CN115444522A

CN115444522A - Auxiliary positioning device and device for improving lumbar puncture precision of lateral median approach

Info

Publication number: CN115444522A
Application number: CN202211274133.9A
Authority: CN
Inventors: 庄源东; 陈春美; 张能深; 王锐; 陈靖; 谢海树; 江研伟; 陈琰; 郑师兴; 陈萍萍; 王春华; 陈阵; 涂献坤; 陈松; 刘仕超; 戴艺海; 吴剑锋; 石松生; 张国良; 杨卫忠
Original assignee: Union Medical College Hospital of Fujian Medical University
Current assignee: Union Medical College Hospital of Fujian Medical University
Priority date: 2022-10-18
Filing date: 2022-10-18
Publication date: 2022-12-09

Abstract

The invention relates to an auxiliary positioner for improving lumbar puncture precision of a lateral median approach, which comprises a positioning bottom plate, an adjusting plate, a height adjusting mechanism and an angle measuring mechanism, wherein the adjusting plate is arranged above the positioning bottom plate in parallel through the height adjusting mechanism and is adjustable in height; an angle measuring mechanism is fixed above the second through hole, the adjusting plate is located at the initial position, the center point of the angle measuring mechanism is overlapped with the circle center of the first through hole, and the center point of the angle measuring mechanism moves on the axis along with the change of the height of the adjusting plate. The invention also provides a device for improving the lumbar puncture precision of the medial lateral approach. The invention has the advantages that: the invention enables the puncture needle to carry out angle adjustment in two directions which are not on the same horizontal plane, and provides accurate measurement for the angle adjustment after needle insertion, thereby improving the success rate of puncture.

Description

Auxiliary positioner and device for improving lumbar puncture precision of lateral median approach

Technical Field

The invention relates to the technical field of lumbar puncture, in particular to an auxiliary positioner and a device for improving the lumbar puncture precision of a medial lateral approach.

Background

Changes in the composition of cerebrospinal fluid can be caused by pathological changes in any part of the central nervous system, such as infection, inflammation, tumor, trauma, edema, and obstruction. Through the examination of cerebrospinal fluid, the basis can be provided for the diagnosis, treatment and prognosis judgment of diseases. Therefore, in clinic, the extraction of cerebrospinal fluid through lumbar puncture belongs to the routine bedside diagnosis and treatment operation in neurology department, and is also a skill which must be mastered by a graduate professional in clinic. The traditional lumbar puncture method adopts a posterior medial approach lumbar puncture technology, the success rate of beginners is less than 70%, the learning means is rough, only the standardized die body is primarily learned and the repeated attempts of the body of a patient are made, and the pain of the patient and family members is increased. Another lumbar puncture method proposed by a small number of neurologists in the prior art adopts a lateral median approach lumbar puncture technology, which has the advantage that a puncture target (a dural sac) is exposed more, so that the puncture fault tolerance range is improved, namely, the range of needle insertion points is wider. However, even in this case, since the position of the spinal canal is invisible to the naked eye, how to adjust the proper needle insertion angle avoids the injury caused by puncturing the supraspinous ligament and the interspinous ligament, and for clinical medical personnel with insufficient clinical experience, the puncture fails due to inaccurate angle control, which increases the pain of the patient.

In the conventional puncture auxiliary tool, the epidermis of a human body is mostly used as a reference plane where the central point of an angle measuring mechanism is located, the puncture angle is measured, and the needle is inserted after the measurement is determined. For example, the publication No. CN209236321U is entitled "positioning device for puncturing lumbar intervertebral disc and thoracolumbar pedicle", and the publication No. CN205514802U is entitled "positioning device for puncturing lumbar intervertebral disc through percutaneous approach to vertebra". However, when the puncture needle is inserted, the puncture needle needs to pass through the skin, the fascia layer and the ligament layer in sequence, and then the puncture needle penetrates the dura mater and reaches the subarachnoid space, wherein the skin comprises an epidermal layer, a dermal layer and a subcutaneous tissue, the subcutaneous tissue is the thickest layer of the skin and consists of loose connective tissue and adipose tissue, and the tissue of the layer is loose and rich in blood vessels, so that the skin has certain mobility, even if a medical worker determines the needle insertion angle by using a positioner, the actual puncture angle can deviate from the measured angle before puncture due to the slippage of the subcutaneous tissue, thereby causing puncture failure, particularly for obese patients, the subcutaneous tissue is thickened, the puncture angle is easy to change due to the slippage, and the puncture success rate can be greatly reduced.

Disclosure of Invention

In order to solve the above problems, an object of the present invention is to provide an auxiliary positioner for improving the accuracy of lumbar puncture in a medial approach, which enables a puncture needle to be angularly adjusted in two directions different from the same horizontal plane, and provides accurate measurement for angular adjustment after needle insertion, thereby improving the success rate of puncture.

In order to achieve the purpose, the invention adopts the following technical scheme:

technical scheme one

An auxiliary positioner for improving the lumbar puncture precision of a lateral median approach comprises a positioning bottom plate, an adjusting plate, a height adjusting mechanism and an angle measuring mechanism, wherein the adjusting plate is arranged above the positioning bottom plate in parallel through the height adjusting mechanism and is adjustable in height; the angle measuring mechanism is fixed above the second through hole, the adjusting plate is located at the initial position, the central point O of the angle measuring mechanism coincides with the circle center of the first through hole, and the central point O of the angle measuring mechanism follows the change of the height of the adjusting plate to move on the axis.

