CN106037895A - Dual-channel acoustic-guided epidural puncture needle - Google Patents
Dual-channel acoustic-guided epidural puncture needle Download PDFInfo
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- CN106037895A CN106037895A CN201610520979.4A CN201610520979A CN106037895A CN 106037895 A CN106037895 A CN 106037895A CN 201610520979 A CN201610520979 A CN 201610520979A CN 106037895 A CN106037895 A CN 106037895A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3401—Puncturing needles for the peridural or subarachnoid space or the plexus, e.g. for anaesthesia
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
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Abstract
A dual-channel acoustic-guided epidural puncture needle is composed of a pressure-taking device, an epidural puncture needle tube, a spinal needle assembly, a needle seat, and a syringe pump connector. An anesthetic catheter channel is arranged inside a needle wall of the epidural puncture needle tube, the end of the anesthetic catheter channel is provided with a bend needle end, the top of the needle wall is provided with a spinal needle tube channel, the needle seat has a double-channel structure, a spinal needle inlet and an anesthetic catheter inlet at one end of the needle seat respectively communicate with the spinal needle tube channel and the anesthetic catheter channel of the epidural puncture needle tube, the spinal needle assembly is composed of a spinal needle, a positioning sleeve and a needle handle, the spinal needle comprises a spinal needle tube wall and a spinal needle tube cavity, and a connecting tube at an outlet end of the pressure-taking device is connected to the needle seat through a connecting pipe connector. According to the puncture needle, a double-channel entry structure of the anesthetic catheter and the spinal needle is adopted, the operation mode of combined spinal-epidural anesthesia is changed, and the success of the puncture and anesthesia is guaranteed; and the structure of the spinal needle with the positioning sleeve and the structure of the epidural needle tube with a back hole are provided so that a guarantee is provided for correct implementation of spinal anesthesia.
Description
Technical field
The present invention relates to technical field of medical instruments, be specifically related to a kind of dual pathways sound wave and guide anesthesia spinal needle.
Background technology
Intravertebral anesthesia is widely used clinically, is usually used in the art of the operations such as extremity, abdominal part or thoracic cavity and postoperative town
Bitterly, other indication also includes such as the analgesia the etc. when analgesia of leg ischemic pain and deathbed care, is sometimes additionally operable to
The traumatic patient of emergency treatment.Another one be the purposes known to the public be exactly the application in painless delivery, do not affecting anemia of pregnant woman
Suitable analgesic effect is provided on the premise of consciousness.
Intravertebral anesthesia generally comprises: one is epidural anesthesia, and another is that subarachnoid anesthesia (is typically also referred to as waist
Fiber crops).Both belong to intravertebral anesthesia, but route of administration, medicine site of action are different.For anaesthetic effect, Hou Zheqi
Effect is fast, definite effect, but general little successive administration, be not suitable for prolonged operations；The former onset is slow, and effect may differ from one
A bit, but can be with successive administration, the operation of applicable long period.The anaesthetic effect of the latter is the whole lower part of the body, by the control of plane
System meets the requirement of different operation, is suitable for the operation of the lower part of the body such as lower abdomen, lower limb.The former anaesthetic effect is that body is a certain
Section, can puncture by diverse location, the applicable operation of all sites in addition to head, the most do not do cervical region,
The epidural anesthesia of upper limb, chest such higher part position.And combined spinal-epidural anesthesia is exactly the combination of first two method, reaching waist
While fiber crops are rapid-action, effective, it is also possible to extend anesthesia duration by epidural anesthesia, it is possible to connect Epidural Analgesia Pump
Carry out Postoperative Analgesia After.
The most any method of above-mentioned intravertebral anesthesia, will be implemented by the operation of epidural puncture.So,
Epidural puncture location, Epidural catheterization, subarachnoid space puncture and become the key method into successful implementation intravertebral anesthesia
Step.
