Puncture needle guide adjusting mechanism with laser auxiliary positioning function
Technical Field
The utility model belongs to the technical field of among the clinical medicine to organ tissue sample and injection therapy puncture needle auxiliary instrument, concretely relates to can add laser assistance-localization real-time function's pjncture needle direction adjustment mechanism.
Background
The abdominal puncture operation needs to directly puncture a puncture needle into an abdominal cavity from the abdominal anterior wall, has dual functions of diagnosis and treatment, and is one of the commonly used operation techniques in clinical medicine. The abdominal puncture is widely applied in clinic and is suitable for patients suspected of having abdominal organ injury after abdominal trauma; those with symptoms of peritoneal irritation but for reasons not suspected of consuming fenestrations of the tract, bleeding from the abdominal cavity; the etiology of the accumulated fluid in the abdominal cavity is unknown; when a large amount of ascites causes dyspnea or obvious abdominal pain, ascites is properly discharged to relieve symptoms; intraperitoneal administration therapy, peritoneal dialysis, etc. The abdominal cavity puncture art has the difference for other punctures that the abdominal cavity area is big, and the puncture selected point is more, and the puncture is carried out the optional angle more, through characteristics such as the puncture angle span after B ultrasonic scanning location is big, is difficult to handle the accuse to the puncture precision, and the puncture process causes damage visceral organ scheduling problem because of the error easily. Notice No. CN 202010168U and CT location percutaneous kidney puncture frame, its purpose is used for solving the degree of depth and the direction of puncture and is difficult for mastering, the operation degree of difficulty is big, puncture repeatedly and increase the painful problem of intraoperative hemorrhage and patient, including the level bar, L type slide caliper rule and horizontal sliding guide, horizontal sliding guide comprises the guide on sliding block and the sliding block, the sliding block is worn to be adorned on the left side of level bar, L type slide caliper rule is worn to be adorned on the right of level bar, there is the shaft hole on the anterior right of sliding block, the guide clamps in the shaft hole, there is the pjncture needle that both ends stretched out the guide outside in the guide, but this patent scheme is only applicable to the puncture of specific part, be not suitable for and exist the problem that B surpasses location and. A needle puncture guide device of publication No. CN 107106121 a, provided with a guide hole through which the needle passes, inclined at a predetermined angle in a height direction, so as to guide an insertion angle of the needle and keep the insertion angle constant when the needle is punctured to a human body side; and a sliding member slidably coupled to the body; wherein a spacing distance between the ultrasonic medical instrument and the guide hole is adjusted by the relative movement of the body or the slide member so that a target position inserted into the trailing end of the injection needle is located on an entry path of the injection needle. This scheme still exists when the lateral shifting span is great that the direction passageway is kept away from the puncture point when needing the huge and long-distance big inclination location of locating rack structure, causes the terminal easy deviation problem of direction. In addition, the scheme also has poor stability in a mode of locking the guide channel by the single shaft, and the problem of shifting the puncture needle tool caused by shifting the guide channel after positioning is easy to cause, so that the precision is influenced and even the smooth operation is influenced.
The puncture needle applied to the abdominal cavity puncture in the current market consists of a needle core and a cannula sheath, and the safety and the practicability are very important, the head of the puncture needle is provided with a protective sleeve protecting device, the tail of the puncture needle is provided with a compression spring to expand and contract freely, and the puncture needle is provided with an indicating mark, the medical use judges the expansion and contraction condition of the protective sleeve according to the indicating mark during the operation, can effectively protect and avoid the viscera injury caused by the puncture needle, but the diameter of the sleeve sheath is obviously larger than that of the core needle, although can reduce the puncture in-process and come the injury to the group meshbelt, the shortcoming is that the puncture resistance is big, and the operation is inconvenient, has blindness nature, also can cause the tissue injury or unsuccessful because of puncture angle difference and because of the resistance causes puncture incline scheduling problem, the sleeve sheath is because the diameter is big and the surface is comparatively smooth make on it can not be better be fixed in the abdominal wall, produces the landing phenomenon easily, probably influences the operation and goes on smoothly beyond that because of the directional problem of puncture causes.
SUMMERY OF THE UTILITY MODEL
The utility model discloses to the pjncture needle of the abdominocentesis art of being applied to now can exist because of the resistance is big and the guide precision is not accurate enough causes incline or landing scheduling problem in the operation process use, provides a can add pjncture needle direction adjustment mechanism of laser assistance-localization real-time function.
