds for each hemorrhoidal vessels that relates to.To wine-colored visual color change, indicate this course of treatment satisfactory near black from cerise in some cases.Turn down electric current then lentamente, and probe and specula are transferred to.
To 42 patients, the order of its average year is 47 years old (make in year scope is 21 years old to 70 years old), estimates, and the content of evaluation is Symptomatic hemorrhoid and treatment.The symptom time that on average has before treatment is 9.7 years (time range is 0.01 to 26 years).The symptom that presents and these symptoms are eliminated required treatment number of times fully and are listed in the table 1.Modal symptom is hemorrhage of rectum (81% patient), next is Pruritus (42%).Internal hemorrhoid is through anal canal outstanding (60%) and pain (42%).Only treat under the situation of a related hemorrhoidal vessels when each diagnosis and treatment, these symptoms are eliminated required mean treatment number of times fully, are respectively 2.0,2.9,2.9 and 2.8 times.
Table 1
Various symptoms in 42 patients that suffer from hemorrhoid and symptom are eliminated required DC current treatment number of times.
Pruritus pain is hemorrhage outstanding
Patient's symptom (%) 62 42 81 60
Symptom is eliminated required
Treatment (X) 2.9 2.8 2.0 2.9
The average pathological changes hemorrhoidal vessels number of each patient is 6.33.The hemorrhoidal vessels that relates to has been shown in II, and the average rank of inflammatory lesion is that left fan-shaped section is the highest, and right front fan-shaped section is minimum.
In 42 patients, to ading up to 17 one-levels, 103 secondarys, 99 three grades and 46 level Four hemorrhoid are treated.Be used for thoroughly eliminating inflammatory hemorrhoid and organize required milliampere quantity, the time and milliampere---time product quantity is directly related with the grade of inflammatory lesion.
The table II
The inflammatory lesion average rank and the hemorrhoid place quadrant section corresponding relation of the hemorrhoid that relate among 42 patients:
Section 12345678
Grade 2.8 1.8 2.5 1.9 2.3 1.2 2.2 2.0
When therapeutic process finished, all patients' symptom had all disappeared.
Carry out following up a case by regular visits to by contacting directly to patient with all patient.Average follow-up period is 18.2 months (scope is 8 months to 34 months).In following up a case by regular visits to evaluation, reported the rebound phenomenon that does not have on the symptomatology.
The DC current effect need not to produce under the situation that the spot tissue forms and causes the hemorrhoid inflammatory resolution.Its accurate mechanism it be unclear that, yet final result is that vascular thrombosis forms, and finally comes off.When electric current was applied on the hemorrhoid, the negative pole of DC current produced hydrolysis and decomposes, and then is tissue contracts.Hydrolysis is decomposed and is caused vascular thrombosis formation, and the hydrolysis decomposition of vasa vasorum is likely most important.
To causing vascular thrombosis to be formed with two kinds of possible explanations by the use DC current: a kind of explanation is the release of free hydrogen, when promptly electrode is placed into saline solns (for example blood) and flows through electric current, will produce free hydrogen; The another kind of explanation is to follow the position that is formed on electrode of hydrogen to produce heat.Two kinds of explanations all will cause the release of Adenosine diphosphate glycoside (AIP) and/or Thrombokinase.
The hemorrhoidal tissue that becomes dry comes off in during 3 days to 7 days gradually, excretes along with discharging feces to.Also do not run into the tissue hemorrhage situation that comes off of following.Follow up a case by regular visits to estimate and disclosed the sign that does not have the spot tissue to form.The persistency of therapeutic effect is because the thorough elimination of the whole blood vessel from vascular root to its hanging portion.
Freely coincide with following (outward) hemorrhoidal vessels clump because go up (interior) hemorrhoidal vessels clump,, and can use the DC current treatment that internal hemorrhoid is carried out equally, the external hemorrhoid inflammatory lesion is eliminated so many patients suffer from the combination (mixed hemorrhoid) of multiple hemorrhoid.
It is relevant that this therapeutic process does not have the pain and the root of internal hemorrhoid to lack the neural distribution of body wall relatively.If patient has neural the distribution above pectinate line, the benefit of topical application 4% is long because of (Xylocaine) can make sticky feeling during the treatment, is no more than the patient degree of patient.
