CN101115448B - 用于肺治疗的装置和方法 - Google Patents

用于肺治疗的装置和方法 Download PDF

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CN101115448B
CN101115448B CN2005800466068A CN200580046606A CN101115448B CN 101115448 B CN101115448 B CN 101115448B CN 2005800466068 A CN2005800466068 A CN 2005800466068A CN 200580046606 A CN200580046606 A CN 200580046606A CN 101115448 B CN101115448 B CN 101115448B
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罗伯特·L·巴里
布赖恩·克兰
迪安·科科伦
谢尔登·K·李
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Abstract

本发明涉及患者肺(例如表现出慢性阻塞性肺疾病(COPD)的肺)的治疗，尤其是，涉及用于导致肺活量减少，优选用于在治疗后获得急性或立即的肺活量减少的方法和装置。肺活量减少是通过将温度高于体温的可冷凝蒸汽递送到患者肺的所希望的区域以损伤其中的组织而实现。到达损伤组织区域的血流和气流基本上被终止，导致目标区域无功能。可选地能源可以用来实现对肺组织的热损伤。

Description

用于肺治疗的装置和方法
技术领域
本发明涉及患者肺部的治疗，例如，涉及慢性阻塞性肺疾病(COPD)的治疗。尤其是，本发明涉及在治疗COPD(如肺气肿)中用于影响肺活量减少的系统、装置和方法。
背景技术
慢性阻塞性肺疾病(COPD)包括慢性支气管炎和肺气肿。COPD通常的特征为气流阻塞，其尤其限制患者在呼气期间的通气量。患有慢性支气管炎的患者具有慢性咳嗽，伴有痰生成，导致呼气阻塞。在患有肺气肿的患者中，肺实质的破坏可以导致失去弹性回弹、气道范围减小、呼气阻塞、以及咳嗽。
可以通过减少患者的有效肺活量来提高患有COPD的患者中的肺功能和生命质量。减少有效肺活量的一种途径是通过手术去除肺的患病部分，以同时促进未患病部分的扩展、重新排列患者的描界器(diagraph)以及使吸入空气从肺的患病部分改道至更健康、功能更好的肺区。手术通常导致约15-30％的有效量减少，其可能不足以引起肺功能的明显提高。并且，即使在采用胸腔镜手术时，传统的肺减小手术也是创伤性的。
最近，提出了用于减少有效肺活量的支气管镜检查方式。参见，如，美国专利第6,592,594号、第6,679,264号、第6,398,775号、和第6,610,043号；以及美国专利公开第2003/0181922号、第2004/0055606号、和第2004/0047855号。导致有效肺活量减少的一个挑战(尤其在气肿的肺中)在于旁路通气或旁路途径。
因此，需要用于不通过手术而减少有效肺活量、以及用于在旁路途径的存在下减少肺活量的装置、方法和系统。本发明致力于满足这些需要以及其他需要。
发明内容
本发明涉及患者肺的治疗，例如，治疗可以通过减少患者有效肺活量来治疗的慢性阻塞性肺疾病(COPD)和其它疾病。尤其是，本发明的方法和装置涉及用于通过将热损伤剂递送至患者肺的目标区域以便使该区域基本上无功能来影响肺活量减小的治疗。
治疗患者的肺的方法包括将热损伤剂递送至患者肺的目标区域以将该区域的组织的温度提高到足以使目标区域内的血流和气流停止的程度。优选地，该热损伤剂损伤下述至少一个：限定目标区域的至少部分肺泡的组织、目标区域中的终末细支气管的组织、以及目标区域中的旁路通道的组织。该方法还可以包括阻塞肺的气道，通过该气道上述热损伤剂被递送至接近热损伤剂进入目标区域位置的点，以便隔离该区域，并防止热损伤剂偏移到目标区域以外的区域。
一种优选的治疗患者肺的方法包括将大气压力的、温度高于体温的可冷凝蒸汽递送至目标区域的肺组织，尤其是限定患者肺内至少部分肺泡的组织。
一种装置，用于将热损伤剂递送至患者肺的目标区域，以将目标区域内的肺组织的温度提高到足以使目标区域基本上无功能，其中该区域中既无血流也无气流存在。用于递送热损伤剂的装置包括细长轴(elongate shaft)，而该细长轴具有近端部分、远端部分、以及在该轴的至少远端部分内延伸的热损伤剂递送腔.该装置在细长轴的远端部分内具有至少一个排放口，其与热损伤剂递送内腔流体连通.热损伤剂产生器与细长轴内的热损伤剂递送腔流体连通，并成一定构造以产生到达目标区域组织的温度高于40℃的热损伤剂，以使该区域基本上无功能.优选地，该装置还包括置于该轴远端部分的阻塞件，以阻塞邻近于热损伤剂的递送位置的气道通路.
