The present disclosure relates to medical devices, and more particularly, to an esophagus PH-myoelectricity combined electrode catheter.
Gastroesophageal reflux is mainly acidic reflux, which can be manifested as acid reflux, heartburn, retrosternal pain, chronic cough, etc. The main causes for gastroesophageal reflux include dysfunction of lower esophageal sphincter, weakened contraction of the diaphragmatic crura, and decreased esophageal peristalsis. Theoretically, diaphragm disfunction may lead to weakened contraction of the diaphragmatic crura and reduced pressure of lower esophageal sphincter, thus resulting in gastroesophageal reflux. However, at present, there is no single catheter that enables simultaneously accurate detection of diaphragm functions and diagnosis of gastroesophageal reflux in clinical practice.
24-hour esophagus PH monitoring is a method for detecting the presence of gastroesophageal reflux. The accurate placement of an esophagus PH electrode catheter is critical for correct diagnosis. It is desirable that a proximal PH electrode be placed 5 cm away from a proximal edge of the lower esophageal sphincter. The current methods for catheter placement in clinical practice are based on manometry and pH gradient along the esophagus.
The esophagus manometry is based on a high-pressure zone created by the the lower esophageal sphincter. The high-pressure zone is a major barrier for gastroesophageal reflux. The manometry usually requires placement of two catheters, increasing the discomfort of the patient. Moreover, the equipment required for manometry is relatively complex and costly. In addition, most patients with gastroesophageal reflux the high-pressure zones of lower esophageal sphincter has been destructed, leading to difficult in accurate placement of the PH electrode catheter.
In the pH gradient method, electrodes are placed based on the differences in pH values between the stomach and the esophagus. However, in patients with hyperchlorhydria or hypochlorhydria, the PH gradients may disappear along the esophagus and the stomach, which affects localization.
The esophagus manometry and the PH gradient method described above are subject to changes in many factors, which interfere correct placement of the catheter leading to difficulty in judgment of gastroesophageal reflux and diaphragm functions.
The aims of the invention are to overcome the above disadvantages in placement of catheter to provide an esophagus PH-myoelectricity combined electrode catheter for detection of gastroesophageal reflux and diaphragm function simultaneously. The catheter can be easily located to the proper place for detection of diaphragm functions, which is useful to discover the potential cause of gastroesophageal reflux.
The object of the present disclosure is achieved by the following technical solution. The esophagus PH-myoelectricity combined electrode catheter includes a catheter body, the PH sensor wires, and the diaphragm electrode wires. There are two PH sensors, a multipair diaphragm EMG electrodes, and a reference electrode which are attached on the surface of the catheter body. The two PH sensors are arranged at the distal end and the middle part of the catheter while the multipair diaphragm EMG recording electrodes are all located between the two PH sensors. The reference electrode is located at the proximal part of the catheter near to the proximal PH sensor. The two PH sensors are separately connected to two different PH wires inside the catheter. The signal output detected by PH sensors is passed to PH processor through the PH wires. The reference electrode and the multipair diaphragm EMG recording electrodes are all connected to the wires inside the catheter and are further connected to a bio-amplifier.
Preferably, there are five electrodes for recording diaphragm EMG with an equal distance between two adjacent electrodes. The gap between the distal PH sensor and the most distal electrode for recording diaphragm EMG is greater than 5 cm while the gap is equal to 5 cm between the proximal PH sensor and the electrode for recording diaphragm EMG located at the middle position.
Preferably, the distance between two adjacent electrodes for recording diaphragm EMG is 1 cm.
Preferably, the five electrodes for recording diaphragm EMG form three pairs of electrodes which are the same in terms of distance between electrodes within a pair. There is one electrode which is a common electrode for two pairs of electrodes.
Preferably, the electrodes for recording diaphragm EMG including the reference electrode are all 1 cm in length.
Preferably, the two PH sensors are both less than 1 cm in length.
