CN102599943B - Medical shunt device for portal hypertension - Google Patents

Abstract

A medical shunt device for portal hypertension mainly consists of a shunt device, a catheter and a catheter connecting part. The shunt device consists of a bottom support, an upper cover and a silicon cushion; the bottom support is a circular structure, and a hollow boss is arranged in the bottom support; two catheter holes are arranged on the wall of the boss; a plurality of fixing holes are arranged on the lower portion of the bottom support; the upper cover is arranged on the upper portion of the boss; a middle hole is arranged on the upper cover; the silicon cushion consists of an upper small circular truncated cone and a lower large circular truncated cone; the small circular truncated cone can be embedded in the middle hole of the upper cover; the small circular truncated cone of the silicon cushion can be embedded in the middle hole of the upper cover from the lower portion of the upper cover; and the lower edge of the large circular truncated cone of the silicon cushion is higher than the catheter holes, and a cavity is formed in the boss. One end of the catheter connecting part is fixedly connected with the catheter holes in the shunt device; and the other end of the catheter connecting part is connected with the catheter. A plurality of side holes are arranged at one end of the catheter so as to prevent thrombus. A complex TIPS (transjugular intrahepatic portosystemic shunt) intervention means is changed into simple and feasible percutaneous puncture technology, surgery time is shortened, and burden on a patient is relieved.

Description

A kind of medical portal hypertension part flow arrangement

Technical field

The invention belongs to technical field of medical instruments, refer to especially a kind of medical portal hypertension part flow arrangement.

Background technology

Later period of hepatocarcinoma patient is most can be with hepatocirrhosis symptoms.In cirrhosis, liver function, lose the compensatory phase and often show as portal hypertension: i.e. esophagus, Therapy for Gastric Variceal massive hemorrhage, intractable ascites pleural fluid repeatedly, seriously jeopardizes patient's life.

At present, the common method for the treatment of above-mentioned portal hypertension is the mode that adopts TIPS intervene operation, its method is: adopt seal wire, microcatheter technology, in liver, between portal vein and hepatic vein, insert metal rack, set up a split channel, to reduce pylic pressure, thereby prevent and reduce the probability of a series of complication such as digestive tract hemorrhage that caused by portal hypertension.

But TIPS intervene operation is the technology of the most difficult in periphery intervention and risk maximum, reason is will be in liver before inserting metal rack, will to liver cirrhosis region, puncture with puncture needle between portal vein and vein, forms path and could further put into support and set up expansion path after puncture.In this process, first, puncture needle will enter in body by conduit, and from jugular vein to hepatic portal vein, path in vivo can be through atrium, and in art, danger is high; Secondly, because patient's degree of cirrhosis is generally all very high, the operation puncturing time is generally all very long, causes the whole operation process also can be very long; Moreover a whole set of operation need to be used a large amount of medical apparatus and instruments, surgery cost is high, and a general operation gets off to spend ten thousand yuan of 3-4.Because difficulty, the risk and cost of TIPS intervene operation are all larger, so the hospital that can carry out at home this technology seldom.

Summary of the invention

The object of the present invention is to provide a kind of medical portal hypertension part flow arrangement.

Technical scheme of the present invention is:

A portal hypertension part flow arrangement, it mainly consists of diverter and conduit and pipe joint element, it is characterized in that: described diverter, is comprised of collet, upper cover, silicagel pad; Wherein,

Described collet is a circular configuration, is provided with the boss of hollow in it; Boss wall is provided with 2 guide holes; In the bottom of collet, be provided with several fixing holes;

Top at boss is provided with upper cover; On be covered with mesopore;

Described silicagel pad is to consist of the large round platform of the little round platform in top and bottom; And little round platform can embed in the mesopore of upper cover; The little round platform of silicagel pad is to embed the mesopore of upper cover from the bottom of upper cover; The lower edge part of the large round platform of silicagel pad, higher than guide hole, forms an empty chamber in boss;

Guide hole Joint in one end of described pipe joint element and diverter; The other end of pipe joint element is connected with conduit.

