CN112353487A - Medical combined ablation needle capable of monitoring pressure and ablation method - Google Patents

Abstract

Translated fromChinese

本发明涉及医用消融针及消融方法技术领域，是一种可监测压力的医用联合消融针及消融方法，前者包括消融针体、消融针尾接口箱、物理消融部件、化学消融部件和压力调节部件，在消融针体消融工作段设置有压力监测元件。本发明消融针结构合理而紧凑，使用方便，其能够实现物理消融方法和化学消融方法联合使用，不仅可实现物理消融+化学消融灌续，亦可实现物理消融+化学消融同步进行；同时本发明所述消融针在联合消融肿瘤时，物理消融及化学消融协作，并通过压力监测元件在消融过程中对瘤体内进行压力实时监测，以调整适宜的消融参数，使消融效果显著提高，实现了1+1＞2的治疗效果。

The invention relates to the technical field of medical ablation needles and ablation methods, and is a medical combined ablation needle and ablation method that can monitor pressure. The former includes an ablation needle body, an ablation needle tail interface box, a physical ablation part, a chemical ablation part and a pressure adjustment part , a pressure monitoring element is arranged in the ablation working section of the ablation needle body. The ablation needle of the invention has a reasonable and compact structure and is easy to use, and can realize the combined use of the physical ablation method and the chemical ablation method, which can not only realize the physical ablation + chemical ablation perfusion, but also realize the simultaneous physical ablation + chemical ablation; The ablation needle cooperates with physical ablation and chemical ablation when jointly ablating the tumor, and monitors the pressure in the tumor in real time through the pressure monitoring element during the ablation process, so as to adjust the appropriate ablation parameters, so that the ablation effect is significantly improved, and 1 +1>2 treatment effect.

Description

Medical combined ablation needle capable of monitoring pressure and ablation method

Technical Field

The invention relates to the technical field of medical ablation needles and ablation methods, in particular to a medical combined ablation needle capable of monitoring pressure and an ablation method.

Background

In clinic, many solid tumors are usually not suitable for surgical excision and other treatments due to many factors, ablation is usually adopted, the currently common ablation can be divided into physical ablation and chemical ablation, the common physical ablation methods include radio frequency ablation, microwave ablation, ultrasound confocal ablation, nanosecond pulsed electric field ablation and the like, and the chemical ablation includes absolute alcohol ablation, acetic acid ablation, hypertonic saline, sodium morrhuate and ethanol solution and the like. The most widely used in clinic is radio frequency ablation, which is most commonly used in solid tumors such as primary liver cancer or metastatic liver cancer; whereas chemical ablation is most commonly performed using absolute alcohol ablation.

The principle of radio frequency ablation is that high-frequency current is directly led into a tumor tissue, ions in the tissue around an electrode continuously change directions under the action of alternating current to generate heat through friction, water inside and outside the tumor tissue is vaporized by utilizing local high temperature to cause protein denaturation and final coagulation necrosis, and the ablation effect on the tumor is that the tumor cells directly generate coagulation necrosis due to the high temperature and simultaneously the high temperature affects various functions of cell membranes, mitochondria and lysosomes; the high temperature causes the blood vessels in the tumor to be coagulated and the blood vessels to be blocked; the tumor cell membrane antigen is exposed in the process of radiofrequency ablation, and the generation of specific antibodies by organisms is increased. However, radio frequency ablation inevitably has thermal damage to surrounding normal tissues, and due to the thermal damage, many tumors of organs located at special positions cannot be ablated, or after ablation, risks such as organ function damage, fever, organ function decompensation and the like occur. Meanwhile, due to the three-dimensional structure of the tumor, the radiofrequency ablation needle is easy to deviate from the spherical center of the tumor body under the guidance of ultrasound or CT during puncture, the ablation of the puncture center is sufficient, and the ablation of the edge of the tumor part is insufficient, so that the tumor is easy to relapse or even transfer after early postoperative ablation.

The principle of the absolute alcohol ablation is that the absolute alcohol is directly injected into a tumor body, so that the tumor cells are dehydrated, the protein is solidified, and small blood vessels in the tumor body are embolized, thereby inactivating the tumor. However, absolute alcohol injection still has many defects, and complications such as abdominal pain, fever, hemoglobinuria, drunkenness-like symptoms and the like are easy to occur during or after operation. In addition, the absolute alcohol amount of one injection is mostly limited to 20mL to 30mL, and the general poisoning symptom of ethanol is easy to appear, when the injection treatment is carried out on liver cancer, the dispersion of absolute alcohol is often limited due to the separation of fibrous tissues in the tumor, and the tumor is often required to be injected in multiple points, so the tolerance of a patient is reduced, the ethanol leakage is easy to appear in multiple injection in multiple times, severe abdominal pain is caused, the risk of tumor cell planting and transfer is increased in multiple injection, and due to the three-dimensional structure of the tumor body, even if the tumor is punctured in multiple points, the insufficient ablation or omission of tumor cells in partial positions is easy to appear, so the early relapse and transfer after the operation are easy to appear.

