CN112546462A - Magnetic dredging device for radioactive narrow biliary tract - Google Patents
Magnetic dredging device for radioactive narrow biliary tract Download PDFInfo
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- CN112546462A CN112546462A CN202011573272.2A CN202011573272A CN112546462A CN 112546462 A CN112546462 A CN 112546462A CN 202011573272 A CN202011573272 A CN 202011573272A CN 112546462 A CN112546462 A CN 112546462A
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Images
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/1001—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
- A61N5/1002—Intraluminal radiation therapy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N2/00—Magnetotherapy
- A61N2/002—Magnetotherapy in combination with another treatment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N2/00—Magnetotherapy
- A61N2/06—Magnetotherapy using magnetic fields produced by permanent magnets
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/1001—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
- A61N5/1007—Arrangements or means for the introduction of sources into the body
Abstract
The invention relates to a magnetic dredging device for radioactive narrow biliary tract. The invention comprises a first traction wire, a first conduit, a first magnet, a first titanium shell, a second magnet and a second titanium shell, wherein silver coatings are plated on the surfaces of the first magnet and the second magnet, the surface of the first magnet is provided with the first titanium shell in a surrounding manner, the surface of the second magnet is provided with the second titanium shell in a surrounding manner, the first conduit is sleeved on the first traction wire, the first conduit is connected with the first titanium shell, the first traction wire is connected with the first titanium shell, the first magnet and the second magnet are in a state of mutual attraction of opposite magnetic poles, and the first conduit is provided with a drainage hole. The invention has the advantages of safety, minimal invasion, effectiveness and quick recovery.
Description
Technical Field
The invention relates to the field of medical instruments, in particular to a magnetic dredging device for a radioactive narrow biliary tract.
Background
Biliary stricture is increasingly common in high-grade cholangiocarcinoma, which is a type of malignant tumor that occurs in the common hepatic duct, left and right hepatic ducts, and the junction. The continuous growth of tumor cells of the disease often causes biliary stricture and even obstruction, and causes severe obstructive jaundice.
Benign biliary stricture is a common complication of liver transplantation, post-biliary surgery and post-biliary injury. The incidence rate of biliary stricture after liver transplantation is about 10-40%. Direct damage to the biliary tract during cholecystectomy results in a biliary stricture incidence of about 0.5%. Biliary stricture is a repair reaction after local bile duct injury, and wound contraction of a wound surface after bile duct injury is a normal process of tissue repair. But excessive tissue proliferation and contraction can cause scar contracture to cause bile duct stenosis. The treatment of biliary stricture is a major problem in biliary surgery.
The currently common treatment methods are surgical operation and interventional drainage: (1) surgical biliary drainage operation, mainly resection of tumor tissue and narrow bile duct-carrying bile duct-jejunum Roux-en-Y cholecystoenterostomy; (2) placing an inner stent tube for drainage in Endoscopic Retrograde Cholangiopancreatography (ERCP); (3) endoscopic nasobiliary drainage (ENBD); (4) the metal internal bracket is placed in a percutaneous transhepatic biliary tract drainage (PTCD) mode to reduce jaundice, and meanwhile, the treatment such as liver protection, anti-inflammation, support and the like is performed, so that the anastomotic caliber is large enough, and a reliable and effective T-shaped tube is placed, and generally the T-shaped tube is placed for 6-9 months. However, the above methods have limitations, the surgical resection rate is only 10% -20%, and the complication is restenosis of the anastomoses; the latter methods, if failing to fully dilate the narrow bile duct, will cause the patients to have the symptoms of repeated and intermittent cholangitis such as high fever, abdominal pain, jaundice, etc. after withdrawing the stent or the drainage tube, and will hardly have an effect on the complete obstruction of the biliary tract. The metal inner support only plays a role in mechanically supporting the bile duct, can quickly relieve jaundice symptoms, but has no treatment effect on tumor and scar tissues, tumor cells or scar tissues can still continue to grow to block the bile duct to cause restenosis, obstructive jaundice can be generated, and the medium-term and long-term treatment effect is not ideal. The traditional method for removing biliary tract scar stenosis needs to perform a second laparotomy.