In one end of conduit, be provided with several side openings, to prevent from forming thrombosis.

Described conduit or pipe joint element, can adopt metal tube or medical macromolecular materials.

Described conduit or pipe joint element diameter are to determine according to required shunt volume, and the size of conduit or pipe joint element diameter and shunt volume is proportional.

The invention has the advantages that: the present invention has reduced the risk of operation: complicated TIPS is got involved to maneuver, become the skin puncture technology of simple possible; Shortened operating time: due to the step of having avoided liver cirrhosis position to puncture, therefore simplified operating procedure, shortened the time in art; Make patient save surgery cost: it is only achievable operation with a small amount of apparatus that a large amount of apparatuses of use are changed into, therefore saved patient's quality cost, has alleviated patient burden.

Accompanying drawing explanation

Fig. 1 is the perspective view of portal hypertension part flow arrangement of the present invention.

Fig. 2 is the top view of portal hypertension part flow arrangement in the present invention.

Fig. 3 is collet perspective view in portal hypertension diverter of the present invention.

Fig. 4 is superstructure schematic diagram in portal hypertension diverter of the present invention.

Fig. 5 is silicagel pad structural representation in portal hypertension diverter of the present invention.

Fig. 6 is guide-tube structure schematic diagram in the present invention.

Fig. 7 is the section structure schematic diagram of portal hypertension diverter in the present invention.

Fig. 8 is another section structure schematic diagram of portal hypertension diverter in the present invention.

Fig. 9 is the schematic diagram of conduit in human body portal vein and vein place puncture enforcement portal hypertension part flow arrangement of the present invention.

Attached number in the figure:

Diverter 1,collet 11,upper cover 12,silicagel pad 13,boss 14,guide hole 15,15 ',fixing hole 16,mesopore 17,roundlet platform 18,large round platform 19,empty chamber 20;

Conduit 2,2 ',side opening 21,21 '; Pipejoint element 22,22 '.

The specific embodiment

Below just in conjunction with Figure of description and embodiment, the invention will be further described.

As shown in Figure 1,2,3, 4, portal hypertension part flow arrangement of the present invention, it mainly bydiverter 1 andconduit 2,2 ' andpipe joint element 22,22 ' form.Describeddiverter 1, is comprised ofcollet 11,upper cover 12,silicagel pad 13; Wherein,

Describedcollet 11 is a circular configuration, is provided with theboss 14 of hollow in it;Boss 14 walls are provided with 2guide holes 15,15 '; In the bottom ofcollet 11, be provided with 4fixing holes 16;

On the top ofboss 14, be provided withupper cover 12;Upper cover 12 is provided withmesopore 17;

Describedsilicagel pad 13 is to consist of thelarge round platform 19 oftop roundlet platform 18 and bottom; Androundlet platform 18 can embed in themesopore 17 ofupper cover 12; Theroundlet platform 18 ofsilicagel pad 13 is to embed themesopore 17 ofupper cover 12 from the bottom ofupper cover 12; The lower edge part of the largeround platform 19 ofsilicagel pad 13 is higher thanguide hole 15, inempty chamber 20 of the interior formation ofboss 14;

Describedpipe joint element 22, one end of 22 ' respectively withdiverter 1 inguide hole 15,15 ' Joint; Pipejoint element 22,22 ' the other end are connected withconduit 2,2 ' respectively; Inconduit 2, one end of 2 ', be provided withseveral side openings 21,21 '.

Describedconduit 2,2 ' or pipejoint element 22,22 ', adopts metal tube.

When application portal hypertension part flow arrangement of the present invention is treated operation, can be different according to the pressure at the difference of patient's hepatocirrhosis symptoms and portal vein place, and need to select theconduit 2,2 ' in the portal hypertension part flow arrangement of different technologies parameter, shunt.