Therefore, a method for ablation of tumors by combining absolute alcohol and radio frequency is explored clinically at present, the combination method is also a simple superposition of the two ablation methods, namely, the tumors are ablated by absolute alcohol and then punctured again for radio frequency ablation, and the current research suggests that injection in the tumors of the absolute alcohol can cause vascular embolism perfused in tumor tissues. The formation of thrombus in tumor blood vessels promotes the necrosis and fibrosis of tumor cells, and the water protective belt formed by absolute alcohol also enhances the ablation effect of heat on tumors. Charring of the surrounding tissues of the electrode pins is delayed after the injection of the anhydrous alcohol in the tumor. The radio frequency ablation is carried out after the injection in the anhydrous alcohol tumor, the local temperature does not rise any more before the anhydrous alcohol is completely vaporized, the carbonization of tissues around the electrode needle is delayed, the heat energy can be further spread, the ablation range is enlarged, and the ablation effect is improved. Meanwhile, the heat resistance of cells can be reduced by causing the tumor cells to be damaged, so that the radio frequency effect is improved, the permeability of cell membranes is increased by the high-temperature effect of radio frequency ablation, and simultaneously, the tumor cells can be killed more efficiently by anhydrous alcohol by the high temperature, so that the two have a synergistic effect, namely, the radio frequency ablation is synergistic by the intratumoral injection of the anhydrous alcohol, and the radio frequency ablation is synergistic by the intratumoral injection of the anhydrous alcohol.

The problems of the current combined ablation are as follows: the mode of injection-radio frequency ablation in the anhydrous alcohol tumor is a two-step puncture method and sequential combination, the simultaneous combined ablation of physical ablation and chemical ablation is not really realized, the risk of increasing needle track planting transfer also exists, and in addition, the problems of insufficient ablation and the like exist due to inconsistent internal positions of the tumor body punctured twice. And the operation flow is more complicated, equipment and disposable consumables which are operated twice need to be prepared, and meanwhile, the risk of postoperative bleeding, pain and other complications in the operation is increased due to the two times of puncture. In addition, the ablation equipment is not improved, the mode free selection and the opportunity free combination of the two combined ablation cannot be realized, and the puncture ablation is not realized by a one-step puncture method.

In addition, in the current clinical ablation of solid tumors, preliminary calculation of the size of the tumor requires time and temperature for ablation, and for chemical ablation, preliminary calculation of the volume of fluid to be injected. However, during ablation, the tumor internal pressure is too high due to over-high local temperature or over-high injection pressure at the puncture site in the tumor during ablation, so that tumor cells drop into blood or are extruded into normal tissues, the ablation treatment effect is poor, and the tumor recurs and metastasizes in early postoperative period, so that the tumor internal pressure monitoring is also necessary besides the detection of the temperature during operation.

Disclosure of Invention

The invention provides a medical combined ablation needle capable of monitoring pressure and an ablation method, overcomes the defects of the prior art, and can effectively solve the problems that the conventional medical ablation needle is poor in ablation effect and combined ablation is not realized by a one-step puncture method.

One of the technical schemes of the invention is realized by the following measures: a medical combined ablation needle capable of monitoring pressure comprises an ablation needle body, an ablation needle tail interface box, a physical ablation part, a chemical ablation part and a pressure adjusting part, wherein the ablation needle body comprises an ablation working section and an ablation non-working section which are connected into a whole from left to right, the right end of the ablation non-working section is fixedly communicated with the left end of the ablation needle tail interface box, the left end of the ablation working section is provided with an ablation needle point, the ablation working section is fixedly provided with a pressure monitoring element, a chemical ablation channel and a pressure monitoring line channel which are mutually isolated are arranged in the ablation needle body, the chemical ablation channel and the pressure monitoring line channel both extend from the tail end of the ablation needle body to the ablation working section, at least two liquid outlets communicated with the left end of the chemical ablation channel are distributed along the side wall of the ablation needle body in the ablation working section, and the liquid outlet end of the chemical ablation part is communicated with the chemical ablation channel, a cooling circulation channel which can cool the medium in the chemical ablation catheter is arranged in the ablation needle tail interface box, the pressure regulating part is electrically connected with the pressure monitoring element, the physical ablation part is connected with the right end of the ablation needle body, and an insulating layer is arranged on the outer side of the ablation non-working section of the ablation needle body.

The following is a further optimization or/and improvement of one of the above-mentioned technical solutions of the invention:

the liquid outlet is spirally distributed at intervals on the side wall of the ablation needle body of the ablation working section.

The pressure adjusting part comprises a pressure signal adjuster and an optical fiber, the pressure signal adjuster is connected with the pressure monitoring element through the optical fiber, the optical fiber penetrates through a pressure monitoring line passing channel in the ablation needle body, the outer wall of the ablation needle body of the ablation working section is provided with a pressure monitoring channel with an opening facing the outside of the ablation needle body, the pressure monitoring element is fixedly installed in the pressure monitoring channel, and the pressure sensing end of the pressure monitoring element is located outside the pressure monitoring channel.

The pressure monitoring element adopts a miniature optical fiber pressure sensor.

