CN1251032A - 为小肠提供液体连通的导管 - Google Patents
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Abstract
一种为小肠提供液体连通的探针,包括一个通过胃插入到小肠的软管(10)和一个导向器(14),所述软管具有近端和远端开口端(10A,10B),并且该软管在远端的预定段处本身具有盘卷趋势;所述导向器可以在软管内自软管的近端移动,用于弄直所述预定段的盘卷,这样软管在实际插入胃内的过程中将为直的。按照本发明,软管至少在所述预定部分具有多毛的、磨砂的、粗糙的、有棱或有肋的外表面(16)。
Description
本发明涉及一种为小肠提供液体连通，例如最好是为所述肠供给营养的供液导管，并且该导管也用于诊断(为了进行肠的X光显影而注射造影剂，或进行肠内容物或粘膜的采样)。所述导管包括一个通过胃插入到小肠的软管和一个导向器，该软管有近端和远端开口端部，并在远端的预定段处本身具有盘卷趋势；所述导向器可以在软管内自软管的近端移动，用于弄直所述预定段的盘卷，这样软管在实际插入胃内的过程中将为直的。
这种类型的导管用于在手术前通过肠供给营养，以便代替更难于管理、几乎需要5至10次以上，并且十分复杂的静脉营养供给。按照EP-C-027897描述的方法，导管的远端定位于小肠中，并且最好是定位于空肠的上段。导管的预定段处具有所述自然盘卷段，该段由于导向器的推入而被弄直。导管的所述盘卷段的远端通过鼻腔或口腔，经咽喉和食道进入胃；也可以经皮进入胃。随着在预定时间内以通常方式进行营养供给，导管通过胃的运动和肠的蠕动从胃前进至小肠中，因为导管的盘卷段在被营养液包围的情况下将受到胃的和小肠的相同方式的作用。这样导管是自动送进的。通常导管的盘卷段将定位在空肠的上段，并且当到达该位置时，导管被固定，这样它将不能进一步前进至小肠中。一旦定位后，由于导管的盘卷段与肠的皱纹状内表面接合而导致导管的远端将锚固在空肠中。设置盘卷段的目的即为在导管和肠壁之间提供最大可能的磨擦。
JP-A-08098889涉及一种现有类型的插入到身体内脏器官内部的导管，该导管的远端具有一个重物，以便能够更容易地插入并定位到器官的正确位置上。该公开文献中的导管的远端部分设有一个导向器，该导向器具有一排多个多面体，这些多面体具有特定单位重量或多倍单位重量并由弹性薄膜包覆，这样导管的外表面变为不均匀的，以便通过器官的蠕动抽搐而前进。据称这种导管的实施例的优点在于在导管插入和改变方向时有利于减少病人的疼痛感。
已经发现在EP-C-0278937中描述的导管在实践中能够很好地达到上述目的。该导管基本上与传统的鼻肠硅树脂软管没有什么不同，因此这种导管的制造成本不会比硅树脂软管的制造成本高。已经发现，在插入之后，该导管在4至6小时之内前进至小肠中。在插入之后，导管将保持在空肠上段的位置处，直到通常7天左右之后将其撤去。该导管过早返回至胃内的可能性很小，因为导管的具有盘卷趋势的段通过与小肠内表面的接合而基本上防止了移位。在使用该导管的例子中，95％的导管达到了小肠中的预定位置并且保持在该位置上。
这种导管的前进可通过给病人提供胃复安或红霉素来刺激胃运动，但由于这种作法具有副作用，因而并不是所有的病人均能承受这些药剂。
本发明的目的是对EP-C-0278937所述导管的改进，使之在不提供所述药剂并且保证安全的前提下自动前进，并且能够使导管保持在预定位置，从而提供导管的保持性能。为了达到上述目的，本发明的导管具有权利要求所述的特征。
为了更详细地说明本发明，下面将结合附图来描述一些实施例，其中：
图1为一个实施例中的导管的侧视图，其中软管被弄直；
图2为图1所示软管的侧视图，其中软管的具有盘卷趋势的预定段处于盘卷状态；
图3为另一实施例中导管远端部分的局部侧视图；以及
图4为第三实施例中图3所示导管的视图。
图1和图2所示的本发明的导管包括一个弹性柔性软管10，该软管最好是由医用塑料或橡胶如聚氨酯或硅树脂橡胶制成的，具有一个近端10A和一个远端10B。导管的外径最好为3.6毫米，内径最好为1.5毫米，但也可以具有其它尺寸。近端10A处设有一个与软管的腔相通的导向器插座11，同时远端10B设有一个与软管腔的另一端相通的帽12，该帽盖着软管的另一端，并且在端部之间设有径向侧孔13。插座11起到供手指抓持的作用，使导管在使用过程中很容易被握持住，并且还可用于将软管的近端安装到一固定件上。
柔性但非弹性，并且具有相对刚度的钢丝线绳导向器14具有与软管10基本相同的长度，可移动地放置于软管内，其中导向器的近端设有手指抓持件15，这样导向器可保持在软管内。
导管邻近远端处的预定段内具有固有(预定)盘卷趋势，从而该段如图2所示基本上呈盘卷螺旋形状(具有记忆功能)。可通过对材料的选择和加热弯曲盘卷在一芯上的软管段来使软管的所述预定段具有上述特性。软管的盘卷部分可包括1至5个圈，并且外径可约为40毫米。当将导向器推进软管的所述预定段时，该段如图1所示基本上被弄直，这意味着导向器所需的对抗上述弯曲力的刚度应大于软管的盘卷力。
按照本发明，软管远端具有盘卷趋势的至少一部分预定段的外表面上设有如图1和2中16表示的散状短毛，以便当它位于肠的预定位置处时可通过增加肠与软管外表面的磨擦来刺激导管前进，并且更有效地防止该处的移位。但是也可以采用其它方式来达到上述目的，例如在软管上设置磨砂的、粗糙或有棱的表面结构。现有技术中的静电技术十分适合于在软管的外部产生多毛的表面。可通过在软管表面涂敷某种胶而使之暂时具有粘接性，然后在静电场下在该表面上施加均匀长度的短纤维，纤维在静电场的影响下保持在从软管外侧径向发散的位置，从而制出所述多毛的表面。胶干固之后纤维将保持上述径向发散的位置。
