WO2023077879A1 - 一种腹膜透析置管固定装置 - Google Patents

一种腹膜透析置管固定装置 Download PDF

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Publication number
WO2023077879A1
WO2023077879A1 PCT/CN2022/108002 CN2022108002W WO2023077879A1 WO 2023077879 A1 WO2023077879 A1 WO 2023077879A1 CN 2022108002 W CN2022108002 W CN 2022108002W WO 2023077879 A1 WO2023077879 A1 WO 2023077879A1
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Prior art keywords
elastic
dialysis catheter
peritoneal dialysis
guide sheath
ring
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PCT/CN2022/108002
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English (en)
French (fr)
Inventor
胡梦思
吕智美
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山东第一医科大学附属省立医院(山东省立医院)
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Priority to GB2310240.3A priority Critical patent/GB2618230A/en
Publication of WO2023077879A1 publication Critical patent/WO2023077879A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
    • A61M1/285—Catheters therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0194—Tunnelling catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02—Holding devices, e.g. on the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02—Holding devices, e.g. on the body
    • A61M25/04—Holding devices, e.g. on the body in the body, e.g. expansible
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/0662—Guide tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M29/00—Dilators with or without means for introducing media, e.g. remedies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0194—Tunnelling catheters
    • A61M2025/0197—Tunnelling catheters for creating an artificial passage within the body, e.g. in order to go around occlusions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02—Holding devices, e.g. on the body
    • A61M2025/0213—Holding devices, e.g. on the body where the catheter is attached by means specifically adapted to a part of the human body
    • A61M2025/0233—Holding devices, e.g. on the body where the catheter is attached by means specifically adapted to a part of the human body specifically adapted for attaching to a body wall by means which are on both sides of the wall, e.g. for attaching to an abdominal wall
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02—Holding devices, e.g. on the body
    • A61M2025/0293—Catheter, guide wire or the like with means for holding, centering, anchoring or frictionally engaging the device within an artificial lumen, e.g. tube
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/10—Trunk
    • A61M2210/1017—Peritoneal cavity

Definitions

  • the invention relates to the field of peritoneal dialysis, in particular to a peritoneal dialysis tube fixing device.
  • Peritoneal dialysis is a commonly used and effective renal replacement therapy for patients with end-stage renal failure or acute renal failure.
  • Peritoneal dialysis uses the peritoneum as a semi-permeable membrane, and uses gravity to pour the prepared dialysate into the patient's peritoneal cavity through a catheter.
  • the peritoneal dialysis solution is constantly replaced to achieve the purpose of removing metabolites and toxic substances in the body and correcting water and electrolyte balance disorders.
  • a peritoneal dialysis channel needs to be established, and a peritoneal dialysis catheter is implanted into the patient's abdominal cavity, that is, peritoneal dialysis catheterization is performed.
  • non-fixed peritoneal dialysis catheter method is used for peritoneal dialysis, that is, a dedicated peritoneal dialysis catheter is implanted into the bladder-rectal recess of male patients or the uterine rectal recess of female patients. Since the peritoneal dialysis catheter is not fixed in the abdominal cavity, the peritoneal dialysis catheter implanted in the patient's body is easy to float and shift. Therefore, after the conventional non-fixed peritoneal dialysis catheter, about 15-20% of the patients have the floating shift of the peritoneal dialysis catheter, resulting in peritoneal dialysis. Dialysis is difficult to carry out, and reoperation is required, which increases the pain and economic pressure of patients.
  • the improved peritoneal dialysis catheterization can effectively avoid postoperative peritoneal dialysis catheter drift.
  • For internal fixation of the abdominal wall it is necessary to incise and suture the anterior sheath, rectus abdominis, posterior sheath, and peritoneum about 3cm below the insertion incision of the peritoneal dialysis catheter.
  • the tube method has the disadvantages of difficult operation, time-consuming operation, large incision, and more tissue damage. If the patient is obese or has high abdominal pressure, the operation is more difficult, and it is even impossible to fix the peritoneal dialysis catheter.
  • the publication number CN 101391119A discloses a peritoneal dialysis tube fixer.
  • the peritoneal dialysis catheter into the incision
  • put a sleeve with a stylet under the anterior abdominal wall of the abdominal cavity lift up the abdominal wall slightly with the bent section of the sleeve arm, and then use the sharp thorn of the stylet to pierce the abdominal wall
  • the tube core is pulled out from the purse with the catheter fixing line, one section of the fixing line is fixed on the membrane dialysis catheter, and the other end is fixed at the puncture hole position, thereby playing the role of fixing the peritoneal dialysis catheter.
  • the technology disclosed in this patent has operational insecurity:
  • the outlet of the puncture of the stylet may not be completely consistent with the place where the bending section of the cannula arm slightly lifts up the abdominal wall, and there is a risk of unsatisfactory puncture or puncture damage to other organs and blood vessels.
  • the purpose of the present invention is to provide a peritoneal dialysis catheter fixing device, which can achieve the purpose of effectively fixing the peritoneal dialysis catheter, avoid the catheter from drifting in the abdominal cavity, and reduce the incidence of secondary operations ; and the operation is simple, the fixed position does not need to be cut, and the trauma is small, which is beneficial to the recovery of the patient and improves the quality of life; the operation is safe during the operation, and it can be compatible with the operation under visual guidance, so as to avoid blind operation during the operation. risk of device damage.
  • Embodiments of the present invention provide a peritoneal dialysis catheter fixing device, comprising:
  • An introducer sheath which is a cavity-type guide
  • the guide sheath core has a tapered front end, which is used to insert into the guide sheath to expand the puncture hole in the abdominal wall, and along the axis direction of the guide sheath core, a through hole is arranged in its center;
  • the elastic catcher includes an elastic ring formed by bending the elastic wire, the elastic ring is located in the middle of the elastic wire, and it is used to pass through the guide sheath to fix the dialysis catheter, and the two ends of the elastic wire are used to be arranged on the Outside the guide sheath, one end is used to fix the dialysis catheter fixing wire, and the other end is used as a holding part.
