CN110327104A - The method of Pericardiocentesis device and paracentesis pericardii - Google Patents
The method of Pericardiocentesis device and paracentesis pericardii Download PDFInfo
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- CN110327104A CN110327104A CN201910768577.XA CN201910768577A CN110327104A CN 110327104 A CN110327104 A CN 110327104A CN 201910768577 A CN201910768577 A CN 201910768577A CN 110327104 A CN110327104 A CN 110327104A
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- core rod
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- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 claims description 5
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Classifications
-
- 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
-
- 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
-
- 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
Abstract
A kind of method that the present invention discloses Pericardiocentesis device and paracentesis pericardii; it is related to the field of medical instrument technology; to solve to be difficult to real-time and multi-angle the movement for monitoring puncture needle during paracentesis pericardii to a certain extent; puncture needle and cardiac muscle and pericardium relative position is set to be difficult to be accurately positioned; and the sharp keen shortage of needle tip protects structure; the technical issues of keeping puncture procedure uncontrollable to be easy to damage cardiac muscle, and then leading to the severe complications such as puncture failure even pericardial tamponade.Pericardiocentesis device provided by the invention is used for three-dimensional mapping system, including needle body and internal core rod；Needle body is in a tubular form, and conductive；One end of needle body is provided with puncture portion, and the other end is provided with grip part；Interfaces of connecting wires is offered on grip part；One end of internal core rod can sequentially pass through the grip part and puncture portion of needle body, and stretch out in puncture portion；Internal core rod is conductive.
Description
Technical field
The present invention relates to technical field of clinical medicine, more particularly, to the side of a kind of Pericardiocentesis device and paracentesis pericardii
Method.
Background technique
It is the foundation stone of many interventional cardiac procedures into epicardial space, for example external membrane of heart radio-frequency ablation procedure refers to and passes through the heart
Packet punctures, and into the interventional therapy means of epicardial space mapping simultaneous ablation, predominating path is under percutaneous xiphoid-process or the apex of the heart
Place punctures pericardium, establishes operating walk way, and conduit enters cavum pericardiale, row epicardial mapping and ablation through this.Similarly, this technology is suitable
For needed after other any internal membrane of heart approach RF ablations failures supraventricular arrhythmias type such as room of epicardial ablation it is early,
Fang Su, room are flutterred with accessory atrioventricular pathways etc..Separately have rare application at present further include: transexocardial left atrial appendage occlusion, esophagus protection with
And epicardial electrode implantation etc., but the following possible application has a bright future.The especially radiofrequency ablation therapy of atrial fibrillation in recent years
Rapid development, has accounted for more than half of entire arrhythmia cordis interventional therapy at present, and the success rate of first ablation is about 70~
80%, at least 10% is related with external membrane of heart lesion in patients with recurrent, it is therefore desirable to positive external membrane of heart intervention.
Pericardium is one layer of connective tissue membrane structure that heart periphery is tightly wrapped in, carry out the heart outside ablative surgery when
It waits, it is necessary to which artificial makes a call to an access the pericardium for being tightly attached to heart outer wall by Pericardiopuncture needle, in order to which ablation apparatus is logical
It crosses the access and enters between heart outer wall and pericardium and melted.
Traditional paracentesis pericardii technology is carried out under x-ray guidance, but since the technology is a two dimensional technique,
Though the position of needle point and pericardium approaches in some angle, may be not close in other angles, that is to say, that be difficult to look for
To best Tangented position, when clinical manipulation, often lead to puncture failure because inserting needle is not in place, inserting needle is too deep, stabs cardiac muscle.Moreover,
Since heart surface has one layer of fat to cause myocardium edge sometimes and unintelligible under x-ray, more in heartbeat
It is difficult to grasp, is also just more easier that damage epicardial surface coronary artery serious consequence occurs, and paracentesis pericardii acquires a certain degree of difficulty,
When operating by traditional technology, quantity of X-rays X is larger, and since the tip of puncture needle is sharp keen, the right ventricular wall that puncture path is just facing
Thin, ventricular beats, it is much accidentally to penetrate right ventricle in addition.
Therefore, it is badly in need of providing a kind of method of Pericardiocentesis device and paracentesis pericardii, it is existing to solve to a certain extent
Technical problem present in technology.
Summary of the invention
The present invention provides a kind of method of Pericardiocentesis device and paracentesis pericardii, to solve paracentesis pericardii to a certain extent
It is difficult to the movement of real-time and multi-angle monitoring puncture needle in the process, puncture needle and cardiac muscle and pericardium relative position is made to be difficult to standard
It determines position and the sharp keen shortage protection structure of needle tip, keeps puncture procedure uncontrollable to be easy to damage cardiac muscle, and then cause
The technical issues of severe complications such as puncture failure even pericardial tamponade.
The present invention provides a kind of Pericardiocentesis device, is used for three-dimensional mapping system, including needle body and internal core rod；Institute
State needle body in a tubular form, and conductive；One end of the needle body is provided with puncture portion, and the other end is provided with
Grip part；Interfaces of connecting wires is offered on the grip part；One end of the internal core rod can sequentially pass through the puncture needle master
The grip part of body and the puncture portion, and stretch out in the puncture portion；The internal core rod is conductive.
Wherein, the outer wall in the puncture portion is stairstepping setting, and one end shape of the puncture portion far from the grip part
At puncture tip.
Specifically, the outer wall of structure is equipped with insulation painting between the puncture portion and the grip part of the needle body
Layer；The grip part and the internal core rod are hollow setting, and one end of the internal core rod is equipped with core rod seat, the core rod seat
It is set in the grip part；One end far from the core rod seat of the internal core rod can sequentially pass through the grip part and institute
Puncture portion is stated, and the grip part can be mutually clamped with the core rod seat.
Further, the inside of the core rod seat offers receiving portion, and described accommodation section is hollow setting；Described accommodation section
Interior to be equipped with elastic component, the one end of the internal core rod far from the puncture tip is connected by sliding block with the elastic component；Work as institute
When stating internal core rod and stretching out in one end of the puncture tip and be pressurized, the elastic component is shunk, and the internal core rod bounces back to described wear
In lancet body；It, can be again under the restoring force effect of the elastic component when one end pressure relief that the internal core rod is pressurized
It is secondary to stretch out in the puncture tip.
Wherein, it is provided with conduction element between the needle body and the interfaces of connecting wires, is inserted into the connecting line and connects
Connecting line in mouthful can be conducted by the interfaces of connecting wires and the conduction element with the needle body.
Specifically, the grip part in the needle body offers liquid injection port, the liquid injection port and the receiving
Portion and the internal core rod are connected, and are used for injecting normal saline or contrast agent.
Further, scale is uniformly provided on the outer wall of the needle body, the scale is for monitoring paracentesis depth；
The end face of the one end of the internal core rod far from the core rod seat is smooth arc.
Wherein, Pericardiocentesis device provided by the invention further includes seal wire；The seal wire can sequentially pass through the core bar
Seat and the internal core rod, and one end of the seal wire can stretch out in the internal core rod, the other end can stretch out in the core bar
Seat.
Specifically, one end that the seal wire can stretch out in the core rod seat is equipped with first electrode, and the seal wire can be stretched
One end for the internal core rod is equipped with second electrode；The first electrode and the second electrode can be connected, and described
One electrode can be connected with the connecting line；It is insulation between the first electrode and the second electrode of the seal wire
Area.
Compared with the existing technology, Pericardiocentesis device of the present invention has the advantage that
Pericardiocentesis device provided by the invention is used for three-dimensional mapping system, including needle body and internal core rod；It punctures
Needle main body is in a tubular form, and conductive；One end of needle body is provided with puncture portion, and the other end is provided with grip part；It holds
It holds and offers interfaces of connecting wires in portion；One end of internal core rod can sequentially pass through the grip part and puncture portion of needle body, and
Stretch out in puncture portion；Internal core rod is conductive.
From this analysis, since needle body is conductive, and being held in Pericardiocentesis device provided by the invention
Portion is held equipped with interfaces of connecting wires, needle body can be electrically connected by connecting line with three-dimensional mapping system.Therefore, three-dimensional mark
Examining system just can carry out real-time monitoring to the puncture position of needle body.
Since internal core rod is arranged in needle body, internal core rod and needle body all have electric conductivity, and inner core
One end of bar stretches out in puncture portion.Therefore, when being in puncture state, by three-dimensional mapping system to puncture portion and internal core rod
It is monitored, can preferably control puncture process, avoid that heart is caused to damage.
Therefore, which efficiently solves in the prior art, supervises due to being difficult to real-time and multi-angle during paracentesis pericardii
The movement for surveying puncture needle is difficult to be accurately positioned to puncture needle and cardiac muscle and pericardium relative position, to be easy to damage cardiac muscle
Disadvantage keeps puncture procedure uncontrollable, so cause puncture failure even the severe complications such as pericardial tamponade the technical issues of.
