Disclosure of Invention
In order to solve the technical problem, the present disclosure provides a method, an apparatus, and a system for controlling tissue perfusion, which can control the pressure during perfusion and avoid the problems of over-high pressure in the tissue lumen.
The technical scheme of the disclosure is realized as follows:
in a first aspect, the present disclosure provides a method of controlling perfusion of tissue, employing a perfusion system having a pressure sensor, a perfusion mechanism, and an injection mechanism; the injection mechanism comprises a first syringe and a second syringe; the method comprises the following steps:
acquiring tissue intimal pressure signals;
and under the condition that the tissue intima pressure signal is determined to meet the set condition, controlling the perfusion mechanism to drive the first injector to inject the fluid into the tissue and controlling the perfusion mechanism to drive the second injector to discharge the fluid in the tissue based on the set strategy.
In one embodiment, the set strategy includes at least one of setting an injection speed, setting an injection frequency, setting an injection time, and setting an injection flow rate.
In one embodiment, before the determining that the tissue intimal pressure signal satisfies the set condition, the method further includes:
controlling the priming mechanism to inject fluid into the first syringe;
controlling the priming mechanism to empty the fluid in the second syringe.
In one embodiment, after the acquiring the tissue intimal pressure signal, the method further comprises:
and under the condition that the tissue intima pressure signal is determined not to meet the set condition, controlling the perfusion mechanism to discharge the fluid in the tissue until the tissue intima pressure meets the set condition.
In a second aspect, the present disclosure provides a device for controlling perfusion of tissue, comprising:
the acquisition module is used for acquiring tissue intima pressure signals;
and the control module is used for controlling the perfusion mechanism to drive the first injector to inject the fluid into the tissues and controlling the perfusion mechanism to drive the second injector to discharge the fluid out of the tissues based on a set strategy under the condition that the tissue intima pressure signal meets a set condition.
In a third aspect, the present disclosure provides a perfusion system comprising:
a controller for executing the above control method;
a priming mechanism electrically connected to the controller,
a pressure sensor electrically connected to the controller;
and an injection mechanism connected with the perfusion mechanism.
In one embodiment, the injection mechanism comprises:
a first injector for injecting fluid into the lumen of the tissue;
and a second syringe for expelling fluid within the tissue.
In one embodiment, the priming mechanism comprises a driver and first and second actuators electrically connected to the driver;
the first actuator is provided with a first openable clamp, and the first openable clamp is used for clamping the first syringe;
the second actuator has a second openable clamp for clamping the second syringe.
In one embodiment, the system further comprises: a fluid circulation assembly coupled to the injection mechanism for providing the fluid to the injection mechanism and for collecting fluid within the tissue withdrawn by the injection mechanism.
In one embodiment, the fluid circulation assembly comprises:
a container for holding a fluid;
the first switch is arranged in the first flow channel and used for controlling the on-off of the first flow channel; the first flow channel is connected between the injection mechanism and the tissue and is used for injecting fluid into the inner cavity of the tissue by the injection mechanism;
the second switch is arranged on the second flow channel and used for controlling the on-off of the second flow channel; the second flow passage is connected between the injection mechanism and the tissue and is used for discharging the fluid in the tissue by the injection mechanism;
a third flow passage connected between the container and the injection mechanism for injecting the fluid of the container into the injection mechanism;
a fourth flow passage connected between the container and the injection mechanism for discharging the fluid in the injection mechanism into the container;
the third switch is arranged on the third flow channel and used for controlling the on-off of the third flow channel;
and the fourth switch is arranged in the fourth flow channel and used for controlling the on-off of the fourth flow channel. The advantages or beneficial effects in the above technical solution at least include:
according to the control method, under the condition that the tissue intimal pressure meets the set conditions, the perfusion mechanism is controlled based on the set strategy, the first injector injects the fluid into the tissue to operate, the perfusion mechanism is controlled to drive the second injector to discharge the fluid in the tissue, so that the pressure in the tissue perfusion process is controllable, the control precision and safety of the tissue intimal pressure in the perfusion process are improved, and the problems that the tissue intimal pressure is too high in the process of manually expanding blood vessels by using the injector in the prior art, the integrity of the skin in a tissue inner cavity is damaged, the inflammatory reaction is activated, the tissue loses the smooth muscle relaxation and contraction function and the like are solved.
