JPH028741B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a ventricular-peritoneal shunt or a ventricular-atrial shunt (hereinafter referred to as "ventricular shunt") that is surgically implanted in the body of a patient with hydrocephalus. ), and particularly relates to a ventricular shunt that can switch the flow rate.

[Conventional technology]

In general, a ventricular shunt consists of a thin tube-shaped ventricular catheter that is inserted into the ventricle, a shunt body (relay chamber) that is connected to this ventricular catheter and consists of a reservoir and a pump chamber, and a shunt body that is connected to the shunt body. It consists of a tube-shaped peritoneal catheter or an atrial catheter that is inserted into the abdominal cavity or atrium.

The shunt body is buried under the scalp on the skull, and inside the shunt body is a relief valve, such as a miter valve, that can be pushed open by the pressure of cerebrospinal fluid, which is fluid discharged from the ventricles. The relief valve functions as a flow rate regulator to regulate the flow rate, and also functions as a check valve.

Examples of such conventional ventricular shunts include the "Plug Valve for Physiological Flow Shunt Mechanism" disclosed in Japanese Patent Application Laid-Open No. 117280/1983, which claims priority based on U.S. Patent Application No. 302181, and U.S. Patent Application No. 183463
``Suction control device for physiological drainage'' disclosed in Japanese Patent Application Laid-Open No. 48-41588 with a priority claim based on No.
is proposed.

[Problem that the invention seeks to solve]

By the way, after implantation of a ventricular shunt, it may be necessary to adjust the regulated flow rate using the aforementioned check valve, but in conventional ventricular shunts, the regulated flow rate is fixed by a single relief valve, so the patient's The main body of the shunt, which is to be implanted in the head, etc., is surgically removed.
There is a problem in that the relief valve must be replaced with a relief valve having an adjusted flow rate of another standard.

The present invention is an attempt to solve these problems, and is designed to enable the flow rate to be changed by a simple operation using a driving force from outside the patient's body, without having to replace the shunt body implanted inside the patient's body. The purpose of the present invention is to provide a flow-switchable ventricular shunt.

[Means for solving the problem] Therefore, the flow rate switching type ventricular shunt of the present invention has the following features:
A ventricular catheter whose tip is inserted into the ventricle of the brain to drain cerebrospinal fluid from the same ventricle, and a peritoneal catheter whose tip is inserted into the peritoneal cavity or atrium to discharge the cerebrospinal fluid to the peritoneal cavity or atrium. or an atrial catheter, a shunt body that is connected to the proximal end of the ventricular catheter and the proximal end of the peritoneal catheter or the atrial catheter so that the catheters communicate with each other, and integrally communicates with the shunt body. A ventricular shunt having a small ventricular reservoir, the ventricular shunt having a check valve capable of preventing backflow of cerebrospinal fluid from the peritoneal catheter or the atrial catheter to the ventricular catheter; A flow rate switching mechanism for switching the flow rate of cerebrospinal fluid sent from the cerebrospinal fluid to the peritoneal catheter or the atrial catheter is provided, and the flow rate switching mechanism connects a plurality of flow channels connected in parallel to each other and a plurality of flow channels connected to each other in parallel. A plurality of flow rate adjustment parts are inserted in each of the plurality of flow passages and can adjust the flow rate in the communication state of each flow path to a predetermined flow rate, and a plurality of flow rate adjustment parts are inserted in each of the plurality of flow passages and can receive a driving force from the outside. The plurality of on-off valves of the flow rate switching mechanism each communicate with the reservoir of the shunt body, and the peritoneal catheter or the atrial catheter side. a cavity communicating with the flow path through an opening, a flexible membrane forming an upper wall surface of the cavity, a valve seat formed around the opening, and a side wall surface of the cavity of the flexible membrane. The present invention is characterized in that it is constructed as a button-type on-off valve equipped with a protruding valve body that is attached and can close the valve seat when the flexible membrane is pressed downward.

