CN101146570B - 具有凸缘的闭塞装置及方法 - Google Patents

具有凸缘的闭塞装置及方法 Download PDF

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CN101146570B
CN101146570B CN200580002183XA CN200580002183A CN101146570B CN 101146570 B CN101146570 B CN 101146570B CN 200580002183X A CN200580002183X A CN 200580002183XA CN 200580002183 A CN200580002183 A CN 200580002183A CN 101146570 B CN101146570 B CN 101146570B
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库尔特·安普拉茨
G·A·蒂尔
P·卢梭
X·古
J·桑托罗
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Abstract

本发明公开了一种可植入型闭塞装置，包括由管状主体延伸出的一个或多个凸缘。本发明提供的凸缘能够辅助将此闭塞装置固定在脉管、腔体、附肢等里面。本发明提供的闭塞装置中至少有一个凸缘包含接近主体一端的凹表面。由于凸缘的形状如凹形，闭塞装置可抵御因某些原因如左心耳在心房纤维颤动时所产生的斥力而导致装置脱离原植入位置。

Description

具有凸缘的闭塞装置及方法
相关申请
本发明专利申请要求如下专利申请的优先权：“申请号为60/560,825，申请日为2004年4月8日，发明名称为“具有凸缘的闭塞装置及方法”的美国临时专利申请案，并全文引用于本说明书。
技术领域
本发明涉及可植入型医疗器械领域，具体涉及可用来闭塞体内脉管、腔体、附肢等的可植入型医疗装置。
背景技术
目前已有各种装置和/或技术用来闭塞患者体内脉管或器官(如心脏)上存在的孔洞。专利号为5,725,552(Kotula等)、5,846,261(Kotula等)、5,944,738(Amplatz等)、6,123,715(Amplatz等)、6,368,339B1(Amplatz)、6,447,531B1(Amplatz)、6,579,303B2(Amplatz)、6,599,308(Amplatz)等美国专利揭示了各种不同的能达到预期效果的闭塞装置(以及其所用材料和制备方法)。
然而，上述专利中所涉及的装置不适合在以下生理学情况下使用，比如当左心耳(LAA)发生心房纤维颤动时，为了减少栓塞的危险，需要闭塞左心耳。左心耳的心房纤维颤动是栓塞形成的重要因素。通过外科手术技术或许能够闭塞左心耳，但大多数情况下是无法达到和/或不可取的。而且，虽然上述专利中某些装置可用来闭塞左心耳，但是例如心房纤维颤动产生的力会导致左心耳排斥这些装置，而这是不希望发生的。
发明内容
本发明提供的一种可植入型闭塞装置包括从一个管状主体延伸的一个或多个凸缘，这些凸缘能够辅助所述装置驻留在脉管、腔体、附肢等里面。
优选的方式是闭塞装置中至少有一个凸缘包含紧靠于主体一端的凹表面。凸缘的形状例如凹形，能够使所述闭塞装置抵御因某些原因如心房纤维颤动时左心耳产生的力所导致的装置脱离原位。在其它具体实施方式中，凸缘缘唇的位置例如位于所述闭塞装置的主体的相对轴向两端之间，能够辅助闭塞装置抵御心房纤维颤动时左心耳产生的力所导致的装置脱离原位。在其他另一些具体实施方式中，多个此处所述具有凹外表面的凸缘也辅助闭塞装置驻留于选定的植入位置上。
本发明所述闭塞装置上的凸缘优选具有背向装置主体的凸外表面。如果凸缘是由凸外表面和面对装置主体的凹外表面组成，所形成的凸缘缘唇和凸缘的形状特别能够抵御由于左心耳的心房纤维颤动而引起的装置脱离所选原位。
