JPH03126469A - Tube for medical treatment and method for using this tube - Google Patents
Tube for medical treatment and method for using this tubeInfo
- Publication number
- JPH03126469A JPH03126469A JP1264035A JP26403589A JPH03126469A JP H03126469 A JPH03126469 A JP H03126469A JP 1264035 A JP1264035 A JP 1264035A JP 26403589 A JP26403589 A JP 26403589A JP H03126469 A JPH03126469 A JP H03126469A
- Authority
- JP
- Japan
- Prior art keywords
- stylet
- tube
- balloon
- blood vessel
- tube body
- 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
Links
- 238000000034 method Methods 0.000 title description 5
- 210000004204 blood vessel Anatomy 0.000 claims abstract description 15
- 239000012530 fluid Substances 0.000 claims abstract description 12
- 239000007924 injection Substances 0.000 claims abstract description 7
- 238000002347 injection Methods 0.000 claims abstract description 7
- 239000008280 blood Substances 0.000 description 15
- 210000004369 blood Anatomy 0.000 description 15
- 210000003191 femoral vein Anatomy 0.000 description 4
- 210000003111 iliac vein Anatomy 0.000 description 4
- 230000017531 blood circulation Effects 0.000 description 3
- 230000004087 circulation Effects 0.000 description 3
- 210000001105 femoral artery Anatomy 0.000 description 3
- 210000005245 right atrium Anatomy 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- 210000003462 vein Anatomy 0.000 description 3
- 239000004952 Polyamide Substances 0.000 description 2
- -1 and among these Polymers 0.000 description 2
- TZCXTZWJZNENPQ-UHFFFAOYSA-L barium sulfate Chemical compound [Ba+2].[O-]S([O-])(=O)=O TZCXTZWJZNENPQ-UHFFFAOYSA-L 0.000 description 2
- 238000003780 insertion Methods 0.000 description 2
- 230000037431 insertion Effects 0.000 description 2
- 229920002647 polyamide Polymers 0.000 description 2
- 229920002379 silicone rubber Polymers 0.000 description 2
- 239000004945 silicone rubber Substances 0.000 description 2
- 229920005992 thermoplastic resin Polymers 0.000 description 2
- 210000000689 upper leg Anatomy 0.000 description 2
- IQESODSFGDRGIW-UHFFFAOYSA-H (4,6-dioxo-1,3,5,2-trioxabisman-2-yl) (4,6-dioxo-1,3,5,2-trioxabisman-2-yl)oxycarbonyl carbonate Chemical compound [Bi+3].[Bi+3].[O-]C(=O)OC([O-])=O.[O-]C(=O)OC([O-])=O.[O-]C(=O)OC([O-])=O IQESODSFGDRGIW-UHFFFAOYSA-H 0.000 description 1
- 206010003497 Asphyxia Diseases 0.000 description 1
- 239000004743 Polypropylene Substances 0.000 description 1
- 210000001367 artery Anatomy 0.000 description 1
- 238000010009 beating Methods 0.000 description 1
- 230000036770 blood supply Effects 0.000 description 1
- 210000000988 bone and bone Anatomy 0.000 description 1
- 238000007675 cardiac surgery Methods 0.000 description 1
- 210000001168 carotid artery common Anatomy 0.000 description 1
- 239000002872 contrast media Substances 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 229920001971 elastomer Polymers 0.000 description 1
- 229920002457 flexible plastic Polymers 0.000 description 1
- 208000028867 ischemia Diseases 0.000 description 1
- 239000002504 physiological saline solution Substances 0.000 description 1
- 229920001155 polypropylene Polymers 0.000 description 1
- 229920002635 polyurethane Polymers 0.000 description 1
- 239000004814 polyurethane Substances 0.000 description 1
- 239000004800 polyvinyl chloride Substances 0.000 description 1
- 229920000915 polyvinyl chloride Polymers 0.000 description 1
- 230000002787 reinforcement Effects 0.000 description 1
- 230000003014 reinforcing effect Effects 0.000 description 1
- 229920005989 resin Polymers 0.000 description 1
- 239000011347 resin Substances 0.000 description 1
- 230000000241 respiratory effect Effects 0.000 description 1
- 239000005060 rubber Substances 0.000 description 1
- 239000007779 soft material Substances 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
Landscapes
- Media Introduction/Drainage Providing Device (AREA)
- External Artificial Organs (AREA)
Abstract
Description
【発明の詳細な説明】
〔産業上の利用分野〕
本発明は、心臓手術時の体外循環等において使用される
、送・脱血用チューブに関するものであり、特に大腿静
脈、大腿動脈のバイパス（以下Ｆ−Ｆバイパスと云う）
において、安定して且つ十分な脱血流量を確保すること
の出来る脱血用チューブとその使用方法に関するもので
ある。Detailed Description of the Invention [Field of Industrial Application] The present invention relates to a blood supply/removal tube used in extracorporeal circulation during cardiac surgery, and in particular to a tube for bypassing the femoral vein or artery ( (hereinafter referred to as F-F bypass)
The present invention relates to a blood removal tube that can ensure a stable and sufficient blood flow rate, and a method for using the same.
心臓手術時には、心臓自体は鼓動を停止し仮死状態とし
て施術が行なわれる。しかし、患者の生命を維持するた
めには、患者の体内への血液の循環を停止することは出
来ない、そこで、患者の血液を体外へ導出し、人工心肺
もしくは人工肺を用いて血液の循環、即ち体外循環を続
ける訳であるが、通常は患者の心臓の右心房がら血液を
体外へ導出（脱血）し、これを人？捕もしくは人工肺に
て浄化した後、再び一般的には患者の動脈（大腿動脈、
総頚動脈など）に戻す。この血液は患者の全身を巡った
後、大静脈に集まり、更に心臓の右心房に返って来る。During heart surgery, the heart itself stops beating and the procedure is performed in a state of asphyxia. However, in order to maintain the patient's life, it is not possible to stop blood circulation within the patient's body.Therefore, the patient's blood is taken out of the body and a heart-lung machine or oxygenator is used to recirculate the blood. In other words, extracorporeal circulation continues, but normally blood is drawn out of the patient's heart from the right atrium (blood removal), and this blood is transferred to a person. After the patient's arteries (femoral artery, femoral artery,
(common carotid artery, etc.). After circulating throughout the patient's body, this blood collects in the vena cava and then returns to the right atrium of the heart.
（Ｆ ｅｍｏｒｏ−Ｆ ｅｍｕｒａ ｌバイパス）具体
的には、患者の大腿部を切開し、静脈血管を露出させ通
常は静脈を切開して脱血用チューブを挿入し、腸骨静脈
、工大静脈を経て右心房までこの時、脱血用チューブの
腸骨静脈から工大静脈への挿入が難しい、これはこの部
分が屈曲狭窄しているためで、特に左側が著しい。また
、心臓手術時には、心臓のある左側をベツド上の上側と
する体位がとられるので左側からの挿入が有利である。(Femoro-Femural Bypass) Specifically, the patient's thigh is incised, the venous blood vessel is exposed, the vein is usually incised, a blood removal tube is inserted, and the iliac vein and vena cava are removed. At this time, it is difficult to insert the blood removal tube from the iliac vein into the vena cava, as this part is bent and constricted, especially on the left side. Furthermore, during heart surgery, the patient is positioned with the left side of the heart above the bed, so insertion from the left side is advantageous.
患者の静脈に挿入する脱血用チューブはより細い方が望
ましいが、脱血流量の確保という面から適切ではない。It is desirable that the blood removal tube inserted into the patient's vein be thinner, but this is not appropriate from the standpoint of ensuring sufficient blood flow for removal.
従って、ある程度の口径を有する従来の脱血用チューブ
では、上記した如く挿入に際しても屈曲部の通過には、
難渋し、かつチューブを進める際、チューブ先端部によ
る血管内壁損傷の恐れもある。Therefore, with conventional blood removal tubes having a certain caliber, it is difficult to pass through the bent part during insertion as described above.
This is difficult, and there is a risk of damage to the inner wall of the blood vessel due to the tip of the tube when advancing the tube.
