JPH0299047A - Calculus treatment apparatus - Google Patents

Abstract

PURPOSE:To enhance the dissolving treatment effect of a calculus by a method wherein a calculus dissolving agent is injected in the circumference of the calculus percutaneously and an ultrasonic wave is applied toward the calculus in the body to promote the calculus dissolving action of the injected dissolving agent and the acting state of the calculus dissolving agent is monitored. CONSTITUTION:The under surface of the water bag 4 of an ultrasonic generator 2 is arranged so as to be brought into contact with the surface opposed to the biliary calculus of the human body lying on a treatment table 6 and the biliary calculus 13 is subsequently detected by an observing ultrasonic probe 5 to insert the leading end part of a balloon catheter 15 in the gall 14. A dissolving agent is injected by the balloon catheter 15. Driving voltage is applied to the ultrasonic vibrator 3 of the ultrasonic generator 2 from an ultrasonic oscillator 12 through an amplifier 11 and the ultrasonic wave from the ultrasonic vibrator 2 is applied to the biliary calculus 13 and the injected dissolving agent. The positioning of the ultrasonic generator 2, the insertion of the balloon catheter 15 in the gall 14 and the injection of the dissolving agent can be known through an observing ultrasonic probe 5, an ultrasonic observation device 8, a CPU 9 and a monitor apparatus 10.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Application Field] The present invention relates to a stone treatment device, and more particularly to a stone treatment device that treats stones formed in the body by dissolving them with a dissolving agent.

[Prior art] In order to easily crush stones such as gallstones that have formed inside the body, a stone dissolving agent is injected into the surrounding area, and then ultrasonic waves are irradiated from outside the body to promote the dissolution effect. This is already known as shown in Japanese Patent Application Laid-open No. 120846/1984.

[Problem to be solved by the invention] By the way, by irradiating ultrasound from outside the body as described above,
In conventional stone treatment devices designed to promote the stone-dissolving effect of a dissolving agent injected into the gallbladder where gallstones are present, there is no means for appropriately perfusing the dissolving agent or for notifying changes in its physical properties. Because there was no such thing, the therapeutic effect was unknown and the therapeutic efficiency was poor.

The purpose of the present invention is to address the shortcomings of conventional stone treatment devices that use a stone dissolving agent, and to actively perfuse the stone with the dissolving agent injected around the stone to observe changes in the physical properties of the dissolving agent. To provide a stone treatment device which obtains optimum dissolution efficiency by controlling ultrasonic irradiation, checking the components of a dissolving agent, and monitoring the dissolution state of stones.

[Means and Effects for Solving the Problems] In order to achieve the above object, the present invention provides a means for injecting a stone-dissolving agent percutaneously or orally around a stone, generating ultrasonic waves,
The apparatus further comprises a means for irradiating the ultrasonic wave toward a stone in the body to promote the stone dissolving action of the injected stone dissolving agent, and a means for monitoring the action state of the injected stone dissolving agent. This is a characteristic feature.

[Example] Hereinafter, the present invention will be described in detail based on the illustrated example.

FIG. 1 is a schematic diagram of a stone treatment device showing an embodiment of the present invention. This stone treatment device includes an ultrasonic irradiation means for irradiating ultrasonic waves to promote the dissolving effect of the dissolving agent injected around the stone, a means for injecting the dissolving agent around the stone, and an injection device. means for perfusing the lysing agent;
The main part consists of means for observing changes in the physical properties of the solubilizer.

The ultrasonic generator 2 as the ultrasonic irradiation means includes a concave ultrasonic vibrator 3 made of a piezoelectric element such as PZT.
The front surface thereof is covered with a water bag 4 made of a soft resin material or the like and filled with an ultrasonic transmission liquid. An observation ultrasonic probe 5 is disposed at the center of the inner surface of the ultrasonic transducer 3.