在一种实施方式中，该装置包括细长轴，而细长轴具有近端部分、远端部分、以及在该轴的至少远端部分内延伸的蒸汽递送内腔。该装置在细长轴的远端部分内具有至少一个排放口，其与蒸汽递送内腔流体连通，其中所述内腔成一定构造以将可冷凝蒸汽递送至目标区域。可冷凝蒸汽产生器与细长轴的蒸汽递送腔流体连通，用于产生温度高于40℃的可冷凝蒸汽，以在目标区域热损伤组织，足以终止到达目标区域的血流和气流。优选地，该装置还包括置于该轴远端部分的阻塞件。递送的可冷凝蒸汽一般为约40℃到80℃，并且优选约50℃到约60℃。该可冷凝蒸汽被递送至目标区域的时间为约5秒到约10分钟，优选约5秒到约10秒。用于形成可冷凝蒸汽的合适的液体包括水基液体和全氟化碳。
除了治疗COPD，还可以通过，例如，还可以将所述方法和装置用于癌前病变、癌性肿瘤、或肺结节来治疗其它疾病。本领域的技术人员可以认识到，减少患者肺(尤其是气肿肺)的总肺活量，对于COPD可以是有效的治疗。
附图说明
图1A示出了体现本发明的特征的用于治疗患者肺的方法。
图1B是图1A所示的患者肺内的肺泡和气泡(alveoli)的放大图。
图2是图1A所示的装置的纵向截面图。
图3A是图2所示的装置沿线3A-3A的横向截面图。
图3B是图2所示的装置沿线3B-3B的横向截面图。
图4是体现本发明的特征的系统的立视图(部分透视)。
图5A是连接至图2所示装置的蒸汽产生器的立视图。
图5B是连接至图2所示装置的蒸汽产生器的立视图，其具有用于储存可汽化液体的筒状物。
图5C是连接至图2所示装置的蒸汽产生器的立视图，其连接至手持操作器或手枪式握把。
具体实施方式
图1示出了体现本发明特征的用于治疗患者肺10的方法，其包括将大气压的、温度高于体温、优选约40℃到约80℃、优选约50℃到约60℃的可冷凝蒸汽12递送至限定患者肺10内的肺泡或气泡14的组织，以便破坏肺泡或气泡14的组织、终末细支气管16的组织、以及旁路通道18的组织。这样的组织损伤使得经处理的区域无功能，原因是经处理区域中的血流和气流被终止。经处理的区域将不再膨胀。
该方法包括通过肺的气道20将可冷凝蒸汽递送到目标肺区域。优选地，气道20是支气管通道，如肺段支气管，并且最优选为亚(sub)肺段支气管20。
可冷凝蒸汽12用于迅速加热目标肺区域(当蒸汽12被递送时)并导致目标肺区域的组织萎陷、皱缩、新内膜(neointima)增生、坏死和纤维化(在本文中共同地称为“生物作用”).这样的生物作用使得目标肺区域无功能.
