CN107361830A - The brachial plexus nerve block needle guard part and its application method of a kind of ultrasound guidance - Google Patents

Abstract

The present invention discloses the brachial plexus nerve block needle guard part and its application method of a kind of ultrasound guidance, external member includes epitheca pin, the epitheca pin pin heart, interior core needle, puts to stay pipe and put and stay tube connector, the epitheca pin pin heart matches with epitheca pin, when epitheca pin pin heart plug-in card is in epitheca pin, epitheca pin pin mind portion is concordant with epitheca pin syringe needle, put and stay pipe sleeve to be located on interior core needle needle body, interior core needle side opening exposes to put to needle point position stays pipe, when be arranged with put the interior core needle plug-in card for staying pipe in epitheca pin when, put and stay pipe tail end to stretch out epitheca pin syringe needle, put and stay tube connector to stay pipe to match with putting.The application method is inserted the good epitheca pin pin heart of grafting and the combination of epitheca pin outside brachial plexus nerve sheath；The heart pin insertion epitheca pin for being cased with putting flow tube is secured to grafting；Puncture to target nerve and inject local anaesthetics after confirming, if necessary to more nerve blocks, the repeatable operation of this step；Flow tube is put in indwelling.The present invention significantly reduces the puncture pain of patient, and it is accurate that it puts pipe, can realize continuous block effect.

Description

An ultrasound-guided brachial plexus block needle set and method of use thereof

technical field

The invention relates to a brachial plexus block needle set under the guidance of ultrasound and a use method thereof.

Background technique

There are two main types of nerve stimulation block needles currently in use:

One is the outer target needle, that is, the beveled needle (the needle tip is at an acute angle of less than 20 degrees). Its disadvantage is that it can easily cause neurovascular cutting damage. When the outer target needle walks in the tissue, it is easy to cause more unnecessary damage, such as tissue cutting. , puncture blood vessels (arteries are prone to hematoma, veins are prone to congestion), puncture or cutting nerves will cause mild skin numbness in the corresponding nerve innervation area, and severe weakness of the corresponding innervated muscles;

The second is that the inner core needle, that is, the side hole needle (the needle tip is a round needle tip), has the disadvantages that it is troublesome in the skin puncture process, the puncture force is large, and the patient feels great pain. At the same time, in the process of puncture, in order to avoid damage to nerves and blood vessels In case of possible damage, try to use a needle tube with a smaller outer diameter. Due to the thinner needle body, the needle body is easily deformed with the movement of muscles and other human tissues during deep puncture, causing the needle tip to shift and causing a deviation in the distance between the needle tip and the nerve.

During the operation, because the outer sheath needle does not actually reach the target nerve attachment, when the indwelling tube is inserted through the outer sheath needle, the position of the catheter is not accurate, and the continuous block effect cannot be guaranteed.

Contents of the invention

In order to solve the above technical problems, the present invention provides an ultrasound-guided brachial plexus block needle kit and its use method, which greatly reduces the patient's puncture pain, and can achieve a continuous block effect with accurate catheter placement.

To achieve the above object, the present invention adopts the following technical solutions:

A brachial plexus block needle kit under the guidance of ultrasound, which comprises an outer sheath needle, an outer sheath needle core, an inner core needle, an indwelling tube and an indwelling tube connector, the outer sheath needle core and the indwelling tube connector The outer sheath needle is matched, when the outer sheath needle core is stuck on the outer sheath needle, the head of the outer sheath needle core is flush with the needle head of the outer sheath needle, and the indwelling tube is sleeved on the On the needle body of the inner core needle, the side hole to the needle tip of the inner core needle is exposed to the indwelling tube. When the inner core needle covered with the indwelling tube is inserted into the outer sheath needle, the The tail end protrudes from the needle of the outer sheath needle, and the indwelling tube connector is matched with the indwelling tube.

