CN105771070A - Washable type H-shaped single-tube double-lumen drainage tube - Google Patents

Abstract

Flushable single-tube double-lumen H-type drainage tube, including T-type drainage tube, T-type adapter tube, epidural anesthesia catheter and anti-reflux drainage bag, T-type drainage tube has two drainage inlets and one drainage outlet, and The direction of the two drainage inlets is opposite; the T-shaped adapter tube has the first port, the second port and the third port, the drainage outlet of the T-shaped drainage tube is connected with the third port of the T-shaped adapter tube, and the second port of the T-shaped adapter tube The mouth of the epidural anesthesia catheter is connected to the anti-reflux drainage bag, the injection end of the epidural anesthesia catheter is connected to the first port of the T-shaped adapter tube, and the outlet end of the epidural anesthesia catheter extends from the first port of the T-shaped adapter tube to the T The drainage head of the type drainage tube. The drainage port of the T-shaped drainage tube of the present invention is relatively large, not easy to block, and both ends are synchronously drained, the drainage range is wide, the positioning is accurate, it is not easy to fall off, and it is not easy to touch the brain tissue; the drainage tube has a built-in flushing tube, which is convenient for flushing and reduces drainage Fluid reflux phenomenon, to avoid infection, high cure rate of patients, fewer complications.

Description

Flushable single-tube double-lumen H-type drainage tube

technical field

The invention belongs to the field of medical devices, in particular to a flushable single-tube double-cavity H-type drainage tube for drainage of intracranial chronic subdural hematoma.

Background technique

Chronic subdural hematoma is one of the most common diseases in neurosurgery. It refers to the hematoma that occurs between the dura mater and arachnoid mater in the brain after head trauma. It usually occurs in children and the elderly, and usually begins to appear after more than 3 weeks of illness symptoms. If chronic subdural hematoma is not treated properly, increased intracranial pressure, neurological dysfunction and mental symptoms may occur, such as headache, mental decline, hemiplegia, coma and even death, seriously affecting people's quality of life and threatening human health.

The treatment of chronic subdural hematoma is divided into conservative treatment and surgical treatment. Conservative treatment is only effective for a small number of patients with hematoma, and most patients still need surgical treatment. Surgical treatment mainly includes hematoma cavity drilling and external drainage, cone drainage, bone flap craniotomy and endoscopic surgery. Bone flap craniotomy is suitable for drainage failure and calcification of hematoma cavity due to the large trauma. It is rarely used for patients with chronic subdural hematoma; Rarely used outside; cone drainage due to high recurrence rate, is not often used. At present, the preferred surgical treatment method is hematoma cavity drilling and external drainage. The curative effect is satisfactory, there are basically no other complications, and the prognosis is good.

At present, the drainage tube commonly used for hematoma cavity drilling and external drainage is No. 12 or No. 14 silicone tube with side holes for external drainage of the ventricle. The hematoma cavity is drilled with a single hole and the drainage tube is placed on the forehead; Double-hole and double-tube drainage can be used in multiple directions, the drainage channel is increased, and the tube can be drained to facilitate flushing. However, the operation of double-hole drilling drainage is more complicated, which prolongs the operation time, increases the trauma, and increases the risk of surgery and the risk of surgery. risk of subsequent infection. Because intraoperative and postoperative flushing of subdural hematoma can increase blood flow and reduce recurrence, some scholars have designed a single-hole double-tube drainage method in order to increase the drainage direction and achieve the purpose of drug injection and flushing. The scope of the bone hole also increases the risk of trauma and surgery, and it has no essential difference from the double-hole double-tube. Many clinical studies have found that there is no essential difference in prognosis and postoperative recurrence rate between single-hole drilling drainage and double-hole drilling drainage. Therefore, most hospitals currently use single-hole irrigation and drainage in clinical practice.