The inlet end of the cooling circulation channel of the ablation needle tail connector box is communicated with a cooling water inlet container through a water inlet conduit, and the outlet end of the cooling circulation channel of the ablation needle tail connector box is communicated with a cooling water return container through a water outlet conduit.

The chemical ablation part comprises a push injection pump, and the liquid outlet end of the push injection pump is communicated with the chemical ablation channel through a chemical ablation catheter; the physical ablation part comprises a radio frequency ablation host, an ablation cathode and an ablation anode, the ablation anode and the ablation cathode are both arranged at the needle tail of the right end of the ablation needle body, and the radio frequency ablation host is respectively connected with the ablation cathode and the ablation anode through leads.

The left end of the ablation working section is provided with a sub-ablation needle tip surrounding the ablation needle tip, and the sub-ablation needle tip is in an umbrella shape after being opened.

The second technical scheme of the invention is realized by the following measures: the ablation method of the medical combined ablation needle capable of monitoring the pressure in one technical scheme comprises the following steps:

preparing various articles and equipment, and connecting corresponding equipment; according to the size of a solid tumor with ablation indication of a human body or a solid tumor model of an experimental animal except a brain tumor, selecting an ablation needle body with the appropriate thickness, under the guidance of ultrasound or CT, selecting an appropriate puncture path and puncture angle to puncture, injecting local anesthetic by using an injection pump while puncturing, after an ablation working section enters a tumor part, slowly pumping a chemical ablation preparation by using the injection pump according to the chemical ablation preparation required by preoperative calculation, simultaneously observing the pressure value of a pressure signal regulator, after the pumping of the chemical ablation preparation is finished, adjusting the ablation power, temperature and ablation time of a radio frequency ablation host according to the size of the tumor, performing radio frequency ablation, and simultaneously closely observing the pressure and temperature through the pressure signal regulator and the radio frequency ablation host respectively, if the pressure is too large, adjusting the ablation power of the radio frequency ablation host and increasing the circulation speed of cooling water, when the needle is to be withdrawn after the ablation is finished, the needle is withdrawn while the injection pump is used for injecting injection water or hypertonic saline water to ablate the needle channel so as to prevent the planting transfer.

The third technical scheme of the invention is realized by the following measures: the ablation method of the medical combined ablation needle capable of monitoring the pressure in one technical scheme comprises the following steps:

preparing various articles and equipment, and connecting corresponding equipment; according to the size of the solid tumor with ablation indication or the experimental animal solid tumor model. Except brain tumors, selecting an ablation needle with the appropriate thickness, selecting an appropriate puncture path and puncture angle for puncturing under the guidance of ultrasound or CT, injecting local anesthetic by using a push injection pump while puncturing, slowly pumping a chemical ablation preparation by using the push injection pump according to the chemical ablation preparation required by preoperative calculation after an ablation working section enters a tumor part, simultaneously adjusting the ablation power, temperature and ablation time of a radio frequency ablation host according to the size of the tumor, carrying out synchronous radio frequency ablation, simultaneously closely observing the pressure and temperature through a pressure signal regulator and the radio frequency ablation host respectively, reducing the ablation power of the radio frequency ablation host and increasing the circulation speed of cooling water if the pressure is too high, and injecting injection water or hypertonic saline for needle channel ablation while withdrawing the needle when the needle is planned to be withdrawn after ablation to prevent the implantation metastasis.

The ablation needle has reasonable and compact structure and convenient use, can realize the combined use of a physical ablation method and a chemical ablation method, not only can realize the irrigation of physical ablation and chemical ablation, but also can realize the synchronous operation of the physical ablation and the chemical ablation; meanwhile, when the ablation needle is used for jointly ablating tumors, the physical ablation and the chemical ablation are cooperated, and the pressure in the tumor body is monitored in real time in the ablation process through the pressure monitoring element so as to adjust proper ablation parameters, so that the ablation effect is obviously improved, and the treatment effect of 1+1 > 2 is realized; in addition, when the ablation needle is used for ablation, anesthesia and combined ablation treatment can be realized only by one-step puncture, compared with the existing ablation mode, the ablation needle has the advantage of reducing needle track planting metastasis, and simultaneously, the ablation is performed on the same puncture part of a tumor by one-step ablation, so that the ablation effect is improved, and complications such as bleeding, pain, injury and the like are reduced.

Drawings

Fig. 1 is a front view structural diagram of a medical combined ablation needle capable of monitoring pressure according to embodiment 1 of the invention.

Fig. 2 is a structural schematic diagram of the needle tail of the medical combined ablation needle capable of monitoring pressure.

FIG. 3 is an enlarged sectional view of the melting section A in FIG. 1.

Fig. 4 is a partially enlarged schematic view of the ablation stage of fig. 1.

The codes in the figures are respectively: 1 is melting needle tail interface box, 2 is melting the working section, 3 is melting the inoperative segment, 4 is melting the needle point, 5 is the pressure monitoring component, 6 is the chemical ablation passageway, 7 is the liquid outlet, 8 is the chemical ablation pipe, 9 is the pressure signal regulator, 10 is optic fibre, 11 is the pipe of intaking, 12 is cooling water inlet container, 13 is the water outlet pipe, 14 is cooling water return liquid container, 15 is the push pump, 16 is the radio frequency ablation host computer, 17 is the wire.

