CN1119127C - 组织热治疗装置 - Google Patents

组织热治疗装置 Download PDF

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CN1119127C
CN1119127C CN96193846A CN96193846A CN1119127C CN 1119127 C CN1119127 C CN 1119127C CN 96193846 A CN96193846 A CN 96193846A CN 96193846 A CN96193846 A CN 96193846A CN 1119127 C CN1119127 C CN 1119127C
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芒努斯·博尔姆斯约
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Abstract

一种人体组织热治疗的装置，由用于人体组织局部加热的加热装置(10)和为检测组织温度的温度传感器(11)组成，上述加热装置被封闭在导管(12)上，导杆(13)连接到第一温度传感器中，导杆(13)在导管(12)中推进通过第一开口，上述第一导杆(13)具有一尖端，用于插进被治疗的人体组织中。

Description

组织热治疗装置
技术领域
本发明涉及一种人体组织热治疗装置。
人体组织非正常生长之类的疾病，可以通过使用热治疗法来进行有效的治疗。非正常生长的组织可以被加热到消失的程度。某种类型的癌和***增生是这种疾病的例子。在治疗时组织的某部位被治疗但其他部位必须受到保护。
技术背景
许多种装置可用于产生热。除微波和射频天线外，通常使用激光。由于要治疗的组织的体积不同，加之上述待治疗的部分组织和不需治疗的邻近组织的热吸收性能也不同，因此在治疗时进行连续控制是必须的。
通常的加热装置包括某种装在加热元件上对相邻的组织检测温度的传感器。这种设计的缺点是温度传感器提供的信息中更多的涉及的是元件的温度而非组织的温度。
这种形式的加热装置的例子在专利EPO370890中已有说明。该装置由封闭在导管内的微波天线组成。所设计的天线对周围的组织传播电磁能。导管同时装有冷却槽以冷却贴近导管的组织。导管内装有一温度传感器，检测导管的温度。因此，所测量的温度与被治疗的组织的温度是不一致的。
加热装置的另一个例子出现在专利US-A-5,366,490中，根据其专利说明书，以前知道的加热装置存在很多缺点。这些缺点中最关键的是加热只能在不十分限定的面积或体积内进行。专门的装置包括一个装在导管中的微波天线，具体地说，因为没有严格地确定出治疗的面积，导致治疗结果明显地存在危险并容易失败。
根据专利US-A-5,366,490，为此提供的治疗装置装在一个可以送出导管的针状物内。导管及针状物在一安装好的超声波装置的配合下被精确地控制。该装置在整个治疗过程中连续监控治疗面积。针状物的控制必须很精确，因为只有在它的附近，局部的治疗效果才是很高的，这种治疗是外科的一种治疗，对执行治疗的人和所需的外科装置要求均很高。
发明简述
本发明的目的在于，在保持传统形式的加热治疗装置的效果的同时，提供一种装有温度传感器的加热装置，它消除了难以限定地进行加热的缺点。该装置包括用于对人体组织局部加热的加热装置和用于检测组织温度的温度传感装置，加热装置被封闭在一个导管中，该导管具空腔，空腔沿着导管从导管体的外部延伸进入并终止于末端；其特征在于，导杆从导管体的外部穿过空腔延伸，并具有一个末端部分，该末端部分通过对位于导管体外部的导杆施加一推进力将其推出上述空腔的末端到达***组织，以及所述温度传感装置包括多个温度传感器，所述温度传感器沿着载体的末端相互间隔布置，以确定在已经插有导杆末端的多个不同径向向外间隔位置上的***组织的温度。
所述管子具有一个端部件，所述端部件是用一种比导管更坚固的材料制造的，以避免导管不必要的弯曲。
优选的是，本发明至少设有一个热吸收装置，用于扩散靠近加热装置的人体组织处的热量。
本发明所提供的装置使对人体组织相关温度数据的记录成为可能。根据本发明，使用这种装置可以在任何门诊部进行而无需外科人员和装置或手术室。
附图的简要说明
