WO2024001634A1 - 一种负压吸引输尿管鞘及输尿管***装置 - Google Patents

一种负压吸引输尿管鞘及输尿管***装置 Download PDF

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Publication number
WO2024001634A1
WO2024001634A1 PCT/CN2023/096797 CN2023096797W WO2024001634A1 WO 2024001634 A1 WO2024001634 A1 WO 2024001634A1 CN 2023096797 W CN2023096797 W CN 2023096797W WO 2024001634 A1 WO2024001634 A1 WO 2024001634A1
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Prior art keywords
sheath
ureteral
negative pressure
guide
suction
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PCT/CN2023/096797
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English (en)
French (fr)
Inventor
唐剑
张翔
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湖南省华芯医疗器械有限公司
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Publication of WO2024001634A1 publication Critical patent/WO2024001634A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/26—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor for producing a shock wave, e.g. laser lithotripsy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes

Definitions

  • the utility model relates to the technical field of medical devices, in particular to a negative pressure suction ureteral sheath and a ureteral insertion device.
  • the ureteral sheath is used in urological surgery to establish a passage for the endoscope and other instruments to enter the urinary tract.
  • some blood clots, small stones, and purulent floc are also naturally discharged from the ureteral sheath. , but this natural drainage method takes a long time to drain, which greatly increases the length of the operation.
  • the ureteral sheath in the related art is usually connected to a negative pressure mechanism to suck out blood clots, small stones and purulent floc during surgery.
  • a negative pressure mechanism to suck out blood clots, small stones and purulent floc during surgery.
  • the suction effect is not good.
  • small stones cannot enter the ureteral sheath, which increases the difficulty and time of the operation.
  • the pressure in the renal pelvis can easily increase. If the operation time is too long, urogenic sepsis can easily occur. blood.
  • the utility model discloses a negative pressure suction ureteral sheath to solve the technical problems of poor suction effect, long operation time and inability to detect the pressure in the renal pelvis of the ureteral sheath in the related art.
  • the present utility model adopts the following technical solutions:
  • the utility model provides a negative pressure suction ureteral sheath, which includes:
  • Pipe sheath the pipe sheath includes a base pipe section and a flexible pipe section, the flexible pipe section is connected to the base pipe section At the distal end, the rigidity of the base pipe section is greater than the rigidity of the flexible pipe section;
  • a guide sleeve is connected to the proximal end of the base pipe section, and the guide sleeve is provided with a suction nozzle and a pressure measuring nozzle that are connected with the base pipe section.
  • the guide sleeve is provided with a guide channel that is in contact with the pipe sheath, the guide channel is provided with an elastic seal, and the elastic seal is provided with a through hole that penetrates the elastic seal.
  • the guide sleeve includes a connecting part and a guide part, the guide channel passes through the connecting part and the guide part, the connecting part is connected to the base tube section, in the insertion direction of the tube sheath, The diameter of the guide portion gradually decreases.
  • the guide portion is tapered in the axial direction of the guide sleeve.
  • the tube sheath is detachably connected to the guide sleeve.
  • a temperature sensing probe is provided at the distal end of the sheath.
  • the length of the flexible tube section matches the length of the active bending section of the endoscope insertion part inserted into the sheath.
  • a partition wall is provided in the sheath, and the partition wall separates the sheath into an endoscope channel and a suction channel, and the endoscope insertion portion inserted into the sheath is located in the endoscope channel.
  • base pipe section and the flexible pipe section are integrally formed, or the base pipe section and the flexible pipe section are bonded and connected.
  • inventions of the present application also provide a ureteral insertion device.
  • the ureteral insertion device includes an inner sheath, a limiting sleeve and the aforementioned negative pressure suction ureteral sheath.
  • the limiting sleeve is provided at the proximal end of the guide sleeve.
  • the inner sheath is inserted into the pipe sheath, and the inner sheath is limitedly matched with the limiting sleeve.
  • the negative pressure suction ureteral sheath disclosed in the embodiment of the application has the suction nozzle connected to the negative pressure mechanism.
  • the front section of the sheath is a flexible tube section. After the endoscope insertion part extends into the sheath, the endoscope insertion part is actively The curved section can drive the flexible tube section to bend, so that the distal end of the sheath can enter the depth of the renal pelvis.
  • the negative pressure attraction of the distal end of the sheath can form a certain attraction and fixation effect on the target stone.
