JP3014346B2 - Peritoneal dialysis catheter - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a peritoneal dialysis catheter having a separate injection port and a drain port for enabling continuous infusion and continuous drainage, thereby having little effect on respiratory circulation even in severely ill patients. Such a continuous peritoneal dialysis method becomes possible.

[0002]

2. Description of the Related Art Continuous parallel peritoneal dialysis is performed by adapting continuous portable peritoneal dialysis to intensive care patients. Has been performed in cases where the time from the dialysis phase to the diuretic phase is long. However, it is generally said that the dialysis fluid does not affect the circulatory dynamics more rapidly than hemodialysis due to the rapid inflow and outflow of the dialysis fluid. However, in severely ill patients, it often affects the circulatory dynamics greatly. In addition, since the diaphragm is pushed up during injection, the respiratory condition, particularly the ventilation pattern, is often deteriorated. In order to prevent this, it is necessary to continuously inject and drain the fluid. However, the conventional catheter for peritoneal dialysis fluid has a single lumen structure, and the drainage cannot be continuously performed. The inventor of the present invention has conducted intensive studies to solve the above problems, and as a result, has developed a double lumen peritoneal dialysis catheter capable of continuously injecting and draining fluid.

[0003]

Means for Solving the Problems [1] The present invention provides a
The abdominal cavity insertion section 2 having the passage 5 and the infusion passage 8 is connected to the drainage passage.
The drainage passage 16 communicating with the passage 5 and the injection passage 8 communicate with each other.
Via the coupling portion 13 having that pouring passage 17, the drainage
A drain passage 22 communicating with the passage 16;
A subcutaneous insertion portion 18 having a liquid injection passage 23 communicating therewith is connected.
To provide a catheter 1 for peritoneal dialysis. [2] In the present invention, the abdominal cavity insertion section 2 includes a drainage section 3 and a liquid injection section.
4 and the inside of the abdominal cavity insertion portion 2 from the front
A drainage passage 5 is formed through the rear, and inserted into the abdominal cavity.
A distal end opening 7 communicating with the drainage passage 5 is formed at the distal end of the portion 2.
And an outer periphery of the drain portion 3 communicates with the drain passage 5.
A plurality of side holes 6 are formed to be, Haiekidori in the infusion section 4
A liquid injection passage 8 is formed through the passage 5 and the partition wall, and
Side hole 9 communicating with the pouring channel 8 on the side is formed, the ventral
The drainage part 3 of the cavity insertion part 2 is a single lumen, and the injection part 4 is
The peritoneal dialysis machine according to [1], formed in a double lumen.
Provide Tetel 1. [3] In the present invention, the connecting portion 1 is provided at the rear end of the abdominal cavity insertion portion 2.
3 are formed, and the subcutaneous insertion portion 18 is formed.
At the front end, mounting grooves 19 and 20 of the connecting portion 13 are formed.
The connecting portion 13 includes the mounting grooves 10 and 11 and the mounting grooves 19,
[1] to [1] through which connection portions 14 and 15 with
The peritoneal dialysis catheter 1 according to [2] is provided. [4] The present invention is configured by connecting the abdominal cavity insertion section 2 to the subcutaneous insertion section 18 via the connecting section 13, and the abdominal cavity insertion section 2 is configured by the drainage section 3 and the liquid injection section 4. Part 2
A drain passage 5 penetrates from the front to the rear, and a distal opening 7 communicating with the drain passage 5 is formed at the distal end of the abdominal cavity insertion portion 2. At the end, mounting grooves 10 and 11 of the connecting portion 13 are formed, a plurality of side holes 6 communicating with the drainage passage 5 are formed on the outer periphery of the drainage portion 3, and the drainage passage 4 is formed in the liquid injection portion 4. Injection passage 8 through 5 and partition wall
Is formed on the side of the liquid injection unit 4, and a side hole 9 communicating with the liquid injection passage 8 is formed. The subcutaneous insertion portion 18 communicates with the drainage passage 5 via the connecting portion 13 from the front to the rear. Drain passage 2
2, a liquid injection passage 23 communicating with the liquid injection passage 8 is formed,
At the front end, mounting grooves 19 and 20 of the connecting portion 13 are formed, and the connecting portion 13 forms a drain passage 16 communicating with the drain passages 5 and 22 and a pouring passage 17 communicating with the pouring passages 8 and 23. The peritoneal dialysis catheter 1 is formed with connecting portions 14 and 15 with the mounting grooves 10 and 11 and the mounting grooves 19 and 20, the drainage portion 3 of the peritoneal cavity insertion portion 2 is formed as a single lumen, and the liquid injection portion 4 is formed as a double lumen. I will provide a.

