CN219307694U - Bracket pusher for nasal biliary pancreatic drainage - Google Patents

Abstract

The utility model relates to the technical field of medical equipment, in particular to a bracket pusher for nasal biliary pancreatic drainage. The utility model provides a bracket pusher for nasal biliary pancreatic drainage, which comprises a first front catheter, a rear catheter and a fixed seat, wherein a cavity is formed in the first front catheter, the rear catheter and the fixed seat are sequentially connected with each other, an internal drainage bracket is sleeved on the first front catheter, and a plurality of first drainage holes communicated with the cavity are formed in a tube body of the first front catheter. The utility model has simple structure and convenient operation, and can change the nasal biliary pancreatic drainage tube into the biliary pancreatic tube internal drainage bracket by single operation in vitro. The utility model is suitable for critical patients with acute cholangitis, malignant high-level cholangiocarcinoma, and the like, and avoids the unsuccessful ERCP operation, bleeding or perforation and damage of sharp objects to intestinal mucosa.

Description

Bracket pusher for nasal biliary pancreatic drainage

Technical Field

The utility model relates to the technical field of medical equipment, in particular to a bracket pusher for nasal biliary pancreatic drainage.

Background

At present, ERCP is widely applied in clinic, and is an important measure for diagnosing and treating biliary pancreatic system diseases, and can be used for clearly diagnosing and treating choledocholithiasis, bile duct stenosis caused by unknown reasons, bile and pancreatic flow abnormality, postoperative bile duct injury, biliary tract complications after liver transplantation and the like. There are also serious complications such as acute pancreatitis after ERCP surgery, delayed bleeding or perforation at the papillary incision, etc. Nasal biliary (pancreas) drainage is performed after operations such as acute cholangitis, high bile duct obstruction, ERCP incision (biliary, pancreatic duct) and stone removal.

At present, an internal drainage bracket and an external drainage tube (a nose gall pancreas drainage tube) are commonly used for postoperative drainage, as shown in fig. 1, an external drainage tube 1 used in the prior art, as shown in fig. 2, an internal drainage bracket 2 used in the prior art comprises a bracket tube body 22, a plurality of bracket drainage holes 23 are respectively arranged on the bracket tube body 22, side holes 24 are arranged on two sides of the bracket tube body 22, and a spring piece 21 is arranged on the side holes 24. In the prior art, as shown in fig. 3 and 4, a stent pusher provided with an internal drainage stent is used, and the stent pusher comprises a fixed seat 3; the downstream position of the fixing seat 3 is smoothly connected with the rear catheter 4 and the front catheter 5, and a guide wire can be penetrated between the rear catheter 4 and the front catheter 5 (this is the prior art and is not repeated here).

The following disadvantages exist in clinical applications:

1. the external drainage tube is led out of the body through the upper digestive tract, the pharyngeal portion and the nasal cavity, and the movement of the external drainage tube can cause strong stimulation to the pharyngeal portion, and can cause serious nausea, even vomiting and other conditions of patients, so that the external drainage tube is displaced.

2. The outer drainage tube remains incapable of exceeding 1 month, and exceeding 1 month can cause electrolyte disturbance due to loss of a large amount of bile (pancreatic juice), and is generally used only for excessive drainage.

3. For high bile duct obstruction, because obstruction exists continuously, if the outer drainage tube is pulled out, ERCP must be carried out again to put into the inner drainage bracket, or a doctor breaks the outer drainage tube positioned outside the nipple of the duodenal drop part through an endoscopic forceps channel entering instrument. The two methods have the problems that the internal drainage stent cannot be placed in an expected position, the operation fails and the like, the possibility of occurrence of unexpected risks is greatly increased, the entering instrument for disconnecting the external drainage tube also easily causes secondary injury to a patient, the edge of the disconnection part of the external drainage tube is irregular, and the damage to the duodenal mucosa of the patient caused by uneven spines is caused.

The intrabiliary (pancreatic) tube drainage stent is commonly used for acute cholangitis and benign and malignant biliary (pancreatic) tube stenosis drainage, and can be clinically used for treatment by placing a single or a plurality of stents. The biliary (pancreas) tube internal drainage stent is simple to operate and short in time consumption, and can be remained in the biliary pancreas tube of a patient without causing discomfort of the patient. The following defects exist in the liner (pancreas) tube internal drainage stent:

1. for patients with high intrahepatic bile duct obstruction, the external drainage tube is generally placed first when the drainage area is very limited, and the internal drainage stent is replaced by the internal drainage stent of the biliary (pancreas) tube at the corresponding position after full drainage, otherwise, serious biliary tract infection can be caused.

