A kind of interior cooled microwave conduit and system of monitoring temperature in real timeTechnical field
The invention belongs to medical instruments field, is related to a kind of interior cooled microwave conduit and system of monitoring temperature in real time, canFor treatment tube intracavitary neoplasm.
Background technology
Surgical cavities internal organs primary malignant tumor or primary carcinoma of liver portal vein and inferior caval vein cancer embolus are unable to, is existingThe difficult point and hot spot of modern oncotherapy research field, with whole body chemotherapy, radiotherapy and other appeasing for complicationTreatment is to be unable to the primary treatment regimen of surgery excision tube chamber tumour, but therapeutic effect is extremely limited.Below with several frequently seenTube chamber malignant tumour illustrate the present invention the application prospect and scope of equipment：
The cancer of the esophagus：The cancer of the esophagus is one of lethal cause of disease of major cancers and the eighth-largest most common pernicious swollen in world wideKnurl.Statistics in 2008 shows that annual new cases are 482,300, has 406,800 patients to die of the disease.Operative treatment is early stageThe preferred treatment method of the cancer of the esophagus, 5 years survival rates are 10% to 36%.Most patient has been advanced tumor, only 15-20%Patient can surgery excision.Dysphagia is the cardinal symptom of the cancer of the esophagus, these patients are only capable of receiving palliative treatment.Outer radiotherapy was onceAlleviate cancerous stricture caused by dysphagia main means, but from start treatment to obtain alleviate need compared with long-term therapy treatmentTime, and to life span extension and nonsignificance.The implantation of metallic support can effectively alleviate dysphagia quickly in oesophagusWith quality of making the life better, but tumour stent in recurrence and growth cause once more oesophagus block and dysphagia.
Malignant obstructive jaundice：Malignant obstructive jaundice be upper abdomen is primary or metastatic tumo(u)r is common complication itOne, it is seen that in cholangiocarcinoma, cancer of pancreas, Tumors of Duodenum, stomach cancer, gallbladder cancer, primary carcinoma of liver, portal lymph node metastatic tumor,Diagnosis of hepatic metastases and anastomotic stenosis after surgery etc..Obstructive jaundice can cause liver, kidney, the heart, lung, enteron aisle, immune, blood coagulation etc. almost to containThe infringement of all vitals functions of lid body, and many adverse effects are brought to the postoperative of patient, treatment not in time will jeopardizeThe life of patient.Existing local infiltration when Most patients are made a definite diagnosis, it is impossible to perform the operation, or existing DISTANT METASTASES IN, only 15%-The 20% feasible radical excision of patient.But obstructive jaundice row operative treatment can increase operation risk and it is postoperative simultaneouslySend out disease.The implantation of metallic support can effectively open narrow bile duct quickly, alleviate jaundice, but due to continued tumor growth, oftenObstruction of stent can be caused, cause jaundice to recur, and while stent is put, the growth of tumour is actively controlled, then is to improve to treatThe key of effect.
Stomach cancer：In the whole world, stomach cancer is the 5th Ming , And of cancer pathogenesis and the As the 3rd in Cancer death rate rankingName , Fen Do account for 7% and 9% case number.In 2012, there are 950,000 people morbidity, and 723,000 people is dead.Stomach cancer is most generalProbability all over generation what East Asia and eastern Europe , And and male's morbidity is twice of women.Betide the cancer in gastric antrum pylorus portionIt is swollen that pyloric part can be caused outlet obstructed, seriously affect feed and the nutrition intake of patient.For inoperable patient, radiotherapyLimited with chemotherapeutic efficacy, stenter to implant is the narrow means first led to again, but patient can only feed liquid diet, and stentRestenosis rate is very high.
Colorectal cancer：Colon cancer is the common malignant tumor of digestive tract for betiding colon site, is apt to occur in rectum and secondShape colon intersection, with the ratio between 40~50 years old age group incidence highest, men and women for 2~3:1.In 2012, there are 1,400,000 newlyThe colorectal cancer of diagnosis, and cause 69.4 ten thousand people dead.Early detection can be with surgery excision, but a big chunk patient is sickBecome late period or patient age is larger, concurrent other serious diseases, it is impossible to perform the operation.The palliative treatments such as chemicotherapy are the masters for the treatment ofWant means.Patient for causing intestinal obstruction, colon implanted metal stent can alleviate obstruction, but effect is limited.RectumCancer refers to from dentate line to the cancer between proctosigmoid intersection, is one of most common malignant tumour of alimentary canal.RectumFor cancer because pelvic cavity is goed deep into its position, anatomy relationship is complicated, and operation is not easy thoroughly, and Postoperative recurrent rate is high.Middle and lower rectal carcinoma and anal canalSphincter approaches, and when operation is difficult anus preserving and its function, and preoperative active treatment, which reduces tumour, to be reduced neoplasm staging, carryThe success rate of high tumor resection rate and anus preserving.Middle and lower rectal carcinoma is well suited for controlling in proctoscope direct-view downlink microwave ablationTreat, reduce tumour.
