CN1216911A - 用于治疗气道阻塞的方法和装置 - Google Patents

用于治疗气道阻塞的方法和装置 Download PDF

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CN1216911A
CN1216911A CN97194323A CN97194323A CN1216911A CN 1216911 A CN1216911 A CN 1216911A CN 97194323 A CN97194323 A CN 97194323A CN 97194323 A CN97194323 A CN 97194323A CN 1216911 A CN1216911 A CN 1216911A
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tongue
electrode assembly
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斯图尔特·D·爱德华兹
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Somnus Medical Technologies Inc
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Abstract

一种减小选择部分的舌体积的装置。它包括一个导管装置。电极装置至少一部分位于导管装置的内部。电极装置用来传送足够的电磁能,用以摘除舌的内部,而不损伤舌下神经。电极进入和退出装置与电极装置耦合,从而在选择的舌表面推进、退出至少一部分电极装置。电缆装置与电极装置耦合。

Description

用于治疗气道阻塞的方法和装置
相关申请的相关参照
本申请是标题为“Method for Treatment of Airway Obstructions”、申请日为1996年2月23日的美国专利申请08/606,195的部分续展申请。该美国专利申请08/606,195参照的是标题为“Ablation Apparatus and System for Removal of SoftPalate Tissue”、申请日为1995年8月18日的美国专利申请08/516,781，该专利申请08/516,781的发明人是Stuart D.Edwards、Edwards J.Gough和DavidL.Douglass，它又是标题为“Method for Reducing Snoring by RF Ablation of theUvula”、申请日为1994年5月9日的美国专利申请08/239,658的部分续展申请。该专利申请还涉及与该专利申请同时申请的一个专利申请，其律师文件号为SOAN1009CIP2，标题为“Method and Apparatus for Treatment of Air WayObstructions”，在此引述供参考。
                  发明背景
发明领域
本发明涉及使患者保持上气道开放的方法，尤其涉及一种采用电磁能量缩小舌和/或舌扁桃体选择部分而不损伤舌下神经的方法。
相关领域的描述
睡眠呼吸暂停综合症的主要症状是：日间嗜睡(hypersomnomulence)、早晨手臂疼痛、智力减退、心率不齐、睡眠时打鼾和翻来复去。它是由于患者在睡眠时经常发作呼吸暂停引起的。传统上将这种综合症分为两种类型。一种类型称为“中央睡眠呼吸暂停综合症(central sleep apnea syndrome)”，其主要特征是屡次丧失兴奋呼吸的功能。第二种类型称为阻塞性睡眠呼吸暂停综合症，其主要特征是睡眠时反复发作呼吸暂停，这是由于患者的上气道阻塞或患者喉前但不包括喉的呼吸道部分的阻塞引起的。
因此，至今为止的治疗包括各种内科、外科和物理治疗。内科治疗包括采用除中枢神经系统抑制剂(如镇静剂或酒精)以外的药物，如普罗替林、安宫黄体酮、乙酰唑胺、茶碱、尼古丁等药物。上述药物有时是有用的，但却很少完全见效。另外，药物经常具有所不希望的副作用。
外科手术包括悬雍垂腭咽成形术(uvulopalatopharyngoplasty)、扁桃体摘除术、对严重的缩颌施行外科校正和气管造口术。在一种手术过程中，使颌(jaw)移开(dislodged)，并向前拉，以便能够进入舌底。这些手术可能有效，但对患者来说具有很高的手术风险，并且这些手术对患者来说是经常是不能接受的。