2. The internal drainage stent of the liner (pancreas) tube is placed, because the bile is very viscous and is easy to block, the internal drainage stent of the liner (pancreas) tube is placed under other conditions, and the risks of blocking or shifting and the like are also caused, and the patency period of the internal drainage stent of the liner (pancreas) tube made of plastic materials is about 3 to 6 months.

3. The drainage stent in the plastic liner (pancreas) tube is easy to be blocked after being left for more than 6 months, and can be replaced only through ERCP operation once the blockage occurs.

Chinese patent CN207384524U discloses a detachable nasobiliary drainage tube, but this patent also requires a second use of an endoscope into the human body to separate the two drainage tubes.

Chinese patent CN215690925U discloses a novel detachable nasobiliary drainage tube, which is to connect the front drainage tube 5 through 1 traction rope 11, and finally break the traction rope 11 through the handle 12, thereby leaving the drainage tube 5 in the bile duct. However, in actual operation, pulling the handle 12, the drainage tube 5 and the rear drainage tube 5 connected by the traction rope 11 causes the drainage tube 5 to be displaced as a whole instead of breaking the connection rope by pulling the handle 12 because the drainage tube 5 is not in a straight state in the body but is bent, so that there is no force point in the human body.

Disclosure of Invention

In order to solve the technical problems, the bracket pusher for nasal biliary pancreatic drainage provided by the utility model can reduce the pressure in the bile duct by retaining the external drainage tube of the nasal biliary (pancreas) after operation, and can determine whether the drainage tube is positioned properly or not by observing the property and drainage quantity of bile (pancreatic juice) which flows out; meanwhile, the active bleeding after operation can be found in time before the patient has no obvious symptoms such as hematemesis and black stool. In addition, because bile is very viscous, normal saline is injected to wash the bile duct, the purpose of relieving obstruction of the bile duct is achieved, bacteria culture is carried out on the bile drained by the bile duct, targeted antibiotics are screened out, the method has remarkable significance for guiding clinical treatment, and if the bile is not needed, the bile duct is directly pulled out in vitro without being treated by an endoscope or other instruments.

The utility model provides a bracket pusher for nasal biliary pancreatic drainage, which is characterized by comprising a first front catheter, a rear catheter and a fixed seat, wherein the first front catheter, the rear catheter and the fixed seat are internally provided with a cavity and are sequentially connected with each other, and a plurality of first guide holes communicated with an inner cavity are formed in a tube body of the first front catheter.

Further, the first front catheter has an outer diameter in the range of 4 to 9Fr.

Further, the outer diameter of the rear duct is in the range of 5 to 10Fr.

Further, a plurality of first diversion holes are arranged on the whole body of the pipe body in a regular arrangement.

Further, the first diversion holes are arranged on the pipe body within a range of less than 15cm from the forefront length.

Further, the first diversion holes are arranged in the range that the length range of the pipe body from the forefront end is smaller than 10cm.

Further, the first diversion holes are arranged at the position, away from the forefront end, of the pipe body, and the length of the first diversion holes is 1cm, 2cm, 3cm, 4cm, 5cm, 6cm, 7cm, 8cm, 9cm or 10cm.

Further, the first front catheter is sleeved with the inner drainage bracket, the outer wall of the first front catheter is provided with a groove, the inner wall of the inner drainage bracket is provided with an outwards convex flange body, and the flange body and the groove are mutually inserted.

Further, the cross sections of the flange body and the groove are rectangular, trapezoidal, semicircular or triangular which are mutually corresponding.

Further, the diameter of the bracket drainage hole on the internal drainage bracket is larger than or equal to that of the first drainage hole.

Compared with the prior art, the utility model has the following beneficial effects:

1. the utility model has simple structure and convenient operation, can be operated without using an endoscope, and can realize the external drainage tube to be changed into the internal drainage bracket of the gall (pancreas) tube by simple operation in vitro.

2. The utility model is especially suitable for critical patients with acute cholangitis and malignant high-level cholangiocarcinoma, and avoids unsuccessful ERCP operation, bleeding or perforation and damage of sharp objects to mucous membranes.

Drawings

FIG. 1 is a general block diagram of an outer drainage tube of the prior art;

FIG. 2 is a front view of a prior art internal drainage stent;

FIG. 3 is a block diagram of a stent pusher with an internal drainage stent installed in the prior art;

FIG. 4 is an enlarged view of the structure of the point A in FIG. 3;

fig. 5 is a front view of the structure in embodiment 1 of the present utility model;

FIG. 6 is a front elevational view of one configuration of the present utility model with the first deflector aperture in place on the first forward draft tube;

FIG. 7 is a view showing another construction of the present utility model in which the first deflector hole is positioned on the first front draft tube;

FIG. 8 is an enlarged schematic view of a portion of the arrangement of the internal drainage stent of FIG. 7;

FIG. 9 is a cross-sectional view of the structure taken in the direction C-C of FIG. 8;

fig. 10 is another structural cross-sectional view taken along the direction C-C in fig. 8.

