CN112915294A - VA-ECMO femoral artery intubation tube for providing lower limb blood perfusion and intubation method - Google Patents

Abstract

Translated fromChinese

本发明公开了一种提供下肢血液灌注的VA‑ECMO股动脉插管及置管方法，插管包括插管本体和穿刺导芯，所述插管本体内部形成有相互独立的主腔和侧腔，所述主腔为前后贯通结构，且在主腔前端外侧边开设有主腔侧孔，所述侧腔包裹于主腔后端部分的外周，且在侧腔外侧边沿同一条前后向直线开设有侧腔侧孔，插管本体在主腔侧孔和侧腔侧孔之间位置设有环形气囊，在侧腔侧孔后端延线位置设有鼓包气囊，所述环形气囊和鼓包气囊均连接有用于充放气的气囊口。本发明通过对股动脉插管结构的改进，实现一次置管能满足下肢血液的灌注，有效降低了下肢缺血并发症的发生率，且操作方便，减小了手术风险和复杂性、以及对患者的创伤。

The invention discloses a VA-ECMO femoral artery cannula and a cannulation method for providing lower extremity blood perfusion. The cannula includes a cannula body and a puncture guide core. The cannula body is internally formed with a main cavity and a side cavity that are independent of each other. , the main cavity is a front and rear through structure, and a main cavity side hole is opened on the outer side of the front end of the main cavity, the side cavity is wrapped around the outer periphery of the rear end part of the main cavity, and the outer edge of the side cavity is along the same front and rear straight line A side cavity side hole is opened, the cannula body is provided with an annular airbag at the position between the main cavity side hole and the side cavity side hole, and a bulging airbag is arranged at the rear end extension of the side cavity side hole. The annular airbag and the bulging airbag Both are connected with airbag ports for inflation and deflation. By improving the structure of the femoral artery cannula, the invention realizes that one-time cannulation can satisfy the blood perfusion of the lower extremity, effectively reduces the incidence of ischemic complications of the lower extremity, and is convenient to operate, reduces the risk and complexity of the operation, and reduces the risk of operation. patient trauma.

Description

VA-ECMO femoral artery intubation tube for providing lower limb blood perfusion and intubation method

Technical Field

The invention relates to the technical field of medical instruments, in particular to a VA-ECMO femoral artery intubation tube for providing lower limb blood perfusion and a tube placement method.

Background

Extracorporeal membrane oxygenation (ECMO), called membrane lung for short, is a new technology for rescuing the lives of critically ill patients. The essence of ECMO is an improved artificial heart-lung machine, the most central parts being the membrane lung and the blood pump, which function as artificial lung and artificial heart, respectively. When ECMO is operated, blood is drawn from the vein, oxygen is absorbed through the membrane lung, carbon dioxide is discharged, and the blood after gas exchange can return to the vein (VV-ECMO) and also to the artery (VA-ECMO) under the driving of the pump. The former is mainly used for external respiration support, and the latter can be used for external respiration support and cardiac support because the blood pump can replace the blood pumping function of the heart.

Among them, VA-ECMO is widely used clinically because of its simple and convenient operation and its ability to rapidly start cardiopulmonary support. In VA-ECMO, femoral artery catheterization is the first choice in adult VA-ECMO because the femoral artery is shallow in position, easy to operate, can be directly placed by percutaneous puncture or incision, and does not affect the cardio-pulmonary resuscitation. However, the femoral artery cannula may block the blood flow of the femoral artery perfusing the lower limb, causing ischemia of the lower limb, and even requiring amputation for patients with serious ischemia, which is also a common complication of VA-ECMO. In order to reduce the incidence of the complications, the conventional solution is to additionally puncture a lower limb perfusion tube, but the method is very troublesome to operate, aggravates the damage of femoral artery and increases the possibility of vascular complications.

Disclosure of Invention

The invention aims to provide a VA-ECMO femoral artery intubation tube for lower limb blood perfusion and a tube placing method, which solve the problem that the VA-ECMO femoral artery intubation is easy to cause lower limb ischemia complications.

The invention realizes the purpose through the following technical scheme:

the utility model provides a VA-ECMO femoral artery intubate of lower limbs blood perfusion, leads the core including intubate body and puncture, intubate body inside is formed with mutually independent main cavity and side chamber, the main cavity is the front and back through structure, and has seted up the main cavity side opening on main cavity front end outside limit, the side chamber wraps up in the periphery of main cavity rear end portion, and has seted up the side chamber side opening to the straight line in the same preceding back of side chamber outside border, and the intubate body is equipped with annular gasbag at main cavity side opening and side chamber side opening position between, is equipped with the swell gasbag in side chamber side opening rear end line position, annular gasbag and swell gasbag all are connected with the gasbag mouth that is used for filling the gassing.

