阅读说明：本技术 一种冷冻消融导管及其应用 (A kind of cryoablation conduit and its application ) 是由 *** 王琨 张鑫 高炜 于 2019-08-29 设计创作，主要内容包括：本发明涉及一种冷冻消融导管及其应用,该冷冻消融导管包括设置隔热区域和消融区域的可扩张构件和管路,管路包括分别与可扩张构件的内腔室连通的进气管路和回气管路；可扩张构件设置有扩张态和收缩态,冷冻介质由进气管路进入可扩张构件内使其成扩张态,隔热区域隔离冷冻介质的冷量传递,消融区域实现冷量传递进行冷冻消融,冷冻介质通过回气管路回流。上述处于扩张状态时的冷冻消融导管具有较大的囊体以用于充分冷量热交换,从而使冷冻损伤穿透整个气道壁,且其设置消融和隔热区域以尽量减少非必要组织的损伤,该冷冻消融导管尤其适用于肺迷走神经损伤,其使用内窥镜配合冷冻消融方法,在达到损伤神经的同时,可有效控制该消融方法的并发症。(The present invention relates to a kind of cryoablation conduit and its application, which includes the expandable members and pipeline that area of insulation and ablation areas is arranged, and pipeline includes the air inlet pipeline being connected to respectively with the inner cavity chamber of expandable members and return line；Expandable members are provided with expanded condition and contracted state, refrigerant is entered in expandable members by air inlet pipeline makes it at expanded condition, the cooling capacity transmitting of refrigerant is isolated in area of insulation, and ablation areas realizes that cooling capacity transmitting carries out cryoablation, and refrigerant is flowed back by return line.It is above-mentioned be in expansion state when cryoablation conduit have biggish utricule be used for abundant cooling capacity heat exchange, to make freezing injury penetrate entire airway walls, and its setting ablation reduces the damage of inessential tissue to the greatest extent with area of insulation, the cryoablation conduit is particularly suitable for lung vagus nerve injury, it cooperates cryoablation method using endoscope, while reaching injuring nerve, the complication of the ablation method can be effectively controlled.)

1. a kind of cryoablation conduit, including expandable members (1) and the pipeline (2) being connect with the expandable members (1), Be characterized in that, area of insulation (11) and ablation areas (12) be set on the expandable members (1), the pipeline (2) include into Air pipe (21) and return line (22), the air inlet pipeline (21), return line (22) with the expandable members (1) Inner cavity chamber's connection.

2. a kind of cryoablation conduit according to claim 1, which is characterized in that prolong the end (21) of the air inlet pipeline It protrudes into the expandable members (1), the distal end fixed seal connection of distal end and the expandable members (1) is expanded described It opens and opens up at least one gas outlet (211) on component (1) internal air inlet pipeline (21).

3. a kind of cryoablation conduit according to claim 2, which is characterized in that the return line (22) is sheathed on institute The outside or the return line (22) for stating air inlet pipeline (21) are arranged side by side with the air inlet pipeline (21), the return line (22) distal end is fixedly connected with the proximal end of the expandable members (1), and is connected with the inner cavity chamber of the expandable members (1) It is logical.

4. a kind of cryoablation conduit according to claim 1, which is characterized in that along circle on the expandable members (1) Temperature sensor and/or pressure sensor is arranged in circumferential direction.

5. a kind of cryoablation conduit according to claim 1, which is characterized in that the appearance of the distal end of the pipeline (2) At least 1 graduation mark (23) is arranged in face.

6. a kind of cryoablation conduit according to any one of claims 1 to 5, which is characterized in that the area of insulation (11) wall thickness is greater than the wall thickness of the ablation areas (12).

7. a kind of cryoablation conduit according to any one of claims 1 to 5, which is characterized in that the area of insulation (11) identical with the wall thickness of ablation areas, the area of insulation (11) material low using the coefficient of heat conduction, the ablation areas (12) material high using conduction-convection problem.

8. a kind of cryoablation conduit according to any one of claims 1 to 5, which is characterized in that the area of insulation It (11) the use of kinds of interlayer is the multilayered structure with the heat-insulated material of stomata.

9. a kind of cryoablation conduit according to any one of claims 1 to 5, which is characterized in that the ablation areas (12) outer diameter is greater than the outer diameter of the area of insulation (11).

10. a kind of cryoablation conduit according to any one of claims 1 to 5, which is characterized in that the ablation areas It (12) is one or more, the ablation areas (12) is in axial direction located at Different Plane, and expandable members (1) is separated For the ablation areas (12) and area of insulation (11) being interspersed in the radial direction.

11. a kind of freeze melting device containing cryoablation conduit according to any one of claims 1 to 5.