  • the pressure measuring nozzle is connected to the pressure measuring device to detect the pressure deep in the renal pelvis in real time to facilitate medical staff to accurately judge and control the operation. time to avoid excessive increase in pressure in the renal pelvis causing urogenic sepsis;
  • the broken stone fragments can be excreted out of the body through the sheath along with the perfusion fluid, which avoids the accumulation of large amounts of gravel in the ureter to form a stone street after surgery and avoids urinary tract obstruction;
  • the flexible tube segment follows the active bending section of the endoscope insertion part, so that the distal end of the flexible tube segment and the distal end of the endoscope insertion part can always be in a close position in the renal pelvis, so that the sheath is A good water circulation is formed at the distal end close to the stone, which can not only avoid the snowstorm phenomenon, make the observation field clear, but also avoid the risk of infection caused by increasing the perfusion volume;
  • the elastic seal provided in the guide sleeve allows the insertion part of the endoscope to enter and blocks the leakage of the perfusion liquid
  • the length of the flexible tube section matches the length of the active bending section of the endoscope insertion part inserted into the sheath, so that the bending amplitude of the flexible tube section is as close or the same as the active bending section, so that the two
  • the orientation of the distal end of the patient should be as consistent as possible to facilitate observation and surgery;
  • the distal end of the tube sheath is equipped with a temperature-sensing probe.
  • the temperature-sensing probe can monitor the temperature in the renal pelvis and provide a reference for medical staff to avoid damaging the patient's kidneys due to high temperatures generated during laser lithotripsy.
  • Figure 1 is a schematic structural diagram of a negative pressure suction ureteral sheath according to an embodiment of the present application
  • Figure 2 is one of the cross-sectional views of the negative pressure suction ureteral sheath according to the embodiment of the present application;
  • Figure 3 is the second cross-sectional view of the negative pressure suction ureteral sheath according to the embodiment of the present application.
  • Figure 4 is a partially enlarged schematic diagram of position A in Figure 3;
  • Figure 5 is a schematic structural diagram of the guide sleeve according to the embodiment of the present application.
  • Figure 6 is a schematic structural diagram of the tube sheath according to the embodiment of the present application.
  • Figure 7 is a schematic structural diagram of the ureteral insertion device according to the embodiment of the present application.
  • first, second, etc. in the description and claims of this application are used to distinguish similar objects and are not used to describe a specific order or sequence. It is to be understood that the figures so used are interchangeable under appropriate circumstances so that the embodiments of the present application can be practiced in orders other than those illustrated or described herein, and that "first,” “second,” etc. are distinguished Objects are usually of one type, and the number of objects is not limited. For example, the first object can be one or multiple.
  • “and/or” in the description and claims indicates at least one of the connected objects, and the character “/" generally indicates that the related objects are in an "or” relationship.
  • proximal end and distal end refer to the far and near positions of the structure relative to human body operation in the use environment, so as to facilitate the description of the positional relationship between components and facilitate understanding; “proximal end” “” and “remote” are relative positional relationships, not absolute.
  • an embodiment of the present application discloses a negative pressure suction ureteral sheath.
  • the disclosed negative pressure suction ureteral sheath includes a sheath 100 and a guide sleeve 200 .
  • the sheath 100 is the basic component of the negative pressure suction ureteral sheath, which can be used in conjunction with an endoscope.
  • the sheath 100 has an inner channel, and the inner channel extends along the axial direction of the sheath 100. After the sheath 100 is inserted into the human body, the endoscope insertion part 600 can be inserted into the human body through the inner channel.
  • the sheath 100 includes a base tube section 110 and a flexible tube section 120.
  • the flexible tube section 120 is connected to the distal end of the base tube section 110.
  • the rigidity of the base tube section 110 is greater than the rigidity of the flexible tube section 120.
  • the flexibility of the flexible pipe section 120 is greater than the flexibility of the base pipe section 110, and the base pipe section 110 itself may have a certain degree of bending elasticity, for example, it may be a structural member made of plastic material.
  • the base tube section 110 can adapt to the physiological moderate curvature of the ureter, and the flexible tube section 120 can be a structural member made of rubber or silicone rubber.
  • the guide sleeve 200 is connected to the proximal end of the sheath 100.
  • the guide sleeve 200 is provided with a guide channel.
  • the guide sleeve 200 is provided with a suction nozzle 211 and a pressure measuring nozzle 212 connected with the guide channel.
  • the suction nozzle 211 and the pressure measuring nozzle 212 are respectively connected with the inner channel of the sheath 100.
  • the suction nozzle 211 is used to connect to the negative pressure mechanism, and the pressure measuring nozzle 212 is used to connect to the pressure measuring device.
  • the diameter of the endoscope insertion part 600 is smaller than the inner diameter of the sheath 100 , so that when the endoscope insertion part 600 extends into the sheath 100 , the inner wall of the sheath 100 and the surface of the endoscope insertion part 600 A gap is formed, which can be used to absorb blood clots, small stones, and purulent floc during surgery, and can also be used to detect the pressure in the renal pelvis.
  • the active bending section of the endoscope insertion part 600 can drive the flexible tube section 120 to bend, so that the distal end of the sheath 100 can enter the depth of the renal pelvis.
  • the negative pressure attraction at the distal end of the sheath 100 can form a certain attraction and fixation effect on the target stone, so as to facilitate rapid laser lithotripsy and reduce the operation time and difficulty; the broken stone fragments can be discharged through the sheath 100 following the perfusion fluid.
  • it avoids the accumulation of a large amount of gravel in the ureter to form a stone street after surgery and avoids urinary tract obstruction.
  • the pressure measuring device connected to the pressure measuring nozzle can detect the pressure deep in the renal pelvis in real time, which facilitates medical staff to accurately judge and control the operation time and avoid urogenic sepsis caused by excessive increase in pressure in the renal pelvis.
  • the inventor found that because the distal end of the existing ureteral sheath is usually placed at the upper end of the ureter or the renal pelvis, when treating kidney stones, water circulation cannot be formed at the front end of the camera component of the endoscope insertion part, resulting in gravel. Dust can easily block the camera components, causing the observation field to be unclear, commonly known as the blizzard phenomenon. In order to pursue a clear field of view, increasing the perfusion volume will lead to high pressure in the kidneys, the risk of infection, and even sepsis.
  • the flexible tube section 120 bends following the endoscope insertion part 600, so that the distal end of the flexible tube section 120 and the distal end of the endoscope insertion part 600 can always be close to each other in the renal pelvis.
  • the perfusate is injected into the renal pelvis through the endoscope
  • the distal end of the endoscope insertion part 600 injects the perfusate
  • the distal end of the flexible tube section 120 absorbs the perfusate
  • the perfusate is injected into the renal pelvis through the endoscope.
  • a good water circulation is formed at the distal end close to the stone, which can not only avoid snowstorms, provide a clear observation field, but also avoid the risk of infection caused by increasing the perfusion volume.
  • An elastic seal 300 is provided in the guide sleeve 200.
  • the elastic seal 300 is located at the proximal end of the suction nozzle 211 and the pressure measuring nozzle 212 to prevent the elastic seal 300 from blocking the connection between the suction nozzle 211 and the pressure measuring nozzle 212 and the inner channel.
  • the elastic seal 300 is provided with a through hole penetrating the elastic seal 300 , and the endoscope insertion part 600 can be inserted into the sheath 100 through the through hole.
  • the elastic seal 300 is a structural member made of polymer material, such as rubber material.
  • the elastic seal 300 is elastically squeezed.
  • the endoscope insertion part 600 is pressed to achieve a sealing effect.
  • the sheath 100 and the guide sleeve 200 are detachably connected.
  • the sheath 100 and the guide sleeve 200 are in a separated state to facilitate medical staff to insert the sheath 100 through the inner sheath 400.
  • the inner sheath 400 is withdrawn, and the guide sleeve 200 is connected to the sheath 100, thereby facilitating the insertion of the endoscope insertion part 600 and achieving sealing of the sheath 100.
  • the length of the active bending section of the endoscope insertion part 600 matches the length of the flexible tube section 120, so that when the active bending section is bent, the bending amplitude of the flexible tube section 120 is as close as possible to the active bending section.
  • the segments should be kept close or the same, so that the orientation of the distal ends of the two should be as consistent as possible to facilitate observation and surgery.
  • the pipe sheath 100 and the guide sleeve 200 are threaded to achieve detachable connection.
  • the pipe sheath 100 is provided with external threads
  • the guide sleeve 200 is provided with internal threads.
  • the pipe sheath 100 and the guide sleeve 200 pass through The threads of the external thread and the internal thread cooperate to achieve a threaded connection; the threaded connection has a stable and reliable connection and is not prone to loosening.
  • laser lithotripsy is usually used to break kidney stones. That is, the laser generated by an external laser generator is guided into the human body. After a channel is established through a ureteroscope and a nephroscope, the stone is approached with a scope, and then the stone is The laser is aimed at the stones to strike. Because the laser has this high-energy and high-efficiency feature, it can break larger stones into small pieces.
  • the negative pressure suction ureteral sheath in the embodiment of the present application also includes a temperature-sensing probe 700.
  • the temperature-sensing probe 700 is provided at the distal end of the sheath 100, and the renal pelvis can be monitored through the temperature-sensing probe 700.
  • the internal temperature is convenient for medical staff to understand the temperature in the renal pelvis, especially at the gravel site, to avoid kidney damage caused by excessive temperature.
  • the guide sleeve 200 includes a connecting part 210 and a guide part 220.
  • the guide channel passes through the connecting part 210 and the guide part 220.
  • the connecting part 210 is connected to the base pipe section 110.