  • the holding part of the elastic wire is provided with a handle.
  • one end of the elastic wire used for fixing the dialysis catheter fixing wire is provided with a fixing hole.
  • the elastic catcher is a split structure.
  • the elastic catch includes a first elastic catch and a second elastic catch, one end of the first elastic catch is provided with a first elastic half ring, and the second elastic One end of the catching piece is provided with a second elastic half ring, and the first elastic half ring and the second elastic half ring are connected together to form an elastic ring.
  • the other end of the first elastic catch is provided with a handle.
  • the other end of the second elastic catch is provided with a fixing hole.
  • the first elastic half-ring or the second elastic half-ring can actively capture the dialysis catheter into its internal space structure by adjusting its position through operation.
  • the radian of the first elastic semi-ring or the second elastic semi-ring is greater than that of the semicircle.
  • the elastic catcher is made of elastic metal wire.
  • the invention provides a peritoneal dialysis catheter fixing device, which can achieve the purpose of reliably fixing the peritoneal dialysis catheter, effectively reduce complications caused by postoperative peritoneal dialysis catheter floating, and at the same time, the operation process has the advantages of simple operation and small trauma , the advantages of high success rate are as follows:
  • the device can effectively fix the peritoneal dialysis catheter, prevent the catheter from drifting in the abdominal cavity, and reduce the incidence of secondary operations;
  • the implantation process of the device is easy to operate, puncture implantation, no incision is required for the fixed position, and the trauma is small, so as to facilitate the recovery of patients and improve the quality of life;
  • the device is compatible with surgery under visual guidance, and can be navigated with the help of modern medical imaging technology, so as to avoid the risk of unpredictable organ damage to patients caused by blind operation during surgery.
  • FIG. 1 is a schematic diagram of the guiding sheath and guiding sheath core disclosed in Embodiment 1;
  • Fig. 2 is a schematic diagram of the elastic catcher disclosed in Embodiment 1;
  • Fig. 3 is a schematic diagram of the compression of the elastic grabber disclosed in the first embodiment through the guide sheath;
  • Fig. 4 is a schematic diagram of stretching the elastic grabber disclosed in Embodiment 1 through the guide sheath;
  • Fig. 5(1), Fig. 5(2), Fig. 5(3), Fig. 5(4), Fig. 5(5) are schematic diagrams of the operation process of the guiding sheath and guiding sheath core disclosed in Embodiment 1;
  • Fig. 6 is a schematic structural view of the elastic catcher disclosed in Embodiment 2.
  • Fig. 7 (1) and Fig. 7 (2) are schematic diagrams of the operation process of the guiding sheath and guiding sheath core disclosed in the second embodiment;
  • the present invention proposes a peritoneal dialysis catheter fixing device.
  • the device can fix the peritoneal dialysis catheter, effectively reducing the Complications caused by the floating peritoneal dialysis catheter after surgery.
  • the operation process has the advantages of simple operation, small trauma and high success rate. The details are as follows:
  • the device can effectively fix the peritoneal dialysis catheter, prevent the catheter from drifting in the abdominal cavity, and reduce the incidence of secondary operations;
  • the implantation process of the device is easy to operate, puncture implantation, no incision is required for the fixed position, and the trauma is small, so as to facilitate the recovery of patients and improve the quality of life;
  • the device is compatible with visually guided surgery, and can be navigated with the help of modern medical imaging technology, avoiding the unpredictable risk of organ damage to patients caused by blind operation during surgery.
  • a peritoneal dialysis catheter fixing device including a guide sheath, a guide sheath core, and an elastic catcher;
  • the guide sheath is a thin-walled cavity-type guide device , used to introduce the elastic grabber into the abdominal cavity at the position where the peritoneal dialysis tube needs to be fixed.
  • the guide sheath core is used in conjunction with the guide sheath, and its front end has a tapered structure for expanding the puncture hole in the abdominal wall; its center has a through hole, which is convenient for the passage of the threading guide wire for directional expansion of the abdominal wall.
  • the elastic grabber made of elastic metal wire, has the ability to return to its original shape after a large deformation, and it is used in conjunction with the introducer sheath.
  • the device can be applied to peritoneal dialysis catheterization, and can safely and effectively fix the peritoneal dialysis catheter.
  • the device is used in conjunction with the abdominal cavity puncture set, which is a commonly used clinical instrument and usually consists of a puncture needle and a puncture guide wire.
  • the peritoneal dialysis catheter fixing device disclosed in this embodiment includes at least three parts: a guide sheath 101 , a guide sheath core 102 , and an elastic catcher 103 .
  • the introducer sheath 101 is a thin-walled cavity-type guide device, which is used to guide the elastic catcher 103 into the abdominal cavity at the position where the peritoneal dialysis tube needs to be fixed. Further, in this embodiment, a protrusion is provided at the tail of the introducer sheath 101 for the convenience of operation. It needs to be further explained that the thin wall here does not specifically refer to a certain thickness, and the thickness only needs to meet the operation requirements.
  • the front end of the guide sheath core 102 has a tapered structure for expanding the puncture hole in the abdominal wall; the guide sheath core 102 is used in conjunction with the guide sheath 101, and along the guide sheath core In the axial direction of the guide sheath core 102, there is a through cavity of about ⁇ 1.0 mm in the center of the guide sheath core 102, which facilitates the passage of a puncture guide wire for directional expansion of the abdominal wall.
  • a protrusion is also provided at the tail of the guide sheath core 102. When the head of the protrusion and the guide sheath When the tail of the guiding sheath 101 touches, it means that the guiding sheath core 102 is punctured in place.
  • the diameter of the through hole in the center of the guiding sheath core 102 is set according to the diameter of the puncture guide wire, and is not limited to ⁇ 1.0 mm disclosed in this embodiment.
  • the elastic catcher 103 in this embodiment is an integral structure, which is made of elastic metal wire (nickel-titanium alloy wire or other elastic materials that can meet the basic performance), and has the ability to recover after large deformation. original ability.