该方法还可以包括在递送可冷凝蒸汽后将真空应用于目标区域，以便进一步补充由引入可冷凝蒸汽12导致的组织收缩和萎陷。在目标区域中产生的真空为约1到约50mm Hg，优选约10到约30mm Hg，以使目标区域有效地萎陷。该真空还可以促进任何残余蒸汽或液体的抽吸。
通常，该蒸汽通过气道应用于目标区域达5秒到10分钟或更长时间。优选地，该可冷凝蒸汽被递送较短时间，约5秒到10秒。因为利用高能蒸汽进行的组织加热和由此造成的损伤是迅速的，因此优选蒸汽应用时间较短。在较长的过程中，较少的蒸汽可以用来引起逐步的组织生物作用或治疗较大区域或体积的组织。单独的过程可以用于要处理的单独的区域。
可冷凝蒸汽12可以从液体产生，如，无菌水或其它液体，如全氯化碳，其具有相对较高的液-气相转变温度，即沸点，优选温度远高于体温。此外，优选地，可冷凝蒸汽12的温度足以提高周围肺实质的温度以造成损伤，例如，至少40℃以上。
在本发明的一种方法中，可冷凝蒸汽12还包括可检测的物质，如，染料，优选生物相容性染料，以检测可冷凝蒸汽12的移动和受影响的肺区域。可选地，或与可视可检测物质一起，诊断超声、内窥镜检查和其它常见的可视技术用来在治疗中和治疗后监测蒸汽治疗和获得的组织结果。
在体现本发明特征的另一方法中，可冷凝蒸汽12用微粒递送。合适的微粒包括：滑石、碳酸钙、抗生素(如四环素和其它青霉素衍生物)、或诱导肺组织纤维化或引起肺组织坏死的其它颗粒物质。
在体现本发明特征的另一方法中，可冷凝蒸汽12包括治疗剂(如麻醉剂或止痛剂)以在治疗中减轻患者的不适和疼痛。止痛剂，如粉末或液体形式的利多卡因，优选被使用或与可冷凝蒸汽12混合。可选地，止痛剂可以被递送至整个肺，或者仅递送至目标肺区域。在该过程前、期间或以后，最好为患者准备疼痛药物，以便可以利用本发明进行治疗而不需要全身麻醉。
在体现本发明特征的另一方法中，除蒸汽12以外，还递送氦或二氧化碳以降低蒸汽12的温度。
本发明的方法包括阻塞接近可冷凝蒸汽12被递送的区域的肺的气道。在一些实施方式中，为了防止可冷凝蒸汽进入并损伤邻近气道和肺区，邻近气道填充有液体，如盐水。到达非目标肺区的气道可以被阻塞以防止蒸汽在其中流动。
在体现本发明特征的一种方法中，递送高强度聚焦超声波(HIFU)能量以损伤肺组织，如肺中的肺泡或气泡组织。优选地，能够递送高强度聚焦超声波(HIFU)的合适的超声换能器(ultrasound transducer)在焦点处通常为约100-10000W/cm2之间。
以足以引起肺组织收缩的量递送HIFU能量。因为HIFU可以被紧密地控制，因此超声能量可以被特异性靶向上皮、平滑肌层、或胶原层。HIFU能量的递送还可以用于引发痊愈反应(包括新内膜增生)，其进一步用于阻塞通道。该方法可以包括导波管，以将HIFU声波引向目标治疗位置。此外，在HIFU之前，可以应用真空以收缩(draw down)气道或肺泡.可选地，如在先前描述的实施方式中，可以在递送HIFU能量后应用真空，以进一步补充由超声能量引入所导致的终末细支气管、肺泡和旁路通道的组织收缩和萎陷.
在另一实施方式中，超声吸收物质，如液体或凝胶，可以被洗提入肺的气道。该吸收物质可以被HIFU能量加热以便热损伤周围组织，导致气道的收缩和/或新内膜增生，其将阻塞气道和/或损伤肺的肺泡。
在一个可选的实施方式中，RF能量可以被递送至患者肺内所期望的位置，以损伤肺组织，但是这通常需要用于有效消融的与肺组织接触的传导流体。
图2示出了体现本发明特征的系统22，其包括具有远端部分26和近端部分28的细长轴24。图2是细长轴24的纵向截面图，而图3A和3B示出了细长轴沿图2所示的线3A-3A和线3B-3B的横向截面图。细长轴24具有至少一个在该轴远端部分26内的用于排放可冷凝蒸汽12的排放口30，以及在细长轴24内与排放口30流体连通的蒸汽递送腔32。蒸汽产生器34与细长轴的腔32相连。
细长轴24还包含真空腔36，其成一定构造以连接于真空源，用于通过在细长轴的远端部分26的真空端口38来施加真空。
细长轴24还具有通向膨胀口42的膨胀腔40。口42与可膨胀的囊46的内部44相通，其中可膨胀的囊46被固定于该轴的远端部分26。膨胀装置48可以为常见的注射器。阻塞件46优选是可扩展的，依从的，并且成一定构造以防止邻近于该件的位置的蒸汽流。合适的气囊物质包括硅酮或胶乳。可膨胀的气囊46的工作面的外部优选具有凹凸或粗糙的表面，以更好地接合气道壁，并在可冷凝蒸汽被递送至目标位置时防止回缩(反冲)(recoil)。
通气系统可以被包括在该装置内以确保高压不超出合适的限制。该通气系统包括轴24内的通气腔50，其于轴24的远端内的口52流体连通。该通气机构可以是压力致动安全阀54。
装置22还包括温度传感器56，例如热电偶，其位于细长轴24的远端部分26，以监测周围温度。当该温度太高时，通过灌洗或冲洗过程促进去除残余蒸汽，使肺区恢复到正常温度。
装置22优选包括位于细长轴24的远端部分上的压力传感器58，以检测目标肺区内的压力。压力传感器58与细长轴24的近端部分28上的压力计60相连通。该压力传感系统可以和通气系统连接，以确保在蒸汽递送期间不超出预定压力限制。目标区域的过膨胀可以导致肺胸膜内的漏气和撕裂。
可以包括合适的流量计(未示出)以监测到达患者肺的目标区域的蒸汽流量。
如图4所示，细长轴24成一定构造以通过内窥镜62(优选支气管镜)的工作管道(未示出)被递送。内窥镜62的工作管道优选在大约1.5mm到3.5mm之间。内窥镜62与内窥镜控制器64和内窥镜监测器66相连。优选地，细长轴24的远端部分26是柔性的，以促进该细长轴在内窥镜56的工作管道内的推进，同时近端部分28足够刚性，以使该轴具有良好的可推性，从而通过和离开该内窥镜的远端开口。轴24的远端部分26为约1-6弗伦奇，当膨胀时阻塞气囊大于内窥镜的工作管道，并且通常为约8弗伦奇。合适的内窥镜为Olympus LF-TP支气管镜。
可选地，或者除使用阻塞件46以外，邻近于递送气道的气道可以例如用流体(如盐水)阻塞.邻近气道内的流体可防止可冷凝蒸汽12进入其它肺区(其不被靶向治疗)，并防止邻近区域的损伤.
优选地，如图5A所示，蒸汽产生器34是在细长轴24的外部，并储存液体供应。液体产生器34具有外壳72，其容纳包括液体室74和内部蒸汽管道76的内部结构。液体可以直接加载入液体室。内部蒸汽管道76从蒸汽产生器34的液体室74延伸到第一腔32的近端部分26，并通过进入口78接受来自液体室74的可冷凝蒸汽12。蒸汽产生器34通过吕埃尔连接件(luer fitting)或类似的机构连接至细长轴24。液体室74具有加热元件，如电阻加热元件，或RF加热器等，用于将液体室内部的液体蒸发为可冷凝蒸汽。当液体被蒸发时，该蒸汽从液体室74穿过内蒸汽导管76并进入装置的细长轴24的蒸汽腔32的近端部分。
可选地，如图5B所示，蒸汽发生器包括筒状室80，其容纳与腔32流体连通的筒82，并包含预定量的用于蒸发的液体。筒82成一定构造以优选地卡合入(snap-fit into)室80中。当蒸汽产生器34被激活时，筒82内的液体被加热为蒸汽。随后可冷凝蒸汽12被递送至第一腔32的近端。被递送至患者肺10的预定体积或预定量的蒸汽压可以在治疗过程前，基于诊断评估或患者的参数(如，用力呼气量(FEV)或其它肺功能和容量指标)加以确定或计算。