The above-mentioned embodiment with other is included in together and submits in claims.For example, base unit 12 can have the carriage that is suitable for laying the assembling hand control part, and base unit can be wall mounted.Probe can have a plurality of electrod assemblies, for example electrodeplate can be one, three, four or even more; The probe pattern also can be various, and for example broken line type, shaped form, linear type or other patterns are selected according to the shape and the size of the hemorrhoid root area that will treat.Electrod assembly also can be bending or zigzag, so that improve the operation of the visual field or contact hemorrhoid.
Again referring to Fig. 9 A, probe can be rotated to the position of giving determined number, for example, by select hole 42 on taper fixture and the manual part ' correspondingly-shaped (as square or other shape) or the termination part 44 by making manual part ', make probe can rotate to a unlimited position around convex shoulder rotation along a screw of probe axis direction.For example, by spring 47 moving partially and withstand termination part 44 ' on the ball 45 of the groove that forms can be used for fixing the position of probe.
This instrument goes for hemorrhoid are carried out radio frequency (RF) treatment, perhaps can be used for the treatment of other state of an illness, for example laceration.
Again and as mentioned above, increase progressively electrode gauge tap 32 ' and the electrode gauge tap 34 that successively decreases ' can arrange side by side, and the 3rd switch 76 is housed, for example, be used for the treatment elapsed time of enumerator 26 is resetted referring to Fig. 9.Manual part or base unit can also comprise the device of the sound signal that treatment time for example or electric current are provided, and perhaps can comprise the device that is used for writing time or other treatment condition.
Claims (14)
1, a kind of being used for comprises patient's hemorrhoid or similar disease instrument of carrying out direct current electrotherapy on one's body: a dc generator device, a ground connection pole plate that is used for patient, an one pole probe, this one pole probe has the eletrode tip of a far-end to be used to penetrate hemorrhoid to play negative electrode, and the manual part of an instrument, be used for supporting probe and control galvanic intensity
It is characterized in that:
Described probe comprise a matrix and extend from matrix at least one with the elongate probe electrode that described remote electrode tip connects, be used for forming conduction and contact with hemorrhoid;
Described instrument manual part comprises:
Handgrip parts below one, its size and structure are suitable for being hung on to by the doctor,
Be used for described probe matrix is connected to the conduction way of contact engagement device of described manual part, described probe axis and described below the handgrip component axes between the angle of cut be the obtuse angle, the selection of described obtuse angle value should make the doctor need not its wrist of gryposis constantly in treatment during hemorrhoid just can hold described instrument manual part;
Above treatment monitor and the control manual part that these parts place the top of the handgrip parts below described usually, and a front panel is arranged, when the remote electrode tip of probe penetrated hemorrhoid, the doctor can see front panel,
Described front panel comprises:
Be used to show the device of the various states of described instrument treatment condition, the described remote electrode tip that is used for device shown and probe is placed in the doctor when holding handgrip parts below described the probe electrode tip of described far-end being penetrated hemorrhoid in the same visual line of sight usually, and
Be used to control the device of unidirectional current intensity, this device is installed near on the handgrip position component below described, so that make the doctor operate described control device with the finger of that hand of holding the handgrip parts below described;
Therefore, when the doctor carried out hemorrhoid treating, he can see therapentic part simultaneously and observe the treatment condition be apparent in the described display device, held this instrument and operated described control device with one, and make the another hands empty.
2, instrument according to claim 1 is characterized in that the described device that is used to show the various states of described instrument treatment condition comprises and is used to show the device for the treatment of the elapsed time.
3, instrument according to claim 1 is characterized in that: the described device that is used to show the various states of described instrument treatment condition comprises the device of the unidirectional current intensity that is used to show that treatment is used.
4, instrument according to claim 1 is characterized in that: describedly be used to show that the device of the various states of described instrument treatment condition comprises the device that is used to show described treatment starting state.
5, instrument according to claim 1 is characterized in that: described control device comprises first device that is used to increase progressively current intensity and is used to successively decrease second device of current intensity.
6, instrument according to claim 5 is characterized in that: described control device further comprises the 3rd device that is used to interrupt DC current.
7, instrument according to claim 6 is characterized in that: described the 3rd device is that startup is activated when installing by described first device and described second.
8, instrument according to claim 1 is characterized in that: described obtuse angle value is approximately 120 °.
9, instrument according to claim 1 is characterized in that: described engagement device comprises:
The taper that gives sizing and shape that described probe matrix is contained, and
By the taper hole that size and dimension limited on the described instrument manual part, so that in the taper hole, insert this taper.
10, instrument according to claim 5 is characterized in that: the cross section common shape of described taper is square, the fillet with the sizing of giving, and corresponding to the size in described taper hole, but slightly littler than the size in described taper hole.