Primary carcinoma of liver inferior caval vein and portal vein tumor thrombus.Hepatocellular carcinoma (hereinafter referred to as liver cancer) is sent out in global malignant tumourSick rate arranges the 6th, and annual new liver cancer case and death have more than 50% generation in China.There is tumour registration ground in ChinaThe latest data in area shows：Onset of liver cancer rate occupies malignant tumour the 4th, and case fatality rate occupies malignant tumour the 3rd.Because early liver cancer facesBed symptom and unobvious, the state of an illness has been progressive stage during 70%~80% patient assessment.At present, the treatment totality prognosis of liver cancer is not stillIt is preferable.Due to the biological characteristics and liver anatomy feature of liver cancer, liver cancer cells easily invade vascular system in liver especiallyPortalsystem, forms portal vein tumor thrombus (portal vein tumor thrombus, PVTT), its incidence of document report is44.2%~62.2%.Once there is PVTT in liver cancer patient, and progression of the disease is rapid, can occur in the short time the inside and outside transfer of liver,Portal hypertension, jaundice, seroperitoneum, Mass median life span are only 2.7 months.PVTT be prognosis in hcc it is main notOne of good factor, occupies important influence in the different clinical staging systems of liver cancer.PVTT invades portal vein scope and is divided into：I type, cancerBolt invades the branch of portal vein of lobe of the liver or hepatic segments；II type, cancer embolus are invaded to left branch of portal vein or right branch；III type, cancer embolus invade toMain portal vein；IV type, cancer embolus are invaded to superior mesenteric vein；Postoperative pathological diagnosis capilary cancer embolus is I0Type.I type cancer embolusFine surgery excision.II type-IV based on non-operative treatment, as portal vein radioactive particle stent, 3 dimensional conformal radiation therapy,Sorafenib treatment, RF ablation, laser ablation and local frost free heat exchanger ablation etc., but therapeutic effect and pay no attention toThink.Primary carcinoma of liver also easily invades inferior caval vein and forms cancer embolus, and cancer embolus obstruction inferior caval vein, causes the organ below obstruction planeExtravasated blood oedema, embolus come off to form most of intrapulmonary transfer and organs transfer, the patient not performed the operation in 1~5 monthIt is dead.For that Operative thrombectomy and there should not be the patient of cavity of resorption vena cava obstruction, led to again with putting radioactive particle vena cave stentVascular treatment is first choice, but more difficult tumor embolus is completely eliminated.
The generally more normal Tissue Blood of tumor tissues supplies more horn of plenty, its temperature capacity is poorer than normal structure, reaches in temperatureTumour cell stops division at 39 DEG C~40 DEG C, DNA of tumor cell can be caused to damage after 41 DEG C~42 DEG C, 45 DEG C~50 DEG C causeThe irreversible damage of tumor tissues, more than the 60 DEG C coagulation necrosis that can cause tumor tissues.It can clinically be used for pipe at presentThe apparatus of intracavitary neoplasm thermal ablation therapy is the Habib Endo HPB bipolar radio frequency conduits of Emcision companies of Britain research and development, itsIt is mainly used for the thermal ablation therapy of bile duct malignant tumour.Its long 1.8m, diameter 8Fr (2.6mm), can be percutaneously through liver approach(percutaneous transhepatic cholangiography, PTC) or through scope approach (endoscopicRetrograde cholangio-pancreatography, ERCP) by 10Fr sheaths by the ring-type of two distance 8mm of catheter tipElectrode is positioned at position where tumour, which can produce the thermal injury zone of length about 25 ± 3mm.This radio frequency ablation catheterSome shortcomings：Cannot monitoring treatment temperature in real time；Two ring electrodes must can be only achieved heat with contact tumor tissue and disappearThe effect melted, ring electrode and normal bile duct tissues contact can cause the non-targeted heating ablation damage of bile duct tissue.
Microwave heat therapeutic/ablation make use of microwave to the fuel factor of biological tissue, pathological tissues is rapidly heated denaturationTo reach therapeutic purposes.The microwave energy that microwave heat therapeutic/ablation is utilized is a kind of high-frequency electromagnetic wave, its frequency betweenBetween 900MHz to 10GH, common frequency is 915MH and two kinds of 2.45GHz.Microwave shrouds the polar molecule in scope, mainTo be the hydrone in tissue, can be with hundred million high speed vibrations of 20-50 per second, molecular friction produces high temperature, and causes local solidificationProperty necrosis, compared to RF ablation, the advantage is that microwave electrodes need not can cause tumor tissues with contact tumor tissueThe rise of interior temperature.Microwave ablation is primarily now used for the treatment of the entity internal organs tumours such as liver cancer, kidney, lung cancer, microwave ablationFor pin in image-guided lower Needle localization in inside tumor, ablation procedure, microwave thermal radiation area produces rapidly 45-100 DEG C of heightTemperature, fast and effeciently can be dehydrated local organization, and tumor tissues produce coagulation necrosis.