在一种实施方式中，如图5C所示，蒸汽产生器34具有延伸入产生器管84内的内部蒸汽管道76。该产生器管84连接于手枪式握把86，该握把成一定构造以连接于细长轴的近端部分26。手枪式握把86可以用来激活蒸汽产生器34的液体室74内的蒸汽12的加热。可冷凝蒸汽从蒸汽产生器34进入手枪式握把86并进入细长轴24。
可选地，蒸汽产生器34可以置于细长轴24内。加热元件，如RF电极或发射器(如螺旋管)，可以被埋置在腔32周围的轴的壁内。该加热器可以用作蒸汽产生器34的替代部件或用来提高或进一步控制从腔32离开排放口30的蒸汽的温度。
优选地，装置22的细长轴24被隔热以避免内窥镜62内的细长轴24的过热。在一种实施方式中，细长轴24包含液体腔(未示出)并且在该腔内递送冷却流体以防止过热。
可冷凝蒸汽12是能够迅速加热肺区以使目标区无功能(其中在该区域内几乎没有或没有血流或气流)的物质。合适的可冷凝蒸汽12选自包括来自水基液体的可冷凝蒸汽的组，如，无菌水、盐水、对照液体，以及其它液体，如全氯化碳、液态抗生素，以及其它具有高液-气相转变温度(即，沸点)的液体，优选高于体温。此外，优选地，可冷凝蒸汽12的温度足以将目标位置的组织的温度提高到引起组织损伤的温度。
在本发明的另一实施方式中，可冷凝蒸汽12包括可检测物质，如染料或生物相容性染料，以使医生能够视觉上追踪治疗的进展和哪个肺区域已经被处理。可选地或和视觉可检测物质一起，诊断超声波、内窥镜检查和其它常见的可视技术用来在治疗中和治疗后监测可冷凝蒸汽治疗和获得的组织结果。
在另一实施方式中，可冷凝蒸汽12包括治疗剂(如麻醉剂或止痛剂)以在治疗中减轻患者的不适和疼痛。止痛剂，如含水粉末或液体形式的利多卡因，优选被使用或与可冷凝蒸汽12混合。可选地，止痛剂可以被递送至整个肺，或者仅递送至目标肺区域。在该过程前、期间或以后，最好为患者准备疼痛药物，以便可以利用本发明进行治疗而不需要全身麻醉。该装置可以包括与细长轴的远端内的药物递送口流体连通的药物递送腔。止痛剂或其他药物可以通过可选的药物递送腔递送至所希望的区域。
在又一实施方式中，装置22的细长轴24具有用于递送除蒸汽12之外的氦或二氧化碳的氦或二氧化碳递送腔(未示出)，以降低可冷凝蒸汽12的温度。
虽然本文已经示出并描述了本发明的各种形式，但是显然可以对本发明作各种改变和改进。此外，本发明的实施方式的单独特征已经在一些附图中示出，在另一些中未示出，但是本领域的技术人员将认识到本发明一种实施方式的单独特征可以与另一实施方式的任何或全部特征组合在一起。因此，本发明不限于所说明的具体实施方式。因此，本发明由所附权利要求在本领域允许的最宽的范围所限定。
本文所用的术语如“元件”、“件”、“装置”、“片段”、“部分”、“组件”、“方法”、“步骤”和类似意思的词语不视为引用35U.S.C§112(6)的条款，除非所附权利要求明显地使用术语“方法”或“步骤”，随后是特定的功能而不参照特定的结构或动作。上述的所有专利和所有专利申请的全文以引用方式并入本文。

Claims (65)

1.一种用于治疗患者肺的系统，包括用于加热液体以形成可冷凝蒸汽的装置和用于将所述可冷凝蒸汽递送到所述患者肺的目标区域的装置，以将所述目标区域中的组织的温度提高到足以使所述目标区域无功能从而形成可冷凝蒸汽损伤，
其中，所述可冷凝蒸汽损伤包括下述的组的至少一种：限定所述患者目标区域的至少部分肺泡的组织、所述目标区域中的终末细支气管的组织、以及所述目标区域中的旁路通道。
2.根据权利要求1所述的系统，其中，所述目标区域中的组织的可冷凝蒸汽损伤引起所述目标区域中的血流和气流被终止。
3.根据权利要求1所述的系统，其中，所述患者肺的气道在接近于所述可冷凝蒸汽进入所述目标区域的部位被阻塞，其中通过所述患者肺的气道递送所述可冷凝蒸汽。
