CN220632743U

CN220632743U - Medical PTCD catheter

Info

Publication number: CN220632743U
Application number: CN202321782150.3U
Authority: CN
Inventors: 周怀胜; 赵伦; 吴征
Original assignee: Individual
Current assignee: Individual
Priority date: 2023-07-08
Filing date: 2023-07-08
Publication date: 2024-03-22
Anticipated expiration: 2033-07-08

Abstract

A medical PTCD catheter effectively solves the problem of infection caused by countercurrent entry of bacterial intestinal juice into biliary tract. The technical scheme for solving the technical problems is that the medical PTCD catheter comprises a drainage bag, a discharge port is arranged at the bottom of the drainage bag, the catheter is connected above the drainage bag and comprises a drainage tube and a conveying pipe positioned in the drainage tube, the conveying pipe is longer than the drainage tube, the drainage tube is placed into a bile duct, the conveying pipe is placed into a duodenum, the drainage tube and the conveying pipe are both unidirectional channels, bile in the bile duct can be introduced into the drainage bag by the drainage tube, and the bile in the drainage bag can be sent into the duodenum by the conveying pipe; the conveying pipe is arranged in the intestinal cavity and is a one-way channel, and only external substances can be conveyed into the intestinal cavity, and the substances in the intestinal cavity cannot flow back through the conveying pipe, so that infection caused by the fact that bacterial intestinal juice flows back into the biliary tract is avoided, and liver function damage is aggravated.

Description

Medical PTCD catheter

Technical Field

The utility model relates to the technical field of catheters, in particular to a medical PTCD catheter.

Background

1. Malignant biliary tract obstruction is malignant biliary tract obstruction diseases caused by biliary tract cancer, gall bladder cancer, pancreatic cancer, ampulla tumor, liver malignant tumor, lymph node metastasis of other tumors and the like, and patients with obstruction have jaundice progressive aggravated and liver function worsened in a short time, and complications such as acute obstructive suppurative cholangitis, renal function, liver failure and the like are easily combined, and even systemic organ failure occurs. The radical surgery is the preferred treatment scheme for patients with early malignant biliary obstruction, but most patients with malignant biliary obstruction lose the meaning of surgery because the anatomy of the obstructed part of the patients with malignant biliary obstruction is complex and the diversity of tumor biology characteristics, and most of the patients have advanced clinical stage when found or have other diseases combined to cause high risk of surgery. Thus, relieving biliary obstruction is an important part of palliative treatment for patients with malignant biliary obstruction.

Current methods for relieving malignant biliary obstruction mainly include surgical biliary drainage, percutaneous transhepatic biliary drainage (PTCD), endoscopic downlink biliary stent drainage (ERBD). The surgical biliary tract drainage has the defects of high operation risk, high mortality rate, low yellowing success rate, high complication occurrence rate and the like, and particularly for patients with advanced biliary tract tumors. With the continuous development and updating of digestive endoscopes and interventional therapy technologies, drainage (ERBD) for patients with malignant biliary obstruction placed through an endoscopic down biliary tract stent is widely applied to clinic, but serious complications such as bleeding, perforation, biliary infection, pancreatitis and the like exist, the requirements on technical conditions are high, the price of an endoscopic down metal stent is high, and the like, and the method is difficult to widely develop in primary hospitals.

