JPH0655204B2 - Multi-function monitor category - Google Patents

Description

TECHNICAL FIELD The present invention relates to a multi-function monitor catheter for diagnosing circulatory function capable of accurately measuring blood pressure and cardiac output with a single catheter.

<Prior Art> The heart is, to put it simply, a pump for discharging blood, and the most basic indicators for evaluating its ability are its discharge pressure and discharge amount, that is, blood pressure and cardiac output. Is.
Therefore, the measurement of blood pressure and cardiac output are both indispensable in the diagnosis of circulatory function.

Conventionally, to measure the blood pressure in each part of the heart and its surroundings, a tube called a catheter is inserted up to the measurement site, and blood pressure is applied to a blood pressure transducer placed outside the body through a liquid filled in the catheter, such as physiological saline. The method of communication is used. However, this method has a problem that the measured blood pressure waveform is distorted due to the compliance of the catheter. Further, if bubbles are present inside the measurement system including the catheter and the blood pressure transducer, the measured blood pressure waveform is further distorted, but it takes a lot of time to completely remove the bubbles inside the measurement system. There is also. Therefore, as a solution to these problems, a so-called catheter tip type sphygmomanometer in which a blood pressure transducer is installed at the catheter tip part has been developed, and a method of directly measuring the blood pressure at the site to be measured using this is becoming popular. is there.

On the other hand, as a method of measuring cardiac output, a measurement technique has been established and a relatively reliable thermodilution method is generally used. In this method, a dedicated catheter having a basic structure as shown in FIG. 3 is used. This catheter 20
Has a temperature sensor 21 at the distal end and a lumen injection port 23 on the operating side from an opening 22 at a position slightly away from the distal end.
It has a lumen that communicates with. This lumen opening 22
Is located in the right ventricle or left atrium when the tip is inserted into the pulmonary artery. Further, the operating side is divided into two parts from the middle, one of which is provided with the previous lumen injection port 23, and the other is provided with an electric connector 24 for transmitting an electric signal from the temperature sensor 21 to the measuring instrument. There is. FIG. 4 shows a state in which the cardiac output is measured by such a catheter 20. As shown in the figure, the catheter 20 passes through the right atrium 28 and the right ventricle 29 of the heart 27, and the temperature sensor 21 at the tip thereof reaches the pulmonary artery 26 of the lung 25.
At this time, the lumen opening 22 is located in the right atrium 28. Here, a liquid (eg, physiological saline having a low temperature) having a temperature lower than the blood temperature is rapidly injected from the lumen injection port 23 (see FIG. 3), and the liquid is ejected from the opening 22 into the right atrium 28 as shown by an arrow T. To do. The cardiac output can be obtained by measuring the change in blood temperature at this time with the temperature sensor 21 and obtaining the time change curve of blood temperature as shown in FIG. By the way,
The area S and the cardiac output shown in the figure are in inverse proportion.

<Problems to be Solved by the Invention> By the way, as described above, both blood pressure and cardiac output are indispensable indicators for diagnosing circulatory function, and only one of them causes a significant decrease in clinical significance. Will end up. Therefore, it is necessary to measure both efficiently and only one insertion
A catheter that can accurately measure both is of great significance. Conventionally, some catheters for measuring cardiac output have a lumen for measuring blood pressure, but this is a method for measuring blood pressure by transmitting pressure to a blood pressure transducer installed outside the body. Inevitable distortion of the blood pressure waveform is unavoidable. Therefore, under the present circumstances, separate catheters must be used to accurately measure both blood pressure and cardiac output, which is troublesome and burdens the patient.

Therefore, an object of the present invention is to provide a multi-function monitor catheter which can measure both blood pressure and cardiac output with a single catheter with high accuracy and can be manufactured at low cost.

<Means for Solving the Problems> A structure of the present invention that achieves the above-mentioned object is a kind of catheter to be inserted and indwelled in a blood vessel in a body, which is used for measuring blood pressure at the distal end portion of the blood vessel insertion portion. It has a sensor chip in which a pressure sensor and a temperature sensor for measuring cardiac output are combined on the same semiconductor substrate, and has a lumen that opens to a position away from the tip of the insertion portion and communicates with the extracorporeal operation unit. It is characterized by having at least one.

<Example> Hereinafter, a preferred example of the present invention will be described with reference to the drawings.

1 (a), (b), and (c) are explanatory views showing the structure of the distal end portion of the multifunctional monitor catheter according to the present embodiment, and FIG. 2 is an explanatory view showing its outline. As shown in these drawings,
A semiconductor sensor chip 2 in which a blood pressure sensor and a temperature sensor are combined is mounted on the tip of the catheter body 1, and a lumen opening 4 is provided at a position slightly apart from the tip. The operating portion of the catheter body 1 is bifurcated, one of which is a lumen injection port 6 communicating with the opening 4 by a lumen, and the other is an electrical connector for transmitting an electric signal from the sensor chip 2 to the measuring device 8. It is 5. The opening 4 is provided at a position located in the right atrium or the right ventricle when the distal end of the catheter body 1 is inserted into the pulmonary artery. From the opening 4, a syringe 7 connected to the lumen inlet 6 is provided. The low temperature liquid in the thermodilution method to be injected is jetted out. Further, blood collection and drug injection are performed through the opening 4.