Why general conventional opposing disappearance technological orientation epidural space, can utilize opposing disappearance technology clinically
Discerning whether to enter epidural space, the quality being because ligamenta flava is the finest and close, it is difficult to pierce through and inject medicine, and the opposing party
Face, epidural cavity pressure is the lowest or in negative pressure, resistance is the least.Need a hands to pin syringe piston forward during operation always
Advancing, another hands hand-held puncture needle order thrusts different tissues.After resistance disappears, piston can be very easy to be pushed into pin
Cylinder, it is simply that have arrived at epidural space.
But the epidural anesthesia of failure is the most common in clinic.Epidural anesthesia is invalid, it is meant that patient is not by (fully)
Anesthesia.Different in this incidence rate of Different hospital, typically between 10-20%, may be higher in teaching hospital's incidence rate.
Having the generation that a lot of reasons leads to the failure, one of them common reason and complication are that die is worn out, and incidence rate is at 0.5-3%
Between, for unfamiliar doctor, incidence rate may be higher.It is typically due to pin in piercing process push away excessively to use
Power and/or too far, causes puncture to exceed epidural space, punctures spinal dura mater, cause cerebrospinal fluid to leak into epidural space.These feelings
Condition would generally bring a kind of consequence die to have a headache after wearing out.The dura mater of 50-80% wears out the head after dura mater all can be caused to wear out
Bitterly, needing to inject autologous blood to epidural and be filled with treatment, this needs to carry out again epidural puncture.In general, sick
People needs within 1-2 days, to keep lying status in hospital.In some cases, puncturing and be also possible to injured nerve fiber, patient there will be temporarily
Property paraesthesia.Additionally also having some rare complication, including epidural abscess and epidural hematoma, this is likely to cause
Patient paralyses.Also having a common and important failure cause is that placement catheter position is improper.If traditional validation testing
Time invalid (as patient body position changes, use extra drug), it is necessary to again do epidural anesthesia, even consider general anesthesia.
Subarachnoid anesthesia is also referred to as lumbar anesthesia, is after using anesthesia spinal needle Needle localization, leads to lumbar anaesthesia puncture needle
Cross epidural puncture syringe intracavity enter into epidural space so that puncture spinal dura mater enter into subarachnoid injection anaesthetic, effect
Rapid and definite；And when operating time is longer or can not give know that operation requires time for time, combined spinal-epidural anesthesia become into anesthesia
The first-selection of doctor.Combined spinal-epidural anesthesia combines the advantage of lumbar anesthesia and epidural anesthesia, makes anaesthetic effect be improved, improves
Operating technology level, has at home and abroad obtained in-depth study and has been widely applied.
It is after epidural space is thrust with combined spinal-epidural anesthesia puncture needle in elder generation that existing combined spinal-epidural anesthesia punctures, then by lumbar anesthesia
Pin thrusts subarachnoid space through combined spinal-epidural anesthesia puncture needle inner chamber implements lumbar anesthesia, and being then log out spinal needle, to carry out dura mater more external
Pipe, then stands up regulation lumbar anesthesia plane.Subarachnoid anesthesia during this and epidural catheter put the order of pipe because being subject to
Structure to anesthesia spinal needle limits, and cannot change, so when inserting segmental epidural catheter, it is possible that lead
Pipe along former lumbar puncture needle the pin hole that spinal dura mater stays be strayed into subarachnoid space thus cause catheter position mistake problem,
Inserting the problem etc. that segmental epidural catheter is failed time and again, these situations are it is possible that such as high-order sensation and nervus motorius hinder
The syndrome such as stagnant, safety coefficient is low, the mishandling life that even can affect patient.
Surgical operation just can meet the needs of operation sometimes for the anesthesia individually carrying out subarachnoid space, under this situation
Operation, be first to carry out epidural puncture, then spinal needle entered epidural space by the inner chamber of anesthesia spinal needle and sting
Enter subarachnoid space.When practical operation, the anesthesia spinal needle inner chamber due to the diameter of spinal needle less (0.4-0.55mm)
Being relatively large in diameter (0.9-1.6mm), spinal needle degree of freedom in puncture needle is relatively big, and spinal needle brings out mouth passing epidural needle
Time, owing to being guided by pin end cutting edge curved surface, spinal needle can be forced to point to uncertain along the bending of puncture needle cutting edge curved surface
Direction thus cause puncture failure or repeat and extend the operating time.