At present, the mainstream external drainage of the hematoma cavity is a straight silicone tube with a side hole and a single lumen drainage. The structure of the straight silicone tube with a side hole and a single lumen drainage tube is shown in Figure 1. Three drainage ports 12 are opened at the front end of the silicone tube 11, and the end is connected to a waste liquid bag. When in use, a straight silicone tube single-chamber drainage tube with side holes is inserted from the opening a of the skull A, so that the drainage ports 12 are located between the dura mater B and the brain. In the hematoma cavity C between the tissues D, try to ensure that the head end of the silicone tube 11 does not touch the brain tissue D, and discharge the waste fluid in the hematoma cavity C into the waste fluid bag. This straight single-lumen drainage tube with side hole silicone tube has the following disadvantages: (1) The direction of the straight drainage tube is not easy to control when it is placed, and it needs to be inserted into the subdural space for a certain length for drainage. The center is easy to shift and slip, and the catheter is too long, which has a certain oppressive effect on the brain tissue. As the thickness of the hematoma decreases, the oppression becomes more obvious, damages the brain tissue, and can induce epilepsy, resulting in neurological dysfunction and even death; (2). Flushing, if intracavitary flushing is required, the flushing fluid and the drainage fluid are in the same pipe. First, the flushing fluid and the drainage fluid cannot flow in and out independently. The flushing fluid needs to be completely in the cranium before it can flow out through the drainage tube. Flushing can cause increased intracranial pressure. Flushing makes the drainage material that has been drained into the lumen enter the cranium again, which is easy to cause infection; (3), the drainage tube is not easy to bend, and it is easy to be compressed and discounted at the bone hole, causing poor drainage; (4), only one-way drainage , the drainage range is limited, and the drainage effect is not good; (5), the drainage tube is thinner, the drainage hole is smaller, and the viscous drainage fluid is easy to block the drainage tube.

Contents of the invention

In order to solve the problems existing in the prior art, the present invention provides a flushable single-tube double-cavity H-type drainage tube for drainage of intracranial subdural hematoma. Moreover, both ends are drained synchronously, the drainage range is wide, the positioning is accurate, it is not easy to fall off, and it is not easy to touch the brain tissue; the drainage tube has a built-in flushing tube, which is convenient for flushing.

The present invention adopts the following technical scheme: a flushable single-tube double-cavity H-type drainage tube, including a T-type drainage tube, a T-shaped transfer tube, an epidural anesthesia catheter and an anti-reflux drainage bag, and the T-type drainage tube is a latex tube. The T-shaped drainage tube has two drainage inlets and one drainage outlet. The two drainage inlets are located on the drainage head of the T-shaped drainage tube, and the directions of the two drainage inlets are opposite; the T-shaped transfer tube has the first port, the second port and the first port. Three ports, the direction of the first port is opposite to that of the second port; the drainage outlet of the T-shaped drainage tube is connected to the third port of the T-shaped tube through an adapter, and the second port of the T-shaped tube is connected to the anti-reflux drainage bag. The liquid injection end of the epidural anesthesia catheter is connected to the first port of the T-shaped adapter tube, and the liquid outlet end of the epidural anesthesia catheter extends from the first port of the T-shaped adapter tube to the drainage head of the T-shaped drainage tube.

When draining subdural hematoma, pinch the drainage head of the T-shaped drainage tube with your fingers, bend the drainage head, and insert it into the hematoma cavity from the opening of the skull. Due to the elasticity of the drainage head, after releasing your fingers, the drainage head returns to its original position. In this state, pull out the T-shaped drainage tube slightly outward, so that the drainage head sticks on the dura, and the waste fluid in the hematoma cavity enters the T-shaped drainage tube from the two drainage inlets, and then flows into the anti-reflux drainage bag. The diameter of the two drainage inlets is relatively large, and the direction is opposite. Without increasing the number of surgical drilling holes and expanding the damage, the single-direction drainage can be changed into two-way drainage, with a wide drainage range and fast drainage speed; the drainage head is stuck in the skull At the beginning, it is not easy to slip and shift, and it is not easy to touch the brain tissue. Even if the hematoma cavity gradually shrinks with the drainage and the brain tissue expands, the arachnoid outside the brain tissue will actively squeeze the drainage head, and the drainage head is soft. Can damage brain tissue.

During intraoperative and postoperative flushing, use a syringe to inject cleaning solution from the injection end of the epidural anesthesia catheter, and the cleaning solution enters the hematoma cavity from the outlet end of the epidural anesthesia catheter. The flushing waste liquid is discharged, and the flushing liquid and waste liquid pass through different chambers during the whole process, which does not affect the drainage effect. It can also flush the hematoma cavity through an independent pipeline, effectively preventing the drainage from the drainage tube from entering the skull again and avoiding infection; and hard The extramembranous anesthesia catheter is thinner, which does not affect the drainage effect, and the flushing flow rate is slower, which is less likely to cause a sudden increase in intracranial pressure.