When the ultrasonic generator 2 configured as described above is used, the water bag 4 is placed in contact with the surface of the human body 7 facing the treatment area lying supine on the treatment table 6, as shown in FIG. be done. An ultrasonic observation device 8 is connected to the ultrasonic probe 5, and the ultrasonic observation device 8 is connected to a monitor device 10 via a CPU 9. The ultrasonic transducer 3 also has an amplifier 11. It is connected to the CPU 9 via an ultrasonic oscillator 12. On the other hand, the tip of a balloon catheter 15 is percutaneously inserted into the gallbladder 14 in which the gallstones 13 have occurred in the human body 7, and the base of the balloon catheter 15 is connected to a pump 16 for injecting a dissolving agent via a perfusion device 17. The above perfusion device 1
7 has a temperature control device 18. One solubilizing agent component analyzer is connected to each, and these devices 18 and 19 are each connected to the CPU 9.

Stone treatment device 1 in this embodiment configured as described above
works as follows. That is, as shown in FIG. 1, first, the lower surface of the water bag 4 of the ultrasonic generator 2 is placed in contact with the surface facing the gallstones 13 of a human body lying supine on the treatment table 6, and then the The gallstone 13 is detected by the viewing ultrasonic probe 5 disposed on the sound wave generator 2, and the tip of the balloon catheter 15 is inserted into the gallbladder 14 toward the gallstone 13. Next, the balloon 15a at the distal end of the balloon catheter 15 is inflated to occlude the population 14a of the gallbladder 14, as shown in FIG.

Thereafter, the dissolving agent is injected using the dissolving agent injection pump 16 using the balloon catheter 15.

By blocking the entrance 14a of the gallbladder 14 with the balloon 15a in this manner, the injected dissolving agent is prevented from flowing into the duodenum or the like. Then, the dissolving agent is perfused by the perfusion device 17, and the dissolving agent is supplied to the temperature control device 18.
a predetermined temperature via the component analyzer 19 and the CPU 9;
It is controlled to have a predetermined component.

On the other hand, a drive voltage is applied to the ultrasonic transducer 3 of the ultrasonic generator 2 from the ultrasonic oscillator 12 via the amplifier 11, and the ultrasonic waves from the ultrasonic transducer 3 are injected into the gallstone 13 and the gallstone 13. Irradiation is directed towards the lysing agent.

In this way, in the stone treatment device 1 of this embodiment, the dissolving agent injected toward the gallstones 13 is transferred to the perfusion device 17. Temperature control device 18. Perfusion is always controlled to specific components and temperature by a component analyzer 19. The reason for checking the liquid temperature of the dissolving agent in this way is that in order to increase the effectiveness of the dissolving agent, it is possible to increase the output of the ultrasonic waves or to lengthen the irradiation time. Due to the heat generation effect, the temperature of the ultrasound irradiation area increases, which has an adverse effect on the living body. Therefore, in order to avoid causing discomfort while the ultrasonic waves are being applied, the temperature of the dissolving agent liquid is checked and the ultrasonic irradiation output is controlled so that it does not exceed a certain temperature. .

In addition, there are certain liquid temperatures that effectively dissolve stones depending on the type of stone, so it is possible to maintain the liquid temperature at that temperature. Furthermore, if the liquid temperature is too low, it will cause discomfort to the patient, so this can also be prevented.

Furthermore, by checking the components of the dissolving agent being perfused, it can be determined to what extent the gallbladder stone 13 has been dissolved. For example, first X-rays.

By determining the amount (components) of gallstones using ultrasound, etc., and comparing this with the cumulative amount of dissolved gallstones, the amount of remaining stones can be determined. Furthermore, it is possible to predict how much time it will take to complete the treatment by estimating the time it will take to complete the treatment based on the treatment time it has taken up to that point.

The positioning of the ultrasonic generator 2, the insertion of the balloon catheter 15 into the gallbladder 14, the injection of the dissolving agent, etc. are all carried out by the observation ultrasonic probe 5. Ultrasonic view 7111
1 device8. CPU9. This can be known through the monitor device 10, and the degree of dissolution can also be directly determined from the size of the gallstone, and the amount of perfusion of the dissolving agent can be appropriately controlled.

For example, if a larger amount of perfusion is more effective, increase the amount, and if it is better not to perfuse too much, perfuse periodically.

FIG. 3 shows a balloon catheter different from the balloon catheter used in the stone treatment device shown in FIG. 1 above,
FIG. 2 is a schematic view of the main part of the balloon catheter inserted orally into the gallbladder.

