A continuous drainage device for the lumbar cistern

Abstract

The present invention belongs to the technical field of medical devices, and specifically relates to a continuous drainage device for the lumbar cistern, including a drainage tube. The right end of the drainage tube is movably connected to a thick-walled sac. A hollow plug is sleeved outside the drainage tube, and the hollow plug is sleeved at the connection between the thick-walled sac and the drainage tube. Convection holes are formed on the outer side of the main body of the drainage tube. The left end of the drainage tube is sealed. A pulling wire is connected to the right side of the sealed end of the drainage tube. The other end of the pulling wire penetrates through the inner cavity of the drainage tube and is connected to an O-shaped pull ring. A transfer pull ring is arranged on the left side of the thick-walled sac, and the transfer pull ring is connected to the O-shaped pull ring. The present invention turns a surgical operation into a medical operation. This product only needs to be installed by lumbar puncture. In theory, all ordinary physicians and anesthesiologists master lumbar puncture, the requirements for operators are reduced, and operations such as incision and suture, craniotomy, general anesthesia, and spinal anesthesia are not involved.

Description

Technical Field

[0001] The present invention relates to the technical field of medical devices, and particularly to a continuous drainage device for the lumbar cistern. Background Art

[0002] Due to the existence of the blood–brain barrier between plasma and brain cells, the prevention, diagnosis, and treatment of intracranial hypertension, craniocerebral trauma hemorrhage, brain tumors, intracranial infections, etc. often require establishing a physical channel between the central nervous system and the outside world.

[0003] Such diseases include:

[0004] Infectious diseases: cryptococcal meningitis, aspergillus meningitis, mucormycosis meningitis, tuberculous meningitis, bacterial meningitis (Staphylococcus aureus, Neisseria meningitidis, Brucella, Streptococcus pneumoniae), viral meningitis (herpes simplex virus, enterovirus, poliovirus, adenovirus, Japanese encephalitis virus, HIV virus), syphilitic meningitis (including other spirochetal meningitis), intracranial parasitic infections (such as cerebral cysticercosis infection, etc.)

[0005] Neoplastic diseases: primary central nervous system tumors, such as primary central nervous system lymphoma (or secondary); Waldenström macroglobulinemia bee_neel syndrome; nervous system metastasis of other tumors, such as leukemia, lung cancer, etc. involving the central nervous system. Among them, intrathecal injection of chemotherapy drugs is one of the most effective methods for preventing and treating central nervous system leukemia (CNS).

[0006] Craniocerebral trauma: diagnosing and draining bloody cerebrospinal fluid, and controlling intracranial pressure.

[0007] Control of central nervous system symptoms: cerebrospinal fluid leakage, intracranial hypertension, etc.

[0008] Currently, the common surgical methods for the above diseases include: 1) repeated lumbar puncture; 2) continuous lumbar cistern drainage; 3) lumbar cistern peritoneal drainage; 4) Ommaya reservoir, etc.

[0009] 1) Lumbar puncture: The operation method is that the patient lies on the bed in a curved lateral position, hugs the knees with both hands, making the lumbar spine convex posteriorly and the intervertebral space widened. After routine local disinfection and infiltration anesthesia, puncture. Generally, when puncturing 4 - 5 cm, there will be resistance, and when feeling the resistance suddenly decrease, then pull out the stylet, rotate the needle tail, and cerebrospinal fluid can be seen dripping out. Then, according to different purposes and specific situations, take and release cerebrospinal fluid. Then insert the stylet, pull out the puncture needle, fix it with a sterilized gauze block, and lie flat without a pillow for 4 - 6 hours.

[0010] 2) Continuous lumbar cistern drainage: Through lumbar puncture, a drainage tube is placed between the lumbar vertebrae to continuously drain cerebrospinal fluid, achieving effects such as reducing pressure and injecting drugs. Advantages: Avoid repeated lumbar punctures (for example, in the treatment of cryptococcal meningitis, lumbar puncture and cerebrospinal fluid drainage may be required every two days sometimes), and the flow rate is controllable, etc.; Disadvantages: There is more exudate, and bacteria are prone to retrograde into the cerebrospinal fluid and cause infection.

