JPS5925761A - Cleaning cathetel - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed Description of the Invention] Ki Jyoaki describes the method of cleaning inside human body cavity FJ) 'a= 1'l' y
In the following, the case of a cerebral surgical irrigation TP catheter, particularly a ventricular irrigation catheter, will be discussed, but the present invention is not limited to this. However, the catheter of the present invention can be used to treat ventriculitis caused by various bacterial infections, intraventricular hemorrhage, meningitis meningitis, cancerous meningitis, and other patients' ventricles, subdurals, It is particularly suitable for epidural irrigation or tL cleaning of the arachnoid F space after subarachnoid hemorrhage.

Conventionally, in order to clean the inside of the ventricle, two ossified tubes are punctured, and each ossified tube is inserted into the ventricle ('''--inject a cleaning fluid such as artificial cerebrospinal fluid through one tube, and bL from the other tube. A method is used in which Western drainage is collected using a rod d3-tL L. However, in this method, it is necessary to provide two ossification tubes, so the arrangement for preventing external infections must be adjusted accordingly. In addition, it is necessary to operate each of the two tubes under X-ray fluoroscopy (or non-fluoroscopy), and it is difficult to manipulate the position of the tubes. 7;1s t-4
It is difficult to ensure that the shaft area is sufficiently covered, and furthermore, there is an imbalance in the introduction and discharge of cleaning liquid due to improper positioning of the tip. There are various problems that occur easily, such as an increase in intracerebral pressure.

The present invention is intended to solve and improve the above-mentioned problems, and its purpose is to require only one insertion hole, facilitate the insertion operation, and reduce the cleaning area. K provides an irrigation catheter that can be suitably configured.

The present invention is characterized by an outer tube and an inner tube inserted into the outer tube to form a first liquid flow path between the outer tube and the inner tube. The distal end portion is inserted into a state in which the distal end protrudes beyond the distal end of the outer tube, and is fixed to the outer tube in this inserted state, and the outer tube and the inner tube each have one or more openings at their distal ends. and a cleaning liquid supply part and a cleaning waste liquid discharge part are formed in one and the other of the first liquid flow path and the second liquid flow path formed upwardly in the internal space of the inner tube 7. It is in the point where it is.

Embodiments of the present invention will be described below with reference to the drawings.

FIG. 1 is an external view showing an outline of a cleaning catheter according to an embodiment of the present invention, and FIG. 2 is an enlarged sectional view with some parts omitted. 1 is composed of an outer tube 2 and an inner tube 3 inserted into the outer tube 2.The outer tube 2 has a distal opening 5 and one or more openings 9 formed in the peripheral wall in the vicinity thereof. The inner tube 3 has an outer diameter smaller than the inner diameter of the outer f-knee j2, and in the example shown in the figure, has a distal opening closed by a closing member 4 made of an X-ray opaque material, and a single or The inner tube 3 has a plurality of openings 12.The inner tube 3 is inserted into the outer tube 2 with its distal end 3A projecting outward from the distal end opening 5 of the outer tube 2. A first liquid flow path 6 is formed between the circumferential surface and the outer circumferential surface of the inner tube 3, and a second liquid flow path 13 is formed between the internal violets of the inner tube 3.Inner tube 3 are inserted in the above manner, they are mutually (= fixed) at the other end of the outer tube 2. This fixation in the illustrated example (2) is done by the connector 8. A small-diameter tip portion 8A press-fitted into the other end of the tube 3, which continues integrally with the small-diameter tip portion 8A (a central portion 8B press-fitted into the other end of the outer tube 2, which continues integrally with the central portion 8B) It has a central through hole 8D that extends from the small-diameter tip portion 8A to the thread portion 8C, and has a protruding rib 8E on the outer periphery of the thread portion 8C.

According to this carp lid 8, the central through hole 8D is communicated with the second liquid flow path 13, and the first liquid flow path 6 is pierced. The outer tube 2 has a branch tube 7 connected to the i-th liquid flow path 6 at a location near the other end thereof.