There is presently no microwave heat therapeutic/ablation system for treatment tube intracavitary neoplasm.The main problems are as follows：(1) pipe intracavitary neoplasm inhomogeneities in tube wall is grown, and has plenty of eccentricity growth, or only section tubular wall is involved, this is just neededWant microwave ablation electrode to be adjacent to tumour as far as possible, while avoid the damage of normal structure；(2) China scholar once usedThe Habib Endo HPB bipolar radio frequency catheter treatment liver cancer portal vein blood vessel cancer embolus of Emcision companies, but since radio frequency disappearsMelt that electrode is more difficult to be adjacent to tumour, and the damage of normal door vein tube wall, therapeutic effect are dissatisfied, it is therefore desirable to which design is a kind ofThe cancer embolus of Endovascular, can be placed in the range of microwave radiation by unique microwave ablation catheter system, but can keep portal vein orPerson's inferior caval vein it is unobstructed, in order to avoid bring secondary damage to the liver being damaged.(3) treatment temperature should be measurable and controllable, withPrevent the excessive damage for causing normal structure of temperature, this just needs the temperature of the treated tumor tissues of monitoring in time；(4) heat transferEffect is brought rapidly up whole microwave antenna, while microwave antenna also produces ohm heat, duct wall is heated up, high temperature will certainlyConduit system is damaged, while the temperature excessive normal structure that easily leads in non-ablation area is killed, pipe of this point for eccentricity growthIntracavitary neoplasm is significant.According to《People's Republic of China (PRC) pharmaceuticals industry standard microwave heat setting equipment YY 0838-2011》In5.9 require, and the heat setting device and normal structure contact portion temperature for intervening heat setting equipment are no more than 45 DEG C.Therefore, except tumor locus,Tumor free normal structure, the tissue temperature that balloon catheter system intervention path is passed through should not be excessive, in order to avoid cause normalTissue is burnt.
The content of the invention
In view of the above-mentioned problems, the present invention is intended to provide a kind of interior cooled microwave conduit and system of monitoring temperature in real time.ShouldConduit and system can carry out different designs according to the difference of organ where tumour, so that targetedly to different types of swollenKnurl carries out microwave heat therapeutic/ablation.
It is for the technical proposal for solving the technical problem of the invention：
The present invention provides a kind of interior cooled microwave conduit of the real-time monitoring temperature of energy, including conduit, the conduit to include：
The antenna channels of built-in microwave antenna, the catheter wall directly over the antenna channels are embedded with thermocouple temperature probe,Expose to detect temperature the distal end of the thermocouple temperature probe；
For from catheter proximal end injection liquid coolant cooling agent injection channel, the cooling agent injection channel with it is describedThere is interval between antenna channels；And
It is fixedly arranged on the eccentricity sacculus or built-in hydrophilic superslide seal wire and in the silk guide passage of distal openings of distal end of catheter；
When the distal end of catheter is installed with eccentricity sacculus, the cooling agent injection channel and antenna channels pass through in distal endAn opening is set to be communicated with eccentricity sacculus respectively, the end at the interval is between two openings；
When the conduit has silk guide passage, the distal end of the hydrophilic superslide seal wire is remote with that can protrude from silk guide passageEnd opening is into the soft section of loop, and the end of the hydrophilic superslide seal wire is fixed in catheter tip side wall, the distal end at the intervalWith opening.
Further, the eccentricity sacculus is fixedly arranged on distal end of catheter by thermal weld or laser welding.
Further, the microwave antenna includes inner wire and wraps the outer conductor outside inner wire, it is described in leadBody has 10-30mm to stretch out outer conductor in microwave antenna distal end.
Further, the conduit realizes interior cooling by liquid coolant, and the distal end of catheter is installed with eccentricity ballDuring capsule, after the liquid coolant enters cooling agent injection channel, flowed out from the opening of cooling agent injection channel distal end, expansion is inclinedDisposition sacculus, then flowed into from the opening of antenna channels distal end, flows through antenna channels cooled microwave antenna, finally from being opened in antennaThe outlet outflow of passage near-end；When the conduit has silk guide passage, the liquid coolant is flowed by cooling agent injection channelTo the distal end of conduit, antenna channels are flowed into from the distal openings at interval, flow through antenna channels cooled microwave antenna, finally from opening upFlowed out in the outlet of antenna channels near-end.
Present invention also offers a kind of interior cooled microwave conduit system of monitoring temperature in real time, including above-mentioned conduit.
Further, said system further includes：Be installed on the switching part of the catheter proximal end, the switching part include with it is coldBut the cooling agent injection channel converting interface that agent injection channel is connected；The antenna channels converting interface connected with antenna channels, the dayThe distal end closed antenna passage of antenna adapter and antenna adapter that connection microwave antenna is built-in with line passage converting interface turnsInterface.
Further, the switching part is connected fixation with conduit by thermal weld or laser welding.
Further, said system further includes microwave generator, and the antenna adapter is connected with coaxial cable, coaxial electricalCable connects microwave generator.
Further, the thermocouple temperature probe is individually drawn from conduit side, is connected by adapter with thermocouple thermometer,In use, the real-time monitoring to temperature is realized.
