CN115252078A

CN115252078A - Pericardium puncture needle

Info

Publication number: CN115252078A
Application number: CN202210898174.9A
Authority: CN
Inventors: 储慧民
Original assignee: Individual
Current assignee: Individual
Priority date: 2022-07-28
Filing date: 2022-07-28
Publication date: 2022-11-01

Abstract

The invention provides a pericardium puncture needle, which belongs to the technical field of puncture needles and comprises a guide component, a puncture component, a positioning pacing component and a three-dimensional modeling component, wherein the puncture component is arranged on one side of the guide component, the puncture component can move along the length direction of the guide component to perform pericardium puncture, the positioning pacing component is arranged at the end parts of the guide component and the puncture component and is used for pacing during pericardium puncture, and the three-dimensional modeling component is electrically connected with the positioning pacing component and is used for judging the relative position of the puncture component compared with the pericardium and the myocardium according to the position of the positioning pacing component. Compared with the prior art, the embodiment of the invention effectively solves the problem that the needle point is difficult to accurately position in real time in the pericardial puncture process, greatly improves the safety of the operation, and simultaneously plays a role in preventing the needle point from damaging the myocardium.

Description

Pericardium puncture needle

Technical Field

The invention belongs to the technical field of puncture needles, and particularly relates to a pericardium puncture needle.

Background

The epicardial space is a foundation stone for a plurality of cardiac interventional operations, for example, epicardial radio frequency ablation refers to interventional treatment means for mapping and parallel ablation in the epicardial space by puncturing the pericardium, the main path is to puncture the pericardium under the percutaneous xiphoid process or at the apex of the heart to establish an operation channel, and a catheter enters the pericardial cavity through the operation channel to perform epicardial mapping and ablation. Similarly, the technique is applicable to any other supraventricular arrhythmia types requiring epicardial ablation after failure of radiofrequency ablation of the endocardial pathway, such as atrioventricular, atrial tachycardias, atrial flutter, and atrioventricular bypass. Other applications that are rare at present include: the plugging of the epicardium left auricle, the esophagus protection, the implantation of the epicardium pacing electrode and the like, but the future application prospect is bright. Particularly, in recent years, the rapid development of radiofrequency ablation therapy of atrial fibrillation accounts for more than half of the whole arrhythmia intervention therapy, the success rate of primary ablation is about 70-80%, and at least 10% of recurrent patients are related to epicardial lesions, so that active epicardial intervention may be needed.

The pericardium is a layer of connective tissue membrane structure tightly wrapped around the periphery of the heart, and when an extracardiac ablation operation is performed, a channel is manually formed on the pericardium tightly attached to the outer wall of the heart through a pericardium puncture needle so that an ablation device can enter between the outer wall of the heart and the pericardium through the channel to perform ablation.

The traditional pericardium puncture technology is performed under the guidance of X-ray, but because the technology is a two-dimensional technology, the positions of a needle point and the pericardium are close to each other at a certain angle, but are not close to each other at other angles, namely, the optimal tangent line position is difficult to find, real-time multi-angle observation is difficult during clinical operation, puncture failure is often caused due to incomplete needle insertion, and the myocardium is punctured due to too deep needle insertion. Moreover, because the heart surface has a layer of fat to lead to the myocardial edge sometimes not clear under the X-ray, therefore, it is more difficult to master when the heart beats, also more easy to take place and damage the epicardium surface coronary artery serious consequence, and the pericardium puncture has certain difficulty, operate according to the traditional technique, the amount of radiation is great, and only puncture needle sharp single electrode in the existing puncture device, can't pace speed while puncturing, can't record the electric potential of the target position accurately, and can't judge the position, direction of the needle point relative to pericardium, epicardium accurately, apt to cause the myocardial damage.

Disclosure of Invention

In order to overcome the defects in the prior art, the embodiment of the invention provides a pericardium puncture needle.

In order to solve the technical problems, the invention provides the following technical scheme:

a pericardial puncture needle, which comprises a guide component, a puncture component, a positioning pacing component and a three-dimensional modeling component,

the puncture component is arranged on one side of the guide component and can move along the length direction of the guide component to puncture the pericardium,

the positioning pacing component is arranged at the end parts of the guide component and the puncture component and is used for pacing when the pericardium is punctured,

the three-dimensional modeling component is electrically connected with the positioning pacing component and used for judging the relative position of the puncture component compared with the pericardium and the cardiac muscle according to the position of the positioning pacing component.

As a further improvement of the invention: the puncture assembly comprises a core rod and a puncture needle tip arranged at one end of the core rod.