In the above, regarding the outer tube 2, when the distal end opening 5 opens the first liquid flow path 6, the opening 9 is not necessarily required, but it is preferable to form the distal end opening 5. This is necessary when the first liquid flow path 6 is actually cut off from the outside. Furthermore, it is not essential to close the distal opening of the inner tube 3 with the closing member 4, and the second liquid flow path 13 may be opened, but this distal opening is easily clogged when inserted into the body, so this should be taken into consideration. It is preferable to form the opening 12 in advance. In the case where the closing member 4 is provided, it is not necessary that the closing member 4i be made of an X-ray opaque material, but by doing so, the tip of the inner tube 3 can be It becomes easy to confirm the position. In consideration of convenience in catheter insertion operation, it is preferable to form an X-ray opaque line 10 in the outer tube 2 or to make the entire or part of the outer tube 2 contain an X-ray opaque material.

In order to fix the outer tube 2 and the inner tube 3 (2) without using the connector 8 (2), known means such as adhesive method, other type of connector (2) method can be used. However, as described in (7) below, it is preferable to use means that can arbitrarily release the fixed state.

In the illustrated example, the branch tube 7 branches at an angle close to the shape of a single letter with respect to the outer tube 2, but the branch angle is arbitrary. This branch tube 7 is
The liquid flowing into the first liquid flow path 6 is separated from the liquid flowing into the $2 liquid flow path 13 for processing. The connector 8 has both a communicating opening and an opening communicating with the second liquid flow path 13.
It may be provided instead.

11 is a length scale formed on the outer periphery between the other end of the outer tube 2 and the branch point of the branch tube 7.

The material of the tube constituting the catheter of the present invention is as follows:
There are no particular restrictions as long as it can be used for medical purposes, but silicone rubber is preferable.

In the figure, the inner tube 3 is shown not to be in contact with the outer tube 2, but there is a portion where the two come into contact, and therefore the first tube 3 is not in contact with the outer tube 2. There is no need for the liquid flow passage 6 to be completely cylindrical.

To show a specific example of the dimensions of an example of the irrigation catheter of the present invention, the outer tube 2 has a total length of 250'' and an outer diameter of 5.5''.
Silk, inner diameter 4. Qm, inner tube 8 has a total length of 270 mm,
The outer diameter is 2.5 mm, the inner diameter is 1.5 mm, the length of the branch tube 7 is 100111, the distance from the branch position to the other end of the outer tube 2 is 100 mm, and the length scale in this part is 11.
The 0 interval is l□m. Of course, these numerical values can be freely changed depending on the purpose.

The irrigation catheter of the present invention has the above-mentioned configuration, and an example of its use will be described below with reference to a case where the illustrated example of the irrigation catheter is used for irrigation of the cerebral ventricles. That is, the third
In the figure, 100 was supine. @ shows the inside of the person's head,
Lateral ventricles 10 on the left and right sides of the patient in this head interior 100
A third ventricle 102 and a fourth ventricle 108 are located in the center of the brain, and the fourth ventricle 10B is connected to the spinal cord. The part of the irrigation catheter 1 located on the distal side of the branch tube 7 is inserted into the head interior 1()0 through the lumen 50 formed in the forehead, and the distal end of the lateral tube 2 is inserted into the lateral ventricle. The connector 8 is attached with the inner tube 3 positioned at an angle of incidence of 101 so that the tip of the inner tube 3 reaches the posterior horn of the lateral ventricle 101, and the Y-tube 20 is connected to it. This Y-shaped tube 20
This tube is similar to a known tube that is incorporated into a ventricular drainage set and used to form a cerebrospinal fluid collection or drug injection port, which is generally referred to as a co-infusion tube. Collection 1 of this Y-tube 20 / Inlet (corresponding to 2 -
A winged needle 111 provided at the tip of the circuit tube 112 of the cleaning liquid supply circuit 110 is pierced and connected to the branch pipe section 20A, and an excess cleaning liquid discharge circuit 130 is connected to the other end of the Y-tube 20. The connector 8 is connected to the second liquid flow path 13 of the irrigation catheter 1.
Both the washing i++ liquid supply circuit 110 and the excess washing liquid discharge circuit 130 are connected via the washing i++ liquid supply circuit 110 and the excess washing liquid discharge circuit 130.