4.根据权利要求1所述的系统，其中，所述可冷凝蒸汽的温度高于60℃。
5.根据权利要求1所述的系统，其中，所述可冷凝蒸汽的温度在大气压下高于80℃。
6.根据权利要求1所述的系统，其中，所述可冷凝蒸汽的温度高于100℃。
7.根据权利要求1所述的系统，其中，所述可冷凝蒸汽被递送至所述目标区域5秒到10分钟。
8.根据权利要求1所述的系统，其中，所述可冷凝蒸汽被递送到所述目标区域5秒到10秒。
9.根据权利要求1所述的系统，其中，所述可冷凝蒸汽是水蒸气。
10.根据权利要求1所述的系统，其中，所述可冷凝蒸汽是全氯化碳蒸汽。
11.根据权利要求1所述的系统，其中，所述可冷凝蒸汽产生自液-气相转变温度在大气压下高于40℃的液体。
12.根据权利要求1所述的系统，其中，所述可冷凝蒸汽产生自液-气相转变温度在大气压下高于50℃的液体。
13.根据权利要求1所述的系统，其中，所述可冷凝蒸汽产生自液-气相转变温度在大气压下高于100℃的液体。
14.根据权利要求1所述的系统，其中，所述可冷凝蒸汽与可检测物质一起被递送。
15.根据权利要求14所述的系统，其中，所述可检测物质是染料。
16.根据权利要求14所述的系统，其中，所述可检测物质是生物相容性的。
17.根据权利要求1所述的系统，其中，所述可冷凝蒸汽与微粒一起被递送。
18.根据权利要求17所述的系统，其中，所述微粒选自由滑石、碳酸钙、或抗生素组成的组。
19.根据权利要求18所述的系统，其中，所述微粒导致所述肺组织的纤维化或坏死。
20.根据权利要求1所述的系统，其中，所述可冷凝蒸汽在所述目标部位迅速加热组织。
21.根据权利要求1所述的系统，其中，所述可冷凝蒸汽通过所述肺的支气管通道被推进到所述目标部位。
22.根据权利要求21所述的系统，其中，所述支气管通道是所述肺的亚肺段支气管。
23.根据权利要求1所述的系统，其中，在所述目标部位内产生真空，以促进其组织结构的萎陷。
24.根据权利要求23所述的系统，其中，所述萎陷的组织结构是包括下列的组的至少一种：所述患者目标区域的肺泡、所述目标区域中的终末细支气管、以及所述目标区域中的旁路通道。
25.根据权利要求23所述的系统，其中，在所述目标部位施加的真空是约50到约60mm Hg。
26.根据权利要求23所述的系统，其中，在所述目标部位施加的真空是约40到约50mm Hg。
27.根据权利要求1所述的系统，包括递送在大气压下温度高于体温的可冷凝蒸汽的装置。
28.一种用于将热损伤剂递送到患者肺的目标区域，以将所述目标区域中的组织的温度提高到足以使所述目标区域无功能的装置，所述装置包括：
(a)细长轴，其具有近端部分、远端部分和在所述轴的至少所述远端部分内延伸的热损伤剂递送内腔；
(b)在所述细长轴远端部分内的至少一个排放口，其与用于递送所述热损伤剂的所述热损伤剂递送内腔流体连通；
(c)热损伤剂产生器，其与所述细长轴中的热损伤剂递送内腔流体连通，用于产生温度高于60℃的热损伤剂，以便热损伤所述目标区域的组织，
其中，所述热损伤剂用于损伤包括下述的组的至少一种：限定所述患者目标区域的至少部分肺泡的组织、所述目标区域中的终末细支气管的组织、以及所述目标区域中的旁路通道。
29.根据权利要求28所述的装置，其中，在所述远端轴部分上具有阻塞件。
30.根据权利要求29所述的装置，其中，所述阻塞件是可扩展的。
31.根据权利要求30所述的装置，其中，所述可扩展的阻塞件是可膨胀的。
32.根据权利要求31所述的装置，其中，所述细长轴包括膨胀腔、与所述膨胀腔流体连通的膨胀口以及所述可膨胀的阻塞件的内部。
33.根据权利要求32所述的装置，其中，所述可膨胀的阻塞件是气囊。
34.根据权利要求28所述的装置，其中，所述热损伤剂是可冷凝蒸汽。
35.根据权利要求28所述的装置，其中，所述细长轴通过内窥镜的工作管道被递送。
36.根据权利要求35所述的装置，其中，所述内窥镜具有直径为约1.5mm到约3.5mm的工作管道。
37.根据权利要求28所述的装置，其中，所述细长轴的至少一部分是热绝缘的。