物理治疗包括减轻体重、鼻咽气道、鼻CPAP(气道恒定加压)和各种夜间使用的舌保持装置。这些治疗方法可能有一些效果，但较麻烦，并且患者感觉不舒服，患者通常不愿意在较长时间内持续使用。减轻体重可能有一些用，但患者很少能做到。
在患有中央睡眠呼吸暂停综合症的患者中，一直采用膈神经定速(phrenicnerve pacing)或膈定速(diaphragmatic pacing)。膈神经定速或膈定速包括采用电刺激来调整和控制患者受膈神经双侧支配的膈，以帮助或支持换气。这种定速(pacing)见J.Mugica等人的Direct Diaphragm Stimulation,J.Mugica等人的PACEvol.10 Jan-Feb.1987,Part Ⅱ,Preliminary Test of a Muscular Diaphragm PacingSystem on Human Patients(自Neurostimulation:An Overview1985,pp263-279，以及1993年6月Nochomovitez在IEEE Eng.医学和生物卷中的ElectricalActivation of Respiration。
然而，人们发现，许多患者仍然具有某种程度的阻塞性睡眠呼吸暂停，并且当吸气力由定速器增大时加剧。由膈的活动所引起的换气还使得上气道在吸气时塌陷，并沿咽喉向下拉患者的舌，而使患者噎塞。于是，这些患者需要用气管造口术作为恰当的治疗。
Trans Am Soc ArtifIntern Organ中由F.Kaeko等人在physiological LaryngealPacemaker描述的生理喉起搏器测量肺的换气量，并刺激恰当的神经打开声门，以治疗呼吸困难。对于治疗睡眠呼吸暂停来说，这种装置是无效的。该装置产生的信号与肺的换气量成比例，因而信号产生得太迟，而无法用作睡眠呼吸暂停治疗的指示。由于阻塞，睡眠呼吸暂停中通常是没有换气量的。
阻塞性睡眠呼吸暂停中一种有效的治疗措施是气管造口术。然而，这种外科手术会造成明显的病态，并且从美容的角度上说是许多患者所不能接受的。其他的外科手术包括尽可能地拉伸舌，并且切除和去除部分舌以及可能使上气道闭合的结构。
因此，人们需要一种治疗气道阻塞疾病的方法和装置。人们还需要一种将足够的电磁能传送到一个人体结构内(包括舌但并非仅限于舌)的方法和装置，用以治疗气道阻塞疾病，同时减小人体结构的外表面的肿胀。
                  发明概述
因此，本发明的目的是提供一种摘除舌内部区域的装置。
本发明的另一个目的是提供一种摘除舌的内部区域而不损伤舌下神经的装置。
本发明的上述目的以及其他的目的是通过减小舌的选择部分的体积(volumn)来实现的。该装置包括一个导管装置。一电极装置至少有一部分位于导管装置的内部。电极装置用来送入足够的电磁能，从而切除舌的内部，而不损伤舌下神经。电极伸入和退出装置与该电极装置耦合，从而使至少一部分电极装置能够伸入或退出所选择的舌面。电缆装置与电极装置耦合。
导管装置包括可以冷却到10到30摄氏度的导管组织接触面。电极可以是空心的，并且与一输注介质源耦合。绝缘套可以与至少一部分电极外面成环绕关系。可以通过导管引入一个或多个电极。另外，一个或多个传感器可以位于切除装置的不同处，包括电极的末端、电极的外表面、绝缘套的末端或导管组织接触面。各种不同的电磁能源可以与包括(但并非仅限于)射频(RF)源和微波源的电极耦合。
在各种实施例中，电极是通过舌腹面、舌背面或舌背引入的。切除术不会损伤舌下神经。
                  附图简述
图1(a)是采用本发明的摘除装置的截面图。
图1(b)是本发明描述导管组织接触面的摘除装置的透射图。
图2是图1(a)中所示摘除装置的导管和连接器的截面图。
图3是图1(a)所示连接器的透射图。
图4是与图1(a)所示摘除装置相关的针形电极的透射图。
图5是采用本发明的方法的柔软针形电极的透射图。
图6是图1(a)所示摘除装置生成的摘除区。
图7是嘴闭上时舌的截面图。
图8是嘴张开时舌的截面图。
图9是舌的截面图。
图10是舌背的透射图。
图11是舌的截面图。
图12是描述舌下神经的位置和摘除区的产生的截面图。
图13是描述多个摘除区的舌的截面图。