The technical scheme for realizing the purpose is as follows: a puncture needle guiding and adjusting mechanism with laser auxiliary positioning is adopted, the lower end and the upper end of a fixed seat are respectively connected with a lower swing rod group and an upper swing rod group, and the tail ends of the two swing rod groups are provided with a guide sleeve assembly.
Lower swing link group: the lower part of the fixed seat is transversely provided with a shaft hole in a penetrating way and is sleeved with a first lock rod in a matching way, the first lock rod is connected with a lock nut A in a threaded way, two sides of the rear end of the lower part of the main swing rod are respectively provided with the shaft hole and hinged on the first lock rod, and the lock nut A is used for locking or releasing; the two sides of the front end of the lower main swing rod are respectively provided with a shaft hole, a cylindrical rotating body is clamped between the shaft holes on the two sides, two ends of the cylindrical rotating body respectively extend outwards to form a first locking shaft, the locking shafts on the two sides penetrate through the shaft holes on the two sides of the rear end of the lower main swing rod, the lower part is respectively provided with a shaft hole from the two sides of the rear end of the swing rod and hinged on the first locking shaft, and the first locking shafts on the two sides are respectively locked or released through a locking nut B.
Upper swing link group: the upper part of the fixed seat is transversely provided with a shaft hole in a penetrating way and is sleeved with a lock rod II in a matching way, the lock rod II is connected with a lock nut C in a threaded way, two sides of the rear end of the upper part of the main swing rod are respectively provided with the shaft hole and hinged on the lock rod II, and the lock rod II is locked or released through the lock nut C; the two sides of the front end of the upper main swing rod are respectively provided with a shaft hole, a cylindrical rotating body is clamped between the shaft holes on the two sides, two ends of the cylindrical rotating body respectively extend outwards to form a second locking shaft, the locking shafts on the two sides penetrate through the shaft holes on the two sides of the rear end of the upper main swing rod, the upper part is respectively provided with a shaft hole from the two sides of the rear end of the swing rod and hinged on the second locking shaft, and the two locking shafts on the two sides are respectively locked or released through a locking nut D.
The length of the lower main swing rod is the same as that of the lower slave swing rod, the length of the upper main swing rod is the same as that of the upper slave swing rod, a laser is arranged at the hinged position of the lower main swing rod and the lower slave swing rod, a sliding rod or a sliding sleeve is hinged out of the upper main swing rod and the upper slave swing rod, and the sliding sleeve or the sliding rod is fixedly connected with the rear side of the laser in a matched and sleeved mode.
The guide sleeve assembly comprises a tubular guide sleeve, a lower end fixing sleeve and an upper end fixing sleeve are fixedly sleeved at the front end and the rear end of the guide sleeve respectively, radial lower end steering pin shafts are symmetrically fixed on two sides of the lower end fixing sleeve, and radial upper end steering pin shafts are symmetrically fixed on two sides of the upper end fixing sleeve.
And a lower shaft hole is arranged at the front end of the lower driven swing rod, an upper shaft hole is arranged at the front end of the upper driven swing rod, and the upper shaft hole and the lower shaft hole are respectively matched and sleeved with the upper steering pin shaft and the lower steering pin shaft.
The lower part owner pendulum rod, lower part from the pendulum rod, upper portion owner pendulum rod and upper portion from the pendulum rod include left and right sides limit pole respectively and fixed as an organic whole through the connecting rod in middle part, when the locking lever that adjacent pendulum rod corresponds and lock mother connect, set up the shaft hole at both sides limit pole end and add lock mother between the shaft hole of both sides limit pole and support the cover.
The lower end fixing sleeve and the upper end fixing sleeve sleeved on the outer side of the guide sleeve can respectively slide along the guide sleeve and are locked and fixed.
The utility model has the advantages that: the utility model discloses the above-mentioned pjncture needle direction adjustment mechanism who contains laser assistance-localization real-time effectively solves the degree of depth and the difficult grasp of direction of puncture, solves the problem that the repeated puncture that probably appears because of the puncture location operation degree of difficulty causes the art in to bleed and patient's misery, the utility model discloses can set up arbitrary location angle and arbitrary height (in the suitable scope) according to B ultrasonic probe, puncture is implemented to the angle that the insertion angle of syringe needle is the same all the time after the location, makes the target position can be located the route of syringe needle, reduces the puncture operation degree of difficulty, ensures that any operation doctor can both improve the accuracy nature of operation. And can realize the definite of multiple regulation syringe needle puncture position through adjusting the angle of insertion of the syringe needle of uide bushing to human body, convenient to use distinguishes that the operation goes on smoothly.
