Pleura fistula exploration and decision support system

Abstract

The invention discloses a pleural fistula exploration and decision support system. The system comprises a respiratory cycle synchronous in-airway gas parameter / end-tidal carbon dioxide (PECO2) / pleural cavity pressure and airflow parameter joint detection part, a lung lobe split integrity analysis and virtual bronchoscope navigation part and a pleural fistula parting and decision support device. A respiratory cycle synchronous in-airway gas parameter / end-breathing carbon dioxide / pleural cavity pressure and airflow parameter combined detection part is arranged, and the respiratory cycle synchronous in-airway gas parameter / end-breathing carbon dioxide / pleural cavity pressure and airflow parameter combined detection method comprises the steps that firstly, respiratory cycle synchronous in-airway gas parameter / end-breathing carbon dioxide / pleural cavity pressure and airflow parameter combined detection is conducted; (2) the end-breathing carbon dioxide adopts a catheter front end detection technology (such as laser and infrared technologies); and (3) a special balloon catheter for sampling gas parameters in the airway / end-breath carbon dioxide.

Description

Technical Field

[0001] The present invention relates to the field of medical technology, specifically to a pleural fistula detection and decision support system; the present invention can also be used in other clinical and scientific research scenarios that require detection of airway fluid parameters, gas composition, and pleural cavity fluid parameters. Background Art

[0002] Pneumothorax is a disease in which gas enters the pleural cavity, causing the lung tissue to collapse under pressure. The formation of pneumothorax is generally caused by a rupture between the lung tissue and the thoracic cavity or an injury to the chest wall, and can be caused by a variety of causes, such as chest injury, underlying lung disease, etc. Pneumothorax is more common in young and middle-aged men with a thin and tall body. Continuous smoking, working in a high-pressure environment, and a family history of pneumothorax are all risk factors. Pneumothorax can be divided into three categories according to the cause: spontaneous, traumatic, and iatrogenic. It can also be classified into closed pneumothorax, open pneumothorax, and tension pneumothorax according to the condition of the pleural rupture. The treatment of pneumothorax through intrabronchial interventional technology has become an important means of refractory pneumothorax. Visceral membrane fistula detection is the key to the success of this treatment technology. However, there is currently a lack of methods for detecting visceral pleural fistulas, and the results are still not ideal. There is also a lack of dedicated pleural fistula detection equipment, which has a great impact on clinical practice and also limits the wider promotion of this technology in clinical practice, thereby benefiting more patients. For this reason, we propose a pleural fistula exploration and decision support system. Summary of the invention

[0003] The purpose of the present invention is to provide a pleural fistula detection and decision support system to solve the problems raised in the above background technology.

[0004] To achieve the above-mentioned purpose, the present invention provides the following technical solutions: a pleural fistula detection and decision support system, including a respiratory cycle synchronized airway gas parameter / end-tidal carbon dioxide (PECO2) / pleural cavity pressure and airflow parameter joint detection component, an interlobar fissure integrity analysis and virtual bronchoscope navigation component and a pleural fistula classification and decision support device, wherein the respiratory cycle synchronized airway gas parameter / end-tidal carbon dioxide / pleural cavity pressure and airflow parameter joint detection component adopts the following method to synchronously detect the following parameters in the same respiratory cycle ① Airway gas parameter detection device: The end of a special balloon catheter is connected to a gas pressure and flow detection element, and the balloon catheter connected to the special balloon catheter is sent into the large airway through the working channel of the bronchoscope, ② Perform balloon tamponade exploration on the bronchus of each lobe segment of the affected lung. After the balloon tamponade the target bronchus, measure the changes in pressure (cmH2O) and airflow (ml / min) of the bronchus; ② Connect the proximal end of the dedicated tube to the gas pressure and flow detection element and the distal end to the chest drainage tube through a three-way connector to detect changes in pleural pleural pressure (cmH2O) and gas flow (ml / min) of the chest drainage tube. Collect the measured data into the "pleural fistula classification and treatment decision system" for analysis; ③ End-tidal carbon dioxide detection device: connect the same balloon catheter mentioned above to the end-tidal carbon dioxide detection element of this device to collect the end-tidal carbon dioxide values ​​(mmHg) at the main bronchus and each lobe segment opening on the affected side;

