CN113558730B - Neurovascular intervention operation auxiliary device - Google Patents
Neurovascular intervention operation auxiliary device Download PDFInfo
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- CN113558730B CN113558730B CN202110813245.6A CN202110813245A CN113558730B CN 113558730 B CN113558730 B CN 113558730B CN 202110813245 A CN202110813245 A CN 202110813245A CN 113558730 B CN113558730 B CN 113558730B
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Abstract
The invention belongs to the technical field of auxiliary instruments for vascular interventional therapy, and particularly relates to an auxiliary device for a neurovascular interventional operation. The invention designs the auxiliary device for the blood vessel interventional operation with the functions of assisting in needle setting, guide wire and catheter introduction by a puncture needle in a targeted manner, is extremely suitable for the blood vessel interventional treatment mode by adopting a Seldinger method and a Seldinger improvement, can assist in positioning the puncture needle in advance, provides a stable puncture path, realizes stable needle setting and needle withdrawing operation, drives the puncture needle to deflect and adjust by taking the central position of the front wall of the puncture blood vessel punctured by the puncture needle as an axis, ensures that the operation is safer and more standard, avoids multiple times of puncture, and can reduce puncture accidents caused by manual operation such as hand shaking.
Description
Technical Field
The invention relates to the technical field of auxiliary instruments for vascular interventional therapy, in particular to an auxiliary device for a neurovascular interventional operation.
Background
In modern times, the incidence and mortality of cancer is high and the trend toward younger cancers is increasing. The traditional treatment method of tumors is mostly selected from surgical treatment, and then chemotherapy, radiotherapy and biological treatment. In many patients, such as some patients with advanced tumors, or when the patients cannot receive surgical treatment due to physical factors or age factors, tumor intervention provides a new choice for patients.
There are two types of tumor intervention, one is vascular intervention and the other is non-vascular intervention. Vascular intervention, including selective arterial perfusion chemotherapy. Under the guidance of image, the catheter is inserted into the artery supplying blood to tumor, and chemotherapeutic medicine is injected. The dosage is 1/2, even 1/5 of the whole vein, and the purpose of local treatment is achieved. It is characterized in that chemotherapy drugs quickly enter tumors within a few seconds; the second method is selective arterial embolization, which adopts a vascular embolization agent to embolize blood supply vessels of tumors temporarily or permanently, in general, to starve the tumors; the third method is chemoembolization, i.e. anti-cancer drugs plus embolization agents.
The existing vascular interventional therapy modes comprise a classic Seldinger method and a Seldinger improvement operation, wherein the Seldinger method comprises the following necessary materials of a guide wire, a catheter, a puncture needle and a puncture cannula in the vascular interventional therapy: as shown in fig. 10, a-puncture the anterior and posterior walls of the blood vessel with a puncture needle with a needle core; b-withdrawing the needle core; c, slowly pulling the needle outwards until the blood is sprayed out from the needle tail; d-rapid insertion of a guide wire; e-withdrawing the needle, introducing the catheter through the guidewire; f-place the catheter into the aorta. The Seldinger modification is a modification of Seldinger puncture method by Driscoll, as shown in fig. 11, a-a blood vessel is directly punctured percutaneously by a puncture needle without a needle core, when a needle tip penetrates through the front wall of the blood vessel and enters the cavity of the blood vessel, and when blood is jetted out from a needle tail, the needle insertion is stopped and the rear wall of the blood vessel is not penetrated any more; b-rapid insertion of a guide wire; c-withdrawing the puncture needle; d-introducing a catheter over a guidewire; e-inserting a catheter into the lumen of the blood vessel; f-placing the catheter into the aorta. In practical application, no matter the classic Seldinger method or the Seldinger improvement operation is adopted for vascular interventional therapy, after an image is compared by an operator, puncture path selection and manual needle inserting and withdrawing operations are carried out without any physical auxiliary device, corresponding auxiliary measures are not needed when a guide wire and a catheter are introduced, the requirements on physical strength and energy of the operator are high, and puncture accidents caused by multiple times of puncture or manual operations such as hand shaking are easy to occur.
Disclosure of Invention
Technical problem to be solved
Aiming at the defects of the prior art, the invention provides a neurovascular interventional operation auxiliary device, which solves the problems that the prior vascular interventional treatment mode requires a patient to compare images, puncture path selection and manual needle inserting and withdrawing operations are carried out without any entity auxiliary device, no corresponding auxiliary measures are provided for guide wire and catheter introduction, the requirements on physical strength and energy of the patient are high, and puncture accidents caused by multiple times of puncture or manual operations such as hand trembling are easy to occur.
The second technical proposal.
Aiming at two vascular interventional treatment modes of a classic Seldinger method and a Seldinger improvement operation, the invention designs a neurovascular interventional operation auxiliary device which has a relatively ideal auxiliary effect.