Further, when the distal end of catheter is installed with eccentricity sacculus, said system is further included in antenna channelsProximal outlet connects the pressure valve converting interface of pressure valve.
Further, the pressure valve is made of one-way cock, spring and grid-like opening, and the spring is positioned at unidirectionalBetween valve and grid-like opening, one-way cock is pushed by its own resilient and is at closed mode, when the one-way cockThe pressure being subject to is opened when being more than the pressure threshold that pressure valve is born.
Further, said system further includes：
The microwave generator of thermocouple thermometer and liquid pump is integrated with, the outlet of liquid coolant is installed on the liquid pumpRoad and inlet duct, liquid pump discharge pressure are higher than water entry pressure；
It is arranged in the operation handle of the catheter proximal end, and including：
The adapter of antenna adapter and thermocouple temperature probe integrates the adapter that forms, the adapter can and coaxial electricalCable connects, and coaxial cable is connected with the microwave generator, and the adapter of the thermocouple temperature probe is to be used for and the heatEven temperature gauge linked adapter, and
Inlet and the flow export opposite with inlet in the liquid coolant that operation handle side is set, the liquidCooling agent inlet and flow export are connected with the outlet conduit and inlet duct of liquid pump respectively.
Further, when the conduit has silk guide passage, said system is further included to be connected with the seal wire through operation handleThe seal wire push handle connect, the seal wire push handle is used to promote seal wire to slide in the silk guide passage of conduit, with distal endThe distal openings for protruding from silk guide passage form arc loop, and the radius of loop can be adjusted according to narrow section vessel diameter.
The present invention difference of organ can use different conduit and system according to where treatment tumour, and its advantage existsIn：
(1) for hollow organ, such as bile duct, oesophagus, colon and the tumour in antrum portion, eccentricity sacculus and microwave are sent outAfter penetrating position where portion is accurately placed into tube chamber tumour, liquid coolant is persistently injected into eccentricity sacculus by liquid pump, it is swollenAfter swollen eccentricity sacculus pushing microwave antenna is close to tumour, tumour is fully inserted in the range of microwave heating, open microwaveAfter ablation, liquid coolant is constantly irrigated into conduit, on the one hand gives sacculus side relatively normal tube wall tissue's cooling,On the one hand normal tube wall is allowed away from microwave rf generator.
The system, which is used to treat disease, to be included, but be not limited solely to inoperable cancer of the esophagus, gastric antrum pylorus cancer,Malignant obstructive jaundice, colorectal cancer, it can also be used to treat the benign lesions such as Barret oesophagus, polyp of colon.For oesophagus, stomachDou Youmen and human colorectal cancerous lesion can use endoscope, computed assisted tomography, magnetic resonance imaging and air-barium doubleThe diagnostics technology such as radiography determines the scope of lesion, thickness, the stenosis of tube chamber.Bile duct disease through computer aid in tomography intoAs (CT), magnetic resonance imaging (MRI), Magnetic Resonance CholangiopancreatogrTohy (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), percutaneousWear transhepatic cholangiography radiography (PTC) technology and determine the scope of lesion, stenosis of bile duct position, the size of lesion.The system can pass through interiorPosition where tube chamber lesion is positioned under sight glass and X-ray examination, by the middle part of sacculus, i.e. position where microwave heating sourcePosition where being placed in tumour maximum diameter.The system can be used for stent stenosis caused by growth in tube chamber tumour internal metal rackTreatment.
(2) invaded for primary carcinoma of liver portal vein and inferior caval vein, cancer embolus is formed in vascular wall, partly or completelyBlocking blood flow, sacculus and foley's tube passage are substituted by the silk guide passage of built-in hydrophilic superslide seal wire, the nearly microwave day of distal end of catheterThere are a long 2-3cm openings at line heat generating spot, wire distal is fixed in conduit, promotes guidewire proximal, seal wire softness section can lead toCross catheter opening and protrude from one arc loop of formation outside conduit, so as to promote microwave antenna to be close to tumour, by Microwave emission portion essenceBehind position where being really placed into lumen of vessels tumor embolus, liquid coolant is injected into microwave antenna passage by liquid pump, distal endSuperslide seal wire into loop is pushed after microwave antenna is close to tumour, tumour is fully inserted in the range of microwave heating.
The system, which is used to treat disease, to be included, but be not limited solely to inoperable primary carcinoma of liver portal vein andVena cave cancer embolus, can be also used for treatment tracheocarcinoma and section above lung bronchogenic carcinoma, with needing to keep endovascular blood flow unobstructedIt is identical, it is necessary to be preferably minimized degree to the airflow influence in trachea and bronchus.For intravascular cancer embolus, computer aided manufacturing can be usedHelp fault imaging, ultrasonic blood vessel imaging, the diagnostics technology such as magnetic resonance imaging and angiogram determine the scope of lesion, thickness,The stenosis of tube chamber.The system, which can pass through under X-ray examination, is positioned over tube chamber lesion place position, by where microwave heating sourcePosition be placed in the position where tumour maximum diameter.Treatment to trachea and bronchus lung cancer, can be in the auxiliary of tracheal endoscopeHelp down, the position position where microwave heating source being placed in where tumour maximum diameter.