PTCD directly punctures intrahepatic bile duct through intercostal tissue and less hepatic parenchyma, compared with ERBD, the operation path is obviously shortened (the PTCD operation path is only 20-30 cm, and the common endoscope length of ERBD is more than 100 cm), so that the operation difficulty is greatly reduced, and the operation success rate is improved; for obstructive jaundice caused by tougher obstruction (such as cholangiocarcinoma), the passing ability of PTCD to the obstruction segment is better than the ERBD route due to a short operation path and a smooth angle, and the treatment success rate of the patient is greatly higher than the ERBD; PTCD is not affected by bile duct surgery (such as biliary-intestinal anastomosis, etc.), but ERBD treatment is very difficult for some patients because of the relative relation of intestinal canal and biliary tract; PTCD may be the only option in this part of patients if biliary tract is obstructed. After the PTCD is routed through the first operation, the patient has almost no uncomfortable feeling in the subsequent treatment, and the PTCD is completely different from the pain feeling of the ERBD route which is the same for each treatment. For general commonly used biliary tract drainage tubes, the PTCD route has very rich product lines for selection, the caliber of the drainage tube is various, the flexibility, the smoothness and the price of the drainage tube are superior to those of the commonly used inclusion tube (stent tube) of the ERBD route.

Thus, PTCD has become an important part of palliative treatment for patients with malignant biliary obstruction in primary hospitals.

2. Existing PTCD procedures suffer from the following disadvantages:

1. PTCD external drainage: bile can not be returned, bile discharged from the outside is mostly discarded, no drainage liquid exists in the intestinal tract, and the absorption of nutrient substances in the intestinal tract is affected.

2. PTCD internal and external drainage (1) a continuous bidirectional channel is established between an intestinal cavity and a biliary tract by a drainage tube, and under the condition of increasing intestinal pressure, bacterial intestinal juice inevitably flows into the biliary tract in a countercurrent way to cause infection; in addition, the recent puncture of the biliary tract is wounded, the wound is not healed, and the chance that bacteria enter the blood circulation through the wound surface is increased. (2) The drainage tube in the liver and the drainage tube in the intestinal tract are easy to be blocked, intermittent flushing is needed, and external bacteria are easy to enter in the flushing process, so that infection is caused.

Disclosure of Invention

Aiming at the situation, the utility model aims to overcome the defects of the prior art and provide a medical PTCD catheter, which effectively solves the problem of infection caused by countercurrent entry of bacterial intestinal juice into biliary tract.

The technical scheme of its solution technical problem is, a medical PTCD pipe, including the drainage bag, drainage bag bottom is equipped with the discharge port, and drainage bag top is connected with the pipe, and the pipe includes the drainage tube and is located the inside conveyer pipe of drainage tube, and the conveyer pipe is longer than the drainage tube, and the bile duct is put into to the drainage tube, and the duodenum is put into to the conveyer pipe, and drainage tube and conveyer pipe are one-way passageway, and the drainage bag can be introduced bile in the bile duct to the drainage bag, and the conveyer pipe can send bile in the drainage bag into the duodenum.

Preferably, one end of the drainage tube positioned in the drainage bag is provided with a first one-way valve, and the first one-way valve forms a structure of one-way flow of the drainage tube.

Preferably, one end of the conveying pipe, which is positioned in the drainage bag, is provided with a second one-way valve, and the second one-way valve forms a structure of one-way flow of the conveying pipe.

Preferably, the conveying pipe and the drainage pipe are divided into two sections, one section is fixed on the drainage bag, and the other section is connected with the section fixed on the drainage bag through the needle core.

The utility model has the following advantages:

1. the conveying pipe is arranged in the intestinal cavity and is a one-way channel, and can only send external substances into the intestinal cavity, and the substances in the intestinal cavity can not flow back through the conveying pipe, so that infection caused by the fact that bacterial intestinal juice flows back into biliary tract is avoided, and liver function damage is aggravated.

2. The bile is favorable for fat digestion and absorption, reduces the loss of water and electrolyte, and can be fed into the intestinal cavity after being eaten, so that the digestion and absorption of the fat of a patient can be helped, the nutrition condition of the patient can be improved to a certain extent, and the life cycle of the patient is prolonged.

3. The drainage tube and the conveying pipe can be detached, and replacement is convenient.

Drawings

Fig. 1 is a schematic diagram of an application of a PDCT tube in the prior art.

Fig. 2 is a schematic structural view of the present utility model.

Fig. 3 is an enlarged schematic view of the structure of fig. 2 a according to the present utility model.