Furthermore, at least one side drainage port is cut on the drainage head of the T-shaped drainage tube, which can perform simultaneous drainage in multiple directions, increase the drainage speed, and prevent the mass from blocking the drainage port.

The flushable single-tube double-cavity H-type drainage tube of the present invention has the following advantages: (1) The drainage head of the T-type drainage tube is T-shaped. The length of the cranial insertion is fixed at a few millimeters, which avoids damage to the brain tissue during postoperative brain swelling, and avoids poor drainage and blockage caused by compression and deformation of the drainage head near the skull; the traditional straight drainage tube head is combined with the The point contact of the brain tissue becomes the line contact between the drainage head and the brain tissue, and the probability of damage to the brain tissue and cortical bridging veins is greatly reduced. During extubation, the smooth surface of the drainage tube should be in contact with the brain surface to avoid damage to the brain tissue through the drainage hole. (2) The T-shaped drainage tube has drainage ports in two opposite directions, and the number of side drainage ports can be increased in the drainage head. It has the characteristics of multi-directional drainage, and the drainage is more complete and thorough. (3) Insert the T-shaped drainage tube into the epidural anesthesia catheter. In addition to not affecting the drainage effect, an independent tube can also be used to flush the hematoma cavity, effectively preventing the drainage from the drainage tube from entering the skull again and avoiding infection. (4) The tubing of the epidural anesthesia catheter is relatively thin (diameter of the tubing is 0.6-1.2mm, and the diameter of the outflow hole is 0.1-0.3mm), and the flushing flow rate is slow, which is not easy to cause a sudden increase in intracranial pressure; T-shaped, effectively clamped on the inner surface of the skull hole, not easy to detach, easy to fix, and embedded in the dura mater, reducing the chance of epidural hematoma; (6) One tube with two cavities, one bone hole is equivalent to two bone holes The effect reduces the surgical injury and shortens the operation time.

Description of drawings

Fig. 1 is a schematic diagram of an existing straight silicone tube single-lumen drainage tube with side holes.

Fig. 2 is a schematic diagram of the flushable single-tube double-lumen H-shaped drainage tube of the present invention.

detailed description

Embodiments of the present invention are described in detail below in conjunction with the accompanying drawings:

The flushable single-tube double-lumen H-type drainage tube, as shown in Figure 2, includes a T-type drainage tube 20, a T-type adapter tube 40, an epidural anesthesia catheter 50 and an anti-reflux drainage bag (existing, not shown) ), the T-shaped drainage tube 20 is a latex tube, the T-shaped drainage tube 20 has two drainage inlets 23, 24 and one drainage outlet 21, and the two drainage inlets 23, 24 are located on the drainage head 22 of the T-shaped drainage tube 20, and The two drainage inlets 23 and 24 are in opposite directions, and a side drainage port 25 is also cut on the drainage head 22; the T-shaped transfer pipe 40 has a first port 41, a second port 42 and a third port 43, and the first port 41 is connected to the second port. The direction of the two ports 42 is opposite, the drainage outlet 21 of the T-shaped drainage tube 20 is connected to the third port 43 of the T-shaped transfer tube 40 through the adapter 30, and the second port 42 of the T-shaped transfer tube 40 is connected to the anti-reflux drainage bag. The liquid injection end 52 of the epidural anesthesia catheter 50 is connected to the first port 41 of the T-shaped adapter tube 40, and the liquid outlet 51 of the epidural anesthesia catheter 50 extends from the first port 41 of the T-shaped adapter tube 40 to the T The drainage head 22 of the type drainage tube 20.

When draining a subdural hematoma, pinch the drainage head 22 of the T-shaped drainage tube 20 with your fingers, bend the drainage head 22 toward the middle, and insert it into the hematoma cavity C from the opening a of the skull A. Since the drainage head 22 has elasticity, it is loose After opening the finger, the drainage head 22 returns to the T-shaped state. As shown in Figure 2, the T-shaped drainage tube 20 is pulled out slightly, so that the drainage head 22 is attached to the dura mater B, and the waste fluid in the hematoma cavity C is drained from the two sides. Inlets 23, 24 and a side drainage port 25 enter the T-shaped drainage tube 20, and then flow into the anti-reflux drainage bag. As the hematoma cavity C gradually shrinks with the drainage, the brain tissue D expands, and the arachnoid outside the brain tissue D Will actively squeeze the drainage head 22, and even block the side drainage port 25, but the two drainage inlets 23, 24 can still play a drainage role.

