技术领域technical field
本发明涉及一种小肠镜引导装置，特别涉及一种能够在放射线下能够显影的小肠镜引导装置，该装置能够在放射线下清楚观察小肠管的走行，并可被拉入小肠镜活检孔道用以引导小肠镜检查的完成，且操作简单易行，使小肠镜技术难度大大降低，提高了小肠镜检查的水平和成功率。The present invention relates to a guide device for small intestine, in particular to a guide device for small intestine that can be visualized under radiation. It guides the completion of the small intestine endoscopic examination, and the operation is simple and easy, so that the technical difficulty of the small intestine endoscopy is greatly reduced, and the level and success rate of the small intestine endoscopic examination are improved.
背景技术Background technique
小肠是人体消化系统中最长的器官，成人全长约5～7米，占消化道全长的75％。小肠上端连接胃幽门，下端在右髂窝与结肠相接，可分为十二指肠、空肠和回肠三部分。由于小肠长而游离、走形迂曲重叠、处于身体较深部位，且远离口腔和肛门，小肠疾病的诊治一直是消化科医生的难题。在过去很长一段时间内，小肠远落后于胃肠道其他部位疾病的诊断。The small intestine is the longest organ in the human digestive system, with a total length of about 5-7 meters in adults, accounting for 75% of the total length of the digestive tract. The upper end of the small intestine connects to the gastric pylorus, and the lower end connects to the colon in the right iliac fossa, and can be divided into three parts: the duodenum, jejunum, and ileum. Because the small intestine is long and free, twists and turns and overlaps, is located in the deep part of the body, and is far away from the mouth and anus, the diagnosis and treatment of small intestine diseases has always been a difficult problem for gastroenterologists. For a long time in the past, the small intestine has lagged far behind in the diagnosis of diseases in other parts of the gastrointestinal tract.
小肠镜的研制及临床应用始于20世纪70年代，传统的小肠镜只能观察近侧段空肠及末端回肠，医学专家们曾尝试各种方法，但远端空肠及回肠的观察仍不能令人满意。1999年，以色列Given公司研制成功了世界上第一个可吞咽的胶囊内镜，可以对全消化道进行摄像，对小肠疾病的检出率较其他传统方法高，其无创性、无交叉感染易为病人所接受。但有其局限性,如胶囊的移动不可控制,肠道内积液可能影响对病变的观察,不能取活检行病理检查以明确病灶性质。2002年，学者山本博德与富士写真光机株式会社共同研制出双气囊电子小肠镜。它的问世与应用，将小肠疾病的诊断和治疗提升到一个全新高度。但现有小肠镜操作技术复杂，一次性检查可窥见全部小肠的几率极低，许多病人需经双侧进镜仍无法检查完全部小肠。The development and clinical application of enteroscopy began in the 1970s. Traditional enteroscopy can only observe the proximal jejunum and terminal ileum. Medical experts have tried various methods, but the observation of the distal jejunum and ileum is still not satisfactory. satisfy. In 1999, the Israeli company Given successfully developed the world's first swallowable capsule endoscope, which can take pictures of the entire digestive tract and has a higher detection rate of small intestinal diseases than other traditional methods. It is non-invasive and free from cross-infection. accepted by the patient. However, it has its limitations, such as uncontrollable movement of the capsule, accumulation of fluid in the intestine may affect the observation of the lesion, and biopsy cannot be taken for pathological examination to clarify the nature of the lesion. In 2002, scholar Yamamoto Hirode and Fuji Photo Photonics Co., Ltd. jointly developed a double-balloon electronic enteroscope. Its appearance and application have raised the diagnosis and treatment of small intestinal diseases to a new level. However, the operation technique of the existing enteroscopy is complicated, and the probability of seeing the entire small intestine in one-time inspection is extremely low. Many patients still cannot inspect the entire small intestine through bilateral endoscopy.
我们的通过对尸体解剖研究发现，人体小肠走行存在非常大的变异，如果对小肠的走行不够了解进镜的过程中极易成袢，因而能够经口完成全小肠检查的成功率不高，且与胃镜、结肠镜检查比较，因小肠走行及结构变异极大，医生在检查前及检查中均无法预知小肠的走行，术中亦无法知道内镜距回盲瓣的距离，因此存在极大的盲目性。Our research on autopsy found that there are great variations in the course of the human small intestine. If you do not know enough about the course of the small intestine, it is easy to form a loop during the process of entering the microscope. Therefore, the success rate of the whole small intestine examination through the mouth is not high, and Compared with gastroscopy and colonoscopy, the course and structure of the small intestine vary greatly, and doctors cannot predict the course of the small intestine before and during the examination, nor can they know the distance between the endoscope and the ileocecal valve during the operation, so there is a huge risk. blindness.
