EP0205817A1 - Système de traitement avec manchette et système de règlement - Google Patents

Système de traitement avec manchette et système de règlement Download PDF

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Publication number
EP0205817A1
EP0205817A1 EP86105630A EP86105630A EP0205817A1 EP 0205817 A1 EP0205817 A1 EP 0205817A1 EP 86105630 A EP86105630 A EP 86105630A EP 86105630 A EP86105630 A EP 86105630A EP 0205817 A1 EP0205817 A1 EP 0205817A1
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EP
European Patent Office
Prior art keywords
individual chambers
pressure
control
control device
fluid
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP86105630A
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German (de)
English (en)
Other versions
EP0205817B1 (fr
Inventor
Hans Bösl
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Individual
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Individual
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Publication date
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Priority to AT86105630T priority Critical patent/ATE59000T1/de
Publication of EP0205817A1 publication Critical patent/EP0205817A1/fr
Application granted granted Critical
Publication of EP0205817B1 publication Critical patent/EP0205817B1/fr
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H9/00—Pneumatic or hydraulic massage
    • A61H9/005—Pneumatic massage
    • A61H9/0078—Pneumatic massage with intermittent or alternately inflated bladders or cuffs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5002—Means for controlling a set of similar massage devices acting in sequence at different locations on a patient