As a further improvement of the invention: the guide assembly comprises a sleeve, and one end of the core rod extends into the sleeve and is in telescopic fit with the sleeve.

As a further improvement of the invention: the positioning pacing assembly includes a first electrode and a second electrode,

the first electrode is arranged at the position of the puncture needle tip, the second electrode is arranged at the end part of the sleeve,

the three-dimensional modeling component is electrically connected with the first electrode and the second electrode.

As a still further improvement of the invention: the three-dimensional modeling assembly is electrically connected with the first electrode and the second electrode through connecting cables.

As a still further improvement of the invention: a holding part is arranged at one end of the sleeve pipe far away from the second electrode,

and a push rod is arranged on one side of the holding part, and one end of the push rod extends into the sleeve and is connected with the core rod.

As a still further improvement of the invention: a channel communicated with the puncture needle tip is arranged in the core bar,

and a water injection part is also arranged on one side of the holding part, is communicated with the channel in the core bar and is used for injecting physiological saline or contrast agent into the core bar.

As a still further improvement of the invention: and the surface of the core rod and the surface of the sleeve are both provided with insulating coatings.

As a still further improvement of the invention: the outer wall of the sleeve is provided with scales along the length direction.

As a still further improvement of the invention: and a connecting cable port coated outside the connecting cable is further arranged on one side of the holding part.

Compared with the prior art, the invention has the beneficial effects that:

1. the needle tip and the electrode form a pacing system, so that the pacing can be performed while puncturing, and the change of the position of the puncture needle can be judged while the change of the ventricular beat frequency is monitored.

2. Through the arrangement of the double-electrode system, the needle point can record the potential change from the pericardium to the epicardium while puncturing, and the position reached by the needle point is judged through the potential change.

3. The arrangement of the double-electrode system can carry out three-dimensional modeling on the puncture cannula and the needle point, and the model can be changed in real time along with the position movement of the needle point, so that the relative position of the needle point can be judged.

The three points effectively solve the problem that the needle point is difficult to accurately position in real time in the pericardial puncture process in the prior art, greatly improve the safety of the operation and play a role in preventing the needle point from damaging the myocardium.

Drawings

FIG. 1 is a schematic structural view of the present invention;

FIG. 2 is a schematic view of the puncture position of the present invention when selecting the left anterior puncture position;

FIG. 3 is a schematic representation of the pericardial puncture of the present invention;

fig. 4 is a schematic view of the puncture performed at a 45 degree angle in the left anterior position in accordance with the present invention.

Detailed Description

The technical solution of the present patent will be described in further detail with reference to the following embodiments.

Reference will now be made in detail to embodiments of the present patent, examples of which are illustrated in the accompanying drawings, wherein like or similar reference numerals refer to the same or similar elements or elements having the same or similar function throughout. The embodiments described below with reference to the drawings are exemplary only for the purpose of explaining the present patent and are not to be construed as limiting the present patent.

Referring to fig. 1, the present embodiment provides a pericardial puncture needle, including a guide component, a puncture component, a positioning and pacing component 3, and a three-dimensional modeling component, where the puncture component is disposed on one side of the guide component, the puncture component can move along a length direction of the guide component to perform pericardial puncture, the positioning and pacing component 3 is disposed at an end of the guide component and an end of the puncture component, and is used for pacing during pericardial puncture, and the three-dimensional modeling component is electrically connected to the positioning and pacing component 3 and is used for determining a relative position of the puncture component compared with the pericardium and myocardium according to a position of the positioning and pacing component 3.

When puncture is carried out, the puncture assembly moves compared with the guide assembly, one end of the puncture assembly pierces into the pericardium, pacing is carried out by the positioning pacing assembly 3 in the process, so that the ventricular beat frequency is driven to change, and then the puncture assembly is judged to be pierced in place; the positioning pacing component 3 is positioned through the three-dimensional modeling component so as to judge the relative position of the puncture component compared with the pericardium and the cardiac muscle.

Referring to fig. 1, in one embodiment, the spike assembly includes a core rod 2 and a spike 4 disposed at one end of the core rod 2.

During puncture, the core rod 2 drives the puncture needle tip 4 to move, and the puncture needle tip 4 punctures the pericardium.

Referring to fig. 1, in one embodiment, the guiding assembly includes a casing 1, and one end of the core rod 2 extends into the casing 1 and is telescopically engaged with the casing 1.

Through the telescopic cooperation of sleeve 1 and core bar 2 to provide the guide effect to the removal of core bar 2, guarantee that core bar 2 can steadily move.

In another embodiment, the guiding assembly may further include a guiding rod, and a ring sleeve is fixedly disposed on one side of the core rod 2, and the ring sleeve is slidably sleeved outside the guiding rod.

The movement of the core rod 2 can also be kept stable through the sliding fit between the ring sleeve and the guide rod piece.

Referring to fig. 1, in one embodiment, the positioning and pacing component 3 includes a first electrode mounted at the tip of the puncture needle tip 4 and a second electrode mounted at the end of the cannula 1, and the three-dimensional modeling component is electrically connected to the first electrode and the second electrode.

The first electrode and the second electrode form a pacing system, so that pacing can be performed simultaneously during puncture, and a fixed pacing frequency can be set, preferably the pacing frequency is 100 times/min; when the puncture needle point 4 is positioned in the sleeve 1 and the first electrode is flush with the second electrode, the three-dimensional modeling component can be positioned to position information, when the puncture needle point 4 punctures, the puncture needle point 4 gradually moves out of the sleeve 1, the first electrode and the second electrode are separated by a distance, the three-dimensional modeling component can be positioned to the position information of the two electrodes, and according to the moving distance (the distance between the two electrodes), the three-dimensional modeling component can model, simulate the shape, the position and the direction of the whole puncture needle point 4 and the sleeve 1, and judge the relative positions of the puncture needle point 4 and the pericardium and the cardiac muscle.

Referring to fig. 1, in one embodiment, the three-dimensional modeling assembly is electrically connected to the first electrode and the second electrode through a connection cable 9.

Referring to fig. 1, in an embodiment, a holding portion 7 is disposed at an end of the sleeve 1 away from the second electrode, a push rod 10 is disposed at one side of the holding portion 7, and an end of the push rod 10 extends into the sleeve 1 and is connected to the core rod 2.

When puncturing, the push rod 10 is pushed to drive the core bar 2 to move along the interior of the casing 1, so as to drive the puncturing needle point 4 to move out of the interior of the casing 1 and puncture the pericardium.

Referring to fig. 1, in one embodiment, a channel communicating with the puncture needle tip 4 is formed inside the core rod 2, a water injection part 6 is further formed on one side of the holding part 7, the water injection part 6 is communicated with the channel inside the core rod 2 and is used for injecting saline or contrast medium into the core rod 2, and the saline or contrast medium is delivered into the body from the puncture needle tip 4.

In one embodiment, a connection cable port 8 is further disposed on one side of the grip portion 7 and covers the connection cable 9, and the connection cable 9 can be protected by the arrangement of the connection cable port 8.

In one embodiment, the surface of the core rod 2 and the surface of the sleeve 1 are both provided with insulating coatings, and the outer wall of the sleeve 1 is provided with scales along the length direction so as to judge the length of the needle and also judge the distance between a first electrode on the puncture needle tip 4 and a second electrode at the end part of the sleeve 1.

The specific working process of the embodiment of the invention is as follows:

1. preparation work before operation; 2. modeling a ventricle under a three-dimensional system; 3. the puncture device connecting cable is connected with the three-dimensional equipment, and the shape, position and direction of the puncture device can be established under the three-dimensional mapping; 4. selecting a puncture body position, wherein the puncture body position is a left front position; 5. beginning pericardium puncture and pacing; 6. the needle point is sent out of the sleeve, the pericardial puncture is started, and the potential can be displayed when the needle point contacts the pericardium; 7. continuously puncturing, wherein the direction of the needle point and the distance change from the needle point to the epicardium can be observed through three-dimensional equipment during puncturing; 8. the needle tip moves forwards slowly, when the needle tip contacts with the myocardium, the needle tip can record the potential change of the myocardium, meanwhile, the ventricular beat frequency changes, and the three-dimensional device can also display that the needle tip reaches the myocardium, and then the puncture is stopped; 9. and (4) a puncture guide wire is fed into the pericardium for puncture, and the guide wire clearly enters the pericardium when the guide wire is shaped along the transparent belt.

Specifically, in step 1, surgical instruments, such as a puncture guide wire, a pericardial puncture needle, a Y-valve, a syringe, and the like, are prepared for preparation before surgery. First, before insertion, the puncture guide wire is passed through the puncture needle, and it is confirmed whether the guide wire can pass smoothly without hindrance and the puncture guide wire is normal in shape. Secondly, heparinized saline is injected into the puncture needle through a Y-shaped valve, and the puncture needle tube is thoroughly washed. And thirdly, withdrawing the puncture guide wire into the puncture needle tube.

Specifically, in step 4, for the puncture body position selection, a proper puncture position and a proper needle inserting angle are selected by analyzing the anatomical structures of the heart, the diaphragm, the xiphoid process and the sternum and the characteristics of X-ray imaging. The Left Anterior (LAO) can clearly judge the left and right diaphragm muscles, preferably the left anterior 40-50 degrees, more preferably the left anterior 45 degrees. The puncture of this position can avoid puncturing and injuring the diaphragm, easily judge the front and back position of the puncture point, easily observe the bright zone at the bottom of the heart, simultaneously can avoid the coronary artery injury, avoid frequent position changes, as shown in fig. 2.

Specifically, step 5 includes: first, the skin puncture point was confirmed, and a 2mm to 3mm incision was made under the xiphoid process with a scalpel. Secondly, the puncture needle is inserted from the skin incision and the spine at an included angle of 20-40 degrees, is definitely above the left diaphragm, and the needle point of the puncture needle gradually approaches the transparent belt in the needle inserting process. And (3) adjusting the puncture point to be positioned between 1/4 and 2/5 of the left side of the heart image, preferably, adjusting the puncture point to be positioned at about 1/3 of the left side of the heart image, pushing the sleeve main body until the sleeve distal end is blocked, judging that the distal end of the sleeve main body is contacted with the pericardium, and as shown in fig. 3, just parallelly sticking the needle point plane to the position of the outer surface of the pericardium of the heart. Preferably, the puncture needle is inserted from the skin incision to form an included angle of 30 degrees with the spine.

Fig. 4 shows a pericardial puncture according to a preferred embodiment of the present invention. As shown in fig. 4, the puncture is performed at a 45-degree angle to the left anterior position, so that the injury of the diaphragm by puncture can be avoided, the anterior and posterior positions of the puncture point can be easily determined, the bright band at the bottom of the heart can be easily observed, and the injury of the coronary artery can be avoided.

In the embodiment of the invention, the second electrode is arranged on the sleeve and drives the first electrode to form a double-electrode system together with the puncture needle tip, so that on one hand, when the puncture needle tip gradually moves from a pericardium to a pericardium, the potential can be monitored in real time when the puncture needle tip punctures, and when the puncture needle tip contacts with a cardiac muscle, the puncture needle tip can monitor that the potential changes; on the other hand, the puncture needle tip and the second electrode on the sleeve can form a pacing system, during the puncture process, the pacing and puncturing are carried out at the same time, the pacing frequency is 100 times/minute, and when the pacing drives the ventricle, the beating frequency of the ventricle changes, so that the puncture needle is further judged to be in place. In addition, the double electrodes formed by the first electrode and the second electrode can be positioned in real time in a three-dimensional system and can accurately display the positions and the directions of the sleeve and the puncture needle tip. The judgment method can accurately and effectively judge the position change of the puncture needle, and greatly improves the safety of the operation.

Although the preferred embodiments of the present patent have been described in detail, the present patent is not limited to the above embodiments, and various changes can be made without departing from the spirit of the present patent within the knowledge of those skilled in the art.

Claims

1. A pericardial puncture needle, which is characterized by comprising a guide component, a puncture component, a positioning pacing component and a three-dimensional modeling component,

2. The pericardial puncture needle of claim 1, wherein the puncture assembly includes a core rod and a puncture needle tip disposed at one end of the core rod.

3. The pericardial puncture needle of claim 2, wherein the guide assembly comprises a cannula, and one end of the core rod extends into the cannula and is telescopically engaged with the cannula.

4. The pericardial puncture needle of claim 3, wherein the positioning and pacing assembly includes a first electrode and a second electrode,

5. The pericardial puncture needle according to claim 3, wherein the three-dimensional modeling assembly is electrically connected to the first electrode and the second electrode via a connection cable.

6. The pericardial puncture needle according to claim 5, wherein a grip portion is provided at an end of the cannula remote from the second electrode,

7. The pericardial puncture needle according to claim 6, wherein a channel communicated with the puncture needle tip is arranged inside the core rod,

and a water injection part is further arranged on one side of the holding part and communicated with the channel inside the core bar, and is used for injecting physiological saline or contrast agent into the core bar.

8. The pericardial puncture needle according to claim 3, wherein the core rod surface and the cannula surface are provided with an insulating coating.

9. The pericardial puncture needle according to claim 3, wherein the outer wall of the cannula is provided with graduations along the length direction.

10. The pericardial puncture needle according to claim 6, wherein a connection cable port covering the outside of the connection cable is further provided on one side of the holding portion.