CN109350197B - Accurate puncture positioning and supporting system for intracranial hematoma minimally invasive puncture - Google Patents
Accurate puncture positioning and supporting system for intracranial hematoma minimally invasive puncture Download PDFInfo
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- CN109350197B CN109350197B CN201811532577.1A CN201811532577A CN109350197B CN 109350197 B CN109350197 B CN 109350197B CN 201811532577 A CN201811532577 A CN 201811532577A CN 109350197 B CN109350197 B CN 109350197B
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- 206010059491 Intracranial haematoma Diseases 0.000 title claims abstract description 13
- 230000002123 temporal effect Effects 0.000 claims description 21
- NIXOWILDQLNWCW-UHFFFAOYSA-N acrylic acid group Chemical group C(C=C)(=O)O NIXOWILDQLNWCW-UHFFFAOYSA-N 0.000 claims description 3
- 230000000149 penetrating effect Effects 0.000 claims description 2
- 238000001356 surgical procedure Methods 0.000 claims 1
- 210000003128 head Anatomy 0.000 description 45
- 206010018852 Haematoma Diseases 0.000 description 18
- 238000000034 method Methods 0.000 description 16
- 238000002591 computed tomography Methods 0.000 description 12
- 230000002146 bilateral effect Effects 0.000 description 8
- 208000032843 Hemorrhage Diseases 0.000 description 7
- 208000034158 bleeding Diseases 0.000 description 7
- 238000003780 insertion Methods 0.000 description 7
- 230000037431 insertion Effects 0.000 description 7
- 210000004556 brain Anatomy 0.000 description 6
- 230000000740 bleeding effect Effects 0.000 description 4
- 230000000694 effects Effects 0.000 description 4
- 210000001061 forehead Anatomy 0.000 description 4
- 230000009286 beneficial effect Effects 0.000 description 3
- 210000000133 brain stem Anatomy 0.000 description 3
- 206010008111 Cerebral haemorrhage Diseases 0.000 description 2
- 230000006378 damage Effects 0.000 description 2
- 210000000613 ear canal Anatomy 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- 230000000452 restraining effect Effects 0.000 description 2
- 208000034059 Basal Ganglia Hemorrhage Diseases 0.000 description 1
- 206010018985 Haemorrhage intracranial Diseases 0.000 description 1
- 208000008574 Intracranial Hemorrhages Diseases 0.000 description 1
- 208000004221 Multiple Trauma Diseases 0.000 description 1
- 208000023637 Multiple injury Diseases 0.000 description 1
- 206010030113 Oedema Diseases 0.000 description 1
- 229910000831 Steel Inorganic materials 0.000 description 1
- 241000746998 Tragus Species 0.000 description 1
- 210000001638 cerebellum Anatomy 0.000 description 1
- 238000007428 craniotomy Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 210000004055 fourth ventricle Anatomy 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 239000007769 metal material Substances 0.000 description 1
- 239000011087 paperboard Substances 0.000 description 1
- 210000003625 skull Anatomy 0.000 description 1
- 210000001154 skull base Anatomy 0.000 description 1
- 239000010959 steel Substances 0.000 description 1
- 210000000211 third ventricle Anatomy 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
Classifications
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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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- 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
- A61B2017/3405—Needle locating or guiding means using mechanical guide means
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Pathology (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Accommodation For Nursing Or Treatment Tables (AREA)
- Surgical Instruments (AREA)
Abstract
The invention belongs to the technical field of medical appliances, and particularly discloses an accurate puncture positioning support system for intracranial hematoma minimally invasive puncture, which comprises two accurate supporters which respectively comprise a support device, wherein the support devices respectively comprise a bottom plate, a supporting plate, a first side plate and a second side plate which are vertically and oppositely arranged on the bottom plate; two sliding holes are respectively arranged on the first side plate and the second side plate at intervals, top plates are respectively arranged at the top ends of the first side plate and the second side plate, studs corresponding to the sliding holes are respectively arranged on the top plates, and two nuts are respectively sleeved on the studs; the support plate comprises a head support plate and a pillow support plate, two symmetrical connecting plates are arranged on two opposite sides of the head support plate and the pillow support plate, sliding holes are formed in the connecting plates, each stud penetrates through the corresponding sliding hole in the corresponding connecting plate, and meanwhile, each connecting plate penetrates through the corresponding sliding hole in the side plate and is located between the two nuts. The support system can flexibly and standard horizontally fix the head of a patient, thereby improving the accuracy of minimally invasive puncture of intracranial hematoma.
Description
Technical Field
The invention relates to the technical field of medical appliances, in particular to an accurate puncture positioning and supporting system for intracranial hematoma minimally invasive puncture.
Background
Based on the limitation that the surgical craniotomy has great trauma, high risk and rapid reduction of local pressure-induced re-bleeding or edema aggravation on cerebral hemorrhage patients, minimally invasive hematoma drainage is increasingly important and applied to clinic. In the past, most of minimally invasive hematoma drainage methods adopt a 3D-slicer software positioning method under CT guidance, and the method simulates the hematoma condition of a patient on a mobile phone to perform positioning, but the method also needs to be converted to the patient in actual operation, needs to re-draw lines for positioning and the like, and has low accuracy. Based on the above, the improved soft channel three-dimensional positioning technology is widely applied to a minimally invasive hematoma drainage method, the technology needs a soft channel drainage tube to enter the cranium for a long distance (the basal ganglia bleeding needs about 12 cm), accurate positioning is needed, particularly the third ventricle, the fourth ventricle and the brainstem drainage are more needed to be accurately positioned, multiple punctures are not allowed, otherwise, the damage is large, the effect is poor, particularly the brainstem puncture is not allowed to fail. However, the accuracy of puncture is not high for medical practitioners with years of clinical experience, and is lower for beginners. In the operation process, the puncture and tube placement position is inaccurate, multiple punctures are needed, and CT is repeated for multiple times. Because the head position of a patient is not fixed, the standard layer of CT scanning is inaccurate, the scanning result of each CT scanning is inconsistent, the puncture plane is difficult to accurately determine, and even if the puncture plane is determined, if the plane cannot be perpendicular to the surface (horizontal plane) of an operation bed, a pipeline can deviate to the skull base or the skull top in the puncture tube placing process, the tube placing accuracy is low, each tube placing is a new tube resetting process, multiple punctures lead to fatigue of operators, assistants and CT technicians, increased risk of patient re-bleeding, distrust of family members and the like.
Disclosure of Invention
In view of the above, it is necessary to provide an accurate puncture positioning and supporting system for minimally invasive puncture of intracranial hematoma, which can flexibly fix the head of a patient according to the level, so that the left side, the right side, the upper side and the lower side of the head of the patient are relatively horizontal, and the plane passing through the canthus line of the patient is perpendicular to the operation plane, thereby effectively improving the accuracy of determining the maximum layer of the hematoma of the brain of the patient and the accuracy of placing a tube, and further effectively improving the removal effect of the hematoma of the brain of the patient.
In order to achieve the above purpose, the technical scheme adopted by the invention is as follows:
The utility model provides an intracranial hematoma is accurate puncture location braced system for minimally invasive puncture, includes first accurate eyelidretractor and second accurate eyelidretractor, first accurate eyelidretractor with second accurate eyelidretractor all includes strutting arrangement and restraint strap, strutting arrangement all includes bottom plate, first curb plate, second curb plate and layer board, first curb plate with second curb plate relative set up in on the bottom plate and with the bottom plate is perpendicular, just first curb plate and/or second curb plate can slide about relative the bottom plate; the first side plate is provided with two first sliding holes at intervals, the first sliding holes are arranged in the vertical direction, the second side plate is provided with two second sliding holes which are symmetrical to the two first sliding holes, the outer side surface of the first side plate is also provided with first positioning scale marks which extend along the length directions of the two first sliding holes, the outer side surface of the second side plate is also provided with second positioning scale marks which extend along the length directions of the two second sliding holes, and the 0 scale marks of the first positioning scale marks and the second positioning scale marks are positioned on the same horizontal plane; the top end of the first side plate is provided with a first top plate, one side edge of the first top plate is level with the inner side surface of the first side plate, the first top plate is provided with a third positioning scale mark extending along the length direction of the first top plate, the top end of the second side plate is provided with a second top plate, one side edge of the second top plate is level with the inner side surface of the second side plate, the second top plate is provided with a fourth positioning scale mark extending along the length direction of the second top plate, the first top plate and the second top plate are parallel to the bottom plate, and 0 scale marks of the third positioning scale mark and the fourth positioning scale mark are positioned on the same horizontal plane; two first studs corresponding to the two first sliding holes are arranged on the first top plate at intervals, two second studs corresponding to the two second sliding holes are arranged on the second top plate at intervals, one ends of the first studs and the second studs are respectively connected with the corresponding first top plate and the second top plate, the other ends of the first studs and the second studs are freely suspended, the ports of the first studs and the second studs are at least flush with the lower ends of the first sliding holes or the second sliding holes, and matched first nuts and second nuts are sleeved on the first studs and the second studs; the support plate comprises a head support plate and a pillow support plate, the rear end of the head support plate is close to the front end of the pillow support plate, the width of the head support plate is equal to that of the pillow support plate, the length of the head support plate is larger than that of the pillow support plate, and a pillow portion through hole is formed in the pillow support plate; the middle parts of the two long sides of the head supporting plate are provided with a first connecting plate and a second connecting plate which are symmetrical, the middle parts of the two long sides of the pillow supporting plate are provided with a third connecting plate and a fourth connecting plate which are symmetrical, and the first connecting plate and the second connecting plate are in mirror symmetry with the third connecting plate and the fourth connecting plate; the first connecting plate and the second connecting plate respectively pass through the first sliding hole and the second sliding hole at the rear end, and the third connecting plate and the fourth connecting plate respectively pass through the first sliding hole and the second sliding hole at the front end; the first connecting plate, the second connecting plate, the third connecting plate and the fourth connecting plate are all provided with third sliding holes in a penetrating mode, the first stud and the second stud at the front end penetrate through the third sliding holes in the third connecting plate and the fourth connecting plate respectively, the first stud and the second stud at the rear end penetrate through the third sliding holes in the first connecting plate and the second connecting plate respectively, the outer diameters of the first nut and the second nut are larger than the aperture of the third sliding holes, and the first nut and the second nut are located above and below the third sliding holes respectively; the restraint strap comprises a sub-strap and a mother strap, the sub-strap is arranged on the first side plate or the first top plate, and the mother strap is symmetrically arranged on the second side plate or the second top plate;
The first accurate support device further comprises a first temporal through hole and a second temporal through hole, the first temporal through hole is arranged at the middle upper part of the first side plate and is positioned between the two first sliding holes, the second temporal through hole is arranged on the second side plate and is symmetrical to the first temporal through hole, and in the first accurate support device, the height of the first side plate is the same as the height of the second side plate; in the second precise supporter, the first side plate is smaller than the second side plate in height.
Further, the first accurate support further comprises an infrared positioner, wherein the infrared positioner comprises a first base clamp, a connecting rod, a first sliding cross rod, a second sliding cross rod, a universal head and a cross infrared lamp which are sequentially connected, the first sliding cross rod is perpendicular to the connecting rod, and the second sliding cross rod is perpendicular to the first sliding cross rod; the first sliding cross rod comprises an inner rod and an outer rod, one end of the inner rod is sleeved in the outer rod, the outer rod can slide relative to the inner rod, the inner rod is connected with the connecting rod, the outer rod is connected with the second sliding cross rod, a sliding piece is arranged on the second sliding cross rod and connected with the universal head, a fastening knob is arranged on the sliding piece, the sliding piece can be stressed to move along the second sliding cross rod when the fastening knob is in a loosening state so as to drive the reticle infrared lamps to synchronously move, and the infrared locator is detachably connected with the first top plate, the second top plate or the bottom plate through a first base clamp.
Further, at least one horizontal column is arranged on the cross infrared lamp.
Further, the second accurate support device further comprises two reference rods, wherein the two reference rods comprise a second base clamp and a long rod connected with the second base clamp, and the two reference rods are detachably connected with the first top plate and the second top plate through the second base clamp respectively.
Further, at least one horizontal column is respectively arranged on the first top plate, the second top plate and the bottom plate.
Further, a plurality of sliding grooves are formed in the bottom plate in the horizontal direction, sliding rods corresponding to the sliding grooves are arranged at the bottom ends of the first side plate and/or the second side plate, and the sliding rods can be stressed to move along the sliding grooves.
Further, the bottom plate, the first side plate, the second side plate, the first top plate, the second top plate and the supporting plate are all made of transparent acrylic plates.
Further, the bottom plate is provided with supporting feet, and the supporting feet are respectively arranged on four corners of the lower surface of the bottom plate.
Further, the front end of the pillow supporting plate and the front end of the bottom plate are positioned on the same horizontal plane, the front end of the pillow supporting plate is arc-shaped, and the arc line is recessed towards the rear end of the pillow supporting plate; the part of the front end of the bottom plate corresponding to the pillow supporting plate is in an arc shape consistent with the arc shape of the front end of the pillow supporting plate.
Further, the number of the restraint bands is 2, wherein the sub-bands of one pair of restraint bands are arranged at the front end of the first side plate or the first top plate, the mother band is symmetrically arranged at the front end of the second side plate or the second top plate, the sub-bands of the other pair of restraint bands are arranged at the rear end of the first side plate or the first top plate, and the mother band is symmetrically arranged at the rear end of the second side plate or the second top plate.
The invention has the following beneficial effects:
1. The two accurate supporters are combined and used for supporting and fixing the head of a patient through the bottom plate, the supporting plate arranged above the bottom plate and the side plates which are oppositely and vertically arranged on two sides of the bottom plate, so that the symmetrical level of the head of the patient is maintained. The first side plate and/or the second side plate can slide left and right relative to the bottom plate, so that the head of a patient can be adjusted to adapt to the sizes of the heads of different patients through sliding adjustment of the side plates, and the aim of fixing the heads of the patient so that the heads of the patient cannot rotate at will is fulfilled; the height of the pillow part and the pillow part of the patient is adjusted by using the head supporting plate and the pillow supporting plate, so that the connecting line of the bilateral lenses of the patient and the intersection point of the nasal roots, the bilateral lenses and the bilateral external auditory meatus of the patient are positioned on the same straight line and the plane perpendicular to the horizontal plane, the standard plane of CT scanning is accurately determined, the consistency of multiple CT scanning is improved, further, the puncture plane is perpendicular to the operation horizontal plane (bed surface) by adjusting the side plates and the supporting plate, the operation operator can grasp the puncture direction, the accuracy of puncture tube placement is improved, the puncture success rate is high, multiple injuries caused by multiple punctures and poor tube placement positions are avoided, more importantly, the risk of re-bleeding is reduced, and the success rate of cerebral hemorrhage treatment of the patient is improved.
2. Above-mentioned accurate puncture location braced system is used to intracranial hematoma wicresoft's puncture technique includes two accurate supporters, wherein, first accurate supporters still includes temporal through-hole and infrared locator, for the use before the art, the apparatus that determines puncture angle usefulness when temporal through-hole and occipital through-hole are used for placing patient corresponding position bleeding, in order to avoid the protruding fixed of both sides board of influence supporter and the level adjustment of layer board of this apparatus, infrared locator then is used for providing the reference line in order to do benefit to the operator and make each point on the plane on same straight line in order to confirm CT scanning's standard plane and the plane of biggest hematoma and make these two planes perpendicular to the horizontal plane, be used for referencing the setting-out simultaneously, in order to promote the precision of setting-out. The second accurate support ware is for using in the art, and its height of first curb plate is less than the height of second curb plate, on the basis of effectively fixing patient's head, avoids the operator to receive the curb plate restriction when carrying out patient temporal portion access location or occipital portion access location, has promoted the convenience of location operation.
3. The accurate support is free of metal materials, so that the influence of metal artifacts under CT is avoided, and the positioning accuracy is further improved.
Drawings
FIG. 1 is a schematic diagram of the structure of a precise puncture positioning and supporting system for intracranial hematoma minimally invasive puncture.
FIG. 2 is a schematic view of a portion of the first precision support of FIG. 1 with the infrared positioner removed.
FIG. 3 is a schematic view of a portion of the second precision support of FIG. 1 with the reference bar removed.
Fig. 4 is a right side view of the first precision support of fig. 1 with the infrared positioner removed in accordance with the present invention.
Fig. 5 is a schematic structural view of a second side plate of the first precision supporter of fig. 1 according to the present invention.
Fig. 6 and 7 are schematic views of the front and rear structures of the floor of fig. 1, respectively, according to the present invention.
Fig. 8 is a schematic view of the structure of the pillow carrier of fig. 1 according to the present invention.
Fig. 9 is a schematic view of the structure of the head pallet of fig. 1 according to the present invention.
Fig. 10 is a schematic view of the structure of the infrared positioner of fig. 1 in accordance with the present invention.
Fig. 11 is a schematic view of the structure of the reference bar of fig. 1 according to the present invention.
Description of main reference numerals:
in the figure, a 100-accurate puncture positioning support system for intracranial hematoma minimally invasive puncture, a 1-first accurate support, a 2-second accurate support, a 11-bottom plate, a 111-sliding groove, a 112-supporting foot, a 12-first side plate, a 121-first sliding hole, a 122-first temporal through hole, a 123-second temporal through hole, a 124-first positioning scale mark, a 13-second side plate, a 131-second sliding hole, a 132-second positioning scale mark, a 14-supporting plate, a 141-head supporting plate, a 142-pillow supporting plate, a 143-pillow through hole, a 144-first connecting plate, a 145-second connecting plate, a 146-third connecting plate, a 147-fourth connecting plate, 148-third sliding hole, 15-first top plate, 151-third positioning scale line, 152-first stud, 16-second top plate, 161-fourth positioning scale line, 162-second stud, 17-first nut, 18-second nut, 19-sliding rod, 3-supporting device, 4-restraining strip, 41-sub-strip, 411-first connector, 42-master strip, 421-second connector, 5-infrared positioner, 51-first base clip, 52-connecting rod, 53-first sliding cross bar, 54-second sliding cross bar, 55-universal head, 56-cross infrared lamp, 57-slider, 58-fastening knob, 6-reference rod, 7-horizontal column.
The invention will be further described in the following detailed description in conjunction with the above-described figures.
Detailed Description
The following description of the embodiments of the present invention will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that the embodiments described are only some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
It will be understood that when an element is referred to as being "fixed to" another element, it can be directly on the other element or intervening elements may also be present. When a component is considered to be "connected" to another component, it can be directly connected to the other component or intervening components may also be present. When an element is referred to as being "disposed on" another element, it can be directly on the other element or intervening elements may also be present. The terms "vertical," "horizontal," "left," "right," and the like are used herein for illustrative purposes only.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The terminology used herein in the description of the invention is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. The term "and/or" as used herein includes any and all combinations of one or more of the associated listed items.
Referring to fig. 1, a preferred embodiment of the present invention provides an accurate puncture positioning support system for minimally invasive intracranial hematoma puncture, which comprises a first accurate support 1 and a second accurate support 2, wherein the first accurate support 1 is used before operation for determining a standard level and a maximum hematoma level of CT scan, and the second accurate support 2 is used during operation for making the maximum hematoma level (puncture level) perpendicular to a horizontal plane.
Referring to fig. 1-6 and fig. 8-9, the first precise support 1 and the second precise support 2 each include a support device 3 and a restraint strap 4, the support device 3 includes a bottom plate 11, a first side plate 12, a second side plate 13 and a support plate 14, the first side plate 12 and the second side plate 13 are oppositely disposed on the bottom plate 11 and are perpendicular to the bottom plate 11, and the second side plate 13 can slide left and right relative to the bottom plate 11, specifically: two sliding grooves 111 are arranged on the bottom plate 11 in the horizontal direction, two sliding rods 19 corresponding to the two sliding grooves 111 are arranged at the bottom end of the second side plate 13, and the sliding rods 19 can move left and right along the sliding grooves 111 under force so as to drive the second side plate 13 to move, and the sliding adjustment is performed according to the head size of a patient so that the head of the patient is well fixed between the two side plates; the first side plate 12 is provided with two first sliding holes 121 at intervals, the first sliding holes 121 are arranged along the vertical direction, and the second side plate 12 is provided with two second sliding holes 131 symmetrical to the two first sliding holes 121; the outer side surface of the first side plate 12 is further provided with first positioning graduation marks 124 extending along the length direction of the two first sliding holes 121, the outer side surface of the second side plate 13 is further provided with second positioning graduation marks 132 extending along the length direction of the two second sliding holes 131, and the 0 graduations of the first positioning graduation marks 124 and the second positioning graduation marks 132 are positioned on the same horizontal plane; the top end of the first side plate 12 is provided with a first top plate 15, one side edge of the first top plate 15 is flush with the inner side surface of the first side plate 12, the first top plate 15 is provided with a third positioning scale line 151 extending along the length direction of the first top plate, the top end of the second side plate 13 is provided with a second top plate 16, one side edge of the second top plate 16 is flush with the inner side surface of the second side plate 13, the second top plate 16 is provided with a fourth positioning scale line 161 extending along the length direction of the second top plate 16, the first top plate 15 and the second top plate 16 are parallel to the bottom plate 11, and 0 scales of the third positioning scale line 151 and the fourth positioning scale line 161 are positioned on the same horizontal plane; the first top plate 15 is provided with two first studs 152 corresponding to the two first sliding holes 121 at intervals, the second top plate 16 is provided with two second studs 162 corresponding to the two second sliding holes 131 at intervals, one ends of the first studs 152 and the second studs 162 are respectively connected with the corresponding first top plate 15 and the second top plate 16, the other ends are free to hang, the ports are at least flush with the lower ends of the first sliding holes 121 or the second sliding holes 131, and the first studs 152 and the second studs 162 are respectively sleeved with a first nut 17 and a second nut 18 which are matched.
In this embodiment, at least one horizontal column 7 is respectively disposed on the first top plate 15, the second top plate 16, and the bottom plate 11, for determining whether the first top plate 15, the second top plate 16, and the bottom plate 11 are in a horizontal state, so as to form the device 3.
Referring to fig. 7, in the present embodiment, the base plate 11 is provided with supporting feet 112, and the supporting feet 112 are respectively disposed at four corners of the lower surface of the base plate 11.
The support plate 14 comprises a head support plate 141 and pillow support plates 142, the pillow support plates 142 are used for supporting the pillow parts of the brain bags of the patients, the head support plate 141 is used for supporting the parts above the pillow parts of the brain bags of the patients, the rear ends of the head support plates 141 and the front ends of the pillow support plates 142 are mutually close, the widths of the head support plates 141 and the pillow support plates 142 are equal, the length of the head support plates 141 is greater than that of the pillow support plates 142, pillow support plates 142 are provided with pillow part through holes 143, the number of the pillow through holes is 2, and the pillow through holes are used for placing tools for determining puncture angles when bleeding at corresponding positions, so that the horizontal adjustment of the heads of the patients is prevented from being influenced by the bulges of the tools; the middle parts of the two long sides of the head supporting plate 141 are provided with a first connecting plate 144 and a second connecting plate 145 which are symmetrical, the middle parts of the two long sides of the pillow supporting plate 142 are provided with a third connecting plate 146 and a fourth connecting plate 147 which are symmetrical, and the first connecting plate 144 and the second connecting plate 145 are in mirror symmetry with the third connecting plate 146 and the fourth connecting plate 147; the first and second connection plates 144 and 145 pass through the first and second sliding holes 121 and 131 at the rear end, respectively, and the third and fourth connection plates 146 and 147 pass through the first and second sliding holes 121 and 131 at the front end, respectively; the first connecting plate 144, the second connecting plate 145, the third connecting plate 146 and the fourth connecting plate 147 are respectively provided with a third sliding hole 148, the first stud 152 and the second stud 162 at the front end respectively pass through the third sliding holes 148 on the third connecting plate 146 and the fourth connecting plate 147, the first stud 152 and the second stud 162 at the rear end respectively pass through the third sliding holes 148 on the first connecting plate 144 and the second connecting plate 145, the outer diameters of the first nut 17 and the second nut 18 are respectively larger than the aperture of the third sliding holes 148, and the first nut 17 and the second nut 18 are respectively positioned above and below the third sliding holes 148.
When the first nut 17 and the second nut 18 are stressed and twisted upwards or downwards, the corresponding connecting plates move upwards or downwards along with the corresponding sliding holes, so that the head supporting plate 141 or the pillow supporting plate 142 is driven to move upwards or downwards, the effect of adjusting the height of the head supporting plate 141 or the pillow supporting plate 142 is achieved, the standard plane and the maximum hematoma plane of CT scanning are vertical to the horizontal plane, and meanwhile, the opposite ends of the corresponding connecting plates are at the same height by reference adjustment of the corresponding positioning graduation marks so as to ensure the level of the corresponding supporting plate; when the first nut 17, the corresponding connecting plate and the second nut 18 on the same side as the second side plate 13 are in a loosened state, the second side plate 13 can slide leftwards or rightwards relative to the bottom plate 11 so as to adjust the interval between the two side plates according to the size of the head of the patient, thereby effectively fixing the head of the patient.
In this embodiment, the front end of the pillow support plate 142 and the front end of the bottom plate 11 are located at the same horizontal plane, the front end of the pillow support plate 142 is arc-shaped, and the arc line is concave towards the rear end of the pillow support plate 142; the front end of the bottom plate 11 corresponds to the pillow support plate 142, and is in a shape of a line consistent with the arc shape of the front end of the pillow support plate 142, and the arc shape is beneficial to improving the comfort of the patient.
The restraint strap 4 is 2 pairs, and every pair of restraint strap includes sub-strap 41 and master strap 42, the tip portion of sub-strap 41 free end is equipped with first connecting piece 411, the tip of master strap 42 free end is equipped with second connecting piece 421, first connecting piece 411 with second connecting piece 421 can detachably link together, so that restraint strap 4 constitutes an annular structure around patient's head with strutting arrangement 3 for prevent second curb plate 13 slides rightwards, has further promoted the fixity of accurate eyelidretractor, and first connecting piece 411 and second connecting piece 421 can be hook face and the hair face of magic subsides respectively, or the son of hidden discount detains with the box etc.. The sub-bands 41 of the pair of restraint bands 4 are arranged at the front end of the first side plate 12, and the mother band 42 is symmetrically arranged at the front end of the second side plate 13 and is used for restraining the forehead of a patient; the sub-bands 41 of the other pair of restraint bands 4 are provided at the rear end of the first side plate 12, and the mother band 42 is symmetrically provided at the rear end of the second side plate 13 for restraining the chin portion of the patient.
The first precise support 1 further includes a first temporal through hole 122 and a second temporal through hole 123, the first temporal through hole 122 is disposed at the middle upper portion of the first side plate 12 and between the two first sliding holes 121, and the second temporal through hole 123 is disposed on the second side plate 13 and symmetrical to the first temporal through hole 122, and is used for placing an appliance for determining a puncture angle when bleeding from a corresponding portion, so as to avoid the protrusion from affecting the head fixation of a patient; and in the first precision supporter 1, the height of the first side plate 12 is the same as the height of the second side plate 13.
With continued reference to fig. 10, the first precision support further includes an infrared location 5 for assisting in determining a plane and drawing a line. The infrared positioner 5 comprises a first base clamp 51, a connecting rod 52, a first sliding cross rod 53, a second sliding cross rod 54, a universal head 55 and a cross infrared lamp 56 which are sequentially connected, wherein the first sliding cross rod 53 is perpendicular to the connecting rod 52, and the second sliding cross rod 54 is perpendicular to the first sliding cross rod 53; the first sliding cross bar 53 comprises an inner bar 531 and an outer bar 532, one end of the inner bar 531 is sleeved in the outer bar 532, the outer bar 532 can slide relative to the inner bar 531, the inner bar 531 is connected with the connecting bar 52, the outer bar 532 is connected with the second sliding cross bar 54, a sliding piece 57 is arranged on the second sliding cross bar 54, the sliding piece 57 is connected with the universal head 55, a fastening knob 58 is arranged on the sliding piece 57, the sliding piece 57 can be forced to move along the second sliding cross bar 54 when the fastening knob 58 is in a loosening state so as to drive the cross infrared lamp 56 to synchronously move, and the infrared positioner 5 is detachably connected with the first top plate 15 through the first base clamp 51. When the CT scan standard plane or the puncture plane is determined, the cross infrared lamp 56 is turned on to emit cross infrared rays on the front face of the head of the patient, the intersection point of the infrared rays and the intersection point of the bilateral lens connecting line of the patient and the nasal root or the intersection point of the maximum hematoma layer and the nasal root are overlapped by adjusting the inner rod 531, the outer rod 532 and the sliding piece 58, and then the rest mark points of the patient are overlapped with the horizontal line of the cross infrared rays by adjusting the head supporting plate 141 and the pillow supporting plate 142 and referring to the third positioning graduation line 151 and the fourth positioning graduation line 161, so that the required plane can be determined. Further, at least one horizontal column 7 is disposed on the reticle infrared lamp 56, for determining whether the reticle infrared lamp 56 is in a horizontal state, so as to ensure accuracy of reference.
In the accurate eyelidretractor of second 2, first curb plate 12 highly be less than the height of second curb plate 13, on the basis of effectively fixing patient's head, avoid the operator to receive the curb plate restriction when carrying out patient temporal portion access location or occipital portion access location, promoted the convenience of location operation.
With reference to fig. 11, the second precision support 2 further includes two reference rods 6, each of which includes a second base clip 61 and a long rod 62 connected to the second base clip 61, the two reference rods are detachably connected to the first top plate and the second top plate respectively through the second base clips, during operation, the two reference rods 6 are respectively clipped on the first top plate 15 and the second top plate 16, and the two reference tubes 6 and the needle insertion point are on the same straight line, so as to observe whether the pierced hose is biased forward or biased backward during the needle insertion process, so as to ensure that the hose is vertically inserted into the intracranial hemorrhage of the patient, preferably, after the two reference tubes 6 are fixed in position, a straight connecting line or connecting rod is connected between the two reference rods 6, and then the hose is slowly inserted close to the connecting line or connecting rod during the needle insertion process, so as to ensure the accuracy of the needle insertion process.
In the present embodiment, the bottom plate 11, the first side plate 12, the second side plate 13, the first top plate 15, the second top plate 16, and the pallet 14 are made of transparent, high-hardness acrylic plates.
The following is a simple introduction of the use method of the accurate puncture positioning and supporting system for the intracranial hematoma minimally invasive puncture:
Step S1: determination of a CT scanning standard plane: marking points at the intersection point of the bilateral lens connecting line and the nasion of the patient, the outer canthus of the bilateral external auditory canal and the projection position (tragus) of the external body surface of the bilateral external auditory canal respectively; after the first accurate supporting device 1 is placed on a patient bed and adjusted until the bottom plate 11, the first top plate 15 and the second top plate 16 are in a horizontal state, the head of a patient is placed in the supporting device 3 and is aligned, and the second side plate 13 is slid until the head of the patient is clamped between the two side plates and cannot rotate at will; turning on the infrared positioning lamp 56, by adjusting the intersection point of the "cross" infrared ray to coincide with the intersection point of the bilateral lens connecting line of the patient and the nasion, and making the horizontal line of the "cross" infrared ray pass through the other four mark points respectively, if the four mark points are not all located on the horizontal line of the "cross" infrared ray, adjusting the head supporting plate 141 and the pillow supporting plate 142 until the five mark points are all located on the horizontal line of the "cross" infrared ray and the plane formed by the five mark points is perpendicular to the horizontal plane (bed surface), the standard plane of CT scanning can be determined, and then connecting the sub-bands 41 and the mother bands 42 of the two pairs of the restraint bands 4, and fixing; finally, the infrared positioner 5 is removed, the patient is pushed into the CT room for examination, and then the patient is properly fine-tuned according to the infrared rays of the CT machine;
Step S2: determination of the maximum level of hematoma, i.e. the puncture plane: marking a maximum hematoma layer on the CT flat plate obtained by scanning, and calculating the distance from a standard plane (namely a CT scanning standard plane) to the maximum hematoma layer; drawing a front midline along the nose tip, the nose root and the top midline of the cranium, measuring out corresponding arc-shaped distances from the nose root (lens position) to the maximum hematoma layer of the forehead along the front midline, and making a forehead mark point; marking mark points above external auditory meatus corresponding to the maximum hematoma layer above external auditory meatus on two sides, wherein a plane formed by connecting the three mark points is a puncture plane which is matched with the maximum hematoma layer on the CT plane; respectively attaching 3 ossicle pieces or 3 small steel balls to the three marking points, fixing the tool for positioning the puncture angle in the early stage, and further determining the puncture plane, the puncture direction and the like by rechecking the CT scanning standard plane;
step S3: drawing lines of the puncture plane: after rechecking and determining, turning on the infrared positioning lamp 56 by using the infrared positioner 5 again, and adjusting to enable the intersection point of the cross infrared ray to coincide with the mark point of the forehead of the patient, enabling the horizontal line of the cross infrared ray to respectively pass through the mark points above the external auditory meatus on the two sides, ensuring that the plane formed by the three mark points is vertical to the horizontal plane (bed surface), and then drawing a line by adopting a self-made ink fountain according to the horizontal line of the cross infrared ray;
Step S4: determination of the puncture plane perpendicular to the bed surface in the puncture process: the head of the patient is placed in the support system 3 of the second accurate support 2 horizontally placed on the sickbed according to the method of the step 1, the puncture plane is perpendicular to the horizontal plane (bed surface) by adjusting the head supporting plate 141 and the pillow supporting plate 142, then the two reference tubes 6 are respectively adjusted to the same horizontal line with the needle insertion point, the drainage hose is placed at the needle insertion point, and the position of the needle insertion point and the two reference tubes 6 are kept on the same plane, and the drainage hose is slowly inserted into the cranium of the patient.
Compared with the supporting method (by filling hard paper boards and the like on the brain of a patient) which needs repeated puncture and causes repeated damage due to poor tube placement position, the accurate puncture positioning supporting system ensures the scanning effect of a CT standard plane, ensures that the scanning result of each repeated CT is almost the same, accurately determines the maximum hematoma puncture plane and accurately draws lines, simultaneously, leads the puncture plane to be perpendicular to the bed surface during operation, is beneficial to operators to grasp the puncture direction, improves the puncture success rate, and more importantly reduces the risk of rebleeding and better saves the life of the brain bleeding patient; and save time and energy of operators, save cost of repeated CT review, and the like.
It will be appreciated that in another embodiment, the second side plate 13 is fixedly connected to the bottom plate, and the first side plate 12 can also slide left and right with respect to the bottom plate 11 or the first side plate 12 and the second side plate 13 can both slide left and right with respect to the bottom plate 11, specifically: a slide groove 111 is provided on the bottom plate 11 at a position corresponding to the slidable side plate in the horizontal direction, and a slide rod 19 corresponding to the slide groove 111 is provided on the corresponding side plate; the number of the slide grooves and the corresponding slide bars is not limited to one or two or more in the present embodiment, and the first side plate 12 and the second side plate 13 may be adjusted.
It will be appreciated that in another embodiment, the pillow through hole 143 may be one, so long as the space is sized to allow for the piercing angle positioning tool used in the positioning of the cerebellum and brainstem by the patient with the occipital access.
It should be understood that, in another embodiment, the number of the restraint bands 4 is not limited to two pairs in the present embodiment, and may be one pair or two or more pairs, as long as the first side plate 12 and the second side plate 13 can be connected and fixed; meanwhile, the mother belt 42 may be connected to other parts of the supporting device 3, for example, to the first top plate 15 or the bottom plate 11, and the sub belt 41 may be connected to other parts of the supporting device 3, for example, to the second top plate 16 or the bottom plate 11, so long as the sub belt 41 and the mother belt 42 may form a loop with the supporting device 3 to fix the patient.
It will be appreciated that in another embodiment, the infrared positioner 5 may be connected to other parts of the supporting device 3 through the first base clip 51, for example, to the first top plate 15, the bottom plate 11, the first side plate 12 and the second side plate 13, so long as the infrared positioner 5 may be fixed to the supporting device 3 and the "cross" infrared rays emitted by the cross-shaped infrared lamp may be adjusted to a desired position.
Claims (8)
1. An intracranial hematoma minimal access surgery is with accurate puncture location braced system, its characterized in that: the device comprises a first accurate support and a second accurate support, wherein the first accurate support and the second accurate support comprise a support device and a restraint strap, the support device comprises a bottom plate, a first side plate, a second side plate and a supporting plate, the first side plate and the second side plate are oppositely arranged on the bottom plate and are perpendicular to the bottom plate, and the first side plate and/or the second side plate can slide left and right relative to the bottom plate; the first side plate is provided with two first sliding holes at intervals, the first sliding holes are arranged in the vertical direction, the second side plate is provided with two second sliding holes which are symmetrical to the two first sliding holes, the outer side surface of the first side plate is also provided with first positioning scale marks which extend along the length directions of the two first sliding holes, the outer side surface of the second side plate is also provided with second positioning scale marks which extend along the length directions of the two second sliding holes, and the 0 scale marks of the first positioning scale marks and the second positioning scale marks are positioned on the same horizontal plane; the top end of the first side plate is provided with a first top plate, one side edge of the first top plate is level with the inner side surface of the first side plate, the first top plate is provided with a third positioning scale mark extending along the length direction of the first top plate, the top end of the second side plate is provided with a second top plate, one side edge of the second top plate is level with the inner side surface of the second side plate, the second top plate is provided with a fourth positioning scale mark extending along the length direction of the second top plate, the first top plate and the second top plate are parallel to the bottom plate, and 0 scale marks of the third positioning scale mark and the fourth positioning scale mark are positioned on the same horizontal plane; two first studs corresponding to the two first sliding holes are arranged on the first top plate at intervals, two second studs corresponding to the two second sliding holes are arranged on the second top plate at intervals, one ends of the first studs and the second studs are respectively connected with the corresponding first top plate and the second top plate, the other ends of the first studs and the second studs are freely suspended, the ports of the first studs and the second studs are at least flush with the lower ends of the first sliding holes or the second sliding holes, and matched first nuts and second nuts are sleeved on the first studs and the second studs; the support plate comprises a head support plate and a pillow support plate, the rear end of the head support plate is close to the front end of the pillow support plate, the width of the head support plate is equal to that of the pillow support plate, the length of the head support plate is larger than that of the pillow support plate, and a pillow portion through hole is formed in the pillow support plate; the middle parts of the two long sides of the head supporting plate are provided with a first connecting plate and a second connecting plate which are symmetrical, the middle parts of the two long sides of the pillow supporting plate are provided with a third connecting plate and a fourth connecting plate which are symmetrical, and the first connecting plate and the second connecting plate are in mirror symmetry with the third connecting plate and the fourth connecting plate; the first connecting plate and the second connecting plate respectively pass through the first sliding hole and the second sliding hole at the rear end, and the third connecting plate and the fourth connecting plate respectively pass through the first sliding hole and the second sliding hole at the front end; the first connecting plate, the second connecting plate, the third connecting plate and the fourth connecting plate are all provided with third sliding holes in a penetrating mode, the first stud and the second stud at the front end penetrate through the third sliding holes in the third connecting plate and the fourth connecting plate respectively, the first stud and the second stud at the rear end penetrate through the third sliding holes in the first connecting plate and the second connecting plate respectively, the outer diameters of the first nut and the second nut are larger than the aperture of the third sliding holes, and the first nut and the second nut are located above and below the third sliding holes respectively; the restraint strap comprises a sub-strap and a mother strap, the sub-strap is arranged on the first side plate or the first top plate, and the mother strap is symmetrically arranged on the second side plate or the second top plate;
The first accurate support device further comprises a first temporal through hole and a second temporal through hole, the first temporal through hole is arranged at the middle upper part of the first side plate and is positioned between the two first sliding holes, the second temporal through hole is arranged on the second side plate and is symmetrical to the first temporal through hole, and in the first accurate support device, the height of the first side plate is the same as the height of the second side plate; in the second precise support, the first side plate is smaller than the second side plate in height;
The first accurate support further comprises an infrared positioner, wherein the infrared positioner comprises a first base clamp, a connecting rod, a first sliding cross rod, a second sliding cross rod, a universal head and a cross infrared lamp which are sequentially connected, the first sliding cross rod is perpendicular to the connecting rod, and the second sliding cross rod is perpendicular to the first sliding cross rod; the first sliding cross rod comprises an inner rod and an outer rod, one end of the inner rod is sleeved in the outer rod, the outer rod can slide relative to the inner rod, the inner rod is connected with the connecting rod, the outer rod is connected with the second sliding cross rod, a sliding piece is arranged on the second sliding cross rod and is connected with the universal head, a fastening knob is arranged on the sliding piece, when the fastening knob is in a loosening state, the sliding piece can be forced to move along the second sliding cross rod so as to drive the reticle infrared lamp to synchronously move, and the infrared positioner is detachably connected with the first top plate, the second top plate or the bottom plate through the first base clamp;
The second accurate support device further comprises two reference rods, wherein the two reference rods comprise a second base clamp and a long rod connected with the second base clamp, and the two reference rods are detachably connected with the first top plate and the second top plate through the second base clamp respectively.
2. The positioning support system of claim 1, wherein: at least one horizontal column is arranged on the cross infrared lamp.
3. The positioning support system of claim 1, wherein: and at least one horizontal column is respectively arranged on the first top plate, the second top plate and the bottom plate.
4. The positioning support system of claim 1, wherein: the bottom plate is provided with a plurality of sliding grooves along the horizontal direction, the bottom ends of the first side plate and/or the second side plate are provided with sliding rods corresponding to the sliding grooves, and the sliding rods can bear force to move along the sliding grooves.
5. The positioning support system of claim 1, wherein: the bottom plate, the first side plate, the second side plate, the first top plate, the second top plate and the supporting plate are all made of transparent acrylic plates.
6. The positioning support system of claim 1, wherein: the bottom plate is provided with supporting feet which are respectively arranged on four corners of the lower surface of the bottom plate.
7. The positioning support system of claim 1, wherein: the front end of the pillow supporting plate and the front end of the bottom plate are positioned on the same horizontal plane, the front end of the pillow supporting plate is in an arc shape, and the arc line is recessed towards the rear end of the pillow supporting plate; the part of the front end of the bottom plate corresponding to the pillow supporting plate is in an arc shape consistent with the arc shape of the front end of the pillow supporting plate.
8. The positioning support system of claim 1, wherein: the number of the restraint bands is 2, wherein the sub-bands of one pair of restraint bands are arranged at the front end of the first side plate or the first top plate, the mother band is symmetrically arranged at the front end of the second side plate or the second top plate, the sub-bands of the other pair of restraint bands are arranged at the rear end of the first side plate or the first top plate, and the mother band is symmetrically arranged at the rear end of the second side plate or the second top plate.
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| WO2017000538A1 (en) * | 2015-07-02 | 2017-01-05 | 贺石生 | Arc-shaped precise positioning device capable of being assembled and disassembled |
| CN205322582U (en) * | 2015-12-28 | 2016-06-22 | 王中菊 | Many function combination formula limbs fixer |
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