技术领域technical field
本发明涉及一种用于止血的器械，尤其是一种可组合使用的止血器械。The invention relates to a device for hemostasis, in particular to a hemostatic device that can be used in combination.
背景技术Background technique
在外科手术中经常会用到电外科止血器械，例如电刀、电凝钳、超声刀、电凝镊等；而目前的电外科器械通常是用于表面止血，止血深度和止血范围较小，在进行大范围切割手术时止血效率较低。现有用于深层消融的器械例如微波消融针，只针对深层特定区域的组织消融，消融区域大多为球形或椭球形等不规则形状，不方便切割，降低了手术效率。实际手术中，止血区域是否规则；尤其，易于切割的长方体形止血区域，对于提高手术效率是非常重要的。但是，目前的止血器械均不能形成长方体形等易于切割止血区域，不能满足快速手术的需求。另外消融区域形状和大小均为固定，无法根据需求进行调整。Electrosurgical hemostatic instruments are often used in surgical operations, such as electric knife, electrocoagulation forceps, ultrasonic knife, electrocoagulation forceps, etc.; however, current electrosurgical instruments are usually used for surface hemostasis, and the hemostatic depth and hemostatic range are small. Hemostasis is less efficient during extensive excision procedures. Existing instruments for deep ablation, such as microwave ablation needles, only target tissue ablation in specific deep areas. Most of the ablation areas are spherical or ellipsoidal and other irregular shapes, which are inconvenient to cut and reduce surgical efficiency. In the actual operation, whether the hemostatic area is regular; especially, the cuboid hemostatic area that is easy to cut is very important to improve the operation efficiency. However, none of the current hemostatic devices can form cuboid-shaped and easy-to-cut hemostatic regions, which cannot meet the needs of rapid surgery. In addition, the shape and size of the ablation area are fixed and cannot be adjusted according to needs.
因多种原因，现有的用于连接止血器械的主机，通常连接止血器械的接口只有一个，一个接口只能连接一个止血器械。而一个止血器械的止血或消融的范围有限，当需要进行大面积病灶组织的切割时，只使用这种单个的止血器械效率很低，大大延长了手术的时间，手术时间通常会达到四五个小时，甚至更长时间，这样不仅容易使医生过于疲劳，更容易增大病人的手术风险。如手术时间过长，病人麻醉的时间也长，出血更多，同时也需要输入更多的血液，这不仅会增加对病人的伤害，而且也会增加病人的医疗费用。Due to various reasons, the existing host for connecting the hemostatic device usually has only one interface for connecting the hemostatic device, and one interface can only be connected with one hemostatic device. However, the range of hemostasis or ablation of a hemostatic device is limited. When it is necessary to cut a large area of lesion tissue, it is very inefficient to use only this single hemostatic device, which greatly prolongs the operation time. The operation time usually reaches four or five. Hours, or even longer, will not only easily make the doctor too tired, but also increase the risk of surgery for the patient. If the operation time is too long, the time for the patient to be anesthetized is also long, the bleeding is more, and more blood needs to be transfused at the same time, which will not only increase the harm to the patient, but also increase the medical expenses of the patient.
发明内容Contents of the invention
有鉴于此，本发明提供一种组合式止血器械，解决了止血器械效率低的技术问题，并且其消融区域形状和大小可调节。In view of this, the present invention provides a combined hemostatic device, which solves the technical problem of low efficiency of the hemostatic device, and the shape and size of the ablation area can be adjusted.
为解决以上技术问题，本发明的技术方案为：一种组合式止血器械，包括若干用于组合使用的止血组件；所述每个止血组件设置有至少一对用于通电止血的电极；每对电极包括一个工作极和一个回路极。各个止血组件分别通过电缆与射频主机连接，使得射频能量在工作机和回路极之间流动。由于组织具有一定阻抗，射频能量流经组织时会产生热量，而该热量令组织螺旋蛋白收缩、脱水，使血管闭合，从而实现止血功能。在止血时，电极本身不会发热，止血的热量来自射频能量流经组织时“欧姆发热”产生的热量。若干的止血组件可自由组合使用(不需要连接件固定在一起)，根据需求调整消融区域的大小和形状。In order to solve the above technical problems, the technical solution of the present invention is: a combined hemostatic device, including several hemostatic components for combined use; each of the hemostatic components is provided with at least one pair of electrodes for electrification to stop bleeding; each pair The electrodes consist of a working pole and a return pole. Each hemostatic component is respectively connected to the radio frequency host through cables, so that the radio frequency energy flows between the working machine and the return electrode. Because the tissue has a certain impedance, when the radio frequency energy flows through the tissue, heat will be generated, and the heat will shrink and dehydrate the tissue helical protein, and close the blood vessel, thereby realizing the hemostasis function. During hemostasis, the electrode itself will not generate heat, and the heat for hemostasis comes from the heat generated by "ohmic heating" when radio frequency energy flows through the tissue. Several hemostatic components can be used in combination freely (without the need for connecting parts to be fixed together), and the size and shape of the ablation area can be adjusted according to requirements.
进一步的，还包括带有插头的总电缆，总电缆至少与两个止血组件电连接。通过一台射频主机连接两个以上的止血组件，并组合成需要的排布方式。若干的止血组件通过带有插头的总电缆与主机上的一个接口相连即可自由组合使用(不需要连接件固定在一起)，根据需求调整消融区域的大小和形状。Further, it also includes a main cable with a plug, and the main cable is electrically connected with at least two hemostatic components. Connect more than two hemostatic components through a radio frequency host, and combine them into the required arrangement. Several hemostatic components can be freely combined and used by connecting with an interface on the host computer through a total cable with a plug (no need for connecting pieces to be fixed together), and the size and shape of the ablation area can be adjusted according to requirements.
作为一种改进，所述总电缆和各个止血组件之间串联有选择开关。选择开关可任意选择控制止血组件通电的数量。这种设计的好处是，医生可根据实际情况选择需要连接的止血组件数量，也可避免不需要用到的止血组件导电而影响手术。As an improvement, a selection switch is connected in series between the main cable and each hemostatic component. The selector switch can arbitrarily select and control the quantity of power supply of the hemostatic component. The advantage of this design is that the doctor can choose the number of hemostatic components that need to be connected according to the actual situation, and it can also prevent the unnecessary hemostatic components from conducting electricity and affecting the operation.