当使用导管时，导管由于导向器14被推入而具有盘卷趋势的预定段被弄直，即导管处于如图1所示状态通过鼻腔或口腔，经咽喉和食道被插入到胃中，或经皮插入到胃中。在上述图1所示软管状态下的盘卷部分的有效长度尺寸为30毫米，大于图2所示状态下的长度。在导管插入至胃内之后，导向器回抽一定距离，该距离与所述有效长度之差相应，即约为30毫米，这样软管将在胃内自由盘卷。然后软管在胃内将前进一相应距离，即约30毫米，因为软管由于盘卷而使其有效长度变短。接下来，将导向器完全从软管中抽回。现在病人以正常方式通过食道吞咽，显然软管的尺寸应为能够给食物提供通过空间。胃中的食物将包围位于胃内的软管盘卷段，并且该软管段将与食物一样受胃的作用，在胃的运动以及小肠的蠕动下前进至小肠中。这样导管如EP-C-02780937所述那样是自动前进的。当导管的远端位于空肠的上段时，导管将固定，例如将导管绑在身体上而不再前进。导管远端在肠内的位置可通过X光控制，出于此目的，可以在远端例如帽中注入合适的造影剂。导管的盘卷段将导管维持在肠的预定位置上，从而起到防止移位的作用。由于所述段制成多毛的、磨砂的、粗糙的或有棱的，因而包围的食物与导管之间的“啮合”与肠的内表面与导管之间的“啮合”将增加，其结果是在插入时导管将不会滑动。因此可以期望导管是百分之百安全的，是自动前进的，并且按照本发明以适当的方式安置导管时，导管可保持在预定位置上。
在导管放置在预定位置上之后，可通过软管进行营养液或药物的供给，或者进行采样。
在图3所示的实施例中，软管的外表面上设有轴向延伸的径向凸起肋17，该肋位于盘卷段的内侧，即在螺旋形盘卷的内侧。在图4所示的实施例中也设有这种肋18，但此时的肋位于盘卷段的外侧。肋应很薄，并且可延伸，应十分柔软和有柔性，可由塑料或橡胶构成。肋可由与软管相同的材料制成，但这一点不是必须的。可对软管进行挤压形成肋，并且肋不仅可以在具有盘卷趋势的预定段上延伸，还可在软管的整个长度段上延伸。软管上可同时具有肋和多毛的、磨砂的、粗糙的或有棱的表面16，并且在同一个软管上可设有两个径向相对的肋，这样具有盘卷趋势的预定段在盘卷状态下在其内侧有一个肋，同时在其外侧也有一个肋。在内侧的肋的宽度可达10毫米，而外侧的肋宽应不大于1á2毫米。在本发明的可以想象得到的其他实施例中，肋包绕软管螺旋延伸。一个或多个肋进一步增强了导管与胃中食物的“啮合”，并且如果如图4所示肋在外侧，则增强了导管与肠内表面的“啮合”以促进自动前进，并且加强了导管在预定位置的固定强度。
Claims (8)
1.一种为小肠提供液体连通，最好是为所述肠提供营养供给的探针，包括一个通过胃插入到小肠的软管(10)和一个导向器(14)，所述软管具有远端和近端开口端(10A，10B)，并且该软管在远端具有本身趋向于盘卷的一预定段，所述导向器(14)可在软管内从软管的近端移动，以便弄直所述预定段，从而在实际将软管插入到胃中时，软管变直，其特征在于软管(10)至少在所述预定部分具有多毛的、磨砂的、粗糙的、有棱的或肋的外表面(16)。
2.如权利要求1所述的探针，其特征在于在软管(10)的外表面上设有轴向延伸的径向凸起肋(17，18)，所述肋至少沿软管的具有盘卷趋势的预定段延伸。
3.如权利要求2所述的探针，其特征在于由所述预定段形成的盘卷部分上的肋(17)位于所述部分的内侧。
4.如权利要求2所述的探针，其特征在于由所述预定段形成的盘卷部分上的肋(18)位于所述部分的外侧。
5.如权利要求2所述的探针，其特征在于肋环绕软管(10)螺旋延伸。
6.如权利要求2至5中任一项所述的探针，其特征在于肋为薄的，并且为可延伸的、柔软的和易于弯曲的。
7.如权利要求1至6中任一项所述的探针，其特征在于由所述预定段形成的盘卷部分包括1至5个圈，并且圈的外径可达40毫米。
8.如权利要求1至7中任一项所述的探针，其特征在于软管上的多毛表面由静电场技术形成，包括从所述表面径向凸起的短纤维。
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| SE97003735 | 1997-02-04 | ||
| SE9700373A SE507786C2 (sv) | 1997-02-04 | 1997-02-04 | Sond för åstadkommande av fluidumförbindelse med tunntarmen |
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| CN1251032A true CN1251032A (zh) | 2000-04-19 |
| CN1142759C CN1142759C (zh) | 2004-03-24 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB988035871A Expired - Fee Related CN1142759C (zh) | 1997-02-04 | 1998-02-02 | 为小肠提供液体连通的导管 |
Country Status (16)
