CN103100138A - Guiding steel wire guiding method and device in subclavian vein catheterization - Google Patents
Guiding steel wire guiding method and device in subclavian vein catheterization Download PDFInfo
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- CN103100138A CN103100138A CN201110358876XA CN201110358876A CN103100138A CN 103100138 A CN103100138 A CN 103100138A CN 201110358876X A CN201110358876X A CN 201110358876XA CN 201110358876 A CN201110358876 A CN 201110358876A CN 103100138 A CN103100138 A CN 103100138A
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- guide wire
- syringe
- steel wire
- subclavian vein
- guider
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Abstract
Provided is a guiding steel wire guiding method in a subclavian vein catheterization. At first, magnetic materials are arranged on a guiding steel wire, and in the process that the guiding steel wire is propelled from the tail end of a needle cylinder to the top end of the needle cylinder, a magnet guide device is utilized to absorb the top end of the guiding steel wire and is arranged outside a guiding steel wire top end path arranged in advance. A guiding steel wire guiding device comprises a puncture needle cylinder, wherein a syringe needle is arranged at the top end of the needle cylinder, a piston is arranged in the needle cylinder and provided with a guiding steel wire channel, the guiding steel wire is arranged in the guiding steel wire channel, the top end of the guiding steel wire penetrates through an inner cavity of the needle cylinder and a needle hole in the syringe needle, the magnet guide device is arranged on the outer side of the top end of the guiding steel wire, and an interval is arranged between the magnet guide device and the top end of the guiding steel wire. According to the guiding steel wire guiding method and the guiding steel wire guiding device, the guiding steel wire can avoid entering abnormal parts of jugular veins and the like, the success rate of subclavian vein puncture is obviously improved, and pain and financial burdens of patients are lightened. Therefore, the method is safe, noninvasive, economical, and environment-friendly.
Description
Technical field
The present invention relates to the mankind life article, relate in particular to medical treatment device, particularly sting device, concrete is guide wire guidance method and the device in a kind of subclavian vein tube placing operation.
Background technology
Central venous catheterization is fast, safely, effectively to set up a kind of important means of dark venous access with critical.Be widely used in Perioperative Blood Transfusion transfusion, intravenous hyperalimentation therapy, measurement of central venous pressure, insertion pulmonary artery catheter, placed the situation such as pacing catheter through vein.Puncture position commonly used has femoral vein, internal jugular vein (Internal Jugular Vein, IJV), subclavian vein (Subclavian Vein Catheterization, SVC).The advantages such as wherein the subclavian vein approach has that position is fixed, wall of vein is difficult for subsiding under shock state, zest is little, patient's limitation of activity is little, be difficult for occurring phlebothrombosis, indwelling catheter time is long, thus subclavian vein to put pipe application clinically more and more extensive.
Subclavian vein is the continuity of axillary vein, be arc inboard approximately 1/3 the back upper place of clavicle that is positioned at slightly made progress by the 1st rib outer rim, its rear and internal jugular vein that walks to sternoclavicular joint merges into venae brachiocephalicae, while along the subclavian vein trend, putting pipe, after guide wire is delivered to subclavian vein sternoclavicular joint end, upwards can, to internal jugular vein, can enter superior vena cava downwards.In prior art, guide wire, in importing process, is probably stopped to rebound by blood vessel wall to cause the catheter position mistake to internal jugular vein.
In prior art, transposition of vessels incidence rate height is to carry out the inherent defect of central venous catheterization through subclavian vein.Wherein with subclavian vein, put when pipe and be strayed into homonymy internal jugular vein proportion (account for whole transposition of vessels 83.3%) at most.Having in reported literature 13587 example adult subclavian vein punctures has 15% not in placely, and wherein most of conduit enters internal jugular vein, causes monitoring CVP higher, even can't measure, and impact judges the state of an illness.Domestic Fuwai Hospital Anesthesia Department report right side subclavian vein puncture 90 examples time, wherein children's's 65 examples are inferior, 44 examples time (67.69%) that do not put in place, 40 examples time enter the right internal jugular vein distal end; Adult's 25 examples time, 4 times (16%) enters the right internal jugular vein distal end.
