CN112043353B - PICC piercing depth - Google Patents

PICC piercing depth Download PDF

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Publication number
CN112043353B
CN112043353B CN202010812895.4A CN202010812895A CN112043353B CN 112043353 B CN112043353 B CN 112043353B CN 202010812895 A CN202010812895 A CN 202010812895A CN 112043353 B CN112043353 B CN 112043353B
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China
Prior art keywords
puncture needle
tube
main body
picc
needle main
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CN202010812895.4A
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Chinese (zh)
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CN112043353A (en
Inventor
李兰
蔡志云
韩秋英
林玉凤
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Zhongshan Hospital Xiamen University
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Zhongshan Hospital Xiamen University
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Priority to CN202010812895.4A priority Critical patent/CN112043353B/en
Publication of CN112043353A publication Critical patent/CN112043353A/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • 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
    • A61B17/3415—Trocars; Puncturing needles for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters
    • 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
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/0612—Devices for protecting the needle; Devices to help insertion of the needle, e.g. wings or holders

Abstract

The invention discloses a PICC (peripherally inserted central catheter) puncturing device which comprises a puncturing needle main body, a skin expanding tube and an outer sheath component, wherein the puncturing needle main body is provided with a needle body; the skin expanding tube is positioned in the puncture needle main body; a tearing opening extending along the axial direction of the puncture needle main body is formed on the side surface of the puncture needle main body; the outer sheath assembly comprises an outer sheath tube which is detachably connected with the skin expanding tube and a driving device which drives the outer sheath tube to move towards the skin expanding tube and pushes the skin expanding tube out of the puncture needle main body; the length of the sheath tube is larger than that of the puncture needle main body. The invention also discloses a puncture method, the skin expanding tube is arranged in the puncture needle main body, the skin expanding tube enters the vein along with the puncture needle, then the puncture needle exits the vein, the skin expanding tube is left in the vein, and finally the PICC tube is inserted into the vein along with the skin expanding tube, so that the PICC tube placement is completed.