| Country | Link |
|---|---|
| US (1) | US7201738B1 (zh) |
| EP (1) | EP0963191B1 (zh) |
| JP (1) | JP2001509710A (zh) |
| CN (1) | CN1142759C (zh) |
| AT (1) | ATE247450T1 (zh) |
| AU (1) | AU733326B2 (zh) |
| BR (1) | BR9807552A (zh) |
| CA (1) | CA2285042C (zh) |
| DE (1) | DE69817330T2 (zh) |
| DK (1) | DK0963191T3 (zh) |
| ES (1) | ES2206884T3 (zh) |
| PL (1) | PL189382B1 (zh) |
| PT (1) | PT963191E (zh) |
| RU (1) | RU2179461C2 (zh) |
| SE (1) | SE507786C2 (zh) |
| WO (1) | WO1998033469A1 (zh) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102614086A (zh) * | 2011-08-10 | 2012-08-01 | 山东峰源医用材料有限公司 | 胃肠营养引流管 |
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| US6589213B2 (en) * | 1997-12-12 | 2003-07-08 | Wilson-Cook Medical Incorporated | Body canal intrusion instrumentation having bi-directional coefficient of surface friction with body tissue |
| US6767339B2 (en) | 1997-12-12 | 2004-07-27 | Wilson-Cook Medical, Inc. | Body canal intrusion instrumentation having bidirectional coefficient of surface friction with body tissue |
| NL1011474C2 (nl) | 1999-03-05 | 2000-09-06 | Sven Ploem | Zelf-positionerende catheter. |
| US6702811B2 (en) | 1999-04-05 | 2004-03-09 | Medtronic, Inc. | Ablation catheter assembly with radially decreasing helix and method of use |
| US7653438B2 (en) | 2002-04-08 | 2010-01-26 | Ardian, Inc. | Methods and apparatus for renal neuromodulation |
| US8774913B2 (en) | 2002-04-08 | 2014-07-08 | Medtronic Ardian Luxembourg S.A.R.L. | Methods and apparatus for intravasculary-induced neuromodulation |
| US20140018880A1 (en) | 2002-04-08 | 2014-01-16 | Medtronic Ardian Luxembourg S.A.R.L. | Methods for monopolar renal neuromodulation |
| US7122048B2 (en) * | 2002-05-03 | 2006-10-17 | Scimed Life Systems, Inc. | Hypotube endoluminal device |
| US8343040B2 (en) * | 2005-05-04 | 2013-01-01 | Olympus Endo Technology America Inc. | Rotate-to-advance catheterization system |
| US20090005645A1 (en) * | 2005-05-04 | 2009-01-01 | Frassica James J | Rotate-to- advance catheterization system |
| US8414477B2 (en) * | 2005-05-04 | 2013-04-09 | Olympus Endo Technology America Inc. | Rotate-to-advance catheterization system |
| US8235942B2 (en) | 2005-05-04 | 2012-08-07 | Olympus Endo Technology America Inc. | Rotate-to-advance catheterization system |