Fig. 4 is a schematic view of a catheter interface structure according to the present utility model.

Description of the embodiments

The following describes the embodiments of the present utility model in further detail with reference to the drawings.

Given by fig. 1 to 4, a medical PTCD pipe, including drainage bag 1, drainage bag 1 bottom is equipped with discharge port 2, and drainage bag 1 top is connected with the pipe, and the pipe includes drainage tube 3 and is located the inside conveyer pipe 4 of drainage tube 3, and conveyer pipe 4 is longer than drainage tube 3, and the bile duct is put into to drainage tube 3, and the duodenum is put into to conveyer pipe 4, and drainage tube 3 is one-way passageway with conveyer pipe 4, and drainage tube 3 can introduce drainage bag 1 with bile in the bile duct, and conveyer pipe 4 can send bile in the drainage bag 1 into the duodenum.

The PTCD tube is a double sleeve, and is divided into an external drainage tube 3 and an internal conveying tube 4. The pipe diameter of the conveying pipe 4 is thinner, can be directly put into the intestinal canal through the narrow part of the biliary tract, is a unidirectional channel, can only return bile, and cannot externally drain bile and intestinal juice. The drainage tube 3 has a slightly thicker tube diameter, is only required to be sleeved outside the conveying tube 4, is put into the biliary tract through the same puncture part, does not need to pass through the Oddi sphincter, can be placed at any part of the left hepatic tube, the right hepatic tube, the hepatic duct and the common bile duct according to the part of the biliary tract obstruction, is a unidirectional channel, can only externally drain bile, and cannot reinfusion bile.

In the utility model, the negative pressure in the drainage bag 1 can drain bile in the bile duct into the drainage bag 1, when the bile is required to be injected into the intestinal tract, the drainage bag 1 is extruded, and the bile in the drainage bag 1 can enter the intestinal tract through the conveying pipe 4 to assist digestion.

In order to realize unidirectional transportation of the drainage tube 3 and the conveying pipe 4, one end of the drainage tube 3, which is positioned in the drainage bag 1, is provided with a first one-way valve 5, the first one-way valve 5 forms a structure of unidirectional flow of the drainage tube 3, one end of the conveying pipe 4, which is positioned in the drainage bag 1, is provided with a second one-way valve 6, and the second one-way valve 6 forms a structure of unidirectional flow of the conveying pipe 4. The first one-way valve 5 and the second one-way valve 6 enable the drainage tube 3 and the conveying pipe 4 to only convey bile in one way, and the situation that bacteria intestinal juice enters the drainage bag 1 in a countercurrent mode is avoided.

Because PTCD pipe belongs to the consumable, need the unscheduled change, for being convenient for change, conveyer pipe 4 and drainage tube 3 divide into two sections, one section is fixed on drainage bag 1, another section is connected with one section of fixing on drainage bag 1 through the nook closing member, the interface department of drainage tube 3 and conveyer pipe 4 is the throat form, the tip of fixing one section with drainage bag 1 is equipped with nook closing member 7, nook closing member 7 is taking the nook closing member, and the nook closing member 7 cover that is connected with conveyer pipe 4 is located the nook closing member 7 inside being connected with drainage tube 3, realize respectively that conveyer pipe 4 is connected with drainage tube 3, guarantee not the series flow between drainage tube 3 and the conveyer pipe 4, for be convenient for change the PDCT pipe, divide into two sections with the pipe, take out one section of arranging in the internal after two sections pipe separation, carry out fixed connection with one section outside the body after changing the pipe of heart, drainage bag 1 can not be extravagant with the bile in the bag.

The specific steps of replacement are as follows: the old delivery tube 4 is placed into the jejunum by the guide wire, the old delivery tube 4 and the drainage tube 3 are pulled out, and the new delivery tube 4 and the drainage tube 3 are placed into the old delivery tube by the guide wire.