Detailed Description
Embodiments of the present disclosure will be described in more detail below with reference to the accompanying drawings. While certain embodiments of the present disclosure are shown in the drawings, it is to be understood that the present disclosure may be embodied in various forms and should not be construed as limited to the embodiments set forth herein, but rather are provided for a more thorough and complete understanding of the present disclosure. It should be understood that the drawings and embodiments of the disclosure are for illustration purposes only and are not intended to limit the scope of the disclosure.
It should be noted that the embodiments and features of the embodiments in the present disclosure may be combined with each other without conflict. The present disclosure will be described in detail below with reference to the accompanying drawings in conjunction with embodiments.
It should be understood that the various steps recited in the method embodiments of the present disclosure may be performed in a different order, and/or performed in parallel. Moreover, method embodiments may include additional steps and/or omit performing the illustrated steps. The scope of the present disclosure is not limited in this respect.
The terms "including," having, "and variations thereof, as used herein, are open-ended, i.e.," including but not limited to. The term "based on" is "based, at least in part, on". The term "one embodiment" means "at least one embodiment"; the term "another embodiment" means "at least one additional embodiment"; the term "some embodiments" means "at least some embodiments". Relevant definitions for other terms will be given in the following description. It should be noted that the terms "first", "second", "third", "fourth", and the like in this disclosure are only used for distinguishing different devices, modules or units, and are not used for limiting the order or interdependence of the functions performed by these devices, modules or units.
Referring to fig. 1 and 4, embodiments of the present disclosure provide a method of perfusion control of tissue, employing a perfusion system having apressure sensor 130, a perfusion mechanism, and an injection mechanism; the injection mechanism includes afirst injector 500a and asecond injector 500 b; the control method can be applied to perfusion control of biological tissues such as great saphenous vein bridges and the like so as to achieve the purposes of expanding, cleaning, smoothing and the like of tissue cavities.
Referring to fig. 1 and 4, a control method provided by the embodiment of the present disclosure includes:
step S100, obtaining tissue intima pressure signals;
and step S200, controlling the perfusion mechanism to drive thefirst injector 500a to inject the fluid into the tissue and controlling the perfusion mechanism to drive thesecond injector 500b to discharge the fluid from the tissue based on the set strategy under the condition that the tissue intima pressure signal meets the set condition.
In the actual perfusion process, the tissue intima pressure can be obtained in real time, whether the tissue intima pressure continuously meets the set condition or not is judged, and the perfusion operation is executed under the condition that the tissue intima pressure meets the set condition;
in the above-mentioned perfusion operation, on one hand, thefirst injector 500a is driven by controlling the perfusion mechanism to inject the fluid into the tissue based on the set strategy, and on the other hand, thesecond injector 500b is driven by controlling the perfusion mechanism to discharge the fluid from the tissue based on the set strategy, in practical application, the fluid in the tissue may be extracted at the same time as the fluid is injected into the tissue, or slightly before or after the fluid is injected, so that the tissue intima pressure is maintained within the set pressure range in the perfusion process, thereby realizing the controllable tissue intima pressure in the perfusion process, and avoiding the problems of tissue injury, etc. due to the overhigh tissue intima pressure.
The setting strategy comprises at least one of setting injection speed, setting injection frequency, setting injection time and setting injection flow; it should be understood that in the actual perfusion operation, different setting strategies can be made according to the tissue intima pressure signal acquired in real time and the change condition of the tissue intima pressure signal; the same setting strategy is adopted under the general condition for the setting strategy of injecting the fluid into the inner cavity and the setting strategy of extracting the fluid in the inner cavity so as to keep the tissue intima pressure stable; however, in practical applications, there may be some special cases, and the setting strategies may be made into a first setting strategy and a second setting strategy according to the needs of practical operations, and the fluid injection step and the fluid extraction step may be respectively assigned to the first setting strategy and the second setting strategy, which are different from each other.