Preferably, the angle measuring mechanism comprises a first measuring scale and a second measuring scale which are perpendicular to each other; the first measuring scale is an arc-shaped beam marked with first angle scales, the first measuring scale is bridged above the second through hole, two end parts of the arc-shaped beam are vertically fixed on the adjusting plate, the second measuring scale is an arc-shaped beam marked with second angle scales, the second measuring scale is fixed at the middle point of the first measuring scale, the fixed points of the first measuring scale and the second measuring scale are located on the axis, the adjusting plate is located at the initial position, and the central points O of the first measuring scale and the second measuring scale are coincident with the circle center of the first through hole.

Preferably, the edge of the first through hole is provided with a first notch for needle insertion, the edge of the second through hole is provided with a second notch for needle insertion, and the first notch and the second notch are arranged up and down correspondingly and are located under the second measuring ruler.

Preferably, the first through hole and the second through hole are both semicircular through holes, the first measuring scale is bridged above the semicircular diameter of the second through hole, and one end part of the second measuring scale is vertically fixed at the midpoint of the first measuring scale.

Preferably, the positioning bottom plate is provided with a first semicircular hole for increasing the swing freedom of the puncture needle, the first semicircular hole is positioned at the circle center of the first through hole, the adjusting plate is provided with a second semicircular hole for increasing the swing space of the puncture needle, and the second semicircular hole is positioned at the circle center of the second through hole; and the upper side and the lower side of the first semicircular hole are respectively provided with a strip-shaped through hole.

More preferably, the zero graduation marks of the first angle graduation and the second angle graduation are both positioned on the axis of the first through hole.

Preferably, the height adjusting mechanism comprises a guide post, a limiting base and a locking component, the guide post is vertically fixed on the positioning bottom plate, the limiting base is fixed on the adjusting plate, and the upper end of the guide post penetrates through the adjusting plate and the limiting base; on the guide post, at least one side is equipped with first straight ruler scale, the regulating plate reciprocates along the guide post and will through locking assembly the relative position locking of guide post and spacing base.

Preferably, the locking assembly comprises a group of ratchets, an ejecting piece and two torsion springs; the limiting base is provided with a groove for accommodating the ejecting piece, the ejecting piece comprises a rotating shaft, an ejecting piece and an ejecting rod, the ejecting piece and the ejecting rod are fixed on the side wall of the rotating shaft, the rotating shaft is arranged in the groove, two end parts of the rotating shaft are rotatably connected with the limiting base, each torsion spring is arranged in the limiting base and is respectively positioned at two sides of the rotating shaft, one end part of each torsion spring is fixedly connected with the inner wall of the limiting base, the other end part of each torsion spring is fixedly connected with the end part of the rotating shaft, and the ratchet is arranged at one side edge of the guide post and is matched with the ejecting piece; reset spring is established to the cover on the guide post, reset spring is located regulating plate and location bottom plate, reset spring's original length equals when the regulating plate is located initial position, the height between regulating plate and the location bottom plate.

Preferably, the positioning bottom plate is provided with a third angle scale for assisting in observing the swing angle of the puncture needle, the third angle scale is concentric with the first through hole, the adjusting plate is provided with a fourth angle scale for assisting in observing the swing angle of the puncture needle, and the fourth angle scale is concentric with the second through hole; and a second ruler scale is arranged on the side of the positioning bottom plate far away from the first through hole.

In order to solve the above problems, a second object of the present invention is to provide a device for improving the accuracy of lumbar puncture in a lateral median approach, which can quickly determine the depth of needle insertion, and can provide an accurate measure for the angle adjustment of the puncture needle by using the position of the needle point after needle insertion as the central point O, and can also provide two angle adjustments for the puncture needle in directions different from the same horizontal plane, thereby improving the accuracy of the angle positioning of the puncture needle, and thus improving the success rate of puncture.

In order to solve the above problems, another object of the present invention is to provide a device for improving the accuracy of a paracentesis.

In order to realize the purpose, the invention adopts the following technical scheme:

technical scheme two

The utility model provides an improve device of other median approach lumbar puncture precision, includes a pjncture needle and as technical scheme one the assistance-localization real-time ware, be equipped with a mark A on the outer wall of pjncture needle, distance d between mark A and the needle point B equals initial height h between assistance-localization real-time ware's regulating plate and the location bottom plate.

The invention has the following beneficial effects:

1. according to the auxiliary positioner for improving the accuracy of the lateral-medial approach lumbar puncture, the central point of the angle measuring mechanism can be adjusted through the height adjusting mechanism, so that the central point of the angle measuring mechanism can be adjusted to the needle point according to the needle inserting depth after a puncture needle is inserted, and accurate auxiliary positioning is provided for the angle adjustment of the puncture needle after the needle is inserted, so that the problem that the angle of the puncture needle is measured on the epidermis of a human body in the prior art, puncture failure is caused by puncture angle deviation caused by skin slippage in the puncture process, an accurate and reliable auxiliary positioning function of the puncture needle is provided for clinical medical staff, and the puncture success rate is greatly improved.

2. According to the auxiliary positioner for improving the accuracy of the lateral-medial approach lumbar puncture, the angle measuring mechanism comprises the first measuring scale and the second measuring scale which are perpendicular to each other, so that two angle adjustments in directions which are not on the same horizontal plane can be provided for the puncture needle, and the accuracy of the angle positioning of the puncture needle is improved.

3. The auxiliary positioner for improving the lateral-medial-approach lumbar puncture precision further provides the third angle scale and the fourth angle scale, so that clinical medical personnel can judge the needle inserting angle in an auxiliary manner according to the projection angle of the puncture needle on the adjusting plate and/or the positioning bottom plate, and the positioning precision of the needle inserting angle is further improved.

4. According to the auxiliary positioner for improving the accuracy of the lateral-medial approach lumbar puncture, the zero scale line of the angle measuring mechanism and the puncture needle for vertical puncture are arranged in the same direction, so that the reading is more visual, and the medical staff can conveniently and quickly determine the angle value.

