Disclosure of Invention
The invention aims to provide a liquid radioactive source applying device, which solves the problems that the dosage of a target area is inaccurate and nuclides are lost due to the existing liquid radionuclide through an oral or intravascular injection method.
The liquid radioactive source applying device is realized in such a way that a nuclide channel is arranged in an applying source catheter, a plurality of nuclide balloons are arranged at the front end of the applying source catheter along the applying source catheter, the nuclide balloons are communicated with the nuclide channel, a nuclide inlet communicated with the nuclide channel is arranged at the rear end of the applying source catheter, a retractable positioning bracket is arranged at the front end of the applying source catheter, the applying source catheter is positioned at the center of the positioning bracket, a bracket recovery inner sleeve is sleeved outside the applying source catheter, a radiation protection outer sleeve is sleeved outside the bracket recovery inner sleeve, a traction wire is connected to the positioning bracket, and the traction wire penetrates through the bracket recovery inner sleeve and extends out of the rear end of the bracket recovery inner sleeve.
The front end of the source applying catheter is provided with a far-end mark, the front end of the radiation-proof outer sleeve is provided with a near-end mark, and the near-end mark and the far-end mark are X-ray development marks.
A guide wire channel is also arranged in the source applying catheter, and the guide wire channel penetrates through the whole source applying catheter.
The locating support comprises a support wall of a reticular structure, a support frame is uniformly arranged on the inner wall of the support wall around an axle center, the support frame is in contact with the outer wall of the source applying catheter or the outer wall of the nuclide saccule, an annular recovery line is arranged at the rear end of the support wall, and the traction line is connected with the recovery line.
The front end of the support recovery inner sleeve is a horn-shaped recovery port, the recovery port is composed of a plurality of valve bodies, and the valve bodies incline outwards in the radial direction of the support recovery inner sleeve.
The nuclear injection device comprises a radiation protection box body, an injector shell is arranged in the radiation protection box body, two ends of the injector shell are respectively communicated with a water inlet pipe and a nuclear species outlet pipe, the nuclear species outlet pipe is used for being communicated with a nuclear species inlet, a water-driven piston is arranged in the injector shell body, the inner cavity of the injector shell body is divided into two cavities, and the cavities communicated with the nuclear species outlet pipe are used for containing liquid nuclear species.
And a pressure measuring pipe is communicated with a cavity communicated with the water inlet pipe in the injector shell, and extends out of the radiation-proof box body and is connected with a pressure measuring device.
The invention is used for the source operation of the liquid radionuclide, and the liquid radionuclide is not directly taken orally or injected into a human body, but is conveyed into the nuclide saccule, and the nuclide does not enter the blood circulation in the nuclide saccule and the source catheter, so that the nuclide is not lost, and is not accumulated in other organs and is not damaged. The number and the size of the nuclide sacculus can be controlled, so that the dosage can be accurately calculated, and the curative effect and the complications can be accurately predicted. Can be used for radiotherapy by puncturing tumor or natural human body cavity, and can be theoretically applied to various tumors. The accurate two-dimensional and three-dimensional dose distribution of the target focus can be accurately calculated on the basis of CT, MRI and other images. The dose distribution of the organs at risk around the target region can be accurately assessed. And can be used for treating vascular stenosis.
The invention can ensure the accuracy of the target area dosage, avoid the recurrence of the illness state and avoid the complications caused by the aggregation of nuclides in other organs.
Detailed Description
As shown in fig. 1, the invention is a liquid radioactive source applying device, which is structurally characterized in that a nuclide channel 1-2 is arranged in an applying source catheter 1, a plurality of nuclide balloons 2 are arranged at the front end of the applying source catheter 1 along the applying source catheter 1, the nuclide balloons 2 are communicated with the nuclide channel 1-2, a nuclide inlet 1-1 communicated with the nuclide channel 1-2 is arranged at the rear end of the applying source catheter 1, a retractable positioning bracket 3 is arranged at the front end of the applying source catheter 1, the applying source catheter 1 is positioned at the center of the positioning bracket 3, a bracket recovery inner sleeve 5 is sleeved outside the applying source catheter 1, a radiation-proof outer sleeve 6 is sleeved outside the bracket recovery inner sleeve 5, a traction wire 4 is connected to the positioning bracket 3, and the traction wire 4 penetrates through the bracket recovery inner sleeve 5 and extends out of the rear end of the bracket recovery inner sleeve 5.