According to the parameter of patient's self Portal Blood Flow and portal vein internal diameter, select the size ofconduit 2,2' diameter.Conduit 2,2 ' diameter carry out calculative determination according to the size of required shunt volume.Known: Portal Blood Flow: L₀=800～900ml/min;

Portal vein pressure: P=12～24cmHg;

Portal vein internal diameter: d₀=10.7mm;

Portal Blood flow velocity: V0=0.145m/s;

Suppose: blood flow speed V1=V0=0.145m/s in diverter;

:

it is required conduit diameter

(1), shunting L₁during=200ml blood, need conduit diameter:

d₁＝(200/800)×10.7mm＝2.7mm；

(2), shunting L₁during=300ml blood, need conduit diameter:

d₁＝(300/800)×10.7mm＝4mm；

(3), shunting L₁during=400ml blood, need conduit diameter:

d₁＝(400/800)×10.7mm＝5.35mm；

Under portal hypertension: diverter internal pressure P2 > P=12～24cmHg;

Blood flow speed V2 > V0=0.145m/s in diverter;

:

it is required conduit diameter

(1), shunting L₂during=200ml blood, need conduit diameter:

d₂＜(200/800)×10.7mm＝2.7mm；

(2), shunting L₂during=300ml blood, need conduit diameter:

d₂＜(300/800)×10.7mm＝4mm；

(3), shunting L₂during=400ml blood, need conduit diameter:

d₂＜(400/800)×10.7mm＝5.35mm。

Known patient's condition: Portal Blood Flow is 800-900ml/min, portal vein internal diameter is 10.7mm, according to required shunt volume, calculates acquired results, shown in list 1:

[table 1]

Embodiment	Shunt volume (ml)	Conduit diameter (mm)
			Embodiment 1	100	1.34
Embodiment 2	200	2.68
			Embodiment 3	300	4.00
Embodiment 4	400	5.35
			Embodiment 5	500	6.69
Embodiment 6	600	8.02
			Embodiment 7	700	9.36
Embodiment 8	800	10.70

According to the above results, can find out, the size ofconduit 2,2 ' diameter and shunt volume is proportional.In conjunction with actual shunt volume analysis, can preferredembodiment 2,3,4 be most preferred embodiment,conduit 2,2 ' diameter be best in scope between 2.68mm-5.35mm.

The present invention is when carrying out portal hypertension shunt operation in application, first at vein and portal vein, carries out percutaneous puncture respectively; And be detained respectively punctureconduit 2,2 ', then respectively tworoot puncture conduits 2,2 ' the other end be connected onportal hypertension diverter 1; Thereby form an external path, finallyportal hypertension diverter 1 is fixedly inserted subcutaneous, operation complete.Visible, apply portal hypertension part flow arrangement of the present invention, can abandon traditional method of making in vivo path, and become, form in vitro path, realize the technology of shunting, it has not only alleviated patient's misery, has also alleviated patient's burden.

Claims (4)

1. a portal hypertension part flow arrangement, it mainly consists of diverter and conduit and pipe joint element, it is characterized in that: described diverter, is comprised of collet, upper cover, silicagel pad; Wherein,

Described collet is a circular configuration, is provided with the boss of hollow in it; Boss wall is provided with 2 guide holes; In the bottom of collet, be provided with several fixing holes;

Top at boss is provided with upper cover; On be covered with mesopore;

Described silicagel pad is to consist of the large round platform of the little round platform in top and bottom; And little round platform can embed in the mesopore of upper cover; The little round platform of silicagel pad is to embed the mesopore of upper cover from the bottom of upper cover; The lower edge part of the large round platform of silicagel pad, higher than guide hole, forms an empty chamber in boss;

Guide hole Joint in one end of described pipe joint element and diverter; The other end of pipe joint element is connected with conduit.

2. portal hypertension part flow arrangement according to claim 1, is characterized in that: in one end of described conduit, be provided with several side openings, to prevent from forming thrombosis.

3. portal hypertension part flow arrangement according to claim 1, is characterized in that: described conduit or pipe joint element, can adopt metal tube or medical macromolecular materials.

4. portal hypertension part flow arrangement according to claim 1, is characterized in that: described conduit or pipe joint element diameter are to determine according to required shunt volume, and the size of conduit or pipe joint element diameter and shunt volume is proportional.

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