5. The auxiliary positioner for improving the accuracy of lumbar puncture in a lateral approach and a medial approach is simple and convenient to operate in a height adjusting mechanism and capable of quickly and automatically locking the height.

6. The device for improving the accuracy of the lumbar puncture in the lateral-medial approach has the advantages of the auxiliary positioner, can quickly determine the needle insertion depth and adjust the central point of the angle measuring mechanism to the needle point of the puncture needle through the height adjusting mechanism, and is more convenient and faster to operate.

Drawings

FIG. 1 is a perspective view of an auxiliary positioner of the present invention;

FIG. 2 is a side view of an auxiliary positioner of the present invention;

FIG. 3 is a front view of an auxiliary positioner of the present invention;

FIG. 4 is a top view of an auxiliary positioner according to the present invention;

FIG. 5 is a longitudinal cross-sectional view of an auxiliary positioner of the present invention;

FIG. 6 is a schematic view of a positioning base plate and guide posts of an auxiliary positioner according to the present invention;

FIG. 7 is a schematic view of an adjustment plate and an angle measurement mechanism of an auxiliary positioner according to the present invention;

FIG. 8 is a schematic view of a poking member of an auxiliary positioner according to the present invention;

FIG. 9 is a schematic view of a puncture needle with an auxiliary positioner and an auxiliary positioning device according to the present invention;

FIG. 10 is a rear midline alignment of an accessory locator of the present invention;

FIG. 11 is a schematic view of an auxiliary positioner and an auxiliary positioning device according to the present invention before angle adjustment;

FIG. 12 is a schematic view of an auxiliary positioner and an auxiliary positioning device according to the present invention in an angle adjustment mode;

FIG. 13 is an auxiliary positioner of the present invention with return springs and a layer of adhesive;

FIG. 14 is a view of the auxiliary positioner of the present invention with reinforcing bars;

FIG. 15 is a perspective view of another embodiment of an auxiliary positioner according to the present invention;

FIG. 16 is a side view of another embodiment of an auxiliary positioner according to the present invention;

FIG. 17 is a front view of another embodiment of an auxiliary positioner according to the present invention;

FIG. 18 is a top view of another embodiment of an auxiliary positioner according to the present invention;

FIG. 19 is a schematic view of an auxiliary positioner according to another embodiment of the present invention before angle adjustment;

FIG. 20 is a schematic view of another embodiment of an auxiliary positioner for adjusting an angle of a positioning member according to the present invention;

description of reference numerals:

10. positioning a bottom plate; 11. a first through hole; 12. a first semicircular hole; 13. strip-shaped through holes; 14. a first opening; 15. third angle scale; 16. a second ruler scale; 17. a first needle inlet; 18. a poster layer;

20. an adjusting plate; 21. a second through hole; 22. a second semicircular hole; 23. a second gap; 24. a fourth angle is graduated; 25. a second needle inlet;

30. a height adjustment mechanism; 31. a guide post; 311 a first straight scale; 32. a limiting base; 321. a groove; 33. a locking assembly; 331. a ratchet; 332. a kick-out member; 3321. a rotating shaft; 3322. a shifting sheet; 3323. a deflector rod; 34. a positioning column; 35. a limiting groove; 36. an elastic member; 37. a stud; 38. adjusting a screw cap; 39. a return spring;

40. an angle measurement mechanism; 41. a first measuring scale; 411. a first angle scale; 42. a second measuring scale; 421. a second angular scale; 43. a third measuring scale; 44. a fourth measuring scale; 45. a support; 46. reinforcing ribs;

50. puncturing needle; 60. a skin layer; 70. posterior layer of thoracolumbar fascia; 80. posterior midline; A. marking; B. a needle tip; o, a center point; d. a distance; h. an initial height.

Detailed Description

The invention is described in further detail below with reference to the figures and specific examples.

Example one

Referring to fig. 1 to 20, an auxiliary positioner for improving the accuracy of paracentesis of the lumbar spine includes a positioning base plate 10, an adjusting plate 20, a height adjusting mechanism 30 and an angle measuring mechanism 40. The positioning base plate 10 is attached to the human skin layer 60. The skin layer 60 includes epidermis, dermis, and subcutaneous tissue. The adjusting plate 20 passes through height adjusting mechanism 30 parallel set up in positioning bottom plate 10 top and height-adjustable, first through-hole 11 has been seted up on the positioning bottom plate 10, be equipped with second through-hole 21 on the adjusting plate 20, first through-hole 11 and the setting of second through-hole 21 coaxial line. The angle measuring mechanism 40 is fixed above the second through hole 21, the adjusting plate 20 is located at the initial position, the center point O of the angle measuring mechanism 40 coincides with the circle center of the first through hole 11, and the center point O of the angle measuring mechanism 40 follows the change of the height of the adjusting plate 20 to move on the axis.

With the auxiliary positioning device of the embodiment, when lumbar puncture is implemented, accurate measurement can be provided for a puncture angle while the deviation of the puncture angle caused by skin slippage is overcome. Referring to fig. 1, fig. 9 to fig. 12, and fig. 19 to fig. 20, the specific process is as follows:

1) Auxiliary locator initialization: the height of the adjusting plate 20 is adjusted to a set initial position.