Detailed Description

The present invention is not limited by the following examples, and specific embodiments may be determined according to the technical solutions and practical situations of the present invention.

In the present invention, for convenience of description, the description of the relative positional relationship of the components is described according to the layout pattern of fig. 1 of the specification, such as: the positional relationship of front, rear, upper, lower, left, right, etc. is determined in accordance with the layout direction of fig. 1 of the specification.

The invention is further described with reference to the following examples and figures:

example 1: as shown in the attached drawings 1 to 4, the medical combined ablation needle capable of monitoring pressure comprises an ablation needle body, an ablation needle tail interface box 1, a physical ablation part, a chemical ablation part and a pressure regulating part, wherein the ablation needle body comprises an ablation working section 2 and an ablationnon-working section 3 which are connected into a whole from left to right, the right end of the ablation non-workingsection 3 is fixedly communicated with the left end of the ablation needle tail interface box 1, the left end of the ablation working section 2 is provided with anablation needle point 4, the ablation working section 2 is fixedly provided with apressure monitoring element 5, the ablation needle body is internally provided with achemical ablation channel 6 and a pressure monitoring line channel which are mutually isolated, thechemical ablation channel 6 and the pressure monitoring line channel both extend from the tail end (right end) of the ablation needle body to the working section 2, the ablation working section 2 is distributed with at least twoliquid outlets 7 communicated with the left end of thechemical ablation channel 6 along the side wall of, the play liquid end that the part was ablated to chemistry passes throughchemical ablation pipe 8 intercommunication withchemical ablation passageway 6, is provided with the cooling circulation channel that can melt the medium cooling in thepipe 8 to chemistry in ablating in ablation backshank interface box 1, and pressure regulation part is connected withpressure monitoring element 5 electricity, and the part is ablated with the right-hand member of ablating the needle body to physics, is provided with the insulating layer in the 3 outsides of ablating non-working sections of ablating the needle body:

(1) the ablation needle can realize the combined use of physical ablation and chemical ablation, not only can realize the irrigation continuation of the physical ablation and the chemical ablation, but also can realize the synchronous operation of the physical ablation and the chemical ablation;

the physical ablation method comprises radio frequency ablation, microwave ablation, ultrasonic confocal ablation, nanosecond pulsed electric field ablation and the like;

according to the current thermal ablation theory, when the tumor is jointly ablated, the chemical ablation dispersity at the edge of the tumor is increased due to the chemical ablation when the radiofrequency ablation is performed, and meanwhile, when the tumor is jointly ablated, liquid around the ablation working section 2 of the ablation needle forms a liquid spherical zone under the action of the radiofrequency thermal ablation, so that the thermal injury to peripheral normal tissues caused by the radiofrequency ablation is limited, and the thermal ablation effect in the liquid spherical zone is increased; in addition, the peripheral liquid spherical zone fully ablates peripheral tumor tissues, limits the chance of shedding, transferring and relapse of tumor cells under thermal ablation, and increases the sensitivity of radio frequency ablation, namely, the ablation needle realizes the treatment effect of 1+1 > 2 due to the combination of physical ablation and chemical ablation;

(2) when the ablation needle is used, a chemical ablation preparation can reach the ablation working section 2 through thechemical ablation channel 6 and then is discharged through theliquid outlet 7. The chemical ablation preparation for combination is selected more, and common absolute alcohol, water for injection or hypertonic saline, acetic acid and the like can be selected during chemical ablation, the dispersity of the absolute alcohol is easily influenced by tumor interstitial separation, but the dispersity of the absolute alcohol can be obviously increased under the thermal ablation of radio frequency ablation; the injection water and the hypertonic saline water are less affected by the dosage, the postoperative complications are lower, the heated chemical ablation preparation can be directly used to increase the treatment effect, and the injection water and the hypertonic saline water are injected to ablate the needle track to reduce the chance of needle track planting transfer when the ablation is finished;

(3) in the ablation process of the ablation needle, the anesthetic can be synchronously injected, the anesthetic is sent to the ablation working section 2 through thechemical ablation channel 6 and then discharged through theliquid outlet 7, so that the pain of a patient in the ablation process and the waste of materials are reduced;

(4) in the ablation process, the pressure in the tumor body is monitored in real time through thepressure monitoring element 5, the pressure is monitored during ablation, the radio frequency ablation is adjusted according to the pressure change, and the falling, planting, transferring and recurrence of tumor cells are reduced;

(5) when the ablation needle is used for ablation, anesthesia and combined ablation treatment can be realized only by one-step puncture, compared with the existing ablation mode, the ablation needle has the advantage of reducing needle track planting metastasis, and simultaneously, the ablation is performed on the same puncture part of a tumor by one-step ablation, so that the ablation effect is increased, and complications such as bleeding, pain, injury and the like are reduced.