The invention specifically adopts the following technical scheme for realizing the purpose:
the utility model provides a neurovascular intervention operation auxiliary device, includes bottom plate, threaded rod, supplementary piercing depth and altitude mixture control subassembly, and is specific:
the threaded rod is vertically arranged on the bottom plate and plays a role in supporting the main body;
the auxiliary puncture device is arranged and comprises a Z-shaped adjusting rod, a puncture positioning assembly which is connected to the end part of the Z-shaped adjusting rod and assists in positioning a puncture needle, and a locking device which is used for fixing the Z-shaped adjusting rod, positioning an initial position, positioning a screwing angle and locking the adjusting rod in a deflection prevention manner, wherein one end of the Z-shaped adjusting rod, which is far away from the puncture positioning assembly, is connected with a knob cap, and the Z-shaped adjusting rod is screwed by the knob cap and then adjusts the deflection of the puncture needle by taking the central position of the front wall of a blood vessel punctured by the puncture needle as an axis; the auxiliary puncture device is used for assisting an operator in puncture operation of a puncture needle and guide wire and catheter introduction operation, the puncture needle can be positioned in advance in an auxiliary manner, a stable puncture path is provided, puncture, guide wire and catheter guidance operation are assisted, operation is more standardized, multiple times of puncture is avoided, and puncture accidents caused by manual operations such as hand trembling can be reduced;
the auxiliary puncture device is characterized in that a height adjusting assembly is arranged, the height adjusting assembly is in threaded connection with a threaded rod, the auxiliary puncture device is installed on the threaded rod through the height adjusting assembly, and the height adjusting assembly is used for adjusting a Z-shaped adjusting rod to be as high as the center of the front wall of a blood vessel punctured by a puncture needle; the Z-shaped adjusting rod is adjusted to be as high as the center of the front wall of the blood vessel punctured by the puncture needle, so that the puncture positioning assembly is conveniently positioned, and the puncture needle is assisted to deflect and adjust the puncture needle by taking the center of the front wall of the blood vessel punctured by the puncture needle as the axis.
Furthermore, the puncture positioning assembly comprises a rod sleeve and an inner screw rod in threaded connection with the inside of the rod sleeve, the rod sleeve is detachably connected with the Z-shaped adjusting rod, a nut erected at the top end of the rod sleeve is arranged at the top of the inner screw rod, and a puncture hole matched with the puncture needle is formed in the inner part of the inner screw rod; the puncture positioning assembly is mainly designed for interventional operations by adopting a Seldinger method, the Seldinger method needs to puncture the front wall and the rear wall of a blood vessel through a puncture needle, when the puncture needle is slowly retracted, a stable skill of an operator is needed, and improper operation is easy to occur.
Furthermore, a connecting end is arranged on the rod sleeve, a clamping block is arranged at the end part of the connecting end, a clamping groove matched with the clamping block in a clamping manner is arranged at the end part of the Z-shaped adjusting rod, external threads are arranged at the connecting end, the clamping block and the end part of the Z-shaped adjusting rod, and the clamping block and the end part of the Z-shaped adjusting rod are locked by a connecting nut matched with the external threads; the mode that adopts the joint can conveniently carry out dismouting and change to puncture locating component, does benefit to simultaneously and debugs the location to puncture locating component, utilizes coupling nut to carry out the lock solid to the tip that fixture block and Z type adjusted the pole, can guarantee the fastness of link.
Furthermore, the locking device comprises a shell, a ratchet wheel, a first brake pawl, a leaf spring, a connecting shaft, a second brake pawl and an adjusting cap, wherein the ratchet wheel is arranged on a pipe section of the Z-shaped adjusting rod penetrating through the shell, the first brake pawl and the leaf spring are arranged inside the shell through a first fixing frame, the leaf spring is in point contact with the outer side surface of the first brake pawl, the leaf spring is matched with the first brake pawl to limit the ratchet wheel to rotate reversely, the second brake pawl is arranged inside the shell through the connecting shaft, the connecting shaft and the Z-shaped adjusting rod are radially consistent, the adjusting cap is arranged at one end of the connecting shaft penetrating to the outside of the shell, a buckling groove is formed in the inclined surface of the ratchet wheel, a buckling block matched with the clamping groove is arranged on the inner side wall of the second brake pawl, and the second brake pawl is matched with the buckling groove in the ratchet wheel through the buckling block to stop the twisted ratchet wheel; the ratchet mechanism is adopted to realize the positioning and locking operation of the Z-shaped adjusting rod, has the characteristics of simple structure and convenience in operation, is easy to adjust the stepping amount and meets the requirement of micro angle adjustment of the puncture needle.
Furthermore, the center of the ratchet wheel is taken as the origin of coordinates, and the included angle between two adjacent ratchets is matched with the included angle between the initial puncture position of the puncture needle for the first time and the final position after the inclination angle of the puncture needle is adjusted when the guide wire is introduced; the structure design can conveniently refer to the ratchet wheel structure, quickly complete the position adjustment operation of the puncture needle, and is more stable and quicker than a manual adjustment mode.