[Effect]

In the above-described flow rate switching type ventricular shunt of the present invention,
By opening and closing the button-type on-off valves inserted in each of the multiple flow paths using driving force from the outside, the multiple on-off valves in the shunt body are individually controlled to open and close, thereby controlling the opening and closing of the multiple flow paths. The communication cutoff state is controlled, the flow rate is switched, and the flow rate of the cerebrospinal fluid becomes the sum of the flow rates regulated by the flow rate regulator inserted in the flow path in the communication state. At that time, the button type on-off valve includes a cavity that communicates with the reservoir of the shunt body and also communicates with the peritoneal catheter side flow path via an opening, a flexible membrane forming an upper wall surface of the cavity, and the flexible membrane that forms the upper wall surface of the cavity. The valve includes a valve seat formed around the opening, and a protruding valve body that is attached to a side wall surface of the cavity of the flexible membrane and can close the valve seat when the flexible membrane is pressed downward. With this structure, the flow rate switching operation can be performed extremely easily and reliably.

That is, when closing the opening/closing valve, it is sufficient to press the flexible membrane with your fingers through the scalp, thereby fitting the protruding valve body into the valve seat and ensuring the valve is closed. In addition, when opening the valve, press the shunt body with your finger on the upstream side of the cavity to push up the flexible membrane with hydraulic pressure and remove the protruding valve body from the valve seat. good.

〔Example〕

Hereinafter, embodiments of the present invention will be described with reference to the drawings. Figures 1 to 10 show a flow rate switching type ventricular shunt as a first embodiment of the present invention.
11 to 16 show an example of application of the present ventricular shunt as a second embodiment of the present invention to an intracranial pressure measuring device.

As shown in FIGS. 1 to 10, in the first embodiment,
The flow-switchable ventricular shunt A has come to be used as an implant, and this flow-switchable ventricular shunt A functions as a ventricular shunt for intracranial pressure measurement, as shown in Figures 1 and 2. The distal end 2 is inserted into the patient's ventricle 19 (see Figure 11).
a tubular ventricular catheter 2 which can be inserted into the ventricle 19 to drain cerebrospinal fluid from the same ventricle 19; and a peritoneal catheter whose tip can be inserted into the peritoneal cavity or atrium to discharge the cerebrospinal fluid to the peritoneal cavity or atrium. or an atrial catheter (hereinafter referred to as "peritoneal catheter") 3;
A shunt made of a soft wall made of silicone resin or the like, which is connected to the proximal end 2a of the ventricular catheter 2 and the proximal end 3a of the peritoneal catheter 3, and has a main passage 10 that allows the catheters 2 and 3 to communicate with each other. The main body (relay room) 1 is comprised of a main body (relay room) 1.

In addition, the shunt main body 1, the ventricular catheter 2, and the peritoneal catheter 3 are provided with a check valve 4 that can prevent backflow of cerebrospinal fluid from the peritoneal catheter 3 to the ventricular catheter 2. valve 4
In this embodiment, miter valves 6 and 7 serving as flow rate adjustment sections of a flow rate switching mechanism 5, which will be described later, also serve this function.

The shunt body 1 includes a main passage 10 that connects to the ventricular catheter 2 and the peritoneal catheter 3, a small chamber-like reservoir 11 that is integrally formed and communicates with the ventricular catheter 2 side of the main passage 10, and a main passage 10 that connects to the ventricular catheter 2 and the peritoneal catheter 3. aisle 10
A branch part 10a formed on the downstream side of the reservoir 11, a branch part 10b formed on the peritoneal catheter 3 side of the main passage 10, and these branch parts 10a.
The first flow path 13 and the second flow path 14 connect the branch portion 10b and the branch portion 10b in parallel.

In addition, as shown in chain lines in FIG. 1, it may be fixed on the skull 17 under the scalp 16 by suturing the scalp 16 with a suture passing through the suture through hole 15.

As shown in FIGS. 1 and 6, the first flow path 13 includes a miter valve as a first flow rate adjusting section that can adjust the flow rate in the communicating state of the first flow path 13 to a predetermined flow rate _Q1 . 6, and a button-type on-off valve 8 as a first on-off valve capable of blocking the first flow path 13 by receiving a driving force from the outside of the shunt body 1.

As shown in FIG. 1, the second flow path 14 has a second flow path that can adjust the flow rate in the communicating state of the second flow path 14 to a predetermined flow rate Q ₂ (here, = 1/2Q ₁ ). The miter valve 7 serves as a flow rate adjustment unit, and the second flow path 14 receives a driving force from the outside of the shunt body 1.
A button-type on-off valve 9 is inserted as a second on-off valve that can shut off the flow.