[0005] The interlobar fissure integrity analysis and virtual bronchoscopy navigation component makes a quantitative analysis of the integrity of the interlobar fissures based on thin-layer CT and collects the measured data into the "pleural fistula classification and treatment decision-making system" to make auxiliary decisions in combination with other data. The incomplete interlobar fissures are located based on thin-layer CT. Under the guidance of the virtual bronchoscopy navigation system, the bronchoscope reaches the incomplete interlobar fissures so as to close the incomplete interlobar fissures when necessary.

[0006] The pleural fistula classification and decision support device accepts the data measured by the above three devices and classifies the pleural fistula, including the following 4 types: ① Type A: single fistula + no bypass ventilation (intact interlobar fissure); ② Type B: single fistula + presence of bypass ventilation (incomplete interlobar fissure); ③ Type C: more than one fistula in different lobes + no bypass ventilation (intact interlobar fissure); ④ Type D: more than one fistula in different lobes + presence of bypass ventilation (incomplete interlobar fissure). According to the above classification, suggestions on fistula closure methods are made for reference by qualified surgeons.

[0007] Preferably, the respiratory cycle synchronized airway gas parameters / end-tidal carbon dioxide / pleural cavity pressure and airflow parameter joint detection component collects the three sets of measured data into the "pleural fistula classification and treatment decision system" for analysis.

[0008] Preferably, the subjects of the pleural fistula exploration are all patients with refractory pneumothorax and patients who voluntarily undergo selective bronchial occlusion to obtain an earlier cure.

[0009] Preferably, the respiratory cycle synchronized airway gas parameters / end-tidal carbon dioxide / pleural cavity pressure and airflow parameters joint detection component includes an intrabronchial balloon catheter detection module (for detecting pressure, flow rate and temperature), a pleural cavity detection module (for detecting pressure, flow rate and temperature) and an intrabronchial end-tidal CO2 detection module (for detecting pressure).

[0010] Preferably, the interlobar fissure integrity analysis and virtual bronchoscope navigation components include an interlobar fissure integrity analysis module (used to calculate data, and analyze the integrity of the interlobar fissure after postoperative CT evaluation of fissure closure, analyze the intraoperative evaluation of the success rate of balloon exploration after closure, analyze the intraoperative and postoperative evaluation of the success rate of bronchial occlusion, analyze the success rate of chest tube removal, and analyze the intraoperative and postoperative safety evaluation indicators).

[0011] Compared with the prior art, the present invention has the following beneficial effects:

[0012] The present invention is provided with a respiratory cycle synchronized airway gas parameter / end-tidal carbon dioxide / pleural cavity pressure and airflow parameter joint detection component, ① respiratory cycle synchronized airway gas parameter / end-tidal carbon dioxide / pleural cavity pressure and airflow parameter joint detection; ② end-tidal carbon dioxide adopts catheter front-end detection technology (such as laser, infrared and other technologies); ③ airway gas parameter / end-tidal carbon dioxide sampling special balloon catheter, interlobar fissure integrity analysis and virtual bronchoscope navigation component are provided, guide the bronchoscope and the special catheter to the incomplete interlobar fissure part, and pleural fistula typing and decision support device are provided, ① according to the respiratory cycle synchronized airway gas parameter / end-tidal carbon dioxide / pleural cavity pressure and airflow parameter joint detection component and the parameters obtained by the interlobar fissure integrity analysis and virtual bronchoscope navigation component, the pleural fistula is typed; ② according to the type of pleural fistula, a treatment reference plan is proposed. BRIEF DESCRIPTION OF THE DRAWINGS

[0013] Figure 1 It is a system diagram of the present invention;

[0014] Figure 2 It is a schematic diagram of the balloon catheter specially used for sampling airway gas parameters / end-tidal carbon dioxide of the present invention. DETAILED DESCRIPTION

[0015] 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.

