CN202409792U - Positioning guide device with guide wire in subclavicular venous access - Google Patents
Positioning guide device with guide wire in subclavicular venous access Download PDFInfo
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- CN202409792U CN202409792U CN 201120448215 CN201120448215U CN202409792U CN 202409792 U CN202409792 U CN 202409792U CN 201120448215 CN201120448215 CN 201120448215 CN 201120448215 U CN201120448215 U CN 201120448215U CN 202409792 U CN202409792 U CN 202409792U
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- guide wire
- needle
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- guide
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Abstract
A positioning guide device with a guide wire in subclavicular venous access comprises a puncture needle. The puncture needle comprises a puncture needle cylinder, a needle head is arranged at the top end of the needle cylinder, a piston is arranged in the needle cylinder, a needle handle is arranged at the tail of the piston, a guide wire channel is continuously arranged in the needle handle and the piston, the guide wire is arranged in the guide wire channel, the top end of the guide wire penetrates through an inner cavity of the needle cylinder and a needle hole in the needle head, a magnet guide device is arranged on the outer side of the top end of the guide wire, and a gap is reserved between the magnet guide device and the top end of the guide wire. When the top end of the guide wire penetrates through the needle hole, the magnet guide device is placed in front of a sternoclavicular joint on a puncture side of a patient, a venous conduit faces a precava and is ensured to be positioned in the precava as the top end of the guide wire is under the action of magnetic force of the magnet guide device, the guide wire can be prevented from mistakenly entering abnormal portions such as an internal jugular vein, the success rate of subclavicular venepuncture can be increased, the pain of a patient is relieved, and the positioning guide device is safe, non-invasive, economical and environment-friendly.
Description
Technical field
This utility model relates to the mankind life article, relates in particular to medical treatment device, particularly sting device, and concrete is guide wire locating guide device in a kind of subclavian vein tube placing operation.
Background technology
Central vein puncture and intubation art is fast, safely, effectively to set up dark venous access to rescue a kind of important means of critical patient.Be widely used in perioperative blood transfusion and infusion, intravenous hyperalimentation therapy, measurement of central venous pressure, insertion PAC, placed situation such as pacing catheter through vein.Puncture position commonly used have femoral vein, internal jugular vein (Internal Jugular Vein, IJV), subclavian vein (Subclavian Vein Catheterization, SVC).Wherein the subclavian vein approach has advantages such as wall of vein is difficult for subsiding under fixed-site, the shock state, zest is little, patient's limitation of activity is little, be difficult for taking place phlebothrombosis, indwelling catheter time is long, so subclavian vein is put pipe application clinically more and more widely.
Subclavian vein is the continuity of axillary vein; Be the arc back upper place that is positioned at clavicle inboard about 1/3 that slightly makes progress by the 1st rib outer rim; Its rear and internal jugular vein that walks to sternoclavicular joint merges into venae brachiocephalicae, when subclavian vein trend is put pipe, after guide wire is delivered to subclavian vein sternoclavicular joint end; Upwards can get into superior vena cava downwards to internal jugular vein.In the prior art, guide wire is stopped to rebound by blood vessel wall to internal jugular vein, to cause the catheter position mistake in importing process probably.
In the prior art, transposition of vessels incidence rate height is the inherent defect that carries out central vein puncture and intubation art through subclavian vein.Wherein put pipe and the time be strayed into homonymy internal jugular vein proportion (account for whole transposition of vessels 83.3%) at most with subclavian vein.Having has 15% not in placely in the reported literature 13587 example adult subclavian vein punctures, wherein most of conduit gets into internal jugular vein, and it is higher to cause monitoring CVP, even can't measure, and influence is judged the state of an illness.Domestic Fuwai Hospital Anesthesia Department of hospital report right side subclavian vein puncture 90 examples are inferior, and wherein children's's 65 examples are inferior, 44 examples time (67.69%) that do not put in place, 40 routine entering right internal jugular vein distal ends; Adult's 25 examples are inferior, and 4 times (16%) gets into the right internal jugular vein distal end.
Ectopic conduit causes line clogging, conduit damage, thrombophlebitis, angiorrhexis and hemodynamic monitoring error easily, even adverse consequences such as cerebrovascular accident.In the prior art, when being employed in guide wire and inserting J type elbow is pointed to methods such as tail end, the blocking-up of compressing supraclavicular region internal jugular vein and avoid conduit to get into internal jugular vein, but said method all non-100% is effective.And, compressing supraclavicular region when inserting guide wire, the blocking-up of row internal jugular vein still has taboo for the cerebral trauma patient.
Summary of the invention
This utility model problem to be solved provides guide wire locating guide device in a kind of subclavian vein tube placing operation, and the guide wire locating guide device will solve in the prior art technical problem that when subclavian vein carries out central vein puncture and intubation art conduit is strayed into internal jugular vein easily in the described this subclavian vein tube placing operation.
Guide wire locating guide device in this subclavian vein tube placing operation of this utility model comprises a puncture needle, and described puncture needle comprises a piercing needle cartridge; The top of described syringe is provided with a syringe needle; Be provided with a piston in the syringe, the afterbody of described piston is provided with a needle handle, is provided with a guide wire passage in described needle handle and the piston continuously; Be provided with a guide wire in the described guide wire passage; The inner chamber of syringe and the pin hole in the described syringe needle are passed in the top of described guide wire, and wherein, described guide wire is made up of magnetic material; The vertical arranged outside of guide wire has a Magnet guider, is provided with the gap between the top of described Magnet guider and guide wire.
Further, described magnetic material is ferrum or cobalt or nickel.
Further, be set with a lever on the described Magnet guider.
Further, its length direction of described guide wire upper edge is provided with scale.
Further, described Magnet guider is surrounded by a cover layer outward.
The operation principle of this utility model: second scale of guide wire is 20cm, and the 3rd scale is 30cm.When the piercing needle cartridge that is connected with puncture needle did not have pumpback blood, the puncture needle needle point was 17.5cm to the length of needle handle afterbody.Control puncture needle syringe pumpback blood is 3ml (being equivalent to 2.5cm), and at this moment, needle point is 20cm to the length of needle handle afterbody.Under the normal condition, the length male of right subclavian vein is about 4cm, and the women is about 3.8cm, and the diameter male is about lcm, and the women is about 0.8cm.Therefore, generally be no more than 24cm from subclavian vein and internal jugular vein interface port to the longest distance of puncture needle needle handle afterbody.In the puncture and intubation process; (about 20cm when the puncture needle needle point is crossed on the guide wire top; Second scale that is guide wire is just at the afterbody of puncture needle needle handle), the Magnet guider is placed on patient's puncture side sternoclavicular joint the place ahead, at this moment; Guide wire has got into subclavian vein, but does not surpass the interface port of subclavian vein and internal jugular vein.At this moment, the top of guide wire receives the magneticaction of Magnet guider, towards superior vena cava.Guide wire continues to insert (about 25cm behind the certain depth; Between second and third scale of guide wire at the afterbody of puncture needle needle handle); Continuing to insert the guide wire resistance has increase, and this is because Magnet guider and guide wire interact, and has hindered guide wire and has advanced.At this moment, remove the Magnet guider, magnetic action disappears, and guide wire can continue to go deep into smoothly superior vena cava to predetermined graduated, and conduit can not be strayed into internal jugular vein.
This utility model is compared with prior art, and its effect is actively with tangible.This utility model utilization is arranged on the vertical direction of advance of Magnet guider pilot steel wire in the outside, guide wire top; Can be when subclavian vein be put pipe; The pilot steel wire correctly gets into superior vena cava; Avoid being strayed into unusual positions such as internal jugular vein, can obviously improve the success rate of subclavian vein puncture, alleviate patient's misery and financial burden.
Description of drawings
Fig. 1 is the structural representation of guide wire locating guide device in the subclavian vein tube placing operation of this utility model.
Fig. 2 is the localized sketch map of guide wire in the subclavian vein tube placing operation; Shown (about 20cm when the puncture needle needle point is crossed on the guide wire top; Second scale that is guide wire is just at the afterbody of puncture needle needle handle); Put the aseptic Magnet guider of a 2cm*2cm, guiding steel wire in patient's puncture side sternoclavicular joint the place ahead.
Fig. 3 is the localized another one sketch map of guide wire in the subclavian vein tube placing operation; Shown when guide wire and inserted about 25cm (being between second and third scale of guide wire) at the afterbody of puncture needle needle handle; Continuing to insert the guide wire resistance has increase, is that guide wire advances because Magnet guider and guide wire interact obstruction, at this moment; The Magnet guider should be removed, guide wire can be inserted smoothly.
