CN116019536A

CN116019536A - Ultrasonic indwelling needle positioning and guiding system and method

Info

Publication number: CN116019536A
Application number: CN202310308633.8A
Authority: CN
Inventors: 黄芬; 龚良庚; 左敏静; 涂惠; 范彬
Original assignee: Second Affiliated Hospital to Nanchang University
Current assignee: Second Affiliated Hospital to Nanchang University
Priority date: 2023-03-28
Filing date: 2023-03-28
Publication date: 2023-04-28
Anticipated expiration: 2043-03-28
Also published as: CN116019536B

Abstract

The utility model discloses a needle location guiding system and method are kept somewhere under supersound, wherein, utilize detecting support, the stroke that the locating support set up respectively, angle adjustment system, obtain required needle angle and the coordinate distance of advancing of different vascular degree through the function conversion, adjust the scale of stroke seat and angle seat, because the axle center of angle scale coincides with the axle center of angle seat sliding track, keep somewhere the needle body and ensure the directional needle point position constantly, and because stroke seat adjustment mechanism can match the stroke scale of needle point to the sound beam middle zone distance, thereby obtain accurate needle gesture and carry out the puncture operation, this mode can provide an accurate check positioning standard for the puncture track of needle puncture is kept somewhere under supersound, make the operator easily accurate control needle coordinate, angle and degree of depth between the corresponding relation, promote disposable puncture success rate, promote popularization and application of needle puncture is kept somewhere under supersound.

Description

Ultrasonic indwelling needle positioning and guiding system and method

Technical Field

The invention belongs to the technical field of indwelling needle puncture, and particularly relates to an ultrasonic indwelling needle positioning and guiding system and method.

Background

The operation process of the indwelling needle puncture under the ultrasonic guidance is generally carried out by medical staff skilled in the art, visual puncture is realized under the assistance of ultrasonic development, and an acoustic beam image is used as a needle insertion positioning standard, so that the indwelling needle puncture has very important application value in actual clinic.

In the process of the puncture operation of the indwelling needle under the current ultrasonic guidance, an in-plane method or an out-of-plane method is mainly adopted for puncture, wherein the in-plane method is to insert the indwelling needle in the direction of the needle body parallel to the long axis side surface (rectangular long side surface) of the ultrasonic probe, the whole process of the needle insertion path can be displayed by the long axis detection image of the acoustic beam, and the needle tip depth is easy to control; the out-of-plane method is to insert the needle in the direction of the needle body of the indwelling needle parallel to the short axis side (the side of the rectangular short side) of the ultrasonic probe, so that a complete anatomic view angle can be obtained, and the quick search can be easily visualized.

The two puncture techniques have certain defects at present due to the limitation of puncture instruments, such as that an ultrasonic probe in an in-plane method has a sound beam long axis parallel to the distribution direction of blood vessels of an object, a sound beam plane cannot obtain a better anatomical view angle, once a needle inserting direction deviates from the sound beam plane, a middle needle body part becomes a unique visible part, an operator misjudges the needle body part as a needle point position, thus the needle inserting parallelism is strictly ensured by the operation technique, and the requirements on the operation technique and the error rate are high; the ultrasonic probe in the out-of-plane method can obtain a good anatomic view angle by making the long axis of the acoustic beam perpendicular to the distribution direction of blood vessels of the trunk or limbs of the subject, but can not be used for probing the whole needle body of the indwelling needle perpendicular to the acoustic beam, and the acoustic beam image can only capture a small section of the needle point, so that the whole needle insertion path can not be displayed.

At present, a checking and positioning device for the needle inserting direction of the ultrasonic indwelling needle puncture operation does not appear on the market, the operation method of medical staff is needed to be relied on to finish the work, the medical resource consumed by an operator with a skillful technology is large, the consumption period is long, the unavoidable error rate exists, and the popularization and the application of the ultrasonic indwelling needle puncture operation are not facilitated. Although the existing patent document CN202123073696.5 provides the function of comparing the needle insertion angle by a reference line, the required needle insertion coordinate distances are different due to the individual difference of the target blood vessel depths of different puncture objects, the unilateral angle comparison function is difficult to accurately determine the corresponding matching relation between the needle insertion angle and the needle insertion coordinate distance, an accurate check positioning standard cannot be provided for the puncture track, and the corresponding needle insertion coordinate position still needs to be determined by the hand feeling of operators in the occasion of coping with different blood vessel depths, so that the disposable puncture success rate cannot be ensured; the prior patent document CN201710142454.6 provides a function of automatically inserting a needle by a stepping motor, but the automatic needle inserting speed can be automatically controlled by utilizing a control point of the stepping motor, and the motor cannot completely replace manual work due to the difference of human body reaction in the needle inserting process, meanwhile, the hidden danger of strong advancing needle appears under adverse reaction, the corresponding matching relation between the needle inserting angle, coordinates and blood vessel depth is urgent to the present, an effective checking and positioning scheme cannot be provided, when the needle inserting angle and coordinates which are correspondingly matched are required to be found under different blood vessel depths, fuzzy positioning still needs to be carried out by virtue of operation handfeel, and deviation caused by mismatching of the needle inserting angle, coordinates and corresponding sizes of blood vessel depths cannot truly improve the disposable puncture success rate, so that the core technical problem faced by the existing needle inserting operation under ultrasound cannot be effectively solved.

Therefore, in order to overcome the above-mentioned drawbacks of the existing ultrasonic needle-indwelling puncture technology, a new technical solution is needed to be proposed and improved.

Disclosure of Invention

Aiming at the problems in the prior art, the invention provides an ultrasonic indwelling needle positioning and guiding system and method, which are used for providing an accurate checking and positioning standard for the puncture track of an ultrasonic indwelling needle puncture, so that an operator can easily and accurately control the corresponding matching relation among needle inserting coordinates, angles and depths, the success rate of disposable puncture is improved, the repeated puncture process is effectively avoided, the pain of a patient is reduced, the operation difficulty is reduced, the dependence of the operation technique is eliminated, the related medical resources and the cultivation period are saved, and the popularization and the application of the ultrasonic indwelling needle puncture are promoted.