[0004]

1 is a schematic view of a catheter 1 for peritoneal dialysis according to the present invention before assembling. FIG. 2 is a sectional view taken along line AA of FIG. 1, FIG. FIG. 4 is a view taken in the direction of arrow C in FIG. The peritoneal dialysis catheter 1 is formed so that the abdominal cavity insertion section 2 and the subcutaneous insertion section 18 can be connected via the connecting section 13. The abdominal cavity insertion section 2 and the subcutaneous insertion section 18 have good biocompatibility and are made of a flexible material (for example, silicone resin), and the connecting section 13 also has good biocompatibility and a hard material (for example, commonly used in peritoneal dialysis). Etc.). The abdominal cavity insertion part 2 is composed of a drainage part 3 and a liquid injection part 4, and a drainage passage 5 is formed inside the abdominal cavity insertion part 2 so as to penetrate from the front to the rear. Has an opening 7 at the distal end thereof, and mounting grooves 10 and 11 of the connecting portion 13 are formed at the rear end of the abdominal cavity insertion portion 2. A plurality of side holes 6 communicating with the drain passage 5 are formed on the outer periphery of the drain portion 3. A liquid injection passage 8 is formed in the liquid injection section 4 via a liquid discharge path 5 and a partition wall, and a side hole 9 communicating with the liquid injection passage 8 is formed in a side portion of the liquid injection section 4. As described above, the drainage part 3 of the abdominal cavity insertion part 2 is formed in a one-lumen structure, and the liquid injection part 4 is formed in a double-lumen structure. For this reason, the drainage passage 5 is formed larger in the drainage part 3 than in the liquid injection part 4. Further, in the liquid injection section 4, the drainage passage 5 is formed larger than the liquid injection passage 8.

[0005] The subcutaneous insertion portion 18 is connected to the drainage passage 5 through the connecting portion 13 from the front to the rear.
, A liquid injection passage 23 communicating with the liquid injection passage 8 is formed, and mounting grooves 19 and 20 of the connecting portion 13 are formed at the end.
Further, a branch connector 24 is disposed behind the subcutaneous insertion portion 18, and a drainage tube 25 and a liquid injection tube 26 are connected to the branch connector 24.
28 are mounted. Further, the connecting portion 13 has a drainage passage 16 communicating with the drainage passages 5 and 22 therein, and a liquid injection passage 8, 23.
A liquid injection passage 17 communicating with the mounting grooves 10 and 11 is formed.
And connection parts 14 and 15 with the mounting grooves 19 and 20 are formed. Also, when connecting and connecting the connecting portion 13 to the mounting grooves 10 and 11 and the mounting grooves 19 and 20 on the outer periphery at the rear of the abdominal cavity insertion portion 2 and the outer periphery at the tip of the subcutaneous insertion portion 18, tie it with a thread from outside. Grooves 29 and 30 are formed so as to be able to be formed.
The merits of connecting the abdominal cavity insertion section 2 and the subcutaneous insertion section 18 via the connection section 13 in the present invention are as follows. At the time of insertion, it is recommended that the abdominal cavity insertion section 2 be inserted along the abdominal wall by inserting a stylet (such as a hard wire) into one lumen of the abdominal cavity insertion section 2.
Is integrally connected to the abdominal cavity insertion section 2 from the beginning, and has a forked portion (a drainage tube 25 and a liquid injection tube 26) at its free end.
If there is, the abdominal cavity insertion part 2 cannot be inserted subcutaneously. Therefore, the abdominal cavity insertion section 2 can be inserted by dividing the abdominal cavity insertion section 2 and the subcutaneous insertion section 18 into two parts as in the present invention. The connection between the abdominal cavity insertion section 2 and the subcutaneous insertion section 18 is performed during surgery, so that the abdominal cavity insertion section 2 and the subcutaneous insertion section 18 are made of a soft material such as silicone and the connecting section 13 is made of a hard material such as titanium which is generally used in peritoneal dialysis. If it is a material,
It is best to tie with a thread as described above.