本发明所述闭塞装置的“外表面”是指从该闭塞装置内部面向外部的面。典型的情况是，外表面是由制造装置的材料来确定的，因而术语“表面”并不要求所述表面是刚性的。例如在本发明中多孔材料(如交错编织的丝束)可以限定外表面，此时，股与股中间仍然留有空隙。
与前述专利所涉及的装置相比，本发明所述闭塞装置优选采用多孔材料制造而成，例如制造本发明闭塞装置的材料优选孔径等于或小于100微米。优选方案采用经编织、针织、捆扎等方法制成的丝束，以便将这些丝束制作所得的闭塞装置植入体内后，更容易地收集血栓到装置表面，从而闭塞左心耳。
前述专利也涉及多种可用来制备本发明所述闭塞装置的方法。优选的是例如，由这些方法和材料提供的本发明所述装置，是可以经压缩后递送到体内某个部位，然后可自动地和/或经加热(或在别的引发剂作用下)而使此装置扩张到它们的松弛状态。因此，优选使用有弹性的材料来制作此闭塞装置，便于装置的压缩和扩展。合适的材料例如可以包括具有形状记忆特性的材料，如镍钛合金等。
如果闭塞装置是由交错编织成的管状结构制成，则本发明装置的编织密度(pick of fabric)优选地较前述专利的装置大。此处“密度”(pick)是指交错编织的管状结构的每单位长度上的圈数。例如，每英寸的密度优选可高达144圈(约合55圈/厘米)或更高，但也可根据需要降低密度。在某些具体实施方式中，如果需要加强闭塞装置收集血栓的能力并提供所需的闭塞功能，优选地可在闭塞装置内或装置上掺入一种纤维或其他结构(例如，如果闭塞装置的密度较低时)。
本发明所述闭塞装置的安置最好采用前述专利中提到的方法，如运用导管和其他装置来辅助安放。优选采用经皮技术实现安放，但这不是必须的。在这种递送方法下，优选用弹性的材料制作装置，该装置能以压缩的状态进行传送，到达选定位置时可扩展(最好自动和/或在诸如加热条件下产生)至松弛或扩展状态。此特性类似于大多数前述专利所描述的。
本发明一方面提供一种在体内安置的医疗装置，包括：带有第一端和第二端的管状主体，所述主体限定了在所述第一端和第二端之间延伸的纵轴，当所述装置处于松弛状态时，所述主体的主体宽度测得与纵轴成横向；在靠近主体第二端处附着于主体的凸缘，该凸缘包含面向主体第一端的凹外表面，当所述装置处于松弛状态时，该凸缘的凸缘宽度横向于纵轴。当装置处于松弛状态时，接近凸缘的主体宽度是该凸缘宽度的一半或高于一半。
本发明第二方面提供一种体内安置的医疗装置，包括：带有第一端和第二端的管状主体，所述主体限定了在所述第一端和第二端之间延伸的纵轴，当所述装置处于松弛状态时，所述主体的主体宽度测得与纵轴成横向；在靠近主体第二端处附着于主体的多个凸缘，所述多个凸缘中每个凸缘均包含面向主体第一端的凹外表面，当所述装置处于松弛状态时，每个凸缘的凸缘宽度横向于纵轴，接近该多个凸缘中每个凸缘的主体宽度小于该凸缘宽度。
本发明第三方面提供一种体内安置的医疗装置，包括：带有第一端和第二端的管状主体，所述主体限定了在所述第一端和第二端之间延伸的纵轴，当所述装置处于松弛状态时，所述主体的主体宽度测得与纵轴成横向；附着于主体的仅有一个凸缘，此唯一凸缘附着于接近主体第二端处，此唯一凸缘具有面向主体第一端的凹外表面；当装置处于松弛状态时，该凸缘的凸缘宽度横向于主体纵轴，接近此唯一凸缘的主体宽度小于该凸缘宽度。
本发明第四方面为，通过将本发明所述闭塞装置安置到心脏的左心耳内，从而提供了一种治疗生理学状态的方法。
在一些具体实施方式中，本发明可以提供一种安置于体内的医疗装置，具有扩展和压缩两种状态，压缩状态便于所述装置经导管管腔通过。该装置可包括多股丝束，它们被处理成跟扩展状态形状相一致，其中每一股都有近端和远端，而且其中至少一个近端和远端固定于一共有终端点。装置还可以包括：由该多股丝束构建形成的管状主体，它具有第一端和第二端，主体限定了在该两端间延伸的纵轴，且该主体的宽度测与与纵轴成横向；由该多股丝束形成的一个或多个凸缘，所述凸缘在靠近主体第二端处附着于主体，当装置处于扩展状态时，凸缘具有面向主体第一端的凹表面，并且该凸缘的宽度横向于纵轴，此凸缘宽度大于装置在扩展状态时的主体宽度。一种选择方案，装置在扩展状态时，凸缘具有背向主体第一端的凸表面。另一种选择方案，凸缘具有远离于纵轴的凸缘唇，当装置在扩展状态时，凸缘唇位于主体第一端和第二端之间。