| US7780650B2 (en) * | 2005-05-04 | 2010-08-24 | Spirus Medical, Inc. | Rotate-to-advance catheterization system |
| DE102006008315B4 (de) * | 2006-02-18 | 2007-12-06 | Hahn-Meitner-Institut Berlin Gmbh | Miniaturisierte Transportsysteme aus einem Formgedächtnis-Polymer und Verfahren zur Herstellung |
| US8574220B2 (en) | 2006-02-28 | 2013-11-05 | Olympus Endo Technology America Inc. | Rotate-to-advance catheterization system |
| US8435229B2 (en) | 2006-02-28 | 2013-05-07 | Olympus Endo Technology America Inc. | Rotate-to-advance catheterization system |
| US8109872B2 (en) * | 2006-03-03 | 2012-02-07 | Cook Medical Technologies Llc | Endoscopic apparatus having an improved catheter |
| CA2651030A1 (en) | 2006-05-08 | 2007-11-15 | Cathrx Ltd | Shape imparting mechanism insertion |
| WO2008121311A1 (en) * | 2007-03-29 | 2008-10-09 | Boston Scientific Scimed, Inc. | Catheter assembly including coiled internal bolster |
| US8870755B2 (en) | 2007-05-18 | 2014-10-28 | Olympus Endo Technology America Inc. | Rotate-to-advance catheterization system |
| DE202008015225U1 (de) | 2008-11-17 | 2010-04-01 | Medi-Globe Gmbh | Katheter zur Behandlung von Übergewicht und Fettleibigkeit bei einem Menschen |
| DE102009057045A1 (de) | 2009-12-04 | 2011-06-09 | Medi-Globe Gmbh | Katheter zur Behandlung von Übergewicht und Fettleibigkeit bei einem Menschen |
| US8689439B2 (en) | 2010-08-06 | 2014-04-08 | Abbott Laboratories | Method for forming a tube for use with a pump delivery system |
| US20120078039A1 (en) * | 2010-09-27 | 2012-03-29 | Kok-Ming Tai | Dilation Device for Placing Catheter Tubes |
| US8377001B2 (en) | 2010-10-01 | 2013-02-19 | Abbott Laboratories | Feeding set for a peristaltic pump system |
| US8377000B2 (en) | 2010-10-01 | 2013-02-19 | Abbott Laboratories | Enteral feeding apparatus having a feeding set |
| BR112013010000A2 (pt) | 2010-10-25 | 2017-10-24 | Medtronic Ardian Luxembourg | aparelho de cateter |
| US10130789B2 (en) * | 2011-06-30 | 2018-11-20 | Covidien Lp | Distal access aspiration guide catheter |
| US8574221B2 (en) | 2011-09-09 | 2013-11-05 | Cook Medical Technologies Llc | Tubular medical device |
| US8888773B2 (en) | 2012-05-11 | 2014-11-18 | Medtronic Ardian Luxembourg S.A.R.L. | Multi-electrode catheter assemblies for renal neuromodulation and associated systems and methods |