Furthermore, the shell is of a cylinder structure, the front end face of the shell is a transparent glass end face, a first initial position indication mark and a final position indication mark are sequentially arranged on the shell in the circumferential direction with the Z-shaped adjusting rod as the circle center, a second initial position indication mark which is vertically and correspondingly arranged with the first initial position indication mark is arranged on the knob cap, the Z-shaped adjusting rod is used as the origin of coordinates, and an included angle between the first initial position indication mark and the final position indication mark is matched with an included angle between the initial position of the initial puncture of the puncture needle and the final position after the inclination angle of the puncture needle is adjusted when the guide wire is introduced; the first initial position indication mark and the final position indication mark are arranged on the shell, the second initial position indication mark is arranged on the knob cap, and when the second initial position indication mark corresponds to the first initial position indication mark up and down, the puncture positioning assembly is located at an initial needle inserting position at the moment, and the puncture needle can be matched for needle inserting operation; when the second initial position indication mark corresponds to the final position indication mark, the puncture positioning component is adjusted to the position required by guide wire introduction at the moment, the operation of an operator is greatly facilitated, the operator can directly observe the ratchet state through the transparent glass end surface, and when the position indicated by the indication mark under the position is consistent with the set position of the puncture positioning component required to be adjusted, the operation is clearer and more intuitive.
Furthermore, the height adjusting assembly consists of a threaded sleeve, an upper locking nut and a lower locking nut, the upper locking nut, the threaded sleeve and the lower locking nut are sequentially connected onto a threaded rod from top to bottom, a sliding block is arranged on the inner wall of the threaded sleeve, a strip-shaped sliding groove in sliding fit with the sliding block is arranged on the outer wall of the threaded rod, and the threaded sleeve is fixed by the threaded connection and matching of the upper locking nut and the lower locking nut with the threaded rod; through setting up the altitude mixture control subassembly, can adjust the pole with the Z type and adjust to the antetheca central point with pjncture needle puncture blood vessel puts unanimous height, conveniently fixes a position puncture locating component, and supplementary pjncture needle carries out pjncture needle deflection adjustment with pjncture needle puncture blood vessel's antetheca central point as the axle center.
(III) advantageous effects
Compared with the prior art, the invention provides an auxiliary device for a neurovascular interventional operation, which has the following beneficial effects:
the invention designs the blood vessel intervention operation auxiliary device with the puncture needle auxiliary needle setting, guide wire and catheter auxiliary leading-in function in a targeted manner, is extremely suitable for the blood vessel intervention treatment mode by adopting a Seldinger method and a Seldinger improvement operation, can perform auxiliary positioning on a puncture needle in advance, provides a stable puncture path, realizes stable needle setting and needle withdrawing operation, drives the puncture needle to deflect and adjust by taking the central position of the front wall of the puncture blood vessel punctured by the puncture needle as an axis, ensures that the operation is safer and more standard, avoids multiple punctures, and can reduce puncture accidents caused by manual operations such as hand trembling and the like.
Drawings
FIG. 1 is a schematic diagram of the position of the neurovascular interventional operation auxiliary device of the invention corresponding to the femoral artery of the human leg root;
FIG. 2 is a schematic view of the structure of the auxiliary puncturing device of the present invention;
FIG. 3 is an exploded view of the puncture positioning assembly of the present invention;
FIG. 4 is a front view of the locking device of the present invention;
FIG. 5 is a schematic view of the internal structure of the locking device of the present invention;
FIG. 6 is a schematic view of the ratchet structure of the present invention having 12 ratchet teeth;
FIG. 7 is a schematic view of a second brake pawl according to the present invention;
FIG. 8 is a schematic view of the connection of the height adjustment assembly of the present invention to the threaded rod;
FIG. 9 is an illustration of the initial position of the initial puncture of the puncture needle and the final position after adjusting the inclination angle of the puncture needle when the guide wire is introduced according to the present invention;
FIG. 10 is a schematic view of a vascular interventional procedure using the Seldinger method;
FIG. 11 is a schematic view of the steps of the vascular interventional procedure of the modified Seldinger procedure.
In the figure: 1. a base plate; 2. a threaded rod; 201. a strip-shaped chute; 3. an auxiliary puncturing device; 301. a Z-shaped adjusting rod; 3011. a card slot; 302. a puncture positioning component; 3021. a rod sleeve; 3022. an inner screw rod; 3023. a nut; 3024. connecting the end heads; 3025. a clamping block; 3026. a connecting nut; 303. a locking device; 3031. a housing; 3032. a ratchet wheel; 3033. a first brake pawl; 3034. a leaf spring; 3035. a connecting shaft; 3036. a second brake pawl; 3037. an adjusting cap; 3038. a first initial position indicator; 3039. a final position indication mark; 3040. a second initial position indicator; 304. a knob cap; 4. a height adjustment assembly; 401. a threaded sleeve; 4011. a slider; 402. locking a nut; 403. and a lower locking nut.
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.
Examples
As shown in fig. 1 to 11, an embodiment of the present invention provides a neurovascular interventional operation assisting device, including:
a bottom plate 1 for installing the device main body is arranged, as shown in fig. 1, the bottom plate 1 can be used for a patient to lie down, and in practical application, a clamping device for fixedly clamping the legs of the patient is arranged on the bottom plate 1 so as to prevent the legs of the patient from moving;
in order to facilitate height adjustment and main body support of the device, a threaded rod 2 is arranged, the threaded rod 2 is vertically arranged on a bottom plate 1 in a matching manner with an installation base, and an installation structure with a plurality of installation holes can be uniformly and radially arranged on the bottom plate 1 along one side of the root position of the thigh of a patient, so that the installation position of the threaded rod 2 can be conveniently and specifically arranged according to the specific condition of the patient;
in order to facilitate stable needle placement, prevent multiple needle application and enable puncture to be more standard, an auxiliary puncture device 3 is arranged to assist puncture, guide wires and catheter guiding operation, the auxiliary puncture device 3 comprises a Z-shaped adjusting rod 301, a puncture positioning assembly 302 which is connected to the end part of the Z-shaped adjusting rod 301 and assists puncture needle positioning, and a locking device 303 which is used for fixing, initial position positioning, screwing angle positioning and adjusting rod deflection preventing locking of the Z-shaped adjusting rod 301, as shown in fig. 2, the Z-shaped adjusting rod 301 is selected as a main middle rotating shaft, because intervention operation needs to be carried out through a puncture femoral artery, a percutaneous femoral artery is required to be inserted, the puncture positioning assembly 302 is positioned above a human body puncture part, and in order to ensure that the middle rotating shaft and the center position of the front wall of a punctured blood vessel are positioned on the same horizontal position, the adjusting rod with a Z-shaped structure is selected as the main middle rotating shaft; one end of the Z-shaped adjusting rod 301, which is far away from the puncture positioning component 302, is connected with a knob cap 304, and the knob cap 304 is arranged to facilitate the forced screwing of the end part of the Z-shaped adjusting rod 301 and adjust the position of the puncture positioning component 302; after the knob cap 304 is screwed, the puncture needle can be deflected by a certain angle by taking the central position of the front wall of the puncture needle puncture blood vessel as the axis of the Z-shaped adjusting rod 301, so that the requirement of introducing a guide wire is met;
because different patients' size, the height is different, consequently, the internal percutaneous femoral artery position of different patients is highly also inconsistent, consequently, need set up a height adjusting assembly 4, with 4 threaded connection of height adjusting assembly on threaded rod 2, adopt the mode of can dismantling connection or welding to install on height adjusting assembly 4 with supplementary piercing depth 3 again, accomplish the group equipment operation promptly, when the preparation before the art, need adjust the position height adjustment of Z type regulation pole 301 to with the anterior wall central point highly uniform of pjncture needle puncture blood vessel through height adjusting assembly 4, conveniently fix a position puncture locating component 302, supplementary pjncture needle carries out pjncture needle deflection adjustment with the anterior wall central point of pjncture needle puncture blood vessel as the axle center.
As shown in fig. 3, in some embodiments, the puncture positioning assembly 302 includes a rod sleeve 3021 and an inner screw 3022 threaded inside the rod sleeve 3021, the rod sleeve 3021 is threaded with the inner screw 3022, when the Seldinger method is used for interventional surgery, in the slow retraction step, after the inner screw 3022 is manually turned, in the process of continuously and slowly raising the inner screw 3022 along the rod sleeve 3021, the puncture needle mounted on the inner screw 3022 is slowly retracted from the back wall of the blood vessel, because the inner screw 3022 is radially consistent with the rod sleeve 3021, the puncture needle raised along with the inner screw 3022 has the characteristic of stable retraction, which can avoid the situation that the retraction position of the puncture needle is too low or too high due to improper operation of an operator, and save energy of the operator; in order to facilitate the disassembly and the replacement of the puncture positioning component 302, the rod sleeve 3021 and the Z-shaped adjusting rod 301 are detachably connected, and the puncture positioning component 302 is more beneficial to positioning during assembly due to the detachable connection mode; in order to better stress the inner screw 3022 and facilitate the screwing out of the inner screw 3022, a nut 3023 which is overlapped on the top end of the rod sleeve 3021 is arranged at the top of the inner screw 3022, and the inner screw 3022 can be stably screwed out by the knob nut 3023; the inner screw rod 3022 is internally provided with a puncture hole matched with the puncture needle, and the puncture hole has the function of providing a puncture path and simultaneously meeting the directional introduction operation of a guide wire and a catheter.
As shown in fig. 3, in some embodiments, a connection end 3024 is disposed on the rod sleeve 3021, a fixture block 3025 is disposed at an end of the connection end 3024, the fixture blocks 3025 are circumferentially and uniformly distributed along an outer side of an end surface of the connection end 3024, the fixture block 3025 may be designed to be a wedge-shaped structure, a clamping slot 3011 in snap fit with the fixture block 3025 is disposed at an end of the Z-shaped adjustment rod 301, the clamping slot 3011 is circumferentially and uniformly distributed along an outer side of an end of the Z-shaped adjustment rod 301, and is set to be a wedge-shaped slot structure, the fixture block 3025 and the clamping slot 3011 are snap fit through the fixture block 3025 and the clamping slot 3011, so that the rod sleeve 3021 and the Z-shaped adjustment rod 301 are combined more tightly, the connection end 3024, the fixture block 3025 and the end of the Z-shaped adjustment rod 301 are all designed to be connection structures having external threads, and a connection nut 3026 adapted to complete locking operation of the fixture block 3025 and the Z-shaped adjustment rod 301, so as to ensure firmness of the connection end.
As shown in fig. 5, in some embodiments, the locking device 303 includes a housing 3031, a ratchet wheel 3032, a first detent pawl 3033, a leaf spring 3034, a connecting shaft 3035, a second detent pawl 3036 and an adjusting cap 3037, wherein the ratchet wheel 3032 is mounted on a pipe section of the Z-shaped adjusting rod 301 penetrating through the interior of the housing 3031, the first detent pawl 3033 and the leaf spring 3034 are mounted inside the housing 3031 through a first fixing frame, and the mounting requires that the leaf spring 3034 always makes point contact with the outer side surface of the first detent pawl 3033, and the leaf spring 3034 always maintains a certain elastic pressure on the first detent pawl 3033, so that the end of the first detent pawl 3033 always makes contact with the ratchet teeth of the ratchet wheel 3032 to prevent the Z-shaped adjusting rod 301 from being reversely rotated due to improper operation; the second brake pawl 3036 is mounted inside the housing 3031 through a connecting shaft 3035, the second brake pawl 3036 is adapted to the ratchet 3032, the connecting shaft 3035 is radially consistent with the Z-shaped adjusting rod 301, in order to facilitate the rotation adjustment of the connecting shaft 3035, an adjusting cap 3037 is arranged and mounted at one end of the connecting shaft 3035 penetrating to the outside of the housing 3031, the opening and closing operation of the second brake pawl 3036 can be realized by adjusting the cap 3037 through a left knob and a right knob, in order to facilitate the rotation brake of the ratchet 3032, a fastening groove is arranged on a ratchet inclined plane of the ratchet 3032, as shown in fig. 6, and a fastening block adapted to the fastening groove is arranged on the inner side wall of the second brake pawl 3036, as shown in fig. 7; after adjustment of the deflection of the puncturing needle is completed, the second detent pawl 3036 is brought close to the wedge block on the ratchet wheel 3032 by screwing the adjusting cap 3037 in the opposite direction, and the ratchet wheel 3032 can be stopped after adjustment of the deflection of the puncturing needle is completed by the snap fit of the snap block with the snap groove on the ratchet wheel 3032 (wedge block).
In some embodiments, the center of the ratchet 3032 is taken as the origin of coordinates, and the included angle between two adjacent ratchets is matched with the included angle between the initial puncture position of the puncture needle and the final position after the inclination angle of the puncture needle is adjusted when the guide wire is introduced; as shown in fig. 9, when the back puncture needle operation is completed and the angle of the puncture needle needs to be adjusted to facilitate the guide wire introduction, that is, when the included angle between the initial needle withdrawal position and the final guide wire introduction position is 30 degrees and the angle of the puncture needle needs to be pressed downwards in an inclined manner to be 30 degrees, as shown in fig. 6, the ratchet 3032 only needs to be designed to have a structure with 12 ratchets (a wedge block arranged outside the ratchet 3032), the center of the ratchet 3032 is taken as the origin of coordinates, the included angle between two adjacent ratchets is 30 degrees, and at this time, the adjustment operation of the angle of the puncture needle can be realized only by screwing the corresponding angle of one ratchet along the inclined downwards pressing direction of the puncture needle, so that the back puncture needle operation is simple and fast in operation.
As shown in fig. 4, in some embodiments, the housing 3031 is configured as a cylindrical structure, and in order to facilitate visual observation of the position structures such as the ratchet 3032 and the pawl in the housing 3031, the front end surface of the housing 3031 may be configured as a transparent glass end surface; in order to facilitate the adjustment operation of the puncture needle angle to be completed at one time, a first initial position indication mark 3038 and a final position indication mark 3039 are sequentially arranged on the shell 3031 in the circumferential direction taking the Z-shaped adjusting rod 301 as the circle center, meanwhile, a second initial position indication mark 3040 which is vertically and correspondingly arranged with the first initial position indication mark 3038 is arranged on the knob cap 304, the Z-shaped adjusting rod 301 is taken as the origin of coordinates, and the included angle between the first initial position indication mark 3038 and the final position indication mark 3039 is matched with the included angle between the initial position of the puncture needle for the first time and the final position after the puncture needle inclination angle is adjusted when the guide wire is introduced; when the second initial position indicator 3040 corresponds to the first initial position indicator 3038 up and down, that is, the puncture positioning assembly 302 is at the initial needle inserting position at this time, and can perform needle inserting operation in cooperation with the puncture needle; when the second initial position indication mark 3040 corresponds to the final position indication mark 3039, it indicates that the puncture positioning assembly 302 has been adjusted to the position required for guiding the guide wire, which is greatly convenient for the operator to operate, the operator can directly observe the ratchet status through the transparent glass end surface, and when the position indicated by the position indication mark is consistent with the predetermined position of the puncture positioning assembly 302 required to be adjusted, it is more clear and intuitive.
As shown in fig. 8, in some embodiments, in order to facilitate height adjustment of the locking device 303, a height adjustment assembly 4 with a simple structure and convenient use is designed as a height adjustment mechanism, the assembly is composed of a threaded sleeve 401, an upper locking nut 402 and a lower locking nut 403, the upper locking nut 402, the threaded sleeve 401 and the lower locking nut 403 are sequentially connected to the threaded rod 2 from top to bottom, in order to ensure stability of movement of the threaded sleeve 401 on the threaded rod 2, a sliding block 4011 is arranged on an inner wall of the threaded sleeve 401 in a sliding connection manner between the threaded sleeve 401 and the threaded rod 2, a strip chute 201 in sliding fit with the sliding block 4011 is arranged on an outer wall of the threaded rod 2, and through sliding fit between the sliding block 4011 and the strip chute 201, the height of the threaded sleeve 401 can be rapidly adjusted, so that the Z-type adjustment rod 301 can be adjusted to a height consistent with a central position of a puncture blood vessel puncture needle, positioning of the puncture positioning assembly 302 is facilitated, and when the Z-type adjustment rod 301 is adjusted to a height consistent with the central position of the front wall of the puncture blood vessel puncture needle, the front wall is maintained, the height adjustment assembly is completed by screwing the upper locking nut 402 and the locking nut 403 onto the upper locking nut 402 and the lower locking nut 403.
This example provides two different modes of operation for interventional procedures using the Seldinger method and using the Seldinger modification, for the steps of the Seldinger method:
the method comprises the following steps: under the guidance of an image, determining the height of the patient's cutaneous femoral artery, sliding the threaded sleeve 401 to the same height along the strip-shaped chute 201 on the threaded rod 2 according to the height of the cutaneous femoral artery, keeping the height of the Z-shaped adjusting rod 301 consistent with the height of the front wall center position of the blood vessel punctured by the puncture needle, and locking the threaded sleeve 401 on the corresponding height position of the threaded rod 2 by screwing the upper locking nut 402 and the lower locking nut 403;
step two: screwing the knob cap 304 to enable the second initial position indication mark 3040 on the knob cap 304 to correspond to the first initial position indication mark 3038 on the front end face of the shell 3031 up and down, screwing the adjusting cap 3037 in the positive direction, and enabling the ratchet wheel 3032 to stop moving through the buckling fit of the buckling block on the second brake pawl 3036 and the buckling groove on the ratchet of the ratchet wheel 3032 so as to determine the initial puncture angle of the puncture needle;
step three: the puncture needle percutaneously punctures the front wall and the rear wall of the blood vessel through the puncture hole of the inner screw rod 3022, the puncture needle tube retreats until blood is ejected after the needle core withdrawing step, the nut 3023 at the top of the inner screw rod 3022 is screwed, the puncture needle is continuously retreated by continuously pushing up the nut 3023 until the end part of the puncture needle is positioned in the blood vessel cavity, and the blood is ejected from the top end of the puncture needle;
step four: the adjusting cap 3037 is screwed in the opposite direction to make the buckling blocks on the second detent pawl 3036 separate from the buckling grooves on the ratchet teeth (the number of the ratchet teeth is 12) of the ratchet wheel 3032, the knob cap 304 is screwed to adjust the deflection of the puncture needle (the deflection is carried out by an angle (30 degrees) corresponding to one ratchet tooth) by taking the center position of the front wall of the puncture blood vessel punctured by the puncture needle as the axis, the second initial position indication mark 3040 on the knob cap 304 corresponds to the final position indication mark 3039, and the guide wire and catheter introduction operation is carried out after the ratchet wheel 3032 is braked.
Procedure for Seldinger modification:
the method comprises the following steps: under the guidance of an image, determining the height of the patient's cutaneous femoral artery, sliding the threaded sleeve 401 to the same height along the strip-shaped chute 201 on the threaded rod 2 according to the height of the cutaneous femoral artery, keeping the height of the Z-shaped adjusting rod 301 consistent with the height of the front wall center position of the blood vessel punctured by the puncture needle, and locking the threaded sleeve 401 on the corresponding height position of the threaded rod 2 by screwing the upper locking nut 402 and the lower locking nut 403;
step two: screwing the knob cap 304 to enable the second initial position indication mark 3040 on the knob cap 304 to vertically correspond to the first initial position indication mark 3038 on the front end surface of the shell 3031, screwing the adjusting cap 3037 in the positive direction, and enabling the ratchet wheel 3032 to stop moving through the buckling fit of the buckling block on the second brake pawl 3036 and the buckling groove on the ratchet of the ratchet wheel 3032, so as to determine the initial puncture angle of the puncture needle;
step three: the puncture needle without the needle core directly punctures the blood vessel percutaneously through the puncture hole of the inner screw rod 3022, when the needle point penetrates the front wall of the blood vessel and enters the blood vessel cavity, and when blood is sprayed out from the needle tail, the needle insertion is stopped;
step four: the adjusting cap 3037 is screwed in the opposite direction to make the buckling blocks on the second stopping pawl 3036 separate from the buckling grooves on the ratchet teeth (the number of the ratchet teeth is 12) of the ratchet wheel 3032, the knob cap 304 is screwed to adjust the deflection of the puncture needle (deflect by an angle (30 degrees) corresponding to one ratchet tooth) by taking the center position of the front wall of the puncture blood vessel punctured by the puncture needle as the axis, the second initial position indication mark 3040 on the knob cap 304 corresponds to the final position indication mark 3039, and the guide wire and the catheter are introduced after the ratchet wheel 3032 is stopped.
Finally, it should be noted that: although the present invention has been described in detail with reference to the foregoing embodiments, it will be apparent to those skilled in the art that changes may be made in the embodiments and/or equivalents thereof without departing from the spirit and scope of the invention. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (4)
1. A neurovascular intervention operation auxiliary device is characterized in that: the neurovascular intervention operation auxiliary device comprises:
a base plate (1);
the threaded rod (2) is vertically arranged on the bottom plate (1), and the threaded rod (2) plays a role in supporting the main body;
the auxiliary puncture device (3) comprises a Z-shaped adjusting rod (301), a puncture positioning assembly (302) which is connected to the end of the Z-shaped adjusting rod (301) and assists in positioning a puncture needle, and a locking device (303) which is used for fixing the Z-shaped adjusting rod (301), positioning an initial position, positioning a screwing angle and locking the adjusting rod in a deflection prevention manner, wherein one end, far away from the puncture positioning assembly (302), of the Z-shaped adjusting rod (301) is connected with a knob cap (304), and the Z-shaped adjusting rod (301) is screwed by the knob cap (304) and then adjusts the deflection of the puncture needle by taking the center position of the front wall of a puncture blood vessel of the puncture needle as an axis;
the height adjusting assembly (4) is in threaded connection with the threaded rod (2), the auxiliary puncture device (3) is installed on the threaded rod (2) through the height adjusting assembly (4), and the height adjusting assembly (4) is used for adjusting the Z-shaped adjusting rod (301) to the height consistent with the center position of the front wall of the puncture blood vessel punctured by the puncture needle;
the locking device (303) comprises a shell (3031), a ratchet wheel (3032), a first brake pawl (3033), a leaf spring (3034), a connecting shaft (3035), a second brake pawl (3036) and an adjusting cap (3037), wherein the ratchet wheel (3032) is mounted on a pipe section of the Z-shaped adjusting rod (301) penetrating through the shell (3031), the first brake pawl (3033) and the leaf spring (3034) are mounted inside the shell (3031) through a first fixing frame, the leaf spring (3034) is in point contact with the outer side surface of the first brake pawl (3033), the leaf spring (3034) and the first brake pawl (3033) are matched to limit the ratchet wheel (3032) to rotate reversely, and the second brake pawl (3036) is mounted inside the shell (3031) through the connecting shaft (3035), the connecting shaft (3035) is radially consistent with the Z-shaped adjusting rod (301), the adjusting cap (3037) is mounted at one end, penetrating through the connecting shaft (3035) to the outside of the shell (3031), of the connecting shaft, a buckling groove is formed in a ratchet slope of the ratchet wheel (3032), a buckling block matched with the buckling groove is arranged on the inner side wall of the second braking pawl (3036), the second braking pawl (3036) enables the screwed ratchet wheel (3032) to stop moving through buckling and matching of the buckling block and the buckling groove in the ratchet wheel (3032), the center of the ratchet wheel (3032) is used as a coordinate origin, and an included angle between every two adjacent ratchet wheels is equal to the initial puncture position of the puncture needle for the first time and the inclination angle of the puncture needle is adjusted when the guide wire is introduced The angle between the final positions of the puncture needle is matched, the shell (3031) is of a cylindrical structure, the front end face of the shell (3031) is a transparent glass end face, a first initial position indication mark (3038) and a final position indication mark (3039) are sequentially arranged on the shell (3031) in the circumferential direction with the Z-shaped adjusting rod (301) as the circle center, a second initial position indication mark (3040) vertically corresponding to the first initial position indication mark (3038) is arranged on the knob cap (304), the Z-shaped adjusting rod (301) is used as the origin of coordinates, and the angle between the first initial position indication mark (3038) and the final position indication mark (3039) is matched with the angle between the initial position of the puncture needle for the first time puncture and the final position of the puncture needle after the inclination angle of the puncture needle is adjusted when the guide wire is introduced.
2. A neurovascular interventional procedure assistance device as defined in claim 1, wherein: puncture locating component (302) are including pole cover (3021) and threaded connection in inside interior screw rod (3022) of pole cover (3021), pole cover (3021) are connected with Z type regulation pole (301) can be dismantled, the top of interior screw rod (3022) is equipped with nut (3023) of setting up on pole cover (3021) top, the inside of interior screw rod (3022) is equipped with the puncture hole with puncture needle assorted.
3. A neurovascular interventional procedure assistance device as set forth in claim 2, wherein: be equipped with connection end (3024) on pole cover (3021), connection end (3024) tip is equipped with fixture block (3025), the tip of Z type regulation pole (301) is equipped with draw-in groove (3011) with fixture block (3025) joint complex, the tip of connecting end (3024), fixture block (3025) and Z type regulation pole (301) all is equipped with the external screw thread, through the coupling nut (3026) lock solid with external screw thread looks adaptation between the tip of fixture block (3025) and Z type regulation pole (301).
4. A neurovascular interventional procedure assistance device as defined in claim 1, wherein: altitude mixture control subassembly (4) are by thread bush (401), lock solid nut (402) and lock solid nut (403) down and constitute, go up lock solid nut (402), thread bush (401) and lock solid nut (403) down and from top to bottom connect gradually on threaded rod (2), be equipped with slider (4011) on the inner wall of thread bush (401), be equipped with on the outer wall of threaded rod (2) with slider (4011) sliding fit's bar spout (201), thread bush (401) are fixed through locking solid nut (402) and lock solid nut (403) down and threaded rod (2) threaded connection cooperation.
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CN202110813245.6A CN113558730B (en) | 2021-07-19 | 2021-07-19 | Neurovascular intervention operation auxiliary device |
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CN113558730B true CN113558730B (en) | 2023-02-07 |
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US5810884A (en) * | 1996-09-09 | 1998-09-22 | Beth Israel Deaconess Medical Center | Apparatus and method for closing a vascular perforation after percutaneous puncture of a blood vessel in a living subject |
CN101120881A (en) * | 2006-08-07 | 2008-02-13 | 上海导向医疗系统有限公司 | CT positioning percutaneously inserting puncture instrument |
CN208447730U (en) * | 2017-09-13 | 2019-02-01 | 随州市中心医院 | A kind of therapeutic device for cardiovascular interventional operation |
CN109692033A (en) * | 2019-03-07 | 2019-04-30 | 谢林 | A kind of percutaneous lumbar intervertebral foramen mirror puncture auxiliary locator |
CN110974370A (en) * | 2019-12-30 | 2020-04-10 | 首都医科大学附属北京妇产医院 | Ultrasonic intervention puncture device capable of preventing miss |
CN211511990U (en) * | 2019-12-31 | 2020-09-18 | 韩会来 | Cardiovascular intervention device |
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2021
- 2021-07-19 CN CN202110813245.6A patent/CN113558730B/en active Active
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US5810884A (en) * | 1996-09-09 | 1998-09-22 | Beth Israel Deaconess Medical Center | Apparatus and method for closing a vascular perforation after percutaneous puncture of a blood vessel in a living subject |
CN101120881A (en) * | 2006-08-07 | 2008-02-13 | 上海导向医疗系统有限公司 | CT positioning percutaneously inserting puncture instrument |
CN208447730U (en) * | 2017-09-13 | 2019-02-01 | 随州市中心医院 | A kind of therapeutic device for cardiovascular interventional operation |
CN109692033A (en) * | 2019-03-07 | 2019-04-30 | 谢林 | A kind of percutaneous lumbar intervertebral foramen mirror puncture auxiliary locator |
CN110974370A (en) * | 2019-12-30 | 2020-04-10 | 首都医科大学附属北京妇产医院 | Ultrasonic intervention puncture device capable of preventing miss |
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