本発明は、従来Ｆ−Ｆバイパス等に際して脱血用チュー
ブを大腿静脈から挿入する際に、進入の難しい腸骨静脈
から工大静脈に対しても容易に、安全確実に、かつ左右
どちらからでも腸骨静脈を通過出来るチューブを提供す
ることを目的とするものである。The present invention makes it possible to easily, safely and reliably insert a blood removal tube from the femoral vein into the femoral vein, which is difficult to enter, from the iliac vein to the vena cava, and from either the left or right side. The purpose is to provide a tube that can be passed through bone veins.
即ち本発明は、先端部が開口し先端部近傍に複数個の側
孔を有すると共に、端末部はラッパ状をなすチューブ本
体と、該チューブ本体の内腔に挿着可能な外径を有し、
端末近傍にストッパーを設けたスタイレットとから構成
され、該スタイレットは先端部にバルーンを装着し長手
方向にはバルーン内に流体を注入するための流体通路を
有すると共に、流体通路の後端には注入口を付設した細
管を接続し、分岐させたことを特徴とする医療用チュー
ブ、および、チューブ本体の内腔にスタイレットを挿着
した医療用チューブの先端部を血管内に挿入し、前記注
入口より流体を注入してスタイレット先端のバルーンを
膨張させた後、チューブ本体とスタイレットを一体に保
持しながら血管内を押し進め、先端部が目標の部位に到
達した後、バルーンを萎ませスタイレットを抜去するこ
とを特徴とする医療用チューブの使用方法である。That is, the present invention has an open end and a plurality of side holes near the end, and the end has a trumpet-shaped tube body and an outer diameter that can be inserted into the inner cavity of the tube body. ,
The stylet has a balloon attached to its tip and has a fluid passage for injecting fluid into the balloon in the longitudinal direction, and a stylet at the rear end of the fluid passage. A medical tube characterized by connecting and branching a thin tube with an injection port, and a medical tube having a stylet inserted into the inner lumen of the tube body, and inserting the distal end of the medical tube into a blood vessel, After inflating the balloon at the tip of the stylet by injecting fluid through the injection port, the tube body and stylet are held together and pushed through the blood vessel, and after the tip reaches the target area, the balloon is deflated. This is a method of using a medical tube characterized by removing the stylet.
本発明において用いられる医療用チューブは、第１図に
示したように、先端部が開口（１）し先端部近傍に複数
個の側脅孔（３）を有すると共に端末部（４）はコネク
ター等と嵌合出来るようにラッパー状の形をなすチュー
ブ本体（２）と、チューブ本体（２）の内腔に内蔵され
たスタイレット（５）とから構成されている。スタイレ
ット先端部（６）にはバルーン（７）が装着され、スタ
イレット（５）の端末近傍にはストッパー（８）を有し
、かつスタイレット（５）の長手方向にはバルーン（７
）を膨張させるための流体通路を設け、その後端には細
径のチューブ（１１）を接続し、分岐させると共にチュ
ーブ（１１）の端部には注入口（９）を有している。バ
ルーン（７）の膨張した状態（１０）は点線で示した通
りである。As shown in FIG. 1, the medical tube used in the present invention has an open end (1), a plurality of side holes (3) near the end, and a terminal end (4) with a connector. It consists of a tube body (2) shaped like a wrapper so that it can be fitted with the tube body (2), and a stylet (5) built into the inner cavity of the tube body (2). A balloon (7) is attached to the tip of the stylet (6), a stopper (8) is provided near the end of the stylet (5), and the balloon (7) is disposed in the longitudinal direction of the stylet (5).
), a small diameter tube (11) is connected to the rear end thereof, and the tube (11) is branched and has an injection port (9) at the end thereof. The inflated state (10) of the balloon (7) is shown by the dotted line.