In order to conveniently determine the descending height of the adjusting plate 20 according to the depth of the vertical needle insertion, the following preparation is also required: a mark A is made on the puncture needle 50, and the distance d between the mark A and the puncture needle point B is equal to the initial height h of the adjusting plate 20 relative to the positioning bottom plate 10. When the needle is inserted perpendicularly to the posterior layer 70 of the thoracolumbar fascia, a height difference is created between the mark A and the adjustment plate 20. At this time, the height of the adjustment plate 20 is lowered by the height adjustment mechanism 30, and the adjustment plate 20 and the mark a are again in the equal height state. Alternatively, the scale values are set on both the height adjustment mechanism 30 and the puncture needle 50, and when the needle point B reaches the posterior layer 70 of thoracolumbar fascia, the depth value of the needle insertion is read out based on the scale value on the puncture needle 50, and then in response, the height of the adjustment plate 20 is adjusted downward by the height adjustment mechanism 30, and a height value adjusted downward is determined based on the scale value on the height adjustment mechanism 30, which is equal to the depth value of the needle insertion.

2) Determining a puncture point: firstly, determining a posterior midline 80, referring to fig. 10, the posterior midline 80 is a midline drawn along the spine, and the arrow direction points to the cephalic direction; taking the spinous process L4 of the waist 4 as an example, the position of the spinous process L4 of the waist 4 is determined, and the position about 1.2 to 1.5 centimeters beside the upper edge of the spinous process L4 of the waist 4 is determined as a skin needle inserting point.

3) Subcutaneous vertical puncture process: needle 50 is inserted perpendicularly into skin layer 60 from the insertion point until it reaches the posterior layer 70 of thoracolumbar fascia, as shown in fig. 11 and 19. The skin layer 60 is loose and the posterior layer 70 of thoracolumbar fascia is flexible, so that the physician can easily determine that the needle 50 has reached the posterior layer 70 of thoracolumbar fascia. Because the puncture needle 50 vertically punctures the skin, the problem of puncture angle deviation caused by skin slippage during oblique puncture is well solved;

4) Adjusting the needle inserting direction: firstly, using the auxiliary positioner, the puncture needle 50 passes through the first through hole 11 and the second through hole 21, so that the positioning bottom plate 10 is attached to the human skin layer 60; secondly, adjusting the auxiliary positioner to enable the puncture needle 50 to be positioned on the axis; at this time, a height difference is generated between the mark a on the puncture needle 50 and the adjustment plate 20, the height adjustment mechanism 30 is adjusted, and the height of the adjustment plate 20 is lowered, as shown in fig. 11 and 19, so that the adjustment plate 20 and the mark a on the puncture needle 50 are located on the same horizontal plane, or the needle insertion depth is read according to the scale value on the puncture needle 50, and then the lower adjustment height value is determined according to the scale on the height adjustment mechanism 30. After the height adjustment of the adjusting plate 20 is completed, the needle point B of the puncture needle 50 returns to the central point O of the angle measuring mechanism 40 again; referring to fig. 12 and 20, finally, the angle measuring mechanism 40 is used to measure the tilting angle of the puncture needle 50, so that the angle measurement is more accurate. When the puncture needle 50 enters the posterior layer 70 of the thoracolumbar fascia, the puncture needle passes through the relatively unstable skin layer 60, the needle inserting angle is adjusted by the auxiliary positioner, the needle inserting angle is accurately measured, then the needle inserting is continued, and at the moment, the puncture needle 50 passes through the skin layer 60, so that the needle inserting angle can be kept stable in the puncture process.

The auxiliary positioner for improving the accuracy of the lateral medial approach lumbar puncture can assist the lateral medial approach lumbar puncture, when the needle point B of the puncture needle 50 reaches the posterior layer 70 of thoracolumbar fascia, the angle measuring mechanism 40 of the auxiliary positioner adjusts the position through the height adjusting mechanism 30, so that the central point O of the angle measuring mechanism 40 follows the needle point B of the puncture needle 50 to reach the posterior layer 70 of thoracolumbar fascia, and then the angle measuring mechanism 40 is used for adjusting the inclination angle of the needle insertion, so that the measurement of the inclination angle of the needle insertion is more accurate. Meanwhile, the posterior layer 70 of the thoracolumbar fascia is more compact relative to the skin layer 60, the relationship between the anatomical structure and the bony structure is more stable, and after the inclination angle of the needle is measured and determined by the angle measuring mechanism 40, the needle finally enters the dural sac from the gap between the posterior layer 70 of the thoracolumbar fascia and the vertebral plate in the following needle inserting process, and the inclination angle of the needle can be kept stable, so that the success rate of puncture is further improved. The auxiliary positioner for improving the accuracy of lumbar puncture in a lateral medial approach can not only provide accurate and reliable guiding function for medical staff who lack clinical experience, but also greatly improve the success rate of overall puncture.

Example two

The difference between the second embodiment and the first embodiment is that a preferred embodiment of the angle measuring mechanism 40 and the height adjusting mechanism 30 is provided.

Referring to fig. 2 to 5 and fig. 7, the angle measuring mechanism 40 includes a first measuring scale 41 and a second measuring scale 42 perpendicular to each other; the first measuring scale 41 is an arc-shaped beam marked with a first angle scale 411, the first measuring scale is bridged above the second through hole 21, two end parts of the arc-shaped beam are vertically fixed on the adjusting plate 20, the second measuring scale 42 is an arc-shaped beam marked with a second angle scale 421, the second measuring scale 42 is fixed at the middle point of the first measuring scale 41, the fixed points of the first measuring scale 41 and the second measuring scale 42 are located on the axis, the adjusting plate 20 is located at the initial position, the central points O of the first measuring scale 41 and the second measuring scale 42 are coincided with the circle center of the first through hole 11, and the central point O of the angle measuring mechanism 40 moves on the axis along with the change of the height of the adjusting plate 20.

On the first angle scale 411 and the second angle scale 421, an optimal swing angle range may be further marked, for example, the scale lines in the optimal swing angle range are set to be red or green or are widened by thickening, so that a doctor can observe the swing angle range conveniently and determine whether the swing angle falls in the optimal angle range.

