WO2017215256A1 - 植入式迷走神经双通道刺激装置 - Google Patents

植入式迷走神经双通道刺激装置 Download PDF

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WO2017215256A1
WO2017215256A1 PCT/CN2017/000380 CN2017000380W WO2017215256A1 WO 2017215256 A1 WO2017215256 A1 WO 2017215256A1 CN 2017000380 W CN2017000380 W CN 2017000380W WO 2017215256 A1 WO2017215256 A1 WO 2017215256A1
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stimulation pulse
pulse generator
vagus nerve
electrical stimulation
wound
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肖波
文志林
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上海市儿童医院
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/36053Implantable neurostimulators for stimulating central or peripheral nerve system adapted for vagal stimulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/0205Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0551Spinal or peripheral nerve electrodes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0551Spinal or peripheral nerve electrodes
    • A61N1/0558Anchoring or fixation means therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation

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  • the present invention relates to medical device technology, and more particularly to a technique for an implantable vagus nerve two-channel stimulation device.
  • An implantable vagus nerve stimulation device is a medical device that stimulates the vagus nerve by outputting an electrical stimulation signal.
  • the existing implantable vagus nerve stimulation device is mainly composed of an electrical stimulation pulse generator, a wound positioning anchor and two wound electrodes of different polarities, and the wound positioning anchor and two wound electrodes are wound around the target in use.
  • a wrap-around anchor is used to position two wound electrodes, and an electrical stimulation pulse generator is used to output an electrical stimulation signal to control the operation of the two wound electrodes to achieve stimulation of the target vagus nerve.
  • the electrode is wound on the target vagus nerve in sequence, but when the proximal wound electrode is wound, the distally wound electrode is still in a free state, and since the distally wound electrode is far away from the wound positioning anchor, the swimming amplitude is also Relatively large, it is easy to interfere with the doctor's operation, which increases the difficulty of the doctor's operation.
  • the electrical stimulation pulse generator is provided with a first stimulation pulse output port for outputting an electrical stimulation pulse, and a second stimulation pulse output port.
  • the electrical leads of the two wound electrodes in the first implanted unit are connected to the electrical stimulation pulse.
  • the first stimulation pulse output port of the device, the electrical leads of the two wound electrodes in the second implant unit are connected to the second stimulation pulse output port of the electrical stimulation pulse generator.
  • wrap-around anchor is a flexible and flexible spiral anchor, and both ends of the wrap-around anchor are fixed with a flexible auxiliary line.
  • the implantable vagus nerve two-channel stimulation device adopts a closed stimulation mode, and in the process of performing electrical stimulation, the physical sign detection module can be used to detect the physical condition of the human body in real time, thereby reducing the risk of stimulation and having high safety characteristics. Therefore, the two implant units can be used to simultaneously perform electrical stimulation on both sides of the vagus nerve, thereby improving the stimulation effect, and in the implant unit, the two wound electrodes are placed on both sides of the wound positioning anchor, and two winding type The distance between the electrode and the wound positioning anchor is relatively close, the swimming amplitude is relatively small, and the influence on the doctor's operation is also small, thereby reducing the difficulty of the doctor's operation.
  • an implantable vagus nerve two-channel stimulation device includes an implant unit and an electrical stimulation pulse generator U1, wherein the device further includes a heart rate for detecting a human body, a vital sign detecting module U2 of the respiratory rate, blood oxygen saturation and the like; the sign detecting module U2 is connected to the electrical stimulation pulse generator U1 by wireless communication or wired communication;
  • the winding positioning anchor is a spiral anchor with elasticity and flexibility, and is wound
  • the inner diameter of the anchor of the anchor is 1.5-1.8 mm
  • the number of coils of the wrap-around anchor is 3 circumferences
  • the unfolding length of the wrap-around anchor is 24-30 mm
  • flexible guide lines are fixed at both ends of the wrap-around anchor.
  • the auxiliary line is an implantable surgical thread
  • the auxiliary line has a line length of 8 to 10 mm, which can facilitate the winding operation during the operation.
  • the electrical stimulation pulse generator, the physical sign detection module, and the manual stimulation control module are all prior art.
  • the wound positioning anchor and the wound electrode in the two implanted units are respectively implanted into the patient, and each implant unit wraps the wrap-around anchor on the target vagus nerve when implanting the wrap-around anchor and the wrap-around electrode.
  • Upper, then two winding electrodes are wound on the target vagus nerve, and the electrical stimulation pulse generator detects the physical condition of the patient in real time through the vital sign detection module;