  • the elastic catching ring 103 described in the embodiment of the present invention has the following capabilities when used in conjunction with the introducer sheath 101 due to its elastic characteristics:
  • the above-mentioned elastic catcher 103 is formed with an elastic ring 1031 , a recovery handle 1032 and a fixing wire fixing hole 1033 by bending the elastic metal wire.
  • the elastic ring 1031 is located in the middle of the elastic wire (the middle here does not specifically refer to the central position), and the elastic ring 1031 provides a passageway for the dialysis catheter, which can be guided by ultrasound or other modern medical imaging methods.
  • the fixing hole 1033 is located at one end of the elastic wire, which is used to fix the fixing wire of the dialysis catheter;
  • the recovery handle 1032 is located at the other end of the elastic wire, and can be pulled by pulling The recovery handle 1032 pulls out the entire elastic catcher 103 from the guide sheath (as shown in Figure 4 ), and at the same time pulls out one end of the fixing wire around the dialysis catheter, so that after withdrawing the device of the invention, the fixing wire passes through the Secure the dialysis catheter to the abdominal wall.
  • the above-mentioned elastic ring 1031 is not a completely closed ring, because it is formed by bending an elastic metal wire, so it cannot be completely closed, and there is a certain gap at the bend, and the elastic ring 1031 does not It must be a ring, and its shape is not limited.
  • Step 1 During peritoneal dialysis catheter placement, determine a suitable fixed position near the entrance of the dialysis catheter, use the peritoneal puncture kit to puncture the abdominal wall, insert the guide wire, and withdraw the puncture needle, as shown in Figure 5(1);
  • Step 2 insert the guide sheath core 102 into the guide sheath 101, pass the guide wire into the cavity of the guide sheath core, and push along the guide wire: the guide sheath core 102 until the front end of the guide sheath 101 penetrates the abdominal wall and enters In the abdominal cavity, withdraw the guide wire and the guide sheath core 102;
  • FIG. 5 (2) shows a schematic diagram of the state where the guide sheath core 102 and the front end of the guide sheath 101 penetrate the abdominal cavity wall and enter the abdominal cavity;
  • Step 3 Compress the elastic capture ring 103, and transport it through the introducer sheath 101 until the elastic ring 1031 completely enters the abdominal cavity and returns to its original shape, as shown in Figure 5(3).
  • Step 4 Under the guidance of ultrasound or other modern medical imaging techniques, pass the dialysis catheter through the center of the elastic ring 1031 and push it to a suitable position; fix one end or the middle of the dialysis catheter fixing line (usually a suture) to the fixing line On the fixing hole 1033, as shown in Figure 5(4).
  • Step 5 Slowly pull the recovery handle 1032 until the elastic catching ring 103 is pulled out from the introducer sheath 101 as a whole, withdraw the introducer sheath 101 (at this time, the dialysis catheter fixing line should keep bypassing the dialysis catheter and keep both ends outside the abdominal wall), tighten the dialysis catheter fixing wire and tie it to a suitable tissue part of the human body (such as muscle, subcutaneous, abdominal wall, etc.), close the puncture hole, and complete the dialysis catheter fixing operation, as shown in Figure 5 (5) Show.
  • This embodiment discloses another peritoneal dialysis catheter fixing device.
  • the guide sheath 101 and the guide sheath core 102 in this device are completely the same as those in the first embodiment, and will not be repeated here.
  • the differences from the first embodiment The main point is that the structure of the elastic catcher is different, as follows:
  • the device disclosed in this embodiment that cooperates with the guide sheath 101 is a split structure, and it includes two parts, namely the first elastic catch 203 and the second elastic catch 204; the first elastic catch Part 203 and the second elastic catching part 204 are all made of elastic metal wire (nickel-titanium alloy wire or other elastic materials that can meet the basic performance), and also have the ability to return to the original shape after large deformation, and it is compatible with the guide sheath After 101 is used together, it has the following abilities:
  • the above-mentioned first elastic catch 203 includes a magnet 2033, a first elastic half ring 2031 and a recovery handle 2032 formed by bending an elastic metal wire; wherein the first elastic half ring 2031 is formed on the elastic At one end of the metal wire, the recovery handle 2032 is formed on the other end of the elastic metal wire, and the magnet 2033 is located on the first elastic half ring 2031 . Further, in this embodiment, the radian of the first elastic half ring 2031 is greater than that of the semicircle. The purpose of this design is to actively capture the dialysis catheter by adjusting the position of the first elastic half ring 2031.
  • the internal space structure of 2031 is the passageway of the dialysis catheter, and the dialysis catheter can be passed through the center of the first elastic semi-ring 2031 under the guidance of ultrasound or other modern medical imaging methods, or under the guidance of ultrasound or other modern medical imaging methods Operate the recovery handle to catch the dialysis catheter into its annular interior; the recovery handle 2032 is used to withdraw the first elastic catch 203 and the second elastic catch 204; the magnet 2033 is used to connect the first elastic catch 203 and the second elastic catch 203 Elastic catch 204.
  • the second elastic catch 204 includes a magnet 2043, a second elastic half ring 2041 and a fixing wire fixing hole 2042 formed by bending an elastic wire, wherein the second elastic half ring 2041 is formed on the elastic wire
  • One end of the fixed wire fixing hole 2042 is formed on the other end of the elastic metal wire, and the magnet 2043 is located on the first and second elastic half rings 2041;
  • the magnet 2043, the magnet 2033 and the first elastic half ring 2031 can be combined to form a non-closed ring, which can accommodate the dialysis catheter;
  • the fixing wire fixing hole 2042 is used to fix the dialysis catheter fixing wire.
  • the arc of the first elastic half ring 2031 and the second elastic catch 204 can also be designed such that the arc of the second elastic catch 204 is larger than the arc of the semicircle, and the first elastic half The arc of the ring 2041 is less than the arc of the semicircle.
  • the magnet 2033 is used in conjunction with the magnet 2043 to combine the first elastic catcher 203 and the second elastic catcher 204 into a whole to form an elastic catcher, and the magnetic force between the two can be satisfied by pulling the recovery handle 2032 to The combination of the first elastic catch 203 and the second elastic catch 204 is pulled out from the introducer sheath.