Note that the structure of the stone treatment device 1 is completely the same as that shown in FIG. 1 above, so a description thereof will be omitted. This balloon catheter 21 is a double balloon catheter, and has two balloons 2 at its distal end that can be inflated and deflated back and forth in the axial direction]
, a, and 21b are provided, and as shown in FIG.
It is arranged so that the entrance 14a of the gallbladder 14 is located between 1a2ib. Next, as shown in FIG.
1a and 21b to expand the population 14a of the gallbladder 14.
occlude the front and back body cavities. Then, the solubilizing agent is injected into the gallbladder 14 through the solubilizing agent inlet 21c bored in the tube wall between the balloons 21a and 21b of the balloon catheter 21, and the solubilizing agent is perfused by the solubilizing agent perfusion device 17.

Although the various devices connected to the perfusion device 17 and the devices connected to the ultrasonic generator 2 in FIG. 1 are all omitted, it goes without saying that they are connected in the same way.

Even if the balloon catheter 21 is orally inserted into the body cavity to control the injection and perfusion of the solubilizing agent, it functions in exactly the same way as the balloon catheter 15 shown in FIG. You can get some effect. In this case, since the balloon catheter 21 is inserted orally, there is also the advantage that there is no need to cause pain to the patient.

FIG. 5 shows another example of the orally inserted double balloon catheter shown in FIGS. 3 and 4 above. This balloon catheter 22 also has two balloons 23 and 24 for occlusion which can be freely inflated and deflated in the axial direction in the same way as the balloon catheter 21 shown in FIG. The balloon 2 is attached to the tube wall of the balloon catheter body between 23 and 24.
3. A liquid feeding hole 25 for injecting the dissolving agent and a draining hole 26 for discharging the injected dissolving agent are respectively drilled near the 24th side, and the dissolving agent is forced through both holes 25° and 26. It is designed to circulate. On the outer periphery of the catheter body between the liquid sending hole 25 and the liquid draining hole 26, there are two PZs for applying ultrasonic vibration to the injected lysing agent.
An ultrasonic transducer 2728 made of piezoelectric ceramic such as T (lead zirconate titanate) is disposed, and the temperature, pH, concentration, etc. of the dissolving agent injected between the Ryogawa sonic transducers 27 and 28 are arranged. A sensor 29 is provided to detect.

According to the balloon catheter 22 configured in this way, it is possible to directly know the physical properties of the dissolving agent that is injected into the body cavity and perfused, so the influence of the injected dissolving agent on the stone can be optimized. This can further improve the effect of stone dissolution treatment.

[Effects of the Invention] As explained above, according to the present invention, (1) the treatment area can be perfused by automatically maintaining the dissolving agent at the optimum temperature and optimum composition.

(2) The degree of treatment can be known at all times, and the time until the end of treatment can be predicted.

(3) Using a balloon catheter, the solubilizing agent can be percutaneously or orally injected into the treatment site and perfused.

(4) The solubilizing agent can be automatically controlled to be optimal.

It is possible to provide a stone treatment device that provides many effects that cannot be obtained with conventional stone treatment devices of this type.

[Brief explanation of the drawing]

FIG. 1 is a schematic configuration diagram of a stone treatment device showing an embodiment of the present invention, FIG. 2 is an enlarged sectional view of essential parts of the stone treatment device shown in FIG. Fig. 1 is a schematic view of a balloon catheter in use, which is different from the balloon catheter used in the stone treatment device; Fig. 4 is an enlarged cross-sectional view of the main part of the balloon catheter shown in Fig. 3; Fig. 5 FIG. 2 is a side view of a main part of another example of a balloon catheter used in a stone treatment device. 1...... Stone treatment device 2...
......Ultrasonic generator (stone dissolution promoting means) 10
......Monitoring device (monitoring means) 13...
・・・・・・Gallstone (stone) 15 21 22・・・・・・Balloon catheter (dissolving agent injection means)

Claims (1)

[Claims] (1) A means of injecting a stone-dissolving agent percutaneously or orally around a stone, and a method of generating ultrasonic waves and irradiating the same ultrasound waves toward the stone within the body to remove the injected stone-dissolving agent. A stone treatment device comprising: means for promoting stone dissolving action; and means for monitoring the action status of the injected stone dissolving agent.