在另一个具体实施例中，本发明还可以提供一种安置在体内的医疗装置，具有扩展和压缩两种状态，压缩状态便于所述装置经导管管腔通过。此医疗装置可以包括多股丝束，它们被处理成与装置的扩展状态时相一致的外形，每一股均具有近端和远端，而且多股丝束中至少有一个近端和远端固定于一共有终端点。装置还可以包括由该多股丝束构成的管状主体，它具有第一端和第二端，该主体限定了在第一和第二端之间延伸的纵轴，该主体的宽度测得与纵轴成横向；以及由该多股丝束形成的一个或多个凸缘，它们在接近主体第二端处附着于主体，每个凸缘包含远离于纵轴的凸缘唇，当装置处于扩展状态时，凸缘唇位于主体第一端和第二端之间；凸缘的凸缘宽度横向于纵轴，在装置处于扩展状态时，该凸缘宽度大于主体宽度。一种选择方案是，当装置处于扩展状态时，凸缘唇位于主体第二端内侧1毫米或多一点处。
本发明所述的这些和其他特点及优点将结合本发明下述示范的具体实施方式做进一步描述。
附图说明
图1是本发明的医疗装置的一个具体实施例的平面图。
图2是图1所示的医疗装置沿图1中2-2的剖面图。
图3是本发明医疗装置另一个具体实施例的剖面图。
图4是本发明的另一种闭塞装置安置于左心耳的示意图。
具体实施方式
以下为本发明的一些具体实施方案，结合构成本发明一部分内容的附图进行描述，这些描述和附图只起举例说明作用，所述实施例是可操作的。应当理解，具体实施下述方案时对于使用方法和结构的变化也将落在本发明的范围中。
图1是本发明医疗装置的一个具体实施例的平面图(沿纵轴的剖面图见图2)，图2是图1所示的装置10沿2-2线(如图1所示)的剖面图。优选用多孔的材料(如针织或交错编织的多股丝束——如金属束)来构建装置10，使所得的装置10在其外部和一般最好是中空的内部之间具有开孔。
再者，图示的装置10具有一种扩展的或舒张的状态，即，当装置10被约束处于诸如传送装置、患者体内等处时，则具有上述状态。当装置10需通过诸如导管或其他装置被安置时，则优选被压缩到相对纵轴ll狭窄得多的外形。所述狭窄的外形优选通过诸如增加夹子40和50之间距离的方式，即用拉力将所述两个夹子分开的方法来实现。
装置10包括主体20和附着在主体20上的凸缘30。主体20优选包含第一端或表面22，以及第二端或表面24。想像的纵轴11在主体20的第一端22与主体20的第二端之间延伸(优选延伸至它的中心)。主体20的主体宽度横向于并通过纵轴。如图示，在第一端22和第二端24之间的主体宽度优选基本上不变化，或者，主体宽度也是可变的，如美国专利6,599,308 B2(Amplatz)中图6A所示。主体最大宽度优选发生在接近于凸缘30与主体20相连接的部位。
主体20的形状优选为管状。虽然将主体20描画为一种普通的圆形管状，但应该理解为，主体20也可以是其它一些管状，诸如正方形、椭圆形、扁椭圆形、六面形或其他合适的管状形状。
在某些实施例中，优选方案为在凸缘30的基部，即在凸缘30的凹表面34与主体20会合处，确定主体20的宽度，即主体20的宽度是凸缘宽度的一半或多一些(凸缘的宽度是指凸缘唇32的外边缘之间沿横向于纵轴lll的方向并通过纵轴111测得的距离)。在某些实施例中，在同一部位的主体宽度优选为凸缘宽度的3/4或大于3/4。