  • Step 1 During peritoneal dialysis catheterization, determine a suitable fixed position near the entrance of the dialysis catheter, use the paracentesis kit to puncture the abdominal wall, insert the guide wire, and withdraw the puncture needle, as shown in Figure 5(1);
  • Step 2 insert the guide sheath core 102 into the guide sheath 101, pass the guide wire into the cavity of the guide sheath core, and push the guide sheath core 102 along the guide wire until the front end of the guide sheath 101 penetrates the abdominal wall and enters the abdominal cavity , withdraw the guide wire and guide sheath core 102, as shown in Figure 5(2);
  • Step 3 compress the first elastic catcher 203, and transport it through the introducer sheath 101 until the first elastic half-ring 2031 completely enters the abdominal cavity and returns to its original shape;
  • Step 4 Under the guidance of ultrasound or other modern medical imaging techniques, pass the dialysis catheter through the center of the first elastic semi-ring 2031 and push it to a suitable position; or operate the recovery handle under the guidance of ultrasound or other modern medical imaging methods The dialysis catheter is captured and entered inside the first elastic semi-ring 2031, as shown in Figure 7(1);
  • Step 5 Compress the second elastic catcher 204, and transport it through the guide sheath 101 to the second elastic half-ring 2041 to completely enter the abdominal cavity and return to its original shape; adjust and compress the position of the second elastic catcher 204 so that the magnet 2033 and the magnet 2043 Combining with each other; fixing the dialysis catheter fixing thread (usually a suture) on the fixing thread fixing hole 2042, as shown in Figure 7 (2);
  • Step 6 Slowly pull the recovery handle 2032 until the combination of the first elastic catch 203 and the second elastic catch 204 is pulled out from the introducer sheath 101 as a whole, withdraw the introducer sheath 101 (at this time the dialysis catheter is fixed).
  • the wire should keep bypassing the dialysis catheter and both ends stay outside the abdominal wall), tighten the dialysis catheter fixing wire and tie it on the abdominal wall, close the puncture hole, and complete the dialysis catheter fixing operation, as shown in Figure 5 (5) shown.
  • the materials used in the embodiments of the present invention must meet the requirements of biocompatibility, and also meet the ability to be developed under ultrasound or other modern medical imaging systems.
  • the schematic diagrams used in the embodiments of the present invention are only for illustration, and the actual implementation scheme may have different shapes from the schematic diagrams.
  • the first elastic semi-ring 2031 and the second elastic semi-ring 2041 may also be rectangular, polygonal and other spatial shapes, as long as they can realize the above functions. .
  • Embodiment 1 or Embodiment 2 The difference between this embodiment and Embodiment 1 or Embodiment 2 is that the fixing hole for the fixing wire is cancelled, and the elastic catcher is directly used as a fixing wire to fix the dialysis catheter.
  • Other structures are exactly the same as Embodiment 1 or Embodiment 2, and will not be repeated here up.
  • the materials used in this embodiment need to meet the requirements of implantable biocompatibility, and also meet the ability to develop under ultrasound or other modern medical imaging systems.
  • Embodiment 1 or Implementation 2 The difference between this embodiment and Embodiment 1 or Implementation 2 is that the fixing hole for the fixing line and the recovery handle are canceled at the same time, and one end of the elastic catcher is directly used as a fixing line to fix the dialysis catheter, and the other end is directly used as a handle to hold, and other structures are the same as Embodiment 1 or Embodiment 2 are completely the same, and will not be repeated here.
  • the materials used in this embodiment need to meet the requirements of implantable biocompatibility, and also meet the ability to develop under ultrasound or other modern medical imaging systems.
  • Embodiment 2 The difference between this embodiment and Embodiment 2 is that no magnets are set on the first elastic catch 203 and the second elastic catch 204, and there is a mechanical structure that can be reliably connected and detached between the two, such as a movable card. Buckle structure, collar structure, hanging buckle structure, and other feasible structures, the rest of the structures are exactly the same as Embodiment 2, or Embodiment 3, and Embodiment 4.
  • the materials used in this embodiment need to meet the requirements of biocompatibility, and also meet the ability to be developed under ultrasound or other modern medical imaging systems.
  • the elastic catcher disclosed in this embodiment can be integral or split, and it can realize the following functions:
  • the dialysis catheter can pass through its center, or when it is split, it can actively capture the dialysis catheter into its internal space structure by adjusting its position through operation;
  • the dialysis catheter fixing line can be fixed at one end, and the other end can be pulled out of the guide sheath as a whole and guide the dialysis catheter fixing line at the same time. After the fixing line is bypassed by the dialysis catheter, one end is pulled out of the guiding sheath. Thereby, the dialysis catheter can be fixed on the abdominal cavity wall through the fixed wire after withdrawing the elastic catch ring;
  • the catcher When the catcher is integral, it can also be directly used as a fixing device to fix the dialysis catheter;
  • the catcher is a split type, there is a reliable connection and detachable structure between the two, such as magnetic connection, movable buckle structure, collar structure, hanging buckle structure, and other feasible structures.
  • the device disclosed in the embodiment of the present invention is used in conjunction with the paracentesis set, and can be used in normal conditions, artificial ascites, pneumoperitoneum, etc., and can also be used for short-term or Long-term fixation.