| US9095321B2 (en) | 2012-11-21 | 2015-08-04 | Medtronic Ardian Luxembourg S.A.R.L. | Cryotherapeutic devices having integral multi-helical balloons and methods of making the same |
| US9179974B2 (en) | 2013-03-15 | 2015-11-10 | Medtronic Ardian Luxembourg S.A.R.L. | Helical push wire electrode |
| US20150073515A1 (en) | 2013-09-09 | 2015-03-12 | Medtronic Ardian Luxembourg S.a.r.I. | Neuromodulation Catheter Devices and Systems Having Energy Delivering Thermocouple Assemblies and Associated Methods |
| US9993250B2 (en) * | 2013-12-19 | 2018-06-12 | Kyungpook National University Industry-Academic Cooperation Foundation | Device for protecting the rectal anastomosis |
| MD795Z (ro) * | 2014-01-16 | 2015-02-28 | Валерий ТИМИРГАЗ | Cateter ghidat |
| JP2017513600A (ja) | 2014-04-24 | 2017-06-01 | メドトロニック アーディアン ルクセンブルク ソシエテ ア レスポンサビリテ リミテ | 編組シャフトを有する神経調節カテーテル及び関連システム及び方法 |
| CN105126227A (zh) * | 2015-09-01 | 2015-12-09 | 王兆华 | 小肠双对比造影导管及其使用方法 |
| JP6718664B2 (ja) * | 2015-09-08 | 2020-07-08 | 雄造 馬塲 | 医療用チューブ、及び医療用チューブセット |
| EP4048133A4 (en) * | 2019-10-21 | 2023-12-06 | Fractyl Health, Inc. | SYSTEMS, DEVICES AND METHODS FOR PERFORMING MEDICAL INTERVENTIONS IN THE INTESTINE |
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| US3399668A (en) * | 1966-02-28 | 1968-09-03 | Edward S. Lundgren | Disposable cholangiography catheter |
| SE459473B (sv) | 1987-02-13 | 1989-07-10 | Stig Bengmark | Slanganordning, saerskilt foer administrering av naeringsmedel direkt i tarmen |
| US4834724A (en) * | 1987-04-06 | 1989-05-30 | Geiss Alan C | Device for aspirating fluids from a body cavity or hollow organ |
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| US5601537A (en) | 1995-06-05 | 1997-02-11 | Frassica; James J. | Catheter system |
| US5902285A (en) | 1997-01-27 | 1999-05-11 | Novartis Nutrition Ag | Jejunal feeding tube |
| JP3527378B2 (ja) * | 1997-01-31 | 2004-05-17 | テルモ株式会社 | 造影用カテーテル |
| US5984896A (en) * | 1997-10-28 | 1999-11-16 | Ojp #73, Inc. | Fixated catheter |
| US6344038B1 (en) * | 1998-12-02 | 2002-02-05 | Paul J. Weber | Surgical anti-friction device |
| US20050245846A1 (en) * | 2004-05-03 | 2005-11-03 | Casey Don E | Vibrating, magnetically guidable catheter with magnetic powder commingled with resin, extruded as an integral part the catheter |