图14是舌腹面的透射图。
图15是舌的截面图。
图16是采用本发明的方法的反馈控制系统的方框图。
图17是采用图16所示反馈控制系统的模拟放大器、模拟多路复用器和微处理器的方框图。
图18是可以用来通过图1所示的导管控制冷却介质流速的温度/阻抗反馈系统的方框图。
                       详细描述
参照图1(a)、图1(b)和图2，图中描绘的是切除舌、舌扁桃体和/或腺样体的摘除装置10。摘除装置10的位置使得一个或多个电极12可以通过舌面引入到舌的内部。摘除装置10可以包括具有可视功能或不具有可视功能的无创伤插管，通入氧气或麻醉剂，并且能够抽吸血液或其他的分泌物。应当理解，摘除装置10用来治疗人体内气体通道受到限制的各种不同的阻塞疾病。一种实施例是用电极12来治疗睡眠呼吸暂停，从而用RF、微波等摘除选择部分的舌、舌扁桃体和/或腺样体。因此，摘除装置10可以用来摘除需要摘除的物质，包括(但并非局限于)舌、扁桃体、鼻甲、软腭组织、硬组织和粘膜组织。在一种实施例中，摘除装置10用来摘除舌的内部区域，缩小体积，从而加大气道的截面积。
在缩小舌体积之前，可以进行术前评估，包括体检、光纤咽镜检查、头部测量分析和多种波动描记监视。体检强调头和颈的评估。还包括对鼻腔的严密检查，查明鼻中隔和鼻甲的变形；因长的、过大软腭或肥大扁桃体而引起的咽阻塞；因突出的舌底(base of tongue)而引起的下咽部阻塞。
摘除装置10包括导管、手柄16、从沿导管的纵向表面形成的不同的端口18或从电极12的末端延伸的一个或多个电极12。还配置有电极进入和退出装置20。电缆与电极12耦合。
电极12至少有一部分位于导管14的内部。每一电极通过导管14的外表面上形成的端口18伸入和退出。电极伸入和退出装置使从导管14伸出的电极12伸入人体结构的内部，或者退回到导管14内。尽管人体结构可以有许多不同的结构，但这里以舌为例。电极12刺破舌的外表面，而进入舌的内部区域。电极12将足够的电磁能送入舌内，使舌充分摘除并缩小。电极12可以是中空的，从而接收各种不同的输液，包括(但非局限于)生理盐水。电极12可以限制在于进入舌后的一定距离内。这可以用绝缘套来实现，绝缘套可以位于电极12上以限制它们的进入，也可以是一种与导管耦合而限制电极12的进入的结构，如限位器(stop)等。
电极12可以包括一个中央腔以接收各种可以引入到舌内部的液体，以及多个输液口。一种合适的液体是电解溶液。冷却电解液是不与组织和电极12直接接触而传送热能的，冷却电解液用来将热能传送到组织。电解液可以冷却到约30到55摄氏度的范围内。
导管14包括通过导管14的内部延伸的导管组织接触面22、冷却介质输入管24和冷却介质输出管26。端口18开在导管14的外部，并且最好开在导管组织接触面22上。端口18与流入输入管24和输出管26的冷却介质是隔开的，冷却介质输入管24和输出管26用来提供至少有1到2cm2的导管组织接触面22的冷却部分。导管组织接触面22的冷却部分至少等于切除的下面区域的截面直径。
导管组织接触面22的冷却部分的尺寸随每一患者的不同而不同。该尺寸足以使传送电磁能以后舌的肿胀最小。肿胀的减小量可以是50％或以上、75％或以上以及90或以上。所提供的冷却量足以使患者在进行缩小手术以后的短时间内回家，而没有因舌而噎咽的风险。我们发现，通过在相当大的区域内提供充分的冷却，可以提高舌内部区域的摘除量。通过提供充分大的导管组织接触面2的冷却面，可以使腺瘤响应为最小。
通过加入可调节的或不可调节的绝缘套32(图3、4和5)，可以调节电极12的电磁能传送面30。绝缘套32可以沿电极12的外表面进入和退出，从而增加或减小电磁能传送面的长度。绝缘套32可以用各种材料制成，包括(但非局限于)尼龙、聚酰亚胺以及其他的热塑料之类的材料。电磁能传送面30的尺寸可以通过其他的方法来改变，包括(但非局限于)形成具有多个能够多路启动或单独启动的电极的分段电极。
手柄16最好用绝缘材料制成。电极12是用不锈钢之类的导电材料制成的。另外，电极可以用成形记忆金属(shaped memory metal)制成，如加州Menlo ParkdRaychem Corporation出售的镍钛材料。在一种实施例中，只有电极12的末端是用成形记忆金属制成的，以便实现所要求的偏移。当引入到口腔内时，可以深入导管14，直至病人产生作呕反应。随后退出导管14，以防止病人作呕。电极12的末端可以是半曲线形的。末端可以成一几何形状，而使之与舌的外表一致。
导管14是可延展的，以便在选择所要切除的切除点时与舌的表面一致。一种封装的软金属，如铜或经退火的金属/塑料材料可以用来形成可延展的导管14。所有的或一部分导管14都是可延展的，或用成形的记忆金属制成。
对于许多应用来说，要求导管14的末端14’是可以弯曲的。这可以在机械上或用记忆金属来实现。可以将操纵索(steering wire)或其他的机械结构装在末端14’的外部或内部。在一种实施例中，位于手柄16上的偏转纽(deflection knob)由医生启动，使操纵索紧固。这就使得由于末端14’的收缩而使其偏转。应当理解，可以用其他的机械装置来替代该操纵索。可以采用偏转而进入较难进入的组织结构。
手柄6可以包含与退出和进入装置20耦合的连接器。连接器34使电极12与电源、反馈控制、温度和/或成象系统耦合。可以包括有RF/温度控制块36。
在一种实施例中，医生沿朝向连接器34的末端的方向移动退出和进入装置20。电极12可以是用弹簧安装的。当退出和进入装置20后退时，弹簧使得选择的电极12伸出导管14。
一个或多个电缆38使电极12与电磁能源40耦合。本发明可以采用各种能源40，将电磁能送入一个人体结构内，包括(但非局限于)RF、微波、超声波、相干光和热传导。能源40最好是一个RF发生器。当采用RF能源时，医生可以用与RF能源40耦合的脚蹋开关(未示出)来接通RF能源40。
一个或多个传感器42可以位于电极12的内表面或外表面上，或单独插入人体结构内。传感器42可以对组织的温度进行精确测量，以便确定：(ⅰ)摘除范围，(ⅱ)切除量，(ⅲ)是否需要作进一步的摘除，以及(ⅳ)摘除部分的几何边界或周边。另外，传感器42可以防止损伤或摘除不需要摘除的组织。
传感器42是一种传统设计的传感器，包括(但非局限于)热敏电阻、热电偶、电阻线等。合适的传感器42包括具有康铜(copper constantene)的T型热电偶、J型、E型、K型、光纤、电阻丝、热电偶IR检测器等。应当理解，传感器42不必是热传感器。
传感器42测量温度和/或阻抗，进行摘除监视。这就减少了对摘除物质周围的组织的破坏。通过监视人体结构内各个点处的温度，可以确定切除的周边部位，并且可以判断何时完成了摘除。无论何时如果传感器42判断超过了要求的摘除温度，则在能源40处接收到一个合适的反馈信号，并调节所传送的能量。
摘除装置10可以包括目测功能，包括(但非局限于)观测镜、目镜、光纤、视频成象等。
另外，可以采用超声波成象来确定电极12的位置和/或确定摘除量。可以在电极12、导管14或分开的装置上放置一个或多个超声波传感器44。在选择的组织部位外部或内部还可以采用一个成象探测器。一种合适的成象探测器型号为21362，是由Hewlett Packard Company制造和销售的。每一超声波传感器44与超声波源(未图示)耦合。
现在参照图6，图中，导管14被引入口腔内，并且多个电极12进入产生不同的摘除区46的舌内。可以以双极或单极方式操作摘除装置10。图6中，电极12是以双极方式工作的，产生足够的摘除区46以缩小舌，而不会影响舌下神经，并造成较大的气道。由于该缩小操作，使得舌背朝着远离气道的方向移动。结果是气道截面直径增大。
摘除装置10还可以工作在单电极方式下。底座(groundpad)可以位于一个方便的位置处，如位于下巴下。单个电极12位于舌内，以产生第一摘除区46。接着电极12可以从舌内退出，移动导管14，并且电极12随后从导管14进入舌的另一内部。产生第二摘除区46。这一过程可以进行多次，在舌内形成不同的摘除区。可以将一个以上的电极引入舌内，并工作在双极方式下。随后可以使电极12重新位于舌内多次，产生多个连接或非连接的摘除区。
现在参照图7到图15，图中绘出了舌和其他组织的各种解剖图。不同的解剖结构如下：颏舌肌或舌体标记为48；颏舌骨肌标记为50；下颌舌骨肌标记为52；舌骨标记为54；舌尖标记为56；舌的腹面(ventral surface)标记为58；舌背标记为60；舌的下背(inferior dorsal)标记为62；会厌谷的反射部位标记为64；舌滤泡标记为66；悬雍垂为68；腺样体区为70；舌的侧面边缘为72；轮廓状乳头为74；腭扁桃体为76；咽为78；多于咽组织是80；盲管(foramen cecum)是82；舌下神经是84；舌系带为86。
舌背60分为前背2/3和舌下背62。轮廓是由轮廓状乳头74和盲管(foramencecum)82决定的。舌下背(inferior dorsal)62是轮廓状乳头74下面的舌面和会厌谷64的上反射部位。会厌谷64的反射面是与会厌连接的舌面。舌滤泡66包含舌扁桃体。
导管14可以通过鼻或口腔引入。电极可以通过舌背面60、舌下背面62、舌腹面58、舌尖56或颏舌骨肌肉50插到舌的内部。另外，电极可以被引入舌滤泡66的内部和腺样体区70内。一旦电极12定位以后，可以调节绝缘套32，而提供每一电极12所要求的电磁能传送面30。
产生摘除区46，而不损伤舌下神经84。这就产生了一个更大的气道，并提供睡眠呼吸综合症的治疗。
不管在什么情况下，电极12的定位以及摘除区46的产生使得舌下神经84不会被摘除或损伤。不会使吞咽和说话受到影响。
现在参照图16和图17，一个开放或闭合的反馈系统将传感器42与能源40耦合。监视组织或电极12的温度，并相应调节能源40的输出功率。如果需要，医生可以取消(override)闭合或开放环路系统(loop system)。可以包括有微处理器，并装在闭合或开放的环路系统中来切断或打开电源，以及调整功率。闭合环路系统采用微处理器88用作控制器、监视温度、调节RF功率、观看结果、重新馈送结果并接着调整功率。
采用传感器42和反馈控制系统，可以在选择的时间内将靠近RF电极12的组织保持在所要求的温度下，而不会对外产生影响(impeding out)。每一RF电极12与产生用于每一RF电极12的独立输出的源相连。在选择的时间长度内，输出在RF电极12处保持所选择的能量。
由电流传感器90测量通过电极12传送的电流。电压由电压传感器92测量。随后在功率和阻抗计算装置94处计算阻抗和功率。计算值可以接着显示在用户接口和显示器96处。代表功率和阻抗值的信号由控制器98接收。
控制信号由控制器98产生，该控制信号正比于实际测量值和所要求的值的差。控制信号由电源电路100用来以合适的量调节功率输出，从而保持在各个RF电极12处传送的所要求的功率。
以类似的方式，传感器42处检测的温度提供反馈以保持选择的功率。在温度测量装置102处测量实际温度，并且将温度显示在用户接口和显示器96上。控制信号是由控制器98产生的，正比于实际测得的温度和所要求的温度之差。控制信号由电源电路100用来以合适的量调节功率输出，从而保持在各个传感器处传送的所要求的温度。可以包括有多路复用器用以在众多的传感器42处测量电流、电压和温度，并且可以以单极或双极方式将能量传送到RF电极12。
控制器98可以是数字的或模拟的控制器，或是一种带有软件的计算机。当控制器98是计算机时，它可以包括一个通过系统总线耦合的CPU。因此，系统可以是一个本领域中所熟知的键盘、盘驱动器或其他非易失存储器系统、显示器和其他的外部设备。与总线耦合的还有程序存储器和数据存储器。
用户接口和显示器96包括操作员控制器和显示器。控制器98可以与成象系统耦合，包括(但非局限于)超声波、CT扫描机、X射线、MRI、乳房X射线等。另外，也可以采用直接观看和触摸成象。
电流传感器90和电压传感器92的输出由控制器98用来保持RF电极12处选择的功率。所传送的RF能量控制功率值。所传送的功率外形(profile)可以组合在控制器98内，还可以勾画(profile)要传送的能量的预置量。
电路、软件和控制器98的反馈产生过程控制和独立于电压和电流变化的选择功率的保持，并用来改变(Ⅰ)选择功率，(ⅱ)占空比(功率的通-断)，(ⅲ)双极或单极能量传送，以及(ⅳ)输注介质传送，包括流速和压力。控制和改变这些过程变量，同时根据传感器42处监视的温度，独立于电压和电流变化地保持要传送的功率。
电流传感器90和电压传感器92与模拟放大器104的输入端相连。模拟放大器104可以是与传感器42一起使用的传统的差分放大器。模拟放大器104的输出顺序由模拟多路复用器106连接到A/D转换器108的输入端。模拟放大器104的输出是代表各个感测温度的电压。数字化放大器输出电压由A/D转换器108提供到微处理器88。微处理器88可以是来自Motorola的68HCⅡ型。但是，应当理解，任何合适的微处理器和通用数字计算机或模拟计算机都可以用来计算阻抗或温度。
微处理器88顺序接收并存储阻抗和温度的数字表述。微处理器88接收的每一数字值对应于不同的温度和阻抗。
计算的功率值和阻抗值可以显示在用户接口和显示器96上。也可以是或者除了功率和阻抗的数字表示以外，计算的阻抗值和功率值可以由微处理器88与功率和阻抗极限比较。当这些值超过预定的功率或阻抗值时，可以在用户接口和显示器96上给出警告，并且另外，可以减小、修改或中断RF能量的传送。来自微处理器88的控制信号可以修改能源40提供的功率电平。
图18描绘的是可以用来控制通过导管14的冷却介质流速的温度/阻抗反馈系统的方框图。电磁能由能源44传送到电极12，并作用于组织。监视器110根据传送到组织的能量确定组织的阻抗，并测得的阻抗值与设定值比较。如果测得的阻抗值超过设定值，则向能源40发送一个中断信号(disabling signal)，停止进一步向电极12传送能量。如果测得的阻抗值在可接受的范围内，则继续使能量作用于该组织部位。在向组织施加能量时，传感器42测量组织和/或电极12的温度。比较器114接收代表测得的温度的信号，并将该值与代表所要求的温度的预置信号比较。如果组织温度太高，则比较器114向需要更高冷却介质流速的流速调节器116发送一个信号，而当温度没有超过所要求的温度时，保持该流速。
为了描述本发明，前文中对本发明的实施例进行的描述。但本发明并非局限于上述这些形式。很明显，对本领域的技术人员来说，还可以有各种变异和修改形式。本发明的保护范围由后文中的权利要求或其等效形式所限定。

Claims (15)

1．一种减小选择部分的舌体积的装置，其特征在于，它包含：
导管装置；
至少有一部分位于导管装置的内部的电极装置，所述电极装置用来传送足够的电磁能，用来摘除舌的内部，而不损伤舌的舌下神经；
电极进入和退出装置，它与所述电极装置耦合，用来从选择的舌表面中推进或退出至少一部分电极；以及
与所述电极装置耦合的电缆装置。
2．如权利要求1所述的装置，其特征在于，它还包含：
与所述电极装置和所述电缆装置耦合的电磁能源装置。
3．如权利要求1所述的装置，其特征在于，它还包含：
至少一部分位于所述导管内部并用来冷却所述舌表面的冷却装置。
4．如权利要求3所述的装置，其特征在于，它还包含：
控制通过所述冷却装置的冷却介质流速的装置。
5．如权利要求1所述的装置，其特征在于，它还包含：
至少有一部分位于所述电极装置外围的绝缘套装置。
6．如权利要求5所述的装置，其特征在于，它还包含：
位于所述绝缘套装置末端的传感器装置。
7．如权利要求1所述的装置，其特征在于，它还包含：
位于所述电极装置的末端的传感器装置。
8．如权利要求1所述的装置，其特征在于，它还包含：
位于所述导管装置的外部的传感器装置。
9．如权利要求1所述的装置，其特征在于，它还包含：
位于所述电极装置的末端的第一传感器装置，和至少一部分位于所述电极装置的外围上的绝缘套装置的末端的第二传感器装置。
10．如权利要求1所述的装置，其特征在于，所述电极装置是一个与RF发生器耦合的RF电极。
11．如权利要求1所述的装置，其特征在于，所述电极装置是一个与微波源耦合的微波天线。
12．如权利要求1所述的装置，其特征在于，它还包含：
与所述电极装置和电磁能源耦合的反馈控制装置。
13．如权利要求12所述的装置，其特征在于，它还包含：
与所述反馈控制装置耦合的超声波装置。
14．如权利要求1所述的装置，其特征在于，所述电极装置包括与RF能源耦合的两个或多个RF电极。
15．如权利要求1所述的装置，其特征在于，它还包含：
与所述电极装置耦合的输注介质源装置。
CN97194323A 1996-05-03 1997-04-15 用于治疗气道阻塞的方法和装置 Pending CN1216911A (zh)

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US5728094A (en) 1998-03-17
AU2462197A (en) 1997-11-26
US5807308A (en) 1998-09-15
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WO1997041788A1 (en) 1997-11-13
EP0901348A1 (en) 1999-03-17
JP2000509622A (ja) 2000-08-02

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