The present utility model can solve the following problems in the prior art against the current situation of PDCT:

and the retrograde infection is avoided to a large extent. Because only the conveying pipe 4 passes through the sphincter of Oddi, the conveying pipe 4 is thinner, the influence on the sphincter of Oddi is smaller, and the conveying pipe 4 is a one-way feedback channel, the continuous two-way channel is avoided, and thus, the infection caused by the countercurrent entering of the bacterial intestinal juice into the biliary tract under the condition of the increase of the intestinal pressure is avoided. Secondly, the whole PTCD tube system is a closed system and is completely isolated from the outside, so that the contact between bile and the outside in the process of outward drainage and intestinal reinfusion can be effectively avoided, the entry of outside bacteria is avoided, and the occurrence of infection is avoided.

Can improve the nutritional status of patients to a certain extent. Related studies have shown that biliary infusion back into the gastrointestinal tract has the following advantages: (1) the bile feedback way accords with the intestinal and liver circulation physiology; (2) is favorable for fat digestion and absorption and reduces the loss of water and electrolyte; (9) enteral nutrition support can be safely and effectively carried out; (4) improving the quality of life of the patient. About 50% -70% of patients with malignant obstructive jaundice have malnutrition before operation, and the degree of the malnutrition is consistent with the incidence rate of postoperative complications.

The drainage bag 1 can replace the working principle of the gall bladder. During non-digestion period, bile is stored in the gallbladder, when the gallbladder is needed for digestion, the bile is discharged from the gallbladder, after 3-5min of food is taken, the food passes through the duodenum to stimulate the mucosa of the duodenum, so that a hormone called cholecystokinin is produced, the gallbladder is contracted, the bile in the gallbladder is immediately discharged into the duodenum to assist the digestion and absorption of fat, and bacteria in the biliary tract and the bile are discharged out of the body together at the same time. Typically, the gallbladder empties half an hour after fat intake. According to the working principle of the gall bladder, after half an hour of eating, or intermittently adjusting and extruding the external drainage device, bile can be directly extruded into jejunum, so that the digestion and absorption of fat are assisted, the nutrition condition of a patient can be improved to a certain extent, and the life cycle of the patient is prolonged.

So far, no matter what PTCD tube belongs to a lost product, the damage to the pipeline caused by the material itself or nursing reasons is common, and in this case, the pipeline needs to be replaced, so that the utility model has the advantage of convenient replacement.

The utility model can replace the traditional intrahepatic and extrahepatic drainage tube and most extrahepatic drainage devices, and has important significance in clinical application.

Claims

1. The utility model provides a medical PTCD pipe, a serial communication port, including drainage bag (1), drainage bag (1) bottom is equipped with discharge port (2), drainage bag (1) top is connected with the pipe, the pipe includes drainage tube (3) and is located inside conveyer pipe (4) of drainage tube (3), conveyer pipe (4) are longer than drainage tube (3), the bile duct is put into to drainage tube (3), the duodenum is put into to conveyer pipe (4), drainage tube (3) are unidirectional channel with conveyer pipe (4), drainage tube (3) can introduce bile in the bile duct into drainage bag (1), conveyer pipe (4) can send bile in drainage bag (1) into the duodenum.

2. The medical PTCD catheter according to claim 1, wherein a first one-way valve (5) is arranged at one end of the drainage tube (3) in the drainage bag (1), and the first one-way valve (5) forms a one-way flow structure of the drainage tube (3).

3. A medical PTCD catheter according to claim 1, characterized in that the end of the delivery tube (4) located in the drainage bag (1) is provided with a second one-way valve (6), and the second one-way valve (6) forms a structure for unidirectional flow of the delivery tube (4).

4. A medical PTCD catheter according to claim 1, characterized in that the delivery tube (4) and the drainage tube (3) are divided into two sections, one section being fixed to the drainage bag (1) and the other section being connected to the section fixed to the drainage bag (1) by means of a needle (7).