JP2010125306A - Probe with electrode for electrochemical treatment of prostate gland disease - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide prostate gland medical treatment equipment which can reduce a burden on patient receiving medical treatment, while a prostate gland disease can be treated with easy operation by puncturing a treatment instrument in a desired region of prostate gland tissue over the whole region of the prostate gland. <P>SOLUTION: In the probe for electrochemical treatment of an affected part of a prostate gland in the body cavity between the intestinal canal and body wall, a distal end 1 is composed of at least an electrode (1), and the probe distal end is punctured into a body cavity between the intestinal canal and body wall from the urethra, and by supplying direct current to a positive electrode and a negative electrode, the medical treatment removes a part of enlarged prostate growth cells and prevent the regeneration thereof. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

本発明は，前立腺疾患の電気化学的治療術に関するものである。  The present invention relates to an electrochemical treatment for prostate disease.

食塩水に＋及び−の電極を置き、直流電流を流した時、＋電極付近の食塩水は強酸性を、−電極付近の食塩水は強鹸性を示す事は公知の事実である。この原理を利用し作られた強酸性水、強鹸性水（強アルカリ水）は優れた機能を持つことから，消毒水、化粧水、洗浄剤、金属切削油の代替、農業用途では植物の根への吸収効果を利用し、成長促進、除虫剤、農作物の収量増加、味覚・糖度などの品質向上など幅広い分野で使用されている。また，医療分野への応用の試みは，強酸性水、強鹸性水（強アルカリ水）開発当初からなされ，これまでにＭＲＳＡ院内感染防止，アトピー性皮膚炎の治療，手指内視鏡等の洗浄消毒，が実用化されている。  It is a known fact that when + and − electrodes are placed in saline and a direct current is passed, the saline near the + electrode is strongly acidic and the saline near the − electrode is strongly saponifiable. Strongly acidic water and strong saponifiable water (strong alkaline water) made using this principle have excellent functions. Therefore, disinfectant water, lotion, detergent, metal cutting oil can be substituted, and agricultural applications Utilizing the root absorption effect, it is used in a wide range of fields such as growth promotion, pesticides, crop yield increase, quality improvement such as taste and sugar content. Attempts to apply it to the medical field have been made since the beginning of the development of strong acid water and strong saponifiable water (strong alkaline water). So far, MRSA nosocomial infection prevention, treatment of atopic dermatitis, hand endoscopes, etc. Cleaning and disinfection has been put into practical use.

ところで，最近，臓器摘出等の手術は，これまの外科的開腹術から，患者に肉体的，精神的苦痛を軽減する経皮的手術や腹腔鏡手術で行われるようになった。  By the way, recently, operations such as organ excision have been performed from percutaneous surgical laparotomy to percutaneous surgery and laparoscopic surgery to reduce physical and mental pain in patients.

例えば，肝腫瘍や腎腫瘍の摘出は，腹部に開けられた１０ｍｍ程度の数個の穴から，内視鏡や鉗子類を挿入して，手元で操作する腹腔鏡手術によって行われるようになっている。すなわち，鉗子先端に取り付けられた剪刀で臓器を切断し，前記腹壁の穴から体外に取り出す。大きいものは，切断時の血液，細胞の飛散を防ぐために腹腔内に挿入した袋の中で小片化した後，体外に取り出す。  For example, removal of liver tumors and kidney tumors has been performed by laparoscopic surgery in which an endoscope and forceps are inserted through several holes of about 10 mm opened in the abdomen and operated at hand. Yes. That is, the organ is cut with a scissors attached to the tip of the forceps and taken out from the hole in the abdominal wall. Larger ones are taken out of the body after being cut into small pieces in a bag inserted into the abdominal cavity to prevent the scattering of blood and cells at the time of cutting.

一方，前立腺肥大症は，経尿道的治療が多い。即ち，電気メス，レーザー或いは凍結プローブを経尿道的に挿入して，切除或いは液体窒素凍結する治療がよく行われている。  On the other hand, prostatic hypertrophy has many transurethral treatments. That is, the treatment of excision or liquid nitrogen freezing by transurethrally inserting an electric knife, laser or cryoprobe is often performed.