Definitions

  • the invention relates to a method for operating a treatment device, comprising a sleeve composed of individual chambers and made of pliable material, a control device for successively filling the individual chambers and connecting elements that connect at least the individual chambers to the control device, and at least one fluid pump that is connected to the control device is connected to the individual chambers, and a device for performing this method.
  • Such a device and the associated method for operating this device have become known, for example, from US Pat. No. 4,311,135. These devices are used to improve venous circulation, decongest the treated tissue (removal of tissue water) and for thrombus treatment.
  • the individual chambers of the cuff described there are inflated by a fluid with a pressure of approximately 40 mb (see column 3, line 67).
  • the individual chambers of the cuff are controlled by a continuously rotating distributor, so that the rotational speed of the distributor is decisive for the degree of filling and thus for the internal pressure of the chambers.
  • the pressure of the individual chambers must therefore be regulated via the speed of rotation of the distributor. If this speed of rotation is constant, the pressure in the chambers differs from person to person because the cuff is filled differently due to the different sizes of the treated extremities.
  • the system is - if also conditional - suitable for the intended purpose.
  • a device according to DE-OS 28 14 691 is also comparable. According to this reference, an operating pressure of about 40 mm Hg is given on page 10, paragraph 3, which corresponds to a pressure of about 55 mb.
  • German utility models G 84 15 045 and G 84 22 047 which describe special control devices used in treatment facilities of the abovementioned, go back to the applicant himself. kind can be included.
  • cuffs of the type mentioned are controlled, which are intended for the decongesting of human extremities in accordance with these literature references.
  • This control device ensures that the individual chambers of an assigned cuff are filled exactly one after the other when a preceding chamber has reached the set pressure.
  • the pressure for the cuff can be set and preselected via the control device. Because of the intended use specified in these references, it must also be assumed here that an operating pressure of 40-50 mb is used.
  • Thrombus treatment has also already been mentioned in various of the publications cited above relating to the prior art.
  • the use of the devices described should form a Thrombus prevented or an existing thrombus resolved.
  • different measures can be distinguished. For example, the vein in which the thrombus is inserted can be cut open and then a thin, inflatable cannula can be pushed through the thrombus and inflated or inflated behind it, so that the entire free vein cross section is filled. Then this device is pulled forward and the thrombus is transported with it. It is a complicated method that places relatively high demands on the manual dexterity of the attending doctor.
  • a thrombus when the vein has been cut open at the appropriate point, can also be expressed by wiping the vein with your finger or thumb. This must be done quickly and vigorously so that the still liquid blood behind the thrombus can be used as a pressure medium during this expulsion, which drives the thrombus in front of it to the point where the vein is open, so that the thrombus here can be driven out.
  • the course of the wire must be clearly recognizable and the course of the wire must be followed exactly during the manual driving process in order to achieve the desired effect.
  • high manual dexterity is required.
  • Another problem in medicine is the voiding of certain parts of the body to be operated on.
  • the invention has for its object to provide a method and a device to enable the emptying of certain extremities or thrombus.
  • a control or regulation of the filling speed of the individual chambers is carried out, with a subsequent chamber being filled without intermediate time when the previous chamber is filled.
  • the speed of advance of the blood in the treated limb can be influenced.
  • the speed can also be varied during a single treatment cycle. For example, a quick refill at the beginning of the first individual chambers and the filling speed of the individual chambers is reduced towards the end.
  • the reverse process is of course also possible.
  • the fact that the successive chambers are filled without intermediate time ensures, on the one hand, a continuous transport of the blood in the desired manner and, on the other hand, avoids an unnecessarily large load on the extremity being treated.
  • a device for carrying out the method according to the invention is also proposed with at least one fluid pump, a control device, a flexible sleeve composed of individual chambers and connecting elements for connecting the pump, control device and sleeve at least, which allows the method according to the invention to be carried out in that devices for setting and / or regulating the fluid pressure and / or the fluid quantity are provided, these devices of course having to be designed in such a way that they cover the desired pressure and quantity range.
  • the devices for setting and / or regulating. of the fluid pressure must therefore allow a pressure of 250 to 600 mb.
  • this device should preferably also enable the lower pressure range from a value greater than 0 to approximately 50 mb, so that the conventional treatment which is already known in the prior art can also be carried out with such a device.
  • the quantity control of the fluid must also be such that, on the one hand, a very slow filling is possible for carrying out the conventional treatment and, on the other hand, a filling which is sufficiently rapid is possible in order to drive out a thrombus on the cut vein.
  • the quantity control must also allow an adapted filling speed to empty the treated limb.
  • the pump must be designed so that it can deliver the necessary amount of fluid at the desired pressure.
  • a device according to the aforementioned utility models G 84 15 045 and G 84 22 043 has proven itself as the starting device for carrying out the method according to the invention.
  • Such a device can be supplemented with relatively simple and known technical means so that the method according to the invention can be carried out and thus such a supplemented device can be used for the purpose described.
  • the description and mode of operation of a control according to the utility models mentioned can be found in these utility models.
  • Such a control device together with a suitable cuff can be used, for example, to drive out a thrombus with the vein open.
  • the cuff with its foremost chamber is arranged behind the point at which the vein blocked by the thrombus is open, care being taken to ensure that there are sufficient chambers behind the thrombus.
  • the individual chambers are then quickly filled with the necessary pressure from the fluid via the control device mentioned, as a result of which the thrombus is rapidly propelled forward and expelled at the opening point of the vein. At the same time, the surrounding tissue is decongested.
  • a cuff 1/2 known per se with single chambers 1/3 is placed around the leg 1/1 in the arrangement shown in FIGS. 1, 2 and 3 and over the envelope 1 / 5 closed with the closures 1/10.
  • the 1/9 leg vein is opened and the 1/2 cuff is positioned to lie between the 1/8 foot and the 1/9 leg vein opening site.
  • the thrombus must be axially in the area of cuff 1/2.
  • the control lines 1/7 are attached to the connectors 1/6 of the sleeve 1/2.
  • control lines 1/7 are connected via the connectors 1/6 to the connection openings 1/6 'of the individual chambers 1/3, so that each individual chamber 1/3 is assigned a control line 1/7. In this way, all individual chambers 1/3 can be supplied with a fluid in a desired order via the control line 1/7.
  • the cuff 1/2 is connected to a control device according to one of the two German utility models G 84 15 054.9 or G 84 22 043.0 as supplemented in the manner necessary for the invention and shown in this supplement in FIG.