图1是根据本发明装置的一个实施例的局部剖面的侧视图。
图2是沿图1中II-II线的剖面图。
图3是根据本发明的一个实际装置的实施例的纵向视图。
图4是根据本发明的实际装置的实施例的沿图3中VI-VI线的剖面图。
图5是根据本发明的替代的实施例的纵向视图。
图6为沿图7中VI-VI线的剖视图，示出根据本发明的另一个替代的装置实施例。
图7是沿图6中VII-VII线的纵向局部剖视图，示出图6中的装置。
对本发明的详细描述
本发明实施例如图1中所示，已***尿道中的导管12其顶端16已进入尿囊17。治疗开始前，一气球18连接到导管12上并在尿囊内膨胀，以避免导管12意外地拨出来。外部的***20示意地表明没有进行治疗的周围组织。
导管12包括用于加热***19组织的加热装置10。在一优选的实施例中，加热装置10包括一用于传播电磁能的天线。通常天线在1MHz-5000MHz频率范围内工作。在另外的实施例中，加热装置10由装有加热液体的容器组成，通过已加热的液体经过导管12循环或者通过某种加热元件直接连接到容器上的方式，来进行加热。加热装置10可直接地或者可通过一中间装置间接地连接到人体组织上。中间装置可设计成当加热时膨胀，达到改善对组织的连接效果，同时也改善了热传递的效果。
还有另一个实施例，加热装置10可以包括一个或几个小的装在导管12外部的射频电极。一个大的电极与导管电极互相作用，以这样的方式即通过射频能量传递热量。
加热装置10的一个作用部分位于***19上。向人体组织进行的这种能量供给，最好通过导管12内的通孔进行。下文参见图2会更详细地说明。
在治疗的过程中，人体组织处于被加热的状态。为了得到最佳的治疗效果，应该在一定的温度范围内进行加热。如果温度过高，不必要的急剧的加热会使人体组织遭受伤害。另一方面，如果温度过低，则达不到需要治疗的效果。为了记录被治疗组织的温度升高，第一温度传感器11连接到第一导杆13中，导杆13通过导管12上的一个通孔并安装或向前推进以便通过导管12上的一个开口。最好在导管的开口上为导杆13设一导向件，以便导杆13相对于导管12按所需要的角度出来和进入组织。导杆13也可在导管12中的一根管子内通过。导向件包括一倾斜部分，导杆13贴着它可以伸出来弯成角度并进一步伸出导管12。导杆13由相对硬的材料构成，便于贯穿***组织。
导杆13或温度传感器11都有一个尖端，可以更方便地***组织。温度传感器11可以用传统的设计如电阻传感器或半导体。对这类传感器需要牵引导线以便顺利地通过导管12。如果使用光学型的传感器，可以通过导管12装设一种光导纤维导线。
使温度传感器11或其导杆13伸出导管的操作是在人体外面的导管12外部通过控制装置来控制的。最好在合适的规定的方法下进行，以便导管***到组织中所需要的深度。在一种简单的设计中，导杆13制造成末端成尖端的硬管并伸出导管12内的通孔里。温度传感器11装在导杆13的一端。导杆13的另一端装有一个手柄。通孔和装在通孔里的导杆13被给定的尺寸和适合于推进程度的抗弯强度决定了导杆纵向的推进距离。通过手柄和导杆所进行的推进由一个停止器或某种制动装置限位，以避免发生温度传感器偶然超过需要的温度检测面积的危险。
在进行组织治疗过程中，通过连续地检测温度，可以精确控制电源和最终结果，因而，对组织发生意外伤害的危险会显著减少。
为了进一步减少这种伤害危险，更准确地说，对周围的组织不要扩大治疗，第二温度传感器14连接到第二导杆15中。第二导杆15设计成在导管12中推进通过并沿导管12的纵向、距离第一导杆13一定距离离开导管12。此距离决定于治疗面积和有充分余地地允许温度传感器14在向前推进的位置上***在治疗时不希望产生损害的组织中。在所示实施例中，第二温度传感器14在***20处检测温度。
图2的剖面图表明导管12如何设计的例子。加热装置10及其能源的导体装在位于中心的中心管子21里。管子21被两个同心圆包围着，传递空腔22、23，通过空腔配给冷却剂用于直接冷却加热装置10邻近的组织。在这种应用中，这样，加热治疗直接朝向距离加热装置10与导管12有一定径向距离的范围内的组织。对于这种情况，加热装置中包括一根天线是很合适的。
冷却剂主要用于避免导管对治疗部位周围组织的加热。这是由于热量损失或加热装置的传导所造成的。
导管圆柱表面不同的部分由两个部分24、25连接，在其中设有细长通孔26可以对气球18充气和放气。部分24、25向内与中心管子21汇合。