That is, the flow path 1 in this ventricular shunt A
3 and 14, from the ventricular catheter 2 to the peritoneal catheter 3, the reservoir 11 and the same reservoir 1 are inserted.
1 and a pump chamber 31 for opening a cutoff valve, which communicates with the check valve 4 via miter valves 6 and 7, and a flow path 13.
A button type cutoff valve 32, which is the above-mentioned on-off valve 8, 9 as a cutoff valve mechanism 34 that can cut off the flow, is sequentially arranged.

This button-type cutoff valve 32 communicates with the pump chamber 31 for opening the cutoff valve of the shunt main body 1, and has an opening 32e in the channel 13 on the side of the peritoneal catheter 3.
A flexible membrane 32a is formed around the opening 32e and a flexible membrane 32a that forms the upper wall surface of the valve chamber 32f and can be dented by receiving an external force from a finger 18 or the like. Valve seat 32c and the flexible membrane 32
It is configured as a push-type on-off valve including a protruding valve body 32b that is attached to the side wall surface of the valve chamber 32f and can close the opening 32e when the flexible membrane 32a is pressed downward.

Note that the reference numeral 35 in the figure indicates a connecting member.

Alternatively, instead of providing the check valve 4, as shown in FIG. Good too.

Furthermore, as shown in FIGS. 7 to 10, in the button type cutoff valve 34, the valve body 32'b and the valve seat 32'c
In this case, the intermediate partition membrane 32'd is pressed downward by the pressure inside the valve chamber 32'f, and the opening 32'e is opened.

The valve body 32'b has three spokes 3.
2'g is connected to the ring 32'h,
The spokes 32'g function as a spring to push the flexible membrane 32'a upward.

When the button type cutoff valve 34 is in the closed state, the constricted portion 32'i, which is the connecting portion between the valve body 32'b and the spoke 32'g, comes into close contact with the opening 32'e.

Since the flow rate switching type ventricular shunt according to the first embodiment of the present invention is constructed as described above, when the ventricular shunt A with button type cutoff mechanism is buried in a predetermined position, the flow rate switching mechanism 5 and the cutoff To operate the valve mechanism 34, as shown by the solid line in FIG.
The protruding valve body 32b attached to the lower center of the valve 2a is inserted into the opening 32 of the intermediate partition membrane 32d, which is the valve seat 32c.
e to close the opening 32e.

Note that in order to open the shutoff valve mechanism 34,
As shown in FIG. 4, the pump chamber 31 for opening the shutoff valve
By pressing the upper flexible membrane 31a, the pressure within the valve chamber 32f is increased, and the valve body 32b is disengaged upward from the opening 32e, thereby opening the shutoff valve mechanism 34.

In addition, the number of flow rate switching units in this embodiment may be three or more, and the regulated flow rates may be set to be different from each other. For example, the regulated flow rate may be sequentially set to 2 ⁿ times the minimum flow rate Q, where n is a natural number. If you have
In addition to switching the flow rate in (2 ⁿ −1) stages,
A mechanism as a shutoff valve mechanism 34 can be provided.

In addition, in the above-mentioned embodiment, the relief valve 6,
7 may be replaced with orifices having different flow rates; in this case, the first and second flow paths 13, 1
A check valve may be inserted into each of the main passages 4 or a single check valve may be inserted into the main passage 10.

This embodiment has a function of switching the flow rate as follows.

As shown in FIGS. 2 and 7, valve bodies 32b, 32'
When each of b is opened, the patient's ventricle 19
The cerebrospinal fluid that has flowed into the reservoir 11 through the ventricular catheter 2 passes through the main passage 10 and the first and second flow passages 13, 14, and enters the valve chamber 32f,
32'f, and if the difference between the pressure of the upstream cerebrospinal fluid and the pressure of the downstream cerebrospinal fluid of the miter valves 6, 7 is equal to or greater than a predetermined value, the miter valves 6, 7 become open, and the miter valves 6, 7 become open.
After passing through two open on-off valves 32,
0b, the cerebrospinal fluid flows out into this branch 10b.
From there, it passes through the peritoneal catheter 3 and flows into the patient's abdominal cavity and atrium.