[0011] 3) Lumbar cistern peritoneal drainage: Through lumbar puncture, a drainage tube is placed between the lumbar vertebrae. The drainage tube enters the abdominal cavity subcutaneously, and the cerebrospinal fluid is introduced into the abdominal cavity and absorbed by the peritoneum. The operation is relatively complex.

[0012] 4) Ommaya reservoir: The Ommaya reservoir is a minimally invasive ventricular drainage tool, invented by Pakistani neurosurgeon Ommaya during the continuous administration of drugs into the lateral ventricle in the treatment of fungal meningitis, called the "chemotherapy reservoir", and later applied to ventricular drainage tools. Advantages: It can be aspirated repeatedly, and chemotherapy (for treating tumors), antibiotics and other drugs can be injected through the reservoir (reducing systemic drug use), avoiding tumor or infection dissemination caused by peritoneal drainage.

[0013] All of the above four operative procedures have defects;

[0014] 1) For the treatment of persistent intracranial hypertension, repeated lumbar punctures are required, increasing the patient's pain, raising the possibility of infection, fibrosis at the puncture site after repeated operations, and may cause persistent low back pain, fecal and urinary incontinence (nerve damage), etc. When reducing pressure and intrathecal injection are performed through lumbar puncture, the changes in cerebrospinal fluid pressure and drug concentration are relatively large, which may cause brain hernia, chemical meningitis, etc.;

[0015] 2) Continuous lumbar cistern drainage reduces the number of punctures and can gradually reduce pressure. However, cerebrospinal fluid often flows out from the puncture site, easily leading to retrograde entry of external bacteria into the lumbar cistern and causing central nervous system infection. Therefore, it can only be retained for 5 - 7 days. Since the external drainage bag is fixed to the hospital bed, the patient's mobility is inconvenient, and the drainage tube has no good fixation structure and is extremely easy to fall out;

[0016] 3) Lumbar cistern peritoneal drainage: The operation must be carried out under operating room conditions, requires anesthesia, the operation is complex, and it cannot be used for patients with infectious diseases (causing infectious peritonitis) and those who cannot tolerate anesthesia;

[0017] 4) For the Ommaya reservoir, general anesthesia and craniotomy are required, and it needs to be completed under the assistance of a senior neurosurgeon and a stereotactic surgical planning system. The operation process damages the brain parenchyma and may also cause hematoma, leading to serious complications.

[0018] Therefore, an improved surgical procedure and its supporting medical device are needed to achieve simple implantation, minimal trauma, non-detachment, non-infection, anti-blockage, painless replacement, multiple diagnostic and therapeutic operations, and convenient nursing for the prevention, diagnosis, and treatment of intracranial lesions. Summary of the Invention

[0019] The purpose of the present invention is to provide a continuous drainage device for the lumbar cistern to solve the problems of high cost and inconvenient operation of the existing lumbar cistern drainage surgery mentioned in the above background technology.

[0020] To achieve the above purpose, the present invention provides the following technical solution: A continuous drainage device for the lumbar cistern, including a drainage tube. The right end of the drainage tube is movably connected to a thick-walled sac. A hollow plug is sleeved outside the drainage tube, and the hollow plug is sleeved at the connection between the thick-walled sac and the drainage tube. Convection holes are opened on the outer side of the main body of the drainage tube. The left end of the drainage tube is sealed. A pulling wire is connected to the right side of the sealed end of the drainage tube. The other end of the pulling wire penetrates through the inner cavity of the drainage tube and is connected to an O-shaped pull ring. A transfer pull ring is arranged on the left side of the thick-walled sac, and the transfer pull ring is connected to the O-shaped pull ring.

[0021] Preferably, the hollow plug includes an expansion plug column. The right end of the expansion plug column is connected to a fixed column, and a suture plate is arranged outside the expansion plug column.

[0022] Preferably, a docking groove and a connection groove are opened on the right side of the main body of the fixed column, and the connection groove is located outside the docking groove.

[0023] Preferably, the thick-walled sac includes a vesicle. A connecting plate is arranged on the left side of the vesicle, and the connecting plate corresponds to the connection groove.

[0024] Preferably, a docking joint is arranged on the left side of the vesicle. The docking joint is movably connected to the drainage tube, and the connection point between the docking joint and the drainage tube is located inside the docking groove.