The insulating layer is arranged on the outer side of the ablationnon-working section 3, so that only the ablation working section 2 and theablation needle tip 4 can be ensured to exert an ablation effect.

The material of the ablation needle body is the same as that of the existing ablation needle body, and is generally a metal material.

The medical combined ablation needle capable of monitoring the pressure can be further optimized or/and improved according to the actual needs:

as shown in fig. 4, in order to make the ablation preparation surround the ablation object (solid tumor for ablation indication) as much as possible and improve the ablation effect, thechemical liquid outlets 7 are spirally and alternately distributed on the side wall of the ablation needle body of the ablation working section 2.

Meanwhile, thechemical liquid outlet 7 is arranged in a spiral shape, so that the anesthesia speed around the ablation object can be accelerated when the anesthetic is pumped through thechemical ablation channel 6.

As shown in fig. 1 and 4, the pressure regulating component includes a pressure signal regulator 9 and anoptical fiber 10, the pressure signal regulator 9 is connected with thepressure monitoring element 5 through theoptical fiber 10, theoptical fiber 10 passes through the pressure monitoring line passing channel in the ablation needle body, a pressure monitoring channel with an opening facing the outside of the ablation needle body is arranged on the outer wall of the ablation needle body of the ablation working section 2, thepressure monitoring element 5 is fixedly installed in the pressure monitoring channel, and the pressure sensing end of thepressure monitoring element 5 is located outside the pressure monitoring channel.

In order to make the pressure monitoring effect better, the pressure sensing end of thepressure monitoring element 5 is arranged outside the pressure monitoring channel.

Thepressure monitoring element 5 is a miniature optical fiber pressure sensor as required.

The miniature optical fiber pressure sensor can adopt the optical fiber sensor with the model number of single channel (general) or fpi-hr (scientific application) or fop-m (standard) provided by Shenzhen European Shenshen opto-electronic technology Limited.

As shown in fig. 1 and 2, the inlet end of the cooling circulation channel of the ablation needle tail connector box 1 is communicated with a cooling water inlet container 12 through awater inlet conduit 11, and the outlet end of the cooling circulation channel of the ablation needle tail connector box 1 is communicated with a coolingwater return container 14 through awater outlet conduit 13.

The cooling circulation medium for cooling can be physiological saline. When the ablation needle is used for ablation, when the pressure or the temperature of an ablation object is too high, the circulation speed of the cooling circulation medium can be increased, so that the pressure or the temperature of the ablation object is reduced. The circulation rate can be controlled by connecting a pumping device to the inlet end of theinlet conduit 11 or/and the outlet end of theoutlet conduit 13.

The cooling water inlet container 12 and the coolingwater return container 14 can adopt physiological saline bottles.

The cooling circulation channel is generally a circulation coil or a hose.

As shown in fig. 1, the chemical ablation part comprises a push injection pump 15, and the liquid outlet end of the push injection pump 15 is communicated with thechemical ablation channel 6 through achemical ablation catheter 8; the physical ablation part comprises a radio frequencyablation host machine 16, an ablation cathode and an ablation anode, the ablation anode and the ablation cathode are both arranged at the needle tail of the right end of the ablation needle body, and the radio frequencyablation host machine 16 is respectively connected with the ablation cathode and the ablation anode through alead 17.

Chemical ablation agents are injected into thechemical ablation channel 6 through the push injection pump 15 and then are discharged through theliquid outlet 7, so that chemical ablation is carried out on an ablation object. The ablation frequency, the ablation temperature and the ablation time can be controlled by theradiofrequency ablation host 16.

The chemical ablation preparation can be one of absolute alcohol, water for injection, and hypertonic saline or heated preparation thereof.

The bolus pump 15 is typically a digital bolus pump.

According to the requirement, the left end of the ablation working section 2 is provided with a sub-ablation needle tip surrounding theablation needle tip 4, and the sub-ablation needle tip is in an umbrella shape after being unfolded.

After the sub-ablation needle points are added to the ablation needle, a multi-pole combined ablation needle is formed. The multi-pole combined ablation needle is suitable for ablation of larger tumors.

Example 2: the ablation method using the medical combined ablation needle capable of monitoring pressure in the embodiment 1 is carried out as follows:

preparing various articles and equipment, and connecting corresponding equipment; according to the size of a solid tumor (except brain tumor) with ablation indication of a human body or a solid tumor model of an experimental animal, an ablation needle body with the appropriate thickness is recommended to be selected according to the current clinical treatment guideline, under the guidance of ultrasound or CT (ablation can be carried out in open abdomen or laparoscopic surgery) after the sterilization and the drape, the appropriate puncture path and puncture angle are selected for puncture, local anesthetic is injected by a digital injection pump while puncture, after an ablation working section 2 enters a tumor part, the chemical ablation preparation is slowly pumped by the digital injection pump according to the chemical ablation required by preoperative calculation, the pressure value of a pressure signal regulator 9 is observed at the same time, after the chemical ablation preparation is injected by the pump, the ablation power, the temperature and the ablation time of a radio frequency ablation host computer 16 are regulated according to the tumor size for radio frequency ablation, and the pressure and the temperature are closely observed through the pressure signal regulator 9 and the radio frequency ablation host computer 16 respectively, if the pressure is too large, the ablation power of the radio frequency ablation host machine 16 is reduced, the speed of cooling water circulation is increased, when the needle is about to withdraw after ablation, the needle is withdrawn, and injection water or hypertonic saline is injected by a digital injection pump to ablate the needle channel to prevent the implantation transfer, and the operation is finished. Vital signs and other treatments were closely observed post-surgery.