图l和图2均显示了可附着在主体20上的夹子40和50。优选地，夹子40和50用来固定形成此编织物(装置)的丝束的末端，假如在此必要的话，正如本说明书中所提到的各种专利所述。另外，最好应用至少一个夹子来辅助装置的安置。图示实施例中，所述夹子40优选包括，例如，具有螺纹的孔42，以便装置10以旋转的方式与安置传送装置连接，所述传送装置本身即包含，例如，与之互补的螺纹。虽然图中所示螺纹位于孔42内部，但应该理解为螺纹也可以选择性地位于夹子40的外部。再者，其他附着机构，如沟漕、孔缝等也可代替螺纹辅助传送安置。
虽然图中所示主体的第一端22和第二端24具有稍凹的形状，但应该理解为第一端22和/或第二端24之一或二者也可以是其他形状，如基本平的、凸的、球状的等结构。
凸缘30连接于主体20的部位优选靠近主体20的第二端24处。优选地，构建主体20的材料，如纤维编织物，与凸缘30一体成型。此处的“一体”是指均由单一连续的材料层，如纤维编织层来形成主体20和凸缘30。或者也可构建主体20，并将凸缘30附加到主体20上，在两者连接前是分隔的、不同的两件。
凸缘30优选包含凹表面34，优选凹表面34面向装置10的第一端22。从任何方向来观察，凹表面34呈弯曲状，例如是一种抛物凹面，或从一个或多个方向看，该凹表面呈线性，这种弯曲状还可以是圆锥形凹表面的截面形成的环状。凹表面34也可以是由一系列平表面组合成的近似凹表面。另一种情况，凹表面34中部分是平表面，而其他部分呈弯曲状。不管凸缘30具有什么怎样的特殊形状，总的来说凸缘30优选包含有一个面向或开口向主体20中第一端22的凹表面。
凸缘30优选包含有一个背向主体20中第一端22的凸表面36。从任何方向来观察，凸表面36呈弯曲状，例如是一种抛物凸面，或从一个或多个方向看，凸表面36呈线性，这种弯曲状还可以是圆锥形凹表面的截面形成的环状。凸表面36也可以是由一系列平表面组合成的近似凸表面。另一种情况，凸表面36中部分是平表面，而其他部分呈弯曲状。不管凸缘30具有什么怎样的特殊形状，总的来说凸缘30优选包含有一个背向主体20中第一端22的凸表面36。
凸缘30优选包含有凸缘唇32，凸缘唇32优选位于靠近凸缘宽度于纵轴来测量的最大外圈处。凸缘唇32优选形成一种相对窄的边沿，以便使装置10通过改变患者体内的组织(如左心耳)的形状来驻留在患者体内。如图2所示，凹表面34和凸表面36优选会合于凸缘唇32。
换个方式来说明本发明所述装置，当装置10是处于扩展状态时，凸缘30优选包含凸缘唇32，它位于主体20中第一端22和第二端24之间。在某些具体实施例中，凸缘唇32优选位于主体20的第二端24向内1毫米或多些的位置(此处“向内”是指朝向主体20的第一端22)。
换个方式来说明本发明所述医疗装置，医疗装置10的轴向长度优选(如图2所示“L”)是主体20第一端22和第二端24之间的距离，它小于凸缘30的最大宽度(横向于纵轴11来测量)。轴向长度与最大凸缘宽度的比例优选是1∶1或较小些。在其他一些情况下，上述比例优选为0.5∶1或较小。
有利的是，本发明方法包含将医疗装置安置在心脏(优选人类心脏)中左心耳内。安置医疗装置10时，优选将主体20中第一端22面向左心耳内部，第二端24位于紧接左心耳开口处。如果医疗装置10上的凸缘30包含面向主体20第一端22的凹表面34，则凹表面34优选面向左心耳的内侧。如果凸缘30包括凸缘唇32，则凸缘唇32优选偏置于左心耳的内侧表面。“偏置”是指：促使医疗装置10成为扩展状态的力使凸缘唇32对左心耳的内侧表面施加朝外的压力。
图3是本发明闭塞装置处于松弛或扩展状态的另一种具体实施方式。在一些具体实施例中，本发明的闭塞装置优选只包含一个凸缘，如图1和图2所示的装置10。或者，图3所示的闭塞装置110包含多个凸缘，如凸缘130a、130b、130c(这些凸缘统称“凸缘130”)，它们从主体120向外延伸。虽然图中所示闭塞装置110包含三个凸缘130，但也应该理解为本发明所述闭塞装置包含多个凸缘，如少至2个、4个或更多的凸缘。图3所示的具体实施例仅仅体现了一种包含多个凸缘的闭塞装置的一个示范性具体实施方式。