The invention is implemented by the following technical scheme: the utility model provides an ultrasonic lower indwelling needle positioning and guiding system, includes the detection support, wherein, the detection support middle part is equipped with the mounting bracket of adaptation ultrasonic probe, be equipped with the stroke seat on the detection support, stroke seat forms sliding fit with the stroke chi of transversely arranging, the stroke chi body is equipped with the stroke scale of transverse distribution, stroke chi one end even has the check seat, check seat installs on the locating support, the detection support the locating support is a font support body, and both the font middle part space is applicable to the limbs of placing the puncture object; the top of the positioning bracket is provided with an angle gauge in an arc shape, the arc shape of the angle gauge is bent towards the direction of the detection bracket, the angle gauge is provided with angle scales distributed in an arc array, an angle seat is sleeved on the arc body of the angle gauge, the angle seat is provided with an extension arm, the extension arm extends towards the axis direction of the arc body of the angle gauge, an auxiliary arm at the end part of the extension arm is provided with a clamp holder, and the clamp holder is used for fixing the indwelling needle body; the axis of the arc body of the angle ruler, the axis of the arc sliding track of the angle seat, the axis of the angle scale and the plane of the side surface of the angle seat are all overlapped with the needle inserting point of the retaining needle and are located on the skin surface of the puncture object.

Further, the stroke seat and the stroke ruler are respectively provided with two stroke seats and are symmetrically distributed on two sides of a sound beam central plane of the ultrasonic probe installed on the installation frame, the installation positions of the angle ruler and the extension arm deviate from the sound beam central plane, the end part of the extension arm is provided with an auxiliary arm extending towards the sound beam central plane, the clamp holder is installed on the auxiliary arm, and the detained needle body clamped on the clamp holder is overlapped with the sound beam central plane.

Further, the clamp holder is sleeved on the auxiliary arm to form a longitudinal sliding assembly, a set screw penetrates through the clamp holder, and the clamp holder is made of disposable sterile materials.

Further, the mounting frame is provided with an ultrasonic probe, the outer wall of the ultrasonic probe is wrapped with a layer of disposable sterile packaging bag, and the mounting frame is clamped and attached to the outer side of the sterile packaging bag; the upper part of the aseptic packaging bag is bound by a rope body to seal the upper part of the ultrasonic probe; an inner layer coupling agent is coated between the detection surface of the ultrasonic probe and the aseptic packaging bag, and an outer layer coupling agent is attached to the outer side of the bag wall of the aseptic packaging bag where the inner layer coupling agent is located.

Furthermore, the detection support and the portal frame body of the positioning support are embedded and matched with the bottom of the detection support to form a height adjusting function, the bottom of the detection support is a plane base, and the bottom of the positioning support is a roller base; hinge seats are arranged at the corners of two sides of the door-shaped frame body of the detection support and the corners of two sides of the door-shaped frame body of the positioning support, and the vertical frame bodies at two sides of the door-shaped frame body are in butt joint with the horizontal frame body of the door-shaped frame body through the hinge seats, so that the vertical frame body and the horizontal frame body form a running fit; the plane base, the roller base and the hinge base are all pre-tightened and limited through set screws which penetrate through the plane base, the roller base and the hinge base.

Furthermore, the stroke seat and the angle seat are all pre-tightened and limited with the stroke ruler and the angle ruler through set screws which penetrate through the stroke seat and the angle seat.

Further, the plane of the end face of the stroke seat facing the checking seat coincides with the central plane of the ultrasonic probe, the plane of the end face of the checking seat facing the stroke seat coincides with the 0 scale mark of the stroke scale, and coincides with the needle inlet point of the indwelling needle.

The invention also provides a method for positioning and guiding the indwelling needle under ultrasound, which adopts the positioning and guiding system as described above and comprises the following steps:

S1: the method comprises the steps of enabling limbs of a puncture object to pass through the middle parts of a portal frame body of a detection bracket and a positioning bracket, coating an outer layer couplant on the skin surface of the puncture object, coating an inner layer couplant on the detection surface of an ultrasonic probe, wrapping the ultrasonic probe in a sterile packaging bag, and fixing the ultrasonic probe through a mounting frame, so that the detection surface of the ultrasonic probe, the inner layer couplant, the bag wall of the sterile packaging bag, the outer layer couplant and the skin surface of the puncture object form seamless attachment in sequence; ensuring that a clamp holder for clamping the indwelling needle adopts disposable sterile materials;

s2: ensuring that the long axis of the sound beam of the ultrasonic probe is perpendicular to the distribution direction of the blood vessels of the detected object, so as to implement the preparation work of the needle insertion operation of the out-of-plane method; starting an ultrasonic developing instrument to drive an ultrasonic probe to output detection ultrasonic waves, obtaining an anatomical visual angle developing image of a puncture object by utilizing a long-axis sound beam image, and synchronously adjusting the detection depth of ultrasonic development so as to search the position of a target blood vessel;

s3: after the target blood vessel position is positioned, moving the detection bracket to enable the blood vessel position to be positioned in the center of a development chart, and recording the detection depth x displayed at the moment;

s4: ensuring that the plane of the end face of the travel seat facing the checking seat coincides with the central plane of the ultrasonic probe, pressing the detection bracket to ensure that the base of the detection bracket is tightly adhered to the bed surface, shifting the positioning bracket to ensure that the positioning bracket drives the travel ruler to linearly slide under the guidance of the travel seat, reading the travel value y of the travel scale of the end face of the travel seat facing the checking seat, stopping shifting operation,

S5: the angle seat is shifted to slide on the arc body of the angle ruler, the angle value gamma of the angle scale pointed by the side face of the angle seat is read, shifting operation is stopped, and the angle value gamma meets the following formula:

γ=arctan(x/y)；

s6: ensuring that the detaining needle body penetrates into the clamp holder on the auxiliary arm at the end part of the extension arm, and ensuring that the detaining needle body enters the needle in the inclined angle gamma under the guidance of the clamp holder, thereby implementing the puncturing operation.

Further, in step S1, the rope is tied to the upper portion of the aseptic packaging bag to seal the upper portion of the ultrasonic probe, and the heights of the detection bracket and the positioning bracket are adjusted to ensure that the axis of the angle scale is located on the skin surface of the puncture subject.

