JPH0356061B2 - - Google Patents
Info
- Publication number
- JPH0356061B2 JPH0356061B2 JP61217633A JP21763386A JPH0356061B2 JP H0356061 B2 JPH0356061 B2 JP H0356061B2 JP 61217633 A JP61217633 A JP 61217633A JP 21763386 A JP21763386 A JP 21763386A JP H0356061 B2 JPH0356061 B2 JP H0356061B2
- Authority
- JP
- Japan
- Prior art keywords
- catheter
- distal end
- annular
- bored
- dialysis
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
- 238000000502 dialysis Methods 0.000 claims description 16
- 230000010412 perfusion Effects 0.000 claims description 13
- 239000000919 ceramic Substances 0.000 claims description 6
- 239000002184 metal Substances 0.000 claims description 6
- 239000002207 metabolite Substances 0.000 description 5
- 238000002560 therapeutic procedure Methods 0.000 description 5
- 210000000683 abdominal cavity Anatomy 0.000 description 4
- 238000003780 insertion Methods 0.000 description 4
- 230000037431 insertion Effects 0.000 description 4
- 210000002747 omentum Anatomy 0.000 description 4
- 238000002347 injection Methods 0.000 description 3
- 239000007924 injection Substances 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 210000003200 peritoneal cavity Anatomy 0.000 description 3
- 230000000694 effects Effects 0.000 description 2
- 230000009545 invasion Effects 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 208000009304 Acute Kidney Injury Diseases 0.000 description 1
- 241000894006 Bacteria Species 0.000 description 1
- 208000001647 Renal Insufficiency Diseases 0.000 description 1
- 208000033626 Renal failure acute Diseases 0.000 description 1
- 210000003815 abdominal wall Anatomy 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 201000011040 acute kidney failure Diseases 0.000 description 1
- 208000012998 acute renal failure Diseases 0.000 description 1
- 208000020832 chronic kidney disease Diseases 0.000 description 1
- 208000022831 chronic renal failure syndrome Diseases 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 238000007599 discharging Methods 0.000 description 1
- 230000009977 dual effect Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 238000001631 haemodialysis Methods 0.000 description 1
- 230000000322 hemodialysis Effects 0.000 description 1
- 201000006370 kidney failure Diseases 0.000 description 1
- 230000003907 kidney function Effects 0.000 description 1
- 210000004379 membrane Anatomy 0.000 description 1
- 239000012528 membrane Substances 0.000 description 1
- 229920000728 polyester Polymers 0.000 description 1
- 229920002379 silicone rubber Polymers 0.000 description 1
- 239000004945 silicone rubber Substances 0.000 description 1
Landscapes
- External Artificial Organs (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Description
【発明の詳細な説明】
この発明は、腹腔内に留置し、人工透析に用い
るカテーテルの改良に関するものである。DETAILED DESCRIPTION OF THE INVENTION The present invention relates to an improvement in a catheter that is placed in the abdominal cavity and used for artificial dialysis.
透析療法は、主として腎の機能を代行する治療
法であり、急性・慢性腎不全の治療として行われ
ている。腎不全に対して、体内に蓄積される有害
代謝産物を除去する方法としては、多くの場合血
液透析療法が用いられるが、その施術が専門医の
監視下でかつ、透析装置の整備された施設におい
て行われなければならない点で、患者に週３回程
度の診療所・病院への通院を余儀なくし、また１
回の治療時間も長時間に亘る負担は決して少ない
ものではなかつた。 Dialysis therapy is a treatment method that mainly substitutes kidney function, and is performed as a treatment for acute and chronic renal failure. Hemodialysis therapy is often used as a method to remove harmful metabolites that accumulate in the body for kidney failure, but it is important that the treatment is performed under the supervision of a specialist and in a facility equipped with dialysis equipment. patients are forced to visit a clinic or hospital about three times a week, and
The burden of long treatment times was not at all low.