Current existing invention design is to be the outer guide groove of pin by the inserting needle highway route design of spinal needle, compares and connect in principle
Closely, but have because technique manufacture on reason needle body thicker, not there is Practical significance, have because design model excessively
Idealization, lacks the support of modern crafts method and can not realize.Relatively practical wire surface guide groove is at puncture needle
Surface Machining goes out a shallow slot line, by spinal needle with the angle of about 300 ° at the afterbody inserting needle of anesthesia spinal needle, utilizes waist
The elastic deformation of fiber crops pin forces spinal needle to be attached on the shallow slot of anesthesia spinal needle and forwards slides at cutting edge.Such method
Shortcoming be that obstacle is met in the front of once spinal needle or spinal needle needle body occurs irregular bending, spinal needle will depart from
Shallow slot points to uncertain direction thus causes puncture failure.
Summary of the invention
The present invention is directed to the deficiency that prior art exists, it is provided that a kind of dual pathways sound wave guides anesthesia spinal needle.
The technical solution adopted for the present invention to solve the technical problems is:
A kind of dual pathways sound wave guides anesthesia spinal needle, by pressure vessel, epidural puncture needle tubing, spinal needle assembly, needle stand and
Syringe pump joint forms, and the pin pars intramuralis of epidural puncture needle tubing arranges anesthetic tube passage, and anesthetic tube channel end is arranged
Bend pipe pin end, pin wall top arranges lumbar anesthesia needle tubing table passage, and needle stand has channel structure, the spinal needle introducing port of needle stand one end
Communicating with lumbar anesthesia needle tubing table passage and the anesthetic tube passage of epidural puncture needle tubing respectively with anesthetic tube entrance, spinal needle is total
Becoming to be made up of spinal needle, positioning sleeve and needle handle, spinal needle includes spinal needle tube wall and spinal needle tube chamber, and pressure vessel two ends connect respectively
Connecing a connecting tube, the connecting tube of pressure vessel entrance point is connected with syringe pump by syringe pump joint, the company of the pressure vessel port of export
Adapter is connected with needle stand by connecting tube joint.
Between above-mentioned needle stand and epidural puncture needle tubing, pushing assisted plate is set.
The lumbar anesthesia needle tubing table channel size of above-mentioned epidural puncture needle tubing is suitable with the size of conventional spinal needle, can accommodate waist
Fiber crops pin passes through from which, thus ensure that anesthetic tube and spinal needle each carry out putting pipe and puncturing, lumbar anesthesia with single path
Needle tubing table passage is semi-closed structure, wherein can accommodate and limit the 3/5 of spinal needle diameter in groove, make spinal needle run through
Journey will not be deviate from outside groove because of external cause or spinal needle self-deformation.
The needle tubing blade surface elbow center of above-mentioned epidural puncture needle tubing arranges a dorsal pore, dorsal pore aperture with match
Spinal needle external diameter identical.
The operation principle of the present invention is: should be full of medical saline during this product work in assembly as working media,
Saline fluid is pumped out, by syringe pump joint → connecting tube by the syringe pump in " sound wave guides epidural puncture guided ware "
→ pressure vessel → connecting tube → anesthetic tube passage → needle handle → epidural puncture needle tubing → bend pipe pin end, when " sound wave guides hard
The outer guiding puncture instrument of film " in syringe pump will be consequently formed the infusion channel of pressure when starting working.Wear when needle end part divides
When lunging into tissue, owing to liquid outlet is stopped, the fluid pressure in assembly can accumulate rising, and this pressure passes through
Expansion chamber and pressure guide hole on pressure vessel conduct to gel silica membrane, the change of pressure are conducted extremely after gel silica membrane compressive deformation
On pressure transducer in " sound wave guides epidural puncture guided ware ", " sound wave guides epidural puncture guided ware " is by this pressure
Change transitions be acoustic signals and figure signal shows on the screen and speaker of instrument, point out with this and guide doctor to sentence
The position of disconnected puncture needle, reaches correctly to puncture the purpose of epidural space；After puncture needle is completed to puncture by said procedure, Yi Shengke
First it is about to anesthetic tube with the sufficient time, at the anesthetic tube entrance 7 of needle stand tail end, anesthetic tube is inserted epidural space,
Then by spinal needle from the lumbar anesthesia needle tubing table passage of the spinal needle porch implanting needle tube-surface of needle stand tail end, and move ahead along guide groove
Enter spinal dura mater to bend pipe pin end along the duct formed by anesthesia spinal needle and thrust subarachnoid injection anaesthetic.When only
Needing to carry out subarachnoid anesthesia without when epidural space places anesthetic tube, doctor can be completed by above-mentioned steps
After epidural puncture, the spinal needle taking band positioning sleeve enters from anesthetic tube porch, now due to the positioning sleeve on spinal needle
Define that spinal needle is in the center of anesthesia spinal needle inner chamber all the time, can be the most successfully by the back of the body of anesthesia spinal needle
Hole passes entrance subarachnoid space, loses without worrying spinal needle can pass along the cambered surface of anesthesia spinal needle blade surface
It is correctly oriented.