Reference numerals

In the figure, a 1-outer drainage tube, a 2-inner drainage support, a 21-shrapnel, a 22-support tube body, a 23-support drainage hole, a 24-side hole, a 25-flange body and a 3-fixing seat; 4-a rear duct; 5-a front catheter; 6-first front duct, 61-first diversion hole, 62-pipe body, 63-groove, 64-wedge head, 65-trapezoid structure.

Detailed Description

Specific embodiments of the present utility model are described in detail below with reference to the accompanying drawings.

Example 1

As shown in fig. 5 and 7, the utility model provides a stent pusher for nasal biliary pancreatic drainage, which comprises a first front catheter 6, a rear catheter 4 and a fixed seat 3, wherein the first front catheter 6 is internally provided with a cavity and is sequentially connected with each other, an internal drainage stent 2 is sleeved on the first front catheter 6, a plurality of first diversion holes 61 communicated with an inner cavity are arranged on a tube body 62 of the first front catheter 6, and the first diversion holes 61 are round holes or elliptical holes. In order to ensure normal use, the outer diameter size range of the first front catheter 6 is 4-9 Fr, the inner diameter size range of the first front catheter 6 is 3-8 Fr, and the outer diameter size range of the rear catheter 4 is 5-10 Fr.

In a further preferred technical solution, the first diversion hole 61 is disposed on the pipe body 62 within a range of less than 15cm from the foremost length L, and in a preferred technical solution, the first diversion hole 61 is disposed on the pipe body 62 within a range of 10-15 cm from the foremost length L, and the first diversion hole 61 may be disposed on the pipe body 62 within a range of 10cm, 11cm, 12cm, 13cm, 14cm or 15cm from the foremost length L, respectively.

In a further preferred embodiment, the first diversion hole 61 is disposed within a range of less than 10cm from the length L of the foremost end of the pipe body 62, and the first diversion hole 61 is disposed within a range of 1cm, 2cm, 3cm, 4cm, 5cm, 6cm, 7cm, 8cm, 9cm or 10cm from the length L of the foremost end of the pipe body 62.

In order to make the stent pusher for nasal biliary pancreatic drainage provided in this embodiment easier to follow the guide wire and also beneficial to pass through the stricture, the front end of the tube 62 in the first anterior catheter 6 is provided with a wedge-shaped head 64 of wedge-shaped structure.

The bracket pusher for nasal biliary pancreatic drainage provided in the embodiment specifically comprises the following steps of:

step 1: placing a guide wire into a gall (pancreas) tube through an endoscope, placing the bracket pusher for drainage of the nose gall pancreas provided by the embodiment into the gall (pancreas) tube along the guide wire through an endoscope forceps channel, observing the placement position through an X-ray machine, and after reaching the expected position, withdrawing the endoscope and keeping the bracket pusher at the corresponding position in the body;

step 2: after the oral-nasal exchange, the fixed seat 3 in the bracket pusher is kept outside the body through nostrils and is fixed so as to achieve the purpose of external drainage;

step 3: after the illness state is stable, the fixing seat 3 is directly pulled out, so that the internal drainage stent 2 in the stent pusher can be kept in the body, namely, the internal drainage stent of the gall (pancreas) tube is changed.

Example 2

This embodiment is modified on the basis of embodiment 1, and the other structures are the same, except that: in the present embodiment, as shown in fig. 6, a plurality of first diversion holes 61 are regularly arranged on the whole body of the tube 62.

As shown in fig. 8-9, since the length of the first front catheter 6 is far longer than that of the inner drainage stent 2, when the inner drainage stent 2 is mounted on the first front catheter 6, the first drainage hole 61 and the stent drainage hole 23 are easy to be misplaced, in order to align the first drainage hole 61 and the stent drainage hole 23 after being mounted, a groove 63 is arranged on the outer wall of the first front catheter 6, an outer convex flange body 25 is arranged on the inner wall of the inner drainage stent 2, the flange body 25 and the groove 63 can be mutually inserted, the effect of ensuring that the first drainage hole 61 and the stent drainage hole 23 are aligned after being mounted is achieved, and the purpose of fully draining the inside of the biliary pancreatic duct is achieved.

In this embodiment, the cross sections of the flange body 25 and the groove 63 are rectangular, trapezoidal, semicircular or triangular, which correspond to each other. In order to ensure drainage efficiency, it is preferable that the diameter of the stent drainage hole 23 on the inner drainage stent 2 is equal to the diameter of the first drainage hole 61 so that no dislocation blockage occurs.