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Abstract

一种植入式迷走神经双通道刺激装置,涉及医疗设备技术领域,所解决的是提高刺激效果、安全性及降低操作难度的技术问题。该装置包括电刺激脉冲发生器(U1),连接电刺激脉冲发生器(U1)的体征检测模块(U2),及两个植入单元;植入单元包括缠绕式定位锚(M1)、柔性的电极封套(T1),及两个极性相异的缠绕式电极(J1、J2),其中的缠绕式定位锚(M1)通过一柔性的连接桥(B1)固定在电极封套(T1)上,两个缠绕式电极(J1、J2)分置于缠绕式定位锚(M1)的两侧,两个缠绕式电极(J1、J2)的电气引线分别穿过电极封套(T1)并与电极封套(T1)固接;两个植入单元中的缠绕式电极(J1、J2)的电气引线分别接到电刺激脉冲发生器(U1)的两个刺激脉冲输出端口。该装置适用于对迷走神经实施电刺激。

Description

植入式迷走神经双通道刺激装置 技术领域
本发明涉及医疗设备技术,特别是涉及一种植入式迷走神经双通道刺激装置的技术。
背景技术
植入式迷走神经刺激装置是通过输出电刺激信号来刺激迷走神经的医疗设备。现有的植入式迷走神经刺激装置主要由电刺激脉冲发生器、缠绕式定位锚及两个极性相异的缠绕式电极组成,使用时将缠绕式定位锚及两个缠绕式电极缠绕在目标迷走神经上,缠绕式定位锚用于定位两个缠绕式电极,电刺激脉冲发生器用于输出电刺激信号来控制两个缠绕式电极工作,从而实现对目标迷走神经的刺激。
现有植入式迷走神经刺激装置都只有两个缠绕式电极,同一时间内只能对单侧的迷走神经进行刺激,其刺激范围较窄,刺激效果也较差,而且现有植入式迷走神经刺激装置采用的是开放式刺激模式,没有针对生命体征参数的监控,存在着潜在的刺激风险,从而给被神经电刺激者带来安全隐患。正是由于开放式刺激模式存在着安全隐患,现有植入式迷走神经刺激装置使用时,在同一时间内都只对单侧的迷走神经进行神经电刺激,因此也只配备了两个缠绕式电极。
并且,现有植入式迷走神经刺激装置中,缠绕式定位锚及两个缠绕式电极是按照手术操作的先后顺序排列的,即两个缠绕式电极都布设在缠绕式定位锚的同一侧,在手术操作时,医生按照缠绕式定位锚、近端缠绕式电极(即离缠绕式定位锚较近的近端缠绕式电极)、远端缠绕式电极的顺序将缠绕式定位锚及两个缠绕式电极依序缠绕在目标迷走神经上,但是在缠绕近端缠绕式电极时,远端缠绕式电极还处在游离状态,而且由于远端缠绕式电极距离缠绕式定位锚较远,游动幅度也会相对较大,容易干扰医生操作,从而增加了医生的操作难度。
发明内容
针对上述现有技术中存在的缺陷,本发明所要解决的技术问题是提供一种刺 激效果好,安全性高,且操作难度低的植入式迷走神经双通道刺激装置。
为了解决上述技术问题,本发明所提供的一种植入式迷走神经双通道刺激装置,包括植入单元、电刺激脉冲发生器,其特征在于:该装置还包括用于检测人体的心率、呼吸频率、血氧饱和度等体征状况的体征检测模块;所述体征检测模块以无线通信或有线通信方式连接电刺激脉冲发生器;
所述植入单元包括缠绕式定位锚、柔性的电极封套,及两个极性相异的缠绕式电极,其中的缠绕式定位锚通过一柔性的连接桥固定在电极封套上,两个缠绕式电极分置于缠绕式定位锚的两侧,两个缠绕式电极的电气引线分别穿过电极封套并与电极封套固接;
所述植入单元有两个,其中的一个植入单元为第一植入单元,另一个植入单元为第二植入单元;
所述电刺激脉冲发生器设有用于输出电刺激脉冲的第一刺激脉冲输出端口、第二刺激脉冲输出端口,第一植入单元中的两个缠绕式电极的电气引线接到电刺激脉冲发生器的第一刺激脉冲输出端口,第二植入单元中的两个缠绕式电极的电气引线接到电刺激脉冲发生器的第二刺激脉冲输出端口。
进一步的,还包括用于向电刺激脉冲发生器输入控制信号的手动刺激控制模块,手动刺激控制模块以无线通信或有线通信方式连接电刺激脉冲发生器。
进一步的,所述缠绕式电极由螺旋形的基载圈,及固定在基载圈上的电极条组成,基载圈具有弹性及柔性,基载圈的两端都固定有柔性的辅助线。
进一步的,所述缠绕式定位锚是具有弹性及柔性的螺旋形锚,缠绕式定位锚的两端都固定有柔性的辅助线。
