CN112704550A

CN112704550A - PICC (peripherally inserted Central catheter) catheter placement instrument and catheter placement method

Info

Publication number: CN112704550A
Application number: CN202110113887.5A
Authority: CN
Inventors: 姜小波
Original assignee: Foshan Special Medical Catheter Co ltd
Current assignee: Foshan Special Medical Catheter Co ltd
Priority date: 2021-01-27
Filing date: 2021-01-27
Publication date: 2021-04-27

Abstract

The invention relates to the technical field of medical appliances, in particular to a PICC (peripherally inserted central catheter) catheter placing device and a catheter placing method. A PICC catheterization instrument comprises an expansion assembly and a tearing sheath assembly, wherein the expansion assembly comprises a puncture needle and an expansion pipe fitting, and the puncture needle is fixed at one end of the expansion pipe fitting; the tearing sheath component is sleeved on the expansion component and is suitable for being fixedly connected with the expansion component. The puncture needle and the expansion pipe are integrated to form the expansion assembly, so that the function of expanding skin is completed at one time, and the injury of a large wound of the traditional blind insertion is improved. Compared with the improved seldinger technology under ultrasonic guidance, the improved seldinger technology reduces the workload of medical workers due to the fact that operation components such as guide wires and the like are reduced, is simple and convenient to operate, saves cost, and can meet clinical requirements.

Description

PICC (peripherally inserted Central catheter) catheter placement instrument and catheter placement method

Technical Field

The invention relates to the technical field of medical appliances, in particular to a PICC (peripherally inserted central catheter) catheter placing device and a catheter placing method.

Background

Picc (peripherally inserted catheter) refers to a catheter that is cannulated via a peripheral vein and delivers the end of the catheter to the superior vena cava. The PICC technology is characterized in that a catheter is used for puncturing from a vein of a peripheral arm, the catheter directly reaches a great vein close to the heart, so that direct contact between chemotherapy drugs and the arm vein is avoided, and the blood flow rate of the great vein is high, so that the chemotherapy drugs can be quickly diluted, and stimulation of the drugs to blood vessels is greatly reduced, so that the upper limb vein can be effectively protected, phlebitis is reduced, pain of a patient is relieved, and the life quality of the patient is improved. The operation is simple, the safety is high, the retention time is long, and the medicine is widely applied to clinic at present.

The most advanced domestic pipe placing technology at present comprises the following steps: the PICC catheterization is carried out by improving the seldinger technology under the guidance of ultrasound, the position of a puncture vein is accurately found by a B-ultrasound machine for puncture, a puncture tool is a puncture needle of 18-20G, the middle of the puncture needle is hollow, and a guide wire can pass through the puncture needle. The puncture needle tip is provided with a metal coating or is manufactured by grinding technology, and can enhance development under B ultrasonic. After the puncture needle is successfully punctured, the guide wire is fed, then the puncture needle is pulled out, the expansion tube and the tearable introduction sheath are fed into the blood vessel along the guide wire, then the guide wire and the expansion tube are withdrawn, the catheter is placed along the introduction sheath until reaching the superior vena cava, and finally the position of the tip of the catheter is determined by X-ray. The technology can discover the blood vessels which can not be seen by naked eyes through blood vessel imaging, improve the success rate of puncture, solve the problem of patients with poor blood vessel conditions and have few complications. The relation between the inner diameter of the blood vessel and surrounding tissues, arteries and veins, the condition of the intima of the blood vessel, unpredictable stenosis and obstruction of the running of the blood vessel, the depth of the blood vessel and the like can be comprehensively evaluated. Meanwhile, the target vein can be accurately determined.

However, in the above operation process, there are many components, the operation is complicated and time-consuming, and the cost is also high.

Disclosure of Invention

The invention aims to provide a PICC catheter insertion puncture instrument which integrates a small needle and an expander to complete the function of skin breaking and expansion at one time. Compared with the improved seldinger technology under the ultrasonic guidance, the cost of the required operation assembly is reduced, and the operation is simple, convenient and quick.