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Abstract

一种腹膜透析置管固定装置，包括：导引鞘（101），其为空腔型导引件；导引鞘芯（102），其前端为锥形结构，用于插入到导引鞘（101）内扩张腹腔壁穿刺孔，沿着导引鞘芯（102）的轴线方向，在其中心设有贯穿孔腔；弹性抓捕器（103），其包括由弹性丝弯曲制作形成的非封闭式弹性环（1031），弹性环（1031）位于弹性丝的中部，其用于穿过导引鞘（101）固定透析导管，且弹性丝的两端用于设置在导引鞘（101）外，其一端用于固定透析导管固定线，另一端作为握持部。该装置可以达到将腹膜透析置管可靠固定的目的，有效地减少术后腹膜透析导管漂浮带来的并发症，同时手术过程具有操作简单，创伤小，成功率高的优点。

Description

一种腹膜透析置管固定装置
本发明要求于2021年11月5日提交中国专利局、申请号为202111305642.9、发明名称为“一种腹膜透析置管固定装置”的中国专利申请的优先权，其全部内容通过引用结合在本发明中。
技术领域
本发明涉及腹膜透析领域，具体涉及一种腹膜透析置管固定装置。
背景技术
腹膜透析是终末期肾功能衰竭患者或急性肾功能衰竭临床常用而有效的肾脏替代治疗方式。腹膜透析是利用腹膜作为半渗透膜，利用重力作用将配制好的透析液经导管灌入患者的腹膜腔，在腹膜两侧存在溶质的浓度梯度差，高浓度一侧的溶质向低浓度一侧移动；水分则从低渗一侧向高渗一侧移动。通过腹腔透析液不断地更换，以达到清除体内代谢产物、毒性物质及纠正水、电解质平衡紊乱的目的。腹膜透析前需要建立腹膜透析通道，将腹膜透析管植入到患者腹腔，即行腹膜透析置管术。
传统的腹膜透析置管术中，采用非固定式腹膜透析导管术方法进行腹膜透析，即将一根专用的腹膜透析导管植入男患者膀胱直肠隐窝或女患者子宫直肠隐窝。由于腹膜透析导管没有固定在腹腔，植入患者体内的腹膜透析导管容易漂浮移位，因此常规非固定式腹膜透析导管术后，大约有15-20％患者发生腹膜透析导管漂浮移位，导致腹膜透析难于进行，需再次手术，增加了患者的痛苦及经济压力。
目前改进型腹膜透析置管术，在腹壁内固定腹透置管，与常规的非固定式腹透置管术相比较，可有效避免术后腹膜透析置管漂移，但如不借助专用器械行腹壁内固定术，则需要在腹膜透析置管的置入切口下方3cm左右再次切开并缝合前鞘、腹直肌、后鞘及腹膜，手术过程明显延长，因此，腹透管腹壁内固定置管的方法有手术难度大、手术费时、患者切口大、组织损伤多等缺点，如患者肥胖或腹压高，手术难度更大，甚至无法固定腹膜透析置管。
为了解决上述问题，有人研发了专用的透析管固定工具以避免腹膜透析导管漂移，比如公开号CN 101391119A公开了一种腹膜透析置管固定器，在该专利公开的方案中，在腹部切口荷包处(腹膜透析导管放入切口)，将一种带管芯的套筒放入腹腔前腹壁下方，用套管臂的折弯段将腹壁略顶起，然后利用管芯的尖刺刺穿腹壁，并由管芯带着导管固定线从荷包处拉出，固定线一段固定在膜透析导管上，另一端在穿刺孔位置固定，从而起到了固定腹膜透析导管的作用。但该专利公开的技术存在操作不安全性：
1.套管在腹腔壁下的通行属于盲视操作，存在损伤腹腔内脏器的风险；
2.由于患者个体差异较大，管芯穿刺的出口并不一定与套管臂的折弯段将腹壁略顶起处完全保持一致，存在穿刺口不理想或穿刺损伤其他脏器血管的风险。
发明内容
针对现有技术存在的不足，本发明的目的是提供一种腹膜透析置管固定装置，该装置可以达成对腹膜透析导管进行有效固定的目的，避免导管在腹腔内漂移，降低二次手术发生率；且操作简单，固定位置无需切开，创伤小，利于患者恢复提高生活质量；手术过程中安全，可以兼容可视引导下进行手术，避 免手术过程中盲目操作给患者带来不可预估的脏器损伤风险。
为了实现上述目的，本发明是通过如下的技术方案来实现：
本发明的实施例提供了一种腹膜透析置管固定装置，包括：
导引鞘，其为空腔型导引件；
导引鞘芯，其前端为锥形结构，用于插入到导引鞘内扩张腹腔壁穿刺孔，沿着导引鞘芯的轴线方向，在其中心设有贯穿孔腔；
弹性抓捕器，其包括由弹性丝弯曲制作形成的弹性环，所述的弹性环位于弹性丝的中部，其用于穿过导引鞘固定透析导管，且弹性丝的两端用于设置在导引鞘外，其一端用于固定透析导管固定线，另一端作为握持部。
作为进一步的技术方案，弹性丝的握持部设有手柄。
作为进一步的技术方案，弹性丝中用于固定透析导管固定线的一端设有固定孔。
作为进一步的技术方案，所述的弹性抓捕器为分体结构。
作为进一步的技术方案，所述的弹性抓捕器包括第一弹性抓捕件和第二弹性抓捕件，所述的第一弹性抓捕件的一端设有第一弹性半环，第二弹性抓捕件的一端设有第二弹性半环，第一弹性半环和第二弹性半环连接在一起形成弹性环。
作为进一步的技术方案，所述的第一弹性抓捕件的另一端设有手柄。
作为进一步的技术方案，所述的第二弹性抓捕件的另一端设有固定孔。
作为进一步的技术方案，所述第一弹性半环或第二弹性半环可通过操作调整其位置主动将透析导管抓捕进入其内部空间结构。
作为进一步的技术方案，第一弹性半环或第二弹性半环的弧度大于半圆的 弧度。
作为进一步的技术方案，所述的弹性抓捕器使用弹性金属丝制作。
上述本发明的实施例的有益效果如下：