The utility model is particularly suitable for the abdominal cavity puncture, which can adapt to the large abdominal cavity area and is difficult to select the best angle and position. The utility model discloses a pendulum rod subassembly and latched position can be fixed a position the position that position sleeve pipe extends to enough far away, through the realization after the B ultrasonic scanning location puncture angle span characteristics such as big, can make transmission angle reduce moreover, can realize the selection of puncture angle on a large scale promptly, and the puncture selected point is more, but the puncture carries out the selected angle more.
The utility model discloses can also be close to the puncture injection point as far as possible with the output of uide bushing through removing pendulum rod group and latched position to can shorten the unsettled distance of pjncture needle, can ensure the stability of pjncture needle by the at utmost, solve the puncture precision and be difficult to the accuse, the puncture process causes the injury internal organs scheduling problem because of the error easily.
The utility model discloses can use each other or make up the use through upper portion pendulum rod group and lower part pendulum rod group, realize that the fixed independent control upper portion pendulum rod group of lower part pendulum rod group is organized to lower part pendulum rod, or the simple and convenient regulation mode of the fixed independent control lower part pendulum rod group of upper portion pendulum rod group, also can adjust upper portion pendulum rod group and lower part pendulum rod group simultaneously for adjustment uide bushing pivot angle and height position, the regulation mode is nimble various. The utility model discloses still be applicable to preoperative prepositioning regulation and locking, lock behind the equal lax state of each lock handheld uide bushing regulation location, the governing speed is fast, and the degree of accuracy is high, conveniently adjusts and locks.
The utility model discloses no matter the uide bushing is adjusted any angle and height among the adjusting device, all there are two strong points all the time and are used for retraining the uide bushing, utilize two strong points to improve the stability of uide bushing from the fixed mode in uide bushing both ends.
The utility model discloses can also install the laser instrument from pendulum rod articulated position in lower part owner pendulum rod and lower part, this laser instrument can swing along with the uide bushing swing, and the angle of laser instrument is retrained by slide bar and sliding sleeve, makes laser instrument amplitude of oscillation be half of uide bushing amplitude of oscillation, and the straight line that is laser instrument place is located the central line between uide bushing and the ultrasonic probe axis of B promptly to laser instrument projection extension line is terminal through the puncture point that is located the abdominal cavity.
Drawings
Fig. 1 is a schematic perspective view of the present invention.
Fig. 2 is a schematic front view of the structure of fig. 1.
Fig. 3 is a schematic view of a coupling structure of the swivel sleeve of fig. 1.
Fig. 4 is a schematic cross-sectional structure of fig. 3.
Fig. 5 is a schematic view showing a fixed state of the lower swing link group.
Fig. 6 is a schematic view showing a fixed state of the upper swing link group.
Fig. 7 is a schematic view showing a state where the upper swing link group and the lower swing link group are not fixed.
Reference numbers in the figures: 01 is a fixed seat, 02 is a lower main swing rod, 03 is a lower slave swing rod, 04 is an upper main swing rod, 05 is an upper slave swing rod, 06 is a guide sleeve, 61 is a lower end fixing sleeve, 62 is an upper end fixing sleeve, 63 is a lower end steering pin shaft, 64 is an upper end steering pin shaft, 07 is a B-ultrasonic probe, 91 is a base, 92 is a sleeve rod, 93 is a sliding sleeve, 94 is a laser, 95 is a rotating body, 96 is a lock shaft, 10 is a puncture needle model, 11 is an installation sleeve ring, 12 is a fixed wire, and 13 is a jackscrew. A. B, C, D are locking nuts respectively.
Detailed Description
Before the abdominal puncture operation, a patient firstly carries out chest X-ray and ultrasonic examination, the patient takes a sitting position, faces to a chair back, and has two crossed arms arranged on the chair back and a headrest arm to widen the intercostal space. The patient can adopt a semi-lying position aiming at partial patients who cannot sit up, and the upper arm puncture part on the affected side is lifted to select the part with percussion sound and eliminated breath sound as the puncture point; or using ultrasonic to inspect the determined point and mark the puncture mark, and holding the positioning guide device shown in figure 1 by hand to align the B-ultrasonic probe right above the part to be punctured.
The puncture needle guide adjusting mechanism with the laser auxiliary positioning function shown in the figure 1 comprises a fixing seat and an installation sleeve ring, wherein the fixing seat is of a plane type and comprises two side rods and a connecting plate body at the middle part, the connecting plate body is connected with the installation sleeve ring through a fixing wire, a screw hole is formed in the side face of the installation sleeve ring and a jackscrew is installed on the side face of the installation sleeve ring, a B-type ultrasonic probