CN1014956B - 人工心包 - Google Patents

人工心包

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Publication number
CN1014956B
CN1014956B CN88101678A CN88101678A CN1014956B CN 1014956 B CN1014956 B CN 1014956B CN 88101678 A CN88101678 A CN 88101678A CN 88101678 A CN88101678 A CN 88101678A CN 1014956 B CN1014956 B CN 1014956B
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CN
China
Prior art keywords
tubule
foreskin
pericardium
heart
artificial
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Expired
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CN88101678A
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English (en)
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CN88101678A (zh
Inventor
雅罗斯拉夫·彼得洛维奇·库里克
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BLAGOVESCHENSKY GOSUDARSTVENNY MEDITSINSKY INST
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BLAGOVESCHENSKY GOSUDARSTVENNY MEDITSINSKY INST
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Publication of CN88101678A publication Critical patent/CN88101678A/zh
Publication of CN1014956B publication Critical patent/CN1014956B/zh
Expired legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2478—Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
    • A61F2/2481—Devices outside the heart wall, e.g. bags, strips or bands
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/10—Location thereof with respect to the patient's body
    • A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
    • A61M60/165—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable in, on, or around the heart
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/20—Type thereof
    • A61M60/247—Positive displacement blood pumps
    • A61M60/253—Positive displacement blood pumps including a displacement member directly acting on the blood
    • A61M60/268—Positive displacement blood pumps including a displacement member directly acting on the blood the displacement member being flexible, e.g. membranes, diaphragms or bladders

Abstract

人工心包，包括一个8字形薄片包皮(1)和将包皮固定于心脏的装置。此固定装置包括沿包皮(1)的轮廓设置的导向槽(5)，位于槽(5)中的弹性细管(6)和位于细管(6)中的弹性绳(7)。包皮(1)上可装有固定器(10)，用以固定心脏起搏器的体内电极(11)。

Description

本发明属于医学领域的人工器官，更准确地说是涉及人工心包。
本发明应用于心脏手术，用以在手术恢复期以后防止在心脏和自然心包之间产生粘连过程。
已知一种人工心包“Pery-Juard”，这是一个由公牛的自然心包生物组织制成的长方形碎片，经过加工处理使其失去抗原性。
在心脏手术之后，用这种人工心包以补绽的形式将自然心包的缺损部分封合。但是，在这种情况下补绽不能复盖整个心脏，因而就可能产生粘连。此外，人工“公牛”心包的异体组织可被机体分离，形成钙质沉着。
还有另一种人工心包，它有一个根据心脏的大小用生物学中性的弹性材料制作的包皮，上面有能将包皮固定在心脏上的装置（参见SU，A，1009457）。
此包皮具有心脏的形状，并能从心底那一面打开。在此包皮的整个表面上有许多通孔。将这种人工心包固定于心脏的装置，是在包皮敞开端一方的一种带状物。心脏手术以后，将心脏放入人工心包包皮的腔体内，并用穿过横向槽的带状物包住主动脉弓，将带状物的端头缝到包皮的边上。经过上述操作以后，人工心包的包皮就能可靠地固定于心脏，并将心脏的整个表面包住，而在心脏的外表面和人工心包的内表面之间形成中间位置，从而避免了在它们之间产生粘连。通孔保证了心脏表面和心包腔体之间自由地液体-生物交换，在心包的腔体中有浆液，以保证心脏收缩时侧壁的滑动。
这种结构的人工心包，必须根据心脏的大小进行选择，因此为了挑选最佳方案，需要大量标准尺寸的心包。利用把带状物缝到包皮上的方法将人工心包固定于心脏，这对于跳动的心脏是很不方便的。此外，在手术之后恢复时期结束时，为了取出这个人工心包，需要切开胸廓，这就增加了手术造成的创伤，会使心包液流出。
本发明的基础是研制一种人工心包结构，这种结构能使得在取出心包时不需切开胸廓，从而可减少手术的创伤，并可防止心包液从自然心包腔体中流出，使得更加通用，使用起来更方便。
本发明的目的在于保证不切开胸廓而能将人工心包取出。
第二个目的是在取出人工心包时，防止心包液从自然心包腔体中流出。
第三个目的是提高人工心包的通用性。
第四个目的是使人工心包使用更方便。
本发明的实质在于，此人工心包有一个用生物学中性的弹性材料按心脏大小制成的包皮，包皮上有将其固定于心脏上的装置，按照本发明的包皮做成一个8字形薄片，薄片的一个椭园体的面积大于另一个，在其顶部有一个舌状的突起。固定包皮的装置是沿薄片轮廓做的导向槽、能沿此导向槽作往复移动并由弹性材料制成的细管和置于该细管内的能相对细管作往复移动的弹性绳，在这种情况下，细管和绳的端头在突起一方由导向槽中伸出去。
为了便于取出人工心包，最好将细管做成等长度的两部分，绳也是由两部分组成，一部分稍短，而另一部分稍长，稍长的长度与那一部分细管的长度相同。
在薄片上最好装有固定器，用以固定心脏起搏器的体内电极。
按照本发明制作的人工心包，勿须切开胸廓就能取出，只须经过自然心包上部一个不足5mm的伤口，皮肤割开5～6mm长。在这种情况下，心脏及其周围的组织不会受到损伤，其中包括自然心包的组织，因此浆液就不会从自然心包腔体中流出。
本发明的人工心包不需要仔细挑选其尺寸，比较通用，使用方便，为将其固定于心脏不需要叠上固定用的接缝。
下面将参照附图及描述本发明的实施例加以说明，其中，
图1表示本发明所述人工心包的俯视图;
图2如同图1，是将人工心包固定于心脏时位置的侧视图;
图3如同图1，人工心包处在无菌包装盒中;
图4为沿图3Ⅳ-Ⅳ的剖面图;
图5为根据本发明的心脏和人工心包位于自然心包腔体内的情况，等比例图。
图1所示的人工心包，包括一个由生物学中性的弹性材料（例如聚氨酯）制成的包皮1和将包皮1固定于心脏的装置。包皮1是一个8字形薄片，薄片的一体椭圆体2的面积大于另一个椭圆体3。椭圆体2的顶部做成舌状突起4。固定装置包括沿薄片轮廓设置的导向槽5和由弹性材料（例如聚氨酯）做成的细管6，细管6置于导向槽5中并能沿槽5的轴线作往复移动。固定装置还包括弹性绳7，该弹性绳置于细管6内，并能相对细管6作往复移动。导向槽5由若干独立的区段构成，这些区段沿薄片轮廓的长度分布，当然也可以将导向槽5沿薄片轮廓的全长做成连续的。通常，导向槽5用与包皮1同样的材料制作。在所述人工心包的实施例中，细管6是由长度相同的两部分6′及6″构成的，它们的端部在小椭圆体3顶部的点8处互相邻 接。弹性绳7是由长度不同的两部分7′及7″构成，7′稍短，另一部分稍长，稍长的长度与细管6的6′在那部分的长度相同。这样一来，绳7的两个部分7′和7″的端头在细管6的6′部分内的点9处互相邻接。细管6和绳7的另一端头则从舌形突起4的一方伸出导向槽5，伸在包皮1的界外。此外，在包皮1的表面上装有固定器10，固定有心脏起搏器的体内电极11。固定器10做成短槽的形状，它的横切面与体内电极11的直径成比例，用聚氨酯薄膜制作并固定在包皮1的表面上。
手术以前，本发明的人工心包保存在无菌的密封包装盒12中（图3，4）。
本发明的人工心包使用方法如下：
在心脏矫正手术完成以后自然心包密闭缝合之前，将人工心包从无菌包装盒12中（图3）取出，垫在心脏后表面的下面直到小椭圆体3的底部（图1、2），而用大椭圆体2从前面将心脏的整个表面和部分血管盖上。这时人工心包位于图2所示的位置。然后将自然心包严密缝合，只在上部留一个不足5mm的伤口，将人工心包的舌形突起4（图5）以及细管6和绳7的端头从心脏上部5mm伤口处引出，置于皮下，然后将皮肤缝合。过10～12天以后，在人工心包舌形突起4的上方将皮肤切开5～6mm。将细管6和弹性绳7的端头以及舌形突起4从切口中引出。此后依次拿掉绳7的两部分7′和7″，然后是细管6的两部分6′和6″，并通过舌形突起4拿掉人工心包的包皮1。
使用本发明的人工心包，勿须切开胸廓就能将其取出，人工心包的构造使得不需要仔细挑选它的尺寸。取出人工心包时不会损伤心脏 及其周围的组织。按照本发明安放心包时，在心脏中固定不需要附加操作，而在取出时心包液不会从自然心包的腔体中流出。

Claims (3)

1、一种人工心包，有一个用生物学中性的弹性材料按心脏大小制成的包皮(1)，包皮上有将其固定于心脏的装置，这种人工心包的特征在于：包皮(1)是8字形薄片，薄片的一个椭圆体(2)比另一个椭圆体的面积大，在椭圆体(2)的顶部有舌形突起(4)，而固定装置包括沿薄片轮廓作出的导向槽(5)和置于该导向槽中由弹性材料制成并能作往复移动的细管(6)，以及置于细管(6)中并能相对其作往复移动的弹性绳(7)，同时细管(6)和绳(7)的端头在薄片的突起一方从导向槽中伸出去。
2、根据权利要求1所述的人工心包，其特征在于，细管（6）由相等长度的两部分（6′和6″）构成，而绳（7）也是由两部分（7′和7″）构成的，其中一部分稍短，另一部分稍长，长出的量与细管（6）中（6′）的那一部分长度相同。
3、根据权利要求1或2所述的人工心包，其特征在于，薄片上装有固定器（10），用以固定心脏起搏器的体内电极（11）。
CN88101678A 1987-02-23 1988-02-23 人工心包 Expired CN1014956B (zh)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SU874197835A SU1604377A1 (ru) 1987-02-23 1987-02-23 Искусственный перикард
SU4197835 1987-02-23

Publications (2)

Publication Number Publication Date
CN88101678A CN88101678A (zh) 1988-09-07
CN1014956B true CN1014956B (zh) 1991-12-04

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US (1) US4936857A (zh)
EP (1) EP0303719A4 (zh)
JP (1) JPH01502405A (zh)
CN (1) CN1014956B (zh)
SU (1) SU1604377A1 (zh)
WO (1) WO1988006027A1 (zh)

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EP0303719A4 (de) 1990-02-20
US4936857A (en) 1990-06-26
WO1988006027A1 (en) 1988-08-25
CN88101678A (zh) 1988-09-07
SU1604377A1 (ru) 1990-11-07
EP0303719A1 (de) 1989-02-22

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