As shown in FIG. 3, the applicator catheter 1 of the present invention has a dual channel structure, including a nuclide channel 1-2 and a guidewire channel 1-3. The guide wire channel 1-3 is used for threading a guide wire, so that the guide wire channel 1-3 penetrates through the whole application catheter 1, and the guide wire can be transmitted from the rear end of the application catheter 1 and can be threaded out from the front end of the application catheter 1 in use. The nuclide channel 1-2 is used for delivering liquid nuclide, so that the rear end of the nuclide channel 1-2 is communicated with the nuclide inlet 1-1, and meanwhile, the front part of the nuclide channel 1-2 is communicated with the nuclide balloons 2 on the applying catheter 1, and the liquid nuclide injected from the nuclide inlet 1-1 enters each nuclide balloon 2 through the nuclide channel 1-2. A switch is arranged on the nuclide inlet 1-1.
The applicator catheter 1 can be guided by a guide wire to the treatment area.
The nuclide balloon 2 is made of flexible materials, the nuclide balloon 2 is propped up when liquid nuclide enters the nuclide balloon 2, and the diameter of the nuclide balloon 2 can be determined according to the requirement, so that the dosage of the nuclide is controlled. The nuclide balloons 2 have a certain length, and a plurality of nuclide balloons 2 can be connected end to end in sequence or can be spaced at certain distance as required, so that the distribution of the dosage is controlled.
However, not all the liquid nuclides in the nuclide balloon 2 can play a therapeutic role, the radiation protection outer sleeve 6 is sleeved outside the source application catheter 1, the unused nuclide balloon 2 is shielded through the radiation protection outer sleeve 6 according to the design requirement of dose distribution, and only the nuclide balloon 2 extending to the front of the radiation protection outer sleeve 6 can act on a target area, so that the length of the radionuclide can be controlled. Meanwhile, if the nuclide balloon 2 is in the radiation protection outer sleeve 6, the nuclide balloon 2 in the radiation protection outer sleeve 6 cannot be filled when the liquid nuclide is injected, so that the nuclide balloon 2 in the radiation protection outer sleeve 6 cannot play a role in treatment. The relative position of the radiation protection sleeve 6 and the applicator catheter 1 can be adjusted according to the length of the tumor, thereby determining the length of the actual treatment.
A distal marker 7 is arranged at the forefront end of the application catheter 1, and a proximal marker 8 is arranged at the forefront end of the radiation-proof outer sleeve 6. The distal marker 7 is used to determine the position of the front end of the applicator catheter 1, and the distal marker 7 is developed under X-rays to locate the starting position of the nuclide balloon 2. The proximal marker 8 is used to determine the frontal position of the front end of the radiation-protective outer sleeve 6, and the proximal marker 8 is developed under X-rays to locate the end position of the nuclide balloon 2 acting on the target. The nuclide balloon 2 can be accurately enabled to act on a preset position by matching the far-end mark 7 and the near-end mark 8 with an X-ray developing technology, and the length of an effective nuclide region (namely the part of the nuclide balloon 2 which is not shielded by the radiation-proof outer sleeve 6 and can directly act on surrounding tissues) can be accurately controlled.
The positioning bracket 3 comprises a bracket wall 3-1 with a reticular structure, a supporting frame 3-2 is uniformly arranged on the inner wall of the bracket wall 3-1 around the axis, the supporting frame 3-2 is contacted with the outer wall of the source applying catheter 1 or the outer wall of the nuclide saccule 2, an annular recovery line is arranged at the rear end of the bracket wall 3-1, and the traction line 4 is connected with the recovery line.
The positioning bracket 3 is made of metal materials or biological materials, the bracket wall 3-1 is cylindrical as a whole, meshes are uniformly formed on the bracket wall 3-1 to form a net structure, and the bracket wall 3-1 of the net structure has certain supporting capacity and can be folded and contracted under the action of certain external force. The support wall 3-1 is contacted with the outer wall of the source applying catheter 1 or the outer wall of the nuclide saccule 2 through the support frame 3-2 with a sheet or column structure, and the support frame 3-2 is uniformly distributed around the axis of the positioning support 3, so that the source applying catheter 1 is positioned at the center of the positioning support 3 under the centering action of the support frame 3-2, and the distances from the nuclide saccule 2 to surrounding human tissues are consistent, so that the radiation dose of nuclide uniformly acts on the surrounding tissues.
The positioning bracket 3 is in a contracted state initially and is hidden in the bracket recovery inner sleeve 5, the positioning bracket 3 advances along with the source application catheter 1, and after the nuclide balloon 2 reaches a preset position, the positioning bracket 3 is released by the retreating bracket recovery inner sleeve 5 and the radiation protection outer sleeve 6, and the positioning bracket 3 is unfolded after the release. The positioning stent 3 is hidden in the stent recovery inner sleeve 5 during the advancing process of the device, thereby preventing the device from being influenced by the advancing process.
