CN107361830B - Brachial plexus blocking needle sleeve under ultrasonic guidance and using method thereof - Google Patents

Abstract

The invention discloses an brachial plexus nerve blocking needle sleeve under ultrasonic guidance and a using method thereof. The using method combines the inserted sheath needle core and the sheath needle to be arranged outside the brachial plexus nerve sheath; the inner core needle sleeved with the flow placing tube is inserted into the outer sheath needle and fixedly spliced with the outer sheath needle; after the target nerve is punctured and confirmed, local anesthetic is injected, and if multiple nerve blocks are needed, the operation can be repeated; the flow tube is left. The invention greatly reduces the puncture pain of the patient, has accurate tube placement and can realize the effect of continuous retardation.

Description

Ultrasound-guided brachial plexus block needle kit 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:

First, the outer target needle is a bevel needle (the needle tip is an acute angle of less than 20 degrees), which has the disadvantage of easily causing neurovascular cutting damage. When the outer target needle is walking 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), puncturing or cutting nerves will lead to numbness of the skin in the corresponding innervated area of the nerve, and weakness of the corresponding innervated muscles in severe cases;

The second is the inner core needle, namely the side hole needle (the needle tip is a round needle tip). The disadvantage is that the skin puncture process is more troublesome, the puncture force is large, and the patient feels great pain. If possible damage, try to use a needle with a smaller outer diameter. Due to the thin needle body, when performing deep puncture, the needle body is easily deformed with the movement of human tissues such as muscles, resulting in displacement of the needle tip and deviation of the distance between the needle tip and the nerve.

Since the outer sheath needle does not really reach the target nerve attachment during the operation, when the indwelling catheter is placed through the outer sheath needle, the position of the catheter is inaccurate, and the continuous blocking effect cannot be guaranteed.

SUMMARY OF THE INVENTION

In order to solve the above technical problems, the present invention provides an ultrasonic-guided brachial plexus block needle set and a method for using the same, which greatly reduce the pain of puncturing the patient, and the cannulation is accurate and can achieve continuous blocking effect.

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, a retention tube and a retention tube connector, the outer sheath needle core and the The outer sheath needle is matched, and when the outer sheath needle core is inserted into 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 retention tube is sleeved on the outer sheath needle. On the needle body of the inner core needle, the side hole of the inner core needle to the needle tip is exposed to the retention tube. When the inner core needle sheathed with the retention tube is inserted into the outer sheath needle, the retention tube is The tail end protrudes from the needle head of the sheath needle, and the indwelling tube connector is matched with the indwelling tube.

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

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

The inner core needle is a side hole thin needle, and the inner core needle includes a thin needle body, the thin needle body is inserted and fixed on the handle part, and the handle part is provided with a hole 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 a plug connection structure.

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

The outer sheath needle core 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 needle heads of the outer sheath needle are flush with each other, and the grip part of the needle core of the outer sheath needle is provided with a blade that matches with the slot of the outer sheath needle.

The retaining tube is also matched with a holder.

A method of using an ultrasound-guided brachial plexus block needle kit. First, insert the outer sheath needle into the outer sheath needle, puncture the skin and subcutaneous tissue together, and stay outside the brachial plexus sheath, Pull out the needle core of the outer sheath needle, insert the inner core needle covered with the retention tube in the outer sheath needle, and make the handle part of the inner needle needle fit with the handle part of the outer sheath needle, so that the inner sheath needle is fitted. The core needle is fixed with the outer sheath needle. At this time, the needle tip of the inner needle extends 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 the brachial plexus sheath. After reaching the target nerve, turn on the nerve electrical stimulator to confirm that there is movement of the muscles innervated by the corresponding brachial plexus. After the injection of local anesthetic is completed, if multiple nerves are to be blocked, hold the handle of the outer sheath needle and insert the inner needle. The needle tip of the core needle is withdrawn to the outside of the brachial plexus sheath, and then the angle is adjusted for the next nerve positioning. After completion, press the pressing part or opening of the outer sheath needle by hand, press the retention tube, and pull out the inner core needle. , and then use the head of the needle core of the outer sheath needle to press the tail end of the indwelling tube, push the indwelling tube down and pull out the outer sheath needle, keep the indwelling tube on the body, and then put the indwelling tube at the end of the indwelling tube. The end is connected to the indwelling tube connector, and the next drug administration operation is performed, and the puncture is completed. .

The beneficial effects of the present invention are as follows: firstly, the outer target needle and the outer target needle are combined to carry out puncture, and through ultrasonic observation, the needle tip is kept at a distance of 2 cm from the nerve. Because it is a beveled needle tip, the puncturing force is small, and the patient feels less pain. The puncture channel is quickly established, and because of the long distance from the nerve, damage to the nerve and blood vessels can be prevented. Pull out the core of the outer target needle, and then use the inner core needle to penetrate through the needle tube of the outer target needle. Because the front section of the inner core needle is designed with ultrasonic imaging, it can be clearly distinguished from the needle body of the outer needle under ultrasound, and then continue. Go deep and perform a nerve stimulation block operation. With the cooperation of ultrasound, the inner core needle is guided to approach the nerve, and the needle tip is moved to the target area. The design of the side hole needle tip of the inner core needle can effectively prevent the cutting and injury of nerves and blood vessels; After puncturing the drug, 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 to the outside of the skin, and will not If there is a discount, so that there is no problem of re-replacement of the indwelling tube, a fixer is installed on the outer wall of the indwelling tube from the connector of the indwelling tube outside the skin and the indwelling tube so far. 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 core of the sheath needle according to the present invention.

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

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

FIG. 1C is a schematic structural diagram of another embodiment of the sheath needle.

FIG. 2A is a schematic structural diagram of a retention tube.

FIG. 2B is a schematic diagram of the structure of the inner core needle.

FIG. 2 is a schematic structural diagram of the indwelling tube sheathed 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 retention tube, the retainer and the retention tube connector of the present invention.

1: sheath needle, 11: thick needle body, 111: needle head, 12: handle part, 121: pressing part, 122: hole, 123: opening, 124: slot, 2: sheath needle core, 21: tube Body, 211: Head, 22: Grip, 221: Insert, 3: Core Needle, 31: Thin Needle Body, 32: Handle, 321: Protrusion, 322: Hole, 311: Side Hole, 4 : flow tube, 41: holder, 5: flow tube connector.

Detailed ways

As shown in Figures 1 to 4, an ultrasound-guided brachial plexus block needle kit includes an outer sheath needle 1, an outer sheath needle core 2, an inner core needle 3, a retention tube 4 and a retention tube Connector 5, the outer sheath needle core 2 is matched with the outer sheath needle 1, when the outer sheath needle core 2 is inserted into the outer sheath needle 1, the head 211 of the outer sheath needle core 2 is flush with the needle head 111 of the outer sheath needle 1. In the same way, the retention tube 4 is sleeved on the fine 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 retention tube 4. When the inner core needle of the retention tube 4 is sleeved 3. When inserted into the outer sheath needle 1, the tail end of the retention tube 4 protrudes from the needle head 111 of the outer sheath needle 1, and the retention tube connector 5 matches the retention tube 4.

As shown in FIG. 1A , the outer sheath needle 1 is a beveled thick needle. The outer sheath needle 1 includes a thick needle body 11 . The tail of the thick needle body 11 is inserted into the handle portion 12 , and the handle portion 12 is provided with a hole for the thick needle body 11 . The cavities 122 communicate with each other, the handle portion 12 of the sheath needle 1 is additionally provided with a pressing portion 121 for pressing the tail end of the retention tube 4 or an opening 123 is provided in the handle portion 12 of the sheath needle 1 (as shown in FIG. 1C ), The tail portion of the retention tube 4 is directly pressed by hand through the opening 123 , and the handle portion 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, in order to prevent tissue damage during the puncture process;

As shown in FIG. 1B , the outer sheath needle core 2 includes a tube body 21 and a holding part 22 , the holding part 21 of the outer sheath needle core 2 and the handle part 12 of the outer sheath needle 1 are in a plug-in structure, and the tube body 21 It is a solid tube body, the tail of the tube body 21 is inserted into the holding part 22, the head 211 of the tube body 21 blocks the needle head 111 of the sheath needle 1, the two are flush, and the outer diameter of the tube body 21 is equal to the outer diameter of the outer sheath. The inner diameter of the needle body 11 of the sheath needle 1; the holding part 22 of the needle core 2 of the outer sheath needle is provided with an insert 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 a plug-in structure.

As shown in FIG. 2B , the inner core needle 3 is a side hole thin needle, 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 defines a cavity with the thin needle body 31 . The connected hole 322, the handle portion 32 is additionally provided with a protrusion 321 that matches the slot 124; 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 setting 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 FIG. 3 , the inner core needle 3 sheathed with the flow tube 4 is inserted into the cavity of the thick needle body 11 of the outer sheath needle 1 through the hole 122 of the outer sheath needle 1 and protrudes from the needle head 111 of the outer sheath needle 1, and the inner The protrusion 321 of the handle portion 32 of the core needle 3 is inserted into the slot 124 of the handle portion 12 of the sheath needle 1 .

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

As shown in FIG. 4 , in order to prevent displacement of the placement tube 4 , a fixer 41 is also matched to the placement tube 4 outside the skin. The end is screwed with the flow tube connector 5, and the flow tube connector 5 is then connected to the catheter, and the next step of drug administration is performed.

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

Step 1: Put the plugged outer sheath needle core and the outer sheath needle into the brachial plexus sheath;

Step 2: Insert the inner needle covered with the flow tube into the outer sheath needle to be fixedly connected to it;

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

Part 4: Indwelling flow tube.

The method of using the brachial plexus block needle set under the guidance of ultrasound is described in detail below: first, insert the outer sheath needle into the outer sheath needle, puncture 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, and insert the inner core needle covered with the retention tube into the outer sheath needle, so that the handle part of the inner needle needle is fitted with the handle part of the outer sheath needle, Fix the inner core needle and the outer sheath needle. At this time, the needle tip of the inner needle extends 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 the brachial plexus sheath. , and then after reaching the target nerve, turn on the nerve electrical stimulator to confirm that there is muscle movement controlled by the corresponding brachial plexus. After the injection of local anesthetic, if you need to block multiple nerves, hold the handle of the sheath needle. Withdraw the needle tip of the inner core needle to the outside of the brachial plexus sheath, then adjust the angle for the next nerve positioning. After completion, press the pressing part or opening of the outer sheath needle with your hands, press the retention tube, and pull out the inner sheath. core needle, and then use the head of the outer sheath needle to press the tail end of the indwelling tube, push the indwelling tube down and pull out the outer sheath needle, keep the indwelling tube on the body, and then place the indwelling tube on the body. The tail end of the tube is connected to the indwelling tube connector, and the next drug administration operation is performed, and the puncture is completed.

Claims (3)

1. An ultrasonic-guided brachial plexus block needle kit, characterized in that: the sheath needle is a bevel thick needle, the sheath needle comprises a thick needle body, the tail end of the thick needle body is fixedly inserted into a handle part, the handle part is provided with a pore channel communicated with a through hole of the thick needle body, the handle part of the sheath needle is additionally provided with a pressing part for pressing the tail end of the remaining tube or is provided with an opening corresponding to the tail part of the remaining tube, the handle part of the sheath needle is provided with a slot, the sheath needle core is matched with the sheath needle, when the sheath needle core is inserted and clamped in the sheath needle, the head part of the sheath needle core is flush with the needle head of the sheath needle, the sheath needle core comprises a tube body and a holding part, the tube body is a solid tube body, the head end of the tube body is closed, and the tail end of the tube body is fixedly inserted into the holding part, the head of the tube body is sealed to block the needle head of the sheath needle, the needle head and the needle head are parallel and level, the holding part of the needle core of the sheath needle is provided with an inserting piece matched with the slot of the sheath needle, the indwelling tube is sleeved on the needle body of the inner core needle, the inner core needle is a side hole thin needle, the inner core needle comprises a thin needle body, the thin needle body is fixedly inserted into the handle part, the handle part is provided with a pore channel communicated with the pore channel of the thin needle body, the handle part of the sheath needle and the handle part of the inner core needle are in an inserting structure, so that the inner core needle and the outer sheath needle are fixed, the side hole to the needle point part of the inner core needle is exposed out of the indwelling tube, when the inner core needle sleeved with the indwelling tube is inserted and clamped in the sheath needle, the tail end of the indwelling tube extends out of the needle head of the sheath needle, the indwelling tube connector is matched with the indwelling tube, and the indwelling tube is also matched with.

2. The ultrasonically guided brachial plexus block needle kit according to claim 1, wherein: the pressing part is a transparent elastic body arranged on the handle part of the sheath needle.

3. The ultrasonically guided brachial plexus block needle kit according to claim 2, wherein: the handle part of the inner core needle is provided with a bulge matched with the slot.

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