Further, in steps S4 and S5, the operations for determining the y and γ values according to the x value are as follows:

when x is less than 10mm, the value of y is greater than x, and the function calculation of gamma is completed by the execution of the computing system;

when x is more than 15mm, the value of y is smaller than x, and the function calculation of gamma is completed by the execution of the computing system;

when x is in accordance with 10 mm-15 mm, the value of y is equal to x, the value of gamma is 45 degrees, the function calculation process of the calculation system is skipped at the moment, and the needle insertion track is determined by adopting an isosceles triangle method.

The beneficial effects of the invention are as follows: the needle position and track can be accurately positioned by utilizing a stroke and angle adjusting system respectively arranged by the detection support and the positioning support and performing conversion operation according to the function of the needle inlet angle, after the blood vessel position and the blood vessel depth are detected by an ultrasonic probe sound beam center image, needle inlet coordinates and inclination angles required by different depths can be converted by utilizing a trigonometric function calculation formula, thereby adjusting the stroke scale of the stroke seat and the angle scale of the angle seat, as the axis of the angle scale coincides with the axis of the sliding track of the angle seat, after the displacement and adjustment of the angle seat, the detained needle body can be constantly ensured to point to the needle inlet point position, and as the adjusting mechanism of the stroke seat can perform matching adjustment according to the stroke scale of the sound beam distance needle inlet point, thereby obtaining accurate needle inlet posture and executing puncture operation.

Drawings

FIG. 1 is a flow chart of a positioning and guiding method according to an embodiment of the invention;

FIG. 2 is a side view of the positioning and guidance system of an embodiment of the invention;

FIG. 3 is a structural elevation view of a positioning guide system in accordance with an embodiment of the present invention;

FIG. 4 is a schematic view of a sterile package according to an embodiment of the present invention;

FIG. 5 is a schematic diagram of a sizing block in accordance with an embodiment of the present invention;

FIG. 6 is a schematic diagram of the principle of puncture positioning in an embodiment of the present invention;

FIG. 7 is a schematic illustration of a puncture trajectory using mid-waist triangulation in accordance with one embodiment of the present invention;

FIG. 8 is a schematic view of a puncture trajectory for a large angle needle insertion method according to an embodiment of the present invention;

FIG. 9 is a schematic illustration of a puncture trajectory for a small angle needle insertion in accordance with one embodiment of the present invention;

FIG. 10 is a schematic diagram illustrating a side tilt state of the positioning guidance system according to an embodiment of the invention;

FIG. 11 is a schematic diagram of a side tilt adjustment of a positioning guidance system in accordance with an embodiment of the invention.

In the figure: the device comprises a 10-detection support, a 10 a-plane base, a 11-mounting rack, a 12-ultrasonic probe, a 12 a-sound beam center plane, a 12 b-inner layer couplant, a 12 c-outer layer couplant, a 13-sterile packaging bag, a 14-rope body, a 20-stroke seat, a 21-stroke ruler, a 21 a-stroke scale, a 21b-0 scale mark, a 30-positioning support, a 30 a-roller base, a 31-checking seat, a 40-angle ruler, a 40 a-angle scale, a 41-angle seat, a 41 a-extension arm, a 41 b-clamp, a 41 c-auxiliary arm, a 42-indwelling needle body, a 42 a-needle inlet point, a 50-hinge seat, a 51-set screw, a 60-puncture object and a 70-target blood vessel.

Detailed Description

The invention is described in further detail below with reference to the drawings.

Example 1

As shown in fig. 2 to 3, an ultrasonic indwelling needle positioning and guiding system comprises a detection support 10, wherein a mounting frame 11 which is matched with an ultrasonic probe 12 is arranged in the middle of the detection support 10, a travel seat 20 is arranged on the detection support 10, the travel seat 20 and a travel ruler 21 which is transversely arranged form sliding fit, a travel scale 21a which is transversely distributed is arranged on a ruler body of the travel ruler 21, one end of the travel ruler 21 is connected with a checking seat 31, the checking seat 31 is arranged on a positioning support 30, the detection support 10 and the positioning support 30 are both in a portal-shaped frame body, the portal-shaped middle space of the detection support 10 and the positioning support 30 are both suitable for placing limbs of a puncture object 60, and the travel ruler 21 slides relative to the travel seat 20 through shifting of the positioning support 30 relative to the detection support 10, so that a travel adjusting function of a needle entering point 42a is formed;

the top of the positioning bracket 30 is provided with an arc-shaped angle gauge 40, the arc-shaped form of the angle gauge 40 bends towards the direction of the detection bracket 10, the angle gauge 40 is provided with arc-shaped array distribution angle scales 40a, an arc-shaped body of the angle gauge 40 is sleeved with an angle seat 41, the angle seat 41 is provided with an extension arm 41a, the extension arm 41a extends towards the axis direction of the arc-shaped body of the angle gauge 40, an auxiliary arm 41c at the end part of the extension arm 41a is provided with a clamp 41b, and the clamp 41b is used for fixing an indwelling needle body; the arc body axle center of the angle ruler 40, the axle center of the arc sliding track of the angle seat 41, the axle center of the angle scale 40a and the plane where the side surface of the angle seat 41 is located are all overlapped with the needle insertion point 42a of the detaining needle and are located on the skin surface of the puncture object 60, so that the angle adjusting function of the needle insertion point 42a is formed by the fact that the detaining needle on the extension arm 41a and the clamp 41b can point to the needle insertion point 42a where the axle center is located at any time in the sliding process of the angle seat 41.

As shown in fig. 3, the stroke seat 20 and the stroke ruler 21 are both provided with two, and are symmetrically distributed on two sides of the sound beam center surface 12a of the ultrasonic probe 12 installed on the installation frame 11, so as to facilitate balance of stroke adjustment actions; the installation positions of the angle gauge 40 and the extension arm 41a deviate from the sound beam center surface 12a, the end part of the extension arm 41a is provided with an auxiliary arm 41c extending towards the sound beam center surface, the clamp 41b is installed on the auxiliary arm 41c, the detaining needle 42 clamped on the clamp 41b is overlapped with the sound beam center surface (clamping can be preferably performed by using a clamping plate or a cylinder structure), so that when an operator performs detaining needle puncturing operation on the sound beam center surface 12a, the angle gauge 40 and the extension arm 41a can provide avoidance for a middle space, hands of the operator can extend into the sound beam center surface 12a to push the detaining needle 42, meanwhile, the auxiliary arm 41c extends towards the middle to ensure that the clamping needle position is kept coincident with the sound beam center surface 12a, and the blood vessel position is positioned on a developed image by taking the sound beam center surface 12a as a reference, so that accurate positioning of the needle entering position is facilitated.