The setting conditions optionally include: the pressure value of the tissue intima is less than or equal to the preset pressure value. Generally, only when the pressure value of the tissue intima is smaller than a set value, fluid can be allowed to be injected into the tissue lumen, so that damage to the tissue intima due to overhigh membrane pressure value in the tissue lumen is avoided.
After obtaining the tissue intima pressure signal, the control method further comprises:
and step S300, controlling the perfusion mechanism to discharge the fluid in the tissue until the tissue intima pressure meets the set condition under the condition that the tissue intima pressure signal does not meet the set condition.
When it is determined that the tissue intima pressure does not satisfy the set condition, which generally means that the tissue intima pressure is too high, in this case, if the perfusion operation is directly performed, the tissue intima pressure will be further increased, and the tissue will be damaged, so that the fluid in the tissue can be firstly pumped out from the tissue, and the perfusion operation can be performed after the pressure in the tissue is reduced to satisfy the set condition, so as to avoid damaging the tissue.
Referring to fig. 2 and 4, in one embodiment, before determining that the tissue intima pressure signal satisfies the set condition, the control method further includes:
s400, controlling a perfusion mechanism to inject fluid into thefirst injector 500 a;
and S500, controlling the perfusion mechanism to empty the fluid in thesecond syringe 500 b.
The above steps are performed to allow thefirst syringe 500a to have fluid therein for injection, while thesecond syringe 500b has sufficient space to allow the fluid in the tissue to be withdrawn.
The control method of the present embodiment further includes terminating the perfusion operation when the termination condition is satisfied; the termination conditions optionally include: the execution times of the perfusion operation reach the set times; or the application parameters of the organization meet the requirements so that the organization can meet the use requirements. For example, when the tissue is a great saphenous vein bridge vessel, the termination condition should be set such that the great saphenous vein bridge vessel meets the requirement of surgical anastomosis.
From the above, in the control method according to the embodiment of the present disclosure, under the condition that it is determined that the tissue intima pressure satisfies the set condition, the perfusion mechanism is controlled to drive thefirst injector 500a to inject the fluid into the tissue and control the perfusion mechanism to drive thesecond injector 500b to discharge the fluid in the tissue based on the set strategy, so that the pressure control in the tissue perfusion process is realized, the control accuracy and the safety of the tissue intima pressure in the perfusion process are improved, and the problems that the tissue intima pressure is too high in the process of manually dilating the blood vessel by using theinjector 500 in the prior art, the integrity of the skin in the tissue lumen is damaged, the inflammatory reaction is activated, and the tissue loses the smooth muscle diastolic contraction function, and the like are solved.
Referring to fig. 3 and 4, embodiments of the present disclosure also provide aperfusion control device 10, comprising:
theacquisition module 11 is used for acquiring tissue intima pressure signals;
and thecontrol module 12 is used for controlling the perfusion mechanism to drive thefirst injector 500a to inject the fluid into the tissue and controlling the perfusion mechanism to drive thesecond injector 500b to discharge the fluid out of the tissue based on the set strategy under the condition that the tissue intima pressure signal meets the set condition.
All relevant contents of each step related to the above method embodiment may be referred to the functional description of the corresponding functional module, and are not described herein again.