Here, the structure of the distal end portion of the catheter body 1 will be described in more detail. The sensor chip 2 has a back surface side (first
In the lower part of the figure (b), a diaphragm part 2a for pressure measurement becomes a thin film state by forming an opening with a trapezoidal cross section in the center part and its tip (the left side in FIG. 1 (b)) It has a temperature sensor portion 2b for temperature measurement which is located, and is supported by the ceramic base 3 from the back side. The connection between the sensor chip 2 and the lead wire 11 leading to the electric connector 5 is
Wiring pattern arranged on the ceramic base 3
The connection from the sensor chip 2 to the wiring pattern 10 is made by Au wire bonding, and from the wiring pattern 10 is made a lead wire by soldering.
11 have been pulled out. Further, the ceramic base 3 is formed with a hole 3a for communicating the opening on the back side of the sensor chip 2 with one end of the air vent tube 12 provided on the lower side of the ceramic base 3. The other end (not shown) of the extraction tube 12 is open to the atmosphere.
As a result, the pressure on the back surface side of the diaphragm portion 2a of the sensor chip 2 becomes atmospheric pressure, and the blood pressure with the atmospheric pressure as the reference pressure is measured. The constituent members such as the sensor chip 2, the ceramic base 3 and the air vent tube 12 are molded and supported by the resin material 13a. At this time, it is desirable that at least a portion of the catheter body 1 to be inserted into the body be surface-coated with a resin material having excellent biocompatibility 13b. Of course, the surface coating 13b is not necessary when sufficient biocompatibility can be obtained only with the resin material 13a. Here, the resin material 13a for protecting at least the diaphragm portion 2a and the temperature sensor portion 2b of the sensor chip 2 and the resin of the surface coating 13b must be made sufficiently thin in order to avoid a decrease in the response speed of the sensor.

In the multi-functional monitor catheter of the present embodiment having the above-mentioned configuration, if the catheter body 1 is inserted once into the body,
The blood pressure at the insertion position can be directly measured by the diaphragm portion 2a, and the cardiac output can be accurately measured by performing the thermodilution method. At this time, the blood pressure waveform and the cardiac output measurement value are displayed on the measuring device 8.

In the present embodiment, by using the sensor chip 2 in which the diaphragm portion 2a and the temperature sensor portion 2b are combined on the same semiconductor substrate, it is possible to reduce the manufacturing cost by reducing the labor for mounting the catheter body 1, and to reduce the blood pressure and This has the effect that both cardiac output can be measured with accuracy. Here, the configuration of the sensor chip 2 is not limited to the above-mentioned one, and may be a combination of a pressure sensor and a temperature sensor on the same substrate, and a mounting state in the catheter body 1. Is not limited to this embodiment.

It should be noted that it is conceivable to mount two different types of sensors on the distal end portion of the catheter body 1 without integrating the pressure sensor and the temperature sensor. In this case, however, the mounting of the sensor is too time-consuming and the manufacturing cost is low. It increases and is not practical.

<Effects of the Invention> As described above in detail with reference to the embodiments, if the multifunctional monitor catheter according to the present invention is used, it is essential to measure the circulatory organ by only inserting the catheter once into the body. Blood pressure and cardiac output can be measured accurately. Further, in the present invention, since the pressure sensor and the temperature sensor are combined on the same substrate to form the sensor chip, the labor for mounting the sensor can be reduced, and the manufacturing cost can be significantly reduced.

[Brief description of drawings]

FIGS. 1 (a), (b) and (c) are structural views of the distal end portion of the multifunctional monitor catheter according to the present embodiment of the present invention, FIG. 2 is an explanatory view showing its outline, and FIG. FIG. 4 is a configuration diagram of a catheter for cardiac output measurement according to the prior art, FIG. 4 is an explanatory diagram showing how cardiac output is measured by the catheter, and FIG. 5 is a graph showing a blood temperature time change curve at that time. is there. In the drawings, 1 is a catheter body, 2 is a sensor chip, 2a is a diaphragm part, 2b is a temperature sensor part, 3 is a ceramic base, 4 is a lumen opening, 5 is an electrical connector, 6 is a lumen inlet, and 12 is an air vent. It is a tube.

 ─────────────────────────────────────────────────── ─── Continuation of the front page (56) References Japanese Patent Publication 4-79650 (JP, B2) Japanese Patent Publication 1-35651 (JP, B2) Japanese Patent Publication 59-21495 (JP, B2)

Claims (1)

[Claims] 1. A kind of catheter to be inserted and placed in a blood vessel in a body, wherein a pressure sensor for measuring blood pressure and a temperature sensor for measuring cardiac output are provided at the tip of the blood vessel insertion portion. A multi-function monitor catheter having a composite sensor chip on the same semiconductor substrate, and having at least one lumen which opens at a position away from the distal end of the insertion portion and communicates with the extracorporeal operation unit.