因此如何预知肠管的走行并指导小肠镜的进镜方向，提高小肠镜的检查效率和成功率是医学界所面临的难题。本研究意在发明一种利用肠道蠕动功能自行通过小肠，在放射线下可清楚显示小肠走行，而且可被拉入小肠镜活检孔道用以引导小肠镜检查的导丝装置。Therefore, how to predict the course of the intestinal tube and guide the direction of entry of the enteroscope to improve the efficiency and success rate of the enteroscope is a difficult problem for the medical community. This study intends to invent a guide wire device that uses the function of intestinal peristalsis to pass through the small intestine by itself, which can clearly show the course of the small intestine under radiation, and can be pulled into the biopsy hole of the enteroscope to guide the enteroscopy.
发明内容Contents of the invention
为解决上述技术问题，本发明的目的在于：提供一种放射线下能够显影的小肠镜引导装置，该装置能够在放射线下清楚观察小肠管的走行，并作为小肠镜的导丝引导进镜方向，提高小肠镜的检查效率和成功率。In order to solve the above-mentioned technical problems, the object of the present invention is to provide a guiding device for enteroscope that can be developed under radiation, which can clearly observe the course of the small intestine tube under radiation, and can be used as a guide wire of enteroscope to guide the direction of the enteroscope. Improve the efficiency and success rate of small intestine endoscopy.
为实现上述目的，本发明所采用的技术方案是：一种放射线下能够显影的小肠镜引导装置，其包括一柔软光滑的导丝，该导丝的前端设有一引导体，该导丝的后端分叉形成第一分叉丝和第二分叉丝，该第一分叉丝连接一能够用注射针注气的气囊，该第二分叉丝的末端设有一用于连接外接丝线的连接结构。In order to achieve the above object, the technical solution adopted by the present invention is: a small enteroscope guiding device that can be developed under radiation, which includes a soft and smooth guide wire, the front end of the guide wire is provided with a guide body, and the rear end of the guide wire The end is bifurcated to form a first bifurcated wire and a second bifurcated wire, the first bifurcated wire is connected to a balloon that can be inflated with an injection needle, and the end of the second bifurcated wire is provided with a connection for connecting an external wire structure.
所述的放射线下能够显影的小肠镜引导装置，该导丝由含有能够在放射线下显影的重金属材质制成；该导丝上设有刻度标记；该导丝的长为4-6m，该导丝的直径为0.6-1.2mm。The enteroscope guiding device that can be developed under radiation, the guide wire is made of heavy metal material that can be developed under radiation; the guide wire is provided with scale marks; the length of the guide wire is 4-6m, the guide wire The diameter of the wire is 0.6-1.2 mm.
所述的放射线下能够显影的小肠镜引导装置，该引导体由含有能够在放射线下显影的重金属材质制成，该引导体最大径向尺寸为8-12mm。In the enteroscope guiding device capable of developing under radiation, the guiding body is made of heavy metal material capable of developing under radiation, and the maximum radial dimension of the guiding body is 8-12mm.
所述的放射线下能够显影的小肠镜引导装置，该气囊由无弹性的硅胶或乳胶材质制成，该气囊具有一充气塞，该充气塞由具有自密闭功能的高分子弹性材料制成，该气囊常态下为未充气状态，该气囊充气后直径为30-60mm。The enteroscope guiding device capable of developing under radiation, the air bag is made of inelastic silica gel or latex material, and the air bag has an inflatable plug made of polymer elastic material with self-sealing function. The airbag is in an uninflated state under normal conditions, and the diameter of the airbag after inflation is 30-60mm.
所述的放射线下能够显影的小肠镜引导装置，该引导体为圆形、方形或椭圆形。In the enteroscope guiding device that can be developed under radiation, the guiding body is circular, square or elliptical.
与现有技术相比，采用上述技术方案的本发明的优点在于：Compared with prior art, the advantage of the present invention adopting above-mentioned technical scheme is:
1)该装置所具有的软体导丝能够在显微镜下显影，解决了小肠镜操作中对小肠走行不了解、进镜方向不可预知、小肠镜检查完成程度无法判断所导致操作不成功的难题。1) The soft guide wire of the device can be visualized under a microscope, which solves the problems of unsuccessful operation caused by ignorance of the course of the small intestine, unpredictable direction of entry, and inability to judge the degree of completion of enteroscopy.