[0025] Preferably, a detachable puncture tube is arranged outside the drainage tube. The puncture tube is configured as a three-way tube, and the length of the drainage tube is greater than the length of the puncture tube.

[0026] Preferably, the drainage tube includes a self-retaining tube, and a detachable waste tube is connected to the right end of the self-retaining tube.

[0027] Preferably, a handle is arranged outside the thick-walled sac, and a positioning plate is arranged outside the hollow plug.

[0028] Compared with the prior art, the beneficial effects of the present invention are:

[0029] 1) The present invention transforms surgical operations into medical operations. This product only requires lumbar puncture for installation. In theory, all general physicians and anesthesiologists master lumbar puncture (lumbar puncture is an item that must be tested for licensed physicians), the operation requirements for personnel are reduced, and it does not involve operations such as incision and suture, craniotomy, general anesthesia, and spinal anesthesia. There is no need for neurosurgical professional operations. In the prior art, the balloon enters the upper abdomen through tunneling in the body from the lumbar skin, and re - incision and suture are required for device replacement, which causes more pain to the patient;

[0030] 2) This device has low requirements for the operation site. It can be operated beside the bed, without the need for a sterile environment, operating room, etc. The low requirements for personnel also enable this project to be carried out in non - tertiary hospitals, facilitating its promotion and application in other backward countries and regions in the world;

[0031] 3) After the operation with this device, the nursing is simple, and there is no incision and no continuous exudation after the operation, almost no nursing is required;

[0032] 4) This device has strong operability. It can perform repeated diagnostic cerebrospinal fluid sampling, continuous drainage, repeated intrathecal injection, long - term pressure measurement, micro - pump drainage or injection, and indwelling sustained - release agents, enabling the intracranial drug concentration to rise slowly, and further reducing the side effects of toxic drugs;

[0033] 5) Low infection rate, anti - blockage, long service life and no need for repeated lumbar puncture for replacement. Since the infection incidence rate is relatively low, the retention time is longer, which can extend the treatment time of certain therapies and reduce the treatment costs of side reactions such as infection and chemotherapy drug toxic side effects. This technology can also prevent the tube wall from being blocked by emboli such as bacterial masses and thrombi;

[0034] 6) The replacement of this technology only requires simple guidance using a special soft cannula, without the need for re - lumbar puncture, without anesthesia, and almost no pain. Therefore, some diseases that originally required inpatient treatment can be followed up and treated regularly in the outpatient clinic, reducing the overall medical costs;

[0035] 7) The survival rate of patients is improved. It can treat patients with poor conditions who cannot tolerate general anesthesia or spinal anesthesia. The first implantation and replacement have no obvious trauma (only puncture holes). In addition, this device avoids craniotomy, avoids repeated lumbar puncture, and indwelling does not affect normal life and sleep, and thus will not cause mental shock to the patient;

[0036] 8) The instruments of this device have no power supply, simple structure, do not involve special materials, and the production cost is very low. BRIEF DESCRIPTION OF THE DRAWINGS

[0037] Figure 1 is a schematic structural diagram of the present invention;

[0038] Figure 2 is a schematic cross - sectional front - view structural diagram of the thick - walled sac of the present invention;

[0039] Figure 3 It is a schematic diagram of the cross-sectional structure of the hollow plug of the present invention;

[0040] Figure 4 It is a schematic diagram of the cross-sectional structure of the puncture tube of the present invention.

[0041] In the figure: 1 drainage tube, 11 self-retained tube, 12 abandoned tube, 13 convection hole, 2 pulling wire, 3 hollow plug, 31 expansion plug column, 32 fixing column, 33 docking groove, 34 connecting groove, 35 suture plate, 36 positioning plate, 4 thick-walled bladder, 41 vesicle, 42 handle, 43 connecting plate, 44 transfer pull ring, 45 docking joint, 5 puncture tube, 6 O-type pull ring. DETAILED DESCRIPTION

[0042] The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0043] In the description of the present invention, it is necessary to understand that the terms "upper", "lower", "front", "back", "left", "right", "top", "bottom", "inside", "outside", etc., indicating the orientation or position relationship are based on the orientation or position relationship shown in the drawings, and are only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the device or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore cannot be understood as a limitation on the present invention.