  • the aforementioned internal threads can be provided on the connecting part 210.
  • the aforementioned external threads can be provided on the base pipe section 110.
  • the diameter of the guide portion 220 gradually decreases; for example, the guide portion 220 is tapered in the axial direction of the guide sleeve 200.
  • the portion 220 can be in the shape of a trumpet with gradually decreasing diameter; with this arrangement, when inserting the endoscope insertion portion 600, the trumpet-shaped guide portion 220 can facilitate the insertion of the endoscope insertion portion 600 into the sheath 100, thereby improving the efficiency of the operation. Convenience.
  • the inventor found that due to the supporting effect of the sheath 100 on the endoscope insertion part 600, it is difficult for the bending of the sheath 100 and the bending of the endoscope insertion part 600 to be completely consistent, so that the endoscope insertion part 600 and It is difficult to keep the gap between the inner walls of the sheath 100 consistent.
  • the gap changes so that the endoscope insertion part 600 occupies a larger size in the radial direction of the sheath 100, which is not conducive to the removal of stone fragments and easily causing blockage.
  • a partition wall 130 is provided inside the sheath 100.
  • the partition wall 130 separates the sheath 100 into an endoscope channel 140 and a suction channel 150.
  • the endoscope The dimensions of the channel 140 match the dimensions of the endoscope insertion portion 600,
  • the endoscope insertion part 600 inserted into the sheath 100 is located in the endoscope channel 140, and the suction nozzle 211 and the pressure measuring nozzle 212 are respectively connected with the suction channel 150; in this embodiment,
  • the partition wall 130 can extend to both ends of the sheath 100 along the axial direction of the sheath 100.
  • the endoscope channel 140 can limit the space occupied by the endoscope insertion part 600 in the radial direction of the sheath 100. , so that the stone fragments can be sucked through the suction channel 150, and the endoscope insertion part 600 is prevented from blocking or interfering with the discharge of blood clots, purulent floc or stone fragments.