2)该装置从概念上更改了传统小肠镜操作的思路，导丝装置可经活检孔道引导小肠镜检查，使操作简单易行；2) The device has conceptually changed the idea of traditional enteroscopy operation, and the guide wire device can guide the enteroscopy through the biopsy channel, making the operation simple and easy;
3)提高了经口或经肛完成全小肠镜检查的成功率和效率，不再只有经验丰富内镜医生实施检查，使年轻医生快速熟练掌握相关技术，从而提高疾病诊疗及治疗水平。3) Improve the success rate and efficiency of complete enteroscopy through the mouth or through the anus. It is no longer only experienced endoscopists who perform inspections, so that young doctors can quickly master relevant technologies, thereby improving the level of disease diagnosis and treatment.
附图说明Description of drawings
图1为本发明使用状态下的示意图。Fig. 1 is a schematic diagram of the present invention in use.
附图标记说明：1-导丝；2-引导体；3-气囊；4-注射针；5-外接丝线；6-刻度标记；7-连接结构；8-第一分叉丝；9-充气塞；10-高密度胶塞；11-充气塞外壁；12-注射针针芯；13-注射针外套管；14-第二分叉丝。Explanation of reference numerals: 1-guide wire; 2-guiding body; 3-air bag; 4-injection needle; 5-external wire; 6-scale mark; 7-connection structure; Plug; 10-high-density rubber plug; 11-outer wall of inflatable plug; 12-injection needle core; 13-injection needle outer sleeve; 14-second bifurcated wire.
具体实施方式detailed description
下面结合具体实施例和附图来进一步描述本发明，本发明的优点和特点将会随着描述而更为清楚。The present invention will be further described below in combination with specific embodiments and accompanying drawings, and the advantages and characteristics of the present invention will become clearer along with the description.
如图1所示，为本发明一种放射线下能够显影的小肠镜引导装置的示意图。该装置主要包括：导丝1；引导体2；气囊3；注射针4；外接丝线5。As shown in FIG. 1 , it is a schematic view of a guiding device for enteroscope that can be developed under radiation according to the present invention. The device mainly includes: a guide wire 1; a guide body 2; an air bag 3; an injection needle 4;
该导丝1质地柔软，内含重金属(如钨、钡等)，因而在放射线下可清楚显影；该导丝长4-6m，可贯穿小肠及结肠；该导丝1直径为0.6-1.2mm，表面光滑，可顺利通过小肠镜活检孔道；该导丝1上设有刻度标记6在放射线下也清晰可见；该导丝1的后端分叉形成第一分叉丝8和第二分叉丝14，该第一分叉丝8可通过粘合、捆绑缠绕等方式连接气囊3，第二分叉丝14的末端设有连接结构7，该连接结构7能够与穿过内镜活检孔道的外接丝线5在内镜下连接。The guide wire 1 is soft and contains heavy metals (such as tungsten, barium, etc.), so it can be clearly visualized under radiation; the guide wire is 4-6m long and can penetrate the small intestine and colon; the diameter of the guide wire 1 is 0.6-1.2mm , the surface is smooth, and can pass through the biopsy channel of the enteroscope smoothly; the guide wire 1 is provided with a scale mark 6 that is also clearly visible under radiation; wire 14, the first bifurcated wire 8 can be connected to the balloon 3 by bonding, binding and winding, and the end of the second bifurcated wire 14 is provided with a connecting structure 7, which can be connected with the endoscopic biopsy channel. The external wire 5 is connected under the endoscope.
该引导体2与导丝1通过捆绑缠绕或粘合等方式连接；该引导体2内也含有重金属材质(如钨、钡等)，因此在放射线下可观察其所在位置；引导体2的直径为8-12mm，在本实施案例中，该引导体2为球形，但并不因此限制引导体2的形状，该引导体的形状还可为方形或椭圆形等其他能够通过胃幽门及肠道的形状，该引导体2能够借助小肠的蠕动带动导丝1的前端向肠管远端前进。The guide body 2 is connected with the guide wire 1 by binding, winding or bonding; the guide body 2 also contains heavy metal materials (such as tungsten, barium, etc.), so its position can be observed under radiation; the diameter of the guide body 2 8-12mm. In this embodiment, the guide body 2 is spherical, but the shape of the guide body 2 is not limited. The shape of the guide body can also be square or oval, etc., which can pass through the gastric pylorus and intestinal tract. The shape of the guide body 2 can drive the front end of the guide wire 1 forward to the distal end of the intestinal tube by means of the peristalsis of the small intestine.