The side cavity is provided with a plurality of side cavity side holes, and a groove is formed at the position of each side cavity side hole of the side cavity.

The further improvement is that the structure of the annular air bag is pear-shaped.

In a further improvement, the inner surfaces of the main and side lumens are coated with a heparin coating.

In a further improvement, the outer surface of the cannula body is marked with a marking line extending backwards along the side hole of the side cavity.

A tube placing method for a VA-ECMO femoral artery intubation comprises the following steps:

the cannula body is inserted into the femoral artery under the guidance of the puncture guide core, the front end of the cannula body faces the proximal end of the femoral artery, the main cavity side hole, the annular air bag and the bulge air bag are positioned inside the femoral artery, and the angle is controlled to enable the side cavity side hole to face the distal end of the femoral artery;

the annular air bag and the bulge air bag are inflated through the air bag opening, the inflated bulge air bag assists in positioning the position of the side hole of the side cavity to ensure that the perfusion blood is injected into the lower limb, and the inflated annular air bag is fully contacted with the inner wall of the femoral artery to ensure that the side cavity blood perfusion pressure enables the blood to smoothly flow to the far end of the lower limb.

The invention has the beneficial effects that: by improving the femoral artery cannula structure, the disposable cannula can meet the requirement of lower limb blood perfusion, effectively reduces the incidence rate of lower limb ischemic complications, is convenient to operate, and reduces the operation risk and complexity and the trauma to a patient.

Drawings

FIG. 1 is a schematic view of the structure of a VA-ECMO femoral artery cannula;

FIG. 2 is a schematic view of the VA-ECMO femoral artery during cannulation;

in the figure: 1. a cannula body; 2. puncturing and guiding the core; 3. a main chamber; 4. a lateral cavity; 5. a main cavity side aperture; 6. side cavity side holes; 7. an annular air bag; 8. swelling the air bag; 9. an air bag port; 10. a plastic joint; 11. a liquid injection port; 12. an annular guidewire; 13. and marking lines.

Detailed Description

The present application will now be described in further detail with reference to the drawings, it should be noted that the following detailed description is given for illustrative purposes only and is not to be construed as limiting the scope of the present application, as those skilled in the art will be able to make numerous insubstantial modifications and adaptations to the present application based on the above disclosure.

As shown in figure 1, a VA-ECMO femoral artery intubate that provides lower limbs blood perfusion,lead core 2 includingintubate body 1 and puncture,intubate body 1 is inside to be formed with mutually independentmain cavity 3 andside chamber 4,main cavity 3 is the front and back through structure, and maincavity side opening 5 has been seted up on 3 front end outside limits of main cavity, main cavity side opening 5 distributes in side all directions, be used for the injection of blood in themain cavity 3,side chamber 4 wraps up in the periphery of 3 rear end parts of main cavity,side chamber 4 generally adopts the flexible glue material to make, and sidechamber side opening 6 has been seted up to the straight line in the same preceding back in 4 outside borders of side chamber, be used for the injection of blood inside chamber 4. In addition, thecannula body 1 is provided with anannular air bag 7 between the maincavity side hole 5 and the sidecavity side hole 6, anexpansion air bag 8 is arranged at the rear end extension line position of the sidecavity side hole 6, and theannular air bag 7 and theexpansion air bag 8 are both connected with an air bag opening 9 for inflation and deflation.

In the invention, a plurality of sidecavity side holes 6 are arranged, a groove is formed at the opening position of each sidecavity side hole 6 of theside cavity 4, the grooves and the sidecavity side holes 6 in the grooves jointly form a blood groove, and the blood groove structure can improve the smoothness of blood circulation and avoid blocking.

In the invention, theannular air bag 7 is pear-shaped, and has a tip end facing forwards and a round end facing backwards. The tip is forward, so that the cannula can be inserted into a blood vessel conveniently, and the pear-shapedannular air bag 7 can be fully contacted with the inner wall of the femoral artery blood vessel after being inflated, so that the side cavity blood perfusion pressure is ensured to ensure that blood smoothly flows to the far end of the lower limb.

In the invention, the rear end of theintubation tube body 1 is provided with aplastic joint 10 with an end cover, theplastic joint 10 is simultaneously connected with themain cavity 3 and theside cavity 4, theplastic joint 10 is provided with aliquid injection port 11 respectively communicated with themain cavity 3 and theside cavity 4, and theplastic joint 10 is of a hard structure, thereby facilitating the connection of pipelines.

In the invention, the inner surfaces of themain cavity 3 and theside cavity 4 are coated with heparin coatings, and the heparin coatings can retain anticoagulation activity and reduce the activation of coagulation mechanisms.