  • the base pipe section 110 and the flexible pipe section 120 can be connected by integral molding or bonding.
  • the embodiment of the present application also provides a ureteral insertion device.
  • the ureteral insertion device includes an inner sheath 400, a limiting sleeve 500 and the aforementioned negative pressure suction ureteral sheath.
  • the limiting sleeve 500 is located at the proximal end of the guide sleeve 200, and the inner sheath 400 Insert into the tube sheath 100, and the inner sheath 400 and the limiting sleeve 500 are limitedly matched.
  • the inner sheath 400 When in use, insert the inner sheath 400 into the inner channel of the sheath 100, then use the inner sheath 400 to insert the sheath 100 into the ureter, withdraw the inner sheath 400, connect the guide sleeve 200 to the proximal end of the sheath 100, and then The endoscope insertion part 600 is inserted into the sheath 100 .
  • the limiting sleeve 500 is provided with a perforation for passing through the inner sheath 400.
  • the inner sheath 400 has a radially protruding protruding portion 410. In the insertion direction of the inner sheath 400, the protruding portion 410 and the end surface where the perforation is located are limited. fit, thereby preventing over-insertion of the inner sheath 400.

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Abstract

一种负压吸引输尿管鞘及输尿管***装置。该负压吸引输尿管鞘包括管鞘（100）和导向套（200），管鞘（100）包括基管段（110）和挠性管段（120），挠性管段（120）连接于基管段（110）的远端，基管段（110）的刚性大于挠性管段（120）的刚性，导向套（200）连接于基管段（110）的近端，导向套（200）设置有与基管段（110）相连通的吸引嘴（211）和测压嘴（212）；其中挠性管段（120）可随着内窥镜***部（600）的弯曲而弯曲，从而使管鞘（100）的远端能够进入肾盂深处，管鞘（100）远端的负压吸引力可以对目标结石形成一定的吸引固定作用，以便于快速进行激光碎石，减少手术时间和手术难度；与此同时，测压嘴（212）连接测压装置，能够实时检测肾盂的压力，方便医护人员做出准确判断，避免肾盂内压力增高时间过长引发尿源性脓毒血症。

Description

一种负压吸引输尿管鞘及输尿管***装置 技术领域
本实用新型涉及医疗器械技术领域，尤其涉及一种负压吸引输尿管鞘及输尿管***装置。
背景技术
输尿管鞘用于泌尿外科手术中，建立一条便于内窥镜和其他器械进入泌尿道的通路，在手术过程中，一些血凝块、细小石块、脓性絮状物也从输尿管鞘中自然排出，但是这种自然排出的方式引流时间长，从而极大的提高了手术的时间长度。
相关技术中的输尿管鞘，通常连接负压机构将手术中的血凝块、细小石块和脓性絮状物吸出，但是，由于输尿管鞘的远端无法弯曲接近病灶区域，导致吸引效果并不理想，例如细小石块无法进入输尿管鞘，增加了手术难度和手术时间；与此同时，在手术操作过程中，肾盂内压力极易增高，若手术时间过长，则易发生尿源性脓毒血症。
因此，提供一种引流效率高且能够实时检测肾盂内压力的负压吸引输尿管鞘，是本领域技术人员亟待解决的技术问题。
实用新型内容
本实用新型公开一种负压吸引输尿管鞘，以解决相关技术中的输尿管鞘存在的吸引效果差、手术时间长和无法检测肾盂内压力的技术问题。
为了解决上述问题，本实用新型采用下述技术方案：
第一方面，本实用新型提供了一种负压吸引输尿管鞘，负压吸引管鞘包括：
管鞘，所述管鞘包括基管段和挠性管段，所述挠性管段连接于所述基管段 的远端，所述基管段的刚性大于所述挠性管段的刚性；
导向套，所述导向套连接于所述基管段的近端，所述导向套设置有与基管段相连通的吸引嘴和测压嘴。
