CN109637321B - Ovum-taking model and application thereof - Google Patents

Ovum-taking model and application thereof Download PDF

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Publication number
CN109637321B
CN109637321B CN201811614099.9A CN201811614099A CN109637321B CN 109637321 B CN109637321 B CN 109637321B CN 201811614099 A CN201811614099 A CN 201811614099A CN 109637321 B CN109637321 B CN 109637321B
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model
follicle
ovum
carrier
aspiration
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CN109637321A (en
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陈博
孙晓岩
许明明
蔡业荣
杨仁东
蒲育栋
陈雪梅
刘容菊
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Dongguan Third People's Hospital (dongguan Shilong People's Hospital)
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Dongguan Third People's Hospital (dongguan Shilong People's Hospital)
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    • GPHYSICS
    • G09EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09BEDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine

Abstract

The invention provides an ovum taking model and application thereof, wherein the model is arranged on the waist and abdomen and is arranged on the thigh 1/3, the model is a standard gynecological examination lithotomy position, the internal structure of the ovum taking model comprises a female vagina model and a carrier carrying a follicle model, the follicle model is distributed on the surface of the carrier, and simulated ova are contained in the follicle model. According to the invention, by simulating the shape and size of the follicle in the ovum-taking operation after excretion promotion, the carrier of the follicle model is simplified, clinical personnel are trained to perform the ovum-taking operation, the skill level of the ovum-taking operation and the ovum recovery rate are improved, the cost of the ovum-taking model is reduced, the carrier is replaced quickly, and the method is convenient and rapid.