The present invention uses dependence sound, image, the mode of visualization guiding in real time, ensure that the success of epidural puncture
Rate, and the structure that anesthetic tube enters with the spinal needle dual pathways, change the mode of operation of combined spinal-epidural anesthesia, it is ensured that puncture
Success with anesthesia；And correct enforcement that the epidural needle tubular construction of the spinal needle structure of band positioning sleeve and band dorsal pore is lumbar anesthesia carries
Supply to ensure, thus there is great using value clinically.
Accompanying drawing explanation
The present invention is further described with embodiment below in conjunction with the accompanying drawings.
Fig. 1 is the structural representation of the present invention；
Fig. 2 is the generalized section of epidural puncture needle tubing of the present invention；
Fig. 3 is the schematic diagram two in a-a cross section in Fig. 2；
Fig. 4 is the structural representation of spinal needle assembly of the present invention.
1 pressure vessel, 2 epidural puncture needle tubings, 3 spinal needle assemblies, 4 needle stands, 5 connecting tubes, 6 connecting tubes, 7 injections in figure
Pump joint, 8 bend pipe pin ends, 9 spinal needle introducing ports, 10 anesthetic tube entrances, 11 pushing assisted plates, 12 connecting tube joints, 21 pin walls, 22
Anesthetic tube passage, 23 dorsal pores, 24 lumbar anesthesia needle tubing table passages, 31 spinal needles, 32 spinal needle tube walls, 33 spinal needle tube chambers, 34 fixed
Position set, 35 needle handles.
Detailed description of the invention
As shown in Figure 1, Figure 2, Figure 3 and Figure 4, a kind of dual pathways sound wave guides anesthesia spinal needle, by pressure vessel 1, dura mater
Outer puncture needle tubing 2, spinal needle assembly 3, needle stand 4 and syringe pump joint 7 form, and the pin wall 21 of epidural puncture needle tubing 2 is internal to be set
Putting anesthetic tube passage 22, anesthetic tube passage 22 end arranges bend pipe pin end 8, and pin wall 21 top arranges lumbar anesthesia needle tubing table passage
24, needle stand 4 has channel structure, and spinal needle introducing port 9 and the anesthetic tube entrance 10 of needle stand 4 one end are worn with epidural respectively
The lumbar anesthesia needle tubing table passage 24 of pricker pipe 2 and anesthetic tube passage 22 communicate, and spinal needle assembly 3 is by spinal needle 31, positioning sleeve 34
Forming with needle handle 35, spinal needle 31 includes that spinal needle tube wall 32 and spinal needle tube chamber 33, pressure vessel 1 two ends connect connecting tube respectively
5 and connecting tube 6, the connecting tube 6 of pressure vessel 1 entrance point is connected with syringe pump by syringe pump joint 7, pressure vessel 1 port of export
Connecting tube 5 is connected with needle stand 4 by connecting tube joint 12.Pushing assisted plate 11 is set between needle stand 4 and epidural puncture needle tubing 2.Firmly
The lumbar anesthesia needle tubing table channel size puncturing needle tubing outside film is suitable with the size of conventional spinal needle, can accommodate spinal needle and lead to from which
Crossing, thus ensure that anesthetic tube and spinal needle each carry out putting pipe and puncturing with single path, lumbar anesthesia needle tubing table passage is
Semi-closed structure, wherein can accommodate and limit the 3/5 of spinal needle diameter in groove, makes the spinal needle will not be because of outward during walking
Portion's reason or spinal needle self-deformation and deviate from outside groove.The needle tubing blade surface elbow center of epidural puncture needle tubing 2 arranges the back of the body
Hole 23, dorsal pore 23 aperture is identical with spinal needle 31 external diameter matched.