进一步地，所述导向套设置有与所述管鞘相对接的导向通道，所述导向通道设置有弹性密封件，所述弹性密封件设置有贯穿所述弹性密封件的通孔。
进一步地，所述导向套包括连接部和导向部，所述导向通道贯通所述连接部和所述导向部，所述连接部与所述基管段相连，在所述管鞘的***方向上，所述导向部的口径逐渐减小。
进一步地，所述导向部在所述导向套的轴向呈锥形。
进一步地，所述管鞘与所述导向套可拆卸相连。
进一步地，所述管鞘的远端设置有温感探头。
进一步地，所述挠性管段的长度与***所述管鞘的内窥镜***部的主动弯曲段的长度相匹配。
进一步地，所述管鞘内设置有分隔壁，所述分隔壁将所述管鞘分隔为内窥镜通道和吸引通道，***所述管鞘的内窥镜***部位于所述内窥镜通道内。
进一步地，所述基管段和所述挠性管段一体成型，或者，所述基管段与所述挠性管段粘接连接。
第二方面，本申请实施例还提供了一种输尿管***装置，输尿管***装置包括内鞘、限位套和前述的负压吸引输尿管鞘，所述限位套设于所述导向套的近端，所述内鞘***所述管鞘内，且所述内鞘与所述限位套限位配合。
本实用新型采用的技术方案能够达到以下有益效果：
第一、本申请实施例公开的负压吸引输尿管鞘，吸引嘴连接负压机构，管鞘的前段为挠性管段，内窥镜***部伸入该管鞘后，内窥镜***部的主动弯曲段能够带动挠性管段发生弯曲，从而使管鞘的远端能够进入肾盂深处，在手术过程中，管鞘的远端的负压吸引力，可以对目标结石形成一定的吸引固定作用，以便于快速进行激光碎石，减少手术时间和手术难度；与此同时，测压嘴连接测压装置，通过实时检测肾盂深处的压力，方便医护人员准确判断并控制手术 时间，避免肾盂内压力增高时间过长引发尿源性脓毒血症；
第二、破碎的结石碎片可以跟随灌注液经管鞘排出体外，避免了术后大量碎石堆积在输尿管形成石街，避免了尿路梗阻；
第三、挠性管段跟随内窥镜***部的主动弯曲段弯曲，使得挠性管段的远端和内窥镜***部的远端在肾盂内能够始终处于相接近的位置，从而在管鞘的远端靠近结石处形成了良好的水循环，既能够规避暴风雪现象，使得观察视野清晰，又能避免加大灌注量而产生感染风险；
第四、导向套内设置的弹性密封件，可供内窥镜***部进入，并阻挡灌注液体漏出；
第五、挠性管段的长度与***所述管鞘的内窥镜***部的主动弯曲段的长度相匹配，使得挠性管段的弯曲幅度尽可能地与主动弯曲段保持相近或相同，使两者的远端的朝向尽可能一致，从而方便观察和手术；
第六、管鞘的远端设置有温感探头，温感探头能够监测肾盂内温度，为医护人员提供参考，避免激光碎石过程中产生高温而损伤病人肾脏。
附图说明
为了更清楚地说明本实用新型实施例或现有技术中的技术方案，下面将对实施例或现有技术描述中所需要使用的附图作简单地介绍，显而易见地，下面描述中的附图仅仅是本实用新型的一些实施例，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其他的附图。
图1是本申请实施例的负压吸引输尿管鞘的结构示意图；
图2是本申请实施例的负压吸引输尿管鞘的剖视图之一；
图3是本申请实施例的负压吸引输尿管鞘的剖视图之二；
图4是图3中A处的局部放大示意图；
图5是本申请实施例的导向套的结构示意图；
图6是本申请实施例的管鞘的结构示意图；
图7是本申请实施例的输尿管***装置的结构示意图。
图中：
100-管鞘，110-基管段，120-挠性管段；200-导向套，210-连接部，211-吸引嘴，212-测压嘴，220-导向部；300-弹性密封件，310-通孔；400-内鞘，410-突出部，500-限位套；600-内窥镜***部；700-温感探头。
具体实施方式
为使本实用新型的目的、技术方案和优点更加清楚，下面将对本实用新型的技术方案进行详细的描述。显然，所描述的实施例仅仅是本实用新型一部分实施例，而不是全部的实施例。基于本实用新型中的实施例，本领域普通技术人员在没有做出创造性劳动的前提下所得到的所有其它实施方式，都属于本实用新型所保护的范围。
本申请的说明书和权利要求书中的术语“第一”、“第二”等是用于区别类似的对象，而不用于描述特定的顺序或先后次序。应该理解这样使用的数据在适当情况下可以互换，以便本申请的实施例能够以除了在这里图示或描述的那些以外的顺序实施，且“第一”、“第二”等所区分的对象通常为一类，并不限定对象的个数，例如第一对象可以是一个，也可以是多个。此外，说明书以及权利要求中“和/或”表示所连接对象的至少其中之一，字符“/”，一般表示前后关联对象是一种“或”的关系。
在本实用新型中，“近端”和“远端”是本结构在使用环境下，相对于人体操作的远近位置，以方便对部件之间的位置关系进行描述，同时方便理解；“近端”和“远端”是相对而言的位置关系，而非绝对的。
下面结合附图1至图7，通过具体的实施例及其应用场景对本申请实施例提供的负压吸引输尿管鞘及输尿管***装置进行详细地说明。
参照图1～图7，本申请实施例公开了一种负压吸引输尿管鞘，所公开的负压吸引输尿管鞘包括管鞘100和导向套200。
其中，管鞘100为负压吸引输尿管鞘的基础构件，其能够与内窥镜配合使用。具体地，管鞘100具有内通道，内通道沿管鞘100的轴向延伸设置，将管鞘100***人体内后，内窥镜***部600可通过该内通道探入人体内。
在本申请实施例中，管鞘100包括基管段110和挠性管段120，挠性管段120连接于基管段110的远端，基管段110的刚性大于挠性管段120的刚性，在内窥镜***部600的主动弯曲段进行弯曲动作时，挠性管段120可跟随主动弯曲段的弯曲而弯曲，进而使得挠性管段120能够弯曲而探入肾盂深处。需要说明的是，在本申请实施例中，挠性管段120的可挠性大于基管段110的可挠性，而基管段110自身可以具有一定的弯曲弹性，例如为塑胶材料制成的结构件，基管段110能够适应输尿管的生理性适度弯曲，挠性管段120可以为橡胶或者硅橡胶制成的结构件。
导向套200连接于管鞘100的近端，导向套200设置有导向通道，导向套200设置有与导向通道连通的吸引嘴211和测压嘴212，在导向套200与管鞘100连接时，吸引嘴211和测压嘴212分别与管鞘100的内通道连通，吸引嘴211用于连接负压机构，测压嘴212用于连接测压装置。需要说明的是，内窥镜***部600的直径小于管鞘100的内径，使得内窥镜***部600在伸入管鞘100内时，管鞘100的内壁与内窥镜***部600的表面形成间隙，该间隙既可以用于吸取手术过长中的血凝块、细小石块、脓性絮状物，也可以用于检测肾盂内压力。
本申请实施例公开的负压吸引输尿管鞘，内窥镜***部600的主动弯曲段能够带动挠性管段120发生弯曲，从而使管鞘100的远端能够进入肾盂深处，在手术过程中，管鞘100的远端的负压吸引力，可以对目标结石形成一定的吸引固定作用，以便于快速进行激光碎石，减少手术时间和手术难度；破碎的结石碎片可以跟随灌注液经管鞘100排出体外，避免了术后大量碎石堆积在输尿管形成石街，避免了尿路梗阻。与此同时，测压嘴连接的测压装置可以实时检测肾盂深处的压力，方便医护人员准确判断并控制手术时间，避免肾盂内压力增高时间过长引发尿源性脓毒血症。
发明人在研究过程中发现，因为现有的输尿管鞘的远端多放置在输尿管上端或肾盂内，在处理肾结石时，无法在内窥镜***部的摄像组件前端形成水循环，产生的碎石粉尘容易遮挡摄像组件，导致观察视野不够清晰，俗称暴风雪现象；而为了追求视野清晰，加大灌注量，会导致肾内高压，发生感染风险，甚至导致败血症发生。而本申请的负压吸引输尿管鞘，挠性管段120跟随内窥镜***部600弯曲，使得挠性管段120的远端和内窥镜***部600的远端在肾盂内能够始终处于相接近的位置，在本申请实施例中，灌注液通过内窥镜向肾盂内注入，内窥镜***部600的远端注入灌注液，而挠性管段120的远端吸取灌注液，在管鞘100的远端靠近结石处形成了良好的水循环，既能够规避暴风雪现象，使得观察视野清晰，又能避免加大灌注量而产生感染风险。
导向套200内设置有弹性密封件300，弹性密封件300位于吸引嘴211和测压嘴212的近端，以避免弹性密封件300隔断吸引嘴211和测压嘴212与内通道的连通状态。弹性密封件300设置有贯穿弹性密封件300的通孔，内窥镜***部600可通过通孔***到管鞘100内。
在本申请实施例中，弹性密封件300为高分子材料制成的结构件，例如为橡胶材料，在内窥镜***部600经通孔***到管鞘100内时，弹性密封件300弹性挤压内窥镜***部600而起到密封作用。
在本申请实施例中，管鞘100与导向套200可拆卸连接，在***管鞘100时，管鞘100与导向套200处于分离状态，以方便医护人员通过内鞘400将管鞘100置入输尿管内，在管鞘100***到适宜位置时，退出内鞘400，再将导向套200与管鞘100连接，从而方便***内窥镜***部600并实现对管鞘100的密封。
在进一步的技术方案中，内窥镜***部600的主动弯曲段的长度与挠性管段120的长度相匹配，使得主动弯曲段在弯曲时，挠性管段120的弯曲幅度尽可能地与主动弯曲段保持相近或相同，使两者的远端的朝向尽可能一致，从而方便观察和手术。
一种可选的实施方式中，管鞘100和导向套200螺纹连接而实现可拆卸相连，例如，管鞘100设置有外螺纹，导向套200设置有内螺纹，管鞘100和导向套200通过外螺纹和内螺纹的螺纹配合实现螺纹连接；采用螺纹连接具有连接稳定可靠，不易出现松动的情况。
在相关技术中，通常采用激光碎石的方式破碎肾结石，即把体外激光发生器产生的激光引导到人体内去，通过输尿管镜、肾镜建立好通道之后，用镜体接近结石，然后用激光对准结石进行打击，因为激光有这种高能高效的特点，可以把比较大的结石打成小块。发明人在研究中发现，高功率激光技术有助于对大且复杂的结石成功实施输尿管镜手术，但会使肾脏收集***的液体温度明显升高，临近组织也可能会受到热损伤；基于此种情况，一种可选的实施方式中，本申请实施例的负压吸引输尿管鞘还包括温感探头700，温感探头700设于管鞘100的远端，通过温感探头700可以监测肾盂内温度，方便医护人员了解肾盂内，尤其是碎石处的温度，避免温度过高而造成肾脏受损。
在进一步的技术方案中，导向套200包括连接部210和导向部220，导向通道贯通连接部210和导向部220，连接部210与基管段110相连，前述的内螺纹可以设置于连接部210，前述的外螺纹可以设置于基管段110，在管鞘100的***方向上，导向部220的口径逐渐减小；例如，所述导向部220在所述导向套200的轴向呈锥形，导向部220可以为口径逐渐减小的喇叭状；如此设置下，在***内窥镜***部600时，喇叭状的导向部220能够方便内窥镜***部600***在管鞘100内，提高操作的便捷性。
发明人在研究过程中发现，基于管鞘100对内窥镜***部600的承托作用，管鞘100的弯曲与内窥镜***部600的弯曲难以完全一致，使得内窥镜***部600与管鞘100内壁之间的间隙难以保持一致，在管鞘100的延伸方向，间隙变化使得内窥镜***部600在管鞘100的径向方向占有较大尺寸，不利于结石碎片的排除，易造成堵塞。基于此种情况，在进一步的技术方案中，所述管鞘100内设置有分隔壁130，所述分隔壁130将所述管鞘100分隔为内窥镜通道140和吸引通道150，内窥镜通道140的尺寸与内窥镜***部600的尺寸相匹配， ***所述管鞘100的内窥镜***部600位于所述内窥镜通道140内，所述吸引嘴211和所述测压嘴212分别与所述吸引通道150连通；在本实施例中，所述分隔壁130可沿管鞘100的轴向延伸至管鞘100的两端，如此设置下，内窥镜通道140能够限制内窥镜***部600在管鞘100径向方向上的空间占用，使结石碎块都能经吸引通道150被吸取，避免内窥镜***部600对血凝块、脓性絮状物或结石碎片的排出造成阻挡或干扰。
在本申请实施例中，基管段110可以和挠性管段120可以采用一体成型或粘接的方式连接。
本申请实施例还提供了一种输尿管***装置，输尿管***装置包括内鞘400、限位套500和前述的负压吸引输尿管鞘，限位套500设于导向套200的近端，内鞘400***管鞘100内，且内鞘400与限位套500限位配合。
在使用时，将内鞘400***管鞘100的内通道内，然后利用内鞘400将管鞘100置入输尿管内，退出内鞘400，将导向套200连接于管鞘100的近端，然后将内窥镜***部600***管鞘100。在本申请中，限位套500设置有用于穿设内鞘400的穿孔，内鞘400具有径向突起的突出部410，在内鞘400的***方向，突出部410与穿孔所在的端面限位配合，从而避免内鞘400的过度***。
需要说明的是，在本文中，术语“包括”、“包含”或者其任何其他变体意在涵盖非排他性的包含，从而使得包括一系列要素的过程、方法、物品或者装置不仅包括那些要素，而且还包括没有明确列出的其他要素，或者是还包括为这种过程、方法、物品或者装置所固有的要素。在没有更多限制的情况下，由语句“包括一个……”限定的要素，并不排除在包括该要素的过程、方法、物品或者装置中还存在另外的相同要素。此外，需要指出的是，本申请实施方式中的方法和装置的范围不限按示出或讨论的顺序来执行功能，还可包括根据所涉及的功能按基本同时的方式或按相反的顺序来执行功能，例如，可以按不同于所描述的次序来执行所描述的方法，并且还可以添加、省去、或组合各种步骤。另外，参照某些示例所描述的特征可在其他示例中被组合。
以上所述，仅为本实用新型的具体实施方式，但本实用新型的保护范围并不局限于此，任何熟悉本技术领域的技术人员在本实用新型揭露的技术范围内，可轻易想到变化或替换，都应涵盖在本实用新型的保护范围之内。

Claims (10)

  1. 一种负压吸引输尿管鞘，其特征在于，包括：
    管鞘(100)，所述管鞘(100)包括基管段(110)和挠性管段(120)，所述挠性管段(120)连接于所述基管段(110)的远端，所述基管段(110)的刚性大于所述挠性管段(120)的刚性；
    导向套(200)，所述导向套(200)连接于所述基管段(110)的近端，所述导向套(200)设置有与基管段(110)相连通的吸引嘴(211)和测压嘴(212)。
  2. 根据权利要求1所述的负压吸引输尿管鞘，其特征在于，所述导向套(200)设置有与所述管鞘(100)相对接的导向通道，所述导向通道设置有弹性密封件(300)，所述弹性密封件(300)设置有贯穿所述弹性密封件(300)的通孔。
  3. 根据权利要求2所述的负压吸引输尿管鞘，其特征在于，所述导向套(200)包括连接部(210)和导向部(220)，所述导向通道贯通所述连接部(210)和所述导向部(220)，所述连接部(210)与所述基管段(110)相连，在所述管鞘(100)的***方向上，所述导向部(220)的口径逐渐减小。
  4. 根据权利要求3所述的负压吸引输尿管鞘，其特征在于，所述导向部(220)在所述导向套(200)的轴向呈锥形。
  5. 根据权利要求1所述的负压吸引输尿管鞘，其特征在于，所述管鞘(100)与所述导向套(200)可拆卸相连。
  6. 根据权利要求1所述的负压吸引输尿管鞘，其特征在于，所述管鞘(100)的远端设置有温感探头(700)。
  7. 根据权利要求1所述的负压吸引输尿管鞘，其特征在于，所述挠性管段(120)的长度与***所述管鞘(100)的内窥镜***部(600)的主动弯曲段的长度相匹配。
  8. 根据权利要求1所述的负压吸引输尿管鞘，其特征在于，所述管鞘(100)内设置有分隔壁(130)，所述分隔壁(130)将所述管鞘(100)分隔为内窥镜通道(140)和吸引通道(150)，***所述管鞘(100)的内窥镜***部(600)位于所述内窥镜通道(140)内，所述吸引嘴(211)和所述测压嘴(212)分别 与所述吸引通道(150)连通。
  9. 根据权利要求1～8任一所述的负压吸引输尿管鞘，其特征在于，所述基管段(110)和所述挠性管段(120)一体成型，或者，所述基管段(110)与所述挠性管段(120)粘接连接。
  10. 一种输尿管***装置，其特征在于，包括内鞘(400)、限位套(500)和权利要求1～9任一所述的负压吸引输尿管鞘，所述限位套(500)设于所述导向套(200)的近端，所述内鞘(400)***所述管鞘(100)内，且所述内鞘(400)与所述限位套(500)限位配合。
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