The ablation method described in this example 2 is a chemical-physical combination irrigation ablation method.

Example 3: the ablation method using the medical combined ablation needle capable of monitoring pressure in the embodiment 1 is carried out as follows:

preparing various articles and equipment, and connecting corresponding equipment; according to the size of a solid tumor (except a brain tumor) with ablation indication of a human body or a solid tumor model of an experimental animal, the selection of an ablation needle with the appropriate thickness is recommended according to the current clinical treatment guideline, under the guidance of ultrasound or CT (ablation can also be carried out in open abdomen or laparoscopic surgery) after the disinfection and the drape, the selection of an appropriate puncture path and puncture angle for puncture is carried out, local anesthetic is injected by a digital injection pump while puncture is carried out, after an ablation working section 2 enters a tumor part, the chemical ablation preparation required by preoperative chemical ablation is slowly pumped by the digital injection pump according to the chemical injection pump, the ablation power, the temperature and the ablation time of a radio frequency ablation host computer 16 are adjusted according to the tumor size for synchronous radio frequency ablation, and the pressure and the temperature are closely observed through a pressure signal regulator 9 and the radio frequency ablation host computer 16 respectively, if the pressure is too large, the ablation power of the radiofrequency ablation host machine 16 is reduced and the speed of cooling water circulation is increased, when needle withdrawal is planned after ablation is completed, the needle is withdrawn, and injection water or hypertonic saline is injected by a digital injection pump to ablate the needle channel to prevent the planting transfer, and the operation is finished. Vital signs and other treatments were closely observed post-surgery.

The ablation method described in this example 3 is a chemical-physical combined synchronous ablation method.

In conclusion, the ablation needle can realize the combined use of the physical ablation method and the chemical ablation method, not only can realize the irrigation continuation of the physical ablation and the chemical ablation, but also can realize the synchronous operation of the physical ablation and the chemical ablation; meanwhile, when the ablation needle is used for jointly ablating tumors, physical ablation and chemical ablation are cooperated, and the pressure in the tumor body is monitored in real time in the ablation process through thepressure monitoring element 5 so as to adjust proper ablation parameters, so that the ablation effect is obviously improved, and the treatment effect of 1+1 > 2 is realized; in addition, when the ablation needle is used for ablation, anesthesia and combined ablation treatment can be realized only by one-step puncture, compared with the existing ablation mode, the ablation needle has the advantage of reducing needle track planting metastasis, and simultaneously, the ablation is performed on the same puncture part of a tumor by one-step ablation, so that the ablation effect is improved, and complications such as bleeding, pain, injury and the like are reduced.

The above technical features constitute a preferred embodiment of the present invention, which has strong adaptability and better implementation effect, and unnecessary technical features can be increased or decreased according to actual needs to meet the requirements of different situations.

Claims (10)

Translated fromChinese

1.一种可监测压力的医用联合消融针，其特征在于包括消融针体、消融针尾接口箱、物理消融部件、化学消融部件和压力调节部件，消融针体包括自左而右连为一体的消融工作段和消融非工作段，消融非工作段右端与消融针尾接口箱左端固定连通，消融工作段的左端设置有消融针尖，且在消融工作段固定安装有压力监测元件，在消融针体内设置有相互隔离的化学消融通道和压力监测过线通道，化学消融通道和压力监测过线通道均自消融针体针尾端延伸至消融工作段，在消融工作段沿消融针体侧壁分布有至少两个与化学消融通道左端连通的出液口，化学消融部件的出液端与化学消融通道通过化学消融导管连通，在消融针尾接口箱内设置有能对化学消融导管内的介质冷却的降温循环通道，压力调节部件与压力监测元件电连接，物理消融部件与消融针体的右端连接，在消融针体的消融非工作段外侧设置有绝缘层。1. A medical combined ablation needle capable of monitoring pressure, characterized in that it comprises an ablation needle body, an ablation needle tail interface box, a physical ablation component, a chemical ablation component and a pressure regulating component, and the ablation needle body includes a left-to-right connection as a whole. The right end of the ablation non-working section is fixedly connected with the left end of the ablation needle tail interface box, the left end of the ablation working section is provided with an ablation needle tip, and a pressure monitoring element is fixedly installed in the ablation working section. There are mutually isolated chemical ablation channels and pressure monitoring wire passages in the body. Both chemical ablation channels and pressure monitoring wire passages extend from the end of the ablation needle to the ablation working section, and are distributed along the side wall of the ablation needle in the ablation working section. There are at least two liquid outlets communicating with the left end of the chemical ablation channel. The liquid outlet end of the chemical ablation component is communicated with the chemical ablation channel through the chemical ablation catheter. The ablation needle tail interface box is provided with a cooling device that can cool the medium in the chemical ablation catheter. The pressure regulating component is electrically connected with the pressure monitoring element, the physical ablation component is connected with the right end of the ablation needle body, and an insulating layer is provided outside the ablation non-working section of the ablation needle body.2.根据权利要求1所述的可监测压力的医用联合消融针，其特征在于出液口呈螺旋状间隔分布在消融工作段的消融针体侧壁处。2 . The medical combined ablation needle capable of monitoring pressure according to claim 1 , wherein the liquid outlet is distributed at a spiral interval at the side wall of the ablation needle body of the ablation working section. 3 .3.根据权利要求1或2所述的可监测压力的医用联合消融针，其特征在于压力调节部件包括压力信号调节器和光纤，压力信号调节器与压力监测元件通过光纤连接，光纤穿过消融针体内的压力监测过线通道，在消融工作段的消融针体外壁上设置有开口朝向消融针体外的压力监测通道，压力监测元件固定安装在压力监测通道内，且压力监测元件的压力感应端位于压力监测通道外。3. The medical combined ablation needle capable of monitoring pressure according to claim 1 or 2, characterized in that the pressure regulating component comprises a pressure signal regulator and an optical fiber, the pressure signal regulator and the pressure monitoring element are connected by an optical fiber, and the optical fiber passes through the ablation A pressure monitoring wire channel in the needle body, a pressure monitoring channel with an opening facing the outside of the ablation needle is set on the outer wall of the ablation needle in the ablation working section, the pressure monitoring element is fixedly installed in the pressure monitoring channel, and the pressure sensing end of the pressure monitoring element Outside the pressure monitoring channel.4.根据权利要求3所述的可监测压力的医用联合消融针，其特征在于压力监测元件采用微型光纤压力传感器。4 . The medical combined ablation needle capable of monitoring pressure according to claim 3 , wherein the pressure monitoring element adopts a miniature optical fiber pressure sensor. 5 .5.根据权利要求1或2或4所述的可监测压力的医用联合消融针，其特征在于消融针尾接口箱的降温循环通道进口端通过进水导管连通有冷却水进液容器，消融针尾接口箱的降温循环通道出口端通过出水导管连通有冷却水回液容器；或/和，消融工作段左端设置有围绕消融针尖的子消融针尖，子消融针尖张开后呈伞状。5. The medical combined ablation needle capable of monitoring pressure according to claim 1, 2 or 4, characterized in that the inlet end of the cooling circulation channel of the ablation needle tail interface box is communicated with a cooling water inlet container through a water inlet conduit, and the ablation needle The outlet end of the cooling circulation channel of the tail interface box is connected with a cooling water return container through a water outlet conduit; or/and, the left end of the ablation working section is provided with a sub-ablation needle tip surrounding the ablation needle tip, and the sub-ablation needle tip is umbrella-shaped when opened.6.根据权利要求3所述的可监测压力的医用联合消融针，其特征在于消融针尾接口箱的降温循环通道进口端通过进水导管连通有冷却水进液容器，消融针尾接口箱的降温循环通道出口端通过出水导管连通有冷却水回液容器；或/和，消融工作段左端设置有围绕消融针尖的子消融针尖，子消融针尖张开后呈伞状。6. The medical combined ablation needle capable of monitoring pressure according to claim 3, characterized in that the inlet end of the cooling circulation channel of the ablation needle tail interface box is connected with a cooling water liquid inlet container through a water inlet conduit, and the ablation needle tail interface box is connected with a cooling water inlet container. The outlet end of the cooling circulation channel is connected with a cooling water return container through a water outlet conduit; or/and, the left end of the ablation working section is provided with a sub-ablation needle tip surrounding the ablation needle tip, and the sub-ablation needle tip is umbrella-shaped when opened.7.根据权利要求1或2或4或6所述的可监测压力的医用联合消融针，其特征在于化学消融部件包括推注泵，推注泵出液端与化学消融通道通过化学消融导管连通；或/和，物理消融部件包括射频消融主机、消融负极和消融正极，消融正极和消融负极均设置在消融针体右端针尾处，射频消融主机分别与消融负极、消融正极通过导线连接。