介入治疗导管表面润滑处理研究

介绍了一种用于介入治疗导管表面润滑处理的方法。对润滑涂层的作用原理、涂覆工艺等进行了论述，并讨论了用于润滑处理的聚合物、溶剂的选择及润滑处理后介入治疗导管表面摩擦系数的变化情况。通过生物安全性试验和临床试用，证明了本方法是安全可靠的。     

PVP在医用导管表面润滑处理中的应用研究

采用特殊工艺在普通医用导管表面结合上一层医用高分子材料 -聚乙烯吡咯烷酮 ( PVP) ,使导管遇水后具有极为润滑的表面 ,摩擦系数仅为普通导管的百分之一左右 ,而且润滑性持久 ;生物实验表明这种经 PVP表面润滑处理的导管具有良好的生物相容性 ,临床应用也取得满意效果     

小儿先天性心脏病介入治疗的围手术期护理

随着人们对介入治疗认识的提高及对其诊治方法的接受，以及新器械不断地涌现，经导管介入治疗小儿先天性心脏病已成为较成熟的技术。大部分小儿先天性心脏病如：动脉导管未闭（PDA）、房间隔缺损（ASD）、室间隔缺损（VSD）等，均可替代外科开胸手术，即刻疗效显著，且避免了外科术后瘢痕问题。它具有并发症少、创伤小、恢复快、患者痛苦小、住院时间短及皮肤完整性美观等优点。     

老年原发性肝癌患者介入治疗前后微循环的变化

目的 研究20例老年肝癌患者经导管化疗栓塞（TACE）治疗前后微循环的变化。方法 将导管经股动脉插入肿瘤区供血动脉进行药物灌注。结果 介入治疗后管襻模糊增，红细胞聚集、微血栓增多（P＜0．05），血浆粘度增加。结论 化疗药物冲击治疗对肝细胞功能、对微血管内皮细胞和血细胞的损害是介入治疗后微循环改变主要原因之一，所以介入治疗后改善肝癌患者微循环、增加血流量、加快血流速度、降低血液粘度，不同程度延缓并控制肿癌转移，延长患者生命有一定意义。     

盐酸丁卡因胶浆(利宁)涂抹气管导管的效果观察

观察全身麻醉时,将盐酸丁卡因胶浆(利宁)涂抹在气管导管表面,特别是气管导管套囊到导管口部位.局麻药丁卡因或高浓度利多卡因喷喉可减少因气管插管刺激引起的呛咳、屏气等呼吸扰乱和不良应激,增加麻醉和手术的安全性[1],但丁卡因及高浓度利多卡因喷喉不能作用到气管表面,盐酸丁卡因胶浆(利宁)含局麻药丁卡因,被广泛应用于胃镜检查及妇产科和泌尿外科等的腔道表面麻醉,因此,我们将盐酸丁卡因胶浆(利宁)涂抹气管导管行气管表面粘膜麻醉同时又可起润滑作用     

特殊类型房间隔缺损的介入治疗

房间隔缺损（atrial septal defect，ASD）经导管封堵治疗是一项新技术，因其创伤小、恢复快及安全有效而被临床医师及患者普遍接受。近年来，随着先心病介入治疗器材的不断改进及介入治疗技术的提高，经导管封堵ASD的适应证不断拓宽，许多特殊类型的ASD（如巨大型ASD、短残边ASD、多孔型ASD、伴房间隔瘤ASD及合并其他心脏畸形的ASD等）均可通过介入治疗手段获得根治。本文仅就上述特殊类型ASD的介入治疗操作技巧及注意事项作一介绍。     

小儿先天性心脏病介入治疗手术73例临床分析

目的评价介入治疗手术在小儿先天性心脏病治疗中的价值。方法总结我院近五年来73例经导管介入治疗的先天性心脏病患儿。其中动脉导管未闭（PDA）35例,继发孔房间隔缺损（ASD）30例,室间隔缺损（VSD）5例,肺动脉辨狭窄（PS）3例。应用AGA Amplatzer封堵器、国产封堵器及球囊扩张导管。结果成功率为100％,术后随访3月-2年,无不良并发症。结论经导管介入治疗小儿先天性心脏病安全,有效,创伤小,操作简单,住院时间短,是一项有发展前景的治疗方法。     

用一种生物相容的扩散膜作为经静脉测氧传感器

本文作者提出一种导管式氧传感器。其表面涂有各种具有扩散膜性质的聚合物。象电位梯度和时间响应实验这样的电化学技术已广泛地应用于评价经血液相容性涂层处理或非处理的各种扩散膜的特性。扫描电子量微镜则广泛用于评价相同膜电极的形态问题。作者对采用聚氨脂膜的各种导管传感器进行了体外和体内的评价。体内研究表明,在生理     