上記療法に比し、腹膜潅流による透析療法は勿
論上記の問題を解決する手段として有用であるに
止まらないが、患者をその家庭において、透析療
法の機会を与えることを可能とする点でも注目さ
れている。 Compared to the above-mentioned therapies, dialysis therapy using peritoneal perfusion is not only useful as a means to solve the above-mentioned problems, but it is also noteworthy in that it allows patients to have the opportunity to undergo dialysis therapy at home. ing.
(1) 従来の技術
腹膜潅流透析に用いる従来のカテーテルは、側
孔を設けてあるのみで、経皮的に腹腔内に留置し
たとき、その留置位置の固定が困難であるばかり
でなく、大網がカテーテルの側孔に巻きついて潅
流透析が不可能となるなどの欠点があつた。(1) Conventional technology Conventional catheters used for peritoneal perfusion dialysis only have a side hole, and when placed percutaneously into the peritoneal cavity, it is not only difficult to fix the position of the catheter, but also very difficult to fix. There were drawbacks such as the mesh wrapping around the side hole of the catheter, making perfusion dialysis impossible.
(2) 解決すべき問題点
前記目的のために行われる所謂持続的腹膜潅流
又は連続的携帯型腹膜潅流（Continuous
ambulatory peritoneal dialysis）と呼ばれる治
療法において最も重要な点は、腹腔内へ必要量の
潅流液を注入することにより有害な代謝産物を潅
流液へ抽出させ、その潅流液を腹腔外へ排出する
ことにある。そこで、この治療に用いるカテーテ
ルの先端は、膜腔内の最も低い位置にあるダグラ
ス窩（男性の場合は直腸膀胱窩、女性の場合は直
腸子宮窩と呼ばれる。）に挿入し、留置する必要
があるが、従来のカテーテルは先端部に側孔が設
けられているのみで、先端部を挿入位置に固定す
る装置を備えていないためカテーテルの先端部が
腹腔内の上方へ移動したりする欠点やカテーテル
の側孔部分に大網が巻きついて塞ぎ、潅流透析を
不可能にする欠点があつた。(2) Problems to be solved So-called continuous peritoneal perfusion or continuous portable peritoneal perfusion performed for the above purpose.
The most important point in the treatment method called ambulatory peritoneal dialysis is that harmful metabolites are extracted into the perfusate by injecting the required amount of perfusate into the peritoneal cavity, and the perfusate is drained outside the peritoneal cavity. be. Therefore, the tip of the catheter used for this treatment must be inserted and left in the Douglas fossa (called the rectovesical fossa in men and the rectouterine fossa in women), which is the lowest position within the membrane cavity. However, conventional catheters only have a side hole at the tip and are not equipped with a device to fix the tip in the insertion position, resulting in the disadvantage that the tip of the catheter may move upward into the abdominal cavity. There was a drawback that the omentum wrapped around the side hole of the catheter and blocked it, making perfusion dialysis impossible.
この発明の目的、経皮的に挿入したカテーテル
の先端をダグラス窩に留め、また大網が巻きつい
て潅流液の注入・排出を妨げることがなく、更に
カテーテルの先端部がダグラス窩より外れ、大網
等がカテーテルに巻きついた場合でも潅流液の注
入及び代謝産物を抽出した潅流液の排出を可能と
する腹膜潅流透析用カテーテルを提供するにあ
る。 The purpose of this invention is to fix the tip of a percutaneously inserted catheter in Douglas's fossa, to prevent the omentum from wrapping around and impeding the injection and drainage of perfusate, and to prevent the tip of the catheter from coming out of Douglas's fossa and causing To provide a catheter for peritoneal perfusion dialysis which allows injection of perfusate and discharge of perfusate from which metabolites have been extracted even when a mesh or the like is wrapped around the catheter.
(3) 問題点を解決する技術手段
上記問題点は、カテーテルを次のように構成す
ることにより解決される。(3) Technical means for solving the problem The above problem can be solved by configuring the catheter as follows.