In this embodiment, the holder 41b is sleeved on the auxiliary arm 41c to form a longitudinal sliding assembly, so that the longitudinal sliding of the holder 41b is utilized to ensure that the held remaining needle 42 overlaps the central surface of the acoustic beam, preferably, the initial state of the holder 41b is accurately centered by a projection overlapping method (the forward projection of the needle head and the needle tail are all coincident with the center line of the probe) or a square attaching method (the needle body and the center line of the probe are all attached to the side wall of the vertical line provided by the square); the clamp 41b is provided with a set screw 51 in a penetrating way so as to ensure the stable posture of the clamp 41b after the overlapping adjustment is completed; the holder 41b is made of disposable sterile materials, preferably medical-grade antibacterial resin or sterile plastic, which is beneficial to ensuring that the holder 41b cannot pollute the retaining needle which is clamped and fixed, ensuring the sterile cleanliness of the retaining needle, disassembling the abutting structure of the holder 41b after the work is finished, discarding the holder 41b, replacing the holder 41b with a new holder 41b (in a non-detachable state under sterile packaging) when the next batch operation is finished, and ensuring that devices which are in direct contact with the retaining needle in each puncture operation meet disposable sterile standards.

As shown in fig. 2 to 4, an ultrasonic probe 12 is arranged on a mounting frame 11, a layer of disposable aseptic packaging bag 13 is wrapped on the outer wall of the ultrasonic probe 12, and the mounting frame 11 is clamped and attached to the outer side of the aseptic packaging bag 13; the upper part of the aseptic packaging bag 13 is bound by the rope body 14 to seal the upper part of the ultrasonic probe 12, the ultrasonic probe 12 cannot be thoroughly sterilized due to the mechanism precision, the probe is prevented from being directly contacted with the skin of a subject by the isolation function of the aseptic packaging bag 13, and the aseptic packaging bag 13 in each puncturing operation adopts a brand new disposable aseptic product, so that the sterility cleanliness of puncturing conditions is effectively ensured;

meanwhile, an inner layer couplant 12b is coated between the detection surface of the ultrasonic probe 12 and the sterile packaging bag 13, an outer layer couplant 12c is attached to the outer side of the bag wall of the sterile packaging bag 13 where the inner layer couplant 12b is located, the outer layer couplant 12c is attached to the skin of a detection object, the sterile packaging bag 13 is bound by the rope body 14 to ensure that the sterile packaging bag 13 is tightly attached to the ultrasonic probe 12 and the inner layer couplant 12b, and an ultrasonic channel of the outer layer couplant 12 c-the sterile packaging bag 13 bag wall-the inner layer couplant 12b is formed.

Before the puncturing operation in this embodiment, the detection performance of the ultrasonic probe 12 in the wrapping state of the aseptic packaging bag 13 may be tested first, the test conditions are set up according to the structure shown in fig. 4, the inner layer couplant 12b, the wall of the aseptic packaging bag 13, and the outer layer couplant 12c are used as the ultrasonic conduction medium, the test object is detected by the ultrasonic diagnostic system Site-Rite80, so as to obtain a clear detection image of the blood vessel of the object, at this time, although a layer of aseptic packaging bag 13 is spaced between the ultrasonic probe 12 and the skin surface of the detection object, the wall of the aseptic packaging bag 13 does not cause obvious acoustic wave reflection due to the seamless connection of the inner and outer couplant, the resolution and the recognition of the acoustic beam image are not obviously affected, and the position of the blood vessel can be clearly positioned, the medical staff can normally implement the recognition operation of the ultrasonic imaging map in this aseptic situation, and has the additional aseptic protection advantage.

Therefore, the aseptic protection structure of the aseptic packaging bag 13 provided by the embodiment has better clinical feasibility.

In this embodiment, the portal frame bodies of the detection bracket 10 and the positioning bracket 30 are embedded and matched with the bottoms of the portal frame bodies to form a height adjusting function, so that the axle center of the angle ruler 40 is favorably located on the skin surface of the puncture object 60 through the height adjusting function;

the two side corners of the portal frame body of the detection support 10 and the positioning support 30 are provided with the hinging seats 50, the two side vertical frame bodies of the portal frame body are connected with the horizontal frame body of the portal frame body through the hinging seats 50, the vertical frame body is in rotary fit with the horizontal frame body, the horizontal frame bodies of the detection support 10 and the positioning support 30 can be adjusted to form an inclined posture under the combined action of the rotation function of the hinging seats 50 and the height adjustment function of the frame body base, when an ideal blood vessel of a puncture object deviates to the side of a limb (such as to the inner side of an ulna), the horizontal frame body can be rotated through the connection of the hinging seats 50, so that a probe and a retaining needle can form a side inclined posture, the probe and the retaining needle can detect and enter the limb of the patient from the inclined upper side of the limb of the object, the limb of the patient does not need to be turned outwards greatly, and seamless connection with the surface of the skin can be ensured;

Simultaneously, the plane base 10a and the roller base 30a are pre-tightened and limited by the through set screw 51, the detection bracket 10 and the positioning bracket 30, so that the height after fixed and adjusted is ensured, and the axial center of the angle ruler 40 is stable; the bottom of the detecting bracket 10 is a plane base 10a, and the bottom of the positioning bracket 30 is a roller base 30a, which is beneficial to moving the positioning bracket 30 by taking the detecting bracket 10 as a reference.

In the present embodiment, the stroke seat 20 and the angle seat 41 are pre-tightened and limited by the set screw 51 penetrating the stroke rule 21 and the angle rule 40, and the adjustment size is fixed by screwing the set screw 51 after the adjustment of the stroke rule 21 and the angle rule 40 is completed, so as to ensure the stability of the needle insertion posture.