该气囊3由无弹性的硅胶或乳胶材质制成，在未充气状态下送入胃腔，在胃内通过注射针4充气，该气囊3充气后与注射针4分离并保持充气状态，该气囊充气后的直径为30-60mm，且气囊3无弹性的特性保证其不会在胃蠕动波下变形越过胃幽门；该气囊3具有一充气塞9结构用以完成注射针4对气囊3的注气；充气塞9由高密度胶塞10和充气塞外壁11组成；高密度胶塞10由高分子弹性材质制成，具有自密封性，使得气囊3在充气后不会漏气；充气塞外壁11向高密度胶塞10气囊内侧延伸，防止注射针4刺破气囊3。The airbag 3 is made of inelastic silica gel or latex material, and is sent into the gastric cavity in an uninflated state, and is inflated through the injection needle 4 in the stomach. After the airbag 3 is inflated, it is separated from the injection needle 4 and remains in an inflated state. The inflated diameter is 30-60mm, and the inelasticity of the airbag 3 ensures that it will not be deformed and cross the gastric pylorus under gastric peristaltic waves; air; the inflatable plug 9 is composed of a high-density rubber plug 10 and an outer wall 11 of the inflatable plug; the high-density rubber plug 10 is made of a polymer elastic material and has self-sealing properties, so that the airbag 3 will not leak after inflating; the outer wall of the inflatable plug 11 extends to the inner side of the high-density rubber stopper 10 airbag to prevent the injection needle 4 from piercing the airbag 3.
该注射针4为目前常规使用的经内镜活检孔道注射针；由注射针针芯12和注射针外套管13组成，两者配合完成注气后脱离。The injection needle 4 is an endoscopic biopsy channel injection needle routinely used at present; it is composed of an injection needle core 12 and an injection needle outer sleeve 13, and the two are separated after completing gas injection.
该外接丝线5为非放射线显影的软体材质，不易拉断且表面光滑，该外接丝线5的直径为0.1-0.5mm，可通过内镜活检孔道与连接结构7连接后再经内镜活检孔道引出，从而引导外接丝线5进入内镜活检孔道。The external thread 5 is made of non-radiographic soft material, which is not easy to break and has a smooth surface. The external thread 5 has a diameter of 0.1-0.5 mm, and can be connected to the connection structure 7 through the endoscopic biopsy channel and then drawn out through the endoscopic biopsy channel. , so as to guide the external wire 5 into the biopsy channel of the endoscope.
下面将具体讲述本发明装置的使用过程。The use process of the device of the present invention will be described in detail below.
步骤一：自口腔置入食管套管，该食管套管能够减轻操作过程中患者的不适感，通过胃镜将导丝1的前端引导体2送入十二指肠降段，继而注射针4通过胃镜活检孔道后插入气囊3的充气塞9，通过胃镜将未充气状态下的气囊3以及剩余导丝1送入胃内，然后用注射针4给气囊3注射气体，使气囊3充气至直径为30-60mm，再通过胃镜活检孔道拔出注射针4。Step 1: Insert an esophageal cannula from the oral cavity. This esophageal cannula can reduce the discomfort of the patient during the operation. The front end guide body 2 of the guide wire 1 is sent into the descending duodenum through the gastroscope, and then the injection needle 4 passes through the Insert the inflation plug 9 of the air bag 3 after the biopsy channel of the gastroscope, send the uninflated air bag 3 and the remaining guide wire 1 into the stomach through the gastroscope, and then use the injection needle 4 to inject gas into the air bag 3 to inflate the air bag 3 to a diameter of 30-60mm, and then pull out the injection needle 4 through the biopsy channel of the gastroscope.
步骤二：患者服用常规导泻剂，利用肠道的蠕动作用，该引导物体2带动导丝1在肠道内向肛门方向前进，此时由于位于导丝1后端的气囊3的直径过大，气囊3会不通过胃幽门，从而固定导丝1的末端连接结构7位于胃内，引导体2经过约四小时自肛门排出，医生在此期间可通过放射线确定引导体2的位置以及导丝1经过的路线，从而使医生在小肠镜检前能够全貌了解小肠的走向和结构。Step 2: The patient takes conventional cathartics and utilizes the peristaltic effect of the intestinal tract. The guiding object 2 drives the guide wire 1 to advance in the direction of the anus in the intestinal tract. 3 will not pass through the gastric pylorus, so that the terminal connection structure 7 of the fixed guide wire 1 is located in the stomach, and the guide body 2 will be discharged from the anus after about four hours. During this period, the doctor can determine the position of the guide body 2 and the passage of the guide wire 1 through radiation. The route, so that the doctor can get a complete picture of the direction and structure of the small intestine before the small intestine endoscopy.