If CT and MRI and other Imaging Technologies cannot specify the thickness of lesion, pipe endo-luminal ultrasound is determined forThe thickness of lesion.
(3) microwave antenna due to ohm heat higher power can heat production, without supercooling, temperature can raise rapidly, damageNormal structure on bad conduit and conduit path, the further lifting of this meeting limit temperature.Cooling agent cooled microwave antenna, can be withImprove microwave output power so that intra-tumor temperature rapidly rises to more than 60 degrees Celsius.It is meanwhile sensitive using embedded catheter wallThe temperature change in ± 0.5 DEG C of the treated tumour of thermocouple temperature probe monitoring in real time is spent, according to the size of tumour, involves tube wallDepth and length, adjust oncotherapy temperature and treatment time by adjusting microwave output power in real time, it is normal not causingTo reach the good therapeutic effect to tumour in the case of tissue major injury.Involve the wider tumour of scope to tube wall, can be withThe position of antenna is progressively adjusted, multiple spot treatment is carried out to tumour.
Brief description of the drawings
Fig. 1 shows that microwave heat therapeutic/ablation system that distal end of catheter of the present invention is installed with eccentricity sacculus inserts luminal organsWhen interior, sacculus and microwave antenna fever section and relative position of the tumour in tube chamber, wherein：20-wall of the lumen, 21-tumour,30-total adapter, 31-balloon inflation channel converting interface, 32-microwave antenna adapter, 33-near-end, 34-distal end, 35-eccentricProperty sacculus, 40-pressure valve, 50-microwave antenna, 91-thermocouple temperature probe, 92-thermocouple thermometer.
Fig. 2 a display present invention distal end is installed with the conduit longitudinal axis section of eccentricity sacculus；Fig. 2 b show catheter proximal end transverse axisSection；Fig. 2 c show conduit cooling agent injection channel opening transverse axis section；Fig. 2 d show antenna channels opening transverse axis section,Wherein：301-the first opening, the 302-the second opening, 303-antenna channels, 304-balloon inflation channel, 33-near-end, 34-remoteEnd, 35-eccentricity sacculus, 37-catheter wall, 38-interval, 51-outer conductor, 52-PTFE insulating layers, 53-inner wire,91-thermocouple temperature probe.
In the case that Fig. 3 a are shown in microwave generator without liquid pump and thermocouple thermometer is integrated, present invention distal end is fixedThere is the structure diagram of the catheter proximal end switching part of eccentricity sacculus, wherein：31-balloon inflation channel converting interface, 34-distal end,35-eccentricity sacculus, 40-pressure valve, 41-cross grid opening, 42-spring, 43-piston, 70-antenna adapter,80-antenna adapter interface, 92-thermocouple thermometer；Fig. 3 b show cross grid open cross-section, wherein, 41-crossed gridGrid opening.
Fig. 4 a are shown in microwave generator be integrated with liquid pump and thermocouple thermometer in the case of, the present invention distal end be installed withThe catheter proximal end operation handle and proximal catheter end portion longitudinal axis section structure diagram of eccentricity sacculus, wherein, 100-manipulatorHandle, 101-coolant inflow catheter, 102-coolant outflow conduit, 103-microwave antenna and thermocouple temperature probe are integrated and turnedConnector, 34-distal end, 37-catheter wall, 38-interval, 303-antenna channels, 304-balloon inflation channel, 51-outer conductor, 91-Thermocouple temperature probe；Fig. 4 b show that antenna adapter and thermocouple temperature probe integrate adapter schematic cross-sectional view, wherein, 55-The patchplug of microwave antenna, the patchplug of 92-thermocouple temperature probe, 103-microwave antenna and thermocouple temperature probe are integratedAdapter.
Fig. 5 a display present invention is equipped with the microwave catheter longitudinal axis section of silk guide passage, and Fig. 5 b catheter proximal end transverse axis blocksFace, Fig. 5 c distal end of catheter seal wires into loop opening transverse axis truncation surface, wherein：303-antenna channels, 305-cooling agent injection channel,306-seal wire is exported into loop, 307-spaced openings, 33-near-end, 34-distal end, 39-seal wire, 37-catheter wall, 38-Every, 51-outer conductor, 52-PTFE insulating layers, 53-inner wire, 91-thermocouple temperature probe.
When Fig. 6 a show the microwave catheter system superslide wire distal of the invention for being equipped with silk guide passage outside conduit into loopLongitudinal axis section, Fig. 6 b catheter proximal end transverse axis truncation surfaces, Fig. 6 c distal end of catheter seal wires into loop opening transverse axis truncation surface, wherein：303—Antenna channels, 305-cooling agent injection channel, 306-seal wire are exported into loop, 307-spaced openings, 33-near-end, 34-remoteEnd, 39-seal wire (show that the soft section in distal end protrudes from the semicircle loop of formation outside conduit) on Fig. 6 c, 37-catheter wall, 38-Every, 51-outer conductor, 52-PTFE insulating layers, 53-inner wire, 91-thermocouple temperature probe.