In this way, the cerebrospinal fluid from the ventricles flows at the maximum flow rate as the sum of the respective regulated flow rates of the two miter valves 6, 7 (Q ₁ +Q ₂ ).

Next, if you want the flow rate to be medium Q ₁ , as shown in Figs. to open the first on-off valve 8, and at the same time open the second on-off valve 8.
The valve bodies 32b, 32'b in the flow path 14 are connected to the valve seat 32.
c, 32'c and close the second on-off valve 9, thereby allowing cerebrospinal fluid to flow only through the first miter valve 6, which has a relatively large regulated flow rate.

Also, if you want to make the flow rate even smaller, _Q2 ,
As shown in FIGS. 3 and 8, the valve bodies 32b, 32'b in the first flow path 13 are seated on the valve seats 32c, 32'c to close the first on-off valve 8, and the second on-off valve 8 is closed. The valve bodies 32b, 32'b in the flow path 14 are connected to the valve seat 3.
2c, 32'c and close the second on-off valve 9, thereby allowing cerebrospinal fluid to flow only through the second miter valve 7, which has a relatively small regulated flow rate.

As mentioned above, in this embodiment, the first miter valve 6 and the second miter valve 7 have mutually different regulated flow rates, so the two miter valves 6 and 7 can switch the flow rate in three stages. Although shutoff is performed, even if both miter valves 6 and 7 have the same regulated flow rate, the flow rate can be switched in two stages: when the flow is allowed to flow only to one of them, and when the flow is allowed to flow to both. can.

When it is desired to stop the outflow of cerebrospinal fluid via this ventricular shunt, the valve bodies 32b and 32'b in the first flow path 13 and the second flow path 14 are moved to the closed position of the valve seat 32c. , 32'c, close both the first and second on-off valves 8, 9, and reach the miter valves 6, 7 from the reservoir 11 through the main passage 10 and the first and second flow passages 13, 14. All that is needed is to block the flow of cerebrospinal fluid.

As shown in FIGS. 11 to 16, the flow rate switching type ventricular shunt according to the second embodiment of the present invention is applied to an intracranial pressure measuring device, and this intracranial pressure measuring device is installed in a patient's body. A ventricular shunt A for intracranial pressure measurement with a button-type flow rate switching mechanism as an implant similar to that of the first embodiment, and a reservoir for intracranial pressure measurement of this ventricular shunt A disposed outside the patient's body. 11 and a pressure detection measuring device B that can be contacted through the scalp 16.

A thin film-like flexible curved dome 11a for intracranial pressure measurement is formed in the upper part of the reservoir 11.

The pressure detection device B includes a pressure detector 23, an amplifier 25 that receives and amplifies a pressure detection signal from a pressure sensor 23e of the pressure detector 23 via a lead wire 24, and an amplified signal from the amplifier 25. It is comprised of a recorder 27 such as a printer for receiving and recording the information via a lead wire 26 and a display device 28 such as a CRT for displaying the information.

The pressure detector 23 is configured as a transcutaneous cerebral pressure sensor, and includes a case 23a, an outer cylinder 23b of a predetermined length connected to the detection end side of the case 23a,
A presser plate 23c connected to the back side of the case 23a
and a columnar pressure receiving plate 23d slidably inserted into the outer cylinder 23b, which is connected to the pressure receiving plate 23d, converts the pressure from the pressure receiving plate 23d into an electrical signal, and outputs it via the lead wire 24. A diffusion-type semiconductor pressure sensor (or load sensor) 23e whose surface is molded with silicon for the purpose of servicing, and a hard spring 2 that applies a biasing force to the pressure sensor 23e inside the case 23a.
3f, and a zero adjuster 23g for positioning the pressure sensor 23e.

In addition, the code|symbol 20 in a figure shows a brain, and 21 shows a dura mater.

Since the intracranial pressure measuring device according to the second embodiment of the present invention is constructed as described above, with the ventricular shunt A as the implanted object buried in a predetermined position, the intracranial pressure measuring device as shown in FIGS. Intracranial pressure can be measured.