Next, an example of a method of using the peritoneal dialysis catheter 1 will be described. The abdominal cavity insertion section 2 cuts the peritoneum after a midline or paramedian incision above the navel, and a stylet (such as a hard wire) is inserted into one lumen (the drainage passage 5 or the injection passage 8) of the abdominal cavity insertion section 2. Are inserted along the abdominal wall and into the Douglas fossa (deep lower part of the abdominal cavity). On the other hand, in order to prevent infection, the subcutaneous insertion portion 18 is incised from the side abdomen at a portion without the forked portion (the drainage tube 25 and the injection tube 26) (on the side of the mounting grooves 19 and 20) with a tunneler (like a thick fishing hook). The subcutaneous crawling is performed so that a large thread is threaded to the part (so-called subcutaneous tunnel), and is fixed through the connecting part 13 under the incision. If the connecting portion 13 is made of a hard material such as titanium, the portion connecting the connecting portion 13 of the abdominal cavity insertion portion 2 and the subcutaneous insertion portion 18 is a relatively soft material such as silicone, so that it can be firmly fixed only by binding with a thread. it can. The forked part (drainage tube 25 and injection tube 26) is exposed to the outside from the skin exit part from the part behind the connection part of the subcutaneous insertion part 18 with the connection part 13. After the drainage container is connected to the connection member 27 and the infusion container containing fresh dialysate is connected to the connection member 28, the used dialysate in the abdominal cavity is discharged from the distal end opening 7 or the side hole 6 into the drainage passage 5,
The collected dialysate is collected in the drainage container via 16, 22 and fresh dialysate is injected into the abdominal cavity via the injection channels 23, 17, 8 and the side hole 9. As described above, the used dialysate can be drained, and the fresh dialysate can be continuously injected and continuously drained. In the catheter system for peritoneal dialysis of the present invention, since the dialysate flow rate can be changed relatively freely, it is easy to adjust the amount of excretion of uremic substances. In addition, since infusion and drainage are continuous, there is little change in circulatory dynamics and discomfort to the patient. In addition, by adjusting the height of the drainage, the pressure in the abdominal cavity can be freely adjusted, and the pressure in the abdominal cavity and the amount of fluid injected can be adjusted according to the condition of the patient, and dialysis optimal for the patient can be performed. In addition, it is possible only with an infusion pump, and a large automatic peritoneal dialysis machine is not required as in the past, and it can be used at home (dialysis during sleep).

[0007]

[Effects of the Invention] Despite its complicated shape, it can be inserted under the rectal bladder with almost the same operation as a conventional catheter, and has a double lumen structure, allowing simultaneous continuous infusion and continuous drainage. Is possible. Continuous peritoneal dialysis that allows constant intraperitoneal pressure is possible. Peritoneal dialysis with little effect on circulatory dynamics is possible. Peritoneal dialysis that does not impair respiratory movement is possible.

[Brief description of the drawings]

FIG. 1 is a schematic view of a catheter for peritoneal dialysis of the present invention.

FIG. 2 is a sectional view taken along line AA of FIG. 1;

FIG. 3 is a view taken in the direction of arrow B in FIG. 1;

FIG. 4 is a view taken in the direction of arrow C in FIG. 1;

FIG. 5 is a view showing a use state of the catheter for peritoneal dialysis of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Peritoneal dialysis catheter 2 Peritoneal cavity insertion part 3 Drainage part 4 Injection part 5, 16, 22 Drainage passage 6, 9 Side hole 7 Tip opening 8, 17, 23 Injection passage 10, 11, 19, 20 Mounting Groove 13 Connecting part 14, 15 Connection part 18 Subcutaneous insertion part 24 Branch connector 25 Drain tube 26 Injection tube 27, 28 Connection member 29, 30 Groove

Claims (4)

(57) [Claims] 1. An abdominal cavity insertion having a drainage passage 5 and an injection passage 8
The part 2, the said liquid discharge passage 5 and discharge passage 16 which communicates with the liquid injection passageway
8 through a connecting portion 13 having a liquid injection passage 17 communicating with
The drainage passage 22 communicating with the drainage passage 16 and the liquid injection passage
Subcutaneous insertion part 18 having a liquid injection passage 23 communicating with a passage 17
The catheter 1 for peritoneal dialysis, wherein the catheter 1 is connected. 2. The abdominal cavity insertion part 2 includes a drainage part 3 and a liquid injection part 4.
Is composed of The inside of the abdominal cavity insertion part 2 is drained from front to back.
A passage 5 is formed to penetrate, and the distal end of the abdominal cavity insertion section 2 is drained.
A distal end opening 7 communicating with the liquid passage 5 is formed, The outer periphery of the drain section 3 is provided with a plurality of
Side hole 6 is formed, The liquid injection section 4 is provided with a liquid injection path 8 through a liquid discharge path 5 and a partition wall.
Is formed on the side of the liquid injection section 4 and communicates with the liquid injection passage 8.
A hole 9 is formed, The drainage part 3 of the abdominal cavity insertion part 2 has a single lumen,
The part 4 is formed as a double lumen,
2. The peritoneal dialysis catheter 1 according to claim 1. 3. A connecting portion 13 is provided at the rear end of the abdominal cavity insertion portion 2.
Mounting grooves 10 and 11 are formed, The subcutaneous insertion portion 18 has a mounting groove 19 at the tip thereof,
20 are formed, The connecting portion 13 is provided with the mounting grooves 10 and 11 and the mounting groove 1.
Connecting portions 14 and 15 to be connected to 9 and 20 are formed.
3. The peritoneal dialysis cassette according to claim 1 or 2,
Tell 1. 4. An abdominal cavity insertion section 2 is connected to a subcutaneous insertion section 18 via a connecting section 13. The abdominal cavity insertion section 2 is composed of a drainage section 3 and a liquid injection section 4. A drain passage 5 penetrates from the front to the rear, and a distal end opening 7 communicating with the drain passage 5 is formed at the distal end of the abdominal cavity insertion section 2.
At the rear end, mounting grooves 10 and 11 for a connecting portion 13 are formed. On the outer periphery of the drain portion 3, a plurality of side holes 6 communicating with the drain passage 5 are formed. A liquid injection passage 8 is formed via the liquid passage 5 and the partition wall, and a side hole 9 communicating with the liquid injection passage 8 is formed in a side portion of the liquid injection section 4.
The subcutaneous insertion portion 18 includes a drainage passage 22 communicating with the drainage passage 5 via the connecting portion 13 from the front to the rear, and a liquid injection passage 8.
A liquid injection passage 23 communicating with the connecting portion 13 is formed at the distal end.
The connecting portions 13 are connected to the drainage passages 5 and 22, respectively.
6, forming the liquid injection passage 17 communicating with the liquid injection passages 8 and 23, and forming the connecting portions 14 and 15 with the mounting grooves 10 and 11 and the mounting grooves 19 and 20; Is a single lumen, injection part 4
Is a double lumen lumen peritoneal dialysis catheter 1.