The specific embodiment
Embodiment 1
As shown in Figure 1, guide wire locating guide device in the subclavian vein tube placing operation of this utility model, described this device comprises a puncture needle; Described puncture needle comprises a piercing needle cartridge 1, and the top of described syringe 1 is provided with a syringe needle 2, is provided with a piston 3 in the syringe 1; The afterbody of described piston 3 is provided with a needle handle 4; Be provided with a guide wire passage continuously in described needle handle 4 and the piston 3, be provided with a guide wire 5 in the described guide wire passage, the inner chamber of syringe 1 and the pin hole in the syringe needle 2 are passed in the top of described guide wire 5; Wherein, Being made up of magnetic material of described guide wire 5, the vertical arranged outside of guide wire 5 has a Magnet guider 6, is provided with the gap between the top of described Magnet guider 6 and guide wire 5.
Further, described magnetic material is ferrum or cobalt or nickel.
Further, be set with a lever 7 on the described Magnet guider 6.
Further, its length direction of described guide wire 5 upper edges is provided with scale.
Further, be surrounded by a cover layer outside the described Magnet guider 6.
The operation principle of present embodiment: second scale of guide wire is 20cm, and the 3rd scale is 30cm.When the piercing needle cartridge that is connected with puncture needle did not have pumpback blood, the puncture needle needle point was 17.5cm to the length of needle handle afterbody.Control puncture needle syringe pumpback blood is 3ml (being equivalent to 2.5cm), and at this moment, needle point is 20cm to the length of needle handle afterbody.Under the normal condition, the length male of right subclavian vein is about 4cm, and the women is about 3.8cm, and the diameter male is about lcm, and the women is about 0.8cm.Therefore, generally be no more than 24cm from subclavian vein 8 and internal jugular vein 7 interface ports (venous angle) to the longest distance of puncture needle needle handle afterbody.In the puncture and intubation process; (about 20cm when the puncture needle needle point is crossed on guide wire 5 tops; Second scale that is guide wire 5 is just at the afterbody of puncture needle needle handle), Magnet guider 6 is placed on patient's puncture side sternoclavicular joint the place ahead, at this moment; Guide wire 5 has got into subclavian vein 8, but does not surpass the interface port of subclavian vein 8 and internal jugular vein 7 (venous angle).At this moment, the top of guide wire 5 receives the magneticaction of Magnet guider 6, towards superior vena cava 9.Guide wire 5 continues to insert (about 25cm behind the certain depth; Between second and third scale of guide wire at the afterbody of puncture needle needle handle); Continuing to insert the guide wire resistance has increase, and this is because Magnet guider 6 interacts with guide wire, has hindered guide wire and has advanced.At this moment, remove Magnet guider 6, magnetic action disappears, and guide wire can continue to go deep into superior vena cava 9 to predetermined graduated, and conduit can not be strayed into internal jugular vein 7.
Concrete, like Fig. 2, shown in Figure 3, in clinical, the first-selected right side subclavian vein 8 that punctures is then selected vein 10 punctures under the left collarbone if should not puncture in the right side, and point of puncture is selected this side chain bone mid point below 1～2cm (a horizontal finger).The two upper limb of patient's dorsal position fall in the health both sides; Head turns to the puncture offside slightly; The interscapular region has filled up so that head is faced upward after a while slightly, and the routine disinfection drape changes puncture needle along the point of puncture inserting needle after with 2% lignocaine local anaesthesia, and puncture needle and thoracic wall are 15～30
., be close to needle point upper limb puncture behind sternoclavicular joint behind the clavicle lower edge, limit slow inserting needle limit pumpback; If no blood back, the then slow withdraw of the needle in limit limit pumpback does not retreat to subcutaneous adjustment direction and punctures again as if still there being blood back when wearing to appropriate depth; Its puncture direction is divided a word with a hyphen at the end of a line to the Adam's apple direction one by one, more promptly shows entering subclavian vein 8 in case see the vein blood back, inserts guide wire 5 immediately; When the puncture needle needle point is crossed at guide wire 5 tips (second scale of steel wire just when needle handle 4 afterbodys, about 20cm), put the aseptic Magnet guider 6 of a 2cm x 2cm near breastbone and clavicle place (sternoclavicular joint the place ahead) at patient's puncture side apertura thoracis superior; Continue slowly to insert guide wire 5, when guide wire 5 top resistances have increase (be about 25cm, between second and third scale of guide wire 5 at the afterbody of needle handle 4); Remove Magnet guider 6 by the assistant; Continue to put into guide wire 5 to desired depth, withdraw from puncture needle, insert conduit to desired depth along guide wire 5 then behind the broken skin and (withdraw from guide wire 5 after 15～16cm); Pumpback is seen and is injected anti-freezing liquid 2～3mL malleation tube sealing when blood back is unimpeded in the conduit and connect with calparine cap or connect fluid infusion, fixes simultaneously.Get final product with medical transparent deposited card is fixing at last.When putting pipe, the J type head direction of puncture needle inclined-plane and guide wire 5 is all towards superior vena cava 9.When puncturing, all patients all give cardiac monitoring and monitoring detecting sphygmus and blood oxygen saturation.