Referring to fig. 4-9, embodiments of the present disclosure also provide a perfusion system, including:
acontroller 121 for executing the control method according to the above embodiment;
a perfusion mechanism electrically connected to thecontroller 121 and connected to the injection mechanism for driving thefirst syringe 500a to inject the fluid into the lumen of the tissue and driving thesecond syringe 500b to discharge the fluid from the tissue under the control of thecontroller 121; the priming mechanism comprises an actuator, and adriver 122 for driving the actuator; thedriver 122 is connected to thecontroller 121, and is configured to receive a control signal from thecontroller 121;
apressure sensor 130 electrically connected to thecontroller 121 for acquiring the tissue intima pressure;
an injectionmechanism comprising injectors 500, the number ofinjectors 500 being preferably two, afirst injector 500a and asecond injector 500b, respectively, thefirst injector 500a being for injecting a fluid into a lumen of a tissue, thesecond injector 500b being for discharging the fluid in the tissue;
the number of the perfusion mechanisms is two, and the perfusion mechanisms are respectively afirst perfusion mechanism 110a and asecond perfusion mechanism 110b, thefirst perfusion mechanism 110a is used for driving thefirst injector 500a, thesecond perfusion mechanism 110b is used for driving thesecond injector 500b, the actuating mechanism of thefirst perfusion mechanism 110a is afirst actuating mechanism 111a, and the actuating mechanism of thesecond perfusion mechanism 110b is asecond actuating mechanism 111 b.
Referring to fig. 4 to 9, in this embodiment, the perfusion system may further include anupper computer 300, where theupper computer 300 may be configured to send a command signal to thecontroller 121, and thecontroller 121 sends a control signal to thedriver 122; it should be noted that the command signal may also be a switch signal manually sent by a worker.
Referring to fig. 4 to 9, the actuator includes an openable andclosable clamp 112, apower part 113, and aguide part 114; thepower part 113 is connected to theopenable clamp 112 for driving theopenable clamp 112 to open and close, thereby pushing or pulling thesyringe 500. Wherein thefirst actuator 111a has a firstopenable clamp 112, and thesecond actuator 111b has a secondopenable clamp 112; the first openable andclosable clamp 112 is used for clamping thefirst syringe 500 a; the second openable andclosable clamp 112 is used to clamp thesecond syringe 500 b.
Theopenable clamp 112 includes afirst clamping portion 115 and asecond clamping portion 116 which are relatively movably arranged, and a clamping area is formed between thefirst clamping portion 115 and thesecond clamping portion 116; in practical applications, theinjector 500 is mounted in the clamping area, theinjection port 510 of theinjector 500 extends out of the clamping area, the syringe barrel and the piston handle 520 of theinjector 500 are located in the clamping area and are respectively connected with thefirst clamping portion 115 and thesecond clamping portion 116, so that the piston handle 520 of theinjector 500 can be pushed or pulled along with the relative movement of thefirst clamping portion 115 and thesecond clamping portion 116.
Alternatively, thefirst clamping portion 115 is fixed to one end of therail member 114, and thesecond clamping portion 116 is movably disposed on therail member 114; thepower component 113 is in transmission connection with thesecond clamping part 116; preferably, thepower member 113 is in transmission connection with thesecond clamping portion 116 through alead screw 117.
Optionally,first clamping portion 115 has afirst jaw 1151 for clampinginjection port 510 ofsyringe 500,first jaw 1151 being fixed to one end ofrail member 114 by afirst bracket 1152; thesecond holding portion 116 has asecond jaw 1161 for holding the plunger handle 520 of thesyringe 500, and thesecond jaw 1161 is movably disposed on therail part 114 by asecond bracket 1162.
Based on the above structure,injection port 510 ofinjector 500 can be clamped onfirst clamping piece 1151,injection port 510 can be extended out of the clamping area, piston handle 520 ofinjector 500 is arranged onsecond clamping piece 1161, and whenpower component 113 pushessecond clamping portion 116 to move,second clamping portion 116 can push piston handle 520 to move, so thatinjector 500 can complete the actions of pushing injection or pulling suction.
Referring to fig. 4-9, optionally, thepower component 113 is a motor, and the power component drives the openable and closable tool to open and close by forward rotation and reverse rotation of the motor, so as to push or pull the piston handle 520 of thesyringe 500 to move.
It should be understood that thepower unit 113 of the present embodiment is not limited to a motor, and a power source such as a hydraulic cylinder or an air cylinder may be used as thepower unit 113.
Thedriver 122 may be adapted according to the type of thepower component 113, so as to convert the control signal into a signal recognizable by thecorresponding power component 113, for example, when thepower component 113 is a motor, thedriver 122 is amotor driver 122, and can receive the control signal and convert the control signal into a two-phase signal or a three-phase signal for controlling the rotation of the motor, so as to control the forward rotation, the reverse rotation, the start, the stop, and the like of the motor.
Referring to fig. 4 to 9, as a preferred embodiment of the present embodiment, the perfusion system further includes: afluid circulation assembly 200 is coupled to the injection mechanism for providing fluid to the injection mechanism and for collecting fluid within tissue withdrawn by the injection mechanism.
Thefluid circulation assembly 200 includes:
acontainer 210 for holding a fluid;
thefirst switch 221 is arranged in the first flow channel and used for controlling the on-off of the first flow channel; the first flow channel is connected between the injection mechanism and the tissue and is used for injecting fluid into the inner cavity of the tissue by the injection mechanism;
thesecond switch 222 is arranged in the second flow channel and used for controlling the on-off of the second flow channel; the second flow passage is connected between the injection mechanism and the tissue and is used for discharging the fluid in the tissue by the injection mechanism;
a third flow path connected between thecontainer 210 and the injection mechanism for injecting the fluid of thecontainer 210 into the injection mechanism;
a fourth flow path connected between thecontainer 210 and the injection mechanism for discharging the fluid in the injection mechanism into thecontainer 210;
thethird switch 223 is arranged on the third flow channel and is used for controlling the on-off of the third flow channel;
and thefourth switch 224 is arranged in the fourth flow channel and is used for controlling the on-off of the fourth flow channel.
Referring to fig. 4 and 9, the perfusion system further includes anupper computer 300 for receiving the pressure signal of thepressure sensor 130 and making a setting strategy according to the pressure signal; and generates a command signal according to the set strategy and sends the command signal to thecontroller 121 to drive the perfusion mechanism to execute perfusion operation according to the set strategy.
For example, the hardware connections of the perfusion system of the embodiments of the present disclosure are as follows:
referring to fig. 9, thecontroller 121 is connected to theupper computer 300 through an RS485 cable, and a Modbus-RTU (Remote Terminal Unit) communication protocol may be used. Thecontroller 121 is connected to thedriver 122, wherein thecontroller 121 is powered by a 5V power supply, a pin PUL + of thedriver 122 is a pulse signal input pin and is electrically connected to a pulse signal output pin PUL of thecontroller 121, an effective edge of a pulse output by thecontroller 121 is adjustable, and a rising edge of the pulse is defaulted to be effective; for reliable response to the pulse signal, the pulse width should be greater than 1.2 us. The pin DIR of thecontroller 121 is a direction output pin for outputting a high/low level signal, and the direction signal should be established at least 5us before the pulse signal in order to ensure reliable commutation of the motor. The initial direction of operation of the motor is related to the motor winding connections, and pins a +, a-, B +, B-of thedriver 122 are connected to corresponding ports of the two-phase four-wire stepper motor, respectively. Interchanging either phase winding (e.g., a +, a-interchange) can change the direction in which the motor initially runs. Pin ENA ofdriver 122 is an enable control signal that is used to enable or disable thedriver 122 output. When the ENA pin is connected to a low level or the internal optocoupler is turned on, thedriver 122 will cut off the current of each phase of the motor to make the motor in a free state and not respond to the step pulse. When the function is not needed, the enable signal terminal is suspended. The directcurrent power supply 400 can output 24V voltage to supply power to each module of the system, thedriver 122 is connected with the 24V directcurrent power supply 400 to supply power, the + V port of thedriver 122 is connected with the positive electrode of the power supply, and the GND port is connected with the negative electrode of the power supply.
Referring to fig. 4 to 9, in this embodiment, thefirst actuator 111a and thesecond actuator 111b may share onedriver 122 according to the actual application requirement, or two drivers may be provided, which are thefirst driver 122a and thesecond driver 122b, respectively, where thefirst driver 122a is connected to thefirst actuator 111a, and thesecond driver 122b is connected to thesecond actuator 111 b. Thecontroller 121 may be provided as twocontrollers 121, namely, afirst controller 121a and asecond controller 121 b.
Referring to fig. 4-9, as an alternative embodiment,controller 121 and the components of the priming mechanism, etc. comprisepriming device 110. Wherein thefirst controller 121a, thefirst driver 122a, thefirst actuator 111a, etc. constitute thefirst perfusion apparatus 110; thesecond controller 121b, thesecond driver 122b, and thesecond actuator 111b constitute thefirst perfusion apparatus 110.
It should be noted that the present embodiment is exemplified by perfusion of biological tissue, wherein the fluid is mainly liquid or gas such as physiological saline suitable for biological tissue.
Referring to fig. 4 to 9, the embodiment takes the perfusion and expansion of the great saphenous vein bridge as an example, wherein the perfused fluid is saline, thecontainer 210 filled with the liquid to be perfused is a saline bag, thepower component 113 of thefirst actuator 111a is afirst stepping motor 113a, and thepower component 113 of thesecond actuator 111b is asecond stepping motor 113 b; based on this, the perfusion operation is specifically as follows:
first, thefirst syringe 500a is filled with physiological saline, and thesecond syringe 500b is emptied;
a second step of opening thefirst switch 221 and thesecond switch 222 to open the paths between thefirst syringe 500a and thesecond syringe 500b and the blood vessel; closing thethird switch 223 and thefourth switch 224 to cut off the communication path between thefirst syringe 500a, thesecond syringe 500b and the saline bag;
thirdly, thefirst stepping motor 113a is rotated forward for a specified number of steps, thefirst injector 500a is advanced for a specified distance, and a certain amount of physiological saline is injected into the blood vessel, so that the pressure of the blood vessel wall is increased;
a fourth step of reversing thesecond stepping motor 113b by a predetermined number of steps to withdraw thesecond syringe 500b by a predetermined distance, thereby drawing a predetermined amount of liquid from the blood vessel and lowering the pressure of the blood vessel wall; preferably, thefirst stepping motor 113a and thesecond stepping motor 113b are rotated in equal steps;
a fifth step of repeating the third and fourth steps such that the saline in thefirst syringe 500a is continuously injected into the blood vessel while the fluid in the blood vessel is extracted by thesecond syringe 500 b;
sixthly, when the saline in thefirst syringe 500a is discharged and/or thesecond syringe 500b is fully pumped, stopping thefirst stepping motor 113a and thesecond stepping motor 113b, opening thethird switch 223 and thefourth switch 224, and simultaneously closing thefirst switch 221 and thesecond switch 222, at this time, the paths between thefirst syringe 500a and thesecond syringe 500b and the saline bag are connected, and the paths between thefirst syringe 500a and thesecond syringe 500b and the blood vessel are disconnected;
seventhly, thefirst stepping motor 113a is rotated reversely, so that thefirst syringe 500a rapidly extracts the normal saline from the normal saline bag until the first syringe is fully extracted; thesecond stepping motor 113b is rotated in the forward direction, so that the liquid in thesecond syringe 500b is rapidly emptied into the saline bag;
and after the seventh step is executed, the state of each part returns to the state of the first step, and at the moment, the steps are repeatedly executed until the preset perfusion turn is reached, and then the operation is finished.
It will be understood by those skilled in the art that the foregoing embodiments are merely for clarity of illustration of the disclosure and are not intended to limit the scope of the disclosure. Other variations or modifications may occur to those skilled in the art, based on the foregoing disclosure, and are still within the scope of the present disclosure.