In the illustrated example, the cleaning liquid supply circuit 110 includes lI,
A cleaning liquid bottle 116 filled with a cleaning liquid consisting of a type of artificial cerebrospinal fluid according to the purpose of cleaning is held at a certain location, to which one end of a circuit tube 112 is connected, and along this circuit tube 112, the flow rate is controlled. An automatic injector 115, a warmer 114 for heating the cleaning liquid to a temperature similar to body temperature, and a filter 113 for filtering the cleaning liquid are provided in this order. It is provided.

Further, a drainage circuit 120 is connected to the branch tube 7 of the irrigation catheter 1 . That is, one end of the circuit tube 122 is connected via the connector 121, and the other end is connected to the overflow pipe 123A in the drip chamber 123, and the drip chamber 123 is connected to a drainage liquid storage part such as a storage bottle 124 or a drainage bag. Connected. The overflow level a of the overflow pipe 123A is generally located at the same level as the patient's ear, specifically the outer ear.

In the excess cleaning liquid discharge circuit 130, a circuit tube 132 is connected to the Y-shaped tube 20 via a connector 131, and like the liquid drainage circuit 120, a drip chamber 133 having an overflow pipe 133A and a storage bottle 134 are connected. However, the overflow level b of the overflow pipe 133A is the same as that of the drain circuit 120.
From the overflow level a of the overflow pipe 123A, for example, 2
It is held at a position 5c+n higher.

To explain in detail the means for connecting the RiJ connection connector 8 to the purified liquid supply circuit 110 and the excess cleaning liquid discharge circuit 130, FIG. 4 is an enlarged sectional view of the Y-shaped tube 20.
A Luer lock male L" 21 that fits the connector 8 is attached to the lower end of the connector. Luer lock type connection means is well known, and the taper 211 on the outer surface of the seam 21 is fitted into the taper 81 of the inner iR1 formed on the thread portion 8C of the connector 8, and the outer surface of the silk seam 21 212
A spiral protrusion 213 formed on the inner surface of the connector 8 is engaged with a production rib 8E formed on the outer periphery of the thread portion 8C of the connector 8, thereby establishing a connection between the Y-shaped tube 20 and the connector 8. The upper end of the Y-tube 2 ( ) is connected to a circuit tube 132 of an excess cleaning liquid discharge circuit 130 by a connector 131 . Instead of this connector 131, a Luer lock type connection means may be used. A branch pipe portion 20A in the middle of the Y-tube 20 is provided with a needle penetration port 22 that serves as a collection port/injection port for a general ventricular drainage set, and the wing-shaped fJIll of the cleaning fluid supply circuit 110 is pierced through this port. connected.

FIG. 5 shows an example of a three-way stopcock 80 that can be used in place of the Y-shaped tube 20 described above. In this example, one connecting pipe section 81 has a Luer lock seam 811 that fits the connector 8. Two other connecting pipe sections 82 and 38 are provided.
Luer lock separations 821 and 881, respectively, are provided for connection to circuit tube 112 and circuit tube 182K, respectively, which have matching Luer lock closures.

Use a connection means other than the Y-shaped pipe 20 or three-way stopcock 8o as described above, such as a single-shaped mixed injection pipe or a Y-shaped mixed injection pipe.
Therefore, as described above, both the cleaning liquid supply circuit 110 and the excess cleaning liquid discharge circuit 180 can be connected to the second liquid flow path 18 of the cleaning catheter 1 so as to communicate with each other.

In the above state, cleaning is performed as follows. That is, the cleaning liquid from the cleaning liquid supply circuit 11.0 is supplied to the other end of the inner tube 3 through the connector 8 at a flow rate controlled by the automatic injector 115 due to the action of gravity, and the second liquid, It flows along the flow path 13 and is ejected into the lateral ventricle 101 from the opening 12 at the distal end of the inner tube 3, and the lateral ventricle 101 is washed with this washing liquid. The cleaning waste liquid that has been used for cleaning, for example after cleaning the tray, flows into the outer tube 2 through the tip 1'' 5 of the outer tube 2 and/or the opening 9, and flows into the first liquid flow path 6. The liquid flows along the line and is discharged from the branch tube 7 to the drainage circuit 12.
0 and passes through the drip chamber 123 to the storage pin 12.
It is stored in 4.