[0044] Example:

[0045] See also Figures 1-4, the present invention provides a technical solution: a continuous drainage device for the lumbar cistern, including a drainage tube 1. The left end of the drainage tube 1 is inserted into the cerebrospinal fluid, and the right end of the drainage tube 1 is movably connected with a thick-walled sac 4. The cerebrospinal fluid can flow into the thick-walled sac 4 through the drainage tube 1. A hollow plug 3 is sleeved outside the drainage tube 1. On the one hand, the hollow plug 3 is used to clamp the drainage tube 1, and on the other hand, it is used to closely fit with the skin, thereby preventing the cerebrospinal fluid from overflowing along the drainage tube 1. The hollow plug 3 is sleeved at the connection between the thick-walled sac 4 and the drainage tube 1. A convection hole 13 is opened on the outer side of the main body of the drainage tube 1. The left end of the drainage tube 1 is sealed, and a pulling wire 2 is connected to the right side of the sealed end of the drainage tube 1. By pulling the pulling wire 2, the pulling wire 2 will pull the left side of the drainage tube 1 to bend. At this time, a part of the pulling wire 2 will protrude from the convection hole 13. By pulling the pulling wire 2, the accumulated tube wall in the drainage tube 1 due to emboli such as bacterial colonies and thrombi can be dredged. The other end of the pulling wire 2 passes through the inner cavity of the drainage tube 1 and is connected with an O-shaped pull ring 6. A transfer pull ring 44 is arranged on the left side of the thick-walled sac 4, and the transfer pull ring 44 is connected with the O-shaped pull ring 6. By rotating the thick-walled sac 4, the thick-walled sac 4 drives the O-shaped pull ring 6 to rotate through the transfer pull ring 44. The O-shaped pull ring 6 drives the pulling wire 2 to move and twist, and the pulling wire 2 rotates around the tube wall of the drainage tube 1 to form a pig-tail structure, so as to further dredge the accumulated substances in the drainage tube 1.

[0046] The hollow plug 3 includes an expansion plug column 31. The expansion plug column 31 is inserted into the subcutaneous tissue, and the subcutaneous tissue is used to squeeze the hollow plug 3. On the one hand, it can press the drainage tube 1 tightly to avoid the drainage tube 1 from retracting, and on the other hand, it can also prevent the cerebrospinal fluid from overflowing along the drainage tube 1. The right end of the expansion plug column 31 is connected with a fixing column 32. A suture plate 35 is arranged outside the expansion plug column 31, and the suture plate 35 is used to suture with the skin to fix the hollow plug 3.

[0047] A docking groove 33 and a connection groove 34 are opened on the right side of the main body of the fixing column 32. The connection groove 34 is located outside the docking groove 33. The thick-walled sac 4 includes a vesicle 41. A connecting plate 43 is arranged on the left side of the vesicle 41. The connecting plate 43 corresponds to the connection groove 34. After the connecting plate 43 is inserted into the connection groove 34, it can still rotate. A docking joint 45 is arranged on the left side of the vesicle 41. The docking joint 45 is movably connected with the drainage tube 1. The connection point between the docking joint 45 and the drainage tube 1 is located inside the docking groove 33. After the docking joint 45 is connected with the drainage tube 1, when the docking joint 45 rotates, the drainage tube 1 fixed by the hollow plug 3 will not rotate along with it.

[0048] A handle 42 is arranged outside the thick-walled sac 4, and a positioning plate 36 is arranged outside the hollow plug 3. The relative distance between the handle 42 and the positioning plate 36 is used to judge the twisting condition of the pulling wire 2.

[0049] A detachable puncture tube 5 is provided on the outer side of the drainage tube 1. The puncture tube 5 is configured as a three-way tube. The length of the drainage tube 1 is 7 cm or more longer than the length of the puncture tube 5. The drainage tube 1 includes a self-retaining tube 11, and a detachable discard tube 12 is connected to the right end of the self-retaining tube 11.