Description

Ovum-taking model and application thereof
Technical Field
The invention belongs to the field of reproductive medicine, relates to a model and application thereof, and particularly relates to an ovum-taking model and application thereof.
Background
In vitro fertilization and embryo transfer (IVF-ET) are colloquially referred to as "tube babies". In fact, in vitro fertilization is a special technique in which ova and sperm are removed from the body, allowed to complete fertilization and development in an artificially controlled environment in vitro, and then early embryos are transferred to the uterus of a female where they are gestated into children. In the process of taking eggs, a clinician uses a special egg taking needle to enter a pelvic cavity through a fornix part behind a vagina under the guidance of B ultrasonic, the egg taking needle penetrates into a follicle on the surface of the ovary according to a puncture line displayed by the B ultrasonic to suck eggs into a test tube, and the test tube is handed to an embryo laboratory worker to identify and pick the eggs out to be placed in an incubator to prepare for the next operation. Therefore, ovum taking is the first critical step in the in vitro fertilization, and the number of the ova which is equivalent to the number of the follicles monitored by the B-ultrasonography in the superovulation promotion process is obtained, especially the number of the ova with the diameter of the follicles between 14mm and 20mm is the key for ensuring the success of the in vitro fertilization, and is also the first factor for ensuring the success of the pregnancy of the patient.
The success rate of the test tube infant is less than 20% due to immaturity of the first conditions in the end of seventies, clinical hyperexcretion promoting medicines are continuously researched in the reproductive medicine field in the last 30 years, clinical medication schemes, embryo culture conditions, test tube infant derivative related technologies and other aspects are research hotspots in the field, the clinical success rate reaches 60% after continuous optimization and progress, and meanwhile, as the number of born test tube infants in the current generation is gradually increased, epigenetics and subsequent development conditions of the test tube infant become new research hotspots.
At present, with the development of reproductive medicine, more and more hospitals develop the test tube baby technology, the demand of clinical ovum taking operators is increased day by day, however, the operation skills of clinicians cannot be improved by theoretical knowledge, and the operation skills of clinical ovum taking operations do not have any chance to be actually operated and exercised, so most of clinicians newly built a reproductive center directly explore and try on patients, gradually improve the operation skills of the clinicians or invite a senior expert to bring education and guide on the patients in front. Due to the lack of operation proficiency and experience, doctors who initially participate in the operation often have inaccurate puncture needle positions, are unfamiliar with ovary positions, and have a weak ovum taking technique, so that the ovum taking time is too long, ovaries, uteruses or vaginas bleed, and the damage of membrane tissue structures is caused. For clinical personnel who newly enter reproductive medicine (tube baby technique), no practice model gives exercise operation skills, and the unskilled operation can damage the physical and mental health of patients and cause economic loss due to the high treatment cost of tube babies.
In addition, in the process of taking the ovum, the operation proficiency of a doctor is crucial to the process of taking the ovum, and can quickly and efficiently take out enough ovum corresponding to the position of ovarian follicles of different clinical individuals, so that the pain of a patient can be reduced to the greatest extent, and the damage of the process of taking the ovum to a female reproductive system can be reduced. Because the newly built reproductive center adopts the intravenous anesthesia mode, if the ovum taking technology is not skilled, the anesthesia time is long, and the risk of patients is increased. How to stably and safely obtain high-quality mature ova and improve the egg obtaining rate is a key link of clinical personnel in the reproductive medicine field.
Therefore, the clinical ovum-taking model has important significance and wide market prospect.
Disclosure of Invention
Aiming at the defects and practical requirements of the prior art, the invention provides the ovum-taking model and the application thereof.
In order to achieve the purpose, the invention adopts the following technical scheme:
in a first aspect, the invention provides an ovum picking model, the model is up to the waist and abdomen and down to 1/3 on the thigh, and a standard gynecological examination lithotomy position, the internal structure of the ovum picking model comprises a female vagina model and a carrier carrying a follicle model, the follicle model is distributed on the surface of the carrier, and simulated ova are contained in the follicle model.
The invention is composed of a lower half body model of an adult female, the model comprises a vaginal model, the use of a vaginal B-ultrasonic probe is convenient, the number and the position of follicles at the date of ovum taking are simulated after clinical superovulation, a large number of follicle models are carried by a carrier, the follicles are similar in appearance, the internal tissue structure is consistent with that of the clinic, and the ovum taking technology can be fully mastered by clinical operators. The carrier is adopted to carry the follicle, the shape of the ovary is not limited, the effect of fixing the follicle can be realized, so that an operator can find and determine the position and the number of the follicle through a vaginal B ultrasonic probe, and a foundation is laid for the subsequent ovum taking process.
Preferably, the support comprises a mesh-structured support.
In the invention, the shape of the carrier is not specially limited, the carrier can be a net-shaped, solid or hollow carrier, the function of carrying the follicles can be realized, the carrier is detachably connected with the inside of the abdominal cavity of the ovum taking model, the situation of the follicles in the abdominal cavity of a human body can be simulated during the ovum taking training, and a clinical operator can master the skill of detecting the position and the number of the follicles through the vagina B ultrasonic.
Preferably, the mesh spacing of the mesh structure is 10-25mm, for example 10mm, 12mm, 14mm, 16mm, 18mm, 20mm, 22mm, 23mm, 24mm or 25 mm.
Preferably, the material of the carrier is any one of silica gel, rubber or PVC, preferably PVC.
In the invention, the carrier which can bear follicle embedding and does not influence the B-ultrasonic radiation effect can be used, and any material which does not influence the B-ultrasonic attenuation can be used for preparing the carrier, and typical non-limited materials such as PVC, silica gel or rubber.
Preferably, the mesh of the mesh structure carrier has a diameter of 0.1 to 0.2mm, which may be 0.1mm, 0.15mm or 0.2mm, for example.
In the invention, the reticular carrier consists of the mesh wires, the diameter of the mesh wires is proper, the fixing and ovum taking processes of the follicle are not influenced, the adhesive force of the follicle model is reduced when the diameter of the mesh wires is too small, and the positioning and observation of the follicle model by the vaginal B-ultrasonography is influenced when the diameter of the mesh wires is too large.
Preferably, the vaginal model is 7-9cm long, for example, 7cm, 8cm, 9cm, preferably 8 cm.
Preferably, the wall thickness of the vaginal model is 0.5-3mm, for example it may be 0.5mm, 0.6mm, 0.7mm, 0.8mm, 0.9mm, 1mm, 1.1mm, 1.2mm, 1.3mm, 1.4mm, 1.5mm, 1.6mm, 1.7mm, 1.8mm, 1.9mm, 2.0mm, 2.1mm, 2.2mm, 2.3mm, 2.4mm, 2.5mm, 2.6mm, 2.7mm, 2.8mm, 2.9mm or 3.0mm, preferably 1-2 mm.
In the invention, the vagina simulation degree is high, so that clinical operators experience the mutual position relation and the operation hand feeling of the B-ultrasonic probe and the vagina during ovum taking, and the requirement of B-ultrasonic development is met.
Preferably, the follicle model has a diameter of 10-25mm, which may be, for example, 10mm, 12mm, 13mm, 15mm, 17mm, 18mm, 20mm, 22mm or 25mm, preferably 12-20 mm.
According to the invention, the size and thickness of the follicle model meet the requirement of the puncture needle for clinical ovum taking operation, and within the parameter range of the size and wall thickness of the follicle, the clinical ovum taking can be highly simulated, so that the proficiency of operators is improved.
Preferably, the number of follicle models is 20-30, for example 20, 22, 24, 26, 28, 30, preferably 26.
Preferably, the thickness of the follicle model is 0.01-0.05mm, for example 0.01mm, 0.02mm, 0.03mm, 0.04mm or 0.05mm, preferably 0.03 mm.
In the invention, in order to fully train the operation proficiency of operators, enough follicle models are uniformly distributed on the carrier, and the inventor finds that the wall thickness of the follicle can be fully developed within the range of 0.01-0.05mm through continuous search, the simulation degree of the puncture process is high, and the process of taking ova is not facilitated by too thin or too thick follicle walls.
Preferably, the follicular model comprises a filling fluid.
In the invention, the follicle model comprises filling liquid for simulating the follicle liquid, the whole follicle model comprises a simulated ovum and the filling liquid, the structure of the follicle is simulated, and the hand feeling of ovum taking is simulated approximately.
Preferably, the filling liquid of the follicle model comprises ultrapure water.
Preferably, the diameter of the simulated ovum is 115-125 μm, such as 115 μm, 116 μm, 118 μm, 120 μm, 122 μm or 125 μm, preferably 120 μm.
Preferably, the material of the simulated ovum comprises PVC.
According to the invention, the follicle model comprises the ovum and the filling liquid, the size of the mature ovum is highly simulated, the ovum is a solid spherical object, and various individualized conditions which can be met by clinical staff are simulated by simulating different follicle sizes and ovum sizes, so that the operation proficiency of the operator is better improved.
Preferably, the carrier is removably attached to the oviposition model for replacement of the carrier.
According to the invention, a carrier with a follicle model is detachably connected with an abdominal cavity of the ovum taking model and is used for replacing the carrier after ovum taking, a clinical operator detects the position and the number of the follicle model through a vaginal B ultrasonic probe, and carries out an ovum taking process through a puncture needle, after all follicles are punctured and simulated ova are obtained, the carrier can be detachably replaced, and a new carrier with the follicle model is used for replacing the original carrier, so that a new ovum taking model is formed for the training of the clinical operator.
Preferably, the oviposition model is provided with openings for replacement of the carrier.
In the invention, the carrier with the follicle model is detachably connected with the inside of the abdominal cavity of the ovum taking model, the ovum taking model is provided with an opening for replacing the carrier after ovum taking, after all the simulated ova of the follicle model on the carrier are obtained, the used carrier can be replaced from the opening of the ovum taking model and replaced by a new carrier carrying the follicle model, the cost of the ovum taking model is reduced, and the next ovum taking training can be carried out only by replacing the carrier, thus being convenient and fast. The invention is not limited to the specific position of the opening on the ovum-taking model, and any position of the opening where the carrier can be replaced falls into the protection scope of the invention.
Preferably, the opening is provided on a waist section of the egg-taking model.
Preferably, the width of the opening is 3-5cm, for example, 3cm, 4cm or 5 cm.
Preferably, the opening is of equal length to the waist.
According to the invention, the opening for replacing the carrier can be arranged on the section of the waist of the egg taking model, the width of the opening is 3-5cm, the replacement of the carrier with the reticular structure is convenient, the length of the opening is equal to that of the waist, and the replacement process of the carrier is smoother.
In a second aspect, the present invention provides a method using the model of the first aspect, specifically including the following steps:
(1) placing the ovum-taking model in a lateral decubitus position of the lithotomy position;
(2) placing a couplant for detection into the condom, placing a vaginal B-ultrasonic probe into the condom, and clamping a fixed puncture frame on the B-ultrasonic probe in the condom;
(3) extending a B-ultrasonic probe into a vaginal model of the model, scanning the interior of a pelvic cavity, and detecting the position and the number of the follicle models;
(4) and operating and rotating the B-ultrasonic probe to slowly puncture the puncture needle into the pelvic cavity through the vagina along the fixed puncture frame according to the position of the follicle in the follicle model, puncturing the puncture needle into the follicle model along the B-ultrasonic guide wire to obtain filling liquid, and observing whether the simulated ovum is successfully obtained by a microscope.
Clinically, follicles contain follicular fluid and ova are released from the follicular fluid, and in order to simulate clinical follicular conditions, the follicle simulator of the present invention contains filling fluid and the follicle simulator is released from the filling fluid.
In a third aspect, the present invention provides use of a model as described in the first aspect for simulating an oviposition procedure.
Compared with the prior art, the invention has the following beneficial effects:
(1) according to the invention, through the ovum-taking model, clinical personnel are trained to carry out ovum-taking operation, the success rate and proficiency of ovum-taking are improved, the medical development is promoted, and the pain and economic loss of patients are reduced;
(2) according to the invention, by matching with proper materials and sizes, the clinical ovum picking process is simulated, the follicle and the ovum are highly simulated, the hand feeling is real, and the requirement of ovum picking training is met;
(3) the invention adopts the replaceable carrier to carry the follicle model, realizes the quick assembly of the ovum-taking model by replacing the carrier, reduces the cost of the ovum-taking model, has convenient replacement of the carrier, is convenient for the repeated training of clinical operators, and improves the ovum-taking rate.
Drawings
FIG. 1 is a diagram showing an ovum retrieval model according to example 1 of the present invention, wherein 1 is a follicle model, 2 is a mesh carrier carrying the follicle model, 3 is a vaginal model, 4 is a mesh carrier replacement opening, and 5 is a simulated ovum;
fig. 2 is a schematic diagram of an ovum-taking model according to example 1 of the present invention, in which 1 is a follicle model, 2 is a mesh carrier carrying the follicle model, 3 is a vaginal model, 5 is a simulated ovum, 6 is a puncture needle, 7 is a B-ultrasonic probe, 8 is a sterile test tube, 9 is a filling liquid, and 10 is a lateral decubitus position of a lithotomy position.
Detailed Description
To further illustrate the technical means and effects of the present invention, the following embodiments further illustrate the technical solutions of the present invention, but the present invention is not limited to the scope of the embodiments.
Example 1
An ovum model is taken, the model is arranged on the waist and abdomen and is arranged on the thigh at 1/3, the standard gynecological examination lithotomy position is shown in figure 1, the internal structure of the ovum model comprises a female vagina model 3 and a reticular carrier 2 carrying a follicle model 1, the mesh spacing of the reticular carrier is 10-25mm, the diameter of a mesh is 0.2mm, the follicle model 1 is distributed on the surface of the reticular carrier 2, the follicle model 1 comprises a simulated ovum 5, the abdomen cross section is provided with an opening 4 for replacing the carrier, the length of the vagina model is 8cm, the vaginal wall thickness is 2mm, 26 follicle models 1 are uniformly distributed on the reticular carrier 2 shown in figure 2, the diameter of the follicle model 1 is 12-20mm, the follicle wall thickness of the follicle model 1 is 0.03mm, the follicle model 1 is filled with ultrapure water, a simulated follicle liquid is filled in the follicle model 1, the simulated ovum 5 is contained in the follicle model 1, the simulated ovum is a small ball made of PVC material, and the diameter of the simulated ovum is 120 mu m;
when the ovum taking model of the invention is used for training ovum taking operation, the model is placed on a gynecological examination bed to be in a lithotomy position lateral lying position 10, a small amount of coupling agent is added into a condom, then a vagina B ultrasonic probe 7 is placed into the condom, then a puncture needle 6 is clamped on the B ultrasonic probe 7 sleeved with the condom, then the B ultrasonic probe 7 is placed into a vagina 3 of the model, the inside of a pelvic cavity is scanned, the position and the number of the follicle model 1 are known, the B ultrasonic probe 7 is controlled to rotate, the puncture needle slowly enters the pelvic cavity through vaginal puncture along a fixed puncture frame according to the position of the follicle model 1, the puncture needle is punctured into the follicle model 1 closest to the B ultrasonic probe 7 along a B ultrasonic guide wire, the puncture needle 6 is punctured into the follicle model 1 slightly and intermittently and sucks the follicle model 1 through a negative pressure aspirator, filling liquid 9 flows into a test tube 8 through a tube connected with the puncture needle 6, the matched laboratory personnel introduce the sterile test tube 8 into a large plate and place the sterile test tube under a microscope to observe whether the simulated ovum 5 is successfully obtained. If no egg-like material is found in the first aspiration, the punctured follicle model 1 is rinsed with an equal amount of rinsing fluid and observed for removal. Recording the number of the taken simulated eggs 5, and calculating whether the egg obtaining rate of the operator reaches the standard according to a calculation formula of the egg obtaining rate (the egg obtaining rate is the number of the taken eggs/26 eggs), wherein the standard of the egg obtaining rate is more than 70%.
In conclusion, the ovum-taking model can be used for enabling clinical operators to be familiar with the ovum-taking process and using the model for training in advance, thereby improving the success rate of ovum taking in subsequent clinical operation; meanwhile, the model of the invention can obviously improve the proficiency of operators, further improve the egg obtaining rate on the basis of successful egg obtaining, and reduce the discomfort of patients in the actual egg obtaining process.
The applicant states that the present invention is illustrated in detail by the above examples, but the present invention is not limited to the above detailed methods, i.e. it is not meant that the present invention must rely on the above detailed methods for its implementation. It should be understood by those skilled in the art that any modification of the present invention, equivalent substitutions of the raw materials of the product of the present invention, addition of auxiliary components, selection of specific modes, etc., are within the scope and disclosure of the present invention.

Claims (23)

1. An ovum picking model, the model is up to the waist and abdomen and down to 1/3 points on the thigh, and is characterized in that the internal structure of the ovum picking model comprises a female vagina model and a carrier carrying a follicle model, the follicle model is distributed on the surface of the carrier, and simulated ova are contained in the follicle model;
the carrier comprises a reticular structure carrier;
the diameter of the mesh structure carrier is 0.1-0.2 mm;
the diameter of the follicle model is 10-25 mm;
the wall thickness of the follicle model is 0.01-0.05 mm;
the follicle model comprises a filling fluid.
2. The egg retrieval model of claim 1, wherein the mesh structure has a mesh spacing of 10-25 mm.
3. The egg retrieval model of claim 1, wherein the carrier is made of any one of silica gel, rubber or PVC.
4. The egg extraction model of claim 1, wherein the carrier is made of PVC.
5. The egg retrieval model of claim 1, wherein the vaginal model is 7-9cm long.
6. The aspiration model of claim 5, wherein the vaginal model is 8cm long.
7. The egg retrieval model of claim 1, wherein the vaginal model has a wall thickness of 0.5-3 mm.
8. The egg retrieval model of claim 7, wherein the vaginal model has a wall thickness of 1-2 mm.
9. The aspiration model of claim 1, wherein the diameter of the follicle model is 12-20 mm.
10. The aspiration model of claim 1, wherein the number of follicle models is 20-30.
11. The aspiration model of claim 10, wherein the number of follicle models is 26.
12. The aspiration model of claim 1, wherein the follicular model has a wall thickness of 0.03 mm.
13. The aspiration model of claim 1, wherein the fluid filling the follicle model comprises ultrapure water.
14. The egg retrieval model of claim 1, wherein the simulated ovum is 115-125 μm in diameter.
15. The egg retrieval model of claim 14, wherein the simulated egg has a diameter of 120 μm.
16. The egg retrieval model of claim 1, wherein the material of the simulated egg comprises PVC.
17. The aspiration model of claim 1, wherein the carrier is removably attached to the aspiration model for replacement of the carrier.
18. The aspiration model of claim 1, wherein the aspiration model is provided with an opening for replacing the carrier.
19. The aspiration model of claim 18, wherein the opening is provided on a waist section of the aspiration model.
20. The egg extraction model of claim 18, wherein the width of the opening is 3-5 cm.
21. The egg extraction model of claim 18 wherein the opening is of equal length to the waist.
22. A method of using a model according to any of claims 1-21, comprising in particular the steps of:
(1) placing the ovum-taking model in a lateral decubitus position of the lithotomy position;
(2) placing a couplant for detection into the condom, placing a vaginal B-ultrasonic probe into the condom, and clamping the fixed puncture frame on the B-ultrasonic probe sleeved with the condom;
(3) extending a B-ultrasonic probe into a vaginal model of the model, scanning the interior of a pelvic cavity, and detecting the position and the number of the follicle models;
(4) and operating and rotating the B-ultrasonic probe to slowly puncture the puncture needle into the pelvic cavity through the vagina along the fixed puncture frame according to the position of the follicle model, puncturing the puncture needle into the follicle model along the B-ultrasonic guide wire to obtain filling liquid, and observing whether the simulated ovum is successfully obtained by a microscope.
23. Use of the oviposition model of any one of claims 1-21 to simulate an oviposition procedure.
CN201811614099.9A 2018-12-27 2018-12-27 Ovum-taking model and application thereof Active CN109637321B (en)

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