The operation principle of the present invention is: should be full of medical saline during this product work in assembly as working media,
Saline fluid is pumped out, by syringe pump joint → connecting tube by the syringe pump in " sound wave guides epidural puncture guided ware "
→ pressure vessel → connecting tube → anesthetic tube passage → needle handle → epidural puncture needle tubing → bend pipe pin end, when " sound wave guides hard
The outer guiding puncture instrument of film " in syringe pump will be consequently formed the infusion channel of pressure when starting working.Wear when needle end part divides
When lunging into tissue, owing to liquid outlet is stopped, the fluid pressure in assembly can accumulate rising, and this pressure passes through
Expansion chamber and pressure guide hole on pressure vessel conduct to gel silica membrane, the change of pressure are conducted extremely after gel silica membrane compressive deformation
On pressure transducer in " sound wave guides epidural puncture guided ware ", " sound wave guides epidural puncture guided ware " is by this pressure
Change transitions be acoustic signals and figure signal shows on the screen and speaker of instrument, point out with this and guide doctor to sentence
The position of disconnected puncture needle, reaches correctly to puncture the purpose of epidural space；After puncture needle is completed to puncture by said procedure, Yi Shengke
First it is about to anesthetic tube with the sufficient time, at the anesthetic tube entrance 7 of needle stand tail end, anesthetic tube is inserted epidural space,
Then by spinal needle from the lumbar anesthesia needle tubing table passage of the spinal needle porch implanting needle tube-surface of needle stand tail end, and move ahead along guide groove
Enter spinal dura mater to bend pipe pin end along the duct formed by anesthesia spinal needle and thrust subarachnoid injection anaesthetic.When only
Needing to carry out subarachnoid anesthesia without when epidural space places anesthetic tube, doctor can be completed by above-mentioned steps
After epidural puncture, the spinal needle taking band positioning sleeve enters from anesthetic tube porch, now due to the positioning sleeve on spinal needle
Define that spinal needle is in the center of anesthesia spinal needle inner chamber all the time, can be the most successfully by the back of the body of anesthesia spinal needle
Hole passes entrance subarachnoid space, loses without worrying spinal needle can pass along the cambered surface of anesthesia spinal needle blade surface
It is correctly oriented.
The invention have the advantage that
Pressure vessel, sensor device and the combination of acoustic image converting system, judge puncture needle position by rule of thumb by anaesthetist with feel
Putting the method improvement with piercing process for judge by sound wave and screen waveform, effect is directly, accurately and true；Can realize
Lumbar puncture needle and anesthetic tube are put pipe and are walked two ways respectively, can first indwelling anesthetic tube, after carry out waist and wear (that is: under arachnoidea
Chamber is anaesthetized) operation, the change of this operation order is greatly improved the job success ratio of anaesthetist；Puncture needle surface lumbar puncture needle passage
The design of semi-closed structure and manufacturing process so that lumbar puncture needle is limited in passage retreats, and avoids the most past semi open model
The lumbar puncture needle abjection guide groove deviation that guide groove design exists punctures direction thus causes the hidden danger of puncture failure；Setting of puncture needle dorsal pore
Meter, solves when lumbar puncture needle moves ahead along puncture needle tube chamber and is forced to bend along pin end arc sword in exit, thus deviate puncture direction
Drawback. because puncture needle dorsal pore diameter is much smaller compared with the diameter of anesthetic tube, be not result in what anesthetic tube passed along dorsal pore
Phenomenon；The design of spinal needle positioning sleeve, avoids spinal needle diameter and causes not with the size redundancy on puncture needle minor diameter fit
Puncture needle dorsal pore and the possibility passed along puncture needle arc sword can accurately be directed at；Can be used for epidural anesthesia, combined spinal-epidural anesthesia,
Extremity, abdominal part or thoracic cavity etc. operation art in and Postoperative Analgesia After, other indication also includes such as leg ischemic pain
Analgesia etc. when analgesia and deathbed care, the traumatic patient of emergency treatment；Application in painless delivery, is not affecting anemia of pregnant woman's consciousness
Suitable analgesic effect is provided under premise；And new anaesthetist's practical teaching and monitoring.