作为一种改进，所述止血组件上设置有用于与其他止血组件配合连接的连接件。各个止血组件之间可通过连接件拼接成不同的状态，使用更方便。As an improvement, the hemostatic component is provided with a connecting piece for mating connection with other hemostatic components. Various hemostatic components can be spliced into different states through connecting pieces, which is more convenient to use.
所述连接件为用于相互配合连接的榫眼和榫头(不限于此方式)。The connectors are mortises and tenons (not limited to this method) for mutual mating connection.
作为进一步的一种改进，所述止血组件为两个，其中一个止血组件上设置有榫眼，另一个止血组件上设置有与榫眼配合连接的榫头。榫眼和榫头即为连接件。卯榫式的连接简单、稳固，易拆卸，并且一字排开的4根电极产生的消融区域可应对大多数情况。As a further improvement, there are two hemostatic components, one of which is provided with a mortise, and the other hemostatic component is provided with a tenon mated with the mortise. The mortise and tenon are the joints. The mortise and tenon connection is simple, stable, and easy to disassemble, and the ablation area generated by the four electrodes lined up can cope with most situations.
作为进一步的一种改进，还包括封装电极的壳体，所述电极延伸出壳体外；所述连接件设置在壳体上。利用壳体收纳线管，方便布置，保护内部结构，同时便于多个止血组件的集成。As a further improvement, it also includes a casing for encapsulating the electrodes, the electrodes extend out of the casing; the connecting piece is arranged on the casing. The casing is used to accommodate the wire tube, which facilitates arrangement, protects the internal structure, and facilitates the integration of multiple hemostatic components.
作为进一步的一种改进，所述止血组件为两个或者两个以上，组合使用时所有电极呈一字型排布，并且工作极和回路极交替排布。As a further improvement, there are two or more hemostatic components, and when used in combination, all the electrodes are arranged in a straight line, and the working electrodes and return electrodes are arranged alternately.
作为一种优选，所述止血组件为两个或两个以上；组合使用时，所有电极排列成两排；所述工作极和回路极交替布置。可形成较宽的消融区域。As a preference, there are two or more hemostatic components; when used in combination, all electrodes are arranged in two rows; the working poles and return poles are arranged alternately. A wider ablation zone can be formed.
作为一种优选，所述止血组件为八字形排布的两个；所述工作极和回路极交替布置。可形成弧形的消融区域。As a preference, there are two hemostatic components arranged in a figure-eight shape; the working poles and return poles are arranged alternately. A curved ablation zone can be formed.
作为一种优选，所述电极为弧形。As a preference, the electrodes are arc-shaped.
作为进一步的优选，若干止血组件围绕成一圈，其电极的弯曲方向朝向圈内，且所有电极均指向同一中心点。形成一个近似杯状的消融区域，以适应某些特殊手术需要。As a further preference, several hemostatic components are formed into a circle, and the bending direction of the electrodes thereof faces inwardly of the circle, and all the electrodes point to the same central point. A nearly cup-shaped ablation area is formed to meet the needs of some special operations.
作为进一步的优选，所述止血组件为六个，并两两拼合成一组，所述工作极和回路极交替布置。两个组件先拼合成一组，然后三组止血组件沿圆周均匀分布。并且所述电极都按工作极、回路极交替排布的方式布置，这样能更好的形成一个闭环。As a further preference, the number of the hemostatic components is six, and they are combined into a group of two, and the working poles and return poles are arranged alternately. The two components are assembled into one group first, and then the three groups of hemostatic components are evenly distributed along the circumference. In addition, the electrodes are arranged in such a way that the working poles and return poles are alternately arranged, so that a closed loop can be better formed.
作为一种改进，所述电极包括直管状的电极本体，所述电极本体一端为封闭的尖端。电极的外形为直管状并具有尖端，使得电极便于深入组织或者平靠在组织上进行止血，适用于各种止血情况。利用壳体上的连接件与其他止血组件连接成一个整体配合使用，在通电消融时更加的稳固。As an improvement, the electrode includes a straight tubular electrode body, and one end of the electrode body is a closed tip. The shape of the electrode is a straight tube with a tip, so that the electrode is convenient to go deep into the tissue or flat against the tissue for hemostasis, and is suitable for various hemostasis situations. The connectors on the casing are used in conjunction with other hemostatic components to be connected as a whole, which is more stable during ablation with electricity.
作为一种改进，所述每个电极均设置有进液口和回液口，并且所述每个电极内均设置有与进液口和回液口连通的空腔，进液口、空腔和回液口构成冷却介质循环通道。目前的止血器械的止血电极没有降温功能，导致组织迅速干结、碳化，出现“粘刀”的现象，此时需要花更多的时间进行清理电极。电极周边的射频能量密度远大于远处的密度，这就导致电极周边的组织会更加容易脱水干结，如果电极周边的组织过早脱水干结，则射频能量无法传输到更远的组织去，那么就无法对远处的组织止血，止血范围大大减小。每个电极为中空具有供冷却介质流动的空腔；冷却介质流经电极的内部，带走电极的热量；因此电极的温度不会过高(保持在25℃左右)，而电极周围的组织不会过早干结，不会出现“粘刀现象”，使得射频能量可以传输出去，令远处的组织产热、脱水、止血。通电后，射频能量能够在组织内部产生大致为长方体的消融区域(或截面呈四边形/梯形的消融区域)，经多次消融后，组织上形成立体的凝固带，构成凝固带的各个边或面均较直(直边、平面)，更加有利于切割。以凝固带边缘为切开线将病变的组织切除，切开侧与原生侧通过凝固带分隔开，避免了出血。同时，通过冷却介质的流动带走了电极上的热量，使得电极始终保持较低的温度，避免了粘刀现象，从而使能量能够持续输出，进而产生较大的止血范围。加之，由于双极电极(工作极和回路极)的设计，射频能量只在电极之间传递，且射频能量会在电极连线的垂直方向扩散，从而形成扁平状的长方体形止血(消融)区域(或截面呈四边形/梯形的消融区域)，止血区域规则，更方便切割手术，能大大提高手术效率。因此，这个改进同时解决了现有止血器械止血区域不规则和容易“粘刀”的技术问题。这个改进不仅可以用于表面止血消融，还可以用于深层组织的止血消融。即可使用针状电极插入深层组织内部，会形成长方体形的消融区域；当平靠组织表面时，可以在组织表面形成较薄的长方体形(或长方形)消融区域。长方体形止血区域的长度或宽度与厚度的比值通常不小于2。As an improvement, each electrode is provided with a liquid inlet and a liquid return port, and each electrode is provided with a cavity communicating with the liquid inlet and the liquid return port, the liquid inlet, the cavity And the liquid return port constitutes a cooling medium circulation channel. The hemostatic electrode of the current hemostatic device has no cooling function, which leads to the rapid drying and carbonization of the tissue, and the phenomenon of "sticking the knife". At this time, it takes more time to clean the electrode. The radio frequency energy density around the electrode is much greater than the density in the distance, which makes the tissue around the electrode more likely to be dehydrated and dry. If the tissue around the electrode is prematurely dehydrated and hardened, the radio frequency energy cannot be transmitted to farther tissues, then the Cannot stop bleeding to distant tissues, and the range of hemostasis is greatly reduced. Each electrode is hollow and has a cavity for the flow of cooling medium; the cooling medium flows through the inside of the electrode and takes away the heat of the electrode; therefore, the temperature of the electrode will not be too high (keep at about 25°C), and the tissue around the electrode will not It will dry prematurely, and there will be no "sticky knife phenomenon", so that the radio frequency energy can be transmitted out, causing heat generation, dehydration, and hemostasis in distant tissues. After electrification, radiofrequency energy can generate a roughly cuboid ablation area (or quadrilateral/trapezoidal ablation area in cross-section) inside the tissue. After multiple ablation, a three-dimensional coagulation zone is formed on the tissue, constituting each side or surface of the coagulation zone. All are relatively straight (straight edge, plane), which is more conducive to cutting. The lesioned tissue was resected with the edge of the coagulation zone as the incision line, and the incision side and the original side were separated by the coagulation zone to avoid bleeding. At the same time, the heat on the electrode is taken away by the flow of the cooling medium, so that the temperature of the electrode is always kept low, avoiding the phenomenon of sticking to the knife, so that the energy can be continuously output, and a larger hemostasis range is generated. In addition, due to the design of the bipolar electrodes (working pole and return pole), radiofrequency energy is only transmitted between the electrodes, and the radiofrequency energy will diffuse in the vertical direction of the electrode connection, thereby forming a flat cuboid hemostatic (ablation) area (or an ablation area with quadrilateral/trapezoidal cross-section), regular hemostatic area, more convenient for cutting operation, and can greatly improve operation efficiency. Therefore, this improvement simultaneously solves the technical problems of irregular hemostatic areas and easy “knife sticking” of existing hemostatic instruments. This improvement can be used not only for surface hemostatic ablation, but also for deep tissue hemostatic ablation. That is, the needle electrode can be inserted into the deep tissue, and a cuboid-shaped ablation area will be formed; when it is flat against the tissue surface, a thinner cuboid-shaped (or rectangular) ablation area can be formed on the tissue surface. The ratio of the length or width to the thickness of the cuboid hemostatic area is usually not less than 2.
作为一种改进，所述进液口位于电极本体上与尖端相对的一端，尖端和进液口之间为电极的空腔；所述回液口设置在电极本体靠近进液口的侧壁上。As an improvement, the liquid inlet is located at the end of the electrode body opposite to the tip, and the cavity between the tip and the liquid inlet is the cavity of the electrode; the liquid return port is arranged on the side wall of the electrode body close to the liquid inlet .
所述进液口处设置有延伸进空腔的进液管，进液管的直径小于电极本体的直径，且进液管位于空腔内部的一端与电极本体的尖端留有间隙。进液管深入电极本体内部，所述进液管直径小于电极本体，使得进液管与电极本体之间具有供冷却介质流动的空腔，使冷却介质的进入通道和回流通道分离，且回流速度效率更高，能更及时带走热量。The liquid inlet is provided with a liquid inlet pipe extending into the cavity, the diameter of the liquid inlet pipe is smaller than that of the electrode body, and there is a gap between the end of the liquid inlet pipe inside the cavity and the tip of the electrode body. The liquid inlet pipe goes deep into the electrode body, and the diameter of the liquid inlet pipe is smaller than the electrode body, so that there is a cavity for the cooling medium to flow between the liquid inlet pipe and the electrode body, so that the cooling medium inlet channel and the return channel are separated, and the return speed It is more efficient and can take away heat in a timely manner.
作为一种改进，所述每个述止血组件中，各个电极的进液口分别通过进液支管连通有进液主管，各个电极的回液口分别通过回液支管连通有回液主管。As an improvement, in each of the hemostatic components, the liquid inlets of the electrodes are respectively connected to the liquid inlet main pipes through the liquid inlet branch pipes, and the liquid return ports of each electrode are respectively connected to the liquid return main pipes through the liquid return branch pipes.
作为一种改进，还包括一个集成装置，所述集成装置包括一个进液总管接口和一个回液总管接口，还设置有分别与各个进液主管连接的进液主管接口，及分别与回液主管连接的各个回液主管接口；所述各个进液主管接口与进液总管接口连通，各个所述回液主管接口与回液总管接口连通。简化后端管道布置，方便使用。As an improvement, it also includes an integrated device. The integrated device includes a liquid inlet main pipe interface and a liquid return main pipe interface. Each connected liquid return main pipe interface; said each liquid inlet main pipe interface communicates with the liquid inlet main pipe interface, and each said liquid return main pipe interface communicates with the liquid return main pipe interface. Simplify the rear-end pipeline layout for easy use.
作为另一种改进，一个所述电极的回液口与另一个所述电极的进液口相连通，使两两电极之间构成串联的冷却介质循环通道。As another improvement, the liquid return port of one electrode is connected to the liquid inlet port of the other electrode, so that a series cooling medium circulation channel is formed between the two electrodes.
进一步的，所述每个电极的作用端平齐；所述每个止血组件的电极相互平行，且相邻的电极之间的间距相等。这样更易形成长方体形的止血区域，效果最好。Further, the active ends of each of the electrodes are flush; the electrodes of each of the hemostatic components are parallel to each other, and the distance between adjacent electrodes is equal. In this way, it is easier to form a cuboid-shaped hemostatic area, and the effect is the best.
作为一种改进，所述电极作用部的长度与宽度之比不小于2。所谓作用部，是指电极可插入组织的部分。为了保证插入深度，电极的作用部的长度至少是其宽度的两倍或者两倍以上。As an improvement, the ratio of the length to the width of the electrode action portion is not less than 2. The "action part" refers to a part where the electrode can be inserted into a tissue. In order to ensure the insertion depth, the length of the active portion of the electrode is at least twice or more than twice the width.
作为一种优选，所述电极为方柱状。As a preference, the electrodes are in the shape of square pillars.
本发明的有益之处在于：具有上述结构的组合式止血器械，每个止血组件可单独使用，也可组合使用，多个止血组件组合在一起使用，操作一次，同样的时间内，止血区域更大，解决了止血器械效率低的技术问题。其组合数量不限，组合的形式多样，可满足不同消融区域大小和形状的需求。目前，为了提高手术效率，缩短手术时间，通常采用的方法是调节主机的输出功率，即在一定范围内提高主机的输出功率，这种方式对提高手术效率很小很小。现有技术没有相同或相近的方案给予本发明以技术启示，由于思维惯性，本领域技术人员也很难想到通过上述方式来实现。另外，由于本发明采用的是间隔设置的工作极和回路极，射频能量仅作用于病灶组织，不会给整个人体通电，也不需要负极板配合，能够避免普通的单极电极因负极板易脱落而造成的安全隐患，不会灼伤人体，同时，也省去了需要使用负极板的麻烦，使得手术更加安全和方便。The advantage of the present invention is that: for the combined hemostatic device with the above structure, each hemostatic component can be used alone or in combination, multiple hemostatic components can be used in combination, once operated, the hemostatic area will be more stable within the same time period. Large, solving the technical problem of low efficiency of the hemostatic device. The number of combinations is not limited, and the combination forms are various, which can meet the needs of different sizes and shapes of ablation areas. At present, in order to improve the operation efficiency and shorten the operation time, the usual method is to adjust the output power of the main machine, that is, to increase the output power of the main machine within a certain range, which has little effect on improving the operation efficiency. There is no identical or similar solution in the prior art to provide technical inspiration to the present invention, and due to the inertia of thinking, it is difficult for those skilled in the art to think of realizing it through the above-mentioned method. In addition, since the present invention adopts the working electrode and the return electrode arranged at intervals, the radio frequency energy only acts on the lesion tissue, does not energize the whole human body, and does not require the cooperation of the negative plate, which can avoid the common unipolar electrode being easily damaged by the negative plate. The potential safety hazard caused by falling off will not burn the human body. At the same time, it also saves the trouble of using the negative plate, making the operation safer and more convenient.
附图说明Description of drawings
图1为本发明的外观结构示意图。Fig. 1 is a schematic diagram of the appearance structure of the present invention.
图2为本发明的内部结构示意图。Fig. 2 is a schematic diagram of the internal structure of the present invention.
图3为电极的结构示意图。Figure 3 is a schematic diagram of the structure of the electrode.
图4为电极中冷却介质的流动方向示意图。Fig. 4 is a schematic diagram of the flow direction of the cooling medium in the electrode.
图5为集尘装置的结构示意图。Fig. 5 is a structural schematic diagram of the dust collecting device.
图6为使用方式实施例1的止血组件俯视排布示意图。FIG. 6 is a schematic top view of the arrangement of the hemostatic components in Example 1 of usage mode.
图7为使用方式实施例1的插入使用状态示意图。Fig. 7 is a schematic diagram of the plug-in use state of Embodiment 1 of the usage mode.
图8为使用方式实施例1中消融区域的示意图。Fig. 8 is a schematic diagram of the ablation area in Example 1 of the usage mode.
图9为使用方式实施例1中平靠使用状态示意图。Fig. 9 is a schematic diagram of a flat leaning use state in Example 1 of the usage mode.
图10为使用方式实施例2的止血组件俯视排布示意图。Fig. 10 is a schematic top view of the arrangement of the hemostatic components in Example 2 of the usage mode.
图11为使用方式实施例2的插入使用状态示意图。Fig. 11 is a schematic diagram of the plug-in use state of Example 2 of the usage mode.
图12为使用方式实施例2中消融区域的示意图。Fig. 12 is a schematic diagram of the ablation area in Example 2 of the usage mode.
图13为使用方式实施例2中平靠使用状态示意图。Fig. 13 is a schematic diagram of a flat leaning use state in Example 2 of the usage mode.
图14为使用方式实施例3的止血组件俯视排布示意图。Fig. 14 is a schematic top view of the arrangement of the hemostatic components in Example 3 of the usage mode.
图15为使用方式实施例3的使用状态示意图。Fig. 15 is a schematic view of the usage state of the usage mode embodiment 3.
图16为使用方式实施例3中消融区域的示意图。Fig. 16 is a schematic diagram of the ablation area in Example 3 of the usage mode.
图17为使用方式实施例4的止血组件俯视排布示意图。Fig. 17 is a schematic top view of the arrangement of the hemostatic components in Example 4 of the usage mode.
图18为使用方式实施例4的使用状态示意图。Fig. 18 is a schematic view of the usage state of the usage mode embodiment 4.
图19为使用方式实施例4中消融区域的示意图。Fig. 19 is a schematic diagram of the ablation area in Example 4 of the usage mode.
图20为使用方式实施例5的使用状态示意图。Fig. 20 is a schematic view of the usage status of the usage mode embodiment 5.
图21为使用方式实施例5中消融区域的示意图。Fig. 21 is a schematic diagram of the ablation area in Example 5 of the usage mode.