The conduit of dystopy easily causes line clogging, conduit damage, thrombophlebitis, angiorrhexis and hemodynamic monitoring error, even the adverse consequences such as cerebrovascular accident.In prior art, adopt methods such as J type elbow being pointed to tail end, the blocking-up of compressing supraclavicular region internal jugular vein when guide wire is inserted to avoid conduit to enter internal jugular vein, but said method is all non-100% effective.And, compressing supraclavicular region while inserting guide wire, the blocking-up of row internal jugular vein, still have taboo for patients with cerebral injury.
Summary of the invention
Problem to be solved by this invention is to provide the guide wire guidance method in a kind of subclavian vein tube placing operation, and the guide wire guidance method in described this subclavian vein tube placing operation will solve in prior art the technical problem that when subclavian vein carries out central venous catheterization conduit easily is strayed into internal jugular vein.
Guide wire guidance method in this subclavian vein tube placing operation of the present invention, comprise that a tail end from syringe advances the process of guide wire to the top of syringe, wherein, before the described tail end from syringe carries out to the process of the top propelling guide wire of syringe, top at described guide wire arranges magnetic material, at the described tail end from syringe, to the process of the top propelling guide wire of syringe, utilize a Magnet guider to attract the top of guide wire.
Further, the step that magnetic material is set on the top of guide wire comprises the process of utilizing magnetic material directly to form guide wire or inlay magnetic material on the guide wire top, and described magnetic material is ferrum or cobalt or nickel.
Further, to the process of the top propelling guide wire of syringe, place described Magnet guider at the described tail end from syringe outside predefined guide wire path.
The present invention also provides the guide wire guider in the subclavian vein tube placing operation of realizing said method, described this device comprises a puncture needle, described puncture needle comprises a syringe, the top of described syringe is provided with a syringe needle, be provided with a piston in syringe, the afterbody of described piston is provided with a needle handle, be provided with continuously a guide wire passage in described needle handle and piston, be provided with a guide wire in described guide wire passage, described guide wire is through the inner chamber of syringe and the pin hole in described syringe needle, wherein, described guide wire consists of magnetic material or is provided with magnetic material, the arranged outside on the top of guide wire has a Magnet guider, be provided with gap between the top of described Magnet guider and guide wire.
Further, described magnetic material is ferrum or cobalt or nickel.
Further, be fixedly installed a lever on described Magnet guider.
Further, be provided with along its length scale on described guide wire.
Further, described Magnet guider is surrounded by a cover layer outward.
Operation principle of the present invention: the second scale of guide wire is 20cm, and the 3rd scale is 30cm.When the piercing needle cartridge be connected with puncture needle does not have pumpback blood, the puncture needle needle point is 17.5cm to the length of needle handle afterbody.Controlling puncture needle syringe pumpback blood is that 3ml(is equivalent to 2.5cm), now, needle point is 20cm to the length of needle handle afterbody.Under normal circumstances, the length male of right subclavian vein is about 4cm, and the women is about 3.8cm, and the diameter male is about lcm, and the women is about 0.8cm.Therefore, generally be no more than 24cm from subclavian vein and internal jugular vein interface port (venous angle) distance the longest to puncture needle needle handle afterbody.In the puncture and intubation process, (about 20cm when the puncture needle needle point is crossed on the guide wire top, be that the second scale of guide wire is just at the afterbody of puncture needle needle handle), the Magnet guider is placed on to patient's puncture side sternoclavicular joint the place ahead, now, guide wire has entered subclavian vein, but does not surpass the interface port of subclavian vein and internal jugular vein (venous angle).Now, the top of guide wire is subject to the magneticaction of Magnet guider, towards superior vena cava.(about 25cm after guide wire continues to insert certain depth, between second and third scale of guide wire at the afterbody of puncture needle needle handle), continuing to insert the guide wire resistance has increase, and this is because Magnet guider and guide wire interact, and has hindered guide wire and has advanced.Now, remove the Magnet guider, magnetic action disappears, and guide wire can continue to go deep into smoothly superior vena cava to predetermined graduated, and conduit can not be strayed into internal jugular vein.
The present invention compares with prior art, and its effect is actively with obvious.Utilization of the present invention is arranged on the direction of advance on the Magnet guider guiding guide wire top in the outside, guide wire top, can be when subclavian vein be put pipe, the guiding guide wire correctly enters superior vena cava, avoid being strayed into the abnormal positions such as internal jugular vein, can obviously improve the success rate of subclavian vein puncture, alleviate patient's misery and financial burden.
The accompanying drawing explanation
Fig. 1 is the structural representation of the guide wire guider in the subclavian vein tube placing operation in the present invention.
Fig. 2 is a schematic diagram of guide wire location in the subclavian vein tube placing operation, shown (about 20cm when the puncture needle needle point is crossed on the guide wire top, be that the second scale of guide wire is just at the afterbody of puncture needle needle handle), put the aseptic Magnet guider of a 2cm*2cm in patient's puncture side sternoclavicular joint the place ahead, guiding steel wire.
Fig. 3 is the another one schematic diagram of guide wire location in the subclavian vein tube placing operation, shown and inserted between second and third scale that about 25cm(is guide wire the afterbody at the puncture needle needle handle when guide wire), continue to insert the guide wire resistance increase is arranged, that guide wire advances because Magnet guider and guide wire interact obstruction, now, the Magnet guider should be removed, guide wire can be inserted smoothly.
The specific embodiment
Guide wire guidance method in subclavian vein tube placing operation of the present invention, comprise that a tail end from syringe 1 advances the process of guide wire 5 to the top of syringe 1, wherein, before the described tail end from syringe 1 carries out to the process of the top propelling guide wire 5 of syringe 1, top at described guide wire 5 arranges magnetic material, at the described tail end from syringe 1, to the process of the top propelling guide wire 5 of syringe, utilize a Magnet guider 6 to attract the top of guide wires 5.
Further, the step that magnetic material is set on guide wire 5 tops comprises the process of utilizing magnetic material directly to form guide wire 5 or inlay magnetic material on the guide wire top, and described magnetic material is ferrum or cobalt or nickel.
Further, to the process of 1 top propelling guide wire 5 of syringe, place described Magnet guider at the described tail end from syringe 1 outside predefined guide wire 5 paths, top.
As shown in Figure 1, the present invention also provides the guide wire guider in the subclavian vein tube placing operation of realizing said method, described this device comprises a piercing needle cartridge 1, the top of described syringe 1 is provided with a syringe needle 2, be provided with a piston 3 in syringe 1, the afterbody of described piston 3 is provided with a needle handle 4, be provided with continuously a guide wire passage in described needle handle 4 and piston 3, be provided with a guide wire 5 in described guide wire passage, the top of described guide wire 5 is through the inner chamber of syringe 1 and the pin hole in syringe needle 2, wherein, described guide wire 5 consists of magnetic material or is provided with magnetic material, the arranged outside on the top of guide wire 5 has a Magnet guider 6, be provided with gap between the top of described Magnet guider 6 and guide wire 5.
Further, described magnetic material is ferrum or cobalt or nickel.
Further, be fixedly installed a lever 7 on described Magnet guider 6.
Further, be provided with along its length scale on described guide wire 5.
Further, be surrounded by a cover layer outside described Magnet guider 6.