(0) The shutoff valve mechanism 34 that can shut off the flow of cerebrospinal fluid from the ventricular catheter 2 to the peritoneal catheter 3 is operated to close the shunt body 1 to shut off the flow of cerebrospinal fluid [the chain line in Fig. 12]. Steps shown
see a1]. In this case, the shutoff valve mechanism 34 is operated by simultaneously closing the first and second flow rate switching sections 5a and 5b.

(1) The cerebrospinal fluid is guided through the ventricular catheter 2 to the intracranial pressure measurement reservoir 11 buried under the scalp 16 and above the skull 17, and the upper dome 11a of the reservoir 11 is guided by the pressure of the cerebrospinal fluid.
Expand it so that it protrudes outward (step a2).

(2) Turn on pressure detection device B and start measurement [see sensor depth L _A at time t _A in FIGS. 13a and 14]. At this time, the detection end 3
0 is separated from the scalp 16 and is in a non-contact state.

Therefore, in this state, no pressure is applied to the dome 11a from the outside.

(3) By bringing the detection end 30 of the pressure detection device B into contact with the upper dome _{11a through the scalp 16 [see sensor depth L B at} time tB in FIGS. 13b and 14], the pressure is detected. Start measuring P (step a3).

(4) Next, push the detection end 30 into the upper dome 11a until the center of the upper surface becomes flat [Fig. 13c
and sensor depth at time tc in Fig. 14
See Lc].

In this state, the tip surface of the pressure receiving plate 23d and the scalp 1
6, and the upper surface of the curved dome 11a forms a quasi-plane (coplane).
An inflection (hereinafter, this inflection point will be referred to as "BP ₁ ") occurs in the relationship between and the detected pressure P.

(5) Further, continue pushing until the upper surface of the upper dome 11a collapses [sensor depth L _D at time t _D in Figures 13 d and 14]
reference].

In this state, the tip surface of the pressure receiving plate 23d is on the scalp 1.
6, an inflection point occurs in the relationship between the indentation depth L and the detected pressure P (hereinafter, this inflection point will be referred to as "BP ₂ ").

(6) The pressure detected by the pressure detection device B during this pushing process is measured by recording it with the recorder 27 or displaying it on the display device 28.
A section (between inflection points _BP1 and _BP2 ) in which the detected pressure P does not change even if the indentation depth L is slightly changed is detected, and the detected pressure P in this section is taken as the intracranial pressure. (Step a4) That is, the indentation depth L and _the detected pressure P have two inflection points BP _{1 and} BP 2, and between the inflection points BP ₁ and BP ₂ , the detected pressure P
The range of change is small.

The principle of the transcutaneous intracranial pressure measurement of this embodiment, which is performed in this manner, is based on the premise that the following conditions are satisfied, and the measurement is performed on the following measurement object.

First, the conditions are that, as shown in FIG. 11, intracranial pressure is derived directly below the scalp 16, and a pressure equal to the intracranial pressure exists in the "soft" dome 11a of radius r.

In this case, the measurement target is the implant body 22 (ventricular shunt body 1) embedded under the scalp 16.
This pressure is measured indirectly from the outside of the scalp 16. At this time, it is assumed that there is almost no change in intracranial pressure even if the scalp 16 and reservoir 11 are lightly compressed.

At this time, the following measurement principle is derived from Laplace's theorem.

As shown in FIG. 15, the dome 11a of the scalp 16 and the implant body 22 (ventricular shunt body 1)
is part of a sphere with radius r, the sphere has an internal pressure (brain pressure) Pi and an external pressure (usually atmospheric pressure)
Laplace's theorem is established between Po and the tension T of the scalp 16 and the dome 11a of the buried object body 22.

That is, the following relationship holds true.

Pi−Po=2T/r (1) Here, when measuring the internal pressure Pi from outside the dome 11a, the condition that Pi=Po should be satisfied under equation (1).

Based on Laplace's theorem, the following measurement principle is established.

Now, try pressing the outside of the dome 11a with a plate 29 as shown in FIG. The upper surface of the dome 11a is made flat by the plate 29. Assuming that the area of the planar portion of this plate 29 is D, in the region of D, r is equivalent to infinity when considered based on Laplace's theorem.

That is, if r is set to ∞, the right side of equation (1) becomes 0, and in this case, Pi=Po holds true. From this, it can be seen that when the dome 11a and the scalp 16 are compressed with an appropriate external pressure, the external pressure applied to the flattened portion becomes equal to the internal pressure.

However, in actual measurements, it is necessary to pay attention to the following points in order to accurately compress only the necessary portions of the dome 11a.

To compress the dome 11a in a flat shape; To detect external pressure only in the region D above; To not crush the dome 11a more than necessary. If these conditions are satisfied, actual measurement can be performed.

According to this embodiment, the following effects and advantages can be obtained.

(1) There is no need to perform pressure zero point adjustment (calibration) for pressure measurement after implantation.

(2) It can be configured so that buried objects do not interfere with the creation of tomographic images using CT scanners, nuclear magnetic resonance scanners, etc.

(3) It is easy to handle and does not cause invasiveness such as brain damage when not being measured.

(4) Burial surgery etc. can be performed easily.

(5) Can be realized at low cost.

In addition, in each of the above-mentioned embodiments, the protruding valve body 3
The materials 2b and 32'b may be made of plastic mixed with a contrast agent so that their positions can be confirmed by X-ray photography.

〔Effect of the invention〕

As detailed above, the flow rate switching type ventricular shunt of the present invention has the advantage that it has a simple structure and can perform the flow rate switching operation, which was conventionally considered difficult, extremely easily and safely. Position can be determined accurately.

In particular, in the brain cavity shunt of the present invention, the on-off valves in the flow channels provided in parallel to each other in the shunt body all communicate with the reservoir of the shunt body and communicate with the peritoneal catheter side flow channel through an opening. a flexible membrane forming an upper wall surface of the cavity; a valve seat formed around the opening; and a flexible membrane attached to a side wall surface of the cavity of the flexible membrane. It is equipped with a protruding valve body that can close the valve seat when the membrane is pressed downward, so when closing the opening/closing valve when switching the flow rate, the flexible membrane is inserted through the scalp with the finger. This allows the protruding valve body to fit into the valve seat and securely close the valve.In addition, when opening the valve, press the shunt at the upstream side of the empty space. By pressing the main body with a finger, the flexible membrane can be pushed up by hydraulic pressure, and the protruding valve element can be easily removed from the valve seat.

[Brief explanation of drawings]

1 to 10 show a flow rate switching type ventricular shunt as a first embodiment of the present invention. FIG. 1 is a plan view thereof, and FIG. 2 is a longitudinal sectional view thereof (the
3 and 4 are longitudinal sectional views of the main parts for explaining the function, and Fig. 5 is a longitudinal sectional view of the main parts showing a modification example in which the check valve is not provided. , Fig. 6 is a sectional view taken along the - arrow in Fig. 2, Fig. 7
Figures 1 to 10 all show modified examples of the button-type on-off valve. Figure 7 is a longitudinal sectional view showing the open state, Figure 8 is a longitudinal sectional view showing the closed state, and Figure 9 is the vertical sectional view showing the closed state. Fig. 7 is a cross-sectional view taken in the direction of the - arrow, and Fig. 10 is a plan view of the valve body viewed from below.
Fig. 6 shows an intracranial pressure measuring device as a second embodiment of the present invention, Fig. 11 is a schematic vertical sectional view showing its measurement state, and Fig. 12 is a flowchart for explaining the measurement procedure. , Figures 13a to 13d are schematic side views showing the measurement procedure;
Figure 4 is a graph to explain the effect, the first
5 and 16 are a schematic perspective view and a side view for explaining the measurement principle. 1... Shunt body (relay chamber), 1a... Soft upper wall, 2... Ventricular catheter, 2a... Proximal end,
2b... Tip part, 3... Peritoneal catheter, 3a...
... Base end portion, 4 ... Check valve, 5 ... Flow rate switching mechanism,
5a...first flow rate switching section, 5b...second flow rate switching section, 6...miter valve as first flow rate adjustment section, 7...miter valve as second flow rate adjustment section, 8... ...Button-type on-off valve as a first on-off valve, 9...Button-type on-off valve as a second on-off valve, 10...Main passage, 10a, 10b...Branch portion, 10c...Flexible membrane, 11 ...Reservoir, 11
a... thin film-like flexible curved dome for intracranial pressure measurement;
13...first channel, 14...second channel, 15
... Suture hole, 16 ... Scalp, 17 ... Skull, 18 ... Finger, 19 ... Ventricle, 20 ... Brain, 2
DESCRIPTION OF SYMBOLS 1... Dura mater, 22... Buried object main body, 23... Pressure detector, 23a... Case, 23b... Outer cylinder as a guide part, 23c... Holding plate, 23d... Column pressure receiving part as a pressure receiving part Plate, 23e...Diffusion type semiconductor pressure sensor (load sensor), 23f...Zero adjuster, 24...Lead wire, 25...Amplifier,
26...Amplifier, 27...Recorder as an external device, 28...Display device as an external device, 29...
...Plate, 30...Detection end, 31...Pump chamber for opening the shutoff valve, 31a...Flexible membrane, 32, 32'...Button type shutoff valve (push type on/off valve), 32a, 3
2'a...Flexible membrane, 32b, 32'b...Protruding valve body, 32c, 32'c...Valve seat, 32d, 32'd
...Intermediate partition membrane, 32e, 32'e...opening,
32f, 32'f... Valve chamber (empty space), 32'g...
Spoke, 32'h...Ring, 32'i...Constriction, 34...Shutoff valve mechanism, 35...Connection member,
A... Ventricular shunt for intracranial pressure measurement as an implant, B... Pressure detection device, CL... Central line.

Claims (1)

[Scope of Claims] 1. A ventricular catheter whose distal end is inserted into the ventricle of the brain to drain cerebrospinal fluid from the ventricle, and a catheter whose distal end is inserted into the abdominal cavity or atrium to drain the cerebrospinal fluid from the same ventricle. A peritoneal catheter or an atrial catheter capable of delivering fluid; a shunt body that is connected to the proximal end of the ventricular catheter and the proximal end of the peritoneal catheter or the atrial catheter, respectively, to communicate the catheters; and the shunt body. A ventricular shunt having a small ventricular reservoir formed in integral communication with a ventricular shunt, the ventricular shunt having a check valve capable of preventing backflow of cerebrospinal fluid from the peritoneal catheter or the atrial catheter to the ventricular catheter; The main body is provided with a flow rate switching mechanism for switching the flow rate of cerebrospinal fluid sent from the ventricular catheter to the peritoneal catheter or the atrial catheter,
The same flow rate switching mechanism is inserted into each of the plurality of channels connected in parallel and the plurality of flow channels to adjust the flow rate in the communication state of each channel to a predetermined flow rate. and a plurality of on-off valves that are inserted into each of the plurality of flow paths and can individually shut off each flow path by receiving a driving force from the outside, and the plurality of on-off valves of the flow rate switching mechanism. a cavity in which each valve communicates with the reservoir of the shunt body and with the peritoneal catheter or atrial catheter side channel through an opening, and a flexible membrane forming an upper wall surface of the cavity;
A valve seat formed around the opening, and a protruding valve body that is attached to a side wall surface of the cavity of the flexible membrane and can close the valve seat when the flexible membrane is pressed downward. A flow rate switching ventricular shunt characterized by being configured as a button-type on-off valve. 2. The flow rate switching type ventricular shunt according to claim 1, wherein the plurality of flow rate adjustment units are configured to have mutually different regulated flow rates. 3. The flow rate switching type ventricular shunt according to claim 2, wherein each regulated flow rate of the plurality of flow rate adjustment units is sequentially set to 2 ⁿ times the minimum flow rate Q, where n is a natural number. 4 At least one of the plurality of flow rate adjusting parts
Claims 1 to 3 are configured as miter valves that are pushed open when the pressure of the cerebrospinal fluid on the upstream side of the flow rate adjustment section becomes greater than the pressure of the cerebrospinal fluid on the downstream side by a predetermined pressure or more. The flow rate switching type ventricular shunt according to any one of the preceding paragraphs. 5. The flow rate switching type ventricular shunt according to claim 4, wherein all of the plurality of flow rate adjustment units are configured as the miter valve and also serve as the check valve.