图中标记：1止血组件、2工作极、3回路极、4进液主管、5回液主管、6主电缆、7榫头、8榫眼、9上壳、10下壳、11进液支管、12回液支管、13电缆、14集成开关装置、15进液主管接口、16回液主管接口、17电缆接口、18进液总管接口、19回液总管接口、20总电缆插口、21组织、22消融区域、23射频能量、24电极插孔、25切开线、26切除侧、27凝固带、41进液主管接头、51回液主管接头、61电缆接头、201电极本体、202进液管、203回液弯管、204进液口、205回液口。Marks in the figure: 1 hemostatic component, 2 working pole, 3 return pole, 4 liquid inlet main pipe, 5 liquid return main pipe, 6 main cable, 7 mortise, 8 mortise, 9 upper shell, 10 lower shell, 11 liquid inlet branch pipe, 12 Liquid return branch pipe, 13 Cable, 14 Integrated switchgear, 15 Liquid inlet main pipe interface, 16 Liquid return main pipe interface, 17 Cable interface, 18 Liquid inlet main pipe interface, 19 Liquid return main pipe interface, 20 Main cable socket, 21 Organization, 22 Ablation area, 23 RF energy, 24 Electrode jack, 25 Incision line, 26 Resection side, 27 Coagulation zone, 41 Main liquid inlet connector, 51 Liquid return main pipe connector, 61 Cable connector, 201 Electrode body, 202 Liquid inlet tube, 203 liquid return elbow, 204 liquid inlet, 205 liquid return port.
具体实施方式Detailed ways
为了使本领域的技术人员更好地理解本发明的技术方案，下面结合具体实施方式对本发明作进一步的详细说明。In order to enable those skilled in the art to better understand the technical solutions of the present invention, the present invention will be further described in detail below in conjunction with specific embodiments.
如图1-图5所示，本发明包括若干(即一个或者一个以上)用于组合使用的止血组件1；所述每个止血组件1设置有至少一对用于通电止血的电极；每对电极包括一个工作极2和一个回路极3。As shown in Figures 1-5, the present invention includes several (i.e. one or more) hemostatic assemblies 1 for combined use; each hemostatic assembly 1 is provided with at least one pair of electrodes for electrification to stop bleeding; each pair The electrodes include a working pole 2 and a return pole 3 .
结构实施例1：选用两个止血组件1进行组合，为了更加方便组合，每个止血组件仅包含一对电极。由于电极需要通电并且需要插入组织，可以预见的是电极最好由金属制作，本实施例中选用的材料为不锈钢。电极通过电缆与射频主机连接，使得射频能量在工作极2和回路极3之间流动。射频能量可以通过与主机相连的脚踏式开关，或者在该止血器械中增设手动开关，进行手动等形式的开关予以控制。Structural Example 1: Two hemostatic components 1 are selected for combination. For more convenient combination, each hemostatic component only includes a pair of electrodes. Since the electrodes need to be energized and inserted into tissues, it is foreseeable that the electrodes are preferably made of metal, and the material selected in this embodiment is stainless steel. The electrodes are connected to the radio frequency host through cables, so that radio frequency energy flows between the working electrode 2 and the return electrode 3 . The radio frequency energy can be controlled by a foot-operated switch connected to the host, or by adding a manual switch in the hemostatic device to perform a manual switch.
结构实施例2：与实施例1不同的是，所述电极包括直管状的电极本体201，所述电极本体201一端为封闭的尖端；还包括用于封装电极的壳体，所述电极本体201尖端延伸出壳体外；所述壳体上设置有可与其他止血组件1壳体配合的连接的连接件。本实施例中，连接件设置在壳体侧壁，连接后使得所有电极呈一字型排布，并且工作极2和回路极3交错排布。连接件的形式可以多样化，只要能将两个止血组件1牢固的连接即可。本实施例中其中一个止血组件的壳体侧壁设置有榫眼8，另一个止血组件的壳体侧壁设置有与榫眼8配合连接的榫头7。榫头7和榫眼8通过过盈配合连接，为了使得连接紧固，榫头7上可以设置环状的凸台。壳体由上壳9和下壳10拼合而成，上壳9和下壳10由工程塑料制成。榫头7和榫眼8也通过拼和构成完整的形状。壳体内设置有支架，用于将各个电极固定并分隔开。Structural Example 2: The difference from Example 1 is that the electrode includes a straight tubular electrode body 201, one end of which is a closed tip; it also includes a shell for encapsulating the electrode, and the electrode body 201 The tip extends out of the casing; the casing is provided with a connecting piece that can cooperate with the casing of other hemostatic components 1 . In this embodiment, the connecting piece is arranged on the side wall of the casing, and after connection, all the electrodes are arranged in a straight line, and the working poles 2 and the return poles 3 are arranged in a staggered manner. The form of the connecting piece can be varied, as long as the two hemostatic components 1 can be firmly connected. In this embodiment, a mortise 8 is provided on the housing side wall of one of the hemostatic components, and a mortise 7 matingly connected with the mortise 8 is provided on the housing side wall of the other hemostatic component. The tenon 7 and the mortise 8 are connected by interference fit. In order to make the connection fast, the tenon 7 may be provided with an annular boss. The housing is assembled by an upper shell 9 and a lower shell 10, and the upper shell 9 and the lower shell 10 are made of engineering plastics. Tenon 7 and tenon 8 also form a complete shape by joining together. A bracket is arranged in the housing for fixing and separating the electrodes.
最好是所有用于组合使用的止血组件都来自同一个射频主机。即还包括带有插头的总电缆，总电缆电连接有两个(甚至两个以上)止血组件。两个止血组件的与同一台射频主机连接。Ideally all hemostatic components used in combination come from the same RF host. That is, it also includes a main cable with a plug, and the main cable is electrically connected with two (or even more than two) hemostatic components. The two hemostatic components are connected to the same radio frequency host.
结构实施例3：与实施例1不同的是，每个电极均设置有进液口204和回液口205，并且所述每个电极内均设置有与进液口204和回液口205连通的空腔，进液口204、空腔和回液口205构成冷却介质循环通道。所述进液口204位于电极本体201上与尖端相对的一端，尖端和进液口204之间为电极的空腔；所述回液口205设置在电极本体靠近进液口204的侧壁上。进液口204处设置有延伸进空腔的进液管202，进液管202与电极本体201同轴，进液管202的直径小于电极本体201的直径，且进液管202位于空腔内部的一端与电极本体201的尖端留有间隙；所述回液口205处连接有回液弯管203。每个电极的作用端平齐；所述每个止血组件的电极相互平行，且相邻的电极之间的间距相等。回液弯管203为90°弯折，其与电极本体201连接端与电极本体201垂直。电极本体201进液口204处通过缩径处理后与进液管202焊接并封闭，回液口205与回液弯管203同样利用焊接的方式进行连接。Structural Example 3: Different from Example 1, each electrode is provided with a liquid inlet 204 and a liquid return port 205, and each electrode is provided with a liquid inlet 204 and a liquid return port 205. The cavity, the liquid inlet 204, the cavity and the liquid return port 205 form a cooling medium circulation channel. The liquid inlet 204 is located at the end of the electrode body 201 opposite to the tip, and the cavity between the tip and the liquid inlet 204 is an electrode cavity; the liquid return port 205 is arranged on the side wall of the electrode body close to the liquid inlet 204 . The liquid inlet 204 is provided with a liquid inlet pipe 202 extending into the cavity, the liquid inlet pipe 202 is coaxial with the electrode body 201, the diameter of the liquid inlet pipe 202 is smaller than the diameter of the electrode body 201, and the liquid inlet pipe 202 is located inside the cavity There is a gap between one end of the electrode body and the tip of the electrode body 201; a liquid return elbow 203 is connected to the liquid return port 205. The active ends of each electrode are flush; the electrodes of each hemostatic component are parallel to each other, and the distance between adjacent electrodes is equal. The liquid return elbow 203 is bent at 90°, and its connection end with the electrode body 201 is perpendicular to the electrode body 201 . The liquid inlet 204 of the electrode body 201 is welded and closed with the liquid inlet pipe 202 after being reduced in diameter, and the liquid return port 205 and the liquid return elbow 203 are also connected by welding.
各个电极的进液口204分别通过进液支管11连通有进液主管4，各个电极的回液口205分别通过回液支管12连通有回液主管5。具体地，电极的进液管202和回液弯管203分别汇聚成进液主管4和回液主管5。进液管202通过柔性的进液支管11与进液主管4连接，所述回液弯管203通过柔性的回液支管12与回液主管5连接。进液支管11与进液管202、回液支管12与回液弯管203均通过过盈配合连接。另外，每个电极均连接有一个电缆13，电缆13汇总至主电缆6。所述进液主管4、回液主管5、主电缆6均设置在壳体顶部。这样使得各个电极无论电路和冷却循环通路都是并联关系，互不影响。图4为冷却介质流动示意图，循环装置驱动冷却介质(包括但不限于生理盐水)从进液主管4分流至各进液支管11，并从进液管202进入各个电极本体201内部与电极发生热交换后，通过回液弯管203、回液支管12最后汇聚到回液主管5，再回流至循环装置完成一次循环。The liquid inlet 204 of each electrode is connected to the liquid inlet main pipe 4 through the liquid inlet branch pipe 11 respectively, and the liquid return port 205 of each electrode is connected to the liquid return main pipe 5 through the liquid return branch pipe 12 respectively. Specifically, the liquid inlet pipe 202 and the liquid return elbow 203 of the electrode converge into the liquid inlet main pipe 4 and the liquid return main pipe 5 respectively. The liquid inlet pipe 202 is connected to the liquid inlet main pipe 4 through the flexible liquid inlet branch pipe 11 , and the liquid return elbow 203 is connected to the liquid return main pipe 5 through the flexible liquid return branch pipe 12 . The liquid inlet branch pipe 11 and the liquid inlet pipe 202 , the liquid return branch pipe 12 and the liquid return elbow 203 are all connected by interference fit. In addition, each electrode is connected to a cable 13 , and the cables 13 are aggregated to the main cable 6 . The liquid inlet main pipe 4, the liquid return main pipe 5 and the main cable 6 are all arranged on the top of the housing. In this way, the electrodes are connected in parallel regardless of the circuit and the cooling circulation path, and do not affect each other. Figure 4 is a schematic diagram of the flow of cooling medium. The circulation device drives the cooling medium (including but not limited to physiological saline) to flow from the main liquid inlet pipe 4 to each liquid inlet branch pipe 11, and enters the inside of each electrode body 201 from the liquid inlet pipe 202 to generate heat with the electrodes. After the exchange, the liquid return elbow 203 and the liquid return branch pipe 12 finally converge to the liquid return main pipe 5, and then return to the circulation device to complete a cycle.
为了方便管路和电缆的布置，还包括一个集成开关装置14，集成开关装置14分为选择开关和集成装置，选择开关控制止血组件通电，集成装置控制止血组件进液和回液。所述集成开关装置14包括一个进液总管接口18、一个回液总管接口19以及总电缆插口20。还设置有分别与各个进液主管4连接的进液主管接口15，分别与各个回液主管5连接的回液主管接口16，分别与各个主电缆6连接电缆接口17；所述各个进液主管接口15与进液总管接口4连通，各个回液主管接口16与回液总管接口5连通，各个电缆接口17与总电缆插口20电连接。In order to facilitate the layout of pipelines and cables, an integrated switch device 14 is also included. The integrated switch device 14 is divided into a selector switch and an integrated device. The integrated switch device 14 includes a liquid inlet manifold interface 18 , a liquid return manifold interface 19 and a main cable socket 20 . There are also liquid inlet main pipe interfaces 15 connected with each liquid inlet main pipe 4 respectively, liquid return main pipe interfaces 16 connected with each liquid return main pipe 5 respectively, and cable interfaces 17 connected with each main cable 6 respectively; The interface 15 communicates with the interface 4 of the liquid inlet main pipe, each main liquid return interface 16 communicates with the interface 5 of the liquid return main pipe, and each cable interface 17 is electrically connected with the main cable socket 20 .
若干进液主管接口15、回液主管接口16、电缆接口17呈一字型排布，其位置与拼合好的两个止血组件1的进液主管4、回液主管5、主电缆6对应。A plurality of liquid inlet main pipes 15, liquid return main pipes 16, and cable ports 17 are arranged in a straight line, and their positions correspond to the liquid inlet pipes 4, liquid return pipes 5, and main cables 6 of the two assembled hemostatic assemblies 1.