The operation principle of the present embodiment: the second scale of guide wire is 20cm, and the 3rd scale is 30cm.When the piercing needle cartridge be connected with puncture needle does not have pumpback blood, the puncture needle needle point is 17.5cm to the length of needle handle afterbody.Controlling puncture needle syringe pumpback blood is that 3ml(is equivalent to 2.5cm), now, needle point is 20cm to the length of needle handle afterbody.Under normal circumstances, the length male of right subclavian vein is about 4cm, and the women is about 3.8cm, and the diameter male is about lcm, and the women is about 0.8cm.Therefore, generally be no more than 24cm from subclavian vein 8 and internal jugular vein 7 interface ports (venous angle) distance the longest to puncture needle needle handle afterbody.In the puncture and intubation process, (about 20cm when the puncture needle needle point is crossed on guide wire 5 tops, be that the second scale of guide wire 5 is just at the afterbody of puncture needle needle handle), Magnet guider 6 is placed on to patient's puncture side sternoclavicular joint the place ahead, now, guide wire 5 has entered subclavian vein 8, but does not surpass subclavian vein 8 and internal jugular vein 7(venous angle) interface port.Now, the top of guide wire 5 is subject to the magneticaction of Magnet guider 6, towards superior vena cava 9.(about 25cm after guide wire 5 continues to insert certain depth, between second and third scale of guide wire at the afterbody of puncture needle needle handle), continuing to insert the guide wire resistance has increase, and this is because Magnet guider 6 and guide wire interact, and has hindered guide wire and has advanced.Now, remove Magnet guider 6, magnetic action disappears, and guide wire can continue to go deep into superior vena cava 9 to predetermined graduated, and conduit can not be strayed into internal jugular vein 7.
Concrete, as shown in Figure 2 and Figure 3, in clinical, the first-selected right side subclavian vein 8 that punctures, select vein 10 under left collarbone if should not puncture in right side, the horizontal finger of 1～2cm(mono-below point of puncture is selected this side chain bone mid point).The two upper limb of patient's dorsal position fall in the health both sides, and head slightly turns to puncture offside, interscapular region slightly to pave so that head is faced upward after a while, and the routine disinfection drape changes puncture needle along the point of puncture inserting needle after with 2% lignocaine local anaesthesia, and puncture needle and thoracic wall are 15～30
., after being close to the clavicle lower edge, needle point upper limb after sternoclavicular joint punctures, limit slow inserting needle limit pumpback, if while wearing to appropriate depth without blood back, the slow withdraw of the needle in limit limit pumpback, if still without blood back, retreating to subcutaneous adjustment direction punctures again, its puncture direction is successively divided a word with a hyphen at the end of a line to the Adam's apple direction, once seeing that more the vein blood back shows enters subclavian vein 8, insert immediately guide wire 5, when the puncture needle needle point is crossed at guide wire 5 tips, (the second scale of steel wire is during just at needle handle 4 afterbody, about 20cm), put the aseptic Magnet guider 6 of a 2cm x 2cm at patient's puncture side apertura thoracis superior near breastbone and clavicle place (sternoclavicular joint the place ahead), continue slowly to insert guide wire 5, (be about 25cm when guide wire 5 top resistance increment, second of guide wire, between three scales at the afterbody of puncture needle needle handle), remove Magnet guider 6 by the assistant, continue to put into guide wire 5 to desired depth, exit puncture needle, then insert conduit to desired depth (15～16cm) backed off after random guide wire 5 along guide wire 5 after broken skin, pumpback is shown in that the interior blood back of conduit injects anti-freezing liquid 2～3mL positive pressure tube sealing and connects with calparine cap or connect fluid infusion when unimpeded, fixed simultaneously.Finally with medical transparent deposited note is fixing, get final product.While putting pipe, the J type head direction of puncture needle inclined-plane and guide wire 5 is all towards superior vena cava 9.When puncturing, all patients all give cardiac monitoring and monitoring detecting sphygmus and blood oxygen saturation.
Claims (8)
1. the guide wire guidance method in a subclavian vein tube placing operation, comprise that a tail end from syringe advances the process of guide wire to the top of syringe, it is characterized in that: before the described tail end from syringe carries out to the process of the top propelling guide wire of syringe, top at described guide wire arranges magnetic material, at the described tail end from syringe, to the process of the top propelling guide wire of syringe, utilize a Magnet guider to attract the top of guide wire.
2. the guide wire guidance method in subclavian vein tube placing operation as claimed in claim 1, it is characterized in that: the step that magnetic material is set on the top of guide wire comprises the process of utilizing magnetic material directly to form guide wire or inlay magnetic material on the guide wire top, and described magnetic material is ferrum or cobalt or nickel.
3. the guide wire guidance method in subclavian vein tube placing operation as claimed in claim 1, it is characterized in that: at the described tail end from syringe, to the process of the top propelling guide wire of syringe, place described Magnet guider outside path, predefined guide wire top.
4. the guide wire guider in a subclavian vein tube placing operation of realizing the described method of claim 1, comprise a piercing needle cartridge, the top of described syringe is provided with a syringe needle, be provided with a piston in syringe, the afterbody of described piston is provided with a needle handle, be provided with continuously a guide wire passage in described needle handle and piston, be provided with a guide wire in described guide wire passage, the top of described guide wire is through the inner chamber of syringe and the pin hole in described syringe needle, it is characterized in that: described guide wire consists of magnetic material or is provided with magnetic material, the arranged outside on the top of guide wire has a Magnet guider, be provided with gap between the top of described Magnet guider and guide wire.
5. the guide wire guider in subclavian vein tube placing operation as claimed in claim 4, it is characterized in that: described magnetic material is ferrum or cobalt or nickel.
6. the guide wire guider in subclavian vein tube placing operation as claimed in claim 4, is characterized in that: be fixedly installed a lever on described Magnet guider.
7. the guide wire guider in subclavian vein tube placing operation as claimed in claim 4, is characterized in that: be provided with along its length scale on described guide wire.
8. the guide wire guider in subclavian vein tube placing operation as claimed in claim 4, it is characterized in that: described Magnet guider is surrounded by a cover layer outward.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201110358876.XA CN103100138B (en) | 2011-11-14 | 2011-11-14 | Guide wire guidance method and device in Inserted subclavian intravenous cather art |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201110358876.XA CN103100138B (en) | 2011-11-14 | 2011-11-14 | Guide wire guidance method and device in Inserted subclavian intravenous cather art |
Publications (2)
| Publication Number | Publication Date |
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| CN103100138A true CN103100138A (en) | 2013-05-15 |
| CN103100138B CN103100138B (en) | 2015-09-30 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201110358876.XA Expired - Fee Related CN103100138B (en) | 2011-11-14 | 2011-11-14 | Guide wire guidance method and device in Inserted subclavian intravenous cather art |
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105268086A (en) * | 2015-11-13 | 2016-01-27 | 中国人民解放军第二军医大学 | Magnetic guidance wire system |
| CN110152162A (en) * | 2018-02-12 | 2019-08-23 | 510心脏装置公司 | It is improved to turn to introducer sheath component |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP1736108A1 (en) * | 2005-06-24 | 2006-12-27 | Terumo Kabushiki Kaisha | Cathether assembly |
| CN201469376U (en) * | 2009-07-31 | 2010-05-19 | 罗光辉 | Vein puncture outfit |
| CN202409792U (en) * | 2011-11-14 | 2012-09-05 | 上海交通大学医学院附属仁济医院 | Positioning guide device with guide wire in subclavicular venous access |
-
2011
- 2011-11-14 CN CN201110358876.XA patent/CN103100138B/en not_active Expired - Fee Related
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP1736108A1 (en) * | 2005-06-24 | 2006-12-27 | Terumo Kabushiki Kaisha | Cathether assembly |
| CN201469376U (en) * | 2009-07-31 | 2010-05-19 | 罗光辉 | Vein puncture outfit |
| CN202409792U (en) * | 2011-11-14 | 2012-09-05 | 上海交通大学医学院附属仁济医院 | Positioning guide device with guide wire in subclavicular venous access |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105268086A (en) * | 2015-11-13 | 2016-01-27 | 中国人民解放军第二军医大学 | Magnetic guidance wire system |
| CN105268086B (en) * | 2015-11-13 | 2018-03-30 | 中国人民解放军第二军医大学 | Magnetic control guiding wire system |
| CN110152162A (en) * | 2018-02-12 | 2019-08-23 | 510心脏装置公司 | It is improved to turn to introducer sheath component |
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| Publication number | Publication date |
|---|---|
| CN103100138B (en) | 2015-09-30 |
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