Description

PICC piercing depth
Technical Field
The invention relates to the technical field of medical instruments, in particular to a PICC (peripherally inserted central catheter) puncturing device.
Background
PICC catheterization is central vein catheterization through peripheral venipuncture, and is to utilize the pipe to puncture from the vein of peripheral arm, and the pipe directly reaches the great vessel that is close to the heart. Avoid the direct contact of chemotherapy medicine and arm vein, the blood reflux of big vein is very fast in addition, can dilute the chemotherapy medicine rapidly, prevents the stimulation of medicine to the blood vessel, consequently can effectual protection upper limbs vein, reduces the emergence of phlebitis, alleviates patient's pain, improves patient's quality of life.
The PICC catheterization method comprises the following steps: (1) puncturing the vein with a puncture needle; (2) leading the guide wire 1 to enter the superior vena cava along the puncture needle; (3) pulling out the puncture needle, and inserting the skin expander and the outer sheath assembly into the superior vena cava along the guide wire 1; (4) drawing out the guide wire 1 and the skin expander; (5) inserting a PICC tube (containing guidewire 2) into the superior vena cava along the outer sheath assembly; (6) pulling out the outer sheath and tearing; (7) the guide wire 2 is drawn out; (8) reserving a 5cm PICC tube outside, and cutting off redundant PICC tubes; (9) sleeving a pressure reducing sleeve on the PICC pipe; (10) and then the PICC pipe is connected to the metal handle of the extension pipe and is clamped with the pressure reducing sleeve.
In the prior art, when a patient is placed with a tube, the tool is penetrated into the vein of the patient for a plurality of times in the preoperative work, so that the pain of the patient is increased.
In view of the above, the applicant has made an intensive study to solve the above problems and has made the present invention.
Disclosure of Invention
The invention aims to provide a PICC puncture device, which solves the problem that the pain of a patient is increased by inserting an auxiliary tool into the vein of the patient for multiple times due to the complicated operation steps of the conventional PICC catheterization.
In order to achieve the above purpose, the solution of the invention is:
the PICC puncture device comprises a puncture needle main body, a skin expanding tube and an outer sheath assembly; the skin expanding tube is positioned in the puncture needle main body; a tearing opening extending along the axial direction of the puncture needle main body is formed on the side surface of the puncture needle main body; the outer sheath assembly comprises an outer sheath tube which is detachably connected with the skin expanding tube and a driving device which drives the outer sheath tube to move towards the skin expanding tube and pushes the skin expanding tube out of the puncture needle main body; the length of the sheath tube is larger than that of the puncture needle main body.
Further, the driving device comprises a driving screw rod and a bearing frame for bearing the driving screw rod; the bearing frame comprises a first connecting rod which is fixedly connected with one end of the sheath tube far away from the puncture needle main body and is vertical to the sheath tube, and a second connecting rod which is vertical to the first connecting rod and is fixedly connected with the end part of the first connecting rod.
Furthermore, the first connecting rod is provided with a first tube through hole which penetrates through the first connecting rod and is communicated with the outer sheath tube, and a second through hole which is parallel to the first through hole and is used for the driving screw to pass through; the second connecting rod is provided with a sliding rail arranged along the length direction of the second connecting rod.
Furthermore, the driving device also comprises a driving block which is detachably connected with the puncture needle main body; the driving block is provided with a sliding groove matched with the sliding rail and a threaded hole matched with the driving screw rod.
Furthermore, a driving handle for an operator to operate is arranged on the driving screw rod.
Furthermore, one end of the outer sheath tube close to the puncture needle main body is provided with a connecting part which is detachably connected with the skin expanding tube.
Furthermore, the connecting part comprises an extending section extending into the puncture needle main body and an outer remaining section positioned outside the puncture needle main body, and the outer diameter of the extending section is smaller than the inner diameter of the puncture needle main body.
Further, the outer remaining section is in a shape of a circular truncated cone.
Further, the tip of stretching into the section be formed with expand the annular joint groove of leather-covered tube joint.
Furthermore, a hand-held part which can be held by an operator is arranged on the side surface of the outer sheath tube; the handheld part is located connecting portion top and with the tear-off mouth is in same side.
Further, the handheld portion has a bottom surface and a top surface, and a first side surface and a second side surface connecting the bottom surface and the top surface, and the area of the bottom surface is smaller than the area of the top surface.
Furthermore, a connecting sheet detachably connected with the driving block is arranged on the puncture needle main body; the driving block is provided with a connecting groove for inserting the connecting sheet.
Further, a pre-inlet is formed at one end of the tearing opening close to the outer remaining section, and the opening width of the pre-inlet is larger than that of the tearing opening.
Furthermore, the inner side wall of the puncture needle body is covered with lubricant.
The invention also provides a puncturing method, which comprises the following steps:
(1) the skin expanding tube is inserted into the vein along with the puncture needle main body;
(2) the puncture needle main body is withdrawn from the vein, and the skin expanding tube is continuously left in the vein;
(3) the PICC tube is penetrated through the sheath tube and enters the vein along the skin expanding tube to reach the designated position;
(4) withdrawing the skin expanding tube from the vein;
(5) drawing out the guide wire in the PICC tube;