Fig. 7 a display present invention is equipped with the microwave catheter system near-end operation handle longitudinal axis section of silk guide passage, wherein,100-operation handle, 101-coolant inflow catheter, 102-coolant outflow conduit, 104-seal wire push handle, 34-Distally, 37-catheter wall, 38-interval, 39-seal wire, 303-antenna channels, 305-cooling agent injection channel, 51-lead outsideBody, 91-thermocouple temperature probe；Fig. 7 b display the present invention be equipped with silk guide passage microwave catheter system antenna adapter andThermocouple temperature probe integrates adapter schematic cross-sectional view, wherein, the patchplug of 55-microwave antenna, 92-thermocouple temperature is visitedThe patchplug of pin, 103-microwave antenna and thermocouple temperature probe integrate adapter, 39-seal wire.
Fig. 8 a show Single Fracture antenna lengthwise cross section；Fig. 8 b show unipole antenna lengthwise cross section；Fig. 8 c show dipole antennaLengthwise cross section；Fig. 8 d show triaxial antennas lengthwise cross section；Fig. 8 e show chokes loop antenna lengthwise cross section, wherein：51-outer conductor,52-PTFE insulating layers, 53-inner wire, 54-chokes ring.
Embodiment
The difference of position and species according to where tumour, the interior cooled microwave conduit and system of the real-time monitoring temperature of the present inventionDifferent structure type can be used, the technology of the present invention is realized below in conjunction with legend and is described.
Treatment to the tumour of the hollow organs such as bile duct, oesophagus, Colon and rectum and antrum, the present invention provide a kind of remote in conduitEnd is installed with the microwave catheter (to be distinguished with following another conduits, the conduit is known as foley's tube below) of eccentricity sacculusAnd system, it is implanted into body lumen organ by endoscope or/and by the guiding of x-ray image documentation equipment.The diameter of conduitMost I can be positioned balloon catheter system by being seated in the catheter sheath of intraluminal 6-10Fr in advance to 1.85-2.0mmIn the tumor locus that will be treated.As shown in Figure 1, system inserted body lumen organ, dash forward on wall of the lumen 20 in oriented tube chamberGo out the tumour 21 of growth, foley's tube distal ports are installed with eccentricity sacculus 35, and eccentricity sacculus is according to the shape of pipe intracavitary neoplasmState, the stenosis and tumour quality of tube chamber can use different materials, by polyethylene terephthalate (PET), gather35 sacculus that the material such as olefin copolymer (POC), nylon (nylon) is made perfusion liquid coolant (below will using brine ice asExample illustrates) after be expanded into fixed diameter under pressure, shape is in half fusiform, internal pressure 2-8atm, suitable for matterThe harder tumour in ground, narrow section internal diameter is smaller, and dilatation balloon can expand narrow section.For the wider tumour institute of narrow section internal diameterTube chamber section, the sacculus that silicon rubber or latex material can be selected to make, this kind of sacculus may be expanded to larger size,Compared with the sacculus that above-mentioned material makes, the sacculus retractility of this material is good, and the sacculus cross section of contraction is smaller, avoids big straightFootpath sacculus needs the problem of internal diameter larger conveying lead sheath.The sacculus of this legend display is half elliptic, and practical application is not onlyIt is limited to the shape, according to the characteristics of lesion such as narrow section internal diameter, tumour quality, selects different sacculus, sacculus shape may not be used yetTogether.The sacculus expanded shown in figure pushes microwave catheter antenna and is close to tumour, antenna fever thermal field covering tumour.
The conduit that the present invention designs has near-end 33 and distal end 34, and with reference to Fig. 2 a- Fig. 2 d, the material of tube wall 37 can be usedThe high molecular materials such as PET, PTFE, nylon, Polypropylene, PVC.Guide-tube structure composition design includes the remote of circle occulting light cunning, inside there are two passages at end 34, one is antenna channels 303, and built-in microwave antenna 50 (including inner wire 53 and outer conductor 51) is simultaneouslyCommunicated in the opening 302 for distally having diameter about 1mm × 0.5mm with eccentricity sacculus 35；Ice is injected into eccentricity sacculus 35The cooling agent injection channel of brine, (is also referred to as balloon inflation channel, corresponding converting interface is known as balloon inflation channel and turns in foley's tubeInterface), i.e., the balloon inflation channel 304 shown in figure, two passages separate that (material at the interval uses phase with conduit by an interval 38With material), 304 distal end of balloon inflation channel has the first opening 301 to be communicated with eccentricity sacculus 35, its openings of sizes is also about1mm × 0.5mm, be spaced 38 end be located at opening 301 and opening 302 between, i.e., the distal end of balloon inflation channel 304 is cecum, noDirectly communicated with antenna channels 303.This unique design ensures the single flow direction of brine ice, and brine ice enters balloon inflation channel304, from 301 outflow of the first opening, antenna channels 303 are flowed into through the second opening 302, are then flowed out again from pressure valve 40.AntennaCatheter wall built-in temperature sensing element-thermocouple temperature probe 91 directly over passage 303, sound end is somewhat exposed, in expanded spheresUnder the pushing of capsule, it is close to tube chamber tumour together with microwave antenna, microwave is monitored while intra-tumor heat production with thermocouple thermometerTreatment temperature, this thermocouple temperature probe to the susceptibility of temperature change at ± 0.5 DEG C, in order to reduce the diameter of conduit as far as possible,A diameter of 0.01 inch (0.025mm) of thermocouple temperature probe, it is embedded in catheter wall, will not increase the diameter of conduit substantially.A variety of internal diameters can be made in this catheter antenna passage 303, the microwave antenna 50 of multiple diameter according to built in actual needs, such as0.020 inch, 0.023 inch, 0.031 inch, 0.034 inch etc..