[0016] See also Figure 1-Figure 2 , pleural fistula exploration and decision support system, including respiratory cycle synchronized airway gas parameters / end-tidal carbon dioxide (PECO2) / pleural cavity pressure and airflow parameter joint detection components, interlobar fissure integrity analysis and virtual bronchoscope navigation components and pleural fistula classification and decision support devices. The respiratory cycle synchronized airway gas parameters / end-tidal carbon dioxide / pleural cavity pressure and airflow parameter joint detection components use the following methods to synchronously detect the following parameters in the same respiratory cycle ① Airway gas parameter detection device: The end of the special balloon catheter is connected to the gas pressure and flow detection element, and the special balloon catheter is sent into the large airway through the working channel of the bronchoscope to perform balloon tamponade exploration on the bronchus of each lobe segment of the affected lung. After the balloon tamponade the target bronchus, the pressure (cmH2O) and airflow (ml / min) of the bronchus are measured respectively. Changes; ② Connect the proximal end of the dedicated tube to the gas pressure and flow detection element and the distal end to the chest drainage tube through a three-way connector to detect changes in pleural and thoracic pressure (cmH2O) and gas flow (ml / min) of the chest drainage tube, and collect the measured data into the "pleural fistula classification and treatment decision system" for analysis; ③ End-tidal carbon dioxide detection device: connect the same balloon catheter mentioned above to the end-tidal carbon dioxide detection element of this device, collect the end-tidal carbon dioxide value (mmHg) at the main bronchus and the opening of each lobe segment on the affected side, ① respiratory cycle synchronized airway gas parameters / end-tidal carbon dioxide / pleural cavity pressure and airflow parameters joint detection; ② End-tidal carbon dioxide adopts catheter front-end detection technology (such as laser, infrared, etc.); ③ Airway gas parameters / end-tidal carbon dioxide sampling dedicated balloon catheter;

[0017] The integrity analysis of the interlobar fissures and virtual bronchoscopic navigation components make quantitative analysis of the integrity of the interlobar fissures based on thin-layer CT and collect the measured data into the "pleural fistula classification and treatment decision system" to make auxiliary decisions in combination with other data. The incomplete interlobar fissures are located based on thin-layer CT. Under the guidance of the virtual bronchoscopic navigation system, the bronchoscope reaches the incomplete interlobar fissures, so as to close the incomplete interlobar fissures when necessary, and guide the bronchoscope and special catheter to the incomplete interlobar fissures.

[0018] The pleural fistula classification and decision support device accepts the data measured by the above three devices and classifies the pleural fistula, including the following 4 types: ① Type A: single fistula + no bypass ventilation (intact interlobar fissure); ② Type B: single fistula + presence of bypass ventilation (incomplete interlobar fissure); ③ Type C: more than one fistula in different lobes + no bypass ventilation (intact interlobar fissure); ④ Type D: more than one fistula in different lobes + presence of bypass ventilation (incomplete interlobar fissure). According to the above classification, the fistula closure method is recommended for reference by qualified surgeons: ① According to the parameters obtained by the combined detection component of the respiratory cycle synchronized airway gas parameters / end-tidal carbon dioxide / pleural cavity pressure and airflow parameters and the interlobar fissure integrity analysis and virtual bronchoscopy navigation component, the pleural fistula is classified; ② According to the type of pleural fistula, a treatment reference plan is proposed.

[0019] The respiratory cycle synchronized airway gas parameters / end-tidal carbon dioxide / pleural cavity pressure and airflow parameter joint detection component collects the three sets of measured data into the "pleural fistula classification and treatment decision system" for analysis.

[0020] Pleural fistula exploration is performed on all patients with refractory pneumothorax and those who voluntarily undergo selective bronchial occlusion to achieve earlier cure.

[0021] The respiratory cycle synchronized airway gas parameters / end-tidal carbon dioxide / pleural cavity pressure and airflow parameter joint detection components include an intrabronchial balloon catheter detection module (for detecting pressure, flow rate and temperature), a pleural cavity detection module (for detecting pressure, flow rate and temperature) and an intrabronchial end-tidal CO2 detection module (for detecting pressure).

[0022] The interlobar fissure integrity analysis and virtual bronchoscopy navigation components include an interlobar fissure integrity analysis module (used to calculate data and analyze the integrity of the interlobar fissure after postoperative CT evaluation of fissure closure, the intraoperative evaluation of the success rate of balloon exploration after closure, the intraoperative and postoperative evaluation of the success rate of bronchial occlusion, the success rate of chest tube removal, and the intraoperative and postoperative safety evaluation indicators).

[0023] Although embodiments of the present invention have been shown and described, it will be appreciated by those skilled in the art that various changes, modifications, substitutions and variations may be made to the embodiments without departing from the principles and spirit of the present invention, and that the scope of the present invention is defined by the appended claims and their equivalents.

Claims

1. A pleural fistula detection and decision support system, including a respiratory cycle synchronized airway gas parameter / end-tidal carbon dioxide / pleural cavity pressure and airflow parameter joint detection component, an interlobar fissure integrity analysis and virtual bronchoscopy navigation component, and a pleural fistula classification and decision support device, characterized in that: The respiratory cycle synchronized airway gas parameter / end-tidal carbon dioxide / pleural cavity pressure and airflow parameter joint detection component adopts the following method to synchronously detect the following parameters in the same respiratory cycle: ① airway gas parameter detection device: the end of the special balloon catheter is connected to the gas pressure and flow detection element, and the special balloon catheter connected to the special balloon catheter is sent into the large airway through the working channel of the bronchoscope to perform balloon tamponade exploration on the bronchus of each lobe segment of the affected lung, and the pressure and airflow changes of the bronchus are measured after the balloon tamponade the target bronchus; ② the proximal end of the special dedicated tube is connected to the gas pressure and flow detection element and the distal end is connected to the chest drainage tube through a three-way connector to detect the changes in pleural pleural pressure and the changes in gas flow of the chest drainage tube, and the measured data are collected into the "pleural fistula classification and treatment decision system" for analysis; ③ end-tidal carbon dioxide detection device: the same balloon catheter mentioned above is connected to the end-tidal carbon dioxide detection element of the device, and the end-tidal carbon dioxide values ​​of the main bronchus and each lobe segment opening on the affected side are detected; The interlobar fissure integrity analysis and virtual bronchoscopy navigation component makes a quantitative analysis of the integrity of the interlobar fissures based on thin-layer CT and collects the measured data into the "pleural fistula classification and treatment decision-making system" to make auxiliary decisions in combination with other data. The incomplete interlobar fissures are located based on thin-layer CT. Under the guidance of the virtual bronchoscopy navigation system, the bronchoscope reaches the incomplete interlobar fissures so as to close the incomplete interlobar fissures when necessary. The pleural fistula classification and decision support device accepts the data measured by the above three devices and classifies the pleural fistula, including the following 4 types: ① Type A: single fistula + no bypass ventilation; ② Type B: single fistula + presence of bypass ventilation; ③ Type C: more than one fistula in different lobes of the lung + no bypass ventilation; ④ Type D: more than one fistula in different lobes of the lung + presence of bypass ventilation. According to the above classification, suggestions on fistula closure methods are made for reference by qualified surgeons.

2. The pleural fistula detection and decision support system according to claim 1, characterized in that: The respiratory cycle synchronized airway gas parameters / end-tidal carbon dioxide / pleural cavity pressure and airflow parameter joint detection component collects the three sets of measured data into the "pleural fistula classification and treatment decision system" for analysis.

3. The pleural fistula detection and decision support system according to claim 1, characterized in that: The subjects of the pleural fistula exploration are all patients with refractory pneumothorax and patients who voluntarily accept selective bronchial occlusion to obtain an earlier cure.

4. The pleural fistula detection and decision support system according to claim 1, characterized in that: The respiratory cycle synchronized airway gas parameter / end-tidal carbon dioxide / pleural cavity pressure and airflow parameter joint detection component comprises an intrabronchial cavity balloon catheter detection module, a pleural cavity detection module and an intrabronchial cavity end-tidal CO2 detection module.

5. The pleural fistula detection and decision support system according to claim 1, characterized in that: The interlobar fissure integrity analysis and virtual bronchoscope navigation component includes an interlobar fissure integrity analysis module.

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