本发明提供的植入式迷走神经双通道刺激装置,采用闭合式刺激模式,在实施电刺激过程中,可以利用体征检测模块实时检测人体体征状况,从而降低了刺激风险,具有安全性高的特点,也因此可以利用两个植入单元同时对两侧迷走神经实施电刺激,提高了刺激效果,并且在植入单元中,两个缠绕式电极分置于缠绕式定位锚的两侧,两个缠绕式电极与缠绕式定位锚的距离都相对较近,游动幅度也相对较小,对医生操作的影响也较小,从而降低了医生的操作难度。
附图说明
图1是本发明实施例的植入式迷走神经双通道刺激装置的结构示意图。
具体实施方式
以下结合附图说明对本发明的实施例作进一步详细描述,但本实施例并不用于限制本发明,凡是采用本发明的相似结构及其相似变化,均应列入本发明的保护范围,本发明中的顿号均表示和的关系。
如图1所示,本发明实施例所提供的一种植入式迷走神经双通道刺激装置,包括植入单元、电刺激脉冲发生器U1,其特征在于:该装置还包括用于检测人体的心率、呼吸频率、血氧饱和度等体征状况的体征检测模块U2;所述体征检测模块U2以无线通信或有线通信方式连接电刺激脉冲发生器U1;
所述植入单元包括缠绕式定位锚M1、柔性的电极封套T1,及两个极性相异的缠绕式电极J1、J2,其中的缠绕式定位锚M1通过一柔性的连接桥B1固定在电极封套T1上,两个缠绕式电极J1、J2分置于缠绕式定位锚M1的两侧,两个缠绕式电极J1、J2的电气引线分别穿过电极封套T1并与电极封套固接;
所述植入单元有两个,其中的一个植入单元为第一植入单元,另一个植入单元为第二植入单元;
所述电刺激脉冲发生器U1设有用于输出电刺激脉冲的第一刺激脉冲输出端口、第二刺激脉冲输出端口,第一植入单元中的两个缠绕式电极J1、J2的电气引线接到电刺激脉冲发生器U1的第一刺激脉冲输出端口,第二植入单元中的两个缠绕式电极J1、J2的电气引线接到电刺激脉冲发生器U1的第二刺激脉冲输出端口。
本发明实施例还包括用于向电刺激脉冲发生器U1输入控制信号的手动刺激控制模块U3,手动刺激控制模块U3以无线通信或有线通信方式连接电刺激脉冲发生器U1。
本发明实施例中,所述缠绕式电极由螺旋形的基载圈,及固定在基载圈上的电极条组成,基载圈具有弹性及柔性,基载圈的螺旋内径为1.5~1.8mm,基载圈的线圈数为2.5个圆周,基载圈的展开长度为18~25mm,基载圈的两端都固定有柔性的辅助线,辅助线为可植入手术用丝线,辅助线的线长为8~10mm,手术中可有助于缠绕操作;电极条为宽度1mm的金属银片,电极条的外表面镀铂,电极条以半埋方式嵌置在基载圈的内侧面中部。
本发明实施例中,所述缠绕式定位锚是具有弹性及柔性的螺旋形锚,缠绕式 定位锚的螺旋内径为1.5~1.8mm,缠绕式定位锚的线圈数为3个圆周,缠绕式定位锚的展开长度为24~30mm,缠绕式定位锚的两端都固定有柔性的辅助线,辅助线为可植入手术用丝线,辅助线的线长为8~10mm,手术中可有助于缠绕操作。
本发明实施例中,所述电极封套的外径为2.7~3mm,连接桥的长度为5~7mm,连接桥的宽度在2.9~3.1mm,电极封套可以对缠绕式电极的电气引线起到保护作用,并且电极封套与缠绕式定位锚通过连接桥相连,通过电极封套与缠绕式定位锚的配合,可以对缠绕式电极起到定位作用。
本发明实施例中,所述电刺激脉冲发生器、体征检测模块、手动刺激控制模块均为现有技术。
本发明实施例所提供的植入式迷走神经双通道刺激装置的刺激方法如下:
将两个植入单元中的缠绕式定位锚、缠绕式电极分别植入患者体内,每个植入单元在植入缠绕式定位锚、缠绕式电极时,先将缠绕式定位锚缠绕在目标迷走神经上,然后再将两个缠绕式电极先后缠绕在目标迷走神经上,电刺激脉冲发生器通过体征检测模块实时检测患者的体征状况;
如果电刺激脉冲发生器收到的体征状况检测数据在预先设定的安全范围内,电刺激脉冲发生器即按照预先设定的刺激控制规则输出电刺激脉冲,使得两个植入单元中的缠绕式电极按照相应的刺激规则对患者的目标迷走神经进行电刺激;
如果电刺激脉冲发生器收到的体征状况检测数据超出预先设定的安全范围内,电刺激脉冲发生器即按照预先设定的安全控制规则,停止输出一侧或双侧电刺激脉冲或对电刺激脉冲的刺激参数进行调整,电刺激脉冲的刺激参数包括电刺激脉宽、电刺激时长、电刺激频率、电刺激单相双相互换、刺激电流强度等;医生可以通过手动刺激控制模块向电刺激脉冲发生器输入相应的手动控制信号,从而对电刺激脉冲发生器实施手动干预。