-
1997
- 1997-02-04 SE SE9700373A patent/SE507786C2/sv not_active IP Right Cessation
-
1998
- 1998-02-02 BR BR9807552-7A patent/BR9807552A/pt not_active Application Discontinuation
- 1998-02-02 US US09/355,665 patent/US7201738B1/en not_active Expired - Fee Related
- 1998-02-02 DE DE69817330T patent/DE69817330T2/de not_active Expired - Lifetime
- 1998-02-02 AU AU58898/98A patent/AU733326B2/en not_active Ceased
- 1998-02-02 JP JP53279198A patent/JP2001509710A/ja not_active Ceased
- 1998-02-02 CA CA002285042A patent/CA2285042C/en not_active Expired - Fee Related
- 1998-02-02 WO PCT/SE1998/000145 patent/WO1998033469A1/en active IP Right Grant
- 1998-02-02 CN CNB988035871A patent/CN1142759C/zh not_active Expired - Fee Related
- 1998-02-02 ES ES98902344T patent/ES2206884T3/es not_active Expired - Lifetime
- 1998-02-02 DK DK98902344T patent/DK0963191T3/da active
- 1998-02-02 EP EP98902344A patent/EP0963191B1/en not_active Expired - Lifetime
- 1998-02-02 PT PT98902344T patent/PT963191E/pt unknown
- 1998-02-02 RU RU99119231/14A patent/RU2179461C2/ru not_active IP Right Cessation
- 1998-02-02 PL PL98334861A patent/PL189382B1/pl not_active IP Right Cessation
- 1998-02-02 AT AT98902344T patent/ATE247450T1/de not_active IP Right Cessation
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102614086A (zh) * | 2011-08-10 | 2012-08-01 | 山东峰源医用材料有限公司 | 胃肠营养引流管 |
Also Published As
| Publication number | Publication date |
|---|---|
| PT963191E (pt) | 2003-12-31 |
| DK0963191T3 (da) | 2003-12-08 |
| AU733326B2 (en) | 2001-05-10 |
| CA2285042A1 (en) | 1998-08-06 |
| US7201738B1 (en) | 2007-04-10 |
| BR9807552A (pt) | 2000-02-01 |
| AU5889898A (en) | 1998-08-25 |
| JP2001509710A (ja) | 2001-07-24 |
| DE69817330D1 (de) | 2003-09-25 |
| SE9700373L (sv) | 1998-07-13 |
| EP0963191A1 (en) | 1999-12-15 |
| PL189382B1 (pl) | 2005-07-29 |
| SE507786C2 (sv) | 1998-07-13 |
| WO1998033469A1 (en) | 1998-08-06 |
| RU2179461C2 (ru) | 2002-02-20 |
| SE9700373D0 (sv) | 1997-02-04 |
| EP0963191B1 (en) | 2003-08-20 |
| ATE247450T1 (de) | 2003-09-15 |
| PL334861A1 (en) | 2000-03-27 |
| CN1142759C (zh) | 2004-03-24 |
| ES2206884T3 (es) | 2004-05-16 |
| DE69817330T2 (de) | 2004-07-01 |
| CA2285042C (en) | 2006-10-17 |
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