12. a kind of if cryoablation conduit according to any one of claims 1 to 5 is in building lung's vagus nerve injury model In application.

13. a kind of side for carrying out lung's vagus nerve injury using cryoablation conduit according to any one of claims 1 to 5 Method, which comprises the following steps: clear target tissue site；The expandable members (1) of introducing freeze melting device simultaneously will It pushes to target tissue；The ablation areas (12) and target tissue for confirming expandable members (1) are coincide；Refrigerant is inputted, institute is made Expandable members (1) are stated into expanded condition,；Cryoablation program is opened, cryoablation is carried out to appointed part, to complete damage lung Portion's vagus nerve.

Technical field

The present invention relates to cryoablation technical field more particularly to a kind of cryoablation conduit and its applications.

Background technique

Cryoablation is to utilize the freezing to local organization, controllably histoclastic treatment method.Cryoablation is in gas In use, compared with heating ablation, freezing does not easily lead to the damage of cartilage in road, and air flue softening seldom occurs, collapses, and prevents after starting Power is narrow；Cold therapy is less to cause to freeze being adhered for position and surrounding tissue；The cold therapy of controllable depth is to neighbouring Big blood vessel and tracheae are not easy to cause serious injury, and do not easily cause perforation bleeding, and be conducive to tissue repair；Cryoablation does not promote meat Bud hyperblastosis, it is not easy to generate cicatricial tissue.

Obstructive lung disease, including asthma, pulmonary emphysema or chronic bronchitis etc., in the U.S., number of the infected is more than 25,000,000 People is estimated to exceed 20,000,000,000 dollars to these disease total costs at present.Due to factors such as air pollution, smokings, disease incidence is Increase.

Chronic Obstructive Pulmonary Disease (chronic obstructive pulmonary disease, COPD) is a kind of normal The disease that can be prevented and treated characterized by continuous flow is limited seen, flow limitation carries out sexual development, with air flue and lung It is dirty related to the chronic inflammatory increased response of toxic granular or gas.The mark of asthma is by the acute of bronchus liner smooth muscle Dyspneic acute attack caused by (air in lungs channel) is shunk, airway diameter is reduced and increases gas-flow resistance.In asthma Bronchoconstriction be " reversible " because actual shrinkage by bronchiectasis medicine or can pass through the passage (In of time Removing causes after the stimulant shunk) it reverses.It is loose or be overexcited however, asthma long-term performance is the inflammation of smooth muscle.

Current main therapeutic modality is drug therapy, rehabilitation, lung volume-reducing operation or surgical operation therapy (as used Surgical resection nervus pulmonalis keeps the function of nerve completely or partially invalid, can improve asthma or pulmonary emphysema), these treatments Method or therapeutic effect are unobvious, or can generate serious complication.

Some researches show that damage lung's vagus nerve, acetylcholine can be inhibited to discharge, inhibit smooth muscle contraction, in turn Improve asthma, COPD symptom, improves lung function.With the development of cryoablation technology and popularizing for application, cryoablation is to control It treats COPD and provides new idea and method.The characteristics of due to above-mentioned cryoablation and advantage, so that it is particularly suited for air flue Tissue is particularly suited for the ablation of lung vagus nerve, damage, therefore cryoablation is one kind for lung vagus nerve injury modeling Suitable method.

The freezing position of current existing cryoablation conduit is mostly sacculus or probe, entire sacculus or probe contacts portion Position is its damage range, and when using which destination organization, position is nondistinctive is melted, damaged to tissue for entire freezing Wound, can bring biggish non-essential damage.Such as Chinese patent CN201710816284.5 discloses a kind of band insulation utricule Cryoablation conduit comprising: tube body and freezing unit, the tube body include along its axially extending cold source inlet chamber, cold Source return-air chamber and full chamber, the freezing unit are arranged in the body distal end part, including with the cold source inlet chamber and institute The insulation utricule stating the first utricule of cold source return-air chamber fluid communication and being connected to the full chamber, when first balloon dilatation When, by filling chamber, it is filled with insulating medium into the insulation utricule, so that region shared by insulation utricule becomes isolation energy and passes Defeated region is realized and prevents energy transmission of the freezing unit to the corresponding space of adiabatic zone, although the patent is provided with The insulation utricule of energy is isolated, but its first utricule for being used to melt still is whole situation, there are still damage ranges to draw greatly The problem of biggish non-essential damage risen.

Summary of the invention

The shortcomings that in order to overcome in the presence of the prior art with it is insufficient, the present invention provides a kind of cryoablation conduit and its phase The application of pass, the cryoablation conduit are provided with ablation areas, area of insulation at freezing position, on ablation areas axial direction Length is short as far as possible, at platypelloid type (due to there is biggish cavity for sufficient heat exchange, it is ensured that freezing depth), is formed radial The flat damage in direction, can effectively reduce inessential tissue damage；Area of insulation can prevent the cooling capacity of refrigerant from transmitting, It is further reduced the damage to inessential tissue, is realized under damage few as far as possible, thorough ablation targets tissue is particularly suitable for lung Vagus nerve tissue.