The near-end 33 of conduit has different designs according to thermocouple thermometer and liquid pump whether is integrated in microwave generator.
It is not whole in it if the microwave generator that oncotherapy doctor uses is simpler, only microwave generatorThermocouple thermometer and liquid pump are closed, the near-end of the foley's tube makees following design, as shown in Figure 3a, there is balloon inflation channel converting interface 31,Pressure valve converting interface.The distal end of pressure valve 40 is cross grid opening 41 (as shown in Figure 3b), spring 42 be located at cross grid andBetween piston 43, in no antenna channels there are certain pressure brine ice promotion, piston 43 is complete under the pushing of spring 42The outlet of hermetically sealed antenna channels near-end.The spring of suitable rigid and elastic force is selected, ensures that brine ice expands eccentricity ball completelyCapsule 35, and keep suitable internal pressure to push microwave antenna.Can be by external compression pump or manual injection device with fixedPressure is to balloon inflation channel Continuous Perfusion brine ice, regulating system pressure, the output terminal and balloon inflation channel interface 31 of external compression pumpInterconnect, when cryosel water pressure rises, eccentricity sacculus 35 expands, when the pressure threshold for reaching the opening of piston 43, brine icePiston 43 is promoted, the opening releases of antenna channels near-end, brine ice outflow pressure valve 40, brine ice is in expansion eccentricity sacculus 35While also cooled microwave antenna.The also one 80 built-in aerial adapter of antenna channels converting interface connected with antenna channels70, the distal end of antenna adapter 70 turns antenna channels by heat-resisting and Heat Conduction Material is not fixed in antenna channels converting interface 80Interface 80 is completely enclosed.Antenna adapter 70 is connected with coaxial cable, coaxial cable connection microwave generator.Thermocouple temperature probeDraw out of conduit, be connected with thermocouple thermometer 92, realize the real-time monitoring to treatment temperature.
If being integrated with thermocouple thermometer and liquid pump in microwave generator, the proximal part of the foley's tube of the system can be withFollowing design is done, as shown in fig. 4 a：The near-end of foley's tube is fixed in an operation handle 100, above and below operation handle 100Side is respectively equipped with the water filling port and water outlet of brine ice, and corresponding extraction brine ice inflow catheter 101 and brine ice outflow are ledPipe 102, the brine ice inflow catheter 101 being connected with balloon inflation channel 304 and the brine ice being connected with antenna channels 303 flow outConduit 102, under the driving for the liquid pump integrated in microwave generator, with reference to Fig. 2 a, makes brine ice from brine ice inflow catheter 101Interior inflow balloon inflation channel 304, order flow out the opening 301 in eccentricity sacculus 35, antenna channels are then flowed into out of opening 302303.There is fixed pressure between brine ice inflow catheter 101 and brine ice outflow conduit 102, about 2-5atm, it is sufficient to expandEccentricity sacculus 35, pushes microwave antenna and thermocouple temperature probe is close to intraluminal tumor tissues.During ablation is implemented, lasting streamDynamic tube wall tissue of the cryosel water cooling without knurl side, microwave antenna and eccentricity sacculus and conduit, tumor tissues be able to thermotherapy andAblation.
As shown in Figure 4 b, it is shown that the proximal end of operation handle is the patchplug 55 and thermocouple temperature probe of microwave antennaPatchplug 92, connected with the coaxial cable distal end jack plug-in type drawn from microwave generator.