Optimally, the support frame 3-2 of the positioning support 3 is in contact with the outer wall of the source catheter 1, the support frame 3-2 has elasticity, the positioning support 3 is sleeved at the corresponding position of the source catheter 1 in the preparation stage, the support frame 3-2 is kept away from the position of the nuclide balloon 2, the support frame 3-2 is in contact with the outer wall of the source catheter 1 between two adjacent nuclide balloons 2, then the positioning support 3 is contracted, the support recovery inner sleeve 5 and the radiation protection outer sleeve 6 are sequentially sleeved on the source catheter 1, the positioning support 3 is hidden, and the positioning support 3 can integrally move along with the device.
The invention is suitable for the treatment of vascular stenosis due to the presence of the positioning stent 3.
Release of the positioning stent 3 is easy to achieve, but recovery of the positioning stent 3 is difficult to achieve, and it is common in the prior art to keep the positioning stent 3 in the human body or to make it of a degradable material. However, in the present invention, the positioning bracket 3 generally needs to be taken out and recovered, and in order to ensure that the positioning bracket 3 can be recovered conveniently, a special design is made in the present invention.
The recovery of the positioning bracket 3 is realized by a recovery wire, a traction wire 4 and a bracket recovery inner sleeve 5.
The rear end of the bracket wall 3-1 is provided with an annular recovery line, the traction line 4 is connected with the recovery line, and because the bracket wall 3-1 is of a net structure, the recovery line passes through all meshes in turn, when the recovery line is pulled by the traction line 4, the recovery line can reduce the shrinkage of the end part of the bracket wall 3-1, and the reduced positioning bracket 3 is pulled out and recovered by the bracket recovery inner sleeve 5.
In order to facilitate the recovery of the positioning support 3, the front end of the support recovery inner sleeve 5 is provided with a horn mouth-shaped recovery port 5-1, the positioning support 3 is contracted under the action of the inclined plane of the horn mouth after entering the horn mouth, and the positioning support can smoothly enter the support recovery inner sleeve 5 after contraction.
Optimally, the recovery port 5-1 is composed of a plurality of petals which are inclined outwardly in the radial direction of the stent recovery inner sleeve 5. The whole stent recovery inner sleeve 5or the recovery port 5-1 is made of flexible materials, the valve body can swing under the action of external force, and the diameter of the profile of the valve body is smaller than the inner diameter of the stent recovery inner sleeve 5 when all the valve bodies are gathered together. The recovery port 5-1 can be formed by cutting the material at the end of the support recovery inner sleeve 5, that is, a plurality of cuts are uniformly cut around the axis at the end of the support recovery inner sleeve 5, so that a plurality of petals are formed by the material at the end of the support recovery inner sleeve 5, and then the petals are bent outwards along the root of the petals, thereby forming the bell-mouth-shaped recovery port 5-1.
The stent recovery inner sleeve 5 is positioned in the radiation protection outer sleeve 6 at the beginning, and the bell mouth is also folded and hidden in the radiation protection outer sleeve 6 at the moment, thereby preventing the device from being influenced in advancing in the blood vessel or tissue of the human body. When the positioning support 3 needs to be recovered, the support recovery inner sleeve 5 is pushed forwards relative to the radiation-proof outer sleeve 6, and the valve body at the front end of the support recovery inner sleeve 5 is outwards opened to form a horn mouth after the support recovery inner sleeve 6 is not bound.
The invention also includes a nuclide injection device for delivering a liquid nuclide into the nuclide balloon 2 of the applicator catheter 1.
The nuclide injection device comprises a radiation protection box body 9, wherein an injector shell 10 is arranged in the radiation protection box body 9, two ends of the injector shell 10 are respectively communicated with a water inlet pipe 12 and a nuclide outlet pipe 13, the nuclide outlet pipe 13 is communicated with a nuclide inlet 1-1, a water-driven piston 11 is arranged in the injector shell 10, the inner cavity of the injector shell 10 is divided into two cavities by the water-driven piston 11, and the cavities communicated with the nuclide outlet pipe 13 are used for containing liquid nuclides.
A pressure measuring tube 14 is communicated with a cavity communicated with the water inlet tube 12 in the syringe shell 10, and the pressure measuring tube 14 extends out of the radiation protection box body 9 and is connected with a pressure measuring device.
The radiation-proof box body 9 is used for shielding rays of liquid nuclide, the injection of the liquid nuclide is driven by water power, direct contact or exposure of operators to the rays is avoided, water is conveyed into the syringe shell 10 through the water inlet pipe 12, the water-driven piston 11 is pushed to move, the liquid nuclide is conveyed to the nuclide inlet 1-1 through the nuclide outflow pipe 13, and the liquid nuclide enters the nuclide balloon 2 through the nuclide channel 1-2. When the nuclide balloon 2 is inflated to the maximum, the liquid pressure of the liquid nuclide is increased, the pressure is conducted to the pressure measuring tube 14 and is obtained through monitoring by the pressure measuring device, the injection of water is stopped after the pressure value displayed by the pressure measuring device reaches a preset value, and the size of the nuclide balloon 2 meets the requirement.