  • the control lines 1/7 are connected to the control device described there.
  • the control lines 1/7 correspond to the control lines 2-10, according to Figure la.
  • the control lines are of such a control device according to figure la then 1/7 or 2-10, "J ie by the arrows in Figure 1 1/11 indicated charged with fluid.
  • the control device determines the pressure of the fluid and can be preset about the Correspondingly controllable pressure source 42, which is connected to a control or regulating device 46 via a control line 50.
  • control pressure line 12 The actually occurring control pressure in the control pressure line 12 can then be read on the manometer 49.
  • the control pressure line 12 is also connected to the control or regulating device via the control pressure line 12a. As a result, the setpoint size and the actual size can be supplied to the device 46 if required.
  • the mass flow of the fluid is determined by the pump output of the pump 44 for the fluid, which is connected via the inlet connection 1 to the control device according to FIG.
  • the pump 44 In order to be able to use the entire device not only in a conventional manner but also in a manner according to the invention, the pump 44 must be able to deliver the necessary amount of fluid at the desired pressure. In order to be able to operate the entire device economically using both the conventional method and the method according to the invention, it may be advantageous not to install the pump 44 as a single pump, but in the form of several pumps. The delivery rate can be changed as required by switching on several pumps.
  • a quantity adjuster 47 can also or additionally be provided in the inlet connection 1, which is connected again via a control line 51 to the control or regulating device 46 already described and receives control or regulating pulses from there.
  • the device 46 is connected to the outlet connections 2-10, which correspond to the connections 1/7 according to FIG. The pressure arriving in the inlet connection 1 can be read off on the manometer 48.
  • control or regulating device 46 which measures the speed, is sufficient of the pressure rise in the respectively assigned line 2 to 10 can calculate the filling speed and thus the mentioned traveling speed and then the quantity adjuster 47 via the control line 51 regulates accordingly.
  • the control can also be carried out according to a predetermined speed program.
  • the individual chambers 39 correspond to the individual chambers 1/3 according to FIG. 1.
  • the individual chambers 39 according to FIG. 1 a are only shown schematically and are all directly adjacent to one another, while the individual chambers 1/3 according to FIG. 1 are arranged in mutual overlap. The mutual overlap prevents undesirable losses in the border areas between two chambers.
  • the thrombus is expelled when the individual chambers 1/3 according to FIG. 1 are inflated rapidly at the foot 1/8 starting in the direction of arrow 1/4 with the necessary pressure.
  • This requires a pressure of at least 250 mb. If necessary. but a pressure of 500 to 600 mb can also be used and necessary.
  • the necessary pressure is first set with the aid of the control device and an adequate delivery rate of the fluid must be ensured via the pump output for the fluid. When dimensioning the control device, care must of course be taken to ensure that it is large enough to enable the necessary fluid throughput at all. The exact setting of the fluid throughput can then be made via the volume adjuster 47.
  • control lines 1/7 (or the corresponding lines 2-10) are activated one after the other by the control device in the order just described and the assigned individual chambers 1/3 or 39 with the desired speed and the set pressure filled with the required fluid. This creates an expulsion movement in the direction of arrow 1/4, so that the thrombus is safely expelled from the opened vein 1/9.
  • FIG. 1 a shows a longitudinal section through a control body that can be used for the implementation of the invention, as can be seen from the two German utility models mentioned, to which express reference is made.
  • a cylindrical control body 13 is used here.
  • the entire length of the cylindrical control body 13 is covered with a tubular rubber skin as the membrane 29.
  • the control body 13 covered with the membrane 29 in this way is inserted with radial play into a tubular hollow body 18 which is approximately the same length as the control body 13.
  • This hollow body 18 is nearby of the rear end on a radially directed inlet opening 37, which is equipped with a hose connector 41.
  • Hose connector 41 is connected via a control pressure line 12 to a pressure source 42 for flow medium.
  • the pressure source 42 can be connected to a control or regulating device 46 via a control line 50,
  • the radial space between the outer surface of the membrane 29 and the inner surface of the hollow body 18 is sealed in the region of the two ends of the hollow body 18 with an O-ring 25 and 26, respectively.
  • the control body 13 has on its surface a number of annular channels 33 which are delimited by annular intermediate webs 32. In each of these annular channels 33 there is an outlet opening 34 and 35, each subsequent outlet opening 34 preferably being arranged somewhat offset in the circumferential direction with respect to the previous outlet opening 34.
  • an inlet connection 1 and the outlet connections 2 to 10 are arranged on the front side 22 of the control body 13 from the front side and distributed in the circumferential direction.
  • the connections 1 to 10 mentioned are each connected to the outlets 34 and 35 via longitudinal bores in the control body 13.
  • inlet port 1 is connected to outlet 34.
  • the outlet connection 2 is connected to the lowest outlet 35 in FIG. 1 a, etc.
  • Behind the last annular channel 33 for the last outlet 35, which is connected to the outlet connection 10 a further ring channel is provided in the control body 13, in which a plurality of outlets 36 are arranged, all of which are connected to the outlet connection 11 arranged on the rear end face 21 via assigned channels.
  • This outlet port 11 can lead directly into the free atmosphere 38, or serve as a connector to other devices, in the embodiment with a silencer 43.
  • the 0-ring 25 before the first outlet that is to say before the outlet 34
  • the 0-ring 26 is arranged behind the last outlet, that is to say behind the outlets 36, which lead into the outlet connection 11. It is entirely possible to provide annular channels for the 0-rings 25 and 26 on the control body 13, as a result of which a better axial fixation of these 0-rings is achieved and, at the same time, a better sealing of the membrane by clamping the membrane 29 in the channels 31 29 compared to the control body 13 is reached.
  • the outlet connections 2 to 10 are each connected to an associated individual chamber 39 or 1/3 via suitable lines, all of the chambers 39 and 1/3 being combined to form a sleeve 40 or 1/2.
  • These single chambers can e.g. form annular hoses, so that the resulting cuff 40 or 1/3 e.g. can be placed over an arm or over a leg.
  • the individual chambers 1/3 are advantageously arranged in mutual overlap in the cuff 1/2.
  • the inlet port 1 is connected to a pressure source 44, which is suitable to fill the chambers 39 and 1/3 and thus the sleeve 40 and 1/2 in the desired manner with pressure medium.
  • the filling speed is influenced on the one hand by the pump power 44 and on the other hand by the setting of the volume control 47. All connections are routed internally to the connecting disk 16, it being possible for there to be arranged connecting tubes, which are not specified on the end face or on the circumference.
  • a treatment device known per se is thus improved in terms of device technology in such a way that one compared to the known ones Devices of the prior art can often be driven at higher pressures and a higher filling speed is achieved.
  • the treatment devices of this type improved in terms of device technology are then operated according to the procedure proposed according to the invention, such operation being possible only through improvements in the device technology.