チューブ本体（２）やスタイレット（５）は柔軟なプラ
スチックあるいはゴムより加工されており、材質として
はチューブ本体（２）はポリ塩化ビニル、ポリウレタン
、ポリアミド等の熱可塑性樹脂、或はシリコーンゴム等
のゴム類が挙げられ、ジ炭酸ビスマス、硫酸バリウム等
のＸ線造影剤をライン状又は全体に含有している方が好
ましいのは云うまでもない。また、ステンレス線や樹脂
製線材をスパイラル状に加工し、壁内に埋め込み補強し
ても良い。スタイレット（５）はチューブ本体（２）同
様熱可塑性樹脂が好ましく、このうち滑りやすく腰のあ
るポリプロピレン、ポリアミド等が好ましく、また必要
に応じて補強用の芯金やワイヤローブ等を内蔵させても
良い。The tube body (2) and stylet (5) are made of flexible plastic or rubber, and the tube body (2) is made of thermoplastic resin such as polyvinyl chloride, polyurethane, polyamide, silicone rubber, etc. It goes without saying that it is preferable to contain an X-ray contrast agent such as bismuth dicarbonate or barium sulfate in the form of a line or the entire surface. Alternatively, stainless steel wire or resin wire may be processed into a spiral shape and embedded within the wall for reinforcement. Like the tube body (2), the stylet (5) is preferably made of thermoplastic resin, and among these, polypropylene, polyamide, etc., which are slippery and have a firm texture, are preferable, and if necessary, a reinforcing core bar, wire robe, etc. may be incorporated. good.
スタイレット先端部（６）は、バルーン（７）の膨張に
より先端部が突出することはなく、血管内への挿入進入
時に血管壁を傷つけることがない。The stylet tip (6) does not protrude due to inflation of the balloon (7) and does not damage the blood vessel wall when inserted into the blood vessel.
また、先端部（６）は突出しても、非常に柔らかい材質
、例えばソフトタイプのシリコーンゴム等で形成されて
おれば支障がない。Further, even if the tip portion (6) protrudes, there is no problem as long as it is made of a very soft material, such as soft silicone rubber.
スクイレット（５）の先端部に装着したバルーン（７）
を膨張させるために生理食塩水やＣＯ２ガスを注入させ
る注入口（９）は、押込み開放式の一方弁であっても、
三方又は三方コックを用いてもどちらでも差支えない。Balloon (7) attached to the tip of the squillette (5)
Even if the inlet (9) for injecting physiological saline or CO2 gas to inflate the gas is a push-open type one-way valve,
A three-way or three-way cock may be used.
この注入口（９）はスタイレット（５）とは適切な長さ
の細径のチューブ（１１）で導入している方が便利であ
る。It is more convenient to introduce this injection port (9) through a thin tube (11) of an appropriate length than the stylet (5).
第２図はスタイレットの断面図であり、中心部が貫通し
てガイドワイヤーが使用出来るタイプの一実施例である
。特にガイドワイヤーを利用して血管内に挿入する手技
は、経皮穿刺タイプの医療用チューブには有用である。FIG. 2 is a cross-sectional view of a stylet, which is an embodiment of a stylet with a central portion passing through it so that a guide wire can be used. In particular, the technique of inserting a guide wire into a blood vessel is useful for percutaneous puncture type medical tubes.
第２図（ａ）は二重背方式であり、ガイドワイヤー用中
心孔（１２）のまわりに、バルーン膨張用の流体通路と
なる外周空間（１３）を配置している。−また、（ｂ）
は２ル一メン方式であり、ガイドワイヤー用中心孔（１
４）の他に並列してバルーン膨張用の内腔（１５）を設
けている。FIG. 2(a) shows a double back system, in which an outer space (13) serving as a fluid passage for balloon inflation is arranged around a central hole (12) for the guide wire. -Also, (b)
is a 2-lumen type, with a center hole for the guide wire (1
In addition to 4), a lumen (15) for balloon inflation is provided in parallel.