Magnetic Compression Anastomosis (MCA) was first proposed by the japanese scholars Obora and was tried clinically to perform intestinal and vascular anastomosis. In recent years, the development of magnetic compression anastomosis technology is rapid, especially in the treatment of biliary stricture and obstruction. In the magnetic pressing technology, pressed tissues between magnets are subjected to ischemia-necrosis-shedding, and tissues beside the pressing are subjected to pathological changes of adhesion-repair-healing, so that the reconstruction of a lumen is finally realized. The magnetic pressing anastomosis, the digestive tract endoscope and the biliary tract intervention technology are combined in Japan and Korea to be used for treating complex biliary tract stenosis patients after living liver transplantation, and relatively ideal effects are obtained. The traditional Chinese medicine is developed by the Lu Yi professor team of the first subsidiary hospital of the Western's university of transportation in China at first, and has the largest number of clinical application patients of the magnetic compression technology in China. Due to the development of novel rare metal materials, modification, advanced clinical research of biomechanics, clinical combined application of minimally invasive technology and other important technical cooperation problems, the application of the magnetic pressing technology in biliary stricture is reported more and more. However, most of the reported cases are complicated biliary stricture cases after liver transplantation, and biliary stricture or obstruction caused by tumor is not included, so that improvement and verification of the technology are needed.
Disclosure of Invention
The invention provides a safe, minimally invasive, effective and quick-recovery magnetic dredger for radioactive narrow biliary tracts, which aims to solve the technical problems in the background technology.
The technical solution of the invention is as follows: the invention relates to a magnetic dredging device for radioactive narrow biliary tract, which is characterized in that: the biliary tract dredger comprises a first traction line, a first catheter, a first magnet, a first titanium shell, a second magnet and a second titanium shell, wherein silver coatings are plated on the surfaces of the first magnet and the second magnet, the surface of the first magnet is provided with the first titanium shell in a surrounding manner, the surface of the second magnet is provided with the second titanium shell in a surrounding manner, the first traction line is sleeved with the first catheter, the first catheter is connected with the first titanium shell, the first traction line is connected with the first titanium shell, a state of mutual attraction of opposite magnetic poles is formed between the first magnet and the second magnet, and a drainage hole is formed in the first catheter.
Preferably, the second titanium shell is connected with a second traction wire, a second guide pipe is sleeved on the second traction wire and connected with the second titanium shell, and a drainage hole is formed in the second guide pipe.
Preferably, the other end of the first catheter is connected with the drainage bag through a Y-shaped joint.
Preferably, the first magnet and the second magnet have the same mechanical structure, are both cylindrical bodies, and have the diameter of 5-7.5 mm and the height of 0.5-1 cm.
Preferably, radioactive substances such as iodine 125 or palladium 103 are uniformly adsorbed on the silver plating layer.
Preferably, the silver plating is 5 to 15um thick.
Preferably, the first titanium shell and the second titanium shell have a thickness of 20 to 50um,
preferably, a TiN ceramic layer with the thickness of 1-25 um is deposited on the surfaces of the first titanium shell and the second titanium shell.
Preferably, the first magnet and the second magnet are neodymium iron boron magnets.
Research shows that the biliary duct intracavity radiation therapy can treat malignant biliary duct obstruction and prevent benign biliary duct stenosis, and has better curative effect. The radiation can inhibit the proliferation of bile duct smooth muscle cells and fibroblasts and promote the apoptosis of the bile duct smooth muscle cells and the fibroblasts. 125I is a low energy radioactive source with an energy of 27.4KeV to 35.4KeV (average energy about 31.4KeV), a tissue half-value layer of 20mm, a tissue penetration of 1.7cm, and a half-life of 59.6 d. 103Pd is a low-energy radioactive source similar to 125I, has short half-life (16.9d), high initial dose of 20-24 cGy/h, 1.7cm of penetrating distance between tissues, 3-4 times of initial dose of 1251 particles, 115Gy of bioequivalent dose and 20.74keV of weighted average energy of gamma rays radiated by 103Pd, and secondary electrons are generated when the released rays interact with substances, so that ionization and excitation of atoms of the substances are caused; the 103Pd radiation dose is very small, and the radiation dose outside 1m is reduced to one ten thousandth because the radiation attenuation rate is inversely proportional to the square of the distance. The gamma rays released continuously by radioactive substances directly destroy the double DNA helix chains of the tumor cell nucleus by photoelectric effect, Compton effect, ionization and the like in the process of penetrating tissues, so that the covalent bonds are broken, and the tumor cells lose the reproductive capacity. Meanwhile, the composition has an oxidation effect on surrounding molecules, blocks and interferes with the metabolism of cells, and promotes the death of the cells. Therefore, the magnetic pressing technology can be used for leading the tumor tissue or the scar tissue to have avascular necrosis and the radioactivity of radioactive substances to kill tumor cells and scar tissue, treating benign and malignant biliary stricture and prolonging the unobstructed time of obstructed biliary tracts.