Preferably, the distal end of the catheter is sealed with a cap and the proximal end of the catheter have connectors which connect wires for PH sensors and the electrodes for recording multiopair diaphragm EMG respectively.
Compared with the prior work, the present disclosure has the following advantages.
1. The esophagus PH-myoelectricity combined catheter integrates the electrodes for recording diaphragm EMG and PH sensors which can simultaneously detect the diaphragm EMG and the PH value in the stomach and in the esophagus. The catheter can not only be accurately placed at the lower esophageal sphincter to adjudge whether there is gastroesophageal reflux, but also accurately record the diaphragm myoelectricity, which is helpful to disclose the cause of gastroesophageal reflux.
2. The esophagus PH-myoelectricity combined catheter does not require placement of two catheters which is needed in traditional way for diagnosis of gastroesophageal reflux, thereby simplifying the procedure for placement of the catheter, reducing the examination cost, and reducing the discomfort of patients.
In the drawing, 1 and 2 are PH sensors located at the end and the middle of the catheter, respectively. 3-7 are electrodes for diaphragm EMG recording. 8 is a reference electrode connecting to the earth. 9 is a catheter body, 10 is a bifurcated head, 11 PH sensor wires extension, 12 extension wires for recording diaphragm EMG, 13 is a PH processor connector, 14 bio-amplifier connector, 15 sealed cap, and I, II, and III are three pairs of electrodes for recording diaphragm EMG.
The present disclosure is described in further detail below with reference to the accompanying drawings and embodiments.
As shown in
Both PH sensors (PH 1 and PH 2) are 0.5 cm in length. The PH sensor 1 is close to the sealed cap at the distal end of the catheter. The PH sensor 1 is designed to detect the PH value in the stomach. When the catheter is in correct position for detection of gastroesophageal reflux, the PH 2 is placed 5 cm away from a proximal edge of the lower esophageal sphincter.
There are five diaphragm EMG electrodes which have an equal distance between two adjacent electrodes. The distance between PH 1 and the distal electrode for EMG recording is larger than 5 cm while the electrode 5 for EMG recording and the PH 2 sensor is 5 cm. The electrodes 3-7 and the reference electrode 8 for recording diaphragm EMG are all 1 cm in length. The distance between two adjacent electrodes for recording diaphragm EMG is 1 cm in length.
The five electrodes for recording diaphragm EMG form three pairs of electrodes which are exact the same in terms of the distance between electrodes within a pair. One electrode (electrode 5) is the common electrode for pair I (electrodes 1 and 5) and pair III (electrode 5 and 7). To position catheter to the gastric-esophagus properly, operator observe diaphragm EMG signals simultaneously recorded from three pairs of electrodes (pairs I, II and III). When pair I and pair III record signal with a similar amplitude but much larger than that recorded by the lead II, indicating that the electrode 5 for recording diaphragm EMG is at the level of esophageal sphincter. Consequently, the PH sensor 2 is at proximal 5 cm from the esophageal sphincter. Under the placement, the pair II record small diaphragm EMG because electrical potentials detected by electrodes 4 and 6 are almost equal and are cancellated. By measuring and analyzing the diaphragm EMG recorded from the esophagus PH-myoelectricity combined electrode catheter, the diaphragm functions can be assessed, which is helpful to find the potential cause of gastroesophageal reflux.
The distal end of the catheter is sealed with a cap, the proximal end of the catheter is designed to have a bifurcated head for connecting to PH processor and a bio-amplifier
The specific embodiments described above are preferred embodiments of the present disclosure, without limiting the present disclosure. Any other variations or other equivalent substitutes made without departing from the technical solution of the present disclosure shall be included in the protection scope of the present disclosure.
Number | Date | Country | Kind |
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202010424512.6 | May 2020 | CN | national |
Filing Document | Filing Date | Country | Kind |
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PCT/CN2020/136448 | 12/15/2020 | WO |