38.根据权利要求28所述的装置，其中，所述细长轴包含容纳冷却流体的冷却剂腔。
39.根据权利要求28所述的装置，其中，压力传感器安装在所述细长轴的所述远端部分上。
40.根据权利要求39所述的装置，其中，压力计设置在所述细长轴的所述近端部分上，以便显示通过所述压力传感器检测的压力。
41.根据权利要求40所述的装置，其中，所述压力计与通气系统相连，所述通气系统在所述细长轴的所述远端部分具有通气口，其与所述细长轴中的通气腔流体连通。
42.根据权利要求41所述的装置，其中，所述通气系统和压力计用于操作反馈回路。
43.根据权利要求42所述的装置，其中，所述压力计与压力控制器相连。
44.根据权利要求28所述的装置，其中，所述细长轴具有用于测量通过所述细长轴的蒸汽流量的流量传感器。
45.根据权利要求44所述的装置，其中，所述流量计与压力控制器相连。
46.根据权利要求28所述的装置，其中，所述细长轴具有位于所述细长轴的远端上的温度传感器。
47.根据权利要求46所述的装置，其中，所述温度传感器是热电偶。
48.根据权利要求28所述的装置，其中，所述热损伤剂产生器具有形成可冷凝蒸汽的液体供应。
49.根据权利要求48所述的装置，其中，所述液体的供应位于所述热损伤剂产生器内。
50.根据权利要求48所述的装置，其中，所述热损伤剂产生器位于阻塞件内。
51.根据权利要求34所述的装置，其中，所述热损伤剂产生器在所述细长轴的外部。
52.根据权利要求36所述的装置，其中，所述热损伤剂产生器具有容纳液体室的外壳。
53.根据权利要求52所述的装置，其中，内蒸汽导管从所述液体室延伸到所述细长轴的近端。
54.根据权利要求53所述的装置，其中，所述内蒸汽导管借助于吕埃尔连接件与所述细长轴相连。
55.根据权利要求54所述的装置，其中，所述内蒸汽导管经由入口接受来自所述液体室的可冷凝蒸汽。
56.根据权利要求52所述的装置，其中，加热元件设置在所述液体室内。
57.根据权利要求56所述的装置，其中，在所述液体室内的所述加热元件是电阻加热元件。
58.根据权利要求28所述的装置，其中，所述蒸汽产生器具有筒状室，其容纳包含其液体室内液体的筒。
59.根据权利要求58所述的装置，其中，所述筒扣合入所述筒状室内的适当位置。
60.根据权利要求58所述的装置，其中，内蒸汽导管延伸入产生器管道，其将所述筒的液体室连接到手枪式把手。
61.根据权利要求60所述的装置，其中，所述手枪式把手附着于所述细长轴的近端。
62.一种用于治疗患者肺的系统，包括用于产生热损伤剂的装置和用于将所述热损伤剂递送到所述患者肺的目标区域的装置，以将所述目标区域中的组织的温度提高到足以使所述目标区域无功能，
其中，所述热损伤剂用于损伤包括下述的组的至少一种：限定所述患者目标区域的至少部分肺泡的组织、所述目标区域中的终末细支气管的组织、以及所述目标区域中的旁路通道。
63.根据权利要求62所述的系统，其中，热损伤剂用于损伤所述目标区域中的组织从而引起所述目标区域中的血流和气流被终止。
64.根据权利要求62所述的系统，其中，所述热损伤剂是温度高于体温的可冷凝蒸汽。
65.根据权利要求62所述的系统，其中，所述热损伤剂是高强度聚焦超声波。
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US11839418B2 (en) 2023-12-12
US20110172654A1 (en) 2011-07-14
US10806501B2 (en) 2020-10-20
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US20170231679A1 (en) 2017-08-17
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CA2587909C (en) 2016-01-05
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