Claims (5)
1. guide wire locating guide device in the subclavian vein tube placing operation; Described this device comprises a puncture needle, and described puncture needle comprises a piercing needle cartridge, and the top of described syringe is provided with a syringe needle; Be provided with a piston in the syringe; The afterbody of described piston is provided with a needle handle, is provided with a guide wire passage in described needle handle and the piston continuously, is provided with a guide wire in the described guide wire passage; The inner chamber of syringe and the pin hole in the said syringe needle are passed in the top of described guide wire; It is characterized in that: described guide wire is made up of magnetic material, and the vertical arranged outside of guide wire has a Magnet guider, is provided with the gap between the top of described Magnet guider and guide wire.
2. guide wire locating guide device in the subclavian vein tube placing operation as claimed in claim 1 is characterized in that: described magnetic material is ferrum or cobalt or nickel.
3. guide wire locating guide device in the subclavian vein tube placing operation as claimed in claim 1 is characterized in that: be set with a lever on the described Magnet guider.
4. guide wire locating guide device in the subclavian vein tube placing operation as claimed in claim 1 is characterized in that: its length direction of described guide wire upper edge is provided with scale.
5. guide wire locating guide device in the subclavian vein tube placing operation as claimed in claim 1 is characterized in that: described Magnet guider is surrounded by a cover layer outward.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 201120448215 CN202409792U (en) | 2011-11-14 | 2011-11-14 | Positioning guide device with guide wire in subclavicular venous access |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 201120448215 CN202409792U (en) | 2011-11-14 | 2011-11-14 | Positioning guide device with guide wire in subclavicular venous access |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN202409792U true CN202409792U (en) | 2012-09-05 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 201120448215 Withdrawn - After Issue CN202409792U (en) | 2011-11-14 | 2011-11-14 | Positioning guide device with guide wire in subclavicular venous access |
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| CN (1) | CN202409792U (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103100138A (en) * | 2011-11-14 | 2013-05-15 | 上海交通大学医学院附属仁济医院 | Guiding steel wire guiding method and device in subclavian vein catheterization |
| CN104770361A (en) * | 2015-03-11 | 2015-07-15 | 浙江大学 | Supplied-liver quickly-fixed perfusion device for liver transplant |
-
2011
- 2011-11-14 CN CN 201120448215 patent/CN202409792U/en not_active Withdrawn - After Issue
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103100138A (en) * | 2011-11-14 | 2013-05-15 | 上海交通大学医学院附属仁济医院 | Guiding steel wire guiding method and device in subclavian vein catheterization |
| CN103100138B (en) * | 2011-11-14 | 2015-09-30 | 上海交通大学医学院附属仁济医院 | Guide wire guidance method and device in Inserted subclavian intravenous cather art |
| CN104770361A (en) * | 2015-03-11 | 2015-07-15 | 浙江大学 | Supplied-liver quickly-fixed perfusion device for liver transplant |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| AV01 | Patent right actively abandoned |
Granted publication date: 20120905 Effective date of abandoning: 20150930 |
|
| AV01 | Patent right actively abandoned |
Granted publication date: 20120905 Effective date of abandoning: 20150930 |
|
| RGAV | Abandon patent right to avoid regrant |