In order to achieve the purpose, the technical scheme adopted by the invention is to provide a PICC (peripherally inserted central catheter) catheterization device which comprises an expansion assembly and a tearing sheath assembly, wherein the expansion assembly comprises a puncture needle and an expansion pipe fitting, and the puncture needle is fixed at one end of the expansion pipe fitting; the tearing sheath component is sleeved on the expansion component and is suitable for being fixedly connected with the expansion component.

Furthermore, the expansion pipe fitting comprises an expansion pipe body sleeved on the puncture needle, and a primary expansion head is arranged at one end, close to the needle point of the puncture needle, of the expansion pipe body.

Furthermore, the primary expansion head is of an inverted cone structure, and the end part, close to the needle point of the puncture needle, of the primary expansion head is gradually thinned.

Furthermore, the needle tip bevel of the puncture needle is spaced from the tip of the primary expansion head by a distance not more than 1 mm.

Further, tear the sheath subassembly and locate including the cover tear sheath pipe of expansion body, tear sheath pipe and be close to the one end of one-level expansion head is equipped with the second grade and expands the head.

Further, second grade expansion head sets up to back taper structure, second grade expansion head is close to the tip tapering of one-level expansion head.

Further, the tail of the primary expansion head is spaced from the tip of the secondary expansion head by a distance of not more than 1 mm.

Furthermore, the expansion assembly further comprises a locking joint, the tearing sheath assembly further comprises a tearing sheath joint, and the locking joint is in threaded connection with the tearing sheath joint after the tearing sheath assembly is sleeved on the expansion assembly.

Further, the tearing sheath assembly further comprises a wing-shaped handle arranged on the tearing sheath joint, and a tearing groove is formed in the tearing sheath joint.

Further, the puncture needle is provided with a metal coating or processed by physical technology, and the development can be enhanced under B ultrasonic.

The invention also provides a catheter placement method, and the PICC catheter placement device comprises the following steps:

assembling and fixing the expansion assembly and the tearing sheath assembly;

observing the development of the needle tip of the puncture needle through a B-ultrasonic machine, and judging a correct puncture point;

after the assembled PICC catheter is conveyed to a designated position under the developing condition, the expansion assembly is pulled out, and the PICC catheter is conveyed through the tearing sheath assembly;

the position of the tip of the delivered PICC catheter is determined by X-ray and the tearing sheath assembly is torn.

The invention has the beneficial effects that:

1. the puncture needle and the expansion pipe are integrated to form the expansion assembly, so that the function of expanding skin is completed at one time, and the injury of a large wound of the traditional blind insertion is improved. Compared with the improved seldinger technology under ultrasonic guidance, the improved seldinger technology reduces the workload of medical workers due to the fact that operation components such as guide wires and the like are reduced, is simple and convenient to operate, saves cost, and can meet clinical requirements.

2. The one-level expansion head sets up to the back taper structure, and when inserting PICC and put a tub apparatus, the one-level expansion head can play the effect of expansion to the puncture point, is convenient for tear the sheath subassembly and injects vein, reduces the wound.

3. The tail part of the first-stage expansion head is spaced from the tip of the second-stage expansion head by a distance not more than 1mm, and if the distance is too large, the risk that the needle tip punctures the vein during puncture of the puncture needle is increased.

4. Through setting up one-level expansion head and second grade expansion head, two expansion heads all adopt the back taper structure, and the back taper structure of two gradients can produce the effect of secondary expansion step by step to the puncture point, is convenient for tear the sheath subassembly and injects vein, reduces the wound.

5. After the tearing sheath component is sleeved on the expansion component, the locking joint is in threaded connection with the tearing sheath joint. Through threaded connection, rotate locking joint promptly, just can realize expansion subassembly and tear the fixed connection of sheath subassembly, and threaded connection is more firm difficult not hard up. Meanwhile, the locking joint is rotated reversely, so that the expansion assembly can be separated from the tearing sheath assembly, and the expansion assembly can be pulled out conveniently.

Drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and other drawings can be obtained by those skilled in the art without creative efforts.