The outer sheath needle is a thick needle with an inclined plane, and the outer sheath needle includes a thick needle body, and the tail end of the thick needle body is inserted into the handle part, and the handle part is provided with a channel communicating with the through hole of the thick needle body. The handle of the sheath needle is further provided with a pressing part for pressing the tail end of the indwelling tube or an opening is opened in the handle of the sheath needle, and the opening corresponds to the tail of the indwelling tube.

The pressing part is a transparent elastic body arranged on the handle part of the outer sheath needle.

The inner core needle is a fine needle with a side hole, and the inner core needle includes a thin needle body, and the thin needle body is inserted into a handle portion, and the handle portion is provided with a channel communicating with the cavity of the thin needle body.

The handle portion of the outer sheath needle and the handle portion of the inner core needle are in an insertion structure.

The handle of the outer sheath needle is provided with a slot, and the handle of the inner core needle is provided with a protrusion matching the slot.

The needle core of the outer sheath needle includes a tube body and a holding part, the head end of the tube body is closed, the tail end of the tube body is inserted into the holding part, and the head of the tube body blocks the outer sheath needle The needles are flush, and the holding part of the needle core of the sheath needle is provided with an insertion piece that matches the slot of the sheath needle.

The indwelling tube is also matched with a holder.

A method for using the brachial plexus block needle set under the guidance of ultrasound, first inserting the core of the outer sheath needle into the outer sheath needle, piercing through the skin and subcutaneous tissue together, and staying outside the brachial plexus sheath, Pull out the core of the outer sheath needle, insert the inner core needle covered with the indwelling tube into the outer sheath needle, make the handle part of the inner needle and the handle part of the outer sheath needle snap fit, and make the inner core needle The core needle and the outer sheath needle are fixed. At this time, the needle tip of the inner needle protrudes out of the needle hole of the outer sheath needle, hold the handle of the inner core needle to adjust the puncture angle, avoid the axillary artery and axillary vein, and pierce into the brachial plexus sheath, and then After arriving at the target nerve, turn on the nerve electrical stimulator, confirm that there is movement of the corresponding muscle innervated by the brachial plexus, and after the local anesthetic is injected, if multiple nerve blocks are required, hold the handle of the outer sheath needle and place the inner The needle tip of the core needle retreats to the outside of the brachial plexus sheath, and then adjust the angle for the next nerve positioning. After completion, press the pressing part or opening of the outer sheath needle with your hand, press the indwelling tube, and pull out the inner core needle , and then use the head of the outer sheath needle core to withstand the tail end of the indwelling tube, push the indwelling tube down and pull out the outer sheath needle at the same time, keep the indwelling tube on the body, and then insert the indwelling tube at the end of the indwelling tube The end is connected to the indwelling tube connector, and the next step of drug administration is performed, and the puncture is completed. .

Beneficial effects of the present invention: first, puncture is performed after combining the outer target needle and the needle center of the outer target needle, and through ultrasonic observation, the needle tip stays at a distance of 2 cm from the nerve. Since the needle tip is inclined, the puncture force is small, and the patient feels less pain, which can The puncture channel is quickly established, and because the distance from the nerve is long, it can prevent damage to the nerve and blood vessel. Pull out the needle core of the outer target needle, and then use the inner core needle to penetrate through the needle tube of the outer target needle. Since the front part of the inner core needle has an ultrasonic imaging design, it can be clearly distinguished from the needle body of the outer needle under ultrasound, and then continue Deep down, perform a nerve stimulation block operation. With the cooperation of ultrasound, guide the inner core needle to approach the nerve and move the needle tip to the target area. The design of the side hole needle tip of the inner core needle can effectively prevent cutting damage to nerves and blood vessels; After puncture administration, it can be directly and accurately placed near the target nerve to ensure the subsequent continuous blocking effect; compared with the traditional indwelling tube, the present invention is much shorter than the traditional indwelling tube exposed outside the skin, and will not There is a discount, so that there will be no problem of replacing the indwelling tube again. A fixer is set on the outer wall of the indwelling tube between the skin external indwelling tube and the indwelling tube connector, and the fixer is fixed on the fixer with medical adhesive tape. on the skin to prevent displacement of the indwelling tube.