For the treatment of primary carcinoma of liver portal vein and vena cave cancer embolus, above-mentioned foley's tube and system are then unsuitable forThe treatment of blood vessel cancer embolus, the sacculus that reason is to expand understand block blood flow, aggravate the infringement of liver function, but, can be above-mentionedMake part on the basis of foley's tube and system to change, with hydrophilic superslide seal wire substitution eccentricity ball that can be in distal end of catheter into loopCapsule, promotes microwave antenna and thermocouple temperature probe is close to Endovascular cancer embolus or tracheal bronchus intracavitary neoplasm, other structures canUsing the structure of above-mentioned foley's tube.Hydrophilic superslide seal wire inner core uses Super elastic alloy material, such as nickel-titanium alloy material, seal wireOuter hydrophilic coating uses grafting PEG (polyethylene glycol), PVP (polyvinylpyrrolidone), or the stronger polysaccharide of water imbibitionClass material, hydrophilic superslide wire distal are the soft section for being about 6-10cm, and it is outer into loop can be pushed out of conduit.Such as Fig. 5 a-5c,Shown in Fig. 6 a-6c, which includes three passages：The antenna channels 303 of built-in microwave antenna, its by the opening of distal end with it is coldBut agent injection channel 305 communicates, and two passage near-ends and stage casing have interval 38 to separate, and ensureing cooling agent, proximally 33 single flow directions are remoteEnd 34, then near-end 33 is flowed back to by antenna channels 303, the 3rd added passage is silk guide passage, and 39 distal end of seal wire is softnessSection is simultaneously fixed in conduit, and nearly Microwave emission section has the opening 306 for being about 3-4cm, promotes the near-end of seal wire and can cause seal wireSoft section protrude from seal wire into a semicircular loop is formed outside loop outlet 306, can push microwave antenna be close to it is intravascular swollenKnurl, while ensure the unobstructed flowing of blood in therapeutic process, the blood flow of flowing can cool down normal side vascular wall, avoid tube wallDamage.
To portal vein tumor thrombus, percutaneous transhepatic puncture portalvein pathway (Percutaneous Transhepatic PortalAccess), 8-10Fr. catheter sheaths are implanted into portal vein, insert pigtail angiography catheter, Smv/pvInterior injection Baryan implements direct portal phlebography, and to show the position of cancer embolus, narrow length and degree, it is quiet to involve doorThe scope of arteries and veins.Microwave catheter system is sent into through catheter sheath after and, position where microwave generation end is positioned at tumour.To under liver cancerVena cave cancer embolus, punctures through femoral vein at groin, inserts 8-10Fr. catheter sheaths, insert pigtail angiography catheter, injectsContrast agent row inferior vena cavography, to show the position of cancer embolus, narrow length and degree, involve the scope of inferior caval vein, togetherThe position being transported to microwave catheter system where cancer embolus sample.To tracheal bronchus cancer, trachea and bronchus endoscope can be usedJoint X-ray examination, inserts 8-10Fr. catheter sheaths, after microwave catheter system is transported to position where cancer embolus.
As shown in Figure 7a, handle 104, seal wire are pushed with being connected seal wire through the seal wire 39 of operation handle 100 by promoting39 soft section protrudes from the semicircle or half elliptic loop that certain radius is formed outside conduit through seal wire into loop outlet 306, according toThe internal diameter of tube chamber where lesion, promotes the seal wire of distal end of catheter to push handle so that pushes microwave antenna into loop seal wire and embedsIt is close to tumour in the thermocouple temperature probe 91 in the catheter wall 37 of the surface of antenna channels 303.Then connection liquid coolant is ledPipe, is illustrated with brine ice, similar with foley's tube, and thermocouple thermometer and liquid are integrated with the microwave generator of the conduitPump, near-end is fixed in an operation handle 100, the upper and lower side of operation handle 100 be respectively equipped with brine ice water filling port andWater outlet, it is corresponding to draw brine ice inflow catheter 101 and brine ice outflow conduit 102, by the outlet conduit of liquid pump cooling agent(not shown) is connected with conduit system coolant inflow catheter 101, the introducing of conduit system coolant outflow conduit 102 and liquid pumpPipeline is connected, and starts the liquid pump integrated in microwave generator, and brine ice is flowed into from the near-end of conduit, and it is logical to flow through cooling agent injectionRoad 305, through spaced openings 307 flow into microwave antenna where antenna channels 303, by coolant outflow conduit 102 flow out intoEnter the introducing pipeline of liquid pump, brine ice constant flow in antenna channels, to reach the effect to microwave antenna cooling.Open micro-Wave producer, the change of the tumor temperature monitored in real time according to thermocouple thermometer, adjusts microwave output power, treatment temperature in real time60 DEG C are maintained at, 10 minutes or so single-point treatment time.For larger cancer embolus, the position of microwave antenna is adjusted, in tube chamberTumour implements multiple spot treatment.Wherein, the proximal end of operation handle 100 is the patchplug 55 and thermocouple temperature probe of microwave antennaPatchplug 92, connected with the coaxial cable distal end jack plug-in type drawn from microwave generator, the seal wire in silk guide passage39 are pierced by from operation handle 100 and are connected with operation handle 100, as shown in Figure 7b.
Microwave antenna used in the present invention can select the microwave of suitable class according to shape of tumor, length, cross-sectional diameterAntenna.Microwave antenna can be Single Fracture antenna (Fig. 8 a), and unipole antenna (Fig. 8 b), dipole antenna (Fig. 8 c), triaxial antennas (are schemed8d), chokes loop antenna (Fig. 8 e).Unipole antenna is shown as in figure, but is not limited solely to unipole antenna.
By taking the unipole antenna shown in Fig. 8 b as an example, microwave antenna includes：Outer conductor 51, centre are PTFE insulating layers 52, interiorFor inner wire 53, inner wire 53 is to overhanging 2-3cm outside outer conductor 52.Fever center has a common boundary for inner wire 53 and outer conductor 51Place, fever center are located at the center of eccentricity sacculus 35.