步骤三：小肠镜检查前用一活检钳夹持一外接丝线5的前端经小肠镜的活检孔道引入到胃中，同时保持外接丝线5的后端位于体外，活检钳在胃内将外接丝线5的前端穿过导丝1末端的连接结构7，并再次通过小肠镜的活检孔道引出体外，继而将外接丝线5的前端和后端共同固定在体外。Step 3: Before the enteroscopy, use a biopsy forceps to hold the front end of an external silk thread 5 and introduce it into the stomach through the biopsy channel of the enteroscope, while keeping the rear end of the external silk thread 5 outside the body, and insert the external silk thread 5 in the stomach with biopsy forceps The front end of the external wire 5 passes through the connection structure 7 at the end of the guide wire 1, and is drawn out of the body through the biopsy channel of the enteroscope again, and then the front end and the rear end of the external wire 5 are jointly fixed outside the body.
步骤四：用一锐器通过小肠镜活检孔道刺破气囊3并断开气囊3与导丝1之间的第一分叉丝8，使气囊3与导丝1脱离，气囊3能够经消化道排出体外，此时外接丝线5和导丝1连接为一体，并经口至肛门完整的贯穿整个消化道。小肠镜操作时，向外牵拉外接丝线5使导丝1进入小肠镜活检孔道，导丝1引导小肠镜操作，提高小肠镜检查的效率和成功率，使小肠镜检查这一复杂而难以掌控的操作变得简单易行。Step 4: Use a sharp instrument to puncture the air bag 3 through the biopsy channel of the enteroscope and disconnect the first bifurcation wire 8 between the air bag 3 and the guide wire 1, so that the air bag 3 and the guide wire 1 are separated, and the air bag 3 can pass through the digestive tract Excreted from the body, at this time the external silk thread 5 and the guide wire 1 are connected as a whole, and run through the entire digestive tract from the mouth to the anus. During the operation of the enteroscope, the external silk thread 5 is pulled outward to make the guide wire 1 enter the biopsy hole of the enteroscope, and the guide wire 1 guides the operation of the enteroscope, which improves the efficiency and success rate of the enteroscope examination, making the enteroscopy examination complicated and difficult to control. The operation becomes simple and easy.
本发明采用上述技术方案的优点是：The present invention adopts the advantage of above-mentioned technical scheme to be:
导丝在放射线下清楚显示小肠的完整走行模式，使操作者在术前对每个患者的小肠走行有一个全面的了解；检查过程中可准确判定前端小肠的走行方向；精准判定内镜前端距回盲瓣的距离；最主要的是导丝可进入活检孔道起到引导作用。因此，此专利很大程度上提高了小肠镜操作的成功率和效率，使小肠镜技术难度大大降低，从而使这一高难度技术得到更好地推广，并有可能研制出新型经导丝引导的小肠镜。The guide wire clearly shows the complete running mode of the small intestine under the radiation, so that the operator has a comprehensive understanding of the small intestine running of each patient before the operation; during the inspection process, the running direction of the small intestine at the front end can be accurately determined; the distance between the front end of the endoscope can be accurately determined The distance from the ileocecal valve; the most important thing is that the guide wire can enter the biopsy channel to play a guiding role. Therefore, this patent greatly improves the success rate and efficiency of enteroscopy operation, and greatly reduces the technical difficulty of enteroscopy, so that this difficult technology can be better promoted, and it is possible to develop a new type of guide wire-guided enteroscopy.
以上实施例仅是范例性的，并不对本发明的范围构成任何限制。本领域技术人员应该理解的是，在不偏离本发明的精神和范围下可以对本发明技术方案的细节和形式进行修改或替换，但这些修改和替换均落入本发明的保护范围内。The above embodiments are only exemplary, and do not constitute any limitation to the scope of the present invention. Those skilled in the art should understand that the details and forms of the technical solutions of the present invention can be modified or replaced without departing from the spirit and scope of the present invention, but these modifications and replacements all fall within the protection scope of the present invention.
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| CN201510084570.8ACN104771129B (en) | 2015-02-16 | 2015-02-16 | The enteroscope guide can developed under lonizing radiation |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510084570.8ACN104771129B (en) | 2015-02-16 | 2015-02-16 | The enteroscope guide can developed under lonizing radiation |
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| CN104771129A CN104771129A (en) | 2015-07-15 |
| CN104771129Btrue CN104771129B (en) | 2016-08-24 |
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| CN201510084570.8AExpired - Fee RelatedCN104771129B (en) | 2015-02-16 | 2015-02-16 | The enteroscope guide can developed under lonizing radiation |
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| CN115844734A (en)* | 2023-01-10 | 2023-03-28 | 上海可映康科技有限公司 | Guide wire, guiding device and jejunum fistulization system |
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