本发明提供了一种腹膜透析导管固定装置，该装置可以达到将腹膜透析置管可靠固定的目的，有效地减少术后腹膜透析导管漂浮带来的并发症，同时手术过程具有操作简单，创伤小，成功率高的优点，具体如下：
1.该装置可以对腹膜透析导管进行有效固定，避免导管在腹腔内漂移，降低二次手术发生率；
2.该装置的植入过程操作简单，穿刺植入，固定位置无需切开，创伤小，以利于患者恢复提高生活质量；
3.该装置可以兼容可视引导下进行手术，可以借助现代医学影像技术进行实施导航，避免手术过程中盲目操作给患者带来不可预估的脏器损伤风险。
附图说明
构成本发明的一部分的说明书附图用来提供对本发明的进一步理解，本发明的示意性实施例及其说明用于解释本发明，并不构成对本发明的不当限定。
图1是实施例一中公开的导引鞘和导引鞘芯的示意图；
图2是实施例一中公开的弹性抓捕器的示意图；
图3是实施例一中公开的弹性抓捕器压缩通过导引鞘示意图；
图4是实施例一中公开的弹性抓捕器拉伸通过导引鞘示意图；
图5(1)、图5(2)图5(3)、图5(4)、图5(5)是实施例1公开的导引鞘和导引鞘芯操作过程示意图；
图6是实施例二中公开的弹性抓捕器的结构示意图；
图7(1)、图7(2)是实施例二中公开的导引鞘和导引鞘芯操作过程示意图；
图中：101-导引鞘，102-导引鞘芯，103-弹性抓捕器，1031-弹性环，1032-回收手柄，1033-固定线固定孔；203-第一弹性抓捕件，204-第一弹性抓捕件；2031-第一弹性半环，2032-回收手柄，2033-磁铁，2041-第二弹性半环，2042-固定线固定孔，2043-磁铁。
具体实施方式
应该指出，以下详细说明都是例示性的，旨在对本发明提供进一步的说明。除非另有指明，本发明使用的所有技术和科学术语具有与本发明所属技术领域的普通技术人员通常理解的相同含义。
正如背景技术所介绍的，现有技术中存在不足，为了解决如上的技术问题，本发明提出了一种腹膜透析导管固定装置，通过手术操作，该装置可以将腹膜透析置管固定，有效地减少术后腹膜透析导管漂浮带来的并发症，同时手术过程具有操作简单，创伤小，成功率高的优点，具体如下：
1)该装置可以达成对腹膜透析导管进行有效固定的目的，避免导管在腹腔内漂移，降低二次手术发生率；
2)该装置的植入过程操作简单，穿刺植入，固定位置无需切开，创伤小，以利于患者恢复提高生活质量；
该装置可以兼容可视引导下进行手术，可以借助现代医学影像技术进行实施导航，避免手术过程中盲目操作给患者带来不可预估的脏器损伤风险。
实施例一
本发明的一种典型的实施方式中，公开了一种腹膜透析置管固定装置，包 括导引鞘、导引鞘芯、弹性抓捕器；导引鞘为一薄壁空腔型导引装置，用于在腹膜透析管需要固定的位置将弹性抓捕器导入腹腔。导引鞘芯与导引鞘配合使用，其前端有锥形结构，用于扩张腹腔壁穿刺孔；其中心有贯穿孔腔，便于穿丝导丝通过，以便定向扩张腹腔壁。弹性抓捕器，使用弹性金属丝制成，具有进行大变形后恢复原状的能力，其与导引鞘配合使用。本装置可以应用于腹膜透析置管术，安全有效的对腹膜透析导管进行固定。本装置与腹腔穿刺套件配合使用，穿刺套件为临床常用器械，常由穿刺针和穿刺导丝组成。
下面结合附图对本发明进行说明：
本实施例中公开的腹膜透析置管固定装置至少包括3个部分：导引鞘101、导引鞘芯102、弹性抓捕器103。
如图1所示，所述的导引鞘101为一薄壁空腔型导引装置，其用于在腹膜透析管需要固定的位置将弹性抓捕器103导入腹腔。进一步的，在本实施例中为了方便操作，在导引鞘101的尾部还设有凸起。其需要进一步说明的是，此处的薄壁没有特指某大小的厚度，其厚度只要满足操作需要即可。
如图1所示，所述的导引鞘芯102，其前端有锥形结构，用于扩张腹腔壁穿刺孔；导引鞘芯102与导引鞘101配合使用，且沿着导引鞘芯102的轴线方向，在导引鞘芯102的中心有一Φ1.0mm左右的贯穿孔腔，该孔腔便于穿刺导丝通过，以便定向扩张腹腔壁。进一步的，在本实施例中为了对导引鞘芯102在导引鞘101内的位置进行限位，在导引鞘芯102的尾部也设有凸起，当该凸起的头部与导引鞘101的尾部接触时，表示导引鞘芯102穿刺到位。
此外，需要说明的是，导引鞘芯102中心的贯穿孔腔直径根据穿刺导丝的直径进行设置，不限于本实施例中公开的Φ1.0mm。
如图2所示，本实施例中的弹性抓捕器103为整体式结构，其使用弹性金属丝(镍钛合金丝或其他可以满足基本性能的弹性材料)制成，具有进行大变形后恢复原状的能力。本发明实施例所述弹性抓捕环103由于其弹性特征，与导引鞘101配合使用具有以下能力：
1.其可以被压缩后进入导引鞘101的空腔，通过导引鞘后又可恢复原始形状(如图3所示)；
2.可以在外力辅助下，通过拉成近似直线型，从一端通过导引鞘拉出(如图4所示)。
进一步的，上述的弹性抓捕器103通过弹性金属丝弯曲形成有弹性环1031、回收手柄1032和固定线固定孔1033。所述的弹性环1031位于弹性金属丝中部位置(此处的中部不特指中心位置)，弹性环1031为透析导管提供了一个可通过的腔道，可以在超声或其他现代医学影像手段的指引下将透析导管由弹性环1031中心通过；固定线固定孔1033位于弹性金属丝的一端，其用于固定透析导管固定线；回收手柄1032位于弹性金属丝的另一端，在操作时，可以通过拉扯回收手柄1032将整个弹性抓捕器103从导引鞘内拉出(如图4所示)，并同时将固定线一端绕过透析导管后拉出，从而在撤出该发明装置后通过固定线将透析导管固定在腹腔壁上。