Therefore, compared with the prior art, the invention has the following advantages:
1) the invention selects the prior neodymium iron boron magnetic material with high magnetic energy product, large domestic storage capacity and good biocompatibility as the magnet material, and the magnet is arranged through the PTBD passage and the ERCP path to treat serious biliary stricture and even biliary complete obstruction which are difficult to treat by other means.
2) The invention realizes the purposes of treating benign and malignant biliary stricture and increasing the unobstructed time of obstructed biliary tracts by loading a silver plating layer which uniformly adsorbs iodine (125I) or palladium (103Pd) on the surface of a magnet and utilizing the silver plating layer to release gamma rays to kill tumor cells or scar tissues.
In a word, the invention provides a safe, minimally invasive, effective and quick-recovery treatment means for patients with biliary tract stenosis and even biliary tract complete obstruction caused by tumor or scar tissue.
Drawings
FIG. 1 is a schematic structural diagram of the present invention.
Fig. 2 is a right side view of the left side structure of fig. 1.
FIG. 3 is a schematic structural view of a silver-plated magnet welded to a titanium case according to the present invention.
Fig. 4 is a schematic structural diagram of an embodiment of the present invention.
The reference numbers are as follows:
1. a first conduit; 2. a drainage hole; 3. a first traction wire; 4. a first magnet; 5. a first titanium shell; 6. a second titanium shell; 7. a second magnet; 8. a second conduit; 9. a second traction wire; 10. a Y-shaped joint; 11. a drainage bag; 12. and (4) silver plating.
Detailed Description
The present invention will be described in further detail with reference to the accompanying drawings and examples.
Referring to fig. 1, the structure of the embodiment of the present invention includes a first traction wire 3, a first guide tube 1, a first magnet 4, a first titanium case 5, a second titanium case 6, and a second magnet 7, wherein the surfaces of the first magnet 4 and the second magnet 7 are plated with a silver plating layer 12 containing adsorbed iodine (125I) or palladium (103Pd), the surface of the first magnet 4 is welded around the first titanium case 5, and the surface of the second magnet 7 is welded around the second titanium case 6. The first traction wire 3 is sleeved with a first conduit 1, the first traction wire 3 is connected with a first titanium shell 5, and the first conduit 1 is connected with the first titanium shell 5. The first magnet 4 and the second magnet 7 are in a state of attracting each other by opposite magnetic poles, and the lateral surface of the first catheter 1 is provided with a drainage hole 2 for draining bile at the proximal end of the biliary stricture part.
Referring to fig. 3, the first magnet 4 and the second magnet 7 have the same mechanical structure, and both are made of neodymium-iron-boron material and are cylinders, the diameter of each cylinder is 5-7.5 mm, and the height of each cylinder is 0.5-1 cm. The surfaces of the first magnet 4 and the second magnet 7 are respectively plated with a silver plating layer 12 with the thickness of 5-15 um, iodine (125I) or palladium (103Pd) is uniformly adsorbed on the silver plating layer 12, the adsorption dose generated by the iodine (125I) or the palladium (103Pd) on the first magnet 4 and the second magnet 7 is 40-60 Gy, the 125I half-life period is 59.6 days, and the penetrating power to tissues is 1.7 cm; 103Pd half-life 16.9 days, tissue penetration distance 1.7 cm. A glow plasma sputtering deposition method or an electric arc plasma deposition method is utilized, a first titanium shell 5 and a second titanium shell 6 with the thickness of 20-50 microns are respectively welded on the surfaces of the first magnet 4 and the second magnet 7 to achieve the purpose of corrosion resistance, and then a TiN ceramic layer with the thickness of 1-25 microns is respectively deposited on the surfaces of the first titanium shell 5 and the second titanium shell 6 to achieve the purpose of wear resistance.
