CN117442174A - Central venous puncture device capable of continuously measuring pressure - Google Patents
Central venous puncture device capable of continuously measuring pressure Download PDFInfo
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- CN117442174A CN117442174A CN202311294961.3A CN202311294961A CN117442174A CN 117442174 A CN117442174 A CN 117442174A CN 202311294961 A CN202311294961 A CN 202311294961A CN 117442174 A CN117442174 A CN 117442174A
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- 238000000034 method Methods 0.000 claims description 21
- 239000003814 drug Substances 0.000 claims description 6
- 239000003146 anticoagulant agent Substances 0.000 claims description 4
- 229940127219 anticoagulant drug Drugs 0.000 claims description 4
- 239000007788 liquid Substances 0.000 claims description 4
- 210000003462 vein Anatomy 0.000 abstract description 19
- 210000001367 artery Anatomy 0.000 abstract description 13
- 210000004369 blood Anatomy 0.000 description 22
- 239000008280 blood Substances 0.000 description 22
- 238000002604 ultrasonography Methods 0.000 description 9
- 238000001802 infusion Methods 0.000 description 6
- 210000005245 right atrium Anatomy 0.000 description 5
- 230000002792 vascular Effects 0.000 description 5
- HTTJABKRGRZYRN-UHFFFAOYSA-N Heparin Chemical compound OC1C(NC(=O)C)C(O)OC(COS(O)(=O)=O)C1OC1C(OS(O)(=O)=O)C(O)C(OC2C(C(OS(O)(=O)=O)C(OC3C(C(O)C(O)C(O3)C(O)=O)OS(O)(=O)=O)C(CO)O2)NS(O)(=O)=O)C(C(O)=O)O1 HTTJABKRGRZYRN-UHFFFAOYSA-N 0.000 description 4
- 229940079593 drug Drugs 0.000 description 4
- 238000004868 gas analysis Methods 0.000 description 4
- 230000036772 blood pressure Effects 0.000 description 3
- 210000004204 blood vessel Anatomy 0.000 description 3
- 229960002897 heparin Drugs 0.000 description 3
- 229920000669 heparin Polymers 0.000 description 3
- 238000001990 intravenous administration Methods 0.000 description 3
- 230000007794 irritation Effects 0.000 description 3
- 230000002093 peripheral effect Effects 0.000 description 3
- 206010016717 Fistula Diseases 0.000 description 2
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 2
- 238000009530 blood pressure measurement Methods 0.000 description 2
- 239000012267 brine Substances 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 230000003890 fistula Effects 0.000 description 2
- 239000012530 fluid Substances 0.000 description 2
- 230000003447 ipsilateral effect Effects 0.000 description 2
- 210000004731 jugular vein Anatomy 0.000 description 2
- 235000016709 nutrition Nutrition 0.000 description 2
- 230000035515 penetration Effects 0.000 description 2
- 210000005259 peripheral blood Anatomy 0.000 description 2
- 239000011886 peripheral blood Substances 0.000 description 2
- 238000010992 reflux Methods 0.000 description 2
- 239000011780 sodium chloride Substances 0.000 description 2
- HPALAKNZSZLMCH-UHFFFAOYSA-M sodium;chloride;hydrate Chemical compound O.[Na+].[Cl-] HPALAKNZSZLMCH-UHFFFAOYSA-M 0.000 description 2
- 239000000243 solution Substances 0.000 description 2
- 210000000115 thoracic cavity Anatomy 0.000 description 2
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 2
- 206010067484 Adverse reaction Diseases 0.000 description 1
- 206010007556 Cardiac failure acute Diseases 0.000 description 1
- 208000028399 Critical Illness Diseases 0.000 description 1
- 102000001554 Hemoglobins Human genes 0.000 description 1
- 108010054147 Hemoglobins Proteins 0.000 description 1
- 229910000831 Steel Inorganic materials 0.000 description 1
- 230000006838 adverse reaction Effects 0.000 description 1
- 208000007502 anemia Diseases 0.000 description 1
- 230000010100 anticoagulation Effects 0.000 description 1
- 230000004872 arterial blood pressure Effects 0.000 description 1
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 210000001715 carotid artery Anatomy 0.000 description 1
- 238000012790 confirmation Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 230000010339 dilation Effects 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 210000003191 femoral vein Anatomy 0.000 description 1
- 239000007789 gas Substances 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 210000005246 left atrium Anatomy 0.000 description 1
- 230000004807 localization Effects 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 238000002483 medication Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 239000001301 oxygen Substances 0.000 description 1
- 229910052760 oxygen Inorganic materials 0.000 description 1
- 201000003144 pneumothorax Diseases 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 230000000541 pulsatile effect Effects 0.000 description 1
- 230000035939 shock Effects 0.000 description 1
- 239000010959 steel Substances 0.000 description 1
- 210000003270 subclavian artery Anatomy 0.000 description 1
- 210000001321 subclavian vein Anatomy 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