また，その他に，マイクロ波による治療も最近注目されている。具体的には，周囲にマイクロ波アンテナを設けたプローブを尿道に挿入して，そのアンテナからマイクロ波を照射して，加温治療する方法，或いは，プローブの一部に金属などの導電体を設け，これにより加温用電解を集中させる方法などがある。実際には，前立腺を４１℃から４４℃の範囲内の温度で加熱する経尿道的温熱治療，５０℃以上に前立腺を加熱して肥大部を擬固する経尿道的高温治療，及び７０℃以上に加熱しで肥大部の水分を蒸散させる経尿道的前立腺蒸散治療、また経尿道的温熱治療及び高温度治療を経直腸的にも行う事も検討されている。  In addition, microwave therapy has recently attracted attention. Specifically, a probe having a microwave antenna around it is inserted into the urethra, and microwave treatment is applied from the antenna to heat treatment, or a conductor such as metal is placed on a part of the probe. There is a method to concentrate heating electrolysis by this. Actually, transurethral hyperthermia treatment that heats the prostate at a temperature in the range of 41 ° C to 44 ° C, transurethral hyperthermia treatment that heats the prostate to 50 ° C or higher and squeezes the enlarged portion, and 70 ° C or higher In addition, transurethral prostate transpiration treatment, in which the water in the enlarged portion is evaporated by heating, transurethral hyperthermia treatment, and high-temperature treatment are also being studied transrectally.

しかしながら，前立腺肥大症治療腹腔鏡手術で臓器摘出する場合，鉗子による切断操作で健常臓器の切断，或いは，摘出臓器の小片化操作時に膀胱を破るなどの事故が起き易いという問題点があった。また，電気メス，レーザー或いは凍結プローブを経尿道的に挿入して，切除或いは液体窒素凍結する治療、温熱治療及び高温度治療の場合は，尿道を傷付ける難点などがあった。これらの治療法では全て患者に痛みを感じさせる為、麻酔が必須であって、前立腺肥大症の治療は高齢者に限られ、高血圧、心臓疾患、糖尿病等の治療中の患者が多く、これら高齢者に対する麻酔はリスクを伴う為、治療を断念するケースが多いのが実態である。  However, when organs are removed by laparoscopic surgery for treatment of benign prostatic hyperplasia, there is a problem that accidents such as cutting of healthy organs by cutting operation with forceps, or rupture of the bladder at the time of fragmenting operation of the extracted organs are likely to occur. In addition, in the case of treatment by excision or liquid nitrogen freezing, thermotherapy, and high temperature treatment by inserting an electrosurgical unit, a laser or a freezing probe transurethrally, there are difficulties in damaging the urethra. All of these treatments make the patient feel pain, so anesthesia is essential, and treatment for benign prostatic hyperplasia is limited to the elderly, and many patients are being treated for hypertension, heart disease, diabetes, etc. Since anesthesia for the elderly is risky, in many cases the treatment is abandoned.

そこで，本発明の一技術的課題は，これらの問題を解決し，麻酔を必要としない等の治療を受ける患者への負担を軽減することができる前立腺治療技術を提供することにある。  Therefore, one technical problem of the present invention is to provide a prostate treatment technique that can solve these problems and reduce the burden on a patient who receives treatment such as not requiring anesthesia.

また，本発明の他の技術的課題は，尿道粘膜等の損傷を受けやすい部位を損傷せずに，前立腺疾患の電気化学的治療を提供することにある。  Another technical problem of the present invention is to provide electrochemical treatment of prostate disease without damaging easily damaged parts such as urethral mucosa.

本発明によれば，体腔内の患部を電気化学的に壊死、溶解、凝固させるプローブであって，少なくとも先端部が１対の＋及び−の電極で構成され，前記先端部は，体腔内に挿入され生体細胞内体液と補充される生理食塩水に直流電流を流す事により強酸性、強鹸性を発生させ患部を壊死、溶解、凝固させることを特徴とする治療法が得られる。また、この治療法には、麻酔の必要性が無い事は多くの患者に対しての福音である。  According to the present invention, a probe for electrochemically necrotizing, dissolving, and coagulating an affected part in a body cavity, at least the tip part is composed of a pair of + and-electrodes, and the tip part is placed in the body cavity. A treatment method characterized by causing strong acidity and strong saponification by causing a direct current to flow through a physiological saline that is inserted and supplemented with biological fluid in a living cell to cause necrosis, dissolution, and coagulation of the affected area. Also, the lack of the need for anesthesia for this treatment is a gospel for many patients.