7. The medical combined ablation needle capable of monitoring pressure according to claim 1 or 2 or 4 or 6, wherein the chemical ablation component comprises a bolus pump, and the liquid end of the bolus pump is communicated with the chemical ablation channel through a chemical ablation catheter or/and, the physical ablation component includes a radio frequency ablation host, ablation negative electrode and ablation positive electrode, the ablation positive electrode and ablation negative electrode are both arranged at the needle tail at the right end of the ablation needle body, and the radio frequency ablation host is respectively connected with the ablation negative electrode and the ablation positive electrode through wires.8.根据权利要求3或5所述的可监测压力的医用联合消融针，其特征在于化学消融部件包括推注泵，推注泵出液端与化学消融通道通过化学消融导管连通；或/和，物理消融部件包括射频消融主机、消融负极和消融正极，消融正极和消融负极均设置在消融针体右端针尾处，射频消融主机分别与消融负极、消融正极通过导线连接。8. The pressure-monitoring medical combined ablation needle according to claim 3 or 5, wherein the chemical ablation component comprises a bolus pump, and the liquid end of the bolus pump communicates with the chemical ablation channel through a chemical ablation catheter; or/and The physical ablation components include a radio frequency ablation host, ablation negative electrode, and ablation positive electrode. Both the ablation positive electrode and the ablation negative electrode are arranged at the needle tail at the right end of the ablation needle body, and the radio frequency ablation host is respectively connected with the ablation negative electrode and ablation positive electrode through wires.9.一种利用根据权利要求1至8任意一项所述的可监测压力的医用联合消融针的消融方法，其特征在于按下述方法进行：9. An ablation method using the pressure-monitorable medical combined ablation needle according to any one of claims 1 to 8, characterized in that it is performed by the following method:备好各种物品及设备，并连接好相应设备；根据人体有消融适应症的实体肿瘤或实验动物实体肿瘤模型的大小，脑肿瘤除外，选取粗细相适应的消融针体，在超声或CT引导下，选取适合的穿刺路径及穿刺角度进行穿刺，边穿刺边用推注泵推注局麻药，消融消融工作段进入肿瘤部位后，根据术前计算的化学消融所需化学消融制剂，用推注泵缓慢泵入化学消融制剂，同时观察压力信号调节器的压力值，化学消融制剂泵注完成后，根据肿瘤大小调整射频消融主机的消融功率、温度及消融时间，进行射频消融，同时通过压力信号调节器和射频消融主机分别密切观察压力及温度，如压力过大，则调小射频消融主机的消融功率及增加降温水循环的速度，完成消融后拟退针时，边退针边经推注泵推注注射用水或高渗盐水对针道消融以防止种植转移。Prepare various items and equipment, and connect the corresponding equipment; according to the size of the solid tumor with ablation indications in the human body or the experimental animal solid tumor model, except for brain tumors, select the ablation needle with the appropriate thickness, and use it under the guidance of ultrasound or CT. Then, select a suitable puncture path and puncture angle for puncture, and use a bolus pump to inject local anesthetic during puncture. After the ablation and ablation working segment enters the tumor site, according to the preoperative calculation of chemical ablation preparations required for chemical ablation, use bolus injection. The pump slowly pumped the chemical ablation preparation, while observing the pressure value of the pressure signal regulator. After the chemical ablation preparation was pumped, adjust the ablation power, temperature and ablation time of the radiofrequency ablation host according to the size of the tumor to perform radiofrequency ablation. At the same time, through the pressure signal The regulator and the radiofrequency ablation host should closely observe the pressure and temperature respectively. If the pressure is too high, reduce the ablation power of the radiofrequency ablation host and increase the speed of the cooling water circulation. A bolus of water for injection or hypertonic saline is used to ablate the needle tract to prevent implant transfer.10.一种利用根据权利要求1至8任意一项所述的可监测压力的医用联合消融针的消融方法，其特征在于按下述方法进行：10. An ablation method using the pressure-monitorable medical combined ablation needle according to any one of claims 1 to 8, characterized in that it is performed as follows:备好各种物品及设备，并连接好相应设备；根据人体有消融适应症的实体肿瘤或实验动物实体肿瘤模型的大小，脑肿瘤除外，选取粗细相适应的消融针，在超声或CT引导下，选取适合的穿刺路径及穿刺角度进行穿刺，边穿刺边用推注泵推注局麻药，消融消融工作段进入肿瘤部位后，根据术前计算的化学消融所需化学消融制剂，用推注泵缓慢泵入化学消融制剂，同时根据肿瘤大小调整射频消融主机的消融功率、温度及消融时间，进行同步射频消融，同时通过压力信号调节器和射频消融主机分别密切观察压力及温度，如压力过大，则调小射频消融主机的消融功率及增加降温水循环的速度，完成消融后拟退针时，边退针边经推注泵推注注射用水或高渗盐水对针道消融防止种植转移。Prepare various items and equipment, and connect the corresponding equipment; according to the size of the solid tumor or experimental animal solid tumor model with indications for ablation in the human body, excluding brain tumors, select an ablation needle with suitable thickness, and under the guidance of ultrasound or CT , select a suitable puncture path and puncture angle for puncture, and use a bolus pump to inject local anesthetic during puncture. After the ablation and ablation working section enters the tumor site, according to the preoperative calculation of chemical ablation preparations required for chemical ablation, use a bolus pump to inject the local anesthetic. Slowly pump chemical ablation preparations, and at the same time adjust the ablation power, temperature and ablation time of the radiofrequency ablation host according to the size of the tumor to perform synchronous radiofrequency ablation. , then reduce the ablation power of the radiofrequency ablation host and increase the speed of the cooling water circulation. When the needle is to be withdrawn after the ablation is completed, the needle is withdrawn and injected with water for injection or hypertonic saline through the bolus pump to ablate the needle tract to prevent implantation transfer.

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