During intraoperative and postoperative flushing, use a syringe to inject cleaning solution from the liquid injection end 52 of the epidural anesthesia catheter 50, and the cleaning solution enters the hematoma cavity C from the liquid outlet 51 of the epidural anesthesia catheter 50, and the hematoma cavity C Flushing is performed, and the flushed waste liquid is discharged through the T-shaped drainage tube 20. The flushing liquid and waste liquid pass through different chambers during the whole process, which does not affect the drainage effect, and can effectively prevent the drainage in the T-shaped drainage tube 20 from entering the skull again. After flushing, use the cap 53 to seal the injection end 52 to avoid infection; and the epidural anesthesia catheter 50 is thinner, so that it does not affect the drainage effect, and the flushing flow rate is relatively slow, which is not easy to cause a sudden increase in intracranial pressure, improving Surgical success rate, reduce the chance of postoperative complications.

Simulate the flushing effect in an open environment: place the drainage head 22 of the T-shaped drainage tube 20 in an open environment, inject blue liquid from the injection end 52 of the epidural anesthesia catheter 50 with a syringe, and the blue liquid can be seen draining from the T-shaped The drainage inlet 23 of the tube 20 flows out, and there is no backflow of the blue liquid in the T-shaped drainage tube 20 .

Simulate the flushing effect in a closed environment: place the drainage head 22 of the T-shaped drainage tube 20 in a closed environment (in a sealed bottle), use a syringe to inject blue liquid from the injection end 52 of the epidural anesthesia catheter 50, and the blue liquid can be seen. The blue liquid flows out from the drainage inlet 23 of the T-shaped drainage tube 20, and there is no blue liquid backflow in the T-shaped drainage tube 20.

For some patients with clinical unilateral chronic subdural hematoma who need surgery, the traditional silicone tube and the flushable single-tube double-lumen H-type drainage tube of the present invention are used to perform drilling and external drainage operations for comparison, and the results show that the present invention The residual fluid volume in the hematoma cavity was (22.76±14.75) ml in patients with flushable single-tube double-lumen H-type drainage tube on the first day after operation, and the days of catheterization were (2.67±0.97) d. The amount of residual fluid in the hematoma cavity was (31.37±14.81) ml on the first day after the operation, and the days of catheterization were (3.34±1.08) d. Patients who used the flushable single-tube double-lumen H-type drainage tube of the present invention had hematoma during extubation The amount of residual fluid in the cavity was (12.90±7.32) ml, and the amount of residual fluid in the hematoma cavity was (15.91±7.95) ml in patients who used traditional silicone tubes during extubation. It can be seen that the flushable single-tube double-lumen H-type drainage tube of the present invention has a good drainage effect in the external drainage of chronic subdural hematoma, and the tube stay time is short, which is a safe and effective way to treat chronic subdural hematoma.

Claims (2)

1. Flushable single-tube double-cavity H type drainage tube, including T-shaped drainage tube, T-shaped transfer tube, segmental epidural catheter and anti-reflux drainage bag, T-shaped drainage tube is latex tubing, it is characterized in that: T-shaped drainage tube has two drain imports and a drain outlet, two drain imports are positioned on the drainage head of T-shaped drainage tube, and two drain imports are in opposite direction；T-shaped transfer tube have first, second mouthful and the 3rd mouthful, first and second mouthful in opposite direction；The drain outlet of T-shaped drainage tube is connected with the 3rd mouthful of T-shaped transfer tube by adaptor, second mouthful of T-shaped transfer tube connects anti-reflux drainage bag, the fluid injection end of segmental epidural catheter is connected with the first of T-shaped transfer tube, and the liquid outlet of segmental epidural catheter extend into the drainage head of T-shaped drainage tube from the first of T-shaped transfer tube.

2. Flushable single-tube double-cavity H type drainage tube according to claim 1, it is characterised in that: the drainage head of T-shaped drainage tube has also been cut at least one side draining hole.