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  • Health & Medical Sciences (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Rehabilitation Therapy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Massaging Devices (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
  • External Artificial Organs (AREA)
  • Percussion Or Vibration Massage (AREA)
EP86105630A 1985-05-23 1986-04-23 Système de traitement avec manchette et système de règlement Expired - Lifetime EP0205817B1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AT86105630T ATE59000T1 (de) 1985-05-23 1986-04-23 Behandlungseinrichtung mit manschette und steuereinrichtung.

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE3518513 1985-05-23
DE3518513 1985-05-23

Publications (2)

Publication Number Publication Date
EP0205817A1 true EP0205817A1 (fr) 1986-12-30
EP0205817B1 EP0205817B1 (fr) 1990-12-12

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ID=6271425

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Application Number Title Priority Date Filing Date
EP86105630A Expired - Lifetime EP0205817B1 (fr) 1985-05-23 1986-04-23 Système de traitement avec manchette et système de règlement

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EP (1) EP0205817B1 (fr)
AT (1) ATE59000T1 (fr)
DE (1) DE3676120D1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0542383A2 (fr) * 1991-11-12 1993-05-19 The Kendall Company Dispositif de compression
DE4202959C1 (en) * 1992-02-01 1993-06-09 Boesl Medizintechnik Gmbh, 5100 Aachen, De Fluid servo-valve with longitudinal recess between sealing rings - has rings on subsidiary control piston sliding in cylinder with openings into recess for relief of fluid pressure
US9649245B2 (en) 2005-09-23 2017-05-16 New Tec Pty Ltd Apparatus for preventing deep vein thrombosis

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19846922C2 (de) * 1998-10-12 2003-12-11 Manuel Fernandez Behandlungsvorrichtung

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3811431A (en) * 1973-01-17 1974-05-21 M Apstein Programmed venous assist pump
FR2405708A1 (fr) * 1977-10-13 1979-05-11 Hydrola Ltd Appareil de traitement du corps
FR2425239A1 (fr) * 1978-05-09 1979-12-07 Vendeville Pierre Appareil destine a la reduction d'un oedeme
DE8415045U1 (de) * 1984-05-17 1984-12-06 Bösl, Hans, 5100 Aachen Steuereinrichtung

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3811431A (en) * 1973-01-17 1974-05-21 M Apstein Programmed venous assist pump
FR2405708A1 (fr) * 1977-10-13 1979-05-11 Hydrola Ltd Appareil de traitement du corps
FR2425239A1 (fr) * 1978-05-09 1979-12-07 Vendeville Pierre Appareil destine a la reduction d'un oedeme
DE8415045U1 (de) * 1984-05-17 1984-12-06 Bösl, Hans, 5100 Aachen Steuereinrichtung

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0542383A2 (fr) * 1991-11-12 1993-05-19 The Kendall Company Dispositif de compression
EP0542383A3 (fr) * 1991-11-12 1994-10-12 Kendall & Co Dispositif de compression.
DE4202959C1 (en) * 1992-02-01 1993-06-09 Boesl Medizintechnik Gmbh, 5100 Aachen, De Fluid servo-valve with longitudinal recess between sealing rings - has rings on subsidiary control piston sliding in cylinder with openings into recess for relief of fluid pressure
US9649245B2 (en) 2005-09-23 2017-05-16 New Tec Pty Ltd Apparatus for preventing deep vein thrombosis

Also Published As

Publication number Publication date
EP0205817B1 (fr) 1990-12-12
ATE59000T1 (de) 1990-12-15
DE3676120D1 (de) 1991-01-24

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