CN110694165A - Neonate PICC catheter that is fixed a position and is directed under direct-view - Google Patents

Neonate PICC catheter that is fixed a position and is directed under direct-view Download PDF

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Publication number
CN110694165A
CN110694165A CN201810743284.1A CN201810743284A CN110694165A CN 110694165 A CN110694165 A CN 110694165A CN 201810743284 A CN201810743284 A CN 201810743284A CN 110694165 A CN110694165 A CN 110694165A
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catheter
body surface
picc
magnetic
picc catheter
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唐彬秩
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133Tip steering devices
    • A61M25/0158Tip steering devices with magnetic or electrical means, e.g. by using piezo materials, electroactive polymers, magnetic materials or by heating of shape memory materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0127Magnetic means; Magnetic markers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M2025/0166Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

The invention discloses a neonatal PICC catheter positioned and oriented by means of a magnetic field, which comprises a PICC catheter with a magnetic end embedded in a silica gel body at the head end and a body surface indicator element. The magnetic end of the conduit is made of a strong magnetic material sintered neodymium iron boron, and the surface of the conduit is coated/plated with a nano-phase plating diamond-like protective film; the body surface indicator element is an arc bottom magnetic strip with color marks in the magnetic pole direction, and the outer surface of the magnetic strip is coated with a polytetrafluoroethylene coating for reducing friction force. When PICC puts the pipe, place the instruction magnetic stripe at the neonate's body surface, just can take place the magnetic field effect with internal pipe magnetism head end and slide to the most advanced corresponding body surface projection position of pipe to the realization is not with the help of extra instrument and equipment, is convenient to carry out real-time location to the pipe directly perceivedly. Meanwhile, the direction of the tip of the catheter can be judged according to the direction pointed by the body surface indication magnetic stripe by utilizing the principle that homopolar poles repel and heteropolar poles attract of the magnetic pole ends, and the abnormal position/direction correcting position/direction pointing of the catheter tip can be indicated by sliding/rotating the body surface indication magnetic stripe.

Description

Neonate PICC catheter that is fixed a position and is directed under direct-view
Technical Field
The invention relates to a PICC (peripherally inserted central catheter) catheter device which can intuitively position and orient in real time in the clinical PICC catheter of a newborn and adjust the position and the orientation of the tip of a catheter in vitro.
Background
The peripheral venous catheterization of a central venous catheter (PICC) is an important life path for the critical neonate, and the rapid and accurate PICC catheterization is one of the prerequisites for rescuing the critical neonate[1]. At present, the PICC catheter placement length is mainly measured and predicted by an operator according to the body surface mark of a newborn in China, and the position and the trend of the tip of the catheter are determined by an X-ray chest film after operation. Because the individual anatomical difference of the newborn is large, the projection of the superior vena cava lower segment on the body surface is influenced by a plurality of factors, the implantation length of the catheter cannot be completely and accurately judged only by the body surface measurement, and the catheter enters the great vessels such as the superior vena cava, the inferior vena cava and the likeThe PICC catheter tip is bent and folded in a relatively large vascular cavity due to catheter insertion propulsion or limb movement of a newborn after catheter insertion, and the PICC catheter is difficult to accurately position at one time[2]
With the development of imaging technology and electrophysiological technology, the PICC catheter tip positioning technology is used in more and more clinical applications, including X-ray chest radiography, B-ultrasound, and intracavitary electrocardiogram[3]. These techniques provide convenience for PICC accurate placement and positioning. Even so, these techniques often require additional specialized technicians and specialized equipment, such as X-ray machines, B-ultrasound machines, special electrodes/electrocardiograph monitors, etc., which are costly, increase medical resource consumption and patient burden, and currently the most widely used X-ray chest radiography positioning techniques also have the disadvantages of radioactivity, hysteresis, etc. These currently common positioning techniques fail to provide a low-cost, convenient and reliable real-time positioning guide for a PICC catheterizer, increase the risks of infection, phlebitis, thrombus/catheter blockage and the like caused by the fact that the catheter is not timely found and corrected, and the like, and the catheter tip position and the direction need to be readjusted by repeatedly extracting/inserting the tail end of the catheter after the catheter tip is found to be abnormal by the X-ray chest radiography after the operation, even the catheter is newly placed by tube drawing, and the X-ray chest radiography is performed again for positioning, thereby increasing the consumption of medical resources and the exposure and infection opportunities of newborn radiation. At present, the device which is simple, convenient, environment-friendly and harmless, does not need extra technology and equipment, can accurately judge the position and the orientation of the tip of the PICC catheter at any time when or after the PICC catheter is placed, and does not need to extract/insert the catheter after the abnormality of the position and the orientation of the tip of the catheter is found, and can directly complete the adjustment of the position and the orientation of the tip of the catheter in vitro.
Disclosure of Invention
Aiming at the defects in the prior art, the invention provides the PICC catheter with the positioning and orienting device, the catheter can directly and accurately display the position and the orientation of the tip of the PICC catheter on the body surface of a newborn without the help of additional instruments, helps a catheterist to intuitively judge the position of the tip of the catheter and whether the catheter has abnormal tip orientation caused by bending and folding in a large blood vessel catheter or not at any time, can correct the abnormal position/orientation of the tip of the PICC catheter by moving a body surface indicator element, does not need to repeatedly extract/insert the catheter, thereby reducing the infection chance and various catheter placing complications caused by the improper tip position of the catheter, and improving the clinical application effect of the PICC catheter for the newborn.
In order to achieve the above object, the neonatal PICC catheter of the present invention employs the following technical solution: including conventional neonatal 1.9 Fr-gauge PICC catheters and body surface indicator elements; the magnetic end is embedded in the silica gel body at the head end of the PICC catheter, the PICC catheter is made of a safe and nontoxic strong magnetic material, the magnetic poles are axially distributed, and a protective film which is good in biocompatibility, oxidation corrosion resistance and nontoxicity is coated/plated on the surface of the PICC catheter; the body surface indicator element is a hollow circular arc bottom magnetic strip with a color marking magnetic pole direction, the used material is completely the same as the ferromagnetic material at the magnetic end of the internal catheter, and the outer surface of the magnetic strip is coated with a material coating with an extremely low friction coefficient. When the PICC catheter is placed in a lying and supine position, the anatomical distance from the superior vena cava to the sternum body surface is 3cm-4cm, and the magnetic head end of the PICC catheter and the body surface indication magnetic strip can generate enough interaction magnetic force.
The invention has the beneficial effects that: insert the PICC pipe that the head end is embedded to have strong magnetic material according to PICC pipe operation rule, place the instruction magnetic stripe at the neonate's body surface when putting the pipe, instruct the magnetic stripe can take place the magnetic field effect with internal pipe magnetism head end and slide to the most advanced corresponding body surface projection position of PICC pipe to the realization need not fix a position in real time to PICC pipe with the help of extra instrument equipment, convenient directly perceivedly at the pipe in-process of putting. Meanwhile, the PICC catheter tip orientation can be judged according to the direction indicated by the body surface indication magnetic stripe by utilizing the principle that the south and north poles of the magnetic field repel each other and attract each other in the same polarity, and the position/orientation of the catheter tip which is abnormal can be corrected by sliding/rotating the body surface indication magnetic stripe.
Drawings
FIG. 1 is a side view of one embodiment of a 1.9Fr sized PICC catheter with a magnetic tip
FIG. 2 is a schematic cross-sectional view of one embodiment of a 1.9Fr sized PICC catheter with a magnetic tip (taking an N-pole cross-section as an example)
FIG. 3 is a side view of an embodiment of a magnetic stripe for body surface indication
FIG. 4 is a cross-sectional view of an embodiment of a magnetic stripe for indicating a body surface (taking an N-terminal cross-section as an example)
Fig. 5 is a diagram of a neonatal PICC catheter in use positioned and oriented by a magnetic field.
Wherein, the silica gel tube wall of the PICC catheter with the specification of 1, 1.9 Fr; 2. 1.9Fr specification PICC catheter lumen; 3. the strong magnets are embedded in the silica gel pipe wall at the head end of the conduit (the magnetic poles of the strong magnets are axially distributed, "|" represents an N pole, and "-" represents an S pole); 4. a surface protective film between the strong magnet and the silica gel tube wall; 5. a body surface indicator element magnet made of the same material as the strong magnet at the head end of the catheter; 6. a body surface indicator element hollow; 7. a body surface indicator element arc bottom; 8. a coating of a low coefficient of friction material on the outer surface of the body surface indicator element.
Detailed Description
The following description of the embodiments of the present invention is provided to facilitate the understanding of the present invention by those skilled in the art, but it should be understood that the present invention is not limited to the scope of the embodiments, and it will be apparent to those skilled in the art that various changes may be made without departing from the spirit and scope of the invention as defined and defined in the appended claims, and all matters produced by the invention using the inventive concept are protected.
Fig. 1 shows a side view of a 1.9 Fr-sized PICC catheter for a neonate whose head end is embedded with a ferromagnetic material, fig. 2 shows a schematic cross-sectional view (taking an N-extreme cross-section as an example) of the 1.9 Fr-sized PICC catheter for a neonate whose head end is embedded with a ferromagnetic material, fig. 3 shows a side view of a magnetic stripe with a magnetic pole direction mark for body surface indication, and fig. 4 shows a schematic cross-sectional view (taking an N-extreme cross-section as an example) of the magnetic stripe with a magnetic pole direction mark for body surface indication. Referring to fig. 1, 2, 3 and 4, the technical solution of the positioning and orienting device for the tip of the neonatal PICC catheter of the present embodiment is:
including 1.9Fr sized PICC catheter for neonates (Total)Length 50cm, outer diameter of the catheter 0.64mm, inner diameter of the catheter 0.28mm)[4]And a body surface indicator element. The annular magnet with the length of 1cm, the outer diameter of 0.61mm, the inner diameter of 0.31mm and the thickness of 0.15mm is embedded in the silica gel body at the head end of the catheter and is made of a neodymium iron boron permanent magnet Nd2Fe14B sintered by a strong magnetic material, the magnetic orthodontic material of the Nd2Fe14B permanent magnet is widely applied in oral medicine, although some scholars think that the neodymium iron boron magnet is harmless to human bodies[5]However, because it is easily oxidized and corroded, resulting in its magnetic property being weakened and releasing potentially harmful products, it is usually coated/plated with a protective film with relatively stable physicochemical properties on the surface to ensure its biological safety[6]. In the embodiment, the Nd2Fe14B surface embedded in the PICC catheter silica gel body is coated with a nano-phase plating diamond-like film with good biocompatibility, oxidation corrosion resistance and nontoxicity, and the biological safety of the nano-phase plating diamond-like film as the surface coating of the neodymium iron boron magnet is proved[7]. The thickness of the Nd2Fe14B annular magnet at the head end of the catheter is slightly smaller than the thickness of the silica gel tube wall of the PICC catheter, so that the risk of the magnet breaking through and being exposed outside the tube wall of the catheter is reduced.
The body surface indicator element is also made of a sintered neodymium iron boron permanent magnet Nd2Fe14B made of a ferromagnetic material, in order to ensure the flexibility and stability of the body surface indicator element, in one embodiment of the invention, the body surface indicator element is designed into a hollow magnetic strip with the length of 1cm and the thickness of 0.1cm, the self weight of the indicator element and the pressure on human tissues are reduced, the contact surface of the magnetic strip and the skin of the neonate is designed into an arc bottom, and the outer surface of the magnetic strip is coated with a material coating with an extremely low friction coefficient, so that the magnetic strip can be attracted and slide under the action of small magnetic force, and the risk of falling off the body surface of the neonate is reduced. In one embodiment of the invention, polytetrafluoroethylene (C2F4) n is used as the material of the outer surface coating of the body surface indicating element, the friction coefficient of the (C2F4) n is extremely low, which is beneficial to the sliding of the magnetic strip on the body surface of a patient, and the (C2F4) n is widely used for manufacturing the artificial blood vessel which has proved that the artificial blood vessel has good biological safety[6]
Referring to fig. 5, the PICC catheter with the head embedded with ferromagnetic material is inserted according to the PICC catheter placement operation protocol, and an integrated indicator element, indicator element and guide are placed on the surface of the newborn body while the catheter is placedThe magnetic material of the catheter head end generates magnetic field induction to be attracted by magnetic force and slides to the corresponding body surface projection position of the PICC catheter tip, and through observing the sliding track and the stopping position of the body surface indicator element along with the change of the position of the PICC catheter tip in vivo, a PICC catheter placement operator can master the position of the PICC catheter tip in real time. In order to reduce the friction of the magnetic strip on the delicate skin of the newborn when the body surface indication magnetic strip slides to the maximum extent, the surface of the magnetic strip can be smeared with infant olive oil before use and then placed on the body surface skin of the newborn. The ideal PICC tip is positioned at the middle-lower 1/3 segment of the superior vena cava or the junction of the superior vena cava and the right atrium, and the corresponding body surface projection area is the 3 rd to 5 th intercostals beside the right sternum, namely the body surface projection position of the superior vena cava[3]. As the PICC catheter insertion depth gradually approaches the expected catheter placement length, the tracing magnetic strip gradually slides to the target area, namely the positioning under the direct-view body surface of the catheter tip is completed, then the PICC catheter is properly fixed, and the magnetic strip is removed. When an operator has doubtful worry about the PICC catheter placement position, whether the catheter is bent and folded in a large blood vessel to cause the abnormality of the position and the orientation of the catheter can be judged at any time by observing the body surface position of the body surface indicator element and the indicated magnetic field direction, and the abnormal tip position and the orientation of the catheter are corrected by sliding/rotating the body surface indicator element by utilizing the principle that like poles of the magnetic field repel each other and opposite poles attract each other, so that the infection, the blood vessel injury and the radiation exposure of the subsequent X-ray chest piece positioning caused by repeatedly drawing/inserting the PICC catheter are avoided.
To sum up, this cover is from area location and the neonate PICC pipe of directional system passes through the mutual magnetic field effect between the embedded ferromagnetic material of pipe head end and the body surface indicator component, just can realize directly seeing down PICC pipe pointed end location and orientation simply conveniently, put the pipe go on and can inspect at any time after putting the pipe, discover and correct the pipe pointed end of dystopy outside the body, reduce the dystopy rate and the relevant complication incidence of pipe that leads to, avoided taking out repeatedly/sending into the pipe and adjust the pipe position, even the pipe is put again in the extubation and the damage of X-ray radiation inspection to the neonate repeatedly, saved the medical resource consumption who carries out PICC with the help of various instruments and equipment and put the pipe puncture location simultaneously. The whole system is made of safe and nontoxic common materials, is simple in structure, economical and practical, and is suitable for popularization and use in basic medical institutions with limited conditions.
Reference to the literature
[1]Smazal AL,Kavars AB,Carlson SJ,et al.Peripherally inserted centralcatheters optimize nutrient intake in moderately preterm infants[J].PediatrRes,2016,80(2):185-189.
[2]Zhou LJ,Xua HZ,Xu MF,et al.An accuracy study of the intracavitaryelectrocardiogram(IC-ECG)guided peripherally inserted central catheter tipplacement among neonates[J].Open Med(Wars),2017,12:125-130.
[3] Lingeri, chenhong, tangmin, etc. the positioning effect of the electrocardiograph monitor in the PICC catheterization of a newborn [ J ]. the contemporary pediatric magazine of china, 2018, 20 (5): 363-367.
[4] Use of placement of weimegadrin, zhongying, hi xiang feather, etc. into a central venous catheter via peripheral veins in pediatric patients [ J ]. chinese primary medicine, 2007, 14 (2): 331-333.
[5] New progress in brave warrior magnetic orthodontic research [ J ] foreign medicine oral medicine minute book, 1994 (05): 3l to 33.
[9] In vitro experimental study of corrosion resistance of different coated neodymium-iron-boron magnets [ J ] journal of practical oral medicine, 2013, 29 (2): 195-197.
[6] Effect of zingiberamine, chenkui, hubona. polytetrafluoroethylene artificial blood vessels on platelet aggregation and cytocompatibility [ J ] chinese tissue engineering research, 2016, 20 (47): 7064-7069.
[7] Jianwei, diamond-like carbon coated neodymium iron boron magnet cytotoxicity in vitro experimental study [ D ] Nanchang university, 2013.

Claims (9)

1. The utility model provides a from catheter device of taking location and orientation system in neonate's clinical PICC catheterization which characterized in that: comprises a 1.9Fr specification PICC catheter with a head end silica gel body embedded with a ferromagnetic material and a body surface indicator element made of the same ferromagnetic material.
2. The neonatal PICC catheter of claim 1, wherein: the strong magnetic material is made of sintered neodymium iron boron permanent magnet Nd2Fe14B or other safe and nontoxic materials, and the thickness of the strong magnetic material at the head end of the catheter is slightly smaller than the thickness of the wall of the PICC catheter.
3. The neonatal PICC catheter of claim 2, wherein: the surface of the ferromagnetic material at the head end of the conduit is coated/plated with a protective film which ensures the internal safe application.
4. The neonatal PICC catheter of claim 3, wherein: the surface protection film is a nano-phase plated diamond-like film or other nontoxic materials with good biocompatibility and oxidation corrosion resistance.
5. The neonatal PICC catheter of claim 1, wherein: the body surface indicator element is a hollow magnetic strip with an arc bottom.
6. The neonatal PICC catheter of claim 1, wherein: the body surface indicator element color marks the magnetic pole direction of the magnetic stripe.
7. The neonatal PICC catheter of claims 5-6, wherein: the body surface indicator element has an outer surface coated with a coating that reduces sliding friction.
8. The neonatal PICC catheter of claim 7, wherein: the outer surface coating of the body surface indicator element is polytetrafluoroethylene (C2F4) n or other non-toxic materials with low friction coefficient.
9. The neonatal PICC catheter of claims 1-8, wherein: abnormalities in the position/orientation of the tip of the PICC catheter in vivo may be corrected by sliding/rotating the body surface indicator element over the surface of the neonate.
CN201810743284.1A 2018-07-09 2018-07-09 Neonate PICC catheter that is fixed a position and is directed under direct-view Pending CN110694165A (en)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4014947A1 (en) * 1990-05-10 1991-11-14 Wolfgang Dr Med Ram Flexible catheter for diagnostic or therapeutic purposes - has very small guiding magnet of high remanence at distal end and extra corporal control magnets
CN1565661A (en) * 1996-06-17 2005-01-19 贝克顿·迪金森公司 Medical tube for insertion and detection within the body of a patient
CN201001771Y (en) * 2006-10-20 2008-01-09 孙永海 Magnetic guiding epidural targeted duct setting device
CN207286429U (en) * 2017-01-12 2018-05-01 南通市第一人民医院 Neonate's trachea cannula conduit with positioning function

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4014947A1 (en) * 1990-05-10 1991-11-14 Wolfgang Dr Med Ram Flexible catheter for diagnostic or therapeutic purposes - has very small guiding magnet of high remanence at distal end and extra corporal control magnets
CN1565661A (en) * 1996-06-17 2005-01-19 贝克顿·迪金森公司 Medical tube for insertion and detection within the body of a patient
CN201001771Y (en) * 2006-10-20 2008-01-09 孙永海 Magnetic guiding epidural targeted duct setting device
CN207286429U (en) * 2017-01-12 2018-05-01 南通市第一人民医院 Neonate's trachea cannula conduit with positioning function

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