本発明による医療用チューブを使用することにより、心
臓手術等における体外循環のために脱血用のチューブを
大腿静脈から挿入して右心房迄進入させる際に、挿入の
難しい腸骨静脈から工大静脈への通過を容易に、安全・
確実、に行なえ、かつ挿入は左右の大腿のどちらからで
も可能であり、このようにして挿入された医療用チュー
ブは、呼吸運動による虚血を起すことなく心臓から高流
量の血液を確実に安定して脱血することが出来、また、
チューブの先端部にはバルーンが装着されているので、
チューブを血管内に挿入、進入させる際に血管内型を損
傷させることがなく好適である。By using the medical tube according to the present invention, when a blood removal tube is inserted from the femoral vein and advanced to the right atrium for extracorporeal circulation in heart surgery, etc., it can be easily inserted from the iliac vein into the vena cava, which is difficult to insert. Easy and safe passage to
It can be done reliably and can be inserted from either the left or right thigh, and the medical tube inserted in this way ensures a stable high flow of blood from the heart without causing ischemia due to respiratory movements. blood can be removed by
A balloon is attached to the tip of the tube, so
It is preferable that the tube is not damaged in the blood vessel when it is inserted into the blood vessel.
第１図は本発明の一実施例となる医療用チューブの全体
構造を示す図で、第２図はガイドワイヤーを使用出来る
タイプのスタイレットの実施例を示す断面図である。FIG. 1 is a diagram showing the overall structure of a medical tube according to an embodiment of the present invention, and FIG. 2 is a sectional view showing an embodiment of a stylet of a type in which a guide wire can be used.
Claims (2)
ると共に、端末部はラッパ状をなすチューブ本体と、該
チューブ本体の内腔に挿着可能な外径を有し、端末近傍
にストッパーを設けたスタイレットとから構成され、該
スタイレットは先端部にバルーンを装着し長手方向には
バルーン内に流体を注入するための流体通路を有すると
共に、流体通路の後端には注入口を付設した細管を接続
し、分岐させたことを特徴とする医療用チューブ。(1) The distal end is open and has a plurality of side holes near the distal end, and the terminal has a trumpet-shaped tube body and an outer diameter that can be inserted into the inner cavity of the tube body. The stylet has a balloon attached to its tip and has a fluid passage for injecting fluid into the balloon in the longitudinal direction, and a stylet at the rear end of the fluid passage. A medical tube characterized by connecting and branching thin tubes with injection ports.
レットを挿着した医療用チューブの先端部を血管内に挿
入し、前記注入口より流体を注入してスタイレット先端
のバルーンを膨張させた後、チューブ本体とスタイレッ
トを一体に保持しながら血管内を押し進め、先端部が目
標の部位に到達した後、バルーンを萎ませスタイレット
を抜去することを特徴とする医療用チューブの使用方法
。(2) The distal end of the medical tube with the stylet inserted into the inner lumen of the tube body according to claim (1) is inserted into the blood vessel, and fluid is injected from the injection port to release the balloon at the distal end of the stylet. A medical tube characterized in that, after being inflated, the tube body and stylet are held together while being pushed through the blood vessel, and after the tip reaches the target area, the balloon is deflated and the stylet is removed. how to use.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP1264035A JP2918577B2 (en) | 1989-10-12 | 1989-10-12 | Medical tubing |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP1264035A JP2918577B2 (en) | 1989-10-12 | 1989-10-12 | Medical tubing |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPH03126469A true JPH03126469A (en) | 1991-05-29 |
| JP2918577B2 JP2918577B2 (en) | 1999-07-12 |
Family
ID=17397644
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP1264035A Expired - Lifetime JP2918577B2 (en) | 1989-10-12 | 1989-10-12 | Medical tubing |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JP2918577B2 (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108721760A (en) * | 2018-03-14 | 2018-11-02 | 河南科技大学第附属医院 | A kind of urological surgery urethral catheterization device |
-
1989
- 1989-10-12 JP JP1264035A patent/JP2918577B2/en not_active Expired - Lifetime
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108721760A (en) * | 2018-03-14 | 2018-11-02 | 河南科技大学第附属医院 | A kind of urological surgery urethral catheterization device |
| CN108721760B (en) * | 2018-03-14 | 2021-01-26 | 王志刚 | Urinary surgery operation is with catheterization device |
Also Published As
| Publication number | Publication date |
|---|---|
| JP2918577B2 (en) | 1999-07-12 |
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