As shown in fig. 10, in order to allow the internal drainage stent 2 to be smoothly inserted into the first front catheter 6, the flange 25 can also quickly enter the groove 63, and the cross section of the groove 63 is a trapezoid structure 65 with a small upper part and a large lower part.

In order to ensure that drainage can be performed normally, the further preferred technical scheme prevents the drainage effect from being affected after the first drainage hole 61 and the stent drainage hole 23 are slightly deviated, and the diameter of the stent drainage hole 23 on the internal drainage stent 2 is greater than that of the first drainage hole 61.

The bracket pusher for nasal biliary pancreatic drainage provided in the embodiment specifically comprises the following steps of:

step 1: placing a guide wire into a gall (pancreas) tube through an endoscope, placing the bracket pusher for drainage of the nose gall pancreas provided by the embodiment into the gall (pancreas) tube along the guide wire through an endoscope forceps channel, observing the placement position through an X-ray machine, and withdrawing the endoscope and keeping the bracket pusher at the corresponding position in the body after reaching the expected position;

step 2: after the oral-nasal exchange, the stent pusher is sent into a body through nostrils, the flange body 25 is aligned with the groove 63, and after the flange body 25 is aligned with the groove 63, the first drainage hole 61 on the first front catheter 6 is aligned with the stent drainage hole 23 on the inner drainage stent 2, so that the drainage can be better performed without dislocation;

step 3: the fixing seat 3 in the bracket pusher is kept outside the body through nostrils and is fixed so as to achieve the purpose of external drainage, and the bracket pusher needs to be used;

step 4: after the illness state of the patient is stable, the fixing seat 3 is directly pulled out, so that the internal drainage stent 2 in the stent pusher can be continuously remained in the body, namely, the internal drainage stent becomes an internal drainage stent of a gall (pancreas) tube.

The present utility model has been described in detail with reference to the specific embodiments and examples thereof, but the present utility model is not limited to the above-described embodiments and examples, and various changes can be made within the knowledge of those skilled in the art without departing from the spirit of the present utility model.

Claims (10)

1. The bracket pusher for the nasal biliary pancreatic drainage is characterized by comprising a first front guide pipe (6), a rear guide pipe (4) and a fixing seat (3), wherein a cavity is formed in the bracket pusher, the first front guide pipe, the rear guide pipe and the fixing seat (3) are sequentially connected with each other, and a plurality of first guide holes (61) communicated with the inner cavity of the first front guide pipe are formed in a pipe body (62) of the first front guide pipe (6).

2. The stent pusher for nasal biliary pancreatic drainage according to claim 1, characterized in that the first anterior catheter (6) has an outer diameter size ranging from 4 to 9Fr.

3. The stent pusher for nasal biliary pancreatic drainage according to claim 1, characterized in that the outer diameter of the rear duct (4) ranges from 5 to 10Fr.

4. The bracket pusher for nasal biliary pancreatic drainage according to claim 1, characterized in that the entire body of the tube body (62) is provided with a plurality of first drainage holes (61) which are regularly arranged.

5. The stent pusher for nasal biliary pancreatic drainage according to claim 1, wherein the first drainage aperture (61) is provided on the tube body (62) in a range of less than 15cm from the foremost length.

6. The stent pusher for nasal biliary pancreatic drainage according to claim 5, wherein the first drainage aperture (61) is disposed within a length of the tube body (62) from the foremost end in a range of less than 10cm.

7. The stent pusher for nasal biliary pancreatic drainage according to claim 6, wherein the first drainage aperture (61) is disposed at the forward-most length of the tube body (62) of 1cm, 2cm, 3cm, 4cm, 5cm, 6cm, 7cm, 8cm, 9cm or 10cm.

8. The bracket pusher for nasal biliary pancreatic drainage according to claim 1, characterized in that the first front catheter (6) is sleeved with an internal drainage bracket (2), the outer wall of the first front catheter (6) is provided with a groove (63), the inner wall of the internal drainage bracket (2) is provided with an externally protruding flange body (25), and the flange body (25) and the groove (63) are mutually inserted.

9. The stent pusher for nasal biliary pancreatic drainage according to claim 8, characterized in that the cross-sections of the flange body (25) and the groove (63) are rectangular, trapezoidal, semicircular or triangular, corresponding to each other.

10. The stent pusher for nasal biliary pancreatic drainage according to claim 8, characterized in that the diameter of the stent drainage aperture (23) on the internal drainage stent (2) is greater than or equal to the diameter of the first drainage aperture (61).

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