以上説明したように，本発明において，前立腺治療に用する場合は，プローブを尿道から体内に穿刺し、前立腺治療部位内にプローブの電極▲１▼を設置後，電気化学的作用により治療が可能となる。治療を受ける患者は痛みを感じない為、麻酔の必要が無く患者への負担を軽減したプローブが提供できる。すなわち，本発明のプローブは，麻酔を不要とし、前立腺組織を５ｍｍから数センチ以上縮小することが出来，且つ９０分前後で尿道を確保する治療を可能にする。  As described above, in the present invention, when used for prostate treatment, the probe can be punctured from the urethra into the body, and after the probe electrode (1) is placed in the prostate treatment site, treatment can be performed by electrochemical action. It becomes. Since the patient who receives treatment does not feel pain, there is no need for anesthesia, and a probe that reduces the burden on the patient can be provided. That is, the probe of the present invention does not require anesthesia, can reduce the prostate tissue from 5 mm to several centimeters or more, and enables treatment for securing the urethra in about 90 minutes.

以下，本発明の実施の形態について図面を参照して説明する。
図１、２は本発明の実施の形態による治療技術の説明に供せられる図であり，図１はプローブの形状を示す図である。図１に示すように，プローブ先端部に，パイプ状のプローブ先端部と，電極、ＰＨセンサー▲１▼、注入口▲２▼、尿排水口▲３▼、バルーン▲４▼、及びバルーン固定リング▲５▼を備えている。プローブ先端部は，導電性金属で電極を構成し，強酸性、強鹸性のＰＨ値を大きくするために，本実施の形態においては，コイル状とする構造を有しているがコイル以外の形状にても問題が無い。同電極▲１▼は患部の大きさに適合する長さに数極使用される。又、治療を強酸性水のみで行う場合は、−電極をプローブ本体内に留める事により可能となる。しかる治療法の場合、イオン透過膜を注水口▲２▼に取り付ける事により、さらに、よりいっそうの強酸性を発揮できる構造と成す。Embodiments of the present invention will be described below with reference to the drawings.
1 and 2 are diagrams used for explaining a treatment technique according to an embodiment of the present invention, and FIG. 1 is a diagram showing a shape of a probe. As shown in FIG. 1, at the probe tip, a pipe-like probe tip, electrode, PH sensor (1), injection port (2), urine drainage port (3), balloon (4), and balloon fixing ring (5) is provided. The probe tip has an electrode made of a conductive metal and has a coiled structure in the present embodiment in order to increase the strongly acidic and strong pH value. There is no problem with the shape. The electrode {circle around (1)} is used in several poles with a length suitable for the size of the affected area. Further, in the case where treatment is performed only with strongly acidic water, it is possible to keep the-electrode in the probe body. In the case of an appropriate treatment, an ion permeable membrane is attached to the water injection port (2) to form a structure that can exhibit even stronger acidity.

また，本発明の実施の形態においては，プローブ先端部は，尿排水口▲３▼を有し、プローブ本体基部の注入口▲２▼−１と一体と成す。これに隣接して尿吸引口▲５▼が備えられている。これはプローブ本体最先端部を治療時に閉鎖した場合、膀胱内に連絡する唯一のルートとなり、排尿、膀胱内への投薬を可能とする。  Further, in the embodiment of the present invention, the probe tip has a urine drain port (3) and is integrated with the inlet (2) -1 of the probe main body base. Adjacent to this, a urine suction port (5) is provided. This is the only route to connect to the bladder when the probe body tip is closed during treatment, allowing urination and medication into the bladder.

また、電極▲１▼、に隣接して注入口▲２▼、ＰＨセンサーを設ける。これは、共にプローブ本体基部注入口▲２▼−１と一体と成し、生理食塩水等の患部への供給口とする構造であり、電気化学的治療中の強酸性水等のＰＨをリアルタイムで測定し、治療終了後電極に正逆の電流を流す場合にはＰＨ６〜７程度の中性付近に回復した時点で電気化学的治療を終了する事が出来る。  Further, an injection port (2) and a PH sensor are provided adjacent to the electrode (1). This is a structure that is integrated with the probe main body base injection port (2) -1 and serves as a supply port to the affected part such as physiological saline, and the pH of strongly acidic water or the like during electrochemical treatment is real-time. In the case where a forward and reverse current is applied to the electrode after the treatment is completed, the electrochemical treatment can be finished when the pH is restored to around neutrality of about 6 to 7.

バルーン▲４▼は柔軟性を持った素材で構成され、バルーン固定リング▲５▼でプローブ本体に固定され、プローブ本体基部のバルーン注水口▲４▼−１と一体を成す。プローブ本体基部のバルーン注水口▲４▼−１は逆止弁を取り付ける構造が便利である。  The balloon {circle around (4)} is made of a flexible material, and is fixed to the probe main body by a balloon fixing ring {circle around (5)}, and is integrated with a balloon water inlet {circle around (4)}-1 at the base of the probe main body. The balloon water injection port {circle around (4)}-1 at the base of the probe body is convenient to attach a check valve.

次に，図１のプローブの一つの適用例として，前立腺肥大治療に用いた場合について具体的に説明する。図２は図１のプローブの使用例を示す概念図である。本発明の実施の形態によるプローブは，超音波医療診断装置によって，標的部位に誘導できるという利点を有している。具体的には，尿道よりプローブを挿入している。膀胱の下部に位置する前立腺に配置されたプローブ先端部電極▲１▼の強酸性、強鹸性の発生は，プローブ基部電極配線を直流電源で治療部位の電極▲１▼のに流すことで行われ、電気化学的に発生した強酸性水、強鹸性水は，＋及び−電極付近に留まり、治療部位に壊死、溶解、凝固を起こさせ、前立腺に空洞を起こさせる事が出来る。この治療に要する時間は１．５時間〜２時間で、充分な治療効果が得られる。  Next, as one application example of the probe of FIG. 1, a case where it is used for prostate hypertrophy treatment will be specifically described. FIG. 2 is a conceptual diagram showing an example of use of the probe of FIG. The probe according to the embodiment of the present invention has an advantage that it can be guided to a target site by an ultrasonic medical diagnostic apparatus. Specifically, a probe is inserted from the urethra. The strong acidity and strong saponification of the probe tip electrode (1) placed in the prostate located in the lower part of the bladder can be generated by flowing the probe base electrode wiring to the electrode (1) at the treatment site with a DC power supply. Electrochemically generated strongly acidic water and strong saponifiable water stay in the vicinity of the + and − electrodes, cause necrosis, dissolution and coagulation at the treatment site, and can cause a cavity in the prostate. The time required for this treatment is 1.5 to 2 hours, and a sufficient therapeutic effect is obtained.

また本発明においては，電極▲１▼を形状記憶合金製にした場合、プローブを尿道より体内に穿刺し，対象前立腺部位に形状記憶合金製電極▲１▼を設置後，電極を４５度Ｃ程度に加熱する事により電極を拡げることが可能になり、治療部位の面積を拡大する事で治療効果を増大させる事が期待できる。  In the present invention, when the electrode (1) is made of a shape memory alloy, the probe is punctured into the body from the urethra, and after the shape memory alloy electrode (1) is placed at the target prostate site, the electrode is about 45 degrees C. It is possible to expand the electrode by heating to a high temperature, and it can be expected to increase the therapeutic effect by expanding the area of the treatment site.

プローブを説明した図  Illustration explaining the probe プローブの使用例を示す概念図  Conceptual diagram showing examples of probe usage

Claims (5)

先端部が少なくとも１対の＋及び−の電極▲１▼Ａ、▲１▼Ｂで構成され，電極▲１▼Ａに隣接した注水口▲２▼と最先端部に尿の排水口▲３▼、バルーン▲４▼、尿吸引口▲５▼を備えたプローブであって、同プローブは、先端部より体腔内に穿刺され、体液及び必要量補充される生理食塩水に浸された電極に直流電流を通電する事により、強酸性、強鹸性を発生させ、前立腺疾患、患部を溶解、壊死、凝固させることを特徴とする電気化学的治療法に使用する電極付プローブ。  The tip part is composed of at least one pair of + and-electrodes (1) A and (1) B, a water injection port (2) adjacent to the electrode (1) A, and a urine drainage port (3) at the most advanced part. A probe having a balloon (4) and a urine suction port (5), which is punctured into a body cavity from the tip and is directly applied to an electrode immersed in a body fluid and a physiological saline supplemented with a necessary amount. A probe with an electrode for use in an electrochemical therapy characterized by causing strong acidity and strong saponification by passing an electric current to dissolve, necrotize, and coagulate prostate disease and affected area. ＰＨ測定用センサーを上記電極付プローブの電極部分に取り付け、リアルタイムでＰＨを測定出来る構造を有し、治療中、及び終了後、電極に＋、−の直流電流を切替える事により、強酸性、強鹸性を自在にコントロールや中和出来る構造を特徴とする前立腺疾患の電気化学的治療法に使用する電極付プローブ。  A sensor for measuring pH is attached to the electrode part of the probe with electrode, and has a structure that can measure PH in real time. By switching +/- DC current to the electrode during and after treatment, strong acidity, strong Probe with electrodes for use in electrochemical treatment of prostate diseases, characterized by a structure that can freely control and neutralize saponification. 形状記憶合金を上記電極付プローブの電極部分に用い、形状記憶合金には導電性に優れた金属等の鍍金を施す等により強酸性、強鹸性を発生させ、電極を任意の形状にする事で、理想的な治療部位範囲の確保や拡大が出来る構造を特徴とする前立腺疾患の電気化学的治療法に使用する電極付プローブ。  A shape memory alloy is used for the electrode part of the above probe with electrode, and the shape memory alloy is made to have strong acidity and strong saponification property by applying a metal having excellent conductivity, etc. A probe with electrodes for use in electrochemical treatment of prostate disease, characterized by a structure that can secure and expand the ideal treatment site range. 上記電極付プローブの電極部分を多極とし、随時回路を切替える事で強酸性、強鹸性が、治療部位に隣接し、もしくは、強酸性、強鹸性の一方が出現する事で前立腺患部に壊死、溶解、凝固作用をさせ治療を行う、電気的切替え回路を備えた多極構造を特徴とする前立腺疾患の電気化学的治療法に使用する電極付プローブ。  The electrode part of the probe with electrode is multipolar, and it is possible to change the circuit at any time, so that strong acidity or strong saponification is adjacent to the treatment site, or one of strong acidity or strong saponification appears in the affected prostate region A probe with electrodes for use in an electrochemical treatment of prostate disease characterized by a multipolar structure with an electrical switching circuit that treats necrosis, dissolution, and coagulation. 注水口▲２▼から食塩水等を治療部位に送り込んだ後、イオン交換膜を取り付けた電極▲１▼Ｂをプローブ内に挿入し、電極▲１▼Ａと電極▲１▼Ｂを注水口▲２▼でイオン交換膜により遮断する構造と成し、イオン交換膜により陽イオン、陰イオンの交換を行い、強酸性度、強鹸性度をさらに上昇させ患部に対し強力に壊死、溶解、凝固作用をさせ治療を行う、イオン交換膜を備えた事を特徴とする前立腺疾患の電気化学的治療法に使用する電極付プローブ。  After the saline solution or the like is sent to the treatment site from the water injection port (2), the electrode (1) B with the ion exchange membrane attached is inserted into the probe, and the electrodes (1) A and (1) B are inserted into the water injection port. In 2 ▼, the structure is blocked by an ion exchange membrane, and the ion exchange membrane exchanges cations and anions to further increase the strong acidity and saponification, thereby necrotizing, dissolving and coagulating the affected area. A probe with an electrode for use in an electrochemical treatment of prostate disease, characterized by comprising an ion exchange membrane for effecting treatment.

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