(6) reserving a section of PICC tube outside, and cutting off redundant PICC tubes;
(7) sleeving a pressure reducing sleeve on the PICC pipe;
(8) connect the PICC pipe to the metal handle of extension pipe on and with the decompression sleeve joint.
Further, in the step (2), the puncture needle main body is pulled out of the vein along the sheath tube by driving the screw, and at the same time, the skin expanding tube is continuously inserted into the vein.
Further, the length of the PICC tube reserved in the step (6) is 5 cm.
After the structure is adopted, the PICC puncture device related by the invention arranges the skin expanding tube in the puncture needle main body, when the puncture needle is punctured, the skin expanding tube enters the vein of a patient along with the puncture needle, at the moment, the driving block connected to the puncture needle main body is driven by the driving screw rod on the outer sheath component to move towards one end of the outer sheath tube far away from the puncture needle, so as to drive the puncture needle main body to move, as the side surface of the puncture needle main body is provided with the tearing opening extending along the axial line direction of the puncture needle main body, the tearing opening is slowly opened under the action of the truncated cone-shaped connecting part in the moving process of the puncture needle, so that the puncture needle can be pulled out along the outer sheath tube, and the skin expanding tube is continuously remained in the vein, when the skin expanding tube is completely separated from the puncture needle, the puncture needle can be taken down from the outer sheath tube, then the PICC tube can be penetrated into the vein along the skin expanding tube, after reaching the designated position, slowly withdraw from and expand the leather hose, only remain the PICC pipe in the vein to accomplish PICC and put the pipe. Compared with the prior art, the scheme reduces the preorder work before PICC (peripherally inserted central catheter) management, and greatly reduces the pain of a patient.
Drawings
FIG. 1 is a schematic structural view of the present invention;
FIG. 2 is an exploded view of the present invention;
FIG. 3 is a schematic cross-sectional view of the present invention;
FIG. 4 is an enlarged view of a portion of FIG. 3 at A;
FIG. 5 is a schematic view of the main structure of the puncture needle of the present invention;
fig. 6 is a schematic structural diagram of a driving block in the present invention.
In the figure: 1-puncture needle main body, 11-tearing opening, 111-pre-inlet and 12-connecting sheet;
2-expanding a leather hose;
3-outer sheath component, 31-outer sheath tube, 311-connecting part, 3111-extending part, 31111-annular clamping groove, 3112-outer remaining part, 312-handheld part, 32-driving device, 321-driving screw rod, 3211-driving handle, 322-bearing frame, 3221-first connecting rod, 32211-first through hole, 32212-second through hole, 3222-second connecting rod, 32221-sliding rail, 323-driving block, 3231-threaded hole, 3232-sliding groove and 3233-connecting groove.
Detailed Description
In order to further explain the technical solution of the present invention, the present invention is explained in detail by the following specific examples.
As shown in fig. 1 to 6, a PICC puncture device includes a puncture needle main body 1, a sheath expanding tube 2, and an outer sheath assembly 3; the skin expanding tube 2 is positioned in the puncture needle main body 1; a tearing opening 11 extending along the axial direction of the puncture needle body 1 is formed on the side surface of the puncture needle body 1; the sheath assembly 3 comprises a sheath tube 31 detachably connected with the skin expanding tube 2 and a driving device 32 for driving the sheath tube 31 to move towards the skin expanding tube 2 and pushing the skin expanding tube 2 out of the puncture needle body 1; the length of the sheath tube 31 is longer than that of the puncture needle body 1. The skin expanding tube 2 is arranged in the puncture needle main body 1, when the puncture needle is punctured, the skin expanding tube 2 enters the vein of a patient along with the puncture needle main body 1, at the moment, the driving block 323 connected to the puncture needle main body 1 is driven to move towards one end of the outer sheath tube 31 far away from the puncture needle through the driving screw rod 321 on the outer sheath component 3, so as to drive the puncture needle main body 1 to move, because the tearing opening 11 extending along the axial direction of the puncture needle main body 1 is formed on the side surface of the puncture needle main body 1, the tearing opening 11 is slowly opened under the action of the circular platform-shaped connecting part 311 in the moving process of the puncture needle, so that the puncture needle can be pulled out along the outer sheath tube 31, the skin expanding tube 2 is continuously remained in the vein, when the skin expanding tube 2 is completely separated from the puncture needle, the puncture needle can be taken down from the outer sheath tube 31, then the PICC tube can be penetrated into the vein along the skin expanding tube 2, after reaching the designated position, slowly withdraw from and expand leather hose 2, only remain the PICC pipe in the vein to accomplish PICC and put the pipe. Reduces the preorder work before PICC catheter placement and greatly reduces the pain of patients.
Preferably, the driving device 32 includes a driving screw 321, and a carrier 322 for carrying the driving screw 321; the carrier 322 comprises a first connecting rod 3221 fixedly connected to one end of the outer sheath 31 away from the puncture needle body 1 and perpendicular to the outer sheath 31, and a second connecting rod 3222 perpendicular to the first connecting rod 3221 and fixedly connected to the end of the first connecting rod 3221. When the puncture needle body 1 is pulled out by the drive screw 321, the puncture needle is stably moved along a straight line, and the injury to the patient is prevented.
Preferably, the first connecting rod 3221 is provided with a first through hole passing through the first connecting rod 3221 and communicating with the outer sheath tube 31, and a second through hole 32212 parallel to the first through hole 32211 and allowing the driving screw 321 to pass through; the second connecting rod 3222 is provided with a slide rail 32221 arranged along the length direction of the second connecting rod 3222. The PICC tube may be inserted into the first through hole 32211, the screw may be inserted into the second through hole 32212, and the slide rail 32221 of the second link 3222 may stabilize the driving block 323 during sliding.