Preferably, referring to fig. 6, 7 and 10, the first through hole 11 and the second through hole 21 are both semicircular through holes. Because the puncture needle 50 punctures from one side of the lumbar when puncturing the lumbar, the first through hole 11 and the second through hole 21 are semicircular through holes, so that the joint area of the positioning bottom plate 10 of the auxiliary positioner and the human body is larger, the use is more convenient, and the structure is simpler and more beautiful. The first measuring ruler 41 is spanned above the semicircular diameter of the second through hole 21, and one end part of the second measuring ruler 42 is vertically fixed at the midpoint of the first measuring ruler 41. The first measuring scale 41 is used for measuring the inclination angle of the puncture needle 50 towards the central line, and the second measuring scale 42 is used for measuring the inclination angle towards the head end. Meanwhile, a first semicircular hole 12 for increasing the swing freedom of the puncture needle 50 is arranged on the positioning bottom plate 10, the first semicircular hole 12 is located at the center of the first through hole 11, a second semicircular hole 22 for increasing the swing space of the puncture needle 50 is arranged on the adjusting plate 20, and the second semicircular hole 22 is located at the center of the second through hole 21. The upper side and the lower side of the first semicircular hole 12 are respectively provided with a strip-shaped through hole 13. The strip-shaped through holes 13 are used for aligning with the posterior median line 80, and one strip-shaped through hole 13 is selected according to the position of the puncture point, namely the left side or the right side of the spinal column, so that the posterior median line 80 falls in the strip-shaped through hole 13, as shown in fig. 10.

When the angle measuring mechanism 40 measures the needle insertion angle, the puncture needle 50 is first brought close to the intersection point of the first measuring scale 41 and the second measuring scale 42, so that the puncture needle 50 is positioned on the axis of the first through hole 11, and then the needle insertion angle is adjusted by using the first angle scale 411 and the second angle scale 421 on the first measuring scale 41 and the second measuring scale 42, for example, the first angle scale 411 on the first measuring scale 41 measures that the puncture needle 50 is inclined towards the rear center line 80 by 15 ± 5 °, and the second angle scale 421 on the second measuring scale 42 measures that the puncture needle 50 is inclined towards the head end by 20 ± 10 °. The angle measuring mechanism 40 has the following advantages: 1. when the lumbar puncture is worn laterally, the puncture needle 50 needs to enter the vertebral canal obliquely and upwards, so that the needle inserting angles can be positioned from the two directions through the first measuring scale 41 and the second measuring scale 42, and the angle measurement is more comprehensive and more accurate. 2. The center point O of the angle measuring mechanism 40 can follow the needle point B of the puncture needle 50 under the adjustment of the height adjusting mechanism 30, so that the measured angle value is more accurate when the angle measuring mechanism 40 measures the needle inserting angle.

Referring to fig. 1, 4, 6 and 7, a third angle scale 15 for assisting in observing the swing angle of the puncture needle 50 is disposed on the positioning bottom plate 10, the third angle scale 15 is concentric with the first through hole 11, a fourth angle scale 24 for assisting in observing the swing angle of the puncture needle 50 is disposed on the adjusting plate 20, and the fourth angle scale 24 is concentric with the second through hole 21. The third angle scale 15 and the fourth angle scale 24 are used for determining the angle value of the puncture needle 50 projected on the positioning bottom plate 10 and the adjusting plate 20. The side of the positioning base plate 10 far from the first through hole 11 is provided with a second ruler scale 16 which can be used for measuring the bypass distance of the needle inserting point when the positioning puncture needle 50 is at the needle inserting point.

Referring to fig. 1, in order to make the operation of inserting the puncture needle 50 into the first through hole 11 and the second through hole 21 easier, in this embodiment, a first notch 14 for inserting the needle is disposed at an edge of the first through hole 11, a second notch 23 for inserting the needle is disposed at an edge of the second through hole 21, and the first notch 14 and the second notch 23 are disposed in an up-down corresponding manner and are located right below the second measuring ruler 42. When the puncture needle 50 vertically penetrates into the posterior layer 70 of the thoracolumbar fascia, the auxiliary positioner enables the puncture needle 50 to enter the first through hole 11 and the second through hole 21 through the first notch 14 and the second notch 23.

Referring to fig. 2, 3 and 5, the height adjusting mechanism 30 includes a guiding column 31, a limiting base 32 and a locking component 33, the guiding column 31 is vertically fixed on the positioning base plate 10, the limiting base 32 is fixed on the adjusting plate 20, and the upper end of the guiding column 31 passes through the adjusting plate 20 and the limiting base 32; at least one side surface of the guide column 31 is provided with a first straight scale 311, the adjusting plate 20 moves up and down along the guide column 31, and the relative positions of the guide column 31 and the limiting base 32 are locked through the locking assembly 33. The start position of the adjusting plate 20 is set to the 0 start position of the first straight scale 311, which facilitates the determination of the start position of the adjusting plate 20 and enables the height value of the adjustment to be measured quickly.

Preferably, referring to fig. 5 and 8, the locking assembly 33 includes a set of ratchet teeth 331, a toggle member 332, and two torsion springs (not shown); the limit base 32 is provided with a groove 321 for accommodating the toggle piece 332, the toggle piece 332 comprises a rotating shaft 3321, a toggle piece 3322 and a toggle rod 3323, the toggle piece 3322 and the toggle rod 3323 are both fixed on the side wall of the rotating shaft 3321, the rotating shaft 3321 is arranged in the groove 321, two end parts of the rotating shaft 3321 are rotatably connected with the limit base 32, each torsion spring is arranged in the limit base 32 and respectively positioned on two sides of the rotating shaft 3321, one end part of each torsion spring is fixedly connected with the inner wall of the limit base 32, the other end part of each torsion spring is fixedly connected with the end part of the rotating shaft 3321, and the ratchet 331 is arranged on one side of the guide column 31 and matched with the toggle piece 3322.

