CN113520539B

CN113520539B - Catheter sheath for central venous catheter and auxiliary device

Info

Publication number: CN113520539B
Application number: CN202110679764.8A
Authority: CN
Inventors: 褚芬芬
Original assignee: First Affiliated Hospital of University of South China
Current assignee: First Affiliated Hospital of University of South China
Priority date: 2021-06-18
Filing date: 2021-06-18
Publication date: 2022-11-29
Anticipated expiration: 2041-06-18
Also published as: CN113520539A

Abstract

The invention discloses a catheter sheath for a central venous cannula and an auxiliary device thereof, which comprise a catheter sheath and an auxiliary device, wherein the catheter sheath is in a slender conical cylinder shape, two groups of tearing belts are symmetrically arranged on a conical catheter sheath body, the catheter sheath can be torn along the tearing belts, and a through groove is preset on the inner wall surface of the conical cylinder body; the driving wheel can move back and forth along the wheel shaft groove under the pulling of the driving rack; when the driving rack is pulled towards the sheath tip of the catheter sheath, the driving wheel rotates from inside to outside, teeth of the driving wheel are meshed with teeth of the inner wall of the catheter sheath, and the catheter sheath is forced to penetrate through the conical channel of the auxiliary device body and to be torn; when the driving rack is pulled towards the tail part of the catheter sheath, the teeth of the driving wheel are disengaged with the inner wall of the catheter sheath again.

Description

Catheter sheath for central venous catheter and auxiliary device

Technical Field

The invention belongs to the technical field of medical consumables, and particularly relates to a catheter sheath for a central venous cannula and an auxiliary device.

Background

The central venous catheterization is an indispensable treatment method for monitoring and treating in emergency resuscitation, critical patients and major surgeries, mainly punctures the internal jugular vein, the external jugular vein, the subclavian vein and the femoral vein through skin, then inserts various catheters into the major vascular cavity or the cardiac cavity, measures various physiological parameters by using the catheters, and simultaneously provides a direct and convenient access for treatment. The method is mainly suitable for the following steps: 1. patients requiring long-term intravenous nutrition or intravenous antibiotic therapy. 2. Critically ill patients, acute circulatory failure, renal failure, etc. require monitoring of central venous pressure. 3. The jugular vein is used for placing a heart and pacemaker patient.

The operation consumables adopted by the central vein catheterization at present generally comprise a puncture needle, a catheter, a stripping sheath, a skin expander, a tunnel needle, a guide wire and the like, wherein the stripping sheath is used for inserting the central vein into the subcutaneous part after the skin expander expands the skin and is shaped into a passing channel of the catheter with soft texture, and the catheter sheath is broken and taken out after the catheter is inserted.

For interim pipe is put into, long-term pipe is put into art still need set up subcutaneous tunnel at the patient subcutaneous, set up subcutaneous tunnel and be equivalent to having set up the skin barrier, reduce the risk of wound infection central vein or pipe route, because the neck position is not convenient for continue to make subcutaneous tunnel, simultaneously in order to compromise pleasing to the eye, generally set up the entry of subcutaneous tunnel one end under the skin near the clavicle, this just makes and is a type A between the entry of subcutaneous tunnel and central vein and be unfavorable for pulling out and tearing of conventional avulsion sheath, next describe in combination with the figure:

fig. 1 shows the situation after the temporary tube is placed, the placing incision of the temporary tube is close to the large vein of the neck of the patient, the distance from the incision to the puncture of the blood vessel is short, and the risk of infection is high. For the procedure of replacing the temporary catheter with the long-term catheter, as shown in fig. 2, a subcutaneous tunnel a is first made, a tunnel needle is used to open a subcutaneous tunnel of about 15CM in length under the skin of the patient, and the long-term catheter is passed through the subcutaneous tunnel a. The temporary catheter is inserted into the central vein along the catheter, the temporary catheter is taken out and inserted into the skin expander, the tearing sheath is inserted into the central vein along the channel expanded by the skin expander, one end of the long-term catheter is plugged into the central vein along the channel of the tearing sheath, the catheter exposed out of the skin needs to be buried under the skin after the catheter is placed into the blood vessel, the catheter is required to be pushed into the tearing sheath while the operator pulls out and tears the tearing sheath, and the long-term catheter can be completely bought into the subcutaneous tissue after the tearing sheath is completely pulled out and torn. Generally, a doctor generally pulls out and tears off the avulsion sheath, and simultaneously inserts the long-term catheter, the process has extremely high requirements on the manipulation of the doctor, and if the doctor does not operate properly, the tube placement may fail, and the pain of a patient may be aggravated.

Disclosure of Invention

The invention mainly aims to provide a catheter sheath for central venous intubation, which can be conveniently pulled out and separated, and simultaneously facilitates the synchronous insertion of a catheter for a long time.

In order to achieve the purpose, the following technical scheme is adopted in the application: the catheter sheath for the central venous intubation comprises a catheter sheath and an auxiliary device, wherein the catheter sheath is in a slender conical barrel shape, two groups of tearing belts are symmetrically arranged on a conical catheter sheath body, the catheter sheath can be torn along the tearing belts, and at least two groups of symmetrically-arranged and continuous teeth are arranged on the inner wall of the catheter sheath; the auxiliary device comprises a hollow conical barrel-shaped body, and a catheter driving wheel set is detachably mounted in the conical barrel-shaped body; the conical barrel-shaped body is provided with a hollow conical channel for the catheter sheath to pass through along the wall surface of the conical barrel-shaped body; a through groove is preset on the inner wall surface of the conical barrel-shaped body; the catheter driving wheel set comprises a wheel set mounting seat consisting of a front part and a rear part, two driving wheels which are meshed with each other and a driving rack for pulling the driving wheels to rotate are vertically mounted in the mounting seat, wheel shafts are arranged at the top and the bottom of the driving wheels and inserted into wheel shaft grooves on the mounting seat, and the wheel shaft grooves are strip-shaped; the upper part of the wheel body of the driving wheel is provided with teeth surrounding the driving wheel; the driving wheel can move back and forth along the wheel shaft groove under the pulling of the driving rack; when the driving rack is pulled towards the sheath tip of the catheter sheath, the driving wheel rotates from inside to outside, teeth of the driving wheel are meshed with teeth of the inner wall of the catheter sheath, and the catheter sheath is forced to penetrate through the conical channel of the auxiliary device body and to be torn; when the driving rack is pulled towards the tail part of the catheter sheath, the teeth of the driving wheel are disengaged from the inner wall of the catheter sheath.

Furthermore, the mounting seat comprises a front section and a rear section which are detachable, and the front section and the rear section of the mounting seat are connected in a detachable buckling mode.

Still further, the auxiliary device also comprises a grab handle arranged on the conical barrel-shaped body and a pressing handle movably hinged on the driving rack, and the pressing handle is pressed to enable the driving rack to move towards the sheath tip of the catheter sheath, so that the driving wheel group is driven to rotate towards the inner side and the catheter is fed into the catheter sheath.

Furthermore, the front part of the mounting seat of the auxiliary device is provided with an upper cutting edge and a lower cutting edge, and the cutting edges enable the tearing groove of the catheter sheath to be directly cut off when the catheter sheath passes through the passage of the auxiliary device.

Preferably, the front part of the mounting seat is provided with a guide roller set which rotates in a single direction, the guide roller set comprises two roller bodies which are vertically arranged, the tops and the bottoms of the roller bodies are inserted into roller column grooves, and the roller column grooves are in a shape of a Chinese character 'ba' facing the sheath tip of the catheter sheath; when the drive rack pulled to 1 sheath point direction of catheter sheath, the guide roller set removed to both sides along the roller groove, for the pipe through providing the guide space, when the drive rack removed to catheter sheath tail direction, the pipe can drive the guide roller along the situation and remove to the sheath tail to the production is to the clamp force of pipe.

Advantageous effects

The central venous catheter sheath and the auxiliary device provided by the invention initiatively solve the difficult problem that the prior art cannot solve the tearing and pulling-out of the catheter sheath, greatly reduce the physical consumption for removing the torn and pulled-out sheath in the operation process of a doctor, and in addition, the auxiliary device provided by the invention is simple and light to operate, has uniform and mild tearing and pulling-out processes and high success rate, relieves the pain of a patient, and reduces the infection risk of the operation of the doctor.

Drawings

In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the drawings needed to be used in the description of the embodiments will be briefly introduced below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings based on these drawings without creative efforts.