杆管柱力学在医学中的应用前景

介入医学是依靠医学影像设备的引导,利用穿刺和导管技术对疾病进行诊断和治疗并以治疗为主的一门学科,是一门独立于内、外科的新兴医学学科,国家正式命名为第三大诊疗技术。介入治疗包括血管性介入治疗和非血管性介入治疗。血管性介入治疗的关键部分是导管和导丝在血管中的作业。通过比较发现,导管和导丝在血管中的作业过程与油气井杆管柱在井筒中的作业过程十分相似。油气井杆管柱力学是在石油工程领域较系统、成熟的力学理论体系。本文主要引述了其中的拉力—扭矩模型,并应用定向井钻柱力学分析软件对模拟血管中导管作业进行了力学分析。     

关节软骨润滑机制理论及仿生软骨材料的摩擦学应用

背景：关节软骨拥有着自然界中已知最有效的润滑,如膝关节和髋关节等,在生理性高压下,其表面摩擦系数低至0.001,如此低的摩擦对于关节正常活动来说非常必要。而软骨一旦发生退化,便易发生骨关节炎,因此探究软骨表面如此高效的润滑机制便显得尤为重要。同时,随着对关节润滑机制研究的深入,仿生软骨材料的飞速发展也为关节软骨之间的润滑及软骨损伤后的治疗带来了希望。目的：探讨关节软骨润滑机制以及仿生软骨材料摩擦学最新研究进展。方法：采用计算机检索中国知网、PubMed、Semantic Scholar、ScienceDirect和Wiley Online Library数据库中有关关节软骨润滑机制和仿生软骨材料的相关研究资料,根据纳入和排除标准,最终共选取60篇文献进行综述。结果与结论：(1)关节软骨的润滑并不是通过单一的机制,而是多种机制共同参与并实现高效润滑。(2)目前软骨润滑机制的主要研究聚焦于边界润滑以及水合润滑。(3)软骨润滑的边界润滑机制模型主要通过透明质酸、润滑素和磷酸酰胆碱等边界分子实现。(4)软骨间多重分子通过协同作用促进软骨润滑,这也为仿生软骨材料的设计提供了一种新思路。(5)用于...     

超滑导尿管润滑涂层性能研究

采用特殊工艺在普通导尿管的表面结合上一层医用高分子材料一聚乙烯吡咯烷酮,使导尿管遇水后具有极为润滑的表面。本文对超滑导尿管的润滑性能进行了研究。实验结果表明：这种超滑导尿管具有非常好的润滑性,摩擦系数仅为普通导尿管的百分之一左右;在水中浸泡１０ 天以上,其摩擦系数无改变,润滑涂层的脱落量不超过附着量的１ ．５％ ,润滑稳定性良好。     

Preparation and evaluation of a lubricious treated cartridge used for implantation of intraocular lenses

In the last decades, many surface modification technologies have been developed in an attempt to improve the function of medical device surfaces by adding or enhancing surface characteristics. These value-added processes included treatment to affect lubricity, hemocompatibility and drug delivery. A unique hydrophilic, lubricious coating was developed to treat hydrophobic polymer surfaces. The coating platforms described are composed of a polyelectrolyte molecular film containing hydrophilic, lubricant molecules. The molecular film is then further cross-linked with di-functional aldehyde molecules to form an interpenetrating network (IPN). The IPN entraps lubricant molecules in the matrix and provides for prolonged stability of the lubricity. This coating was applied to cartridges which were used to deliver intraocular lenses (IOLs) that replaced the cataractous crystalline lenses in patients In order to determine the safety and effectiveness of the coating, a rabbit in vivo study was designed to evaluate the ease of implantation and postoperative response to implantation of the foldable acrylic IOLs. The performance evaluation of the lubricious treated cartridges focused on the ease of insertion and post-IOL implantation response. It was found that the UNFOLDER Emerald Insertion System (Advanced Medical Optics) with lubricious treated cartridges generally required lower insertion forces than the standard UNFOLDER Emerald cartridges. The postoperative inflammatory response following lens extraction and posterior chamber implantation of low (6D), medium (20D) and high (30D) diopter foldable acrylic IOLs with both treated and standard cartridges was mild. Inflammation generally resolved by 3 weeks. Thus, in this animal study, the coating was shown to be effective in assisting the delivery of IOLs through cartridges, without causing any adverse effects.     