The operation steps of the height adjusting mechanism 30 are as follows: when the adjusting plate 20 needs to be slid downwards, the adjusting plate 20 is pressed downwards, the plectrum 3322 positioned between the ratchets 331 is repeatedly rotated downwards under the action of the downward pressure of the adjusting plate 20, namely rebounding action is carried out, after the plectrum 3322 is confirmed to reach the adjusting position, downward pressure is not applied to the adjusting plate 20, the plectrum 3322 rebounds under the action of a torsion spring and is clamped into a gap between every two adjacent ratchets 331, and the height of the adjusting plate 20 is locked. When the adjusting plate 20 needs to be adjusted back to the initial position, the shift lever 3323 is shifted upwards to enable the shifting piece 3322 to be far away from the ratchet 331, when the adjusting plate 20 is lifted to the initial position, the shift lever 3323 is released, the shifting piece 3322 is clamped into the gap of the ratchet 331, and the adjusting plate 20 is locked at the initial position. The height adjusting mechanism 30 of the present embodiment is easy to operate and can automatically lock the height quickly.

Further, for the convenience that improves regulating plate 20 and reset, reset spring 39 is established to the cover on the guide post 31, reset spring 39 is located regulating plate 20 and location bottom plate 10, when reset spring 39's original length equals regulating plate 20 and is located initial position, regulating plate 20 and the height between the bottom plate 10 of location. When the adjusting plate 20 needs to be adjusted back to the initial position, the shifting rod 3323 is shifted upwards to enable the shifting piece 3322 to be far away from the ratchet 331, the adjusting plate 20 is rapidly restored under the tension action of the return spring 39, the adjusting plate 20 is lifted to the initial position, the shifting rod 3323 is released, the shifting piece 3322 is clamped into the gap of the ratchet 331, and the adjusting plate 20 is locked at the initial position.

Referring to fig. 12, a pasting layer 18 is further disposed on the bottom surface of the positioning base plate 10. After the placement position of the auxiliary positioning device is determined, the release paper on the pasting layer is torn off, the auxiliary positioning device is fixed on the skin, the two hands of a doctor are released, and the puncture operation is more convenient.

Furthermore, the guide post 31 and the positioning base plate 10 are detachably and fixedly connected, for example, by a snap-fit method: the positioning bottom plate 10 is provided with a notch for accommodating the bottom of the guide post 31, the inner wall of the periphery of the notch is provided with a clamping groove, the outer wall of the bottom of the guide post 31 is provided with a clamping protrusion, and the clamping protrusion is embedded into the clamping groove, so that the guide post 31 is fixed on the positioning bottom plate 10. Because the positioning bottom plate 10 and the height adjusting mechanism 30 are detachable, and the height adjusting mechanism 30 and the adjusting plate 20 are in detachable connection, the difficulty of the production process can be reduced, and the portable outdoor air conditioner can be carried conveniently.

Referring to fig. 13, in order to improve the stability of the angle measuring mechanism 40, a rib 46 is disposed between the first measuring ruler 41 and the limiting base 32, so as to improve the stability and firmness of the first measuring ruler 41 and the second measuring ruler 42.

The auxiliary positioner can be made of transparent materials and can also be made of non-transparent materials.

The second embodiment has the following advantages in addition to the advantages of the first embodiment: 1. the angle measuring mechanism 40 can provide two angle measurements in directions different from the same horizontal plane for the puncture needle 50, and can assist in judging the needle inserting angle according to the projection angle of the puncture needle 50 on the adjusting plate and/or the positioning bottom plate, so that the positioning accuracy of the needle inserting angle is greatly improved; 2. when the height adjusting mechanism 30 is used for adjusting the height, the operation is simple and convenient, and the position of the adjusting plate 20 can be quickly locked; 3. the positioning bottom plate 10 is provided with second ruler scales 16, so that the side-by-side distance of the needle inserting point can be conveniently measured; 4. the positioning bottom plate 10 is provided with a strip-shaped through hole 13, and the strip-shaped through hole is aligned with the rear median line 80, so that the placing position of the auxiliary positioner can be quickly determined.

EXAMPLE III

The difference between the first and third embodiments of the present invention is that another embodiment of the angle measuring mechanism 40 and the height adjusting mechanism 30 is provided.

Referring to fig. 15 to 20, the angle measuring mechanism 40 includes a third measuring ruler 43 and a fourth measuring ruler 44 disposed up and down and crossed with each other, and both ends of the third measuring ruler 43 and the fourth measuring ruler 44 are fixed on the adjusting plate 20. In the present embodiment, both ends of the third measuring tape 43 and the fourth measuring tape 44 are fixed to the adjusting plate 20 by brackets 45. The intersection point of the third measuring tape 43 and the fourth measuring tape 44 and the zero graduation line of the third measuring tape 43 and the fourth measuring tape 44 are both located on the axis of the first through hole 11, that is, the 0 ° value of the third measuring tape 43 and the fourth measuring tape 44 is set at the intersection point. The adjusting plate 20 is located at an initial position, the center points O of the third measuring scale 43 and the fourth measuring scale 44 coincide with the center of the first through hole 11, and the horizontal reference plane where the center points O are located moves on the axis along with the height adjustment of the adjusting plate 20. When the angle measuring mechanism 40 measures the needle insertion angle, the puncture needle 50 is first brought close to the intersection point of the third measuring scale 43 and the fourth measuring scale 44, so that the puncture needle 50 is positioned on the axis of the first through hole 11, and the needle insertion angle is then adjusted by using the angle scale values on the third measuring scale 43 and the fourth measuring scale 44, which is the same as the measuring method of the first measuring scale 41 and the second measuring scale 42 in the second embodiment.