As shown in fig. 5, the plane of the end face of the travel seat 20 facing the checking seat 31 coincides with the center plane of the ultrasonic probe 12, the plane of the end face of the checking seat 31 facing the travel seat 20 coincides with the 0 scale mark 21b of the travel scale 21a and coincides with the position of the needle insertion point 42a of the indwelling needle, when the operator adjusts the size of the travel ruler 21, the end face of the checking seat 31 can be checked as the view angle reference of the 0 scale mark 21b, the end face of the travel seat 20 is taken as the view angle reference of the travel scale 21a, after the travel scale 21a is read by the view angle reference of the travel seat 20, the end plane of the travel seat 20 coincides with the ultrasonic detection middle area, and the end plane of the checking seat 31 coincides with the position of the needle insertion point 42a, so that the travel scale 21a read by the end face of the travel seat 20 is the distance between the ultrasonic detection middle area and the position of the needle insertion point 42a, thereby realizing the travel adjustment and checking functions of the position of the needle insertion point 42 a.

As shown in fig. 1, this embodiment also provides a positioning and guiding method for an indwelling needle under ultrasound, which adopts the positioning and guiding system as described above, and includes the following steps:

s1: the limbs of a puncture object 60 penetrate through the middle parts of the portal frame bodies of the detection bracket 10 and the positioning bracket 30, an outer layer couplant 12c is coated on the skin surface of the puncture object 60, an inner layer couplant 12b is coated on the detection surface of an ultrasonic probe 12, the ultrasonic probe 12 is wrapped in a sterile packaging bag 13 and fixed through a mounting frame 11, a rope body 14 is bound on the upper part of the sterile packaging bag 13 to seal the upper part of the ultrasonic probe 12, so that the gap between the bag body and the probe is reduced, and the detection surface of the ultrasonic probe 12, the inner layer couplant 12b, the bag wall of the sterile packaging bag 13, the outer layer couplant 12c and the skin surface of the puncture object 60 form seamless adhesion in sequence; the gripper 41b for holding the indwelling needle is ensured to adopt disposable sterile materials, so that sterile detection conditions are set up;

simultaneously, the heights of the detection bracket 10 and the positioning bracket 30 are adjusted to ensure that the axle center of the angle scale 40a is located on the skin surface of the puncture object 60, the set screw 51 is screwed to fix the bracket height, so that the axle center of the angle scale 40 is ensured to be overlapped with the skin surface of the puncture object 60, and the height coordinate of the needle inserting position is stabilized;

S2: ensuring that the long axis of the sound beam of the ultrasonic probe 12 is perpendicular to the distribution direction of the blood vessels of the detected object, thereby carrying out the preparation work of the needle insertion operation by the out-of-plane method; starting an ultrasonic development instrument to drive an ultrasonic probe 12 to output detection ultrasonic waves, obtaining an anatomic visual angle development image of a puncture object 60 by utilizing a long-axis sound beam image, synchronously adjusting the detection depth of ultrasonic development, searching the position of a target blood vessel 70, and obtaining a good anatomic visual angle by utilizing the long-axis sound beam image so as to be beneficial to quickly positioning the target blood vessel 70;

s3: after the position of the target blood vessel 70 is positioned, the detection bracket 10 is moved (the lateral and longitudinal fine adjustment is performed on the bed surface) to enable the blood vessel position to be in the center of the display chart, and the detection depth x of the target blood vessel 70 at the time is recorded;

s4: ensuring that the plane of the end face of the stroke seat 20 facing the checking seat 31 coincides with the longitudinal center plane of the ultrasonic probe 12, pressing the detection bracket 10 to enable the base of the detection bracket to be tightly attached to the bed surface to be fixed, shifting the positioning bracket 30 to drive the stroke ruler 21 to linearly slide under the guidance of the stroke seat 20, reading the stroke value y of the stroke scale 21a of the end face of the stroke seat 20 facing the checking seat 31, stopping shifting operation, and as shown in fig. 5, since the end face of the checking seat 31 coincides with the position of the 0 scale mark 21b and the needle inlet point 42a and the end face of the stroke seat 20 coincides with the sound beam center position of the ultrasonic probe 12, adjusting the position of the sound beam center position to coincide with the position of the target blood vessel 70 in the step S3, so that the stroke value y is the transverse distance between the sound beam center position (the position of the target blood vessel 70) and the position of the needle inlet point 42 a;

S5: shifting the angle seat 41 to enable the angle seat to slide on the arc body of the angle gauge 40, because the center of the sliding track of the angle seat 41 coincides with the axis of the angle gauge 40 and the extension arm 41a points to the axis of the angle gauge 40, the extension arm 41a and the needle inserting direction in the sliding process of the angle seat 41 can be ensured to point to the axis of the angle gauge 40 at any time, the stroke value y obtained by positioning in the step S4 is ensured to be unchanged, and because the positioning principle of the puncture process is shown in fig. 6, the puncture included angle gamma and the ultrasonic detection depth x and the needle inserting distance y form a tangent function relation (tan gamma=x/y), the puncture included angle gamma required by the indwelling needle can be calculated by a function conversion formula gamma=arctan (x/y), preferably, a software calculation system can be used for quick calculation, the angle value of the angle scale 40a corresponding to the side surface of the angle seat 41 is adjusted according to the calculated gamma value, the angle value of the angle seat 41 is equal to the gamma, the accurate indwelling needle inserting angle is ensured, the depth of a target blood vessel 70, the needle inserting distance is matched with the needle inserting angle value, the accurate puncture coordinate is easy to provide a correct positioning coordinate relation of the needle inserting depth and the needle inserting needle positioning coordinate is matched with the needle positioning standard of the needle positioning coordinate of an operator;

S6: by the above steps, the parameters of the travel value and the angle value of the indwelling needle are obtained, so that the indwelling needle can be ensured to accurately reach the target blood vessel 70, at the moment, the indwelling needle body 42 is penetrated into the clamp 41b on the auxiliary arm 41c at the end part of the extension arm 41a, the indwelling needle body 42 is ensured to enter the needle in the inclined angle gamma under the guidance of the clamp 41b, the puncturing operation is carried out, the indwelling needle accurately penetrates into the target blood vessel 70 according to the track shown in fig. 6, and the success rate of disposable puncturing is ensured.

Example two

The difference between the embodiment and the first embodiment lies in setting the reference range of the blood vessel depth, so that the working steps in the depth of the reference range are simplified by the isosceles triangle method, and the high-efficiency working of the puncture process of the indwelling needle under ultrasound is facilitated.