- 230000000472 traumatic effect Effects 0.000 description 1
- 238000012285 ultrasound imaging Methods 0.000 description 1
- 230000002227 vasoactive effect Effects 0.000 description 1
- 210000001631 vena cava inferior Anatomy 0.000 description 1
- 210000002620 vena cava superior Anatomy 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/0215—Measuring pressure in heart or blood vessels by means inserted into the body
- A61B5/02152—Measuring pressure in heart or blood vessels by means inserted into the body specially adapted for venous pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Pathology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- General Health & Medical Sciences (AREA)
- Medical Informatics (AREA)
- Animal Behavior & Ethology (AREA)
- Cardiology (AREA)
- Physics & Mathematics (AREA)
- Vascular Medicine (AREA)
- Biophysics (AREA)
- Physiology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
Abstract
The invention discloses a central venous puncture device capable of continuously measuring pressure; comprises a puncture needle, a pressure transducer, a pressure bag, a negative pressure device and a monitor. The puncture needle is provided with a first interface, a second interface and a third interface, wherein the third interface is positioned at the upper end of the puncture needle, the first interface and the second interface are positioned on the side wall of the puncture needle, and the second interface is positioned between the first interface and the third interface. The pressure interface of the pressure transducer is communicated with the first interface through a medical hose, the pressure bag is communicated with the inflow interface of the pressure transducer through another medical hose, and the pressure transducer is electrically connected with the monitor. The invention can display the intravascular pressure at the front end of the puncture needle on the monitor in real time, know the intravascular pressure in real time, and judge whether the position of the puncture needle point is a vein or an artery according to different pressure values and waveforms.
Description
Technical Field
The invention relates to the technical field of medical equipment, in particular to a central venous puncture device capable of continuously measuring pressure.
Background
Central venipuncture is a very important specialty puncture. The central vein refers to the segment of the vein before the right atrium after the superior and inferior vena cava meet. The vein is positioned in the chest cavity and connected with the right atrium, and cannot be directly punctured, so that a vein blood vessel which is close in position and can be punctured through the body surface needs to be selected for puncturing, and the subclavian vein or the internal jugular vein is usually selected as a puncturing access way. Femoral veins may also be selected as the puncture vessel, but because of the relatively long distance from the right atrium, the measurement of central venous pressure is relatively inaccurate and generally less preferred.
Clinically, central venous catheterization is mainly used in the following ways:
1. some critically ill patients require monitoring of central venous pressure and need to be accomplished through a central venous catheter. 2. Patients with critical diseases often need vasoactive drugs for support, or some drugs with larger vascular irritation are applied, peripheral blood vessels cannot tolerate, central veins are thick, blood flow velocity is high, and adverse reactions caused by vascular irritation cannot be caused by the drugs. 3. Some patients who require prolonged fasting require intravenous nutritional support, and these intravenous nutritional medications require infusion through a central venous catheter in order to avoid irritation of peripheral blood vessels. 4. Some critical patients need a large amount of quick fluid infusion and central vein catheterization. Compared with a peripheral vascular indwelling needle, the central venous catheter has thicker lumen, and can meet the requirements on fluid infusion speed and volume. 5. Patients who need long-term infusion treatment and have poor peripheral vascular conditions and cannot leave the peripheral vascular indwelling needle can be infused through the central venous catheter to ensure treatment.
When central venipuncture is performed, various factors in the operation process can cause various complications, wherein the most common is that an artery is wrongly penetrated, and particularly the artery is not found after the artery is wrongly penetrated, and serious consequences are often caused after a dilator is placed. The result of the wrong puncture is serious, and the target vein which is already placed with the tube needs to be confirmed.