(1) 先端部２に単数もしくは複数の金属球又はセ
ラミツク球１０を埋設し、前記先端部２よりも
少し基端側に屈曲部３を形成するとともに、屈
曲部３よりも少し基端側に複数の側孔４を穿設
して該側孔４を穿設した管壁の一部を螺旋状に
した環状部５を形成したことを特徴とする腹膜
潅流透析用カテーテル
(2) 先端部２に単数もしくは複数の金属球又はセ
ラミツク球１０を埋設し、前記先端部２よりも
少し基端側に屈曲部３を形成するとともに、屈
曲部３よりも少し基端側に複数の側孔４を穿設
して該側孔４を穿設した管壁の一部を螺旋状に
した環状部５を形成し、環状部５よりも少し基
端側に環状のカフ６を単数又は複数個嵌着した
ことを特徴とする腹膜潅流透析用カテーテル
(3) 前記環状のカフ６は、その全部又は一部がカ
テーテルに固着されていることを特徴とする腹
膜潅流透析用カテーテル
(4) 実施例
本発明の実施例を図面により説明する。第１図
は本発明の実施例を示す側面図、第２図は同正面
図、第３図は第１図Ａ−A′線断面図、第４図は
第１図Ｂ−B′線断面図である。カテーテル本体
１は、例えばシリコーンゴムなどを用いて筒管状
に形成されるが、その先端に適宜の重さの金属球
又はセラミツク球１０を埋設した先端部２が設け
られ、該先端部２よりも少し基端側に屈曲部３が
形成されるとともに、屈曲部３よりも少し基端側
管壁にルーメンに達する複数の側孔４を穿設して
該側孔４を穿設した管壁の一部を螺旋状にした環
状部５が形成されている。(1) One or more metal or ceramic balls 10 are buried in the distal end 2, and a bent part 3 is formed a little closer to the proximal end than the distal end 2; A catheter for peritoneal perfusion dialysis (2), characterized in that a plurality of side holes 4 are bored and a part of the tube wall in which the side holes 4 are bored forms an annular part 5 in a spiral shape. One or more metal balls or ceramic balls 10 are embedded in the base, and a bent part 3 is formed slightly closer to the proximal end than the distal end part 2, and a plurality of side holes 4 are formed slightly closer to the proximal end than the bent part 3. A part of the tube wall in which the side hole 4 has been bored is formed into a spiral annular part 5, and one or more annular cuffs 6 are fitted a little closer to the proximal end than the annular part 5. (3) A catheter for peritoneal perfusion dialysis, characterized in that the annular cuff 6 is wholly or partially fixed to the catheter (4) Embodiment The present invention An example will be explained with reference to the drawings. Fig. 1 is a side view showing an embodiment of the present invention, Fig. 2 is a front view thereof, Fig. 3 is a sectional view taken along line A-A' in Fig. 1, and Fig. 4 is a sectional view taken along line B-B' in Fig. 1. It is a diagram. The catheter main body 1 is formed into a cylindrical shape using, for example, silicone rubber, and is provided with a distal end portion 2 in which a metal ball or ceramic ball 10 of an appropriate weight is embedded at the distal end. A bent portion 3 is formed slightly on the proximal side, and a plurality of side holes 4 reaching the lumen are bored in the tube wall slightly closer to the proximal end than the bent portion 3, and the side holes 4 are formed in the tube wall. An annular portion 5 having a partially spiral shape is formed.
前記屈曲部３は、カテーテル本体１の長手方向
に沿つて複数箇所ルーメンに達するまで切り、カ
テーテル本体１を正面方向（先端方向）から背面
方向へ押圧することにより形成される。 The bent portion 3 is formed by cutting the catheter body 1 at a plurality of locations along the longitudinal direction until reaching the lumen, and pressing the catheter body 1 from the front direction (distal direction) to the back direction.
もう一の発明の実施例は単数又は複数のカフ６
がカテーテル本体１に嵌着されている。該カフ６
は、カテーテル本体１と同質の材質の物を環状に
形成したカフ環９に例えばポリエステルをフエル
ト状とし、環状に形成して嵌合するか該フエルト
状物を巻き付けるなど適宜な方法で形成したフエ
ルト状環８を固着して成るが、その内径はカテー
テル本体１の外径と同一かやや小さめにし、カテ
ーテル本体１に嵌合する際には、カテーテル本体
１をその長手方向に引き延ばして細くして行う。
また、カフ６はカテーテル本体１に嵌着後にその
全部又は一部を固着して用いることも施術上適宜
に選択される。 Another embodiment of the invention includes one or more cuffs 6
is fitted into the catheter body 1. The cuff 6
The cuff ring 9 is made of the same material as the catheter body 1 and is formed into an annular shape, for example, by making polyester into a felt shape and fitting it into an annular shape, or by wrapping the felt material around it. The inner diameter of the ring 8 is the same as or slightly smaller than the outer diameter of the catheter body 1, and when it is fitted to the catheter body 1, the catheter body 1 is stretched in the longitudinal direction to make it thinner. conduct.
In addition, it is also possible to use the cuff 6 by fixing all or a part thereof to the catheter main body 1 after fitting it into the catheter body 1, as appropriate for the treatment.
なお、カテーテル本体１は、その壁中にＸ線造
影線７を埋設すれば、施術にあたりカテーテルの
挿入位置を確認できるので、これを設けることが
望ましい。 Note that it is desirable that the catheter body 1 has an X-ray contrast line 7 embedded in its wall so that the insertion position of the catheter can be confirmed during the treatment.
(5) 本発明の作用効果
腹膜潅流透析を行うには、これによる患者への
侵襲ができるだけ少ないことが望まれるが、本発
明によるカテーテルは、先端部２に適宜の重さの
金属球又はセラミツク球１０が埋設されているの
で、患者の腹腔内に経皮的に挿入する際その重さ
を利用してカテーテルの操作が容易になるし、ル
ーメンにガイドワイヤー又はスタイレツトを挿入
して屈曲部３を延ばすことができるので、患者の
腹壁を前記先端部２の径より大きく傷つける必要
がない（従つて、トラカールによる挿入が可能）
から侵襲を最小限に止めることができる。また、
カテーテルの挿入後ガイドワイヤー（スタイレツ
ト）を引き抜けば、その先端は前記先端部２の重
さと再び形成される屈曲部３によりダグラス窩に
固定留置され、腹腔内の上方に移動する恐れがな
いため、大網等が巻き付いて潅流液の注入及び代
謝産物を抽出した潅流液の排出を妨げることもな
くなるばかりでなく、もし先端部２がダグラス窩
より外れ、大網等がカテーテルに巻き付いた場合
でも、環状部５の内側の側孔まで塞がれてしまう
ことはないので、潅流液の注入及び代謝産物を抽
出した潅流液の排出を行うことができる二重の作
用効果を有する。(5) Effects of the present invention In order to perform peritoneal perfusion dialysis, it is desirable that the invasion to the patient be as little as possible. Since the bulb 10 is embedded, its weight makes it easier to operate the catheter when it is percutaneously inserted into the patient's abdominal cavity. can be extended, so there is no need to injure the patient's abdominal wall larger than the diameter of the tip 2 (therefore, insertion using a trocar is possible)
Invasion can be kept to a minimum. Also,
When the guide wire (stylet) is pulled out after insertion of the catheter, its tip is fixed in the Douglas fossa by the weight of the tip 2 and the re-formed bend 3, so there is no risk of it moving upward into the abdominal cavity. Not only does this prevent the omentum, etc. from wrapping around the catheter and impeding the injection of the perfusate and the discharge of the perfusate from which metabolites have been extracted, but also even if the tip 2 comes out of the Douglas fossa and the omentum, etc. wraps around the catheter. Since the side hole inside the annular portion 5 is not blocked, it has a dual effect of injecting the perfusate and discharging the perfusate from which metabolites have been extracted.
なお、カフ６は、カテーテル本体１に固着して
ある場合は勿論、嵌着しただけである場合でもカ
テーテル本体１をその長手方向に引き延ばさなけ
ればその位置を変えることはないので、カテーテ
ルを腹壁に固定すること及び細菌などの進入を阻
止する効果を有する。 Note that the cuff 6 will not change its position unless the catheter body 1 is stretched in its longitudinal direction, not only when it is fixed to the catheter body 1 but also when it is just fitted. It has the effect of fixing to the skin and preventing the entry of bacteria, etc.
第１図は本発明の実施例を示す側面図、第２図
は同正面図、第３図は第１図Ａ−A′線断面図、
第４図は第１図Ｂ−B′線断面図である。
１……カテーテル本体、２……先端部、３……
屈曲部、４……側孔、５……環状部、６……カ
フ、７……造影線、８……フエルト状環、９……
カフ環、１０……球。
FIG. 1 is a side view showing an embodiment of the present invention, FIG. 2 is a front view thereof, and FIG. 3 is a sectional view taken along the line A-A' in FIG. 1.
FIG. 4 is a sectional view taken along line B-B' in FIG. 1. 1... Catheter body, 2... Tip part, 3...
Bent part, 4... Side hole, 5... Annular part, 6... Cuff, 7... Contrast line, 8... Felt-shaped ring, 9...
Cuff ring, 10... ball.
Claims (1)
ラミツク球１０を埋設し、前記先端部２よりも少
し基端側に屈曲部３を形成するとともに、屈曲部
３よりも少し基端側に複数の側孔４を穿設して該
側孔４を穿設した管壁の一部を螺旋状にした環状
部５を形成したことを特徴とする腹膜潅流透析用
カテーテル。 ２ 先端部２に単数もしくは複数の金属球又はセ
ラミツク球１０を埋設し、前記先端部２よりも少
し基端側に屈曲部３を形成するとともに、屈曲部
３よりも少し基端側に複数の側孔４を穿設して該
側孔４を穿設した管壁の一部を螺旋状にした環状
部５を形成し、環状部５よりも少し基端側に環状
のカフ６を単数又は複数個嵌着したことを特徴と
する腹膜潅流透析用カテーテル。 ３ 前記環状のカフ６は、その全部又は一部がカ
テーテルに固着されていることを特徴とすル特許
請求の範囲第２項記載の腹膜潅流透析用カテーテ
ル。[Claims] 1. One or more metal balls or ceramic balls 10 are embedded in the distal end portion 2, and a bent portion 3 is formed a little closer to the proximal side than the distal end portion 2, and a bent portion 3 is formed slightly more proximally than the bent portion 3. A catheter for peritoneal perfusion dialysis, characterized in that a plurality of side holes 4 are bored on the proximal end side, and an annular portion 5 is formed by forming a part of the tube wall in which the side holes 4 are bored into a spiral shape. 2. One or more metal balls or ceramic balls 10 are buried in the distal end 2, and a bent part 3 is formed a little closer to the proximal end than the distal end 2, and a plurality of metal balls or ceramic balls 10 are embedded in the distal end 2. A side hole 4 is bored, and a part of the tube wall in which the side hole 4 is bored forms an annular part 5 in a spiral shape, and a single or annular cuff 6 is provided at a slightly proximal side of the annular part 5. A catheter for peritoneal perfusion dialysis, characterized in that a plurality of catheters are fitted. 3. The peritoneal perfusion dialysis catheter according to claim 2, wherein the annular cuff 6 is entirely or partially fixed to the catheter.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP61217633A JPS6371258A (en) | 1986-09-16 | 1986-09-16 | Peritoneal perfusion dialysis catheter |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP61217633A JPS6371258A (en) | 1986-09-16 | 1986-09-16 | Peritoneal perfusion dialysis catheter |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPS6371258A JPS6371258A (en) | 1988-03-31 |
| JPH0356061B2 true JPH0356061B2 (en) | 1991-08-27 |
Family
ID=16707324
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP61217633A Granted JPS6371258A (en) | 1986-09-16 | 1986-09-16 | Peritoneal perfusion dialysis catheter |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JPS6371258A (en) |
-
1986
- 1986-09-16 JP JP61217633A patent/JPS6371258A/en active Granted
Also Published As
| Publication number | Publication date |
|---|---|
| JPS6371258A (en) | 1988-03-31 |
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