As shown in fig. 1, this embodiment provides a positioning and guiding method for an indwelling needle under ultrasound, and the positioning and guiding system according to the first embodiment is adopted, and includes the following steps:

Meanwhile, the heights of the detection bracket 10 and the positioning bracket 30 are adjusted to ensure that the axle center of the angle scale 40a is located on the skin surface of the puncture object 60, and the height coordinate of the needle inserting position is stabilized;

s3: after the target blood vessel 70 is positioned, the detection bracket 10 is moved (transversely and longitudinally finely adjusted on the bed surface) to enable the blood vessel position to be positioned in the center of a developing diagram, the detection depth x displayed at the moment is recorded, the blood vessel depth required to be punctured in conventional operation is generally 5-20 mm, the centering depth range is set to be a reference range of 10-15 mm, in the embodiment, the measured blood vessel depth x is 12.5mm, and the isosceles triangle method can be directly adopted to determine the needle inserting track because x accords with the reference range;

S4: ensuring that the plane of the end face of the stroke seat 20 facing the checking seat 31 coincides with the central plane of the ultrasonic probe 12, pressing the detection bracket 10 to enable the base of the detection bracket to be tightly attached to the bed surface to be fixed, shifting the positioning bracket 30 to enable the detection bracket to drive the stroke ruler 21 to linearly slide under the guidance of the stroke seat 20, reading the stroke value y of the stroke scale 21a of the end face of the stroke seat 20 facing the checking seat 31, stopping shifting operation, as shown in fig. 5, because the end face of the checking seat 31 coincides with the position of the 0 scale mark 21b and the needle inlet point 42a, and the end face of the stroke seat 20 coincides with the sound beam central position of the ultrasonic probe 12, adjusting the step S3 to enable the sound beam central position to coincide with the position of the target blood vessel 70, so that the stroke value y is the transverse distance between the sound beam central position (the position of the target blood vessel 70) and the position of the needle inlet point 42a, and because the blood vessel depth x accords with the reference range, and the needle inlet track of the isosceles triangle method can directly position the target blood vessel 70, so that the stroke value y takes 12.5mm;

s5: the angle seat 41 is shifted to slide on the arc body of the angle ruler 40, because the center of the sliding track of the angle seat 41 coincides with the axis of the angle ruler 40 and the extension arm 41a points to the axis of the angle ruler 40, the extension arm 41a and the needle inserting direction in the sliding process of the angle seat 41 can be ensured to point to the axis of the angle ruler 40 at any time, the stroke value y obtained by positioning in the step S4 is ensured to be unchanged, the positioning principle of the puncture process is shown in fig. 6, the puncture included angle gamma forms a tangent function relation with the ultrasonic detection depth x and the needle inserting distance y (tan gamma=x/y), and at the moment, the blood vessel depth x accords with the reference range, the target blood vessel 70 can be directly positioned through the needle inserting track of the isosceles triangle method, so that the angle value gamma takes 45 degrees, and the triangle track shown in fig. 6 is equivalent to the isosceles triangle track shown in fig. 7, so that the accurate indwelling needle inserting angle value is obtained.

S6: the steps are adopted to obtain that the indwelling needle advances to advance at an inclined angle of 45 degrees at a distance of 12.5mm, the indwelling needle can accurately reach the target blood vessel 70 by means of an isosceles triangle needle advancing track, at the moment, the indwelling needle body 42 is penetrated into the clamp 41b on the auxiliary arm 41c at the end part of the extension arm 41a, the indwelling needle body 42 is ensured to advance at an inclined angle of 45 degrees under the guidance of the clamp 41b, so that the puncture operation is implemented, the track shown in fig. 7 accurately pierces the target blood vessel 70, the success rate of disposable puncture is ensured, the operation process is simplified, and an operator can easily control the accurate needle advancing position, angle and depth.

Example III

The difference between the embodiment and the first embodiment lies in setting the reference range of the blood vessel depth, so as to realize accurate positioning when the blood vessel depth is larger than the reference range, and simultaneously shorten the needle insertion track at a large angle, reduce the pain of the patient under deep puncture and reduce the operation difficulty.

s3: after the target blood vessel 70 is positioned, the detection bracket 10 is moved (transversely and longitudinally finely adjusted on the bed surface) to enable the blood vessel position to be positioned in the center of a display chart, the detection depth x displayed at the moment is recorded, the blood vessel depth required to be punctured in conventional operation is generally 5-20 mm, the centering range is set to be a reference range of 10-15 mm, in the embodiment, the measured blood vessel depth x is 17.5mm, and because the blood vessel depth x is larger than the reference range, a large-angle needle insertion method is required to be adopted to shorten the needle insertion track, so that the pain of a patient is reduced and the operation difficulty is reduced;

S4: ensuring that the plane of the end face of the stroke seat 20 facing the checking seat 31 coincides with the central plane of the ultrasonic probe 12, pressing the detection bracket 10 to enable the base of the detection bracket to be tightly attached to the bed surface to be fixed, shifting the positioning bracket 30 to enable the detection bracket to drive the stroke ruler 21 to linearly slide under the guidance of the stroke seat 20, reading the stroke value y of the stroke scale 21a of the end face of the stroke seat 20 facing the checking seat 31, stopping shifting operation, and as shown in fig. 5, since the end face of the checking seat 31 coincides with the position of the 0 scale mark 21b and the needle feeding point 42a and the end face of the stroke seat 20 coincides with the sound beam central position of the ultrasonic probe 12, adjusting the step S3 to enable the sound beam central position to coincide with the target blood vessel 70, so that the stroke value y is the transverse distance between the sound beam central position (the target blood vessel 70 position) and the needle feeding point 42a position, and since the blood vessel depth x is large, the stroke value y needs to be properly reduced to enable the needle body to be fed at a large angle to prevent the needle feeding track from overlong, and therefore the stroke value y takes 7.5mm;

s5: shifting the angle seat 41 to slide on the arc body of the angle ruler 40, because the center of the sliding track of the angle seat 41 coincides with the axis of the angle ruler 40 and the extension arm 41a points to the axis of the angle ruler 40, the extension arm 41a and the needle inserting direction in the sliding process of the angle seat 41 can be ensured to point to the axis of the angle ruler 40 at any time, the stroke value y obtained by positioning in the step S4 is ensured to be unchanged, as shown in fig. 6, the positioning principle of the puncture process is that the puncture included angle gamma forms a tangent function relation with the ultrasonic detection depth x and the needle inserting distance y (tan gamma=x/y), the gamma value is calculated according to gamma=arctan (x/y), and the gamma=66 DEG 48 'is calculated quickly by a software calculation system, so that the needle inserting angle value gamma takes 66 DEG 48', the triangle track shown in fig. 6 is equivalent to the large-angle needle inserting track shown in fig. 8, thereby obtaining an accurate indwelling needle inserting angle value, and simultaneously effectively limiting the length of the needle inserting track;

S6: the steps are adopted to obtain that the indwelling needle advances into the advancing needle at the pitch of 7.5mm and the inclination angle of 66 degrees 48', at the moment, the indwelling needle body 42 is penetrated into the clamp holder 41b on the auxiliary arm 41c at the end part of the extension arm 41a, the puncturing operation is carried out under the guidance of the clamp holder 41b, the target blood vessel 70 is accurately punctured according to the track shown in fig. 8, the success rate of disposable puncturing is ensured, and simultaneously, the needle advancing track is shortened by utilizing the large-angle needle advancing method, the pain of patients under deep puncturing is reduced, and the operation difficulty is reduced.

Example IV

The difference between the embodiment and the first embodiment is that the reference range of the blood vessel depth is set, so that accurate positioning when the blood vessel depth is smaller than the reference range is realized, and meanwhile, the needle insertion track is prolonged by a small angle so as to be beneficial to ultrasonic probe irradiation positioning, and the stability of the needle body under shallow puncture is ensured.

s3: after the target blood vessel 70 is positioned, the detection bracket 10 is moved (transversely and longitudinally fine-tuned on the bed surface) to enable the blood vessel position to be positioned in the center of a display chart, the detection depth x displayed at the moment is recorded, the blood vessel depth required to be punctured in conventional operation is generally 5-20 mm, the centering range is set to be a reference range of 10-15 mm, in the embodiment, the measured blood vessel depth x is 7.5mm, and a small-angle needle insertion method is required to be adopted to prolong the needle insertion track so as to be beneficial to ultrasonic probe irradiation positioning because the blood vessel depth x is smaller than the reference range, and the stability of a needle body under shallow puncture is ensured;

S4: ensuring that the plane of the end face of the stroke seat 20 facing the checking seat 31 coincides with the central plane of the ultrasonic probe 12, pressing the detection bracket 10 to enable the base of the detection bracket to be tightly attached to the bed surface to be fixed, shifting the positioning bracket 30 to enable the detection bracket to drive the stroke ruler 21 to linearly slide under the guidance of the stroke seat 20, reading the stroke value y of the stroke scale 21a of the end face of the stroke seat 20 facing the checking seat 31, stopping shifting operation, and as shown in fig. 5, since the end face of the checking seat 31 coincides with the position of the 0 scale mark 21b and the needle inlet point 42a and the end face of the stroke seat 20 coincides with the sound beam central position of the ultrasonic probe 12, adjusting the step S3 to enable the sound beam central position to coincide with the target blood vessel 70, so that the stroke value y is the transverse distance between the sound beam central position (the target blood vessel 70 position) and the needle inlet point 42a position, and since the blood vessel depth x is smaller, the stroke value y needs to be properly increased to enable the needle to be inserted at a small angle to ensure the needle stability, and therefore the stroke value y is 17.5mm;

s5: shifting the angle seat 41 to enable the angle seat to slide on the arc body of the angle ruler 40, because the center of a sliding track of the angle seat 41 is coincided with the axis of the angle ruler 40 and the extension arm 41a points to the axis of the angle ruler 40, the extension arm 41a and the needle inserting direction in the sliding process of the angle seat 41 can be ensured to point to the axis of the angle ruler 40 at any time, the stroke value y obtained by positioning in the step S4 is ensured to be unchanged, as shown in the positioning principle of the puncture process in the figure 6, a tangent function relation (tan gamma=x/y) is formed between the puncture included angle gamma and the ultrasonic detection depth x and the needle inserting distance y, a gamma value is calculated according to gamma=arctan (x/y), and gamma=23 DEG 12 'is calculated rapidly through a software computing system, so that the needle inserting angle value gamma takes 23 DEG 12', the triangle track shown in the figure 6 is equivalent to the small-angle needle inserting track shown in the figure 9, so that the accurate remaining needle inserting angle value can be ensured, and the needle inserting track with the small-angle can be ensured to obtain a longer probe area under ultrasonic development, so as to be beneficial to positioning;

S6: the steps are adopted to obtain that the indwelling needle advances into the advancing needle at 17.5mm intervals and a dip angle of 23 degrees 12', at this time, the indwelling needle body 42 is inserted into the clamp 41b on the auxiliary arm 41c at the end part of the extension arm 41a, the puncturing operation is carried out under the guidance of the clamp 41b, the target blood vessel 70 is accurately punctured according to the track shown in fig. 9, the success rate of disposable puncturing is ensured, and simultaneously, the needle advancing track is prolonged by utilizing a large-angle needle advancing method so as to be beneficial to ultrasonic probe positioning, and the stability of the needle body under shallow layer puncturing is ensured.

Example five

The present embodiment differs from the first embodiment in that the sideways state of the positioning guide system is adjusted so as to be suitable for accurate needle insertion when the ideal blood vessel of the puncture subject is biased toward the side of the limb.

As shown in fig. 10, when the ideal blood vessel at the arm of the puncture subject 60 is deviated to the ulna area on the side (as in the right area of fig. 10), at this time, the shifting detection support 10 is moved to raise the left vertical support and lower the right vertical support (the direction is according to fig. 10), under the assistance of the rotation function provided by the hinge seat 50 at the corner of the door-shaped support, the horizontal support in the middle of the door-shaped support 10 is tilted, during actual operation, the fastening screw 51 can be loosened first, the one-side stroke seat 20 is directly held upwards, the other-side stroke seat 20 is pressed downwards, the two-side vertical supports of the detection support 10 and the positioning support 30 are synchronously raised under the connection of the stroke ruler 21, and at the same time, the horizontal support in the middle part can be synchronously tilted by means of the ultrasonic display map, when the ideal blood vessel is displayed at the center of the image in the state of the shallowest depth, the most fit of the puncture subject 60 can be ensured, and then the fastening screw 51 is screwed to ensure the two-side inclined support of the hinge seat 50.

As shown in fig. 11, after the lifting and shifting adjustment of the vertical frames on both sides, the horizontal postures of the detecting support 10 and the positioning support 30 are adjusted from the horizontal postures shown in the state 1 to the side inclined postures shown in the state 2, so that the ultrasonic probe 12 and the retaining needle 42 are both directed to the puncture object 60 in the inclined direction, but since the initial postures of the ultrasonic probe 12 and the retaining needle 42 are deflected, the side inclined ultrasonic probe 12 and the retaining needle 42 are not overlapped in the direction (as shown by the arrow in the state 2 in fig. 11), at this time, the clamp 41b can be slid by the sliding fit of the clamp 41b and the auxiliary arm 41c, and the alignment is performed by the projection overlapping method or the square rule attaching method (as shown in the first embodiment), so that the retaining needle 42 is overlapped again on the sound beam center 12a of the ultrasonic probe 12 to form the arrow overlapping state shown in the state 3 in fig. 11, and then the ultrasonic detection and needle feeding operation are performed from the side inclined direction in the direction shown in fig. 10 (as the same as the first embodiment), so that the positioning guide system can be applied to the side blood vessel of the puncture object 60, so that the arm of the patient does not need to twist the ultrasonic probe 12 to be connected to the skin through the seamless skin surface by the coupling agent.

The above-described embodiments are only preferred embodiments of the present invention, and are not limited in form, but it should be understood that other modifications, variations and equivalents may be made to the embodiments by those skilled in the art, and are intended to be included within the scope of the present invention as defined in the following claims.

Claims

1. The utility model provides an ultrasonic lower keep somewhere needle location guiding system, includes detection support, its characterized in that: the middle part of the detection support is provided with a mounting frame which is matched with the ultrasonic probe, the detection support is provided with a travel seat, the travel seat is in sliding fit with a travel ruler which is transversely arranged, a travel ruler body is provided with travel scales which are transversely distributed, one end of the travel ruler is connected with a checking seat, the checking seat is arranged on a positioning support, the detection support and the positioning support are both of a portal-shaped frame body, and the portal-shaped middle spaces of the detection support and the positioning support are both suitable for placing limbs of a puncture object; the top of the positioning bracket is provided with an angle gauge in an arc shape, the arc shape of the angle gauge is bent towards the direction of the detection bracket, the angle gauge is provided with angle scales distributed in an arc array, an angle seat is sleeved on the arc body of the angle gauge, the angle seat is provided with an extension arm, the extension arm extends towards the axis direction of the arc body of the angle gauge, an auxiliary arm at the end part of the extension arm is provided with a clamp holder, and the clamp holder is used for fixing the indwelling needle body; the axis of the arc body of the angle ruler, the axis of the arc sliding track of the angle seat, the axis of the angle scale and the plane of the side surface of the angle seat are all overlapped with the needle inserting point of the retaining needle and are located on the skin surface of the puncture object.

2. The ultrasound indwelling needle positioning guidance system according to claim 1, wherein: the ultrasonic probe comprises a travel seat, a travel ruler, an angle ruler, a holder and an ultrasonic probe, wherein the travel seat and the travel ruler are respectively provided with two travel rulers, the two travel rulers are respectively symmetrically distributed on two sides of a sound beam central plane of the ultrasonic probe installed on the mounting frame, the installation positions of the angle ruler and the extension arm deviate from the sound beam central plane, the end part of the extension arm is provided with an auxiliary arm extending towards the sound beam central plane, the holder is installed on the auxiliary arm, and a remaining needle body clamped on the holder is overlapped with the sound beam central plane.

3. The ultrasound indwelling needle positioning guidance system according to claim 2, wherein: the clamp holder is sleeved on the auxiliary arm to form a longitudinal sliding assembly, a set screw penetrates through the clamp holder, and the clamp holder is made of disposable sterile materials.

4. The ultrasound indwelling needle positioning guidance system according to claim 1, wherein: the ultrasonic probe is arranged on the mounting frame, the outer wall of the ultrasonic probe is wrapped with a layer of disposable sterile packaging bag, and the mounting frame is clamped and attached to the outer side of the sterile packaging bag; the upper part of the aseptic packaging bag is bound by a rope body to seal the upper part of the ultrasonic probe; an inner layer coupling agent is coated between the detection surface of the ultrasonic probe and the aseptic packaging bag, and an outer layer coupling agent is attached to the outer side of the bag wall of the aseptic packaging bag where the inner layer coupling agent is located.

5. The ultrasound indwelling needle positioning guidance system according to claim 1, wherein: the detection support and the portal frame body of the positioning support are embedded and matched with the bottom of the detection support to form a height adjusting function, the bottom of the detection support is a plane base, and the bottom of the positioning support is a roller base; hinge seats are arranged at the corners of two sides of the door-shaped frame body of the detection support and the corners of two sides of the door-shaped frame body of the positioning support, and the vertical frame bodies at two sides of the door-shaped frame body are in butt joint with the horizontal frame body of the door-shaped frame body through the hinge seats, so that the vertical frame body and the horizontal frame body form a running fit; the plane base, the roller base and the hinge base are all pre-tightened and limited through set screws which penetrate through the plane base, the roller base and the hinge base.

6. The ultrasound indwelling needle positioning guidance system according to claim 1, wherein: the travel seat and the angle seat are all pre-tightened and limited with the travel ruler and the angle ruler through set screws which penetrate through the travel seat and the angle seat.

7. The ultrasound indwelling needle positioning guidance system according to claim 1, wherein: the plane of the end face of the travel seat facing the checking seat coincides with the central plane of the ultrasonic probe, the plane of the end face of the checking seat facing the travel seat coincides with the 0 scale mark of the travel scale and coincides with the needle inlet point of the indwelling needle.

8. A positioning and guiding method for an ultrasonic indwelling needle, using the positioning and guiding system according to any one of claims 1 to 7, characterized in that: the method comprises the following steps:

γ=arctan(x/y)；

9. The method for positioning and guiding an indwelling needle under ultrasound according to claim 8, wherein: in step S1, the rope body is bound on the upper part of the aseptic packaging bag to seal the upper part of the ultrasonic probe, and the heights of the detection bracket and the positioning bracket are adjusted to ensure that the axle center of the angle scale is located on the skin surface of the puncture object.

10. The method for positioning and guiding an indwelling needle under ultrasound according to claim 8, wherein: in steps S4 and S5, the operations for determining the y and γ values according to the x value are as follows: