CN1021194C - Two-phase stereo positioning instrument and stereo positioning method - Google Patents

Abstract

The present invention provides a bidirectional stereo positioning instrument and a stereo positioning method for the early diagnosis of lung cancer by the puncture biopsy of small focuses of the lung. The instrument is composed of an upright post, a transverse rod and a base, wherein the upright post and the transverse rod are attached with verniers with metal markers, and a double-coordinate double-plane stereo positioning principle is formed when the instrument works. The positioning method comprises the primary positioning, the perpendicular perspective positioning and the horizontal photography rechecking. The positioning instrument of the present invention has the advantages of simple and convenient operation, exact and reliable positioning, high hit rate of the puncture for one time, few complications, low cost of the instrument, small volume and portability, and provides a decisive effective measure for the universal development of the early diagnosis by skin puncture and lung biopsy in the wide range comprising China.

Description

Two-phase stereo positioning instrument and stereo positioning method

The present invention proposes is a kind of two-phase localization method and instrument thereof when being used for pulmonary's small lesion aspiration biopsy early diagnosis pulmonary carcinoma.Be YC-I type medical multifunctional two-phase stereo positioning instrument and solid locating method thereof.

At present, both at home and abroad lung puncture the most basic localization method commonly used is to take the photograph sheet and fluoroscopy location according to positive lateral chest film, body layer, also has minority to introduce CT location or B ultrasonic guiding localised puncture etc. down.All these many localization methods nearly all are monoplane detection and location punctures, and a flat field of view finding puncture needle had reached intralesional when its limitation was to puncture.May above or below focus, cause puncture failure in fact.In fact be difficult to accomplish early diagnosis pulmonary carcinoma.According to the data at home and abroad statistics, after making a definite diagnosis, patients with lung cancer have 80% patient to belong to late period, lose the chance of operative treatment.

The objective of the invention is to problem, propose a kind of relatively localization method and the corresponding practical and effective location instrument equipment of typing at above-mentioned existence.Solve the accurate localized difficult problem when being used for pulmonary's small lesion aspiration biopsy early diagnosis pulmonary carcinoma effectively, realize the purpose of early diagnosis treatment pulmonary carcinoma.Advantages such as and have easy to operationly, accurate positioning is reliable, and one-time puncture shoots straight, and complication is few.

Technical solution of the present invention:

Two-phase stereo positioning instrument is the one-level stripping, and is removable, two coordinate formula stereotaxic instrument, and its structure is as shown in drawings.Its agent structure forms the two coordinate principle by column and cross bar (base), adopt the stripping formula, make its range of activity big, and can satisfy the needs of X line machine lift adjustment when locating, the span between cross bar and base can be suitable for absolute great majority among the crowd and the widespread usage meaning is arranged.Apparatus subject material available metal or nonmetal also can be used plastics, preferably forms with roentgenolucen novel senior engineering plastic thermoplastic.Column divides sheath seat and stripping, and a groove between stripping and the sheath seat, groove are located at sheath seat inboard, and stripping is can extract out, recover.Respectively there is a pin to be connected between stripping and cross bar, sheath seat and base, can folds between them.Be launched into 90 degree during work, indicate scale respectively on cross bar, column (stripping, sheath seat), respectively be furnished with totally 3 of the verniers of a band metal marker on column and cross bar, it is to slidably reciprocate, and rises and regulates positioning action.The vernier that metal marker is arranged on the roentgenolucen main frame band, the one, help the formation of focus and labelling sharp contrast degree in the three-dimensional location, particularly at small lesion; The 2nd, it replaces the local anesthetic syringe needle of original usefulness of marking, and then can avoid level to thrust the possibility that pneumothorax appears in pleural space because of the bruising syringe needle effectively when sheet is taken the photograph in the side position.Thereby safer reliable, vernier metal marker central part prepares aperture can be passed through for puncture needle.

Solid locating method (promptly vertically adding level to perspective takes the photograph the biplane stereo positioning technique that sheet is checked adjustment to the side position)

(1) just fixed, take the photograph sheet according to plain chest film and body layer and just decide entry point, pathway and the degree of depth; (2) vertically to the perspective location, will just fix a point to do the positive side of body surface position labelling with typeface number, perspective is adjusted vertically to the location; (3) level is to checking, keeping somewhere in the thoracic cavity (outside the pleura) with the local anaesthesia syringe needle marks, the level of immediately doing is to X line pipe and the coaxial sheet of taking the photograph of this local anaesthesia syringe needle, check to select and finish the two-phase stereo location at the optimum puncturing point of same level height with focus, after the location is satisfied, select for use and be not with nook closing member fine needle (using pin No. 21, external diameter 0.8mm) to be connected with the 30mL syringe more.Thorn reaches focus under x-ray guidance, negative pressure-pumping get standard inspection this, reduce pressure and keep under the slight negative pressure and pull out pin, not have blood in the pin letter for well.Specimen smear is immediately sent cytology or bacteriology checking.Art finishes cough, the breathing situation of observing.The Chest X-rays check has or not hemopneumothorax, the long 8-16cm of puncture needle, this group paracentesis depth 5.5～11.5cm after half an hour.

Realize best way of the present invention

Patient gets dorsal position, launches this instrument and becomes 90 °, and base is flat between Ipsilateral breast rear wall and the X line board face, and then column pastes the pleurobranch wall, and cross bar places preceding thoracic wall, can come into effect three-dimensional positioning function.Concrete positioning action is as follows: (1) just fixes under the x-ray guidance, relies on cross bar vernier metal marker, and cephalad or foot side shifting position finder are observed and determined body layer transverse section, pulmonary small lesion place, fixedly two-phase stereo positioning instrument; (2) vertically to the perspective location, mobile again cross bar vernier is done vertical perspective location, relies on its metal marker to determine small lesion front and back of living in sagittal plane, and cross bar vernier reading is is simultaneously checked and approved the puncture depth of needle; (3) level is to checking, the mobile column vernier, and the level of doing is taken the photograph sheet to X line pipe and the coaxial side of vernier metal marker position, relies on column vernier metal marker to determine small lesion volume of living in plane.So, vertical and level is closed in first periodic body layer transverse section to the biplane intersection, form three flat and stereo cross points, be this pulmonary's small lesion central point, finish satisfied very soon and crossed space location accurately, carry out the aspiration biopsy early diagnosis, be specially adapted to the accurate localised puncture early diagnosis of pulmonary's 1cm left and right sides small lesion.

If patient gets lateral position, the positioning action method is identical.

Trial state:

The middle small lesion 150 many cases localised punctures diagnosis of pulmonary's diameter less than 3cm finished in clinical practice in the past few years.The 74 routine specimen satisfactions of having reported of puncturing obtain rate 95.9%, the positive diagnosis rate 89.2% of one-time puncture, and none example is done three times and is punctured, and 12 routine hilus pulumonis type pathological changes all once puncture and obtain positive diagnosis.Puncture has 49 examples to undergo surgery among the person of making a definite diagnosis, malignant change 35 examples wherein, operation back 34 examples, pathological diagnosis unanimity; Benign lesion 14 routine post-operative pathological diagnosis are all consistent.Full group puncture complication is the slight pneumothoraxs of 8 examples only, how very fast absorption spontaneous recovery.Do not have about severe complication malignant tumor diameter 1cm such as hemorrhage death pulmonary's small lesion also one-time puncture biopsy comparatively freely make a definite diagnosis, whole localised puncture diagnosis can be finished about half an hour.

The present invention is used for the accurate stereotaxic localized puncture early diagnosis of pulmonary's small lesion pulmonary carcinoma.Have that method is simple, accurate positioning is reliable, and novelty reasonable in design is regulated nimblely, and repeatable strong, one-time puncture shoots straight.Advantages such as complication is few.Also be used for forward and backward, side, multi-faceted puncture location, neck road simultaneously.Small and exquisite, easy to carry.For generally carrying out percutaneous transthoracic needle biopsy.Early diagnosis pulmonary carcinoma provides decisive effective measures.The present invention also is applicable to the localised puncture (liver, kidney etc.) at other positions of human body, or foreign body takes out the accurate location that requirements such as fixed point treatment are done.

Accompanying drawing is the structural representation of two-phase stereo positioning instrument.

In the accompanying drawing 1 is column, the 2nd, column sheath seat, the 3rd, column stripping, the 4th, slogan banner, the 5th, base, the 6th, vernier, the 7th, metal aperture, the 8th, pin, the 9th, graduation apparatus, the 10th, inside groove.

Claims (3)

1, two-phase stereo positioning instrument, form by column, cross bar, base, it is characterized in that column sheath seat, stripping, in sheath seat inboard a groove is arranged, stripping can be extracted out in groove, reset, the last pin of each links to each other between column sheath seat and base, stripping and channel bar, can fold, be launched into 90 degree, on sheath seat, stripping, channel bar, respectively indicate scale, and a band metal aperture vernier is respectively arranged, and vernier can slide.

2, two-phase stereo positioning instrument according to claim 1 is characterized in that the optimal material of main elements such as column cross bar is selected roentgenolucen novel senior engineering plastic for use.

3, two-phase stereo localization method:

(1) just fixed, to take the photograph sheet according to plain chest film and body layer and decide just that entry point, pathway and the degree of depth (2) are vertical will just fix a point to do the positive side of body surface position labelling to the perspective location with typeface number, the perspective adjustment is vertically to the location; (3) level is to checking, and keeps somewhere in thoracic wall (outside the pleura) with the local anaesthesia syringe needle and marks.The level of immediately doing is checked and is selected and the optimum puncturing point of focus in same level height to X line pipe and the coaxial sheet of taking the photograph of this local anaesthesia syringe needle, finishes the two-phase stereo location.

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