According to the invention, theannular guide wire 12 is arranged on thecannula body 1 along the cavity walls of themain cavity 3 and theside cavity 4, and theannular guide wire 12 increases the toughness of the puncture tube and is beneficial to puncture.

In the invention, the outer surface of thecannula body 1 is marked with amarking line 13 which extends backwards along the sidecavity side hole 6, so that the orientation of the groove and the sidecavity side hole 6 can be visually determined.

As shown in fig. 2, the present invention further provides a tube placing method for the VA-ECMO femoral artery intubation, which comprises the following steps:

thecannula body 1 is inserted into the femoral artery under the guidance of thepuncture guide core 2, the front end of thecannula body 1 faces the proximal end of the femoral artery, the maincavity side hole 5, theannular air bag 7 and thebulge air bag 8 are positioned in the femoral artery, and the angle is controlled to enable the sidecavity side hole 6 to face the distal end of the femoral artery;

inflateannular gasbag 7 and swellgasbag 8 throughgasbag mouth 9, the supplementary location side chamber side opening 6 position ofswell gasbag 8 after the inflation (can observe concrete position under the supersound after inflating, the position of being convenient for is confirmed, can deflate after the position is confirmed) to avoidintubate body 1 to move partially, guarantee to infuse the blood and pour into the low limbs,annular gasbag 7 after the inflation fully contacts with femoral artery inner wall, make blood flow to the low limbs distal end smoothly with the pressure of guaranteeing 4 blood perfusion of side chamber.

After the tube placement is finished, thepuncture guide core 2 can be drawn out and connected with a pipeline for blood perfusion. Of course, during perfusion, themain chamber 3 is perfused with more blood than theside chamber 4, ensuring that VA-ECMO proceeds efficiently.

The above-mentioned embodiments only express several embodiments of the present invention, and the description thereof is more specific and detailed, but not construed as limiting the scope of the present invention. It should be noted that, for a person skilled in the art, several variations and modifications can be made without departing from the inventive concept, which falls within the scope of the present invention.

Claims (6)

1. A VA-ECMO femoral artery cannula for providing lower limb blood perfusion comprises a cannula body (1) and a puncture guide core (2), and is characterized in that: intubate body (1) inside main cavity (3) and the side chamber (4) that are formed with mutually independent, main cavity (3) link up the structure for the front and back, and main cavity side opening (5) have been seted up on main cavity (3) front end outside limit, side chamber (4) parcel is in the periphery of main cavity (3) rear end portion, and has seted up side chamber side opening (6) to the straight line around side chamber (4) outside border is the same, intubate body (1) is equipped with annular gasbag (7) in main cavity side opening (5) and side chamber side opening (6) position between, is equipped with at side chamber side opening (6) rear end extension line position and swells gasbag (8), annular gasbag (7) and swell gasbag (8) all are connected with gasbag mouth (9) that are used for filling the gassing.

2. The VA-ECMO femoral artery cannula for providing lower extremity blood perfusion of claim 1, wherein: the side cavity side holes (6) are provided with a plurality of grooves, and the side cavity (4) is provided with a groove at the position of each side cavity side hole (6).

3. The VA-ECMO femoral artery cannula for providing lower extremity blood perfusion of claim 1, wherein: the structure of the annular air bag (7) is pear-shaped.

4. The VA-ECMO femoral artery cannula for providing lower extremity blood perfusion of claim 1, wherein: the inner surfaces of the main cavity (3) and the side cavity (4) are coated with heparin coatings.

5. The VA-ECMO femoral artery cannula for providing lower extremity blood perfusion of claim 1, wherein: the outer surface of the cannula body (1) is marked with a marking line (13) which extends backwards along the side cavity side hole (6).

6. A method for placement of a VA-ECMO femoral artery cannula according to any one of claims 1-5, wherein: comprises the steps of

The cannula body (1) is inserted into the femoral artery under the guidance of the puncture guide core (2), the front end of the cannula body (1) faces to the proximal end of the femoral artery, the main cavity side hole (5), the annular air bag (7) and the bulge air bag (8) are positioned inside the femoral artery, and the angle is controlled to enable the side cavity side hole (6) to face to the distal end of the femoral artery;

the annular air bag (7) and the bulge air bag (8) are inflated through the air bag opening (9), the inflated bulge air bag (8) assists in positioning the position of the side cavity side hole (6) to ensure that the perfusion blood is injected into the lower limb, and the inflated annular air bag (7) is fully contacted with the inner wall of the femoral artery to ensure that the blood perfusion pressure of the side cavity (4) enables the blood to smoothly flow to the far end of the lower limb.

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