Referring to fig. 4, in another embodiment of the present invention, the second titanium shell 6 is connected to a second traction wire 9, the second traction wire 9 is further sleeved with a second catheter 8, the second catheter 8 is connected to the second titanium shell 6, the lateral surface of the second catheter 8 is also provided with a drainage hole 2, and the other end of the first catheter 1 is connected to a drainage bag 11 through a Y-shaped connector 10.
The using process of the invention is as follows:
the first stage is as follows: the PTBD channel is established. After local anesthesia, a proper bile duct puncture line PTBD is selected under the guidance of B ultrasound or X ray, a PTBD channel is gradually expanded, and a drainage tube of 2F is usually added every week until the PTBD channel is expanded to 16F-18F.
And a second stage: performing a squeezing operation. After basic anesthesia, observing the condition of a papilla after a conventional lower duodenoscope lens reaches the duodenum, expanding a balloon with the diameter of 8-10 mm, inserting a guide wire and a catheter into a common bile duct through the papilla, simultaneously pushing a small amount of diluted contrast agent through a PTBD and an ERCP, simultaneously developing two ends of the narrow bile duct, and shooting at a positive position and a lateral position to clearly determine the spatial anatomical relationship of the narrow bile duct. The PTBD drainage tube is pulled out, and a skin sinus is placed into a 16-18F external sheath tube. The first magnet 4 is selected, the magnet is placed in the sinus under the guidance of a 14F catheter, the first magnet 4 is slowly pushed to the upper end of the narrow bile duct under the dynamic monitoring of X-rays, and the second magnet 7 is pushed to the lower part of the stricture in the common bile duct (according to the magnetic pole direction of the first magnet 4) through the ERCP path by using an 8.5F pusher under the endoscope again. The positions of the first magnet 4 and the second magnet 7 are adjusted to mutually and firmly attract and squeeze the narrow part of the biliary tract. The external sheath is pulled out and is respectively placed into the first catheter 1 and the second catheter 8 through a PTCD route and an ERCP route, the first catheter 1 is connected with the Y-shaped joint 10 and is connected with the drainage bag 11, and the first catheter 1 and the second catheter 8 are properly fixed at the position out of the body surface.
And a third stage: and (5) continuously performing magnetic squeezing. X-ray inspection is carried out every 5-7 days, and the position and the state of the magnet are dynamically monitored, so that the time for finishing squeezing can be judged.
A fourth stage: and taking out the magnet. When the contrast medium is pushed into the PTBD tube to fully develop the visible biliary tract and the visible magnet under the X-ray has larger mobility in the biliary tract, the pressing process is completed, and the magnet can be taken out through the first traction wire 3 or the second traction wire 9 in the PTBD channel or through the ERCP path.
According to the invention, the biliary tract is punctured through PTC, the guide wire is inserted to the near side of the narrow biliary tract through the skin surface, and then the guide wire and the catheter are inserted to the far side of the narrow biliary tract through the nipple through a duodenoscope, so that two channels, namely a PTBD channel and an ERCP path, are successfully established. The two magnets are guided and pushed by the catheter in sequence and are respectively and successfully placed on the near side and the far side of the narrow biliary tract through the biliary tract expanded by the saccule, the two magnets press the narrow biliary tract tumor tissue clamped in the biliary tract after absorbing the force, the loaded iodine (125I) or palladium (103Pd) releases gamma rays to kill the narrow biliary tract tumor tissue to cause necrosis, the two magnets absorbing the force and the narrow biliary tract tumor tissue clamped in the magnet are smoothly taken out through a PTBD channel or an ERCP path, and the narrow part of the bile duct is unobstructed.