The present invention also provides a kind of methods for carrying out paracentesis pericardii using above-mentioned Pericardiocentesis device, include the following steps:
The ventricle three-dimensional matrice building of S1, three-dimensional mapping system；
The connection and installation of S2, sting device and three-dimensional mapping system；
S3, puncture procedure is carried out using needle body；When puncture, pass through three-dimensional mapping system real-time monitoring puncture tip
Position, and when stairstepping setting puncture portion be hampered, needle body generate pulsatory feeling when, stop puncture；
S4, internal core rod is pushed in needle body, and one end of internal core rod is made to protrude from puncture portion；Continue push to wear
Lancet body, until monopole occurs stablizing ventricle epimysium characteristic potential change, and three-dimensional mapping system in three-dimensional mapping system
Show that the one end for the internal core rod for protruding from puncture portion has touched the external membrane of heart in system, then puncture tip reaches puncture position, stops
It punctures；
S5, seal wire is protruded into the through-hole of internal core rod, position and form by three-dimensional mapping system monitoring seal wire are sentenced
Whether disconnected puncture succeeds.
Possessed advantage is identical compared with the existing technology with above-mentioned Pericardiocentesis device for the method for paracentesis pericardii, herein not
It repeats again.
Detailed description of the invention
It, below will be to specific in order to illustrate more clearly of the specific embodiment of the invention or technical solution in the prior art
Embodiment or attached drawing needed to be used in the description of the prior art be briefly described, it should be apparent that, it is described below
Attached drawing is some embodiments of the present invention, for those of ordinary skill in the art, before not making the creative labor
It puts, is also possible to obtain other drawings based on these drawings.
Fig. 1 is the overall structure diagram of Pericardiocentesis device provided in an embodiment of the present invention；
Fig. 2 is the structural schematic diagram of internal core rod in Pericardiocentesis device provided in an embodiment of the present invention；
Fig. 3 is the structural schematic diagram of needle body in Pericardiocentesis device provided in an embodiment of the present invention；
Fig. 4 is the structural schematic diagram of seal wire in Pericardiocentesis device provided in an embodiment of the present invention；
Fig. 5 is the overall flow schematic diagram of paracentesis pericardii method provided by the invention.
In figure: 1- needle body；101- puncture portion；2- internal core rod；The grip part 3-；4- interfaces of connecting wires；5- connecting line；
6- sliding block；7- elastic component；8- core rod seat；9- through-hole；10- liquid injection port；11- scale；12- seal wire；13- first electrode；14- second
Electrode.
Specific embodiment
Technical solution of the present invention is clearly and completely described below in conjunction with attached drawing, it is clear that described implementation
Example is a part of the embodiment of the present invention, instead of all the embodiments.Based on the embodiments of the present invention, ordinary skill
Personnel's every other embodiment obtained without making creative work, shall fall within the protection scope of the present invention.
In the description of the present invention, it should be noted that term " center ", "upper", "lower", "left", "right", "vertical",
The orientation or positional relationship of the instructions such as "horizontal", "inner", "outside" be based on the orientation or positional relationship shown in the drawings, merely to
Convenient for description the present invention and simplify description, rather than the device or element of indication or suggestion meaning must have a particular orientation,
It is constructed and operated in a specific orientation, therefore is not considered as limiting the invention.In addition, term " first ", " second ",
" third " is used for descriptive purposes only and cannot be understood as indicating or suggesting relative importance.
In the description of the present invention, it should be noted that unless otherwise clearly defined and limited, term " installation ", " phase
Even ", " connection " shall be understood in a broad sense, for example, it may be being fixedly connected, may be a detachable connection, or be integrally connected；It can
To be mechanical connection, it is also possible to be electrically connected；It can be directly connected, can also can be indirectly connected through an intermediary
Connection inside two elements.For the ordinary skill in the art, above-mentioned term can be understood at this with concrete condition
Concrete meaning in invention.
Fig. 1 is the overall structure diagram of Pericardiocentesis device provided in an embodiment of the present invention；Fig. 2 is the embodiment of the present invention
The structural schematic diagram of internal core rod in the Pericardiocentesis device of offer.
As shown in Figure 1 with Figure 2, Pericardiocentesis device provided in an embodiment of the present invention, including needle body 1 and inner core
Bar 2；Needle body 1 is in a tubular form, and conductive；One end of needle body 1 is provided with puncture portion 101, and the other end is set
It is equipped with grip part 3；Interfaces of connecting wires 4 is offered on grip part 3；One end of internal core rod 2 can sequentially pass through needle body 1
Grip part 3 and puncture portion 101, and stretch out in puncture portion 101；Internal core rod 2 is conductive.