进一步的需要说明的是，上述的弹性环1031并非是一个完全封闭的环，由于其是通过弹性金属丝弯曲形成的，因此无法完全封闭，弯折处具有一定的间隙，且弹性环1031并不一定是圆环，其形状不受限制。
下面对该装置的具体使用过程进行说明：
步骤1：腹膜透析导管置管术中，在透析导管入口附近确定合适的固定位 置,使用腹腔穿刺套件穿刺腹腔壁,置入导丝,撤出穿刺针,如图5(1)所示；
步骤2：将导引鞘芯102插入导引鞘101,将导丝穿入导引鞘芯的孔腔,沿导丝推送:导引鞘芯102,直至导引鞘101前端穿透腹腔壁进入腹腔,撤出导丝和导引鞘芯102；图5(2)所示为导引鞘芯102和导引鞘101前端穿透腹腔壁进入腹腔状态的示意图；
步骤3：压缩弹性抓捕环103,并通过导引鞘101输送至弹性环1031完全进入腹腔并恢复原状，如图5(3)所示。
步骤4：在超声或其他现代医学影像技术的指引下,将透析导管从弹性环1031中心穿过并推送至合适位置；将透析导管固定线(一般为缝合线)的一端或中部固定在固定线固定孔1033上，如图5(4)所示。
步骤5：缓慢拉动回收手柄1032，直至弹性抓捕环103被整体从导引鞘101中拉出,撤出导引鞘101(此时透析导管固定线应保持绕过透析导管且两端留在腹腔壁外),拉紧透析导管固定线并将其在人体合适组织部位处(如肌肉、皮下、腹壁等)打结固定,关闭穿刺孔,完成透析导管固定操作，如图5(5)所示。
需要说明的是本实施例中所用材料需满足生物相容性要求,亦满足在超声或其他现代医学影像系统下显影的能力。
实施例二
本实施例公开了另外一种腹膜透析置管固定装置，该装置中的导引鞘101、导引鞘芯102与实施例一完全相同，在此不进行赘述了，其与实施例一的不同点主要在于弹性抓捕器的结构不同，具体如下：
本实施例中公开与导引鞘101配合的装置弹性抓捕器为分体式结构，其包括两部分，分别是第一弹性抓捕件203、第二弹性抓捕件204；第一弹性抓捕件 203、第二弹性抓捕件204均使用弹性金属丝(镍钛合金丝或其他可以满足基本性能的弹性材料)制成，且也具有进行大变形后恢复原状的能力,其与导引鞘101配合使用后，具有以下能力：
1.其可以被压缩后进入导引鞘101的空腔，通过导引鞘后又可恢复原始形状；
2.可以在外力辅助下，通过拉成近似直线型，从一端通过导引鞘拉出。
进一步的，上述的第一弹性抓捕件203包括磁铁2033以及由弹性金属丝弯折形成的第一弹性半环2031和回收手柄2032；其中第一弹性半环第一弹性半环2031形成于弹性金属丝的一端，回收手柄2032形成于弹性金属丝的另一端，磁铁2033位于第一弹性半环2031上。进一步的，本实施例中第一弹性半环2031的弧度大于半圆的弧度，这么设计的目的是可以通过操作调整第一弹性半环的2031位置主动将透析导管抓捕进入，第一弹性半环2031的内部空间结构为透析导管的通过腔道，可以在超声或其他现代医学影像手段的指引下将透析导管由第一弹性半环2031中心通过,或在超声或其他现代医学影像手段的指引下操作回收手柄将透析导管抓捕进入其环形内部；回收手柄2032用于撤回第一弹性抓捕件203和第二弹性抓捕件204；磁铁2033用于连接第一弹性抓捕件203和第二弹性抓捕件204。
进一步的，所述的第二弹性抓捕件204包括磁铁2043以及由弹性金属丝弯折形成的第二弹性半环2041和固定线固定孔2042,其中第二弹性半环2041形成于弹性金属丝的一端，固定线固定孔2042形成于弹性金属丝的另一端，磁铁2043位于第一第二弹性半环2041上；其中第二弹性半环2041的弧度小于半圆的弧度，第二弹性半环2041可以通过磁铁2043、磁铁2033与第一弹性半环2031 组合为一非封闭状的圆环,该圆环可容纳透析导管；所述的固定线固定孔2042用于固定透析导管固定线。
需要说明的是，在其他实施例中，第一弹性半环2031和第二弹性抓捕件204圆环弧度还可以设计成第二弹性抓捕件204的弧度大于半圆的弧度，第一弹性半环2041的弧度小于半圆的弧度。
进一步的，磁铁2033与磁铁2043配合使用将第一弹性抓捕件203和第二弹性抓捕件204组合为一个整体形成弹性抓捕器,二者之间的磁力可以满足通过拉扯回收手柄2032将第一弹性抓捕件203和第二弹性抓捕件204组合体从导引鞘内拉出。
本实施例方案公开的装置，其具体使用操作过程如下：
步骤1：腹膜透析导管置管术中，在透析导管入口附近确定合适的固定位置,使用腹腔穿刺套件穿刺腹腔壁,置入导丝,撤出穿刺针,如图5(1)所示；
步骤2：将导引鞘芯102插入导引鞘101,将导丝穿入导引鞘芯的孔腔,沿导丝推送导引鞘芯102,直至导引鞘101前端穿透腹腔壁进入腹腔,撤出导丝和导引鞘芯102,如图5(2)所示；
步骤3：压缩第一弹性抓捕件203,并通过导引鞘101输送至第一弹性半环2031完全进入腹腔并恢复原状；
步骤4：在超声或其他现代医学影像技术的指引下,将透析导管从第一弹性半环2031中心穿过并推送至合适位置；或在超声或其他现代医学影像手段的指引下操作回收手柄将透析导管抓捕进入第一弹性半环2031内部,如图7(1)所示；
步骤5：压缩第二弹性抓捕件204,并通过导引鞘101输送至第二弹性半环2041完全进入腹腔并恢复原状；调整压缩第二弹性抓捕件204位置,使磁铁2033 与磁铁2043相互结合；将透析导管固定线(一般为缝合线)固定在固定线固定孔2042上,如图7(2)所示；