根据本发明装置的实用的实施例，图4中表明，管子27用聚四氟乙烯或类似的材料制造，装在导管12的内部外侧。管子27与装在导管12上的套筒28配合。套筒28的一部分在管子27的管口外面带有斜面部分29。套筒28与加热装置10之间的关系最好以这种方式配置，即套筒28在操作状态位于加热装置10的外圆上或工作范围以外。
套筒28也有加强作用，防止导管12由于导杆13的向前推进引起的不希望有的向下弯曲。调节套筒28的长度可以保持导管12的柔软性和可挠性。
导杆13可以装有一个或几个温度传感器11、14并伸进管子27中。导杆13是坚固的并具有尖端。导杆推进并通过管子27达到斜面部分29，斜面部分29最好由相对硬的材料构成，导杆13弯曲成一定角度从导管12的纵向伸出来。一个有利的角度至少大约为20°，合适的角度是30°。当导杆13连续***时，其顶端将***套筒28外面的组织。当连续向前推进时会进一步***组织。导杆13和管子27的材料是这样选择的，使它们之间的摩擦力适合地低。
如图3所示，导杆13配备了若干温度传感器。它们之间以一定距离排列。第一温度传感器11装在导杆13的顶端，第二温度传感器14装在离顶端相应的一个正常距离处。该正常距离是推出套筒28的导杆再向前推进的距离。而第二个温度传感器14装在治疗部位的外周。在上述两个温度传感器11、14之间装有另一个温度传感器11’。第三个温度传感器11’在正常操作状态下被装在治疗部位的中间。
在图4和图5的实施例中，管子27穿入导管12内部，最好是穿入空腔22或23之中的一个内。管子27的一端连接在一个端片上，该端片象套筒一样包括斜面部分29，端片30构成导管12的一部分，或者连接在导管12上，以便使斜面部分29位于在导管12上的开口31的外面。管子27穿过开口31。根据本实施例，当制造导管时，管子27从外面穿进开口31，然后穿过导管并在导管的一个开口端抽出。图5表示上述程序。其中端片30还未装到导管12的外部。用于管子27的某些材料必须可以通过机械连接例如通过夹紧将管子固定到端片30上。机械连接后，管子27呈现那样的方向，即导杆被推出管子27的小孔，到达斜面部分29并以需要的角度朝向外边。
端片30和管子27的小孔最好用薄膜覆盖。这可使导管12在使用前，进行简单的消毒和清洁。一但导管12***治疗部位，薄膜由于导杆13和温度传感器的向前推进而被刺破。在一个实施例中，端片30是用软板制成，它罩在导管12的部分外圆周上。
一些应用证明用两个温度传感器是不够的。在导管12上为导杆13和有关的温度传感器设有若干个细长通孔。加热装置也可被设置成若干单独元件，这些单独元件同样可以装在几根管子或通孔内。
在图6的实施例中，管子27装在导管12的专门通孔内，管子27实际上整个地通过导管12。销子32(见图7)从管子27的末端对着顶端16***管子27。销子32是管子中的末端零件并具有一个尖锐的斜端面33。这与上述实施例中的斜面29具有同样的作用。假如在这个实施例中，导管12需要加强，一个或数个加强元件34最好装在导管12中，以确保导管12具有一个完全光滑的外表面。如图6中所示，加强元件34最好装在空腔22和23中。
图7根据图6的设计只表示导管12的一部分。导杆13已进入管子27并到达一个位置，其端面将接触销子32的端面。如上述的实施例中，当导杆13进一步***管子27时，会离开轴向发生偏斜。该倾斜角度决定于斜面部分29的倾斜角度。这在本实施例中是由销子32的斜端面来表示的。在所示实施例中，导管13将刺过管子27和导管12的内壁。在另一个实施例中，导管12可以在被穿入的部位设计一个减薄部，也可以在导管12或者管子27上预先开一个口。当***尿道或类似部位时，该开口最好用薄膜或类似薄膜的材料盖住。
当导管13相对于斜面29或斜端面33偏转时会出现阻力的增加。这一阻力的增加可以用来确定一个起始点，这个起始点决定了导杆13的顶端和温度传感装置11***组织的深度。该深度也决定于倾斜角度。至少由第一温度传感器13产生的信号将被传送到显示器，通过显示器，护理人员可以评定治疗情况，最好这信号也输入一个在此未作详细说明的一个控制器，该控制器控制加热装置的电源。在使用多个温度传感器的情况下，最好将它们都连接到显示器和(或)控制器上。