闭塞装置110除了其大小和凸缘130的数目与图1和图2所示的闭塞装置10不同外，两者的构造是一样的。因而闭塞装置110优选经压缩后成为压缩的状态，以便于***到传送装置(如导管、套管)的管腔中。当闭塞装置处于压缩的状态时，夹子140和150之间的距离优选远于如图3所示当该闭塞装置处于舒张或扩展状态时它们的距离。
本说明书中所述闭塞装置10的各种变形及可选择的特征，同样适合于图3所示的具体实施方案。闭塞装置110包含第一端122、第二端124、夹子140和150(夹子140优选包含带有螺纹的孔142)，以及(优选位于中心的)纵轴111。尽管本装置描述成由交错编织的多股丝束构成，但是，此装置也可以由其他任何合适的材料来制备。
图3所示的具体实施方式中有一个特征是图1和图2没有表现出来的，即主体120的压缩是从第一端122沿着纵轴111移动至第二端124。如本说明书描述的，当从第一端122沿着纵轴111移动至第二端124时，主体宽度(横向于并穿过纵轴111来测量的)在减少。闭塞装置110的这种压缩变窄过程是逐步的，最终成为一种类似锥形的外形，但也应该理解为，此压缩是可选择的(即，包含多个凸缘的闭塞装置不一定必须包含压缩变窄的主体)，并且可以以任何方式进行(例如，压缩变窄可以是分步进行、非均匀的方式等等)。
闭塞装置110中每个凸缘130优选含有凹表面134a、134b、134c(在此统称“凹表面134”)，这些凹表面面向闭塞装置110中第一端122。从任何方向来观察，凹表面134是呈弯曲状，例如是一种抛物凹面，或从一个或多个方向看，凹表面呈线性，这种弯曲状还可以是圆锥形凹表面的截面形成的环状。每个凹表面134也可以是由一系列平表面组合成的近似凹表面。另一种情况，凹表面134中部分是平表面，其他部分是呈弯曲状。不管凸缘130具有什么怎样的特殊形状，总的来说每个凸缘130优选包含有一个面向或开口向主体120中第一端122的凹表面134。
再者，虽然凸缘130中每一个包含面向主体第一端122的凹表面134，但也应该理解为，在包含3个或更多的凸缘130的具体实施方式中，仅仅两个或更多的凸缘130需包含面向第一端122的凹表面134。例如，在图示具体实施方式中，凸缘130有一个可以不包含面向第一端122的凹表面，只要凸缘130中至少有两个凸缘确实包含面向第一端122的凹表面134就可以了。
凸缘130中的两个或更多的凸缘优选包含凸表面136a、136b、136c(此处统称“凸表面136”)，这些凸表面背向主体120的第一端122。从任何方向来观察，凸表面136是呈弯曲状，例如是一种抛物凸面，或从一个或多个方向看，凸表面136呈线性，例如可以是圆锥形凸表面的截面形成的环状。凸表面136也可以是由一系列平表面组合成的近似凸表面。另一种情况，凸表面136中部分是平表面，其他部分呈弯曲状。不管凸缘130具有什么怎样的特殊形状，总的来说凸缘130中两个或更多的凸缘优选包含有一个背向主体120的第一端122的凸表面136。
凸缘130中每个凸缘优选包含凸缘唇132a、132b、132c(在此统称“凸缘唇132”)，这些凸缘唇优选位于靠近凸缘宽度(横向于纵轴来测量)的最大外圈处。凸缘唇132优选形成一种相对窄的边沿，以便使闭塞装置110通过改变患者体内组织(如左心耳)的形状来驻留在患者体内。如图3所示，凹表面134和凸表面136优选会合在凸缘唇132。
图4是本发明闭塞装置210的另一种具体实施方式，即闭塞装置210定位安置于左心耳202内。图中显示了闭塞装置210的轮廓，仅描述了凸缘230偏置于左心耳202的内侧表面204。闭塞装置210中第二端224面向左心耳202时，其第一端222背向左心耳。这样，凸缘230的凹表面也面向外部，即离开左心耳202的内部。如以上讨论，本发明的闭塞装置在定位安置后，凸缘的朝向优选可辅助此装置驻留在左心耳202内部。应该理解为，本发明所述闭塞装置在左心耳内的安置仅是示范性的例子，这种装置可用于任何需要闭塞的部位，如孔口、脉管、腔体等处。