Claims (4)
1. dual pathways sound wave guides an anesthesia spinal needle, by pressure vessel, epidural puncture needle tubing, spinal needle assembly, needle stand
Forming with syringe pump joint, the pin pars intramuralis of epidural puncture needle tubing arranges anesthetic tube passage, and anesthetic tube channel end sets
Putting bend pipe pin end, pin wall top arranges lumbar anesthesia needle tubing table passage, and needle stand has channel structure, and the spinal needle of needle stand one end imports
Mouth and anesthetic tube entrance communicate with lumbar anesthesia needle tubing table passage and the anesthetic tube passage of epidural puncture needle tubing respectively, spinal needle
Assembly is made up of spinal needle, positioning sleeve and needle handle, and spinal needle includes spinal needle tube wall and spinal needle tube chamber, pressure vessel two ends respectively
Connecting a connecting tube, the connecting tube of pressure vessel entrance point is connected with syringe pump by syringe pump joint, the pressure vessel port of export
Connecting tube is connected with needle stand by connecting tube joint.
Dual pathways sound wave the most according to claim 1 guides anesthesia spinal needle, it is characterized in that needle stand and epidural puncture
Pushing assisted plate is set between needle tubing.
Dual pathways sound wave the most according to claim 1 guides anesthesia spinal needle, it is characterized in that epidural puncture needle tubing
Lumbar anesthesia needle tubing table channel size is suitable with the size of conventional spinal needle, can accommodate spinal needle and pass through from which, thus ensure that fiber crops
Liquor-saturated conduit and spinal needle each carry out putting pipe and puncturing with single path, and lumbar anesthesia needle tubing table passage is semi-closed structure, wherein
Can accommodate and limit the 3/5 of spinal needle diameter in groove, make the spinal needle will not be because of external cause or spinal needle during walking
Self-deformation and deviate from outside groove.
Dual pathways sound wave the most according to claim 1 guides anesthesia spinal needle, it is characterized in that epidural puncture needle tubing
Needle tubing blade surface elbow center arranges a dorsal pore, and dorsal pore aperture is identical with the spinal needle external diameter matched.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201610520979.4A CN106037895A (en) | 2016-07-05 | 2016-07-05 | Dual-channel acoustic-guided epidural puncture needle |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201610520979.4A CN106037895A (en) | 2016-07-05 | 2016-07-05 | Dual-channel acoustic-guided epidural puncture needle |
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108652721A (en) * | 2018-07-16 | 2018-10-16 | 杭州三坛医疗科技有限公司 | A kind of intelligence cavum epidural puncture device |
| CN108742795A (en) * | 2018-06-22 | 2018-11-06 | 杭州三坛医疗科技有限公司 | Infusion device and its control method in intelligent marrow |
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108742795A (en) * | 2018-06-22 | 2018-11-06 | 杭州三坛医疗科技有限公司 | Infusion device and its control method in intelligent marrow |
| CN108742795B (en) * | 2018-06-22 | 2023-10-03 | 杭州三坛医疗科技有限公司 | Intelligent intramedullary transfusion device and control method thereof |
| CN108652721A (en) * | 2018-07-16 | 2018-10-16 | 杭州三坛医疗科技有限公司 | A kind of intelligence cavum epidural puncture device |
| CN108652721B (en) * | 2018-07-16 | 2023-08-18 | 杭州三坛医疗科技有限公司 | Intelligent epidural space puncture device |
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Application publication date: 20161026 |