Preparation and evaluation of a lubricious treated cartridge used for implantation of intraocular lenses

In the last decades, many surface modification technologies have been developed in an attempt to improve the function of medical device surfaces by adding or enhancing surface characteristics. These value-added processes included treatment to affect lubricity, hemocompatibility and drug delivery. A unique hydrophilic, lubricious coating was developed to treat hydrophobic polymer surfaces. The coating platforms described are composed of a polyelectrolyte molecular film containing hydrophilic, lubricant molecules. The molecular film is then further cross-linked with di-functional aldehyde molecules to form an interpenetrating network (IPN). The IPN entraps lubricant molecules in the matrix and provides for prolonged stability of the lubricity. This coating was applied to cartridges which were used to deliver intraocular lenses (IOLs) that replaced the cataractous crystalline lenses in patients In order to determine the safety and effectiveness of the coating, a rabbit in vivo study was designed to evaluate the ease of implantation and postoperative response to implantation of the foldable acrylic IOLs. The performance evaluation of the lubricious treated cartridges focused on the ease of insertion and post-IOL implantation response. It was found that the UNFOLDER^? Emerald Insertion System (Advanced Medical Optics) with lubricious treated cartridges generally required lower insertion forces than the standard UNFOLDER^? Emerald cartridges. The postoperative inflammatory response following lens extraction and posterior chamber implantation of low (6D), medium (20D) and high (30D) diopter foldable acrylic IOLs with both treated and standard cartridges was mild. Inflammation generally resolved by 3 weeks. Thus, in this animal study, the coating was shown to be effective in assisting the delivery of IOLs through cartridges, without causing any adverse effects.     

Chitosan/poly(vinyl alcohol) blending hydrogel coating improves the surface characteristics of segmented polyurethane urethral catheters

Segmented polyurethane (SPU) is commonly used to manufacture urethral catheters. Surface modifications for SPU catheters are needed to reduce friction and protein adsorption, in order to minimize catheter-related complications, including urethral trauma, encrustation, catheter obstruction, bacterial colonization, and infection. In this study, a four-step surface modification method was developed to create a thin lubricious layer of chitosan/poly(vinyl alcohol) (PVA) hydrogel on the SPU catheter. Modification steps included oxidation of the SPU surface, functionalities modification, carbodiimide reaction and coupling, and hydrogel crosslinking. The success of each modification step was confirmed by Fourier transform infrared spectroscopy. Measurement of the water contact angle revealed that hydrogel coating created a highly hydrophilic surface and atomic force microscope analyses demonstrated that the surface was slippery. Protein absorption of the SPU catheter was significantly reduced by coating hydrogel. Chitosan in the hydrogel could provide antimicrobial activity, and the hydrogel coating SPU samples showed significant antibacterial effects in this study. In summary, the four-step modification method developed in this study provided a simple and effective way to coat the surface of SPU catheters with a chitosan/PVA blending hydrogel that could help to minimize the risk of complications related to the use of urethral catheters.     

Heparin release from slippery-when-wet guide wires for intravascular use

Thin metallic wires with an adherent hydrophilic/ lubricious polymeric coating were manufactured in a new extrusion-like procedure. This procedure is part of a novel and efficient way of assembling lubricious guide wires for intravascular interventions, such as percutaneous transluminal angioplasty. It is reported that heparin can readily be incorporated in the hydrophilic coating. A set of heparin-containing guidewire models was made and studied in detail. This showed that (i). immersion of the guide-wire models in an aqueous environment leads to release of heparin from their surface; (ii). the presence of heparin in the coating does not impede the lubricity of the coils; (iii). addition of stearic acid in the coating, next to heparin, does not influence the lubricity of the guide-wire models. Two different charges of heparin (designated heparin-low and heparin-high) were incorporated in the coating. It is discussed that release of heparin from the surface of medical devices (e.g. guide wires and catheters) is much more effective than systemic heparinization, basically because dissolved heparin molecules have a much larger probability of simply passing a medical device's surface (axial convection) rather than contacting it (radial diffusion).     

Metallic wires with an adherent lubricious and blood-compatible polymeric coating and their use in the manufacture of novel slippery-when-wet guidewires: possible applications related to controlled local drug delivery

A new procedure was developed for the controlled application of adherent hydrophilic and biocompatible coatings onto the surface of "endless" metallic wires. Use of copolymers of 1-vinyl-2-pyrrolidinone and alkylmethacrylates provided coatings with excellent adherence and lubricity, and markedly low thrombogenicity. Coated wires could be spiralized without damaging the coating; the resulting coils are potentially useful as lubricious guidewires for use in, for example, interventional cardiology or urology. This study demonstrates that the lubricity of the coating is dependent on the composition (hydrophilicity) of the coating biomaterial, as well as on the thickness of the coating. Furthermore, the results imply that the adherence of the hydrophilic coating is essentially due to entanglement of the binder polymer chains and the hydrophilic copolymer chains. Moreover, the idea to use the hydrophilic coating on the wire as a temporary depot for controlled local drug delivery was explored. The coating was loaded with the dye rhodamine, and release of the dye upon immersion of the coated wire in water was studied. This work revealed that release of the drug is dependent on the composition of the coating. The potential utility of such wires with a drug-charged coating for controlled local drug delivery is discussed briefly.     

Antibacterial coating on in-line suction respiratory catheter to inhibit the bacterial biofilm formation using renewable cardanyl methacrylate copolymer

Health-care materials associated with infections are very common in hospital admitted patients. There are generally infected by contact with the catheter or other multipurpose devices which are contacted with microbes. The respiratory infections associated with the pathogens having strong biofilm forming ability on catheter surface, causes life-threatening in every year. Therefore, a catheter coating material is of great interest which inhibits the biofilm formation of pathogens on a catheter to prevent respiratory infections. In this study, we synthesized cardanol containing copolymers as antimicrobial healthcare material via radical polymerization of cardanyl methacrylate (CMA) with styrene (St) monomer in presence of free radical initiator. The rate of polymerization was drastically reduced with the increase of feeding CMA monomer in copolymer. The thermal and mechanical properties were found to increase with incorporation of cardanol moiety in brittle and hard polystyrene. This soft copolymer was grafted onto polyvinyl chloride respiratory catheter which showed high antibacterial activity, inhibit the biofilm formation and also prevent bacterial adhesion. Therefore, the developed coating material on respiratory catheter surface is effective way to control the respiratory catheter-associated nosocomial infections.     

Prolonged catheter survival in intermittent hemodialysis using a less thrombogenic micropatterned polymer modification

Adequate vascular access is a major prerequisite for hemodialysis treatment. Catheter related complications, in particular thrombus formation, are frequent, difficult to handle, and cost intensive. We investigated whether a new surface modified catheter containing a microdomain structure is beneficial for catheter survival. Surface thrombogenicity of standard double lumen catheters (STD-DC) and surface modified film-coated domain structured double lumen catheters (FCDS-DC) consisting of a novel reactive polyurethane copolymer coating was assessed by measurement of thrombinantithrombin (TAT) III complex in vitro. Furthermore, in a randomized observational study with 20 patients on hemodialysis, we analyzed catheter survival of either STD-DC (GamCath GDK 11 French, length 12.5 or 15 cm) or FCDS-DC (GamCath Dolphin GDK 11 French, length 12.5 or 15 cm). Catheter care protocol was identical, and dialysis treatment parameters were kept constant in both groups. In vitro measured surface thrombogenicity was reduced in the modified catheter compared with standard catheter. The clinical investigation revealed that both number of days before catheter removal according to clinical requirements and number of treatments per catheter were significantly higher with the modified catheter as compared with the standard catheter (14.5 vs. 10.3 days; 7 vs. 4 treatments; p < 0.03, Fisher-Yates test). Micropatterned surface coating with a polyurethane polymer significantly increased catheter survival and the number of treatments per catheter.     

A novel ultra high molecular weight polyethylene-hyaluronan microcomposite for use in total joint replacements. I. Synthesis and physical/chemical characterization

A novel microcomposite between ultra high molecular weight polyethylene (UHMWPE) and hyaluronan (HA) was developed to create a hydrophilic and lubricious UHMWPE surface for total joint replacement and other biomedical load-bearing applications. Preforms with interconnected micropores were used as the UHMWPE starting material to form a microcomposite with HA, rather than starting with fully dense, bulk UHMWPE. HA was silylated first to increase its hydrophobicity and compatibility with UHMWPE. The silylated groups were removed through hydrolysis prior to final compression molding. A uniform and enzymatic degradation resistant HA film layer was produced on the microcomposite surface, which quickly hydrated in water, forming a lubricious surface film that was fully wetted by water drops during contact angle measurements. Presence of HA film on the composite surface was also demonstrated through X-ray photoelectron spectroscopy analysis and Toluidine Blue O dye assay. The mechanical and tribological properties evaluation of the novel microcomposites are presented in Part II.     

介入医学栓塞材料

分类叙述了目前常用的几种介入医学栓塞材料 ,并对理想的栓塞材料及栓塞材料的发展方向进行了探讨。