To achieve the above object, the present invention adopts the following technical scheme:

The first aspect of the invention is to provide a kind of cryoablation conduit, including expandable members and with it is described expansible The pipeline of component connection, is arranged area of insulation and ablation areas in the expandable members, the pipeline include air inlet pipeline and Return line, the air inlet pipeline, return line are connected to the inner cavity chamber of the expandable members.

Further, the expandable members are provided with expanded condition and contracted state, refrigerant by the air inlet pipeline into Enter in the expandable members, make the expandable members at expanded condition, the cooling capacity of the area of insulation isolation refrigerant passes It passs, the ablation areas realizes that cooling capacity transmitting carries out cryoablation, achievees the purpose that treatment, and refrigerant passes through the muffler Road reflux.

Further, the end of the air inlet pipeline extends into the expandable members, distal end and the expansible structure The distal end fixed seal connection of part opens up at least one gas outlet on the air inlet pipeline inside the expandable members,.More into One step, the air inlet pipeline axial same plane position open up at least two symmetrical gas outlet or it is described into Air pipe respectively opens up at least one gas outlet in axial Different Plane position.

Further, the return line be sheathed on the air inlet pipeline outside or the return line (22) with it is described Air inlet pipeline (21) is arranged side by side, and the distal end of the return line (22) is fixedly connected with the proximal end of the expandable members, and It is connected to the inner cavity chamber of the expandable members.

Further, peripherally disposed temperature sensor and/or pressure sensor in the expandable members.Temperature The type of sensor and/or pressure sensor is any suitable sensor commonly used in the art, wherein temperature sensor Surface temperature for real-time monitoring expandable members；Pressure sensor is for real-time monitoring expandable members to the pressure of airway walls Power.

Further, at least 1 graduation mark is arranged in the outer surface of the distal end of the pipeline.Further, the scale Line is printing graduation mark or engraving graduation mark, and above-mentioned graduation mark is for measuring distance.

Further, the wall thickness of the area of insulation is greater than the wall thickness of the ablation areas.Wherein, the material in 2 regions It may be the same or different, the region heat-transfer effect thicker from wall thickness in terms of the heat transmitting angle area difference thinner than wall thickness, i.e. thermal insulation areas Domain can play certain insulation effect.

Further, the area of insulation is identical with the wall thickness of ablation areas, and the area of insulation uses the coefficient of heat conduction Low material, the ablation areas material high using the coefficient of heat conduction.It will be appreciated that above-mentioned material can be conventional for this field Any suitable material used, such as the low material of the coefficient of heat conduction are polyvinyl chloride, thermal coefficient: 0.14W/m × K； The high material of the coefficient of heat conduction is polyamide, thermal coefficient: 0.25W/m × K.

Further, the area of insulation is the multilayered structure with the heat-insulated material of stomata using kinds of interlayer.It is appreciated that , above-mentioned with the heat-insulated material of stomata can be any suitable material commonly used in the art, such as heat-barrier material uses Most high molecular materials be made as it is porous, such as: high-incidence foaming polypropylene, expanded polystyrene (EPS), polyurethane foam plastics.

Further, the outer diameter of the ablation areas is greater than the outer diameter of the area of insulation.Further, the ablation The outer diameter in region is 1.05~1.5 times of the outer diameter of area of insulation；It is highly preferred that the outer wall of the ablation areas is towards outer lug Hemispherical or near hemispherical structure.

Further, the ablation areas is one or more, and the ablation areas is in axial direction located at Different Plane, Expandable members are divided into the ablation areas and area of insulation being interspersed in the radial direction by it.

The second aspect of the invention is to provide a kind of freeze melting device containing any above-mentioned cryoablation conduit, Wherein the freeze melting device includes refrigerant conveying device commonly used in the art, is connected to the air inlet pipeline, Further include refrigerant reflux unit commonly used in the art, is connected to the return line；In addition it further includes ability The conventional use of cryoablation conduit guide system in domain and positioning device etc..

The third aspect of the invention is to provide any above-mentioned cryoablation conduit of one kind in building lung's vagus nerve Application in damage model, wherein lung's vagus nerve injury model is in vitro lung tissue vagus nerve injury model, described Isolated-lung is tissue-derived in larger animal, such as ox, sheep, pig etc..