From this analysis, in Pericardiocentesis device provided by the invention, since needle body 1 is conductive, and
Grip part 3 is equipped with interfaces of connecting wires 4, and needle body 1 can be electrically connected by connecting line 5 with three-dimensional mapping system.Therefore,
Three-dimensional mapping system just can carry out real-time monitoring to the puncture position of needle body 1.
Since internal core rod 2 is arranged in needle body 1, internal core rod 2 and needle body 1 all have electric conductivity, and
One end of internal core rod 2 stretches out in puncture portion 101.Therefore, when being in puncture state, by three-dimensional mapping system to puncture portion
101 and internal core rod 2 be monitored, can preferably control puncture process, avoid that heart is caused to damage.
It should be added that, in the application, the length that internal core rod 2 stretches out puncture portion 101 is preferably 1- herein
2mm。
Therefore, which efficiently solves in the prior art, supervises due to being difficult to real-time and multi-angle during paracentesis pericardii
The movement for surveying puncture needle is difficult to be accurately positioned to puncture needle and cardiac muscle and pericardium relative position, to be easy to damage cardiac muscle
Disadvantage keeps puncture procedure uncontrollable, so cause puncture failure even the severe complications such as pericardial tamponade the technical issues of.
Herein it should be added that, since human body myocardial contraction can discharge bioelectricity, filled by paracentesis pericardii
The real-time monitoring that can be realized in three-dimensional mapping system to puncture position is set, the safety of puncture procedure is improved.
Three-dimensional mapping system is first three-dimensional mapping and ablation system applied to cardiac electrophysiology in the world.It is easy to
It grasps and uses, is compatible strong, itself can constantly expand upgrading, it has also become the platform of the following Advanced Technology Extension, it can be by shadow
The technologies such as picture, ultrasound, magnetic navigation and three-dimensional electrolysis are cutd open Mapping System and are fused together, and have the double positioning of magnetoelectricity, Image Creation modeling
(FAM) and the characteristics of overall process optimization.
Wherein, as shown in Figure 1 with Figure 2, puncture portion 101 is stairstepping setting, and puncture portion 101 is far from grip part 3
One end forms puncture tip.
Needle body 1 realizes the purpose punctured by puncture tip, and since puncture portion 101 is stairstepping setting,
Therefore, when puncture portion 101 is hampered in puncture process, and needle body 1 has pulsatory feeling, can stop puncturing.Pass through ladder
The puncture state in the puncture portion 101 of shape setting and the position for combining three-dimensional mapping systematic observation puncture tip, can be to puncture
Position carry out clear and complete monitoring, improve the safety of puncture process again.
It should be added that, the puncture portion 101 of stairstepping setting can be by same puncture needle by grinding etc. herein
Means are formed, and can also be formed by a needle tubing and a puncture needle head by the forms such as welding or riveting.
Wherein, as shown in Figure 1 with Figure 2, the outer wall of structure is set between the puncture portion 101 and grip part 3 of needle body 1
There is insulating coating.
Due to needle body 1 puncture tip during paracentesis pericardii bring risk highest, so puncture tip
It needs accurately to show in three-dimensional mapping system.Therefore, it is necessary to the outer wall of structure between puncture portion 101 and grip part 3 is arranged
Insulating coating, to ensure that needle body 1 enters the part of human body, only puncture portion 101 can develop in three-dimensional mapping system,
So that it is guaranteed that the safety of puncture process.
Specifically, as shown in Figure 1 with Figure 2, grip part 3 and internal core rod 2 are hollow setting, and one end of internal core rod 2
Equipped with core rod seat 8, core rod seat 8 is set in grip part 3；One end of the separate core rod seat 8 of internal core rod 2 can sequentially pass through gripping
Portion 3 and puncture portion 101, and grip part 3 can be clamped with 8 phase of core rod seat.
Setting grip part 3 can facilitate medical staff to hold, to carry out puncture and other operations.And hollow setting is held
It holds portion 3 and needle body 1 is capable of forming channel, facilitate the extraction of internal core rod 2 and protrude into.
Internal core rod 2 is hollow setting, and the core rod seat 8 in internal core rod 2 can be clamped with 3 phase of grip part, therefore grip part 3
It is also capable of forming channel with internal core rod 2, it is convenient to protrude into and extract or inject the medical agents such as developer to seal wire 12.
Herein it should be added that, itself ask in grip part 3 preferably using infundibulate be arranged, inner core can be made
Bar 2 to protrude into process more convenient.But it is not limited only to infundibulate setting, the setting of other cylindricalitys is also able to achieve medical staff's
It holds.
The clamping of grip part 3 and core rod seat 8 can be realized by forms such as card slot or buckles, when the form using card slot
When, spiral protrusion can be set in the inner wall of grip part 3, matching spiral groove is set in the outer wall of core rod seat 8,
By rotation, the purpose of clamping is realized.
And realize the relatively fixed form being not limited only to using clamping of grip part 3 and core rod seat 8, by core rod seat 8
On add flexible pad, can also be realized by the frictional force increased between the elastic deformation and grip part 3 and core rod seat 8 of flexible pad
The two it is relatively fixed.
Further, as shown in Figure 1 with Figure 2, the inside of core rod seat 8 offers receiving portion, and receiving portion is hollow setting；
Elastic component 7 is equipped in receiving portion, the one end of internal core rod 2 far from puncture tip is connected by sliding block 6 with elastic component 7；Work as inner core
When one end that bar 2 stretches out in puncture tip is pressurized, elastic component 7 is shunk, and internal core rod 2 bounces back in needle body 1；Work as internal core rod
When one end pressure relief of 2 compressions, puncture tip can be stretched out in again under the restoring force effect of elastic component 7.
So that internal core rod 2 is stretched in needle body 1 by elastic component 7, the puncture position of puncture needle can be carried out real
When monitor, when needle body 1 is in puncture procedure, internal core rod 2 by drag effect push 6 compression elastic piece 7 of sliding block, thus
It shrinks in needle body 1；When reaching puncture position, 2 resistance of internal core rod disappears, and elastic component 7 generates restoring force, to give
6 thrust of sliding block makes internal core rod 2 stretch out needle body 1.
It should be added that, when being provided with elastic component 7 in core rod seat 8, elastic component 7 is relatively solid with sliding block 6 herein
Fixed connection, and sliding block 6 also on offer the hole being connected with the through-hole 9 of internal core rod 2, the core rod seat 8 of hollow setting can be with cunning
Block 6 and internal core rod 2 form channel, facilitate protruding into and extracting for seal wire 12.
Since seal wire 12 is required to across core rod seat 8 and internal core rod 2, the one end of core rod seat 8 far from internal core rod 2
End face on offer and meet the hole that seal wire 12 passes through, and the elastic component 7 in the application preferably uses spring, therefore, spring
Internal diameter be greater than aperture with aperture on core rod seat 8.
Further, as shown in Figure 1 with Figure 2, it is provided with conduction element between needle body 1 and interfaces of connecting wires 4, inserted
Entering the connecting line 5 in interfaces of connecting wires 4 can be conducted by interfaces of connecting wires 4 and conduction element with needle body 1.
By conduction element, connecting line 5 can be made quickly to be connected with needle body 1.In use, by the one of connecting line 5
In end insertion interfaces of connecting wires 4, the other end connects three-dimensional mapping system, since interfaces of connecting wires 4 passes through conduction element and puncture needle
Main body 1 is conducted, and therefore, three-dimensional mapping system is capable of the puncture position of real-time monitoring needle body 1.
It should be added that, conduction element can be made of conducting wire or other conductive materials herein, the one of conduction element
End can be fixedly connected with needle body 1, and the other end is fixedly connected with interfaces of connecting wires 4.
Fig. 3 is the structural schematic diagram of needle body 1 in Pericardiocentesis device provided in an embodiment of the present invention.
Wherein, as shown in figure 3, the grip part 3 in needle body 1 offers liquid injection port 10, liquid injection port 10 and receiving portion
And internal core rod 2 is connected, and is used for injecting normal saline or contrast agent.
After puncture procedure, the mode rebuild according to X-ray or ultrasound detects puncture position, then needs to puncture position
Injecting normal saline or contrast agent.Therefore, liquid injection port 10 is set and liquid injection port 10 can be connected to grip part 3 or internal core rod 2, it can
Conveniently to realize the operation to puncture position injecting normal saline or contrast agent.And liquid injection port 10 is set can also be more preferable
The scope of application for making Pericardiocentesis device it is wider.
Further, as shown in Figure 1-Figure 3, scale 11 is uniformly provided on the outer wall of needle body 1, scale 11 is used for
Monitor paracentesis depth；The end face of the one end of internal core rod 2 far from core rod seat 8 is smooth arc.
Scale 11, which is arranged, can prompt the insertion depth of puncture needle, make anticipation before reaching puncture position, make to puncture through
Journey is more accurate controllable, improves the safety of puncture.
Setting smooth cambered surface for the end face of internal core rod 2 can effectively avoid the problem that causing heart damage.
It should be added that, the position between grip part 3 and puncture portion 101 is arranged in scale 11 in the application herein
It sets, and one scale 11 is set every 10mm.
Fig. 4 is the structural schematic diagram of seal wire 12 in Pericardiocentesis device provided in an embodiment of the present invention.
Wherein, as Figure 1-Figure 4, Pericardiocentesis device provided by the invention further includes seal wire 12；Seal wire 12 can be according to
It is secondary to pass through core rod seat 8 and internal core rod 2, and one end of seal wire 12 can stretch out in internal core rod 2, the other end can stretch out in core rod seat
8。
In pericardium puncture process, when showing that the head end of internal core rod 2 touches the external membrane of heart in three-dimensional mapping system, by second
Electrode 14 sequentially passes through the through-hole 9 of core rod seat 8 and internal core rod 2, and seal wire 12 is made to reach puncture position, the first electrode 13 of the other end
It stretches out in core rod seat 8 and is connected with three-dimensional mapping system, can be realized the real-time monitoring second electrode in three-dimensional mapping system
14 specific location, to realize the further judgement to paracentesis pericardii success or not.
Also, when the second electrode 14 of seal wire 12 cannot move freely in pericardium, then paracentesis pericardii is failed, and extraction is led
Silk 12 reuses needle body 1 and carries out puncture procedure；When the head end for showing internal core rod 2 again by three-dimensional mapping system
When touching the external membrane of heart, it is repeatedly inserted into seal wire 12, whether detection paracentesis pericardii succeeds, and punctures the hand after the continuous progress of successful subsequent
Art operating procedure.
Specifically, as Figure 1-Figure 4, one end that seal wire 12 can stretch out in core rod seat 8 is equipped with first electrode 13, seal wire
12 one end that can stretch out in internal core rod 2 are equipped with second electrode 14；First electrode 13 and second electrode 14 can be connected, and first
Electrode 13 can be connected with connecting line 5；It is insulation layer between the first electrode 13 and second electrode 14 of seal wire 12.
Due to needing to extract needle body 1 and internal core rod 2, seal wire 12 is reserved in pericardium after paracentesis pericardii success
It is inside monitored and guides.Therefore, it is necessary to set exhausted for 12 part of seal wire between first electrode 13 and second electrode 14
Edge, and realized by the way of insulating coating in the application and insulated between the first electrode 13 of seal wire 12 and second electrode 14.And
By the part between first electrode 13 and second electrode 14 be set as insulation can make seal wire 12 in three-dimensional mapping system be only
Second electrode 14 is developed.
Fig. 5 is the overall flow schematic diagram of paracentesis pericardii method provided by the invention.
The embodiment of the present invention also provides a kind of method of paracentesis pericardii, as shown in figure 5, including the following steps: S1, three-dimensional mark
The ventricle three-dimensional matrice of examining system constructs；The connection and installation of S2, sting device and three-dimensional mapping system；S3, puncture needle is used
Main body 1 carries out puncture procedure；When puncture, by the position of three-dimensional mapping system real-time monitoring puncture tip, and when stairstepping is set
The puncture portion 101 set is hampered, and when needle body 1 generates pulsatory feeling, stops puncturing；S4, internal core rod 2 is pushed into puncture needle master
In body 1, and one end of internal core rod 2 is made to protrude from puncture portion 101；Continue to push needle body 1, until in three-dimensional mapping system
Monopole occurs stablizing ventricle epimysium characteristic potential change, and display protrudes from the interior of puncture portion 101 in three-dimensional mapping system
One end of core bar 2 has touched the external membrane of heart, then puncture tip reaches puncture position, stops puncturing；S5, seal wire 12 is protruded into inner core
In the through-hole 9 of bar 2, position and form by three-dimensional mapping system monitoring seal wire 12 judge whether puncture succeeds.
Specifically, the ventricle three-dimensional matrice of three-dimensional mapping system constructs in step S1:
Firstly, preoperative be heart coronary artery CT, using the three-dimensional mapping system with visual fusion component in three dimension system
It rebuilds, for the fusion of structure previewed with image, tricuspid annulus and right ventricle are primary structure, are lost if it is the left room rhythm of the heart
Often, aortic sinus and left ventricle will also construct.
Later, heart positioning is carried out in body surface in advance using three-dimensional navigation conduit, by taking three-dimensional mapping system as an example, usually selected
Select under xiphoid-process and angulus sterni two o'clock and therebetween each intercostal of left border of sternum as heart in body surface projection scope, after positioning with
CT is merged and is judged the distance of left ventricular apex portion and xiphoid-process.
Finally with three-dimensional navigation conduit mapping left and right ventricles and threedimensional model is constructed, in order to carry out visual fusion, carefully marked
Survey aortic sinus, annulus of mitral valve, tricuspid annulus, His beam；It is right in order to keep model near point of puncture and matrix more accurate
Apex and antetheca also will mappings repeatedly.
It should be added that, if having used three-dimensional intracardiac echocardiography, after respiration gate control, emphasis building is left herein
Right ventricle pericardium, apex and antetheca.
After the completion of the ventricle three-dimensional matrice building of step S1 three-dimensional mapping system, start to carry out step S2, sting device
With the connection and installation of three-dimensional mapping system.
By in one end insertion interfaces of connecting wires 4 of connecting line 5, the other end is connected with three-dimensional mapping system.
When S2, the connection of sting device and three-dimensional mapping system and after be installed, start to carry out S3, using puncture needle master
Body 1 carries out puncture procedure；Puncturing operation operation carries out paracentesis pericardii under xiphoid-process in patient's local anaesthesia downlink, pareordia sterile drape,
Left shoulder joint is directed toward in needle point direction, and with wall of the chest angle at 45 °, lateral wall is inclined before show the left room of needle point direction in three-dimensional mapping system
Lower direction.
When puncture, the relative distance of the right ventricle structure of puncture tip and three-dimensional reconstruction is observed, while observing puncture tip
On single electrode potential variation, when pericardial features potential change occurs in monopole, while feeling that puncture tip meets obstructions and fights
Innervation shows that puncture tip has contacted pericardium, and the puncture portion 101 of stairstepping setting can block pericardium, stop puncturing.
When S3, puncture procedure are completed, starts to carry out S4, carries out protection operation using internal core rod 2；Push internal core rod 2 arrives
Bottom is blocked with needle body 1, and it is 1-2mm that internal core rod 2, which stretches out puncture tip distance,；Continue to push needle body 1, until
There is very big resistance, and monopole occurs stablizing ventricle epimysium characteristic potential change, three-dimensional mark in three-dimensional mapping system
Examining system shows that core bar head end has touched the external membrane of heart, then reaches puncture position, stops puncturing.
Patient may there are also the clinical manifestations such as ventricular arrhythmia or pain at this time.
When above-mentioned steps completion, then proves paracentesis pericardii success, continue step S5, seal wire 12 is protruded into internal core rod 2
Through-hole 9 in, position and form by three-dimensional mapping system monitoring seal wire 12, judge puncture whether succeed.
When the second electrode 14 of seal wire 12 reaches puncture position, if seal wire 12 can be moved freely in epicardial space,
Then puncture success；If continuously push seal wire 12, second electrode 14 can be moved freely always in the 1-2cm of heart periphery, then be punctured
Success；If second electrode 14 is shown in heart or in the place far from heart, puncture failure.Extract seal wire 12 out, and again
Puncture procedure is carried out using needle body 1, until the second electrode 14 of seal wire 12 can be free in the 1-2cm of heart periphery always
It is mobile, show paracentesis pericardii success.
After whether successfully seal wire 12 is completed to judgement is punctured, needle body 1 and internal core rod 2 are extracted, by seal wire
12 are reserved in puncture position, have performed the operation guiding function for subsequent cardiac ablation.
Finally, it should be noted that it is obvious to a person skilled in the art that the present invention is not limited to above-mentioned exemplary implementations
The details of example, and without departing from the spirit or essential characteristics of the present invention, it can realize in other specific forms
The present invention.Therefore, in all respects, the present embodiments are to be considered as illustrative and not restrictive, this hair
Bright range is indicated by the appended claims rather than the foregoing description, it is intended that containing for the equivalent requirements of the claims will be fallen in
All changes in justice and range are included within the present invention.
In addition, it should be understood that although this specification is described in terms of embodiments, but not each embodiment is only wrapped
Containing an independent technical solution, this description of the specification is merely for the sake of clarity, and those skilled in the art should
It considers the specification as a whole, the technical solutions in the various embodiments may also be suitably combined, forms those skilled in the art
The other embodiments being understood that.
Claims (10)
1. a kind of Pericardiocentesis device is used for three-dimensional mapping system, which is characterized in that including needle body and internal core rod；
The needle body is in a tubular form, and conductive；
One end of the needle body is provided with puncture portion, and the other end is provided with grip part；
Interfaces of connecting wires is offered on the grip part；
One end of the internal core rod can sequentially pass through the grip part and the puncture portion of the needle body, and stretch out
In the puncture portion；
The internal core rod is conductive.
2. Pericardiocentesis device according to claim 1, which is characterized in that the outer wall in the puncture portion sets for stairstepping
It sets, and the puncture portion forms puncture tip far from one end of the grip part.
3. Pericardiocentesis device according to claim 2, which is characterized in that the puncture portion of the needle body with
The outer wall of structure is equipped with insulating coating between the grip part；
The grip part and the internal core rod are hollow setting, and one end of the internal core rod is equipped with core rod seat, the core bar
Seat is set in the grip part；
One end far from the core rod seat of the internal core rod can sequentially pass through the grip part and the puncture portion, and described
Grip part can be mutually clamped with the core rod seat.
4. Pericardiocentesis device according to claim 3, which is characterized in that the inside of the core rod seat offers receiving
Portion, described accommodation section are hollow setting；
Elastic component is equipped in described accommodation section, the one end of the internal core rod far from the puncture tip passes through sliding block and the elasticity
Part is connected；
When one end that the internal core rod stretches out in the puncture tip is pressurized, the elastic component is shunk, the internal core rod retraction
In to the needle body；
When one end pressure relief that the internal core rod is pressurized, can be stretched out in again under the restoring force effect of the elastic component
The puncture tip.
5. Pericardiocentesis device according to claim 4, which is characterized in that the needle body and the connecting line connect
It is provided with conduction element between mouthful, the connecting line being inserted into the interfaces of connecting wires by the interfaces of connecting wires and described can be led
Parts are conducted with the needle body.
6. Pericardiocentesis device according to claim 5, which is characterized in that the grip part in the needle body
Offer liquid injection port, the liquid injection port with described accommodation section and the internal core rod be connected, be used for injecting normal saline
Or contrast agent.
7. Pericardiocentesis device according to claim 6, which is characterized in that uniformly set on the outer wall of the needle body
There is scale, the scale is for monitoring paracentesis depth；
The end face of the one end of the internal core rod far from the core rod seat is smooth arc.
8. Pericardiocentesis device according to claim 7, which is characterized in that further include seal wire；
The seal wire can sequentially pass through the core rod seat and the internal core rod, and one end of the seal wire can stretch out in it is described
Internal core rod, the other end can stretch out in the core rod seat.
9. Pericardiocentesis device according to claim 8, which is characterized in that the seal wire can stretch out in the core rod seat
One end be equipped with first electrode, the seal wire can stretch out in the internal core rod one end be equipped with second electrode；
The first electrode and the second electrode can be connected, and the first electrode can be connected with the connecting line；
It is insulation layer between the first electrode and the second electrode of the seal wire.
10. a kind of method of the paracentesis pericardii carried out using Pericardiocentesis device described in the claims 8 or 9, special
Sign is, includes the following steps:
The ventricle three-dimensional matrice building of S1, three-dimensional mapping system；
The connection and installation of S2, sting device and three-dimensional mapping system；
S3, puncture procedure is carried out using needle body；When puncture, pass through the position of three-dimensional mapping system real-time monitoring puncture tip
It sets, and when the puncture portion of stairstepping setting is hampered, when needle body generates pulsatory feeling, stops puncturing；
S4, internal core rod is pushed in needle body, and one end of internal core rod is made to protrude from puncture portion；Continue to push puncture needle
Main body, until monopole occurs stablizing ventricle epimysium characteristic potential change in three-dimensional mapping system, and in three-dimensional mapping system
Show that the one end for the internal core rod for protruding from puncture portion has touched the external membrane of heart, then puncture tip reaches puncture position, stops puncturing；
S5, seal wire is protruded into the through-hole of internal core rod, is worn by the position and form, judgement of three-dimensional mapping system monitoring seal wire
Whether thorn succeeds.
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
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| CN201910768577.XA CN110327104A (en) | 2019-08-20 | 2019-08-20 | The method of Pericardiocentesis device and paracentesis pericardii |
| PCT/CN2020/084753 WO2021031587A1 (en) | 2019-08-20 | 2020-04-14 | Pericardiocentesis device and pericardiocentesis method |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201910768577.XA CN110327104A (en) | 2019-08-20 | 2019-08-20 | The method of Pericardiocentesis device and paracentesis pericardii |
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
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| WO2021031587A1 (en) * | 2019-08-20 | 2021-02-25 | 武汉律动医疗科技有限公司 | Pericardiocentesis device and pericardiocentesis method |
| CN117018438A (en) * | 2023-08-21 | 2023-11-10 | 北京老年医院 | Visual temporary pacemaker electrode |
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| WO2021031587A1 (en) | 2021-02-25 |
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