The radiation-proof case 9 is supported by lead glass, and can shield rays and observe the internal condition from the outside.
When the invention is used for treating tumors, the steps are as follows:
1. The channel of the treatment area is established, namely, the channel can be established by a thicker trocar after the percutaneous puncture is carried out to directly reach the tumor for the treatment of the tumor, the guide wire can be placed in the channel tumor through the normal channel of the human body, the channel is established, and the guide wire can be placed in the channel for the vascular stenosis through a conventional vascular intervention way.
2. The method comprises the steps of placing an application catheter 1 in a treatment area, inserting a guide wire head end into an established treatment area channel, inserting a guide wire tail into the head end of the application catheter 1 after a guide wire reaches a preset position, ensuring that the guide wire position is unchanged after the guide wire tail end comes out of the application catheter tail end, and enabling the guide wire to pass through a guide wire channel 1-3 in the application catheter 1. The source catheter 1, the positioning bracket 3, the bracket recovery inner sleeve 5 and the radiation protection outer sleeve 6 are inserted into a treatment area, the position of the far-end mark 7 is observed in real time through X rays and the like, and when the front end of the nuclide balloon 2 reaches a preset position, the length required to be treated is determined according to images. The retreating bracket recovers the inner sleeve 5 and the radiation-proof outer sleeve 6, and releases the positioning bracket 3. Meanwhile, the number of the balloons to be released is calculated according to the length of each balloon, the stent recovery inner sleeve 5 and the radiation protection outer sleeve 6 are continuously retracted, and when the proximal mark 8 reaches a preset position, the condition that enough nuclide balloons 2 are released is indicated.
3. Liquid nuclide preparation, namely filling liquid nuclide and contrast agent in a cavity communicated with a nuclide outflow pipe 13 in a syringe shell 10, then placing the syringe shell 10 into a radiation protection box body 9, and respectively extending a water inlet pipe 12 and the nuclide outflow pipe 13 from holes on two side walls of the radiation protection box body 9. The nuclide outflow tube 13 is connected with the nuclide inlet 1-1, and the pressure measuring tube 14 is connected with a pressure measuring device.
4. Liquid nuclide injection, namely opening the switch of the nuclide inlet 1-1, using a syringe or a liquid pumping device to convey water into the syringe shell 10 through the water inlet pipe 12, observing the position of the water piston 11 in the syringe shell 10 through lead glass, and observing the expansion condition of the saccule under X-ray perspective. And observing the pressure value measured by the pressure measuring device, stopping injection when the pressure reaches a preset pressure value, and closing the switch of the nuclide inlet 1-1. At this time, the nuclide balloon 2 is filled with the liquid nuclide as shown in fig. 4, and the nuclide balloon 2 is filled with the liquid nuclide.
5. And (3) nuclide treatment, namely scanning a treatment area CT or MRI, calculating the time required to be treated according to the size, depth, length and the like of the tumor, opening a switch of a nuclide inlet 1-1 after the treatment time is reached, and extracting the liquid nuclide in a nuclide balloon 2.
6. The stent recovery inner sleeve 5 is pushed forward, the front end of the stent recovery inner sleeve 5 stretches out of the radiation protection outer sleeve 6, the horn mouth at the front end of the stent recovery inner sleeve opens as shown in figure 1, then the recovery line is pulled back, and the stent 3 to be positioned completely enters the stent recovery inner sleeve 5 and then the stent 1 is pulled out along the guide wire. The extracted parts are all placed in a radiation-proof container for innocent treatment.
The invention is used for the application operation of liquid radionuclides, and the liquid radionuclides are not directly taken orally or injected into a human body, but are conveyed into the nuclide balloon 2, and the nuclides are not lost in the nuclide balloon 2 and the application catheter 1, so that the nuclides are not accumulated in other organs and are not damaged. The number and the size of the nuclide balloons 2 can be controlled, so that the dosage can be accurately calculated, and the curative effect and the complications can be accurately predicted. Can be used for radiotherapy by puncturing tumor or natural human body cavity, and can be theoretically applied to various tumors. The accurate two-dimensional and three-dimensional dose distribution of the target focus can be accurately calculated on the basis of CT, MRI and other images. The dose distribution of the organs at risk around the target region can be accurately assessed. And can be used for treating vascular stenosis.
The invention can ensure the accuracy of the target area dosage, avoid the recurrence of the illness state and avoid the complications caused by the aggregation of nuclides in other organs.