In this way, the object and cleaning of the car are achieved, the present invention (
In the second case, the following effects can be obtained. That is, in the operation of inserting the irrigation catheter 1 into the body, the inner tube 3
is inserted into the outer tube 2, so what has to be inserted into the body is essentially one catheter. Therefore, the insertion operation is easy and the required 14S position (2) is difficult to insert. Compared to conventional irrigation catheters, the number of characters is reduced by half,
Accurate positioning (1) is easy, and in the case of insertion and ventricular lavage (2), the canal hole only requires one side sound, and in this respect, AI is also easy to operate. )
, the risk of infection is also halved. This effect is achieved by first inserting only the outer tube 2 into the body, then inserting the inner tube 3 from the other end opening outside the body using the outer tube 2 as a guide, and inserting its distal end 3A into the distal opening of the outer tube 2. An insertion method in which the inner tube 3 is inserted into the body by inserting the inner tube 3 into the outer tube 2, and then the distal end 3A of the inner tube 3 is made to protrude. The device can be inserted into the body either by inserting it into the outer tube 2 or by inserting it into the body. Note that this intracorporeal insertion operation is preferably performed under X-ray fluoroscopy-F, and for this purpose, the X-ray opaque line 10
It is preferable to provide a closing member 4 made of an X-ray opaque material.
The protrusion length of the distal end 3A of the inner tube 3 that protrudes more is strictly determined (the second is the opening 12 and the distal opening 5F'1L < is the opening 1).
ISF according to the distance between -19 and
Moreover, since this protrusion length can be changed freely, -C appropriate cleaning for the range to be 15Is 7.
t,c can be done, and the above-mentioned positional manipulation 1. That is, the protruding length of the tip 3A is determined by cutting off the outer tube 2 and γ; Advance the inner tube 2 first!'+Iii !l (The protrusion length to 3 will be the same as the resection length, so 1;lL ('J"・1・I
A can be made larger or the inner tube 3
The other end? Excise - C inner tube 2 after iJJ, 1
-i tightening l tip i1s 3 Since the protruding length of A becomes smaller by the resection length l;+', ij IJ in t-fh,
lJ can be made smaller by 1- f L, a;
f■'Tip part: (A
By setting the protrusion length of J-, it is always Jl)d1
11J 1. -Cn11. It is possible to connect with InΦmi1 river. Such a 7i'e (-f'・lfl: (enlargement of the surrounding area and distance) is small even during surgery.'
In this case, the inner tube 3 is
; d, or f (because the retraction is good, there is no adverse effect on the tissues in contact with the catheter. In this way, in order to change the size of the cleaning area, the outer tube 2 and the inner tube 3 are The fixing means can be arbitrarily released, for example, by means of a coil cover 8 (preferably two) as shown in the figure. Also, a 1" length bulge 11 is formed at the other end of the outer tube 2. By doing so, it is possible to know the protruding length of the distal end portion 3A of the inner tube 3, which is convenient for making the resection length accurate even when removing tJ+.

As described above, according to the cleaning catheter of the present invention, only one insertion hole is required for insertion into the body, and the insertion operation or positioning operation can be performed accurately at each site without any confusion.151: It is possible to set the range from 3 to 1 and to change the set range.

And the present invention (in the second case, the second one in the inner first rule tube 2)
Only the liquid flow paths 1:3 to 6n11 (supply circuit IN) may be disconnected, and in this case, the same effects as described above can be obtained.