11, according to claim 1 or 9 described instruments, it is characterized in that: described probe is removable, and comprises the elongate probe electrode that at least two parallel arrangements are laid.
12, instrument according to claim 11 is characterized in that: depart from the eletrode tip of at least two far-ends of described elongate probe is vertical each other.
13, a kind ofly be used for hemorrhoid or the similar disease instrument that carries out direct current electrotherapy on one's body to patient, in this instrument, use a direct current electric generator device, a ground connection pole plate (or pad) that is used for patient, an one pole probe, this one pole probe has the eletrode tip of a far-end to be used to penetrate hemorrhoid to play negative electrode, and the manual part of an instrument, be used for supporting probe and control galvanic intensity;
Described probe comprise a matrix and extend from matrix at least one with the elongate probe electrode that described remote electrode tip connects, be used for forming conduction and contact with hemorrhoid;
Described instrument manual part comprises:
Handgrip parts below one, its size and structure are suitable for being hung on to by the doctor,
Be used for described probe matrix is connected to the conduction way of contact engagement device of described manual part, described probe axis and described below the handgrip component axes between the angle of cut be the obtuse angle, the selection of described obtuse angle value should make the doctor need not its wrist of gryposis constantly when the treatment hemorrhoid just can hold described instrument manual part, described probe matrix comprises a taper that gives sizing and shape, and by the taper hole that size and dimension limited on the described instrument manual part, so that in the taper hole, insert this taper, the cross section common shape of described taper is square, fillet with the sizing of giving, corresponding to the size in described taper hole, but slightly littler than the size in described taper hole.
Above treatment monitor and control handgrip parts that these parts place the top of the handgrip parts below described usually, and a front panel is arranged, when the remote electrode tip of probe penetrated hemorrhoid, the doctor can see front panel,
Described front panel comprises:
Be used to show the device of the various states of described instrument treatment condition, comprise and be used to show the device for the treatment of the elapsed time, the device that is used to show the device of the unidirectional current intensity for the treatment of use and is used to show described treatment starting state, the described remote electrode tip that is used for device shown and probe is placed in the doctor when holding handgrip parts below described the probe electrode tip of described far-end being penetrated hemorrhoid in the same visual line of sight usually, and
Be used to control the device of unidirectional current intensity, this device is placed near on the described following handgrip position component, so that make the doctor operate described control device with the finger of that hand of holding the handgrip parts below described, described control device comprises first device that is used to increase progressively current intensity at least, with second device that is used to increase progressively current intensity
Therefore when the doctor carries out hemorrhoid treating, he can see simultaneously that therapentic part and observation are apparent in the treatment condition in the described display device, holds this instrument and operates described control device with one, and make the another hands empty.
14, a kind of being used for comprises patient's hemorrhoid or similar disease instrument of carrying out direct current electrotherapy on one's body: a dc generator device, a ground connection pole plate that is used for patient, an one pole probe, this one pole probe has the eletrode tip of a far-end to be used to penetrate hemorrhoid to play negative electrode, and the manual part of an instrument, be used for supporting probe and control galvanic intensity
It is characterized in that:
Described probe comprises a matrix, with at least one the elongated one pole probe electrode that connects with the remote electrode tip that extends from matrix, being used for forming conduction with hemorrhoid contacts, described probe further comprises and is used for described probe matrix is connected to the manual part engagement device with the conduction way of contact, the angle of cut between described probe axis and the manual part axis is the obtuse angle, the selection of described obtuse angle value should make the doctor when the treatment hemorrhoid, need not its wrist of gryposis constantly and just can hold described instrument, described probe matrix comprises a taper that gives sizing and shape, and by the taper hole that size and dimension limited on the described instrument manual part, so that in the taper hole, insert described taper, the cross section common shape of described taper is square, fillet with the sizing of giving, corresponding to the size in described taper hole, but slightly littler than the size in described taper hole.