Description of drawings

Fig. 1 is a schematic diagram of the combined structure of the sheath needle and the sheath needle core of the present invention.

FIG. 1A is a schematic structural view of the sheath needle in FIG. 1 .

FIG. 1B is a schematic structural view of the sheath needle core in FIG. 1 .

Fig. 1C is a schematic structural view of another embodiment of the sheath needle.

Fig. 2A is a schematic diagram of the structure of the indwelling tube.

Fig. 2B is a schematic structural view of the inner core needle.

Fig. 2 is a schematic structural view of the indwelling tube sleeved on the inner core needle of the present invention.

Fig. 3 is a schematic diagram of the assembly of the outer sheath needle, the inner core needle and the indwelling tube of the present invention.

Fig. 4 is a schematic diagram of the combined structure of the indwelling tube, the fixer and the indwelling tube connector of the present invention.

1: outer sheath needle, 11: thick needle body, 111: needle head, 12: handle part, 121: pressing part, 122: hole, 123: opening, 124: slot, 2: outer sheath needle core, 21: tube Body, 211: head, 22: grip part, 221: insert piece, 3: inner core needle, 31: thin needle body, 32: handle part, 321: protrusion, 322: channel, 311: side hole, 4 : flow tube, 41: fixer, 5: flow tube connector.

detailed description

As shown in Figures 1 to 4, a brachial plexus block needle kit under the guidance of ultrasound, which includes an outer sheath needle 1, an outer sheath needle core 2, an inner core needle 3, an indwelling tube 4 and an indwelling tube Connector 5, the sheath needle core 2 is matched with the sheath needle 1, when the sheath needle core 2 is inserted into the sheath needle 1, the head 211 of the sheath needle core 2 is flush with the needle head 111 of the sheath needle 1 The indwelling tube 4 is set on the thin needle body 31 of the inner core needle 3, and the side hole 311 of the inner core needle 3 to the needle tip is exposed to the indwelling tube 4. When the inner core needle of the indwelling tube 4 is set 3 When inserting and locking the outer sheath needle 1, the tail end of the indwelling tube 4 protrudes from the needle head 111 of the sheath needle 1, and the indwelling tube connector 5 matches the indwelling tube 4.

As shown in Figure 1A, the outer sheath needle 1 is a thick needle with an inclined plane, and the outer sheath needle 1 includes a thick needle body 11. The hole 122 connected to the cavity, the handle portion 12 of the sheath needle 1 is additionally provided with a pressing portion 121 for pressing the tail end of the indwelling tube 4 or an opening 123 is opened in the handle portion 12 of the sheath needle 1 (as shown in FIG. 1C ), The tail of the indwelling tube 4 is directly pressed by hand through the opening 123 , and the handle 12 of the sheath needle 1 is provided with a slot 124 .

The pressing part 121 is a transparent elastic body provided on the handle part 12 of the sheath needle 1 .

The outer sheath needle 1 is matched with an outer sheath needle core 2, the purpose is to prevent tissue damage during puncture;

As shown in Figure 1B, the sheath needle core 2 includes a tubular body 21 and a grip portion 22, the grip portion 21 of the sheath needle core 2 and the handle portion 12 of the sheath needle 1 are in an inserting structure, and the tubular body 21 It is a solid tubular body, the tail of the tubular body 21 is inserted into the grip part 22, the head 211 of the tubular body 21 blocks the needle head 111 of the outer sheath needle 1, the two are flush, and the outer diameter of the tubular body 21 is equal to the outer sheath needle 111. The inner diameter of the needle body 11 of the sheath needle 1 ; the gripping portion 22 of the needle core 2 of the sheath needle is provided with an insertion piece 221 matching the slot 124 .

The handle portion 12 of the outer sheath needle 1 and the handle portion 32 of the inner core needle 3 are in an insertion structure.

As shown in Figure 2B, the inner core needle 3 is a fine needle with a side hole, the inner core needle 3 includes a thin needle body 31, one end of the thin needle body 31 is inserted into the handle part 32, and the handle part 32 has a cavity with the fine needle body 31 Connected hole 322, the handle portion 32 is additionally provided with a protrusion 321 matching the slot 124; the tail end of the thin needle body 31 of the inner core needle 3 is connected with a lead, and the other end of the lead is connected with the nerve electrical stimulator, ( not shown in the figure).

As shown in FIG. 2A , it is a schematic structural diagram of the flow tube 4 .

As shown in FIG. 2 , the flow tube 4 is sleeved on the thin needle body 31 of the inner core needle 3 along the length direction thereof, and the side hole 311 of the thin needle body 31 is exposed to the needle tip.

As shown in Figure 3, the inner core needle 3 sleeved with the flow tube 4 is inserted into the cavity of the thick needle body 11 of the outer sheath needle 1 through the channel 122 of the outer sheath needle 1 and extends out the needle head 111 of the outer sheath needle 1. The protrusion 321 of the handle part 32 of the core needle 3 is inserted into the slot 124 of the handle part 12 of the sheath needle 1 .

The needle tip of the inner core needle 3 stretches out from the needle head 111 of the outer sheath needle 1, and the extension length is about 1 cm.

As shown in Figure 4, in order to prevent the displacement of the flow tube 4, a fixer 41 is also matched on the indwelling tube 4 outside the skin. Screw on the flow tube connector 5 at the end, and then connect the flow tube connector 5 to the catheter for the next step of drug delivery.

The use process of the brachial plexus block needle set under the guidance of ultrasound of the present invention is roughly summarized as four steps;

Step 1: Insert the inserted sheath needle core and sheath needle into the outer sheath of the brachial plexus;

Step 2: Insert the inner needle covered with the flow tube into the outer sheath needle and fix it;

Step 3: After the puncture to the target nerve is confirmed, local anesthetic is injected. If multiple nerve blocks are required, this step can be repeated;

Part Four: Indwelling the flow tube.

The method of using the brachial plexus block needle kit under the guidance of ultrasound is described in detail below: first, insert the core of the outer sheath needle into the outer sheath needle, puncture through the skin and subcutaneous tissue together, and stay in the brachial plexus sheath In addition, pull out the needle core of the outer sheath needle, put the inner core needle covered with the indwelling tube into the outer sheath needle, make the handle part of the inner needle and the handle part of the outer sheath needle engage, Fix the inner core needle and the outer sheath needle. At this time, the needle tip of the inner core needle protrudes out of the needle hole of the outer sheath needle. Hold the handle of the inner core needle to adjust the puncture angle, avoiding the axillary artery and axillary vein, and puncture into the brachial plexus sheath. , and then after arriving at the target nerve, turn on the nerve electrical stimulator, confirm that there is movement of the corresponding muscle innervated by the brachial plexus, and after the local anesthetic is injected, if multiple nerve blocks are required, hold the handle of the outer sheath needle, Withdraw the needle tip of the inner core needle to the outside of the brachial plexus sheath, then adjust the angle, and perform the next nerve positioning. core needle, and then use the head of the outer sheath needle core to withstand the tail end of the indwelling tube, push the indwelling tube down and pull out the outer sheath needle at the same time, keep the indwelling tube on the body, and then indwell The end of the tube is connected to the indwelling tube connector, and the next step of drug administration is performed, and the puncture is completed.

Claims (9)