步骤6：缓慢拉动回收手柄2032，直至第一弹性抓捕件203和第二弹性抓捕件204组合体被整体从导引鞘101中拉出,撤出导引鞘101(此时透析导管固定线应保持绕过透析导管且两端留在腹腔壁外),拉紧透析导管固定线并将其在腹腔壁上打结固定,关闭穿刺孔,完成透析导管固定操作,如图5(5)所示。
本发明实施例所用材料需满足生物相容性要求,亦满足在超声或其他现代医学影像系统下显影的能力。
本发明实施例所用示意图仅用于示意,实际实现方案外形可以与示意图有差别，第一弹性半环2031、第二弹性半环2041亦可以为矩形、多边形等空间外形,能实现上述功能即可。
实施例三
本实施例与实施例一或者实施二的区别在于：取消固定线固定孔，将弹性抓捕器直接作为固定线固定透析导管，其他结构与实施例一或者实施二完全相同，在此不进行赘述了。
本实施例所用材料需满足可植入级生物相容性要求,亦满足在超声或其他现代医学影像系统下显影的能力。
实施例四
本实施例与实施例一或者实施二的区别在于：同时取消固定线固定孔和回收手柄，将弹性抓捕器的一端直接作为固定线固定透析导管，另一端直接作为手柄握持，其他结构与实施例一或者实施二完全相同，在此不进行赘述了。
本实施例所用材料需满足可植入级生物相容性要求,亦满足在超声或其他 现代医学影像系统下显影的能力。
实施例五
本实施例与实施例二的区别在于：第一弹性抓捕件203和第二弹性抓捕件204上不设置磁铁,二者之间设置有可以可靠连接并可分离的机械结构,例如活动卡扣结构、套环结构、挂扣结构，等可行结构，其余结构与实施例二、或者实施例三、实施例四完全相同。
本实施例所用材料需满足生物相容性要求,亦满足在超声或其他现代医学影像系统下显影的能力。
综上所述，本实施例中公开的弹性抓捕器可以是整体式也可以是分体式，其可以实现下述功能：
1.通过导引鞘输送入腹腔内后，可以展开并呈现出环形或其他空间结构，其内部可以容纳透析导管通过；
2.可以在超声或其他现代医学影像手段的指引下将透析导管由其中心通过，或呈分体式时可以通过操作调整其位置主动将透析导管抓捕进入其内部空间结构；
3.可以在一端固定透析导管固定线，可以通过拉扯另一端将其整体从导引鞘内拉出并同时导引透析导管固定线，将固定线绕过透析导管后一端拉出导引鞘，从而在撤出弹性抓捕环后可以通过固定线将透析导管固定在腹腔壁上；
4.当该抓捕器为整体式时，亦可以直接作为固定装置固定透析导管；
5.当该抓捕器为分体式时二者之间设置有可以可靠连接并可分离的结构,例如磁性连接、活动卡扣结构、套环结构、挂扣结构，等可行结构。
需要说明的是，本发实施例中公开的装置与腹腔穿刺套件配合使用，可在 正常状态、人造腹水、气腹等状态下使用，也可用于植入类医疗器械在人体脏器内短期或长期固定。
此外，需要特别说的是，上述的五个实施例中公开的技术方案，并非相互排斥，其可以在同一个腹膜手术中，同时采用上述的多种装置或者任一种、或者任两种装置、或者任三种装置等对腹膜透析导管同时进行固定。
最后还需要说明的是，诸如第一和第二之类的关系术语仅仅用来将一个实体或者操作与另一实体或操作区分开来，而不一定要求或者暗示这些实体或操作之间存在任何这种实际的关系或者顺序。
以上所述仅为本发明的优选实施例而已，并不用于限制本发明，对于本领域的技术人员来说，本发明可以有各种更改和变化。凡在本发明的精神和原则之内，所作的任何修改、等同替换、改进等，均应包含在本发明的保护范围之内。

Claims (10)

  1. 一种腹膜透析置管固定装置，其特征在于，包括：
    导引鞘，其为空腔型导引件；
    导引鞘芯，其前端为锥形结构，用于插入到导引鞘内扩张腹腔壁穿刺孔，沿着导引鞘芯的轴线方向，在其中心设有贯穿孔腔；
    弹性抓捕器，其包括由弹性丝弯曲制作形成的弹性环，所述的弹性环位于弹性丝的中部，其用于穿过导引鞘固定透析导管，且弹性丝的两端用于设置在导引鞘外，其一端用于固定透析导管固定线，另一端作为握持部。
  2. 如权利要求1所述的腹膜透析置管固定装置，其特征在于，弹性丝的握持部设有手柄。
  3. 如权利要求1所述的腹膜透析置管固定装置，其特征在于，弹性丝中用于固定透析导管固定线的一端设有固定孔。
  4. 如权利要求1所述的腹膜透析置管固定装置，其特征在于，所述的弹性抓捕器为分体结构。
  5. 如权利要求4所述的腹膜透析置管固定装置，其特征在于，所述的弹性抓捕器包括第一弹性抓捕件和第二弹性抓捕件，所述的第一弹性抓捕件的一端设有第一弹性半环，第二弹性抓捕件的一端设有第二弹性半环，第一弹性半环和第二弹性半环连接在一起形成弹性环。
  6. 如权利要求5所述的腹膜透析置管固定装置，其特征在于，所述的第一弹性抓捕件的另一端设有手柄。
  7. 如权利要求5所述的腹膜透析置管固定装置，其特征在于，所述的第二弹性抓捕件的另一端设有固定孔。
  8. 如权利要求5所述的腹膜透析置管固定装置，其特征在于，所述第一弹 性半环或第二弹性半环可通过操作调整其位置主动将透析导管抓捕进入其内部空间结构。
  9. 如权利要求5所述的腹膜透析置管固定装置，其特征在于，第一弹性半环或第二弹性半环的弧度大于半圆的弧度。
  10. 如权利要求1所述的腹膜透析置管固定装置，其特征在于，所述的弹性抓捕器使用弹性金属丝制作。
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