Applications Claiming Priority (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US4769887A | 1987-05-08 | 1987-05-08 | |
| US047,698 | 1987-05-08 | ||
| US4837487A | 1987-05-11 | 1987-05-11 | |
| US048,374 | 1987-05-11 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN2053099U true CN2053099U (en) | 1990-02-21 |
Family
ID=26725335
Family Applications (2)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN88103613.7A Expired CN1013475B (en) | 1987-05-08 | 1988-05-07 | Medical instrument for therapy of hemorrhoidal lesions |
| CN88207129U Expired - Lifetime CN2053099U (en) | 1987-05-08 | 1988-05-07 | Medical apparatus for treating piles |
Family Applications Before (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN88103613.7A Expired CN1013475B (en) | 1987-05-08 | 1988-05-07 | Medical instrument for therapy of hemorrhoidal lesions |
Country Status (7)
| Country | Link |
|---|---|
| JP (2) | JP2542673B2 (en) |
| CN (2) | CN1013475B (en) |
| CA (1) | CA1327633C (en) |
| DE (2) | DE3815862C2 (en) |
| FR (1) | FR2614778B1 (en) |
| GB (1) | GB2206796B (en) |
| IT (2) | IT8853122V0 (en) |
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| CN106236249A (en) * | 2016-09-09 | 2016-12-21 | 深圳半岛医疗有限公司 | Be suitable to treatment head and the treatment handle of hemorrhoid treating |
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| ES2366845B1 (en) * | 2010-12-15 | 2012-10-08 | Universitat Pompeu Fabra | SYSTEM FOR THE ELECTROCHEMICAL PREVENTION OF TUMOR DISEMINATION IN NEEDLE AND METHOD TRAJECTS FOR USING THE SYSTEM. |
| CN108469894A (en) * | 2018-03-13 | 2018-08-31 | 深圳阿凡达智控有限公司 | Voice recognition chip control method, device and system |
| CN109224293A (en) * | 2018-08-30 | 2019-01-18 | 浙江自贸区费米善科技发展有限公司 | A kind of radiofrequency treatment device and its application method |
| CZ2018483A3 (en) * | 2018-09-18 | 2020-03-04 | Compex, Spol. S R.O. | A method of applying an electrocauter for thermal stimulation of the vaginal mucosa and the apparatus for carrying this out |
| GB2600114B (en) * | 2020-10-20 | 2023-07-19 | Exroid Tech Limited | A probe electrode |
Family Cites Families (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4016881A (en) * | 1973-07-04 | 1977-04-12 | Centre De Recherche Industrielle Du Quebec | Instrument for use in laparoscopic tubal cauterization |
| DE3627221A1 (en) * | 1986-01-15 | 1988-02-18 | Siemens Ag | HF surgical instrument with performance control from the surgical handle |
-
1988
- 1988-05-06 CA CA000566128A patent/CA1327633C/en not_active Expired - Fee Related
- 1988-05-07 CN CN88103613.7A patent/CN1013475B/en not_active Expired
- 1988-05-07 CN CN88207129U patent/CN2053099U/en not_active Expired - Lifetime
- 1988-05-09 IT IT8853122U patent/IT8853122V0/en unknown
- 1988-05-09 DE DE3815862A patent/DE3815862C2/en not_active Expired - Fee Related
- 1988-05-09 IT IT67427/88A patent/IT1219280B/en active
- 1988-05-09 FR FR888806228A patent/FR2614778B1/en not_active Expired - Fee Related
- 1988-05-09 JP JP63112297A patent/JP2542673B2/en not_active Expired - Lifetime
- 1988-05-09 GB GB8810911A patent/GB2206796B/en not_active Expired - Lifetime
- 1988-05-09 DE DE8806167U patent/DE8806167U1/en not_active Expired
- 1988-05-09 JP JP1988061031U patent/JPH0546775Y2/ja not_active Expired - Lifetime
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106236249A (en) * | 2016-09-09 | 2016-12-21 | 深圳半岛医疗有限公司 | Be suitable to treatment head and the treatment handle of hemorrhoid treating |
Also Published As
| Publication number | Publication date |
|---|---|
| DE8806167U1 (en) | 1988-12-15 |
| IT1219280B (en) | 1990-05-03 |
| FR2614778B1 (en) | 1991-04-12 |
| CA1327633C (en) | 1994-03-08 |
| JPS6417250U (en) | 1989-01-27 |
| CN1031187A (en) | 1989-02-22 |
| GB2206796A (en) | 1989-01-18 |
| FR2614778A1 (en) | 1988-11-10 |
| GB2206796B (en) | 1992-01-02 |
| DE3815862A1 (en) | 1988-11-24 |
| JPS6415036A (en) | 1989-01-19 |
| CN1013475B (en) | 1991-08-14 |
| DE3815862C2 (en) | 1997-01-16 |
| JPH0546775Y2 (en) | 1993-12-08 |
| JP2542673B2 (en) | 1996-10-09 |
| IT8867427A0 (en) | 1988-05-09 |
| IT8853122V0 (en) | 1988-05-09 |
| GB8810911D0 (en) | 1988-06-15 |
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