为了方便连接，进液主管4、回液主管5、主电缆6端部设置有分别与集成开关装置14上的进液主管接口15、回液主管接口16、电缆接口17配合连接的进液主管接头41、回液主管接头51、电缆接头61。In order to facilitate the connection, the ends of the liquid inlet main pipe 4, the liquid return main pipe 5 and the main cable 6 are respectively provided with the liquid inlet main pipe interface 15, the liquid return main pipe interface 16, and the cable interface 17 on the integrated switch device 14. Connector 41, liquid return main pipe connector 51, cable connector 61.
本实施例中，“选择开关”和“集成装置”合二为一，组成了集成开关装置14。实际上“选择开关”负责电连接而“集成装置”负责冷却介质进出，其原理类似。实际使用中，可通过集成开关装置14拆卸或者安装若干个止血组件，以达到使用要求。In this embodiment, the “selector switch” and the “integrated device” are combined into one to form the integrated switch device 14 . In fact, the "selector switch" is responsible for the electrical connection and the "integrated device" is responsible for the cooling medium in and out, the principle is similar. In actual use, several hemostatic components can be disassembled or installed through the integrated switch device 14 to meet usage requirements.
为了进一步提高绝缘性，电极本体201位于壳体内的部分包裹有绝缘层，绝缘层可以通过热缩管或者绝缘胶带实现。当然，为了使得射频能量在工作极2和回路极3之间流通，至少电极本体201的尖端需要裸露在外。最好是电极本体201延伸出壳体的部分都裸露。In order to further improve the insulation, the part of the electrode body 201 located in the casing is wrapped with an insulating layer, which can be realized by heat shrinkable tube or insulating tape. Of course, in order to allow the radio frequency energy to flow between the working electrode 2 and the return electrode 3, at least the tip of the electrode body 201 needs to be exposed. Preferably, the part of the electrode body 201 extending out of the casing is exposed.
电极本体201具有尖端的一端延伸出壳体，延伸长度优选为3～10cm，电极1之间的间距优选为5～12mm，电极本体201直径优选为1.0～2mm，当然并不局限于上述尺寸，可根据实际需求进行适应性调整。电极本体201上还可以设置刻度，以标示插入组织的深度。One end of the electrode body 201 with a pointed end extends out of the casing, the extension length is preferably 3-10 cm, the distance between the electrodes 1 is preferably 5-12 mm, and the diameter of the electrode body 201 is preferably 1.0-2 mm, and of course it is not limited to the above-mentioned dimensions. Adaptive adjustments can be made according to actual needs. A scale can also be set on the electrode body 201 to mark the depth of insertion into the tissue.
电极作用部的长度与宽度之比不小于2。所谓作用部，是指电极可插入组织的部分。为了保证插入深度，电极的作用部的长度至少是其宽度的两倍或者两倍以上。本实施例中，电极的作用部为裸露于壳体外的部分。The ratio of the length to the width of the electrode action part is not less than 2. The "action part" refers to a part where the electrode can be inserted into a tissue. In order to ensure the insertion depth, the length of the active portion of the electrode is at least twice or more than twice the width. In this embodiment, the active part of the electrode is a part exposed outside the housing.
另外，电极也可方柱状。方柱包括三棱柱、4方柱、5方柱等，本发明中并不限制。In addition, the electrodes can also be square columnar. Square columns include triangular prisms, 4-square columns, 5-square columns, etc., which are not limited in the present invention.
当然，本申请中的止血组件也可不利用连接件连接使用。Of course, the hemostatic assembly in the present application can also be used without using the connecting piece.
本申请中电极的排布也不一定是交错，即电极不仅能按照：工作极-回路极-工作极-回路极的方式排布，也可按照：工作极-回路极-回路极-工作极的方式排布。The arrangement of the electrodes in this application is not necessarily staggered, that is, the electrodes can not only be arranged according to: working electrode-return electrode-working electrode-return electrode, but also according to: working electrode-return electrode-return electrode-working electrode arranged in a manner.
本申请中，也不排斥电极之间串联的冷却循环方式，即一根电极的回液口与下一根电极的进液口连接并以此类推，使两两电极之间构成串联的冷却介质循环通道。In this application, the cooling cycle method in series between electrodes is not excluded, that is, the liquid return port of one electrode is connected to the liquid inlet port of the next electrode, and so on, so that two electrodes form a series cooling medium loop channel.
以下为本发明的使用方式实施例。The following are usage examples of the present invention.
如图6-图9所示，使用方式实施例1为单个止血组件运用。As shown in Fig. 6-Fig. 9, usage example 1 is the use of a single hemostatic component.
以插入组织21止血为例。电极插入组织21形成电极插孔24，通电后射频能量23在工作极2和回流极3之间流动。由于组织21具有一定阻抗，射频能量流经组织21时会产生热量，而该热量令组织螺旋蛋白收缩、脱水，使血管闭合，从而实现止血功能。射频能量23通过的区域为消融区域22，经多次消融后，组织21上形成凝固带27。以凝固带27边缘为切开线25将病变的组织切除，切开侧26与原生侧通过凝固带27分隔开，避免了出血。单个止血组件1仅两个电极，形成的消融区域22较小，因此消融后的凝固带27也较为狭窄。Take inserting tissue 21 to stop bleeding as an example. The electrode is inserted into the tissue 21 to form an electrode socket 24 , and the radio frequency energy 23 flows between the working electrode 2 and the return electrode 3 after electrification. Since the tissue 21 has a certain impedance, when the radio frequency energy flows through the tissue 21, heat will be generated, and the heat will shrink and dehydrate the tissue helical proteins, and close the blood vessels, thereby realizing the hemostasis function. The region through which the radiofrequency energy 23 passes is the ablation region 22 , and after multiple times of ablation, a coagulation zone 27 is formed on the tissue 21 . The lesioned tissue is resected with the edge of the coagulation zone 27 as the incision line 25, and the incision side 26 is separated from the original side by the coagulation zone 27 to avoid bleeding. A single hemostatic component 1 has only two electrodes, and the ablation area 22 formed is relatively small, so the coagulation zone 27 after ablation is also relatively narrow.