Claims (4)

  1. 一种植入式迷走神经双通道刺激装置,包括植入单元、电刺激脉冲发生器,其特征在于:该装置还包括用于检测人体的心率、呼吸频率、血氧饱和度等体征状况的体征检测模块;所述体征检测模块以无线通信或有线通信方式连接电刺激脉冲发生器;
    所述植入单元包括缠绕式定位锚、柔性的电极封套,及两个极性相异的缠绕式电极,其中的缠绕式定位锚通过一柔性的连接桥固定在电极封套上,两个缠绕式电极分置于缠绕式定位锚的两侧,两个缠绕式电极的电气引线分别穿过电极封套并与电极封套固接;
    所述植入单元有两个,其中的一个植入单元为第一植入单元,另一个植入单元为第二植入单元;
    所述电刺激脉冲发生器设有用于输出电刺激脉冲的第一刺激脉冲输出端口、第二刺激脉冲输出端口,第一植入单元中的两个缠绕式电极的电气引线接到电刺激脉冲发生器的第一刺激脉冲输出端口,第二植入单元中的两个缠绕式电极的电气引线接到电刺激脉冲发生器的第二刺激脉冲输出端口。
  2. 根据权利要求1所述的植入式迷走神经双通道刺激装置,其特征在于:还包括用于向电刺激脉冲发生器输入控制信号的手动刺激控制模块,手动刺激控制模块以无线通信或有线通信方式连接电刺激脉冲发生器。
  3. 根据权利要求1所述的植入式迷走神经双通道刺激装置,其特征在于:所述缠绕式电极由螺旋形的基载圈,及固定在基载圈上的电极条组成,基载圈具有弹性及柔性,基载圈的两端都固定有柔性的辅助线。
  4. 根据权利要求1所述的植入式迷走神经双通道刺激装置,其特征在于:所述缠绕式定位锚是具有弹性及柔性的螺旋形锚,缠绕式定位锚的两端都固定有柔性的辅助线。
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