The angle measuring mechanism 40 has the following advantages: 1. when the lumbar puncture side is worn, the puncture needle 50 needs to be obliquely upwards inserted into the spinal canal, so that the needle inserting angles can be positioned from two directions through the third measuring scale 43 and the fourth measuring scale 44, and the angle measurement is more comprehensive and accurate. 2. The zero graduation line is arranged on the axis of the first through hole 11, so that the angle measuring mechanism 40 can read more conveniently when measuring the needle inserting angle of the puncture needle 50. 3. The center point O of the angle measuring mechanism 40 can follow the needle point B of the puncture needle 50 under the adjustment of the height adjusting mechanism 30, which makes the angle measuring mechanism 40 more accurate in measuring the needle insertion angle.

In order to make the operation of inserting the puncture needle 50 into the first through hole 11 and the second through hole 21 easier, in this embodiment, a first needle inlet 17 is formed at the edge of the positioning bottom plate 10, the first needle inlet 17 is communicated with the first through hole 11, a second needle inlet 25 is formed at the edge of the adjusting plate 20, the second needle inlet 25 is communicated with the second through hole 21, and the first needle inlet 17 and the second needle inlet 25 are overlapped up and down. After the puncture needle 50 vertically penetrates into the posterior layer 70 of the thoracolumbar fascia, the auxiliary locator guides the puncture needle 50 into the first through hole 11 and the second through hole 21 through the first needle inlet 17 and the second needle inlet 25.

Height adjustment mechanism 30 includes four reference columns 34, two spacing grooves 35, an elastic component 36, a double-screw bolt 37 and an adjusting nut 38, each the one end interval vertical fixation of reference column 34 on the positioning bottom plate 10, the other end passes adjusting plate 20 and with adjusting plate 20 sliding connection, double-screw bolt 37 top-down passes adjusting plate 20 and one end are fixed on the positioning bottom plate 10, the other end is located adjusting plate 20's top, adjusting nut 38 is located on the double-screw bolt 37 and be located adjusting plate 20's top, the elastic component 36 cover is established on the double-screw bolt 37 and be located between adjusting plate 20 and the positioning bottom plate 10, spacing groove 35 is located respectively positioning bottom plate 10's upper surface with adjusting plate 20's lower bottom surface, the both ends of elastic component 36 pass through spacing groove 35 location. Generally, the elastic member 36 is a spring. The positioning column 34 plays a role in guiding and positioning the up-and-down sliding of the adjusting plate 20. The two limiting grooves 35 enable the elastic element 36 to keep a state of being vertical to the positioning base plate 10 under the action of external force. When the height of the adjusting plate 20 needs to be adjusted downwards, the adjusting nut 38 is rotated to generate downward pressure on the adjusting plate 20, so that the elastic piece 36 is compressed, and the adjusting plate 20 is kept stably descending under the guidance of the positioning column 34.

The third embodiment has the following advantages in addition to the advantages of the first embodiment: 1. the angle measuring mechanism 40 can provide two angle adjustments in directions which are not on the same horizontal plane for the puncture needle 50, so that the positioning accuracy of the needle inserting angle is improved; 2. the angle measuring mechanism 40 takes the needle point B of the puncture needle 50 as a central point O, and takes the direction of the puncture needle 50 as a zero graduation line, so that the angle measurement is more accurate, and the reading of the angle value of the puncture needle 50 is more visual and clear; 3. when the height adjusting mechanism 30 adjusts the height, the operation is simple and convenient, and the lifting is stable.

Based on the same inventive concept, the application also provides a device applied in combination with the auxiliary positioner in the first embodiment, the second embodiment and the third embodiment, which is detailed in the fourth embodiment.

Example four

Referring to fig. 1 to 20, a device for improving the accuracy of a paracentesis lumbar puncture includes a puncture needle 50 and an auxiliary positioner according to the first to third embodiments, wherein a mark a is disposed on an outer wall of the puncture needle 50, and a distance d between the mark a and a needle point B is equal to an initial height h between an adjusting plate 20 of the auxiliary positioner and a positioning bottom plate 10.

The mark A can be marked on the outer wall of the needle rod of the puncture needle of any needle type and is not limited to the needle type shown in fig. 9.

The outer wall of the puncture needle 50 is provided with the mark A, the needle inserting depth can be rapidly determined through the height difference between the mark A and the adjusting plate 20, the central point O of the angle measuring mechanism 40 is adjusted to the needle point B of the puncture needle 50 through the height adjusting mechanism, the operation is more convenient and faster, and the accuracy of the needle inserting angle is ensured.

The method of using the four-point puncture needle 50 in combination with the auxiliary positioner according to the present embodiment is described in the first embodiment, the second embodiment, and the third embodiment.

The fourth embodiment has the advantages of fast determining the needle insertion depth, determining the height of the adjusting plate 20, and the like besides the advantages of the first embodiment, the second embodiment, and the third embodiment.

The above description is only an embodiment of the present invention, and is not intended to limit the scope of the present invention, and all equivalent structural changes made by using the contents of the present specification and the drawings, or directly or indirectly applied to other related technical fields, are included in the scope of the present invention.

Claims

1. The utility model provides an improve assistance-localization real-time way lumbar puncture precision's of other median approach assistance-localization real-time which characterized in that: the device comprises a positioning bottom plate (10), an adjusting plate (20), a height adjusting mechanism (30) and an angle measuring mechanism (40), wherein the adjusting plate (20) is arranged above the positioning bottom plate (10) in parallel through the height adjusting mechanism (30) and is adjustable in height, a first through hole (11) is formed in the positioning bottom plate (10), a second through hole (21) is formed in the adjusting plate (20), and the first through hole (11) and the second through hole (21) are arranged in a coaxial line; the angle measurement mechanism (40) is fixed above the second through hole (21), the adjusting plate (20) is located at the initial position, the center point O of the angle measurement mechanism (40) is overlapped with the circle center of the first through hole (11), and the center point O of the angle measurement mechanism (40) follows the change of the height of the adjusting plate (20) to move on the axis.