Fig. 1 is a perspective view of a PICC catheter placement device provided in embodiment 1 of the present invention;

fig. 2 is a front view of a PICC catheter placement device provided in embodiment 1 of the present invention;

FIG. 3 is an enlarged view of portion A of FIG. 2;

FIG. 4 is a schematic diagram illustrating an overall configuration of a dilation assembly utilized in a PICC catheterization apparatus, according to example 1 of the present disclosure;

fig. 5 is a schematic overall structure diagram of a tearing sheath assembly adopted by a PICC catheter placement apparatus according to embodiment 1 of the present invention;

description of reference numerals:

1. an expansion assembly; 11. puncturing needle; 12. expanding the pipe fitting; 121. expanding the pipe body; 122. a primary expansion head; 123. expanding the pipe joint; 13. locking the joint; 2. tearing the sheath assembly; 21. tearing the sheath and sheath tube; 22. a secondary expansion head; 23. tearing the sheath joint; 231. a tearing groove; 24. a wing-shaped handle.

Detailed Description

The technical solutions of the present invention will be described clearly and completely with reference to the accompanying drawings, and it should be understood that the described embodiments are some, but not all embodiments of the present invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

In the description of the present invention, it should be noted that the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc., indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, and are only for convenience of description and simplicity of description, but do not indicate or imply that the device or element being referred to must have a particular orientation, be constructed and operated in a particular orientation, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and "third" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.

In the description of the present invention, it should be noted that, unless otherwise explicitly specified or limited, the terms "mounted," "connected," and "connected" are to be construed broadly, e.g., as meaning either a fixed connection, a removable connection, or an integral connection; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.

In addition, the technical features involved in the different embodiments of the present invention described below may be combined with each other as long as they do not conflict with each other.

Example 1

Referring to fig. 1 to 5, a PICC catheter placement device provided as an embodiment of the present invention includes a stent assembly 1 and a sheath tearing assembly 2, wherein the stent assembly 1 includes a puncture needle 11 and a stent tube 12, and the puncture needle 11 is fixed to one end of the stent tube 12; the tearing sheath component 2 is sleeved on the expansion component 1 and is suitable for being fixedly connected to the expansion component 1. By integrating the puncture needle 11 and the expansion pipe fitting 12 into the expansion assembly 1, the function of expanding skin is completed at one time, and the injury of a large wound of the traditional blind insertion is improved. Compared with the improved seldinger technology under the ultrasonic guidance, the operation assembly is reduced, the workload of medical workers is reduced, the operation is simple, convenient and fast, the cost is saved, and the clinical requirement can be met.

Specifically, the expansion tube 12 includes an expansion tube 121 sleeved on the puncture needle 11 and an expansion tube joint 123 disposed at one end of the expansion tube 121, and a primary expansion head 122 is disposed at one end of the expansion tube 121 close to the needle tip of the puncture needle 11. The material of the expansion pipe body 121 may be PE, ABS, PP, PEBX, POM, or the like, and the expansion pipe joint 123 is formed by injection-molding the same material as the expansion pipe body 121 and is connected to the expansion pipe body 121. The primary expansion head 122 is arranged in an inverted cone structure, and the end part of the primary expansion head 122 close to the needle point of the puncture needle 11 is tapered. The first-order expansion head 122 is arranged to be of an inverted cone structure, when the PICC is inserted into a catheter placing instrument, the first-order expansion head 122 can play a role in expanding a puncture point, the sheath assembly 2 can be torn conveniently, the vein can be inserted, and the wound is reduced. The tearing sheath component 2 comprises a tearing sheath tube 21 sleeved on the expanding tube body 121 and a tearing sheath joint 23 arranged at one end of the tearing sheath tube 21, and a secondary expanding head 22 is arranged at one end, close to the primary expanding head 122, of the tearing sheath tube 21. The secondary expansion head 22 is configured as an inverted cone, and the end of the secondary expansion head 22 adjacent to the primary expansion head 122 is tapered. Through setting up one-level expansion head 122 and second grade expansion head 22, two expansion heads all adopt the back taper structure, and the back taper structure of two gradients can produce the effect of secondary expansion step by step to the puncture point, is convenient for tear sheath subassembly 2 and injects vein, reduces the wound. The tearing sheath 21 can be made of PE, PU, PTFE or PP and the like, and the tearing sheath joint 23 is made of the same material as the tearing sheath 21 and is connected with the tearing sheath 21 in an injection molding manner. The tip of the tearing sheath 21 is shaped by high-frequency heating. The outer diameter of the needle tube of the puncture needle 11 is consistent with the inner diameter of the formed tip of the expansion tube body 121; the outer diameter of the expanding tube body 121 is consistent with the inner diameter of the tearing sheath tube 21 after the tip is formed; the tip of the dilating tube 121 and the tip of the introducer sheath are shaped to form a first dilating head 122 and a second dilating head 22 having an inverted cone structure, which can cover tightly to reduce the puncture force.