Claims (10)

1、一种人体组织热治疗装置，包括用于对人体组织局部加热的加热装置(10)和用于检测组织温度的温度传感装置，加热装置(10)被封闭在一个导管(12)中，该导管具空腔(22)，空腔(22)沿着导管从导管体的外部延伸进入并终止于末端；
其特征在于，导杆(13)从导管体的外部穿过空腔延伸，并具有一个末端部分，通过对位于导管体外部的导杆施加一推进力，该末端部分被推出上述空腔的末端到达***组织，以及
所述温度传感装置包括多个温度传感器(11，11’，14)，所述温度传感器沿着导杆的末端相互间隔布置，以确定在已经插有导杆末端的多个不同径向向外间隔位置上的***组织的温度。
2、根据权利要求1的装置，其特征在于，导杆(13)被装在位于导管(12)中的管(27)中。
3、根据权利要求2的装置，其特征在于，所述管子(27)具有一个端部件(28，32)，该端部件设有一个斜面部分(29)，用于使导杆(13)偏转。
4、根据权利要求3的装置，其特征在于，端部件(28)装在导管(12)的外部，且所述端部件(28)是用一种比导管(12)更坚固的材料制造的，以避免导管(12)不必要的弯曲。
5、根据权利要求3的装置，其特征在于，端部件(32)装在导管(12)的内部。
6、根据权利要求5的装置，其特征在于，至少有一个加强元件(34)装在导管(12)内。
7、根据权利要求1中的装置，其特征在于，加热装置至少为一个用于传递能量至人体组织的微波天线。
8、根据权利要求6的装置，其特征在于，加强元件(34)装在导管(12)的空腔(22，23)中。
9、根据权利要求1的装置，其特征在于，至少设有一个热吸收装置，用于扩散靠近加热装置(10)的人体组织处的热量。
10、根据权利要求1的装置，其特征在于，所述多个温度传感器(11，11’，14)连接在控制装置上，以控制加热装置(10)的能量。
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SE505332C2 (sv) 1997-08-11
EP0835077B1 (en) 2006-11-02
JPH11505155A (ja) 1999-05-18
WO1996036288A1 (en) 1996-11-21
USRE38299E1 (en) 2003-11-11
HK1013914A1 (en) 1999-09-17
DE69636674T2 (de) 2007-09-06
SE9501875L (sv) 1996-11-19
AU5915996A (en) 1996-11-29
CA2221211A1 (en) 1996-11-21
SE9501875D0 (sv) 1995-05-18
DE69636674D1 (de) 2006-12-14
ES2276403T3 (es) 2007-06-16
AU697403B2 (en) 1998-10-08
EP0835077A1 (en) 1998-04-15
CN1184411A (zh) 1998-06-10
US5964791A (en) 1999-10-12

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