Preferably, the driving means 32 further comprises a driving block 323 detachably connected to the puncture needle main body 1; the driving block 323 is provided with a sliding groove 3232 engaged with the sliding rail 32221, and a threaded hole 3231 engaged with the driving screw 321. The driving block 323 is more stable when sliding due to the matching of the sliding groove 3232 and the sliding rail 32221, and the driving block 323 can move along the driving screw rod 321 to drive the puncture needle main body 1 to move when the driving screw rod 321 rotates due to the matching of the threaded hole 3231 and the driving screw rod.
Preferably, the driving screw 321 is provided with a driving handle 3211 operable by an operator. By driving the handle 3211, the operator can save more effort.
Preferably, a connecting part 311 detachably connected with the dilating tube 2 is provided at one end of the sheath tube 31 close to the puncture needle body 1. The expanding leather tube 2 is detachably arranged on the connecting part 311, and the use is more convenient.
Preferably, the connecting portion 311 includes an extending section 3111 extending into the needle body 1 and an outer remaining section 3112 located outside the needle body 1, and the outer diameter of the extending section 3111 is smaller than the inner diameter of the needle body 1. The connection between the needle main body 1 and the outer sheath 31 can be further stabilized by the protruding section 3111 of the connecting portion 311.
Preferably, the outer retention section 3112 is frustoconical. When the puncture needle body 1 is retreating from the vein, the truncated cone-shaped surplus section 3112 makes it easier to open the puncture needle body 1 and thus to retreat the puncture needle body 1.
Preferably, the end of the protruding section 3111 is formed with an annular engaging groove 31111 for engaging with the dilating tube 2. The skin expanding tube 2 is clamped in the annular clamping groove 31111, so that the skin expanding tube 2 can be pushed into the vein more easily.
Preferably, a hand-held portion 312 for an operator to hold is provided on a side surface of the sheath tube 31; hand-held portion 312 is located above connecting portion 311 and on the same side as tear notch 11. The stabilization sheath assembly 3 is held by the holding portion 312, and the puncture needle body 1 can be withdrawn along the sheath tube 31 only when the holding portion 312 is on the same side as the tear port 11.
Preferably, the handle portion 312 has a bottom surface and a top surface, and a first side surface and a second side surface connecting the bottom surface and the top surface, the bottom surface having an area smaller than that of the top surface. Tear-off opening 11 is easier to pass through from handle 312 when the area of the bottom surface is smaller than the area of the top surface.
Preferably, the puncture needle body 1 is provided with a connecting piece 12 which is detachably connected with the driving block 323; the driving block 323 is provided with a coupling groove 3233 into which the coupling piece 12 is inserted. The connecting piece 12 is inserted into the connecting groove 3233 of the driving block 323, and the puncture needle body 1 is moved by the driving block 323.
Preferably, one end of the tear notch 11 near the outer remaining section 3112 is formed with a pre-entry port 111, and the opening width of the pre-entry port 111 is larger than that of the tear notch 11. The opening width of the pre-entry port 111 is larger than the opening width of the tear port 11 so that the puncture needle body 1 can more easily pass through the sheath tube 31.
Preferably, the inner side wall of the puncture needle body 1 is covered with lubricant. The dilating catheter 2 can be easily separated from the puncture needle main body 1 through the lubricant, the dilating catheter 2 is prevented from being brought out of the vein by the puncture needle main body 1, and the lubricant is a mixed solution of normal saline, dexamethasone and lidocaine.
The invention also provides a puncturing method, which comprises the following steps:
(1) the skin expanding tube 2 is punctured into a vein along with the puncture needle body 1;
(2) withdrawing the puncture needle main body 1 from the vein, and continuously keeping the skin expanding tube 2 in the vein;
(3) the PICC tube is penetrated through the outer sheath tube 31 and enters the vein along the skin expanding tube 2 to reach the designated position;
(4) withdrawing the skin expanding tube 2 from the vein;
(5) drawing out the guide wire in the PICC tube;
(6) reserving a section of PICC tube outside, and cutting off redundant PICC tubes;
(7) sleeving a pressure reducing sleeve on the PICC pipe;
(8) connect the PICC pipe to the metal handle of extension pipe on and with the decompression sleeve joint.
According to the puncture method, the skin expanding tube 2 is pre-installed in the puncture needle main body 1, so that the skin expanding tube 2 directly enters the vein along with the puncture needle, the steps of inserting the guide wire and then inserting the skin expanding tube 2 are reduced, the operation process is reduced, and the pain of a patient is relieved.
Preferably, in step (2), the puncture needle body 1 is pulled out of the vein along the sheath tube 31 by driving the screw 321, and the skin expanding tube 2 is continuously inserted into the vein. The puncture needle body 1 and the outer sheath tube 31 are moved toward each other by the drive screw 321, and the expandable sheath tube 2 is continuously inserted into the vein while the puncture needle body 1 is pulled out.
Preferably, the length of the PICC tube reserved in step (6) is 5 cm. Reserving the PICC pipe of 5 centimetres can make things convenient for subsequent cover pressure reducing sleeve and the operation of installation extension pipe more, can not hinder the action in patient's later stage moreover.
The above embodiments and drawings are not intended to limit the form and style of the present invention, and any suitable changes or modifications thereof by those skilled in the art should be considered as not departing from the scope of the present invention.

Claims (7)

1. A PICC puncture device comprises a puncture needle main body, a skin expanding tube and an outer sheath component; the method is characterized in that: the skin expanding tube is positioned in the puncture needle main body; a tearing opening extending along the axial direction of the puncture needle main body is formed on the side surface of the puncture needle main body; the outer sheath assembly comprises an outer sheath tube which is detachably connected with the skin expanding tube and a driving device which drives the outer sheath tube to move towards the skin expanding tube and pushes the skin expanding tube out of the puncture needle main body; the length of the outer sheath tube is greater than that of the puncture needle main body; the driving device comprises a driving screw rod and a bearing frame for bearing the driving screw rod; the bearing frame comprises a first connecting rod which is fixedly connected with one end of the sheath tube far away from the puncture needle main body and is vertical to the sheath tube, and a second connecting rod which is vertical to the first connecting rod and is fixedly connected with the end part of the first connecting rod; the first connecting rod is provided with a first through hole which penetrates through the first connecting rod and is communicated with the outer sheath tube, and a second through hole which is parallel to the first through hole and is used for the driving screw to pass through; the second connecting rod is provided with a slide rail arranged along the length direction of the second connecting rod, and the driving device also comprises a driving block which is detachably connected with the puncture needle main body; the puncture needle comprises a puncture needle body, a driving block, an outer sheath tube, a skin expanding tube, a connecting part and a connecting part, wherein the driving block is provided with a sliding groove matched with the sliding rail and a threaded hole matched with the driving screw rod, the driving screw rod is provided with a driving handle operated by an operator, one end of the outer sheath tube close to the puncture needle body is provided with the connecting part detachably connected with the skin expanding tube, the connecting part comprises an extending section extending into the puncture needle body and an outer remaining section located outside the puncture needle body, the outer diameter of the extending section is smaller than the inner diameter of the puncture needle body, and the outer remaining section is in a circular truncated cone shape and enables the puncture needle body to be opened when the puncture needle body exits a vein.
2. The PICC puncturing device of claim 1, wherein: the end of the stretching section is provided with an annular clamping groove clamped with the skin expanding tube.
3. The PICC puncturing device of claim 2, wherein: a hand-held part which can be held by an operator is arranged on the side surface of the outer sheath tube; the handheld part is located connecting portion top and with the tear-off mouth is in same side.
4. The PICC puncturing device of claim 3, wherein: the handheld portion is provided with a bottom surface, a top surface, a first side surface and a second side surface, wherein the first side surface and the second side surface are used for connecting the bottom surface and the top surface, and the area of the bottom surface is smaller than that of the top surface.
5. The PICC puncturing device of claim 4, wherein: the puncture needle main body is provided with a connecting sheet which is detachably connected with the driving block; the driving block is provided with a connecting groove for inserting the connecting sheet.
6. The PICC puncturing device of claim 5, wherein: one end of the tearing opening close to the outer remaining section is provided with a pre-inlet, and the opening width of the pre-inlet is larger than that of the tearing opening.
7. The PICC puncturing device of claim 6, wherein: and the inner side wall of the puncture needle main body is covered with lubricant.
CN202010812895.4A 2020-08-13 2020-08-13 PICC piercing depth Active CN112043353B (en)

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CN113288356B (en) * 2021-05-20 2022-07-08 河北益合科技发展有限公司 Central venous puncture device

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CN208464215U (en) * 2017-07-10 2019-02-05 广东百合医疗科技股份有限公司 A kind of vessel catheter sheath
CN108992142A (en) * 2018-06-28 2018-12-14 苏州市吴江区第人民医院 Minute blood vessel expands skin component and its method of intubation with gradual PICC conduit
CN110559054A (en) * 2019-09-18 2019-12-13 许加友 Gastrointestinal surgery abdominal cavity operation puncture device
CN111419351A (en) * 2020-03-31 2020-07-17 秦磊 Puncture device for abdominal operation

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