2. The auxiliary positioner for improving the accuracy of lumbar puncture of a medial approach of a lateral spine as claimed in claim 1, wherein: the angle measuring mechanism (40) comprises a first measuring scale (41) and a second measuring scale (42) which are perpendicular to each other; the first measuring scale (41) is an arc-shaped beam marked with a first angle scale (411), the first measuring scale is bridged above the second through hole (21), two end parts of the arc-shaped beam are vertically fixed on the adjusting plate (20), the second measuring scale (42) is an arc-shaped beam marked with a second angle scale (421), the second measuring scale (42) is fixed at the middle point of the first measuring scale (41), the fixed points of the first measuring scale (41) and the second measuring scale (42) are located on the axis, the adjusting plate (20) is located at the initial position, and the central points O of the first measuring scale (41) and the second measuring scale (42) are coincided with the circle center of the first through hole (11).

3. The auxiliary positioner for improving the accuracy of lumbar puncture of a medial approach of a lateral spine as claimed in claim 2, wherein: the border of first through-hole (11) is equipped with first opening (14) that are used for inserting the needle, the border of border (21) of second through-hole (21) is equipped with second opening (23) that are used for inserting the needle, first opening (14) and second opening (23) correspond the setting from top to bottom and are located under second measurement chi (42).

4. The auxiliary positioner for improving the accuracy of paracentesis of the lumbar spine in the medial lateral approach of claim 2, wherein: the first through hole (11) and the second through hole (21) are both semicircular through holes, the first measuring scale (41) is bridged above the semicircular diameter of the second through hole (21), and one end part of the second measuring scale (42) is vertically fixed at the midpoint of the first measuring scale (41).

5. The auxiliary positioner for improving the accuracy of lumbar puncture of a medial approach of a lateral spine as claimed in claim 4, wherein: a first semicircular hole (12) used for increasing the swing freedom degree of the puncture needle is formed in the positioning bottom plate (10), the first semicircular hole (12) is located at the circle center of the first through hole (11), a second semicircular hole (22) used for increasing the swing space of the puncture needle is formed in the adjusting plate (20), and the second semicircular hole (22) is located at the circle center of the second through hole (21); the upper side and the lower side of the first semicircular hole (12) are respectively provided with a strip-shaped through hole (13).

6. The auxiliary positioner for improving the accuracy of lumbar puncture of a medial approach of a lateral spine as claimed in claim 2, wherein: the zero scale marks of the first angle scale (411) and the second angle scale (421) are both positioned on the axis.

7. The auxiliary positioner for improving the accuracy of paracentesis of the lumbar spine in the medial lateral approach as claimed in claim 1, wherein: the height adjusting mechanism (30) comprises a guide column (31), a limiting base (32) and a locking component (33), the guide column (31) is vertically fixed on the positioning bottom plate (10), the limiting base (32) is fixed on the adjusting plate (20), and the upper end part of the guide column (31) penetrates through the adjusting plate (20) and the limiting base (32); at least one side surface of the guide column (31) is provided with a first straight scale (311), the adjusting plate (20) moves up and down along the guide column (31) and locks the relative positions of the guide column (31) and the limiting base (32) through the locking assembly (33).

8. The auxiliary positioner for improving the accuracy of lumbar puncture of a medial approach of a patient according to claim 7, wherein: the locking assembly (33) comprises a group of ratchets (331), a poking piece (332) and two torsion springs; the limiting base (32) is provided with a groove (321) for accommodating the ejecting member (332), the ejecting member (332) comprises a rotating shaft (3321), an ejecting piece (3322) and an ejecting rod (3323), the ejecting piece (3322) and the ejecting rod (3323) are fixed on the side wall of the rotating shaft (3321), the rotating shaft (3321) is arranged in the groove (321), two ends of the rotating shaft are rotatably connected with the limiting base (32), each torsion spring is arranged in the limiting base (32) and respectively positioned at two sides of the rotating shaft (3321), one end of each torsion spring is fixedly connected with the inner wall of the limiting base (32), the other end of each torsion spring is fixedly connected with the end of the rotating shaft (3321), and the ratchet (331) is arranged at one side of the guide column (31) and matched with the ejecting piece (3322); reset spring (39) are established to the cover on guide post (31), reset spring (39) are located regulating plate (20) and location bottom plate (10), when the original length of reset spring (39) equals regulating plate (20) and is located initial position, regulating plate (20) and the height between location bottom plate (10).

9. The auxiliary positioner for improving the accuracy of lumbar puncture of a medial approach of a patient according to claim 2, wherein: a third angle scale (15) for assisting in observing the swing angle of the puncture needle is arranged on the positioning bottom plate (10), the third angle scale (15) is concentric with the first through hole (11), a fourth angle scale (24) for assisting in observing the swing angle of the puncture needle is arranged on the adjusting plate (20), and the fourth angle scale (24) is concentric with the second through hole (21); and a second ruler scale (16) is arranged on the side of the positioning bottom plate (10) far away from the first through hole (11).

10. The utility model provides an improve device of other median approach lumbar puncture precision which characterized in that: comprising a puncture needle (50) and an auxiliary locator according to any one of claims 1 to 9, wherein the outer wall of the puncture needle (50) is provided with a mark A, and the distance d between the mark A and the needle point B is equal to the initial height h between an adjusting plate (20) and a locating bottom plate (10) of the auxiliary locator.