[0050] Instructions for use:

[0051] I. How to implant;

[0052] a. The patient lies on the bed in a curved lateral position, with both hands holding the knees, making the lumbar spine kyphotic and the intervertebral space widened. After local routine disinfection and infiltration anesthesia, puncture is generally performed at the 5th lumbar intervertebral space. When the double-headed lumbar puncture needle (referring to the puncture tube 5 + hard metal puncture needle) is inserted into the subcutaneous tissue for 4 - 5 cm, there will be resistance. When the resistance suddenly decreases, slowly pull out the needle core (do not completely withdraw it), and rotate the needle tail, then cerebrospinal fluid can be seen dripping out from the side hole of the double-headed lumbar puncture needle. Immediately push the needle core back into the puncture needle to prevent too rapid change in intracranial pressure;

[0053] b. While slowly pulling out the needle core, push the drainage tube 1 into the side hole. It can be seen that cerebrospinal fluid flows out from the drainage tube 1. Further, while pushing the drainage tube 1, pull out the puncture tube 5 (during this process, prevent the drainage tube 1 from slipping out). After the puncture tube 5 is completely withdrawn, gently cut the drainage tube 1 at the middle fold line with force (at this time, the self-retaining tube 11 is separated from the discard tube 12), exposing the drainage tube 1 and the pulling wire 2. Discard the discard tube 12 and retain the self-retaining tube 11 remaining in the human body;

[0054] c. Fix the pulling wire 2 to the head end of the drainage tube 1, pass the drainage tube 1 through the hollow plug 3, pull out the pulling wire 2, and fixedly connect its O-shaped pull ring 6 with the transfer pull ring 44 on the left side of the thick-walled sac 4;

[0055] d. After firmly connecting the thick-walled sac 4, the hollow plug 3 and the drainage tube 1, apply pressure to the thick-walled sac 4 part, press the hollow plug 3 and the drainage tube 1 into the subcutaneous tissue, and fix the hollow plug 3 and the skin by tying a suture;

[0056] e. Rotate the thick-walled sac 4 to guide the pulling wire 2 to wind around the drainage tube 1, so that the end of the drainage tube 1 in the lumbar cistern forms a coiled structure;

[0057] II. Disposal of blockage of the drainage tube 1;

[0058] a. Rotate the thick-walled sac 4 repeatedly in the reverse and forward directions, so that the pulling wire 2 moves up and down in the drainage tube 1, cutting the thrombus and bacterial mass to cause shedding;

[0059] b. Inject a certain amount of normal saline through the non-invasive needle, verify the patency of the drainage tube 1, and then withdraw an equal amount of liquid. Send it for inspection if necessary;

[0060] III. Replace with a new thick-walled sac 4 set

[0061] a. Rotate the thick-walled sac 4 in the reverse direction, and successively remove structures such as the thick-walled sac 4 and the hollow plug 3 (cut the suture), pull out the O-ring 6 at the head of the pulling wire 2, and then hook the end of the self-retaining tube 11 with the head end of the discarded tube 12 part of the new drainage tube 1;

[0062] b. The puncture tube successively enters the lumbar cistern along ① the self-retaining tube 11 part of the new drainage tube 1, ② the head end of the discarded tube 12 part, and ③ the self-retaining tube 11 part of the old drainage tube 1. Keep the head end of the old drainage tube 1 protruding beyond the puncture tube 5, separate the new and old drainage tubes 1, relax the pulling wire 2 of the old drainage tube 1, and straighten the "pig's tail" structure of the coiled part of the drainage tube 1 in the lumbar cistern to facilitate removal;

[0063] c. While slowly withdrawing the old drainage tube 1, quickly insert the new drainage tube 1 through the side hole of the puncture tube 5, and the subsequent operations are the same as in "one";

[0064] IV. Operations such as measuring cerebrospinal fluid pressure, drainage, and intrathecal injection;

[0065] a. After the thick-walled sac 4 is fixed, pierce the thick-walled sac 4 with a non-traumatic needle (a thin injection needle). Cerebrospinal fluid flows out from the non-traumatic needle. Connect the non-traumatic needle to a capillary glass manometer tube. The long side of the manometer tube is perpendicular to the ground, and read the liquid level height to reflect the cerebrospinal fluid pressure;

[0066] b. The pulling wire 2 makes the end of the drainage tube 1 present a "pig's tail" structure and is not easily dislodged;

[0067] c. Slide the hollow plug 3 along the drainage tube 1, and the hollow plug 3 is connected to the thick-walled sac 4;

[0068] d. Press the thick-walled sac 4 forcefully to make the hollow plug 3 enter the subcutaneous tissue for fixation, and the pulling wire 2 is fixed to the thick-walled sac 4;

[0069] e. Fix it to the skin with an infusion patch or suture it to the skin;

[0070] f. Perform operations such as drainage and intrathecal injection, and also perform operations through the non-traumatic needle, similar to the ommaya reservoir.

[0071] The above shows and describes the basic principles, main features and advantages of the present invention. For those skilled in the art, it is obvious that the present invention is not limited to the details of the above exemplary embodiments, and can be implemented in other specific forms without departing from the spirit or basic features of the present invention; therefore, in any regard, the embodiments should be regarded as exemplary and non-limiting. The scope of the present invention is defined by the appended claims rather than the above description. Therefore, all changes falling within the meaning and scope of the equivalent elements of the claims are intended to be included in the present invention, and any reference signs in the claims should not be regarded as limiting the claims involved.

[0072] Although embodiments of the present invention have been shown and described, those of ordinary skill in the art will appreciate that various changes, modifications, substitutions and variations can be made to these embodiments without departing from the principles and spirit of the present invention. The scope of the present invention is defined by the appended claims and their equivalents.

Claims

1. A continuous drainage device for the lumbar cistern, comprising a drainage tube (1), Characterized in that: The right end of the drainage tube (1) is movably connected to a thick-walled sac (4), a hollow plug (3) is sleeved on the outside of the drainage tube (1), the hollow plug (3) is sleeved at the connection between the thick-walled sac (4) and the drainage tube (1), a convection hole (13) is formed on the outer side of the main body of the drainage tube (1), the left end of the drainage tube (1) is sealed, a pulling wire (2) is connected to the right side of the sealed end of the drainage tube (1), the other end of the pulling wire (2) penetrates through the inner cavity of the drainage tube (1) and is connected to an O-shaped pull ring (6), a transfer pull ring (44) is arranged on the left side of the thick-walled sac (4), and the transfer pull ring (44) is connected to the O-shaped pull ring (6); When the pulling wire (2) pulls the left side of the drainage tube (1) to bend, a part of the pulling wire (2) will be exposed from the convection hole (13).

2. A continuous drainage device for the lumbar cistern according to claim 1, Characterized in that: The hollow plug (3) comprises an expansion plug column (31), the right end of the expansion plug column (31) is connected to a fixed column (32), and a suture plate (35) is arranged on the outside of the expansion plug column (31).

3. A continuous drainage device for the lumbar cistern according to claim 2, Characterized in that: A docking groove (33) and a connection groove (34) are formed on the right side of the main body of the fixed column (32), and the connection groove (34) is located outside the docking groove (33).

4. A continuous drainage device for the lumbar cistern according to claim 3, Characterized in that: The thick-walled sac (4) comprises a vesicle (41), a connecting plate (43) is arranged on the left side of the vesicle (41), and the connecting plate (43) corresponds to the connection groove (34).

5. A continuous drainage device for the lumbar cistern according to claim 4, Characterized in that: A docking joint (45) is arranged on the left side of the vesicle (41), the docking joint (45) is movably connected to the drainage tube (1), and the connection point of the docking joint (45) and the drainage tube (1) is located inside the docking groove (33).

6. A continuous drainage device for the lumbar cistern according to claim 1, Characterized in that: A detachable puncture tube (5) is arranged on the outside of the drainage tube (1), the puncture tube (5) is arranged as a three-way tube, and the length of the drainage tube (1) is greater than the length of the puncture tube (5).

7. A continuous drainage device for the lumbar cistern according to claim 6, Characterized in that: The drainage tube (1) comprises a self-retaining tube (11), and a detachable waste tube (12) is connected to the right end of the self-retaining tube (11).

8. A continuous drainage device for the lumbar cistern according to claim 1, Characterized in that: A handle (42) is arranged on the outside of the thick-walled sac (4), and a positioning plate (36) is arranged on the outside of the hollow plug (3).

Images