The above embodiments are only specific embodiments disclosed in the present invention, but the scope of the present invention is not limited thereto, and the scope of the present invention disclosed in the present invention should be subject to the scope of the claims.
Claims (9)
1. The utility model provides a magnetic force dredge of radioactive narrow biliary tract which characterized in that: biliary tract dredge includes first pull wire, first pipe, first magnet, first titanium shell, second magnet and second titanium shell, silver-plated layer has all been plated on first magnet and second magnet surface, first magnet surface encircles and is provided with first titanium shell, second magnet surface encircles and is provided with second titanium shell, the cover has first pipe on the first pull wire, first pipe connects with first titanium shell, first pull wire links to each other with first titanium shell, be the state of opposite polarity magnetic pole inter attraction between first magnet and the second magnet, it has the drainage hole to open on the first pipe.
2. The magnetic force dredger according to claim 1, characterized in that: the second titanium shell is connected with a second traction wire, a second guide pipe is sleeved on the second traction wire and connected with the second titanium shell, and a drainage hole is formed in the second guide pipe.
3. The magnetic force dredger according to claim 2, characterized in that: the other end of the first catheter is connected with a drainage bag through a Y-shaped joint.
4. The magnetic force dredger according to any one of claims 1 to 3, wherein: the first magnet and the second magnet have the same mechanical structure and are cylindrical bodies, the diameter of each cylinder is 5-7.5 mm, and the height of each cylinder is 0.5-1 cm.
5. The magnetic force dredger according to claim 4, wherein: iodine 125 or palladium 103 is uniformly adsorbed on the silver plating layer.
6. The magnetic force dredger according to claim 5, wherein: the thickness of the silver plating layer is 5-15 um.
7. The magnetic force dredger according to claim 6, wherein: the thickness of first titanium shell and second titanium shell is 20-50 um.
8. The magnetic force dredger according to claim 7, wherein: and a TiN ceramic layer with the thickness of 1-25 um is deposited on the surfaces of the first titanium shell and the second titanium shell.
9. The magnetic force dredger according to claim 8, wherein: the first magnet and the second magnet are neodymium iron boron magnets.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011573272.2A CN112546462A (en) | 2020-12-28 | 2020-12-28 | Magnetic dredging device for radioactive narrow biliary tract |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011573272.2A CN112546462A (en) | 2020-12-28 | 2020-12-28 | Magnetic dredging device for radioactive narrow biliary tract |
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| Publication Number | Publication Date |
|---|---|
| CN112546462A true CN112546462A (en) | 2021-03-26 |
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| CN202011573272.2A Pending CN112546462A (en) | 2020-12-28 | 2020-12-28 | Magnetic dredging device for radioactive narrow biliary tract |
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| CN203677727U (en) * | 2013-12-13 | 2014-07-02 | 深圳市库珀科技发展有限公司 | Three-cavity structured biliary tract drainage catheter capable of carrying radioactive particles |
| CN204318983U (en) * | 2014-12-04 | 2015-05-13 | 王学栋 | A kind of antibacterial radioactivity biliary tract rack of recoverable |
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| US20030088142A1 (en) * | 2001-11-02 | 2003-05-08 | Terwillinger Richard A. | Delivery system and method for interstitial radiation therapy using seed strands constructed with preformed strand housing |
| GB0819893D0 (en) * | 2008-10-30 | 2008-12-10 | Homerton University Hospital N | Catheter |
| CN102205167A (en) * | 2011-01-17 | 2011-10-05 | 青岛市市立医院 | Integrated biliary tract internal irradiation balloon drainage tube |
| CN202427047U (en) * | 2012-01-10 | 2012-09-12 | 复旦大学附属中山医院 | Implantable iodine-125 radioactive seed strip |
| CN102631225A (en) * | 2012-03-27 | 2012-08-15 | 西安交通大学 | Dredging device for narrow biliary tract by means of magnetic compression |
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| CN204318983U (en) * | 2014-12-04 | 2015-05-13 | 王学栋 | A kind of antibacterial radioactivity biliary tract rack of recoverable |
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