FIG. 1 is a schematic view of a temporary tube after insertion;

FIG. 2 is a schematic view of a long-term tube after deployment;

FIG. 3 is a schematic view of an embodiment of a catheter sheath;

FIG. 4 is an overall perspective view of the embodiment;

FIG. 5 is a partial schematic view of an embodiment of an auxiliary device (cutting edge);

FIG. 6 is a schematic view of an exemplary auxiliary device;

FIG. 7 is a sectional view of an auxiliary device according to an embodiment;

FIG. 8 is a mounting base of an auxiliary device according to an embodiment;

fig. 9 is a perspective view of the embodiment.

Detailed Description

The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. 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.

Example 1

As shown in fig. 3-8, the catheter sheath for central venous intubation and the auxiliary device thereof comprise a catheter sheath 1 and an auxiliary device 2, wherein the catheter sheath 1 is a slender conical cylinder 1a, two groups of tearing bands 1b adopting thinning treatment are symmetrically arranged on the sheath body of the catheter sheath 1, the catheter sheath can be torn along the tearing bands 1b by applying external force to the catheter sheath for opening, and the inner wall of the catheter sheath 1 is provided with at least one group of teeth 1c which are oppositely arranged and are continuous as required; the auxiliary device 2 is used for assisting the catheter sheath 1 to be further sent into the catheter 3 after most of the catheter 3 is inserted, and comprises a conical barrel-shaped body 2a with a hollow interior, a flat attaching surface 2a1 (used for attaching to the skin) is arranged at the lower part of the body 2a, and a catheter driving wheel set 2b is hollow and detachably mounted in the body 2 a; the body 2a can be disassembled into a left half part and a right half part which are symmetrically designed, and the two parts are buckled and connected; the body 2a is provided with a hollow conical cylindrical channel 2a2 along the wall surface, and the catheter sheath 1 can be inserted into the body 2a along the conical cylindrical channel; the inner wall of the body is preset with a tooth socket 2a3 for the teeth of the catheter sheath to pass through; the catheter driving wheel set 2b comprises a detachable wheel set mounting seat 2b1, two driving wheels 2b2 which are meshed with each other and a driving rack 2b3 which pulls the driving wheels 2b2 to rotate are mounted in the mounting seat 2b1, wheel shafts are arranged at the top and the bottom of the driving wheels 2b2 and are inserted into wheel shaft grooves 2b11 in the mounting seat, the wheel shaft grooves 2b11 are long-strip-shaped, teeth 2b21 surrounding the driving wheels are arranged at the upper parts of the driving wheels 2b2, and the teeth 2b21 of the two driving wheels 2b2 are meshed with each other; the upper part of the driving wheel 2b2 is also provided with a gear 2b22, the gear 2b22 is meshed with a driving rack 2b3, the driving wheel 2b2 can move back and forth along a wheel axle groove 2b11 under the pulling of the driving rack 2b3, when the driving rack 2b3 is pulled towards the sheath tip of the catheter sheath, the driving wheel 2b2 rotates from inside to outside, teeth of the driving wheel 2b2 are meshed with teeth 1c on the inner wall of the catheter sheath 1 and force the catheter sheath 1 to move outwards and pass through the conical channel of the auxiliary device body, and the catheter sheath 1 is expanded and torn in the passing process; when the driving rack 2b3 is pulled towards the tail part of the catheter sheath 1, the teeth of the driving wheel 2b2 are disengaged with the teeth of the inner wall of the catheter sheath 1 again, and the operation is repeated, so that the catheter sheath 1 can be gradually pulled out of the skin of the patient, torn and synchronously fed into the body of the patient.

Considering that the catheter 3 may be inadvertently pulled out by the driving wheel set 2b during the process of moving the driving wheel set 2b backwards along the axle slot, the present invention provides a guide roller set 2b4 rotating in one direction at the front of the mounting seat 2b1, wherein the guide roller set 2b4 includes two vertically arranged roller bodies 2b41, the top and bottom of the roller bodies 2b41 are inserted into the roller column slot 2b42, the roller column slot 2b42 is in a shape of "eight" facing the sheath tip of the catheter sheath, when the driving rack 2b3 is pulled towards the sheath tip of the catheter sheath 1, the guide roller set 2b4 moves along the roller column slot 2b42 to both sides to provide a guide space for the catheter to pass through, when the driving rack 2b3 moves towards the sheath tail of the catheter sheath 1, the catheter 3 will drive the guide roller 1 to move towards the tail sheath along with the force, thereby generating a certain degree of clamping force, and at the same time, the roller set of rotating in one direction is designed such that the catheter 3 cannot move along the tail of the catheter 1 under the action of clamping force and friction force.

Further, the mounting seat 2b1 comprises a front section and a rear section which are detachable, and the front section and the rear section of the mounting seat are connected in a detachable buckling mode.

Furthermore, the auxiliary device also comprises a grab handle arranged on the conical barrel-shaped body and a pressing handle movably hinged on the driving rack, and the pressing handle is pressed to enable the driving rack to move towards the sheath tip of the catheter sheath, so that the driving wheel set is driven to rotate inwards to enable the catheter to be fed into the catheter sheath.

It should be noted that the axle grooves of the driving wheel are symmetrically arranged on two sides of the center line of the auxiliary device, and because the auxiliary device body is flared, when the driving wheel moves along the axle to the tail of the catheter sheath, the teeth of the driving wheel and the teeth of the catheter sheath are disengaged.

The using method of the invention is as follows: first, the auxiliary device is sleeved on the tail part of the catheter sheath, the auxiliary device is used for pushing the catheter sheath to enable the catheter sheath to be mostly inserted into the skin of a patient, the catheter is passed through a driving wheel and a guide roller of the auxiliary device and is guided along the catheter sheath to enter the body of the patient, and then the removal work of the catheter sheath is started to prepare for operation.

In the process of pressing the pressing handle of the catheter sheath auxiliary device, the driving rack is driven to move from the tail of the catheter sheath to the sheath tip of the catheter sheath by the front pressing section, in the moving process, the driving wheel set moves towards the sheath tip of the catheter sheath in the pulling process, when the wheel shaft of the driving wheel set moves to a front dead center, teeth of the driving wheel are meshed with teeth of the inner wall of the catheter sheath, the rear driving wheel rotates after being pressed to drive the teeth of the catheter sheath to move backwards, expand and tear, and finally the catheter sheath passing through the auxiliary device is torn into two halves and pulled out of the skin of a patient along with the rotation of the driving wheel.

Of course, the catheter sheath cannot be completely torn and pulled out by single pressing, the repeated pressing-recovery-pressing is needed, the recovery process is the process that the driving rack moves in the opposite direction by the pressing handle, the driving gear can be pulled to the tail end of the tooth groove, the teeth of the driving gear are disengaged from the teeth of the inner wall of the catheter sheath in the process, the pulling effect on the catheter sheath is also briefly lost, and the catheter sheath is prevented from being pushed into the skin of a patient by the rack in the opposite direction.

In the process of the cycle, the invention has a ingenious point, namely, in the process of tearing and pulling the catheter sheath, the final implantation of the catheter is synchronously carried out, although before the catheter sheath is pulled out, most of the catheter passes through the catheter sheath and is embedded into the subcutaneous part and the blood vessel of a patient, the catheter is required to be further inserted into the subcutaneous part because the catheter is finally embedded into the subcutaneous part and is not exposed outside, the action is originally manually operated by a doctor, operation gloves are carried, the operation is inconvenient, the gloves are easy to break, and infection risks are caused, so that the invention arranges a unidirectional rotating guide roller group in an auxiliary device, when the driving roller group is pulled to rotate inwards by a rack, the driving roller group extrudes and drives the catheter sheath to move, at the moment, the guide roller group moves to the front end of the roller groove due to the driving of the catheter, the gap between the guide roller groups is increased, and the catheter can freely pass through; when the driving rack moves towards the tail part of the catheter sheath, the driving wheel group moves towards the tail part of the catheter sheath, because the teeth of the driving wheel are disengaged from the teeth of the inner wall of the catheter sheath, the driving wheel group can automatically rotate, the pulling force applied to the catheter is weakened, meanwhile, due to the design of the guide roller group with one-way rotation, when the catheter presents the trend of pulling outwards, the guide roller group moves towards the near end of the roller groove under the action of the friction force between the catheter and the surface of the roller body, the catheter is gradually clamped in the process, and because the guide roller group can only rotate in one way, the resistance of the outward (tail part of the catheter sheath) movement of the catheter is very large, and the function that the catheter can almost only move towards the catheter sheath and the blood vessel of a patient and can not be pulled out is realized.

In order to more conveniently realize the reciprocating motion of the pressing handle, a return spring is required to be arranged between the pressing handle and the fixing handle, the return spring can enable the pressing handle to automatically return to the original state after being pressed, and the return process spontaneously realizes the process of driving the rack to move towards the tail part of the catheter sheath.

In order to realize the tearing of the catheter sheath more lightly, the invention also arranges an upper cutting edge and a lower cutting edge at the front part of the mounting seat of the auxiliary device, and when the catheter sheath passes through the passage of the auxiliary device, the cutting edges directly cut off the tearing groove of the catheter sheath.

The above examples are merely illustrative of the present invention for clarity and are not intended to limit the scope of the invention. Other variations and modifications will be apparent to persons skilled in the art in light of the above description. Nor is it necessary or exhaustive for all embodiments. And obvious variations or modifications of the invention may be made without departing from the scope of the invention.

Claims

1. Central venous catheter is with pipe sheath and auxiliary device thereof, including pipe sheath and auxiliary device, its characterized in that: the catheter sheath is in a slender conical cylinder shape, two groups of tearing belts are symmetrically arranged on a sheath body of the conical cylinder-shaped catheter sheath, and the catheter sheath can be torn along the tearing belts; the inner wall of the catheter sheath is provided with at least two groups of symmetrically arranged and continuous teeth; the auxiliary device comprises a hollow conical barrel-shaped body, and a catheter driving wheel set is detachably mounted in the conical barrel-shaped body; the conical barrel-shaped body is provided with a hollow conical channel for the catheter sheath to pass through along the wall surface of the conical barrel-shaped body; a through groove is preset on the inner wall surface of the conical barrel-shaped body; the catheter driving wheel set comprises a wheel set mounting seat consisting of a front part and a rear part, two driving wheels which are meshed with each other and a driving rack for pulling the driving wheels to rotate are vertically mounted in the wheel set mounting seat, wheel shafts are arranged at the top and the bottom of the driving wheels and inserted into wheel shaft grooves on the wheel set mounting seat, and the wheel shaft grooves are strip-shaped; the upper part of the wheel body of the driving wheel is provided with teeth surrounding the driving wheel; the driving wheel can move back and forth along the wheel shaft groove under the pulling of the driving rack; when the driving rack is pulled towards the sheath tip of the catheter sheath, the driving wheel rotates from inside to outside, teeth of the driving wheel are meshed with teeth of the inner wall of the catheter sheath, and the catheter sheath is forced to penetrate through the conical channel of the auxiliary device body and is torn; when the driving rack is pulled towards the tail part of the catheter sheath, the teeth of the driving wheel are disengaged from the inner wall of the catheter sheath, the wheel set mounting seat comprises a front section and a rear section which are detachable, and the front section and the rear section of the wheel set mounting seat are connected in a detachable buckling mode;

the front part of the wheel set mounting seat is provided with a guide roller set which rotates in a one-way mode, the guide roller set comprises two roller bodies which are vertically arranged, the tops and the bottoms of the roller bodies are inserted into roller column grooves, and the roller column grooves are in a shape of a Chinese character 'ba' facing the sheath tip of the catheter sheath; when the drive rack is pulled to catheter sheath point direction, the guide roller set moves to both sides along the roller groove, and for the pipe through providing the guide space, when the drive rack moves to catheter sheath tail direction, the pipe can drive the guide roller to move to the sheath tail along the situation to the production is to the clamp force of pipe.

2. The catheter sheath for central venous cannulae and the auxiliary device thereof as claimed in claim 1, wherein: the auxiliary device also comprises a grab handle arranged on the conical barrel-shaped body and a pressing handle movably hinged on the driving rack, and the pressing handle is pressed to enable the driving rack to move towards the sheath tip of the catheter sheath, so that the driving wheel group of the catheter is driven to rotate towards the inner side and the catheter is sent into the catheter sheath.

3. The catheter sheath for central venous intubation and the auxiliary device thereof according to claim 2, wherein: the front part of the wheel set mounting seat of the auxiliary device is provided with an upper cutting edge and a lower cutting edge, and when the catheter sheath passes through the passage of the auxiliary device, the cutting edges directly cut off the tearing groove of the catheter sheath.