CN114831708A - Arteriopuncture positioning device and using method thereof - Google Patents
Arteriopuncture positioning device and using method thereof Download PDFInfo
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- CN114831708A CN114831708A CN202210488515.5A CN202210488515A CN114831708A CN 114831708 A CN114831708 A CN 114831708A CN 202210488515 A CN202210488515 A CN 202210488515A CN 114831708 A CN114831708 A CN 114831708A
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
- A61B8/0841—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating instruments
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- A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
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- A61B8/4272—Details of probe positioning or probe attachment to the patient involving the acoustic interface between the transducer and the tissue
- A61B8/4281—Details of probe positioning or probe attachment to the patient involving the acoustic interface between the transducer and the tissue characterised by sound-transmitting media or devices for coupling the transducer to the tissue
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- A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
- A61B90/13—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints guided by light, e.g. laser pointers
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- A61B2017/3413—Needle locating or guiding means guided by ultrasound
Abstract
The application relates to the technical field of medical equipment, in particular to an arterial puncture positioning device and an application method thereof, wherein the arterial puncture positioning device comprises: the ultrasonic probe comprises a shell formed with a probe head, and a positioning point for aligning the position of the artery is arranged at the position, close to the probe head, of the shell; the probe is provided with a long shaft and a short shaft which are vertically arranged; the axis of the laser transmitter is vertical to the long axis of the detection head, a light beam emitted by the laser transmitter is projected on a human hand to form a marking light ray, and the marking light ray passes through the positioning point; the mounting, ultrasonic probe and laser emitter all set up in the mounting. The artery puncture positioning device provided by the embodiment of the application can position the needle inserting point and the needle inserting direction in the depth, the walking direction and the walking length in a three-dimensional positioning mode, and obviously improves the positioning precision, so that the puncture and indwelling accuracy of the trocar is improved, and the pain of a patient caused by puncture failure is reduced.
Description
Technical Field
The application relates to the technical field of medical equipment, in particular to an arterial puncture positioning device and an application method thereof.
Background
Radial artery puncture catheterization is an important means for realizing intraoperative continuous hemodynamic index monitoring and perioperative blood sample testing to treat internal environment disorder in critical patients, and a large number of blind puncture methods are still used in primary hospitals in clinical application due to equipment limitation since the last 70 th century.
The conventional techniques are roughly classified into the following three types:
the direct puncture method comprises the following steps: determining the pulse position and trend of the artery, selecting a needle insertion point, and performing radial artery puncture by using a 20G remaining needle after the local anesthetic or general anesthetic is injected into the artery side skin and subcutaneous injection. The direction of the needle point is opposite to the direction of blood flow, the included angle between the needle body and the skin is different according to the fat and thin degree of a patient, the needle is slowly inserted, when the needle core is found to have blood return, the puncture needle is pressed down and is pushed forwards by 2 mm-3 mm, the needle core still has blood return, the needle core is slightly withdrawn, the continuous blood return is still seen, the outer sleeve can be pushed forwards, the needle core is withdrawn, at the moment, the tail part of the sleeve is required to eject blood outwards in a pulsating manner, and the successful puncture and tube placement is indicated.
(II) penetration method: the needle insertion point, the needle insertion direction and the angle are the same as above. When blood returns, the needle core is pushed forward about 1-2 mm (the needle core is withdrawn without blood return), then the needle core is withdrawn, the sleeve is slowly withdrawn, the needle is stopped being withdrawn when blood spraying occurs, the sleeve is pushed forward immediately, no resistance feeling is produced during delivery, and blood spraying is continued, so that the successful puncture is indicated.
(III) ultrasonic guiding method: and (3) sterilizing the ultrasonic probe, determining the radial artery, adjusting the image depth to enable the radial artery imaging to be in the central position of a screen, and inserting the indwelling needle at an angle of 45-60 degrees, wherein the frequency of the ultrasonic probe is 5-13 MHz. The indwelling needle is slightly flicked, the probe is adjusted to ensure that the needle head is clearly developed on a screen, and in the process that the needle tip is pushed towards the artery, the probe is inclined to ensure that the needle tip is always visible. The position of the needle tip is determined at regular intervals to ensure that the needle tip is always positioned above the arterial blood vessel. After the indwelling needle is inserted into a blood vessel cavity, whether blood backflow exists or not is checked, the correct needle point position is determined, the indwelling needle is adjusted to be horizontal, the sleeve is pushed forward, then the thin needle in the indwelling needle is withdrawn, and the arterial pressure waveform appears when the sensor is connected, which indicates that the puncture is successful.
But the above solution causes the artery to flex due to the wrist being unstretched or hyperextended; puncture point selection errors, such as slight movement of the ultrasonic probe causing relative skin slippage and asynchrony of hands and eyes in the single-person operation process; too large or too small an angle between the needle tip and the skin; the needle insertion direction deviates from the artery anatomical running, such as vertical deviation or angular deviation; excessive attempts to activate vasospasm or local structural destruction of the artery to form a hematoma; the needle point is close to the vessel wall after the puncture of the artery, thus forming the difficulty of placing the vessel; the failure rate caused by the anatomical abnormality of individual non-operative physiological and pathological arteries is at a high level, especially for patients with low degree of fit such as pediatric patients.
Aiming at various failure factors, as the superiority of the ultrasound-guided arteriopuncture is increasingly obvious compared with the traditional palpation technology, methods for optimizing and improving the ultrasound-guided arteriopuncture technology and improving the success rate are continuously proposed in the anesthesia society of nearly ten years, such as a dynamic needle point method, an ultrasound development strip auxiliary imaging, intelligent glasses combined ultrasound direct vision guidance, subcutaneous injection of physiological saline, local application of nitroglycerin to expand blood vessels, guide wire auxiliary catheter placement and tibial posterior artery selection, and the like. However, since the unilateral improvement cannot eliminate the interference of other factors, the effective reduction of the comprehensive failure rate cannot be guaranteed.
Disclosure of Invention
The application aims to provide an artery puncture positioning device and an artery puncture positioning device using method, so that the technical problem that in the prior art, puncture failure rate is high in a process of puncturing an artery and placing a tube in the prior art is solved to a certain extent.
The application provides an arteriopuncture positioner includes: the ultrasonic probe comprises a shell formed with a probe head, and a positioning point for aligning the position of the artery is arranged at the position, close to the probe head, of the shell; the probe is provided with a long shaft and a short shaft which are vertically arranged;
the axis of the laser emitter is perpendicular to the long axis of the detecting head, a light beam emitted by the laser emitter is projected on a human hand to form a marking light ray, and the marking light ray passes through the positioning point;
the mounting, ultrasonic probe with laser emitter all set up in the mounting.
In the above technical solution, further, the arteriopuncture positioning device further includes a trocar for remaining in a hand arm portion of a person;
the marking light ray reflects the artery running of a human hand, and is used for guiding the needle inserting direction of the trocar.
In any of the above technical solutions, further, the arterial puncture positioning device further includes a wrist supporting device for adjusting a wrist bending angle of the human hand.
In any of the above technical solutions, further, the fixing member includes a first fixing seat and a second fixing seat;
the first fixing seat comprises: the ultrasonic probe fixing device comprises a fixed back plate, wherein a first fixing plate and a second fixing plate are respectively arranged on two side edges of the fixed back plate extending along the length direction, and an installation groove for fixing the ultrasonic probe is defined by the first fixing plate, the second fixing plate and the fixed back plate together;
the second fixed seat is arranged on one side, away from the ultrasonic probe, of the fixed back plate; the second fixing seat is provided with a limiting groove for arranging the laser transmitter.
In any of the above technical solutions, the fixing member is provided with a positioning member, the positioning member includes a connecting rod and a positioning rod which are vertically connected, the connecting rod is connected with the first fixing seat, and the length direction of the positioning rod is parallel to the central line of the ultrasonic probe extending along the length direction.
In any of the above technical solutions, further, the arteriopuncture positioning device further includes a stent; the bracket includes: at least two mutually rotatable support arms, wherein one of the support arms is connected with a fixed position; the fixing piece is arranged on the other supporting arm.
The application also provides an artery puncture positioning device using method, which is suitable for the artery puncture positioning device in any technical scheme, so that the artery puncture positioning device has all beneficial technical effects, and is not repeated herein.
The artery puncture positioning device using method comprises the following steps: the method comprises the following steps:
adjusting the relative position of a laser transmitter arranged on an ultrasonic probe and the ultrasonic probe, so that a light beam emitted by the laser transmitter can pass through a positioning point of the ultrasonic probe and then be projected on the skin surface of the arm of the human hand;
the positioning point of the ultrasonic probe is close to a position 1cm below a wrist striation, the ultrasonic depth of the ultrasonic probe is adjusted to a preset range or a preset value, then an artery is determined at the middle position of an ultrasonic image, and a first marking point is marked on the surface of the skin of the hand at the current position;
moving the ultrasonic probe towards the proximal end of the hand by a preset distance, then adjusting the ultrasonic depth of the ultrasonic probe again, determining the artery at the middle position of the ultrasonic image again, and then marking a second marking point on the skin surface of the hand at the current position;
and after the angle of the ultrasonic probe relative to the human arm is adjusted, the light beam emitted by the laser emitter passes through the first mark point and the second mark point.
In the above technical solution, further, an extension direction of a straight line where a connection line between the first marking point and the second marking point is located toward a proximal end of the arm is taken as a running direction of the trocar.
In any of the above technical solutions, further, the method for using the arteriopuncture positioning device further includes the following steps: determining the needle inserting point of the trocar;
under the condition that the second mark point is determined, the ultrasonic probe is placed at the second mark point, and according to the artery depth shown by the ultrasonic probe, the second mark point moves towards the laser straight line at the far end by the distance of the artery depth to be the needle inserting point;
when puncturing is carried out, the trocar is aligned with the needle inserting point, and meanwhile, the trocar is inclined relative to the skin surface of a human hand.
In any of the above technical solutions, further, the using method of the arterial puncture positioning device further includes a preparation step before positioning:
coating a sterile couplant on the ultrasonic probe, and wrapping the ultrasonic probe by using a sterile protective sleeve;
and smearing the sterile couplant on the outer surface of the sterile protective sleeve again.
In any of the above technical solutions, further, the preparation step before positioning further includes:
a support device is padded below the wrist joint of the hand;
and (5) disinfecting the skin of the hand part and paving a hole towel.
Compared with the prior art, the beneficial effect of this application is:
the application provides an arteriopuncture positioner includes: the ultrasonic probe comprises a shell formed with a probe head, and a positioning point for aligning the position of the artery is arranged at the position, close to the probe head, of the shell; the probe is provided with a long shaft and a short shaft which are vertically arranged; the axis of the laser transmitter is perpendicular to the long axis of the detecting head, a light beam emitted by the laser transmitter is projected on a human hand to form a marking light ray, and the marking light ray passes through the positioning point; the mounting, ultrasonic probe and laser emitter all set up in the mounting.
The artery puncture positioning device provided by the embodiment of the application can position the needle inserting point and the needle inserting direction in the depth, the walking direction and the walking length in a three-dimensional positioning mode, and obviously improves the positioning precision, so that the puncture and indwelling accuracy of the trocar is improved, and the pain of a patient caused by puncture failure is reduced.
The application provides an artery puncture positioner application method is applicable to the aforesaid artery puncture positioner, carry out the location before radial artery puncture is kept somewhere according to this method, can clearly, accurately judge into the needle point and go into the needle and walk the line direction, and then show the rate of accuracy that improves follow-up radial artery puncture, avoid the repetitive operation, bring unnecessary misery to the patient, moreover, the artery puncture positioner that this application embodiment provided is particularly useful for children.
Drawings
In order to more clearly illustrate the detailed description of the present application or the technical solutions in the prior art, the drawings needed to be used in the detailed description of the present application or the prior art description will be briefly introduced below, and it is obvious that the drawings in the following description are some embodiments of the present application, and other drawings can be obtained by those skilled in the art without creative efforts.
Fig. 1 is a schematic structural view of an arterial puncture positioning device provided in an embodiment of the present application;
FIG. 2 is a schematic view of another structure of the arteriopuncture positioning device provided in the embodiments of the present application;
FIG. 3 is another schematic structural diagram of an arterial puncture positioning device provided in the embodiment of the present application;
fig. 4 is a schematic structural diagram of a fixing member of an arterial puncture positioning device provided in an embodiment of the application.
Reference numerals:
1-ultrasonic probe, 101-positioning point, a-long axis, b-short axis, 2-laser emitter, 3-trocar, 4-marking light, 5-wrist supporting device, 6-bracket, 601-first arm, 602-second arm, 603-first connecting piece, 604-second connecting piece, 7-first marking point, 8-second marking point, 9-needle entering point, 10-first fixing seat, 1011-fixing back plate, 1012-first fixing plate, 1013-second fixing plate, 11-second fixing seat, 1101-limiting groove, 1102-opening, 12-positioning piece, 1201-connecting rod and 1202-positioning rod.
Detailed Description
The technical solutions of the present application will be described clearly and completely with reference to the accompanying drawings, and it should be understood that the described embodiments are only some embodiments of the present application, but not all embodiments.
The components of the embodiments of the present application, generally described and illustrated in the figures herein, can be arranged and designed in a wide variety of different configurations. Thus, the following detailed description of the embodiments of the present application, presented in the accompanying drawings, is not intended to limit the scope of the claimed application, but is merely representative of selected embodiments of the application.
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 application.
In the description of the present application, it should be noted that the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", and the like 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, and 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 application. 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 application, it is to 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 meaning of the above terms in the present application can be understood in a specific case by those of ordinary skill in the art.
An arterial puncture positioning device and a method for using the arterial puncture positioning device according to an embodiment of the present application are described below with reference to fig. 1 to 4.
First aspect
Referring to fig. 1 to 4, an embodiment of the present application provides an arterial puncture positioning device, which specifically includes: ultrasonic probe 1, laser emitter 2, mounting and support 6, wherein, the mounting includes first fixing base 10 and second fixing base 11, and ultrasonic probe 1 sets up on first fixing base 10, and laser emitter 2 sets up on second fixing base 11, and the mounting rotates with support 6 to be connected.
In particular, the ultrasound probe 1 comprises a housing and important components arranged inside the housing, the structure and the principle of the ultrasound probe 1 being well known and well understood by a person skilled in the art. The bottom (or the head) of casing is formed with and is used for just obtaining the probe of ultrasonic image to the human skin surface, is provided with setpoint 101 in the front of casing near the opening position of probe, and when ultrasonic probe 1 was in actual use, setpoint 101 was the setpoint 101 of medical personnel preliminary judgement artery position. Further, the probe has a major axis a and a minor axis b perpendicular to each other, a marking light ray 4 formed by a light beam emitted from the laser emitter and projected on a human hand in a line shape is arranged perpendicular to the major axis a, and (an extension line of) the marking light ray 4 passes through the positioning point 101.
It should be noted that the artery puncture positioning device provided in the embodiment of the present application is actually a radial artery puncture positioning device for a hand and an arm, and a target patient can be a group of young children, infants and the like, so as to reduce the failure rate of puncture failure of patients with low fitting degree and reduce pain caused by puncture failure to the patients.
Preferably, the ultrasound probe 1 used in the embodiment of the present application may be a model produced by shenzhen meirui biomedical electronics gmbh of: mindray ultrasound probe 1, DC-8ELITE, available directly.
Further, when the arteriopuncture positioning device provided by the present application is used, an axis of the laser emitter 2 having a slender cylindrical shape should be parallel to a central line (i.e. a positioning central line) of the whole ultrasonic probe 1 extending along the length direction, so that a light beam emitted by the laser emitter 2 can fall on the skin on the surface of the arm of the human hand and leave a linear marking light 4, a projection of the light beam emitted by the laser emitter 2 falling on the shell of the ultrasonic probe 1 can pass through the positioning point 101 in the length or height direction of the vertical ultrasonic probe 1, and the marking light 4 falling on the human hand and an extension line thereof can pass through the positioning point 101 on the surface of the skin of the arm of the human hand, and the marking light 4 is perpendicular to the long axis a of the probe, so that the extending direction of the marking light 4 can reflect the running direction of the artery of the human hand.
It should be noted that the entire ultrasonic probe 1 does not necessarily have a regular shape, but the length from one end of the probe to one end of the tail terminal of the ultrasonic probe 1 should be longer than the length in the direction parallel to the arm of the human hand, that is, the width of the ultrasonic probe 1.
After a probe of the ultrasonic probe 1 is contacted with a human hand, an ultrasonic image with the cross section being the arm depth along the human arm can be obtained, the artery depth of the human arm can be obtained, the marking light 4 of the laser transmitter 2 falling on the human arm extends approximately along the length direction of the human arm, namely, the light beam falling on the human arm is perpendicular to the ultrasonic image, so that a three-dimensional positioning system is formed, the needle inserting point 9 and the needle inserting direction can be positioned in the depth direction, the walking direction and the walking length direction, the positioning precision is obviously improved, the accuracy of puncture and indwelling of the trocar 3 is improved, and the pain of a patient caused by puncture failure is reduced.
Preferably, the laser transmitter 2 may be a model manufactured by Shenzhen Zhonglai technology Limited as: the ZLM120AL650-22130BXS device, although not limited thereto.
More preferably, the diameter of the light transmission emitted by the laser emitter 2 is approximately 2mm, matching the thickness of the radial artery of children, children.
Further, the first fixing base 10 includes: the fixing back plate 1011, the first fixing plate 1012 and the second fixing plate 1013 are symmetrically arranged on two sides of the fixing back plate 1011 extending along the length direction, the first fixing plate 1012, the second fixing plate 1013 and the fixing back plate 1011 jointly enclose a mounting groove, the ultrasonic probe 1 is arranged on the mounting groove, preferably, the shape of the mounting groove is matched with the shape of the shell of the ultrasonic probe 1, and the mounting groove is narrow at the top and wide at the bottom, so that the adaptability and the stability between the ultrasonic probe 1 and the mounting groove are ensured, the situation that the ultrasonic probe 1 shakes or loosens when a medical worker operates the arterial puncture positioning device is avoided, in addition, the main body part of the ultrasonic probe 1 is arranged in the mounting groove, and the probe penetrates out from the bottom opening of the mounting groove, so as to obtain an ultrasonic image.
The second fixing seat 11 is disposed on an outer wall surface of the fixing back plate 1011 and protrudes relative to the fixing back plate 1011, the second fixing seat 11 is formed with a cylindrical-like limiting groove 1101, an axial direction of the limiting groove 1101 is parallel to the positioning center line, and an opening 1102 is formed on a side wall of the limiting groove 1101 along the axial direction of the limiting groove 1101, preferably, a diameter of the laser emitter 2 is slightly larger than that of the limiting groove 1101, so that after the laser emitter 2 is disposed in the limiting groove 1101, the limiting groove 1101 can guide the laser emitter 2, and the laser emitter 2 can be stably clamped in the limiting groove 1101.
Further, the outer wall surface of the fixed back plate 1011 is provided with a positioning piece 12, the positioning piece 12 is located below the second fixing seat 11, the positioning piece 12 comprises a connecting rod 1201 and a positioning rod 1202 which are perpendicular to each other, the connecting rod 1201 is perpendicular to the fixed back plate 1011, the positioning rod 1202 is parallel to the surface of the fixed back plate 1011, preferably, the positioning rod 1202 is parallel to a positioning center line, so that the projection of the laser emitter 2 falling on the fixed back plate 1011 can pass through the positioning rod 1202 and also pass through the positioning point 101, and therefore the relation between the light emitted by the laser emitter 2 and the ultrasonic probe 1 and the positioning point 101 can be judged by observing the relation between the light emitted by the laser emitter 2 and the positioning rod 1202, and the laser emitter 2 and the ultrasonic probe 1 can be found in time and adjusted when being deviated.
Further, the artery puncture positioning device provided by the embodiment of the application further comprises a trocar (3), and the trocar (3) is used for carrying out indwelling operation after the artery puncture positioning device is used for positioning the radial artery of the child patient.
It should be noted that the artery puncture positioning device and the artery puncture positioning device using method provided by the present application are only intended for determining the needle insertion point, and after the needle insertion point is determined, the technical scheme of the artery puncture positioning device and the artery puncture positioning device using method is instantly finished, and the following operations, such as the following puncture, the needle insertion and the trocar indwelling, are not related, and the following operations do not belong to the scope covered by the technical scheme of the present application.
Preferably, the trocar 3 used in the embodiment of the present application may be a 24G trocar 3 having a model number C0141 manufactured by Shanghai Progain medical instruments Inc., but it is not limited thereto and is directly available.
Further, the bracket 6 includes: the robot comprises a first arm part 601 and a second arm part 602, wherein one end of the first arm part 601 is hinged to a first connecting piece 603, the first connecting piece 603 is used for connecting and fixing the first arm part 601 to a specified position, the other end of the first arm part 601 is hinged to one end of the second arm part 602, and the angle between the first arm part 601 and the second arm part is adjustable; the other end of the second arm 602 is hinged to a second connecting piece 604, the position of the first fixing seat 10 avoiding the mounting groove or the position of the second fixing seat 11 avoiding the limiting groove 1101 and the second connecting piece 604 are adjusted, and by adjusting the angle of the hinged position between any two adjacent parts among the first connecting piece 603, the first arm 601, the second arm 602 and the second connecting piece 604, the ultrasonic probe 1 and the laser emitter 2 can be adjusted to be close to or far away from the arm of the patient, and the angle of the ultrasonic probe 1 and the laser emitter 2 relative to the arm of the patient can also be adjusted.
It should be noted that the rotation direction or the bending direction between the first connecting member 603 and the first arm 601, the rotation direction between the first arm 601 and the second arm 602, and the rotation direction between the second arm 602 and the second connecting member 604 are different from each other in pairs, or the connecting positions of two adjacent arms can rotate in a universal direction, so that the positions and angles of the ultrasonic probe 1 and the laser emitter 2 relative to the arm of the child can be adjusted in multiple dimensions by the present bracket 6.
Further, the first connecting member 603 includes a U-shaped structure, which includes two wall plates facing each other, one of the wall plates is hinged to the first arm 601, the other wall plate is provided with a jackscrew in a penetrating manner, the jackscrew is in threaded connection with the wall plate, after the U-shaped structure of the first connecting member 603 is inserted into the plate-shaped designated position from the opening, the jackscrew is screwed to the wall plate by a certain depth, so that the first connecting member 603 and the designated position can be locked, and the whole support 6 is fixed.
The second connecting member 604 has a bent structure including a first bent portion and a second bent portion extending in different directions, and the first bent portion is hinged to the third arm portion.
Further, the arteriopuncture positioning device provided in the embodiment of the present application further includes a wrist supporting device 5, preferably, the wrist supporting device 5 may be a cotton towel roll, after the infant completes the anesthesia induction, one arm is selected to be slightly extended, and a cotton towel roll is padded under the wrist joint to make the wrist joint in a slightly dorsiflexed state, so that the arm is in a horizontal state as much as possible.
To sum up, the arteriopuncture positioning device provided by the embodiment of the application can position the needle inserting point and the needle inserting direction in the depth, the walking direction and the walking length in a three-dimensional positioning mode, so that the positioning precision is obviously improved, the puncture and indwelling accuracy of the trocar is improved, and the pain of a patient caused by puncture failure is reduced.
(II) second aspect
The embodiment of the application further provides a using method of the arterial puncture positioning device, which is suitable for the arterial puncture positioning device in the first embodiment, so that all the beneficial technical effects of the arterial puncture positioning device are achieved, and the same technical features and beneficial effects are not repeated.
The application method of the artery puncture positioning device provided by the embodiment of the application specifically comprises the following steps:
s1, preparing before puncture positioning;
the method specifically comprises the following steps:
flatly placing the arm of the infant patient, and placing a cotton towel roll below the wrist joint of the infant patient to enable the wrist joint to be in a slight back stretching state;
then, the part to be punctured is properly expanded, an iodophor solution is used for disinfecting the radial artery puncture position and the periphery, and then a hole towel is laid to leak out of the puncture area;
smearing sterile couplant on the surface of the ultrasonic probe 1, wrapping the ultrasonic probe 1 and a second fixing seat 11 for clamping and fixing the laser transmitter 2 by using a sterile protective sleeve, and fully attaching a probe of the ultrasonic probe 1 to the sterile protective sleeve to exhaust air bubbles;
then, at least the part of the outer surface of the sterile protective sleeve corresponding to the detecting head is coated with the sterile couplant again, and then the bracket 6 is pulled or pushed to enable the detecting head to be close to the arm skin of the infant.
The arrangement is more sanitary and safer, and can avoid cross infection between patients.
S2, arranging the laser emitter 2 on the second fixed seat 11, so that the laser emitter 2 is located at the middle-upper position of the surface of the ultrasonic probe 1, and the laser emitter 2 is prevented from protruding relative to the probe;
then, it is determined that the marking light of the laser beam emitted by the laser emitter 2 falling on the hand can pass through the positioning point 101 of the ultrasonic probe 1, and the laser beam falling on the wrist of the child patient projects light.
S3, firstly, the positioning point 101 of the ultrasonic probe 1 is close to the position, close to the arm proximal end by 1cm, of the distance between the wrist striation of the infant, the ultrasonic depth is adjusted to a preset value, then the ultrasonic probe 1 is adjusted in a reciprocating mode, the middle position of the (radial) artery in the ultrasonic image is determined, the positioning point 101 is just opposite to the position, corresponding to the skin surface of the arm of the infant, of the first marking point 7 at the current position, and meanwhile the artery depth is determined according to the detection result of the ultrasonic probe 1.
It should be noted that the ultrasound depth should be appropriately adjusted according to the age, obesity, etc. of the patient, and therefore, the ultrasound depth is preferably a range value, in the embodiment of the present application, the ultrasound depth is preferably 2.5cm, and such a value is suitable for the infant, and ensures the accuracy of the radial artery positioning and the imaging definition for the infant.
Further, after the first marking point 7 is marked, the ultrasonic probe 1 is moved towards the proximal end of the human arm by the fish-hole distance, the middle position of the ultrasonic image is determined again according to the steps, and then the second marking point 8 is marked, wherein the first marking point 7 and the second marking point 8 are marked by using a sterile marker pen.
The straight line where the connecting line of the first marking point 7 and the second marking point 8 is located can reflect the running direction of the radial artery of the child patient, and the needle is moved in the direction towards the arm proximal end along the connecting line of the first marking point 7 and the second marking point 8 after the trocar 3 is inserted into the needle.
In addition, during the selection of the first marking point 7 and the second marking point 8, i.e. during the acquisition of the ultrasonic image, the ultrasonic probe 1 may be disposed obliquely with respect to the surface of the flat arm of the person, preferably, an angle between a side (front) of the ultrasonic probe 1 near the wrist striation and the upper surface of the arm is about 120 °, and an angle between a side (back) of the ultrasonic probe 1 near the proximal end and the upper surface of the arm is about 60 °.
S4, determining the needle inserting point 9 of the trocar 3; after the second mark point 8 is determined, moving the ultrasonic probe 1 towards the arm proximal end for a distance, preferably, the moving distance is the artery depth, and is about 1.5cm, under the distance, the ultrasonic image of the radial artery of the child patient can still be clearly displayed, and a positioning space is also provided for the needle insertion point 9;
the position of the current ultrasonic probe 1 is taken as a reference, the ultrasonic probe moves forwards for a preset distance towards the wrist striation of the child, preferably, the preset distance is about 0.5cm, the current position is the needle insertion point 9, the preset distance is selected by about 0.5cm, the radial artery needle insertion point 9 aiming at the child can be accurately judged under the level that the ultrasonic probe 1 moves forwards for 0.5cm after being positioned at the second mark point 8, and the judgment standard of the age range of the child can be applied, so that the success rate of radial artery puncture is further improved.
It should be noted that the determined distance of the needle insertion point 9 and the setting of the predetermined distance, ultrasound depth and other parameters are reasonably adjusted by the age, weight, height, shape and the like of the patient, which can be fully understood by those skilled in the art and will not be described herein again.
Further, when the trocar 3 is used for puncture, the needle head of the trocar 3 is aligned with the needle insertion point 9, then the trocar 3 and the ultrasonic probe 1 are vertically inserted into the needle as much as possible, the trocar 3 and the upper surface of the arm form an angle of approximately 30 degrees, the trocar 3 is inserted into the needle to a proper extent along the running direction indicated by the light rays projected on the arm skin of the child, the needle insertion angle of the trocar 3 is slowly pressed down after blood return, then the needle core is gradually withdrawn, and the blood return is usually inserted into the cannula, so that the puncture and indwelling insertion of the radial artery are completed.
According to the method, the positioning before radial artery puncture indwelling is carried out, the needle inserting point and the needle inserting traveling direction can be clearly and accurately judged, the accuracy of subsequent radial artery puncture is obviously improved, repeated operation is avoided, unnecessary pain is brought to a patient, and the artery puncture positioning device is particularly suitable for children.
Finally, it should be noted that: the above embodiments are only used for illustrating the technical solutions of the present application, and not for limiting the same; although the present application has been described in detail with reference to the foregoing embodiments, it should be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; and the modifications or the substitutions do not make the essence of the corresponding technical solutions depart from the scope of the technical solutions of the embodiments of the present application.
Claims (10)
1. An arterial puncture positioning device, comprising:
the ultrasonic probe comprises a shell formed with a probe head, and a positioning point for aligning the position of the artery is arranged at the position, close to the probe head, of the shell; the probe is provided with a long shaft and a short shaft which are vertically arranged;
the axis of the laser emitter is perpendicular to the long axis of the detecting head, a light beam emitted by the laser emitter is projected on a human hand to form a marking light ray, and the marking light ray passes through the positioning point;
the mounting, ultrasonic probe with laser emitter all set up in the mounting.
2. The arteriopuncture positioning device of claim 1, further comprising a trocar for indwelling in a human arm;
the marking light ray reflects the artery running of a human hand, and is used for guiding the needle inserting direction of the trocar.
3. The arterial puncture positioning device of claim 1, further comprising a wrist support means for adjusting the wrist bending angle of a human hand.
4. The arterial puncture positioning device of claim 1, wherein the anchor comprises a first anchor seat and a second anchor seat;
the first fixing seat comprises: the ultrasonic probe fixing device comprises a fixed back plate, wherein a first fixing plate and a second fixing plate are respectively arranged on two side edges of the fixed back plate extending along the length direction, and an installation groove for fixing the ultrasonic probe is defined by the first fixing plate, the second fixing plate and the fixed back plate together;
the second fixed seat is arranged on one side, away from the ultrasonic probe, of the fixed back plate; the second fixing seat is provided with a limiting groove for arranging the laser transmitter.
5. The arteriopuncture positioning device of claim 4, wherein the fixing member is provided with a positioning member, the positioning member comprises a connecting rod and a positioning rod which are vertically connected, the connecting rod is connected with the first fixing seat, and the length direction of the positioning rod is parallel to a central line of the ultrasonic probe extending along the length direction.
6. The arterial puncture positioning device of any one of claims 1-5, further comprising a stent; the bracket includes: at least two mutually rotatable support arms, wherein one of the support arms is connected with a fixed position; the fixing piece is arranged on the other supporting arm.
7. An artery puncture positioning device using method is characterized by comprising the following steps:
adjusting the relative position of a laser transmitter arranged on an ultrasonic probe and the ultrasonic probe, so that a light beam emitted by the laser transmitter can pass through a positioning point of the ultrasonic probe and then be projected on the skin surface of the arm of the human hand;
the positioning point of the ultrasonic probe is close to a position 1cm below a wrist striation, the ultrasonic depth of the ultrasonic probe is adjusted to a preset range or a preset value, then an artery is determined at the middle position of an ultrasonic image, and a first marking point is marked on the surface of the skin of the hand at the current position;
moving the ultrasonic probe towards the proximal end of the hand for a preset distance, then adjusting the ultrasonic depth of the ultrasonic probe again, determining the artery in the middle of the ultrasonic image again, and then marking a second marking point on the skin surface of the hand at the current position;
after the angle of the ultrasonic probe relative to the human arm is adjusted, enabling the light beam emitted by the laser emitter to pass through the first marking point and the second marking point;
and the straight line direction of the connecting line of the first marking point and the second marking point is used as the running direction of the trocar.
8. The method for using an arterial puncture positioning device according to claim 7, further comprising the steps of: determining the needle inserting point of the trocar;
under the condition that the second mark point is determined, the ultrasonic probe is placed at the second mark point, and according to the artery depth shown by the ultrasonic probe, the second mark point moves towards the laser straight line at the far end by the distance of the artery depth to be the needle inserting point;
when puncturing is carried out, the trocar is aligned with the needle inserting point, and meanwhile, the trocar is inclined relative to the skin surface of a human hand.
9. The method for using an arterial puncture positioning device according to claim 6, further comprising the steps of preparing before positioning:
coating a sterile couplant on the ultrasonic probe, and wrapping the ultrasonic probe by using a sterile protective sleeve;
and smearing the sterile couplant on the outer surface of the sterile protective sleeve again.
10. The method of using an arterial puncture positioning device of claim 9, wherein said pre-positioning preparation step further comprises:
a support device is padded below the wrist joint of the hand;
and (5) disinfecting the skin of the hand part and paving a hole towel.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
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| CN202210488515.5A CN114831708A (en) | 2022-05-06 | 2022-05-06 | Arteriopuncture positioning device and using method thereof |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202210488515.5A CN114831708A (en) | 2022-05-06 | 2022-05-06 | Arteriopuncture positioning device and using method thereof |
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