1. A kind of 1. brachial plexus nerve block needle guard part of ultrasound guidance, it is characterised in that：It include epitheca pin, the epitheca pin pin heart, Interior core needle, put to stay pipe and put and stay tube connector, the epitheca pin pin heart matches with the epitheca pin, when the epitheca pin pin heart plug-in card is at this During epitheca pin, the head of the epitheca pin pin heart is concordant with the syringe needle of the epitheca pin, and this puts the needle body for staying pipe sleeve to be located at the interior core needle On, side opening to the needle point position of the interior core needle, which exposes to this, is put and stays pipe, and the interior core needle plug-in card of pipe is stayed at this when being arranged with this and putting During epitheca pin, this puts the syringe needle for staying the tail end of pipe to stretch out the epitheca pin, and this, which is put, stays tube connector to put with this to stay pipe to match.
2. A kind of 2. brachial plexus nerve block needle guard part of ultrasound guidance according to claim 1, it is characterised in that：It is described outer Sheath pin is inclined-plane bodkin, and the epitheca pin includes bodkin body, the tail end of the bodkin body insert it is solid in handle portion, the handle portion offer with The duct of the through hole connection of the bodkin body, the handle portion of the epitheca pin, which separately opens up one and is used to pressing, described puts the pressing for staying pipe tail end Portion opens up an opening in the handle portion of the epitheca pin, and the opening stays the afterbody of pipe corresponding with described put.
3. A kind of 3. brachial plexus nerve block needle guard part of ultrasound guidance according to claim 2, it is characterised in that：It is described to press Splenium is a transparent elastomer for being arranged on the epitheca pin handle portion.
4. A kind of 4. brachial plexus nerve block needle guard part of ultrasound guidance according to Claims 2 or 3, it is characterised in that：Institute It is side opening fine needle to state interior core needle, and the interior core needle includes fine needle body, and the fine needle body is inserted admittedly in handle portion, and the handle portion is offered with being somebody's turn to do The duct of the vestibule connection of fine needle body.
5. A kind of 5. brachial plexus nerve block needle guard part of ultrasound guidance according to claim 4, it is characterised in that：It is described outer The handle portion of the handle portion of sheath pin and the interior core needle is connected structure.
6. A kind of 6. brachial plexus nerve block needle guard part of ultrasound guidance according to claim 5, it is characterised in that：It is described outer The handle portion of sheath pin is provided with a slot, and a projection matched with the slot is provided with the handle portion of the interior core needle.
7. A kind of 7. brachial plexus nerve block needle guard part of ultrasound guidance according to claim 6, it is characterised in that：It is described outer Sheath pin pin pericardium includes body and grip part, and body head end closing, the aft end of the body is inserted admittedly in the grip part, the body Head block the syringe needle of the epitheca pin, both are in concordant shape, the grip part of the epitheca pin pin heart be provided with it is described outer The inserted sheet of the slot matching of sheath pin.
8. A kind of 8. brachial plexus nerve block needle guard part of ultrasound guidance according to claim 7, it is characterised in that：It is described to put Pipe is stayed also to match a fixator.
9. A kind of 9. application method of the brachial plexus nerve block needle guard part of ultrasound guidance, it is characterised in that：First by epitheca pin pin In heart insertion epitheca pin, skin, hypodermis are punctured through together, is rested on outside brachial plexus nerve sheath, the epitheca pin pin heart is extracted, at this Inserted in epitheca pin and be cased with putting the interior core needle for staying pipe, the handle portion of the interior core needle is matched somebody with somebody with the handle portion card of the epitheca pin, make this Interior core needle is fixed with the epitheca pin, and now, the needle point of the interior core needle stretches out the syringe needle hole of the epitheca pin, holds the interior core needle handle Portion adjusts puncture angle, avoids axillary artery and axillary vein, is pierced into brachial plexus nerve sheath, after then reaching target nerve, opens nerve Electric stimulating instrument, after confirmation has the muscular movement that corresponding brachial plexus nerve is dominated, after injection local anaesthetics terminates, it need to such as carry out more Nerve block, then epitheca pin handle is held, interior core needle needle point is fallen back on outside brachial plexus nerve sheath, then adjustment angle, carried out next Secondary nerve positioning, after the completion of, press section or the opening of epitheca pin are pressed with hand, presses to put and stays pipe, core needle in extraction, then Withstood with the head of the epitheca pin pin heart and put the tail end mouth of pipe for staying pipe, push, which is put, downwards stays pipe while extract epitheca pin, and pipe is stayed by putting Rest on body, then stay pipe tail end to connect to put and stay tube connector, carry out next step dosing techniques, puncture terminates putting.