图9为平靠组织21进行止血的示意图，平靠的方式适用于浅表大面积止血。FIG. 9 is a schematic diagram of hemostasis by leaning against the tissue 21, and the way of leaning against the tissue 21 is suitable for superficial and large-area hemostasis.
如图10-13所示，使用方式实施例2为两个止血组件1一字排开拼合。值得注意的是，工作极2和回流极3需要交错设置。As shown in FIGS. 10-13 , the usage example 2 is that two hemostatic components 1 are lined up and put together. It is worth noting that the working electrode 2 and the return electrode 3 need to be arranged alternately.
两个止血组件1一字排开的拼合方式有四个电极在同一直线上，可形成较大的消融区域22，故多次消融后的凝固带27也较长。The combination of two hemostatic components 1 lined up has four electrodes on the same straight line, which can form a larger ablation area 22, so the coagulation zone 27 after multiple ablation is also longer.
图13为平靠组织21进行止血的示意图，平靠的方式适用于浅表大面积止血。FIG. 13 is a schematic diagram of hemostasis by leaning against the tissue 21 flatly. The flat leaning method is suitable for superficial and large-area hemostasis.
如图14-16所示，使用方式实施例3为两个止血组件1重叠拼合，同样需要注意的是工作极2和回流极3需要交错开。所有电极排布成两排。As shown in Figures 14-16, the third usage mode is that two hemostatic components 1 are overlapped and combined. It should also be noted that the working electrode 2 and the return electrode 3 need to be staggered. All electrodes are arranged in two rows.
两个止血组件1重叠的拼合方式有四个电极呈方形布置，可形成较大的消融区域22，故而多次消融后的凝固带27也较宽。The two overlapping haemostatic components 1 have four electrodes arranged in a square shape, which can form a larger ablation area 22, so the coagulation zone 27 after multiple ablation is also wider.
此方式拼合不适于平靠止血。另外此方式的组合使用并不需要连接件将两个止血组件1组合成一体，只需要使用者通过手持的方式把控两个止血组件1的位置即可。This method of splicing is not suitable for hemostasis. In addition, the combined use of this method does not require a connecting piece to combine the two hemostatic components 1 into one body, and only requires the user to control the positions of the two hemostatic components 1 by hand.
如图17-19所示，使用方式实施例4为两个止血组件1弧形组合，同样需要注意的是工作极2和回流极3需要交错开。As shown in Figures 17-19, the fourth usage mode is an arc combination of two hemostatic components 1, and it should also be noted that the working electrode 2 and the return electrode 3 need to be staggered.
两个止血组件1弧形排布的拼合方式有四个电极成弧形，故而多次消融后的凝固带27呈弧形。The combination of the two hemostatic components 1 arranged in an arc shape has four electrodes in an arc shape, so the coagulation zone 27 after multiple ablations is in an arc shape.
此方式拼合不适于平靠止血。另外此方式的组合使用并不需要连接件将两个止血组件1组合成一体，只需要使用者通过手持的方式把控两个止血组件1的位置即可。This method of splicing is not suitable for hemostasis. In addition, the combined use of this method does not require a connecting piece to combine the two hemostatic components 1 into one body, and only requires the user to control the positions of the two hemostatic components 1 by hand.
如图20-21所示，使用方式实施例5中，所有电极为弧形，并向圈内弯折。止血组件1为六个，并两两拼合成一组，止血组件之间无需连接件连接。工作极2和回路极3交替布置。止血组件1围绕成一圈，其电极均指向同一中心点。As shown in Figures 20-21, in Example 5 of the usage mode, all the electrodes are arc-shaped and bent inward. There are six hemostatic components 1, and they are put together in pairs, and the hemostatic components do not need to be connected by connectors. Working poles 2 and return poles 3 are arranged alternately. The hemostatic assembly 1 is surrounded in a circle, and its electrodes all point to the same central point.
此方式可形成杯状的消融区域，切除侧位于中间类似半球形，适用于一些特殊手术的要求。This method can form a cup-shaped ablation area, and the resection side is in the middle similar to a hemisphere, which is suitable for some special surgical requirements.
以上仅是本发明的优选实施方式，应当指出的是，上述优选实施方式不应视为对本发明的限制，本发明的保护范围应当以权利要求所限定的范围为准。对于本技术领域的普通技术人员来说，在不脱离本发明的精神和范围内，还可以做出若干改进和润饰，这些改进和润饰也应视为本发明的保护范围。The above are only preferred implementations of the present invention, and it should be noted that the above preferred implementations should not be regarded as limiting the present invention, and the scope of protection of the present invention should be based on the scope defined in the claims. For those skilled in the art, without departing from the spirit and scope of the present invention, some improvements and modifications can also be made, and these improvements and modifications should also be regarded as the protection scope of the present invention.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910670161.4ACN110301974B (en) | 2019-07-23 | 2019-07-23 | Combined hemostatic instrument |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910670161.4ACN110301974B (en) | 2019-07-23 | 2019-07-23 | Combined hemostatic instrument |
| Publication Number | Publication Date |
|---|---|
| CN110301974Atrue CN110301974A (en) | 2019-10-08 |
| CN110301974B CN110301974B (en) | 2024-09-27 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201910670161.4AActiveCN110301974B (en) | 2019-07-23 | 2019-07-23 | Combined hemostatic instrument |
| Country | Link |
|---|---|
| CN (1) | CN110301974B (en) |
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| TA01 | Transfer of patent application right | Effective date of registration:20221227 Address after:Huayin Industrial Port, No. 618, West Section of Kelin Road, Chengdu Cross Strait Science and Technology Industrial Development Park, Wenjiang District, Chengdu, 610000, Sichuan Applicant after:CHENGDU MECHAN ELECTRONIC TECHNOLOGY CO.,LTD. Address before:No. 37, Wuhou District National School Lane, Chengdu, Sichuan Province Applicant before:WEST CHINA HOSPITAL OF SICHUAN University Applicant before:CHENGDU MECHAN ELECTRONIC TECHNOLOGY CO.,LTD. | |
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