however,! l! (Please refer to the example in Figure 53), Condolence 2
Wash the lfk body flow 1r313 (-p liquid supply circuit 110
only) ゛Overflow/i(, ffl lI discharge circuit 13
0 by Y-shaped positive 20, three-way activation 1], ;40 by constructing ``[connection''] by other convenient means (),
i; I: (The tq solution is supplied to the first and second portions!
/ J Sho is done. For example, in the example shown in FIG.
9. The first liquid flow path 6 is closed for some reason, '44
Jν1, or blockage '1 in the drainage circuit 120.
1 or r'51", 1fJ7fl
Supply circuit 1.10t)) (S1]et, I automatic/L
Due to an abnormality in the human device 115, there will be 115 planned M days; 1.
In cases such as when g ffl rfM is supplied,
Inside the brain 1 (+ (, 611 supply in 1 is excessive and the pressure inside the brain is -L 1,7. t,, If it stays as it is, it will cause danger 2, but 11i4'-'+i internal pressure is - 1
−ψ1. -zu;! ), the liquid level in the turn il'ii tuner 132 of the excess cleaning liquid drain circuit 130 rises,
Overflow level b of overflow control 133A within drip ¥133
If you exceed y7, it will be 1.7J"7'l is a drip *13
There is a roar as the water flows down into the interior of the room and is discharged. That is, excess 61
−． t■Il+l-Jul output circuit 1: Hl is over+ll
l I,,,i'/', I liquid (varnish-J t, pa.
f path flow path 41/i formation 6 () LJ) Ca-
,,) c, (h+ ?7!r, 'ii' l 3
: By setting the height of (overflow of A, level 1), it is possible to prevent the internal pressure from rising above a certain level.
You can ljl.

In this way, the second liquid flow path 13 of the irrigation catheter 1
By connecting the cleaning (PK!i) supply circuit 110 and the excess cleaning liquid discharge circuit 130 using an overflow mechanism, it is possible to prevent excessive supply of cleaning liquid from rain, especially as shown in the usage example. It is extremely suitable for intracerebroventricular i';

Although the description has focused on one embodiment of the civil engineering invention, various modifications can be made to the present invention.

For example, in the above-mentioned example, the first liquid flow path 6 is used as a cleaning drainage liquid outlet path, and the second I'lk body flow path 1l) 1
, fp liquid inlet path, but /;1. of the example in FIG. it
; f) Catheter l (place it twice and wash it into the branch tube
:pz supply circuit or excess cleaning liquid discharge circuit 2
Tangent b'1. bt the first liquid flow path 6 as follows:
/7+liquid outlet, and connect the drain circuit to connector 8. be.

As described in -1- below, according to the present invention, only one insertion hole is required, and the intermediary operation can be easily performed.
Because of this, Saru 7:I-: can provide a disputed cabootel.

4.1'λI Curved Circular Explanation No. 1 JA-Kyomeiso TF Buds Power Tedel's External Example r11. ! l;<1, Figure 2 is an enlarged view of a part of Figure 1.
The explanatory diagrams, Figures 4 and 5, when F force data is conveniently used in the brain test 15147, show how the power supply circuit works when using the power supply circuit. 1 (ζ1) wash l't
＋? lν μ of the means for connecting with the discharge circuit
It is a 1111 view showing the side of the body.

1... Irrigation catheter 2... Duplex on the 1st side (
Inner Duop 3A...Tip 5...Tip 1-1 6...First liquid flow path 7
・Branch duplex 8...-=I Neck-9, 12・
... Open El 13... PI", 2 liquid flow path 20 ... 7-shaped pipe 20A... Branch pipe section 22
... Needle penetration ['' 30... Three-way stopcock + (1 (+
... Inside the head 101 ... Ill'll ventricle 11
0...Cleaning liquid supply circuit 111...Winged @l IJ2...Circuit 4
1--B 113...Filter 114...Warmer 115--Automatic injector 120...Drain circuit 1
22...Circuit duplex 123...Drip chamber 123
A... Tank flow pipe 130... Excess cleaning liquid discharge circuit 132...-Circuit duplex 133... Drip chamber 13
3A... Overflow pipe Figure 4

Claims (1)

[Claims] (2) It consists of an outer tube and an inner tube that is inserted into the outer tube to form a first liquid flow path between the outer tube and the outer tube, and the inner tube has its tip end connected to the outer tube. +1lll tube tip! '
The outer tube and the inner tube are inserted in a state protruding from the +hi and fixed to the outer tube in this inserted state, and the outer tube and the inner tube each have a diameter or +M number of openings L1 at their distal ends. One and the other of the second liquid flow path formed by the first liquid flow path and the interior of the inner tube
1-The washing device is characterized in that a discharge section is formed in the first liquid supply section and the second discharge section 71;1. Purification catheter 1゜2) The cleaning liquid supply section is connected to a purification liquid supply circuit and an excess liquid discharge circuit. L-tip M catheter.