在本说明书及附属的权利要求中单数形式的“a，”“and，”和“the”也包括复数形式的指代物，除非本说明书另外有清楚的标记。
在说明书中引用的所有文献及出版物以全文形式引用于本说明书。说明书在此阐述本发明具体实施方式，并可在本发明的发明范围内做出一定的改变。这些变更和修改对于本领域技术人员来说是显而易见的，因此并没有超出本发明的发明范围，同样也应该理解为，本发明不局限于此说明书所述的几种说明性实施方式。所以，仅由权利要求书及其等同表达方式对本发明作出限定。

Claims (11)

1.一种在体内安置的医疗装置，其中，该装置包括：
包含第一端和第二端的管状主体，所述主体限定了在第一端与第二端之间延伸的纵轴，所述主体包括测得与纵轴成横向的主体宽度；以及
在靠近主体第二端处附着于主体的凸缘，所述凸缘具有面对主体第一端的凹入外表面和面对主体第二端的凸出表面，凹入和凸出表面在凸缘唇处接合在一起，所述凸缘唇位于主体第一端和第二端之间并沿纵轴位于第二端向内至少1毫米的位置，所述凸缘具有与纵轴成横向的最外凸缘宽度；
其中，当医疗装置处于松弛构造时测量主体宽度和凸缘宽度，靠近凸缘处的主体宽度是凸缘宽度的一半或大于一半。
2.一种在体内安置的医疗装置，其中，该装置包括：
包含第一端和第二端的管状主体，所述主体限定了在第一端与第二端之间延伸的纵轴，所述主体包括测得与纵轴成横向的主体宽度；以及
在靠近主体第二端处附着于主体的多个凸缘，每个凸缘具有面对主体第一端的凹入外表面和面对主体第二端的凸出表面，凹入和凸出表面在凸缘唇处接合在一起，所述凸缘唇位于主体第一端和第二端之间并沿纵轴位于第二端向内至少1毫米的位置，每个凸缘具有与纵轴成横向的凸缘宽度，
其中，当装置处于松弛构造时测量主体宽度和凸缘宽度，靠近每个凸缘的主体宽度是凸缘宽度的一半或大于一半。
3.一种在体内安置的医疗装置，其中，该装置包括：
包含第一端和第二端的管状主体，所述主体限定了在第一端与第二端之间延伸的纵轴，所述主体包括测得与纵轴成横向的主体宽度；以及
在靠近主体第二端处附着于主体的唯一凸缘，所述唯一凸缘具有面对主体第一端的凹入外表面和面对主体第二端的凸出表面，凹入和凸出表面在凸缘唇处接合在一起，所述凸缘唇位于主体第一端和第二端之间并沿纵轴位于第二端向内至少1毫米的位置，该凸缘具有与纵轴成横向的最外凸缘宽度，
其中，当装置处于松弛构造时测量主体宽度和凸缘宽度，靠近所述唯一凸缘的主体宽度是凸缘宽度的一半或大于一半。
4.如权利要求1-3中任一项所述的医疗装置，其特征在于，所述装置包括压缩构造，其中第一端和第二端之间的距离扩大，以至于主体宽度和凸缘宽度随之缩小，以使装置通过导管管腔，并且在离开管腔后所述装置恢复到松弛构造。
5.如权利要求1-3中任一项所述的医疗装置，其特征在于，所述装置包含多股丝束，它们经处理形成了与装置的松弛构造一致的形状，所述多股中每一股均包含一近端和一远端，在多股中的近端和远端中的至少一个固定于一共有终端点。
6.如权利要求4所述的医疗装置，其特征在于，所述装置包含多股丝束，它们经处理形成了与装置的松弛构造一致的形状，所述多股中每一股均包含一近端和一远端，在多股中的近端和远端中的至少一个固定于一共有终端点。
7.如权利要求5所述的医疗装置，其特征在于，所述多股丝束排列成一种编织物。
8.如权利要求7所述的医疗装置，其特征在于，所述凸缘包含两层编织物。
9.如权利要求5所述的医疗装置，其特征在于，所述装置还包含在共用终端点附着于装置的夹子。
10.如权利要求9所述的医疗装置，其特征在于，所述夹子包括螺纹，所述螺纹适于可旋转地接纳带有互补螺纹的传送装置。
11.如权利要求5所述的医疗装置，其特征在于，所述共用终端点位于紧靠装置第一端处。
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