The fourth aspect of the invention is a kind of using any above-mentioned cryoablation conduit progress lung's vagus nerve damage The method of wound comprising following steps: clear target tissue site；It introduces the expandable members of freeze melting device and is pushed To target tissue；The ablation areas and target tissue for confirming expandable members are coincide；Input refrigerant, make the expandable members at Expanded condition opens cryoablation program, carries out cryoablation to appointed part, to complete to damage lung's vagus nerve.

Further, above-mentioned target tissue is in vitro lung tissue.

Further, the method for lung's vagus nerve injury includes the following steps: the targeting of clearly in vitro lung tissue Position；Under endoscope monitoring, introduce the cryoablation conduit, the cryoablation conduit include expandable members and with institute The pipeline of expandable members proximal end connection is stated, the expandable members are provided with expanded condition and contracted state, push the freezing and disappear Melt conduit and reach target tissue, and makes the distally extending distal portions beyond endoscope in the distal end of the cryoablation conduit；Really Recognize damage location and target tissue coincide；Refrigerant is inputted, the expandable members is made to open cryoablation program at expanded condition, The cryoablation program includes cryoablation process and rewarming process, carries out cryoablation to appointed part, reaches damage lung Portion's vagus nerve purpose.

Further, the target tissue can be multiple target tissues, can be, but not limited to as left principal bronchus, right main branch Tracheae, or simultaneously include left and right main bronchus.

Further, the target tissue can all carry out cryoablation primary, can also be performed in multiple times freezing and disappear Melt.

Further, described that endoscope is introduced into step, lung's airmanship can be combined.

Further, the cryoablation conduit step is introduced, the channel through the endoscope itself is can be and introduces, It can be the cryoablation conduit to introduce side by side with the endoscope.

Further, the confirmation operative site and target tissue anastomosis procedure, can line-of-sight observation, can also combine a variety of Detection method, such as X-ray machine.

Further, cryoablation program is opened, the cryoablation program includes cryoablation process and rewarming process, Cryoablation is carried out to appointed part, reaches the damage vagal purpose of lung, it can be multiple to the same target tissue multiple cold Freeze ablation lesions, to reach better cryoablation damage effect.

Further, the refrigerant is liquid nitrogen, can also be other suitable refrigerants.

The present invention by adopting the above technical scheme, has the following technical effect that

1. while reaching damage lung's vagus nerve, being realized using the interventional method of endoscope cooperation cryoablation Wound is small, operating time is short, easy to operate, highly-safe, while the complication of effectively control operation；

2. being provided with area of insulation, ablation areas in expandable members, the relatively major lumen due to expandable members is for filling Divide heat exchange, the length of ablation areas in the axial direction can be shorter, had not only been able to achieve the vagal damage of lung, but also can subtract as far as possible The damage of few inessential tissue；

3. being provided with area of insulation on refrigerating plant, in ablation procedure, isolation cooling capacity transmitting is further protected inessential Injury tissue；

4. the central cross-section of ablation areas in axial direction can be Different Plane, i.e., along axial Disjunct distribution, formed axial Upper interruption damages (incomplete circumferential damage), and interruption damage can reduce the stimulation of the damage to airway walls tissue, is not easy to cause The complication such as perforation, Airway Collapse, while can guarantee lung's vagus nerve injury again, stop nerve conduction.

Detailed description of the invention

Fig. 1 is the structural schematic diagram of cryoablation conduit in one embodiment of the invention.

Fig. 2 is the cross-sectional view of cryoablation conduit in one embodiment of the invention.

Fig. 3 is enlarged drawing at the A of cryoablation conduit shown in Fig. 2.

Fig. 4 is the cross-sectional view of cryoablation conduit in another embodiment of the present invention.

Fig. 5 is the cross-sectional view of cryoablation conduit in another embodiment of the present invention.

Fig. 6 is the cross-sectional view of cryoablation conduit in another embodiment of the present invention.

Fig. 7 is the cross-sectional view of cryoablation conduit in another embodiment of the present invention.

Fig. 8 is the cross-sectional view of cryoablation conduit in another embodiment of the present invention.

Wherein, appended drawing reference are as follows:

Expandable members 1；Area of insulation 11；Ablation areas 12；Pipeline 2；Air inlet pipeline 21；Return line 22；Graduation mark 23；Gas outlet 211.

Specific embodiment

The present invention relates to a kind of cryoablation conduits, including expandable members and the pipe connecting with the expandable members Road, is arranged area of insulation and ablation areas in the expandable members, and the pipeline includes air inlet pipeline and return line, described Air inlet pipeline, return line are connected to the inner cavity chamber of the expandable members.The invention further relates to above-mentioned cryoablation conduits Application.

With reference to the accompanying drawings and examples, further description of the specific embodiments of the present invention.Following embodiment is only For clearly illustrating technical solution of the present invention, and not intended to limit the protection scope of the present invention.