As a variant, the primary expansion head 122 and/or the secondary expansion head 22 may also be provided in a cambered configuration, through which a secondary expansion action may also be produced at the puncture site.

Furthermore, the outer diameter range of the needle tube of the puncture needle 11 is 0.8-1.2 mm; the outer diameter range of the expansion pipe body 121 is 1.3-2.0 mm; the outer diameter of the tearing sheath tube 21 ranges from 1.5 mm to 2.5 mm. Above-mentioned a plurality of size coordination, convenience and flexibility that the reinforcing PICC put the use of a tub instrument.

Furthermore, the distance between the needle tip bevel of the puncture needle 11 and the tip of the primary expansion head 122 is L1, and L1 is less than or equal to 1 mm. The distance between the tail part of the first-stage expansion head 122 and the tip of the second-stage expansion head 22 is L2, and L2 is less than or equal to 1 mm. If these two distances are too large, the risk of the needle tip puncturing the vein during the puncture of the puncture needle 11 increases.

Further, the expansion assembly 1 further comprises a locking joint 13, and after the tearing sheath assembly 2 is sleeved on the expansion assembly 1, the locking joint 13 is in threaded connection with the tearing sheath joint 23.

Specifically, the locking joint 13 is press-fitted and connected to the expansion joint 123 by physical action. The tearing sheath joint 23 is provided with external threads, and the locking joint 13 is a connecting sleeve and is provided with internal threads. Through threaded connection, rotate lock joint 13 promptly, just can realize expansion subassembly 1 and the fixed connection who tears sheath subassembly 2, and threaded connection is more firm difficult not hard up. Meanwhile, the locking head on the expansion component 1 is rotated reversely, so that the expansion component 1 and the tearing sheath component 2 can be separated, and the expansion component 1 can be conveniently pulled out. The locking joint 13 on the expansion tube joint 123 ensures that the tearing sheath 21 enters the human body along with the expansion tube 121 during puncturing and the expansion tube 121 does not retreat. The lateral wall ring of lock joint 13 is equipped with a plurality of friction protrusion of a week, through setting up friction protrusion, can increase the frictional force of lock joint 13 and hand, is convenient for rotate lock joint 13.

As a variant, the screw connection can be fixed by means of a plug or snap connection.

Further, the tearing sheath assembly 2 further comprises a wing-shaped handle 24 arranged on the tearing sheath joint 23, and a tearing groove 231 is arranged on the tearing sheath joint 23. The tearing sheath joint 23 is symmetrically provided with a pair of tearing grooves 231, and the tearing sheath tube 21 is provided with tearing lines corresponding to the tearing grooves 231.

Further, the puncture needle 11 is provided with a metal coating or processed by physical techniques, which can enhance visualization under B-mode ultrasound. The physical technology processing adopts a laser marking technology to punch small holes on the surface of the needle tube, adopts a wire cutting technology to cut the intricate and crossed wire grooves on the surface of the needle tube and presses an indentation on the surface of the needle tube.

Example 2

The embodiment of the invention provides a tube placing method, which adopts the PICC tube placing instrument in the embodiment 1 and comprises the following steps:

firstly, assembling and fixing the expansion assembly 1 and the tearing sheath assembly 2, observing development of a needle point of a puncture needle 11 through a B-ultrasonic machine, judging a correct puncture point, and preparing before the puncture point is placed into a vein;

secondly, sending the assembled PICC catheter setting device to a specified position under the developing condition, then pulling out the expansion assembly 1, and sending the PICC catheter into the developing device through the tearing sheath assembly 2;

finally, the position of the tip of the delivered PICC catheter is determined by X-ray and the sheath assembly 2 is torn.

The catheterization method that this embodiment adopted adopts the PICC catheterization apparatus of embodiment 1, can once accomplish the function of the expansion of broken skin, has reached twice mesh of expanding step by step, has improved the injury of the big wound of traditional blind insertion, compares improvement stopper T ge technique under the supersound guide simultaneously, has reduced operating elements such as guide wire and has also reduced medical personnel's work load, and easy and simple to handle swiftly practices thrift the cost, can satisfy clinical needs simultaneously.

The embodiments of the present invention are preferred embodiments of the present invention, and the scope of the present invention is not limited by these embodiments, so: all equivalent changes made according to the structure, shape and principle of the invention are covered by the protection scope of the invention.

Claims

1. A PICC catheterization apparatus, comprising:

the expansion assembly (1) comprises a puncture needle (11) and an expansion pipe fitting (12), wherein the puncture needle (11) is fixed at one end of the expansion pipe fitting (12);

the tearing sheath component (2) is sleeved on the expansion component (1) and is suitable for being fixedly connected to the expansion component (1).

2. The PICC catheter placement device according to claim 1, wherein the expansion tube (12) includes an expansion tube (121) that is disposed around the puncture needle (11), and a primary expansion head (122) is disposed at an end of the expansion tube (121) that is close to the needle tip of the puncture needle (11).

3. The PICC catheter introducer of claim 2, wherein the primary dilator head (122) is configured as an inverted cone, the end of the primary dilator head (122) proximal to the tip of the introducer needle (11) being tapered.

4. The PICC catheter introducer of claim 2, wherein the needle tip bevel of the needle (11) is spaced no more than 1mm from the tip of the primary dilator head (122).

5. The PICC catheter placement device according to claim 3, wherein the tear-away sheath assembly (2) includes a tear-away sheath (21) that is disposed around the catheter body (121), and a secondary dilator (22) is disposed at an end of the tear-away sheath (21) that is adjacent to the primary dilator (122).

6. The PICC catheter introducer of claim 5, wherein the secondary dilation head (22) is configured as an inverted cone, the secondary dilation head (22) tapering proximate to an end of the primary dilation head (122).

7. The PICC catheter introducer of claim 5, wherein the trailing portion of the primary dilator head (122) is spaced no more than 1mm from the tip of the secondary dilator head (22).

8. The PICC catheter placement device according to claim 1, wherein the expansion assembly (1) further comprises a locking connector (13), the tear-away sheath assembly (2) further comprises a tear-away sheath connector (23), and the locking connector (13) is in threaded connection with the tear-away sheath connector (23) after the tear-away sheath assembly (2) is sleeved on the expansion assembly (1).

9. The PICC catheter placement instrument according to claim 8, wherein the tear sheath assembly (2) further includes a winged handle (24) disposed on the tear sheath connector (23), the tear sheath connector (23) having a tear groove (231) disposed thereon.

10. A PICC catheter placement device according to claim 6, wherein said puncture needle (11) is provided with a metal coating or is physically processed to enhance visualization under B-ultrasound.

11. A method of using the PICC catheter device of any of claims 1-10, comprising the steps of:

assembling and fixing the expansion assembly (1) and the tearing sheath assembly (2);

observing the development of the needle point of the puncture needle (11) through a B-ultrasonic machine, and judging a correct puncture point;

after the assembled PICC catheter is mechanically sent to a designated position under the developing condition, the expansion assembly (1) is pulled out, and a PICC catheter is sent through the tearing sheath assembly (2);

the position of the tip of the PICC catheter to be fed is determined by X-ray, and the tearing sheath component (2) is torn.