It is not uncommon for the arterial catheterization to occur without timely discovery after incorrect arterial access during central venipuncture, once it occurs, the treatment is very troublesome, and serious complications are caused, so that serious influence is caused on patients, and even life is endangered. Thus, it is particularly important to be able to determine the arteriovenous at the first time of penetration without increasing trauma. Thus, the puncture operation efficiency is improved, the complication occurrence rate is reduced, the consumption of medical resources is reduced, and certain economic and social benefits are brought.
Currently, when a blood vessel is subjected to central venipuncture, arteriovenous distinction is mainly achieved by the following methods:
1. color viewing method: i.e. by observing the color of the blood drawn back. The general arterial blood color is bright red, and the venous blood color is dark red, which is the most traditional and commonly used method.
2. Pressure measurement: the most powerful published evidence confirming a guidewire in a vein is pressure measurement. This technique requires connecting a length of intravenous tubing to a catheter or needle that has been placed into the target vessel. Intravascular pressure can be measured by 2 methods: 1) Vertically holding the infusion tube and reading the height of the water column; 2) The infusion tube is connected with the pressure transducer to directly measure pressure.
3. Ultrasonic positioning: currently, relatively more accurate, many specialized communities and guidelines recommend the use of ultrasound guidance to perfect a central venous puncture catheter. Ultrasound is used not only to identify blood vessels, but also to track the entry of a guidewire into the corresponding blood vessel from a skin penetration site. An important function of ultrasound is to confirm the position of the needle tip in real time, because the internal jugular vein can be well visualized when the ultrasound short axis surface is swept, the puncture needle tip and the needle shaft can be visualized in the ultrasound image, and the real-time ultrasound is currently recommended to be used for positioning the needle tip position in real time in the central vein puncture process.
4. Blood gas analysis: the blood gas analysis is carried out on the blood which is withdrawn, and whether the blood is venous blood is generally easy to distinguish according to the blood gas analysis result in the artery and the vein.
However, the above-mentioned arteriovenous distinction method still has the following disadvantages:
1. regarding the color viewing method, the following disturbances may be present:
1) When the strong light irradiates under the shadowless lamp of the operating room, the color of venous blood can be very red.
2) Venous blood may also be reddish in color when there is more saline and less blood in the syringe.
3) When the patient inhales high concentration oxygen or anemia is severe, the venous blood may also be very red in color.
4) Arterial blood may also be dark red if the patient is poorly oxygenated or has low hemoglobin.
5) If the patient's central vein is stenosed and an ipsilateral internal limb fistula is incorporated, the blood in the vein may also be very red when this side is punctured.
2. Regarding manometry, the following disturbances may be present:
1) Venous blood pressure can also be great in patients with acute heart failure, sitting up to breathe.
2) When arterial pressure is low in patients with severe shock, the patients can have no pulsatile bleeding when they pass through the artery by mistake.
3) If the patient's central vein is stenosed and an ipsilateral internal limb fistula is incorporated, the blood pressure in the vein will also be great when this side is punctured.
4) If the needle tip enters the inclined surface of the needle tip in the artery or the needle tip part enters the artery, the pressure is not large.
3. With respect to ultrasound localization, an inexperienced operator may not be able to remotely scan to determine the needle tip position, which may result in false carotid artery, pneumothorax, and other complications. In addition, ultrasound cannot scan thoracic tissue beyond 5 cm depth. The guidewire may be out of the scope of ultrasound confirmation when it passes completely through the venous vessel and reaches the subclavian artery. Likewise, focusing on ultrasound imaging during lancing and disregarding the view of the patient may result in over-penetration.
In addition, there is also a case that the needle is unstable during central venipuncture, and the needle tip moves forward during the process of removing the syringe needle tube and inserting the guide wire. At this time, if not found in time, complications such as arterial dilation, catheter placement into an artery, and the like may occur. As shown in fig. 1. At this time, since the arteriovenous is already confirmed before the steel wire is inserted, the finding is often not timely, and serious consequences are caused. While viewing the right atrium with TEE is considered the most reliable indicator for confirming that the guidewire is in the right atrium, the procedure is complex, traumatic and generally not used.
4. The blood gas analysis is reliable, but the operation time is long, if the blood gas machine is far away, the time is long, and in addition, additional personnel are needed to participate, so that the operation process is time-consuming and labor-consuming and is complicated as a whole.
Disclosure of Invention
Aiming at the defects in the prior art, the invention provides a central venous puncture device capable of continuously measuring pressure; comprises a puncture needle, a pressure transducer, a negative pressure device and a monitor; the puncture needle is provided with a first interface, a second interface and a third interface, the pressure interface of the pressure transducer is communicated with the first interface, the negative pressure device is communicated with the third interface, and the pressure transducer is electrically connected with the monitor.
Preferably, a pressure bag is also included, which communicates with the inflow interface of the pressure transducer. The pressure bag is filled with anticoagulant liquid, and the pressure in the pressure bag is 180-220mmHg.
Preferably, the negative pressure device is a medical injector.
Preferably, the third interface is located at the upper end of the puncture needle, the first interface and the second interface are located at the side wall of the puncture needle, and the second interface is located between the first interface and the third interface.
Preferably, the pressure interface of the pressure transducer is communicated with the first interface, and the inflow interface of the pressure transducer is communicated with the pressure bag through medical hoses respectively.
The beneficial effects of this equipment are embodied in: in the central venipuncture process, the pressure transducer is connected through the side hole of the puncture needle, heparin brine is filled in the puncture needle and the medical hose, and along with the advancement of the puncture needle, the intravascular pressure at the front end of the puncture needle can be displayed on the monitor in real time, the intravascular pressure can be known in real time, and whether the position of the puncture needle point is a vein or an artery can be judged through different pressure values and waveforms. Can effectively avoid the occurrence of serious complications of the arterial catheter caused by misjudgment in the central venous puncture process.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below. Like elements or portions are generally identified by like reference numerals throughout the several figures. In the drawings, elements or portions thereof are not necessarily drawn to scale.
Fig. 1 is a schematic diagram of a central venipuncture in the background art.
Fig. 2 is a schematic structural diagram of the first embodiment.
In the drawing, a puncture needle 1, a pressure transducer 2, a pressure bag 3, a negative pressure device 4, a monitor 5, a first interface 6, a second interface 7, a third interface 8 and a medical hose 9.
Detailed Description
Embodiments of the technical scheme of the present invention will be described in detail below with reference to the accompanying drawings. The following examples are only for more clearly illustrating the technical aspects of the present invention, and thus are merely examples, and are not intended to limit the scope of the present invention.
It is noted that unless otherwise indicated, technical or scientific terms used herein should be given the ordinary meaning as understood by one of ordinary skill in the art to which this invention pertains.
Embodiment one:
as shown in fig. 2, the present embodiment provides a central venous puncture device that can continuously measure pressure; comprises a puncture needle 1, a pressure transducer 2, a pressure bag 3, a negative pressure device 4 and a monitor 5. The puncture needle 1 is provided with a first interface 6, a second interface 7 and a third interface 8, wherein the third interface 8 is positioned at the upper end of the puncture needle 1, the first interface 6 and the second interface 7 are positioned at the side wall of the puncture needle 1, and the second interface 7 is positioned between the first interface 6 and the third interface 8.
The pressure connection of the pressure transducer 2 communicates with the first connection 6 via a medical hose 9, the inflow connection of the pressure bag 3 with the pressure transducer 2 communicates with the further medical hose 9, and the pressure transducer 2 is electrically connected with the monitor 5. The pressure transducer 2 converts the received hydraulic pressure into an electric signal and sends the electric signal to the monitor 5, and the real-time pressure value is displayed by the monitor 5. The pressure bag 3 is filled with anticoagulant liquid medicine, and the pressure in the pressure bag 3 is 180 mmHg to 220mmHg. Wherein, the anticoagulant liquid adopts heparin brine, which has good blood anticoagulation effect.
The negative pressure device 4 is communicated with the third interface 8, specifically, the negative pressure device 4 is a medical injector, and the negative pressure is generated by pulling a piston rod of the medical injector.
Embodiment two:
an embodiment II provides an arteriovenous judgment method in a central venous puncture process, which is based on the central venous puncture device capable of continuously measuring pressure in the embodiment I, and comprises the following steps:
s1, opening a switch of an inflow interface of the pressure bag and the pressure transducer, filling heparin saline into the puncture needle and a medical hose between the puncture needle and the pressure transducer, and closing the switch of the inflow interface, wherein the pressure transducer is not communicated with the pressure bag.
S2, the pressure transducer is fixed at the same horizontal height with the left atrium of the patient, and meanwhile, the numerical value of the pressure transducer is zeroed.
S3, immediately pulling the piston rod for a certain distance after the lower end of the puncture needle is penetrated into the skin of the puncture part, so that a certain negative pressure is formed in the puncture needle.
S4, the puncture needle continues to puncture, the puncturing process is slow, and once blood returns in the puncture needle, the needle insertion is stopped, and meanwhile, the change of the pressure value and the waveform displayed by the monitor are observed.
S5, judging whether the puncture part is an artery or a vein through the pressure value and the waveform of the monitor, if the pressure is too high, the puncture part is an artery, and the puncture part needs to be withdrawn from the puncture needle to be changed for puncture. If the pressure is lower, the vein is formed, and then the guide wire is placed from the second interface, and then the subsequent operation is performed. The second interface is always in a closed state during the whole puncturing process.
The judging method can continuously measure pressure in the whole central venipuncture process, monitor the pressure in the puncture needle in real time, utilize the heparin salt water filled in the blood pressure lumen, and display the intravascular pressure at the front end of the puncture needle on the monitor in real time along with the advancement of the puncture needle, so as to know the intravascular pressure in real time, judge whether the position of the puncture needle point is a vein or an artery according to different pressure values and waveforms, and avoid serious complications of an arterial internal tube caused by misjudgment. In addition, the blood reflux puncture needle is a distance, so that the blood reflux puncture needle is convenient for observing the blood color, and a reference is provided for manually judging the arteriovenous vessels.
Finally, it should be noted that: the above embodiments are only for illustrating the technical solution of the present invention, and not for limiting the same; although the invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical scheme described in the foregoing embodiments can be modified or some or all of the technical features thereof can be replaced by equivalents; such modifications and substitutions do not depart from the spirit of the invention, and are intended to be included within the scope of the appended claims and description.
Claims (10)
1. A central venous puncture device capable of continuously measuring pressure; the method is characterized in that: comprises a puncture needle, a pressure transducer, a negative pressure device and a monitor; the puncture needle is provided with a first interface, a second interface and a third interface, the pressure interface of the pressure transducer is communicated with the first interface, the negative pressure device is communicated with the third interface, and the pressure transducer is electrically connected with the monitor.
2. A continuous pressure measuring central venous puncturing device as claimed in claim 1, wherein: a pressure bag is also included, which communicates with the inflow interface of the pressure transducer.
3. A continuous pressure measuring central venous puncturing device as claimed in claim 1, wherein: the negative pressure device is a medical injector.
4. A continuous pressure measuring central venous puncturing device as claimed in claim 1, wherein: the third interface is positioned at the upper end of the puncture needle.
5. A continuous pressure measuring central venous puncturing device as claimed in claim 4, wherein: the first interface and the second interface are positioned on the side wall of the puncture needle.
6. A continuous pressure measuring central venous puncturing device as claimed in claim 5, wherein: the second interface is located between the first interface and the third interface.
7. A continuous pressure measuring central venous puncturing device as claimed in claim 1, wherein: the pressure interface of the pressure transducer is communicated with the first interface through a medical hose.
8. A continuous pressure measuring central venous puncturing device as claimed in claim 1, wherein: the inflow interface of the pressure transducer is communicated with the pressure bag through another medical hose.
9. A continuous pressure measuring central venous puncturing device as claimed in claim 2, wherein: and anticoagulant liquid medicine is filled in the pressure bag.
10. A continuous pressure measuring central venous puncturing device as claimed in claim 9, wherein: the pressure in the pressure bag is 180-220mmHg.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202311294961.3A CN117442174A (en) | 2023-10-08 | 2023-10-08 | Central venous puncture device capable of continuously measuring pressure |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202311294961.3A CN117442174A (en) | 2023-10-08 | 2023-10-08 | Central venous puncture device capable of continuously measuring pressure |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN117442174A true CN117442174A (en) | 2024-01-26 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202311294961.3A Pending CN117442174A (en) | 2023-10-08 | 2023-10-08 | Central venous puncture device capable of continuously measuring pressure |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN117442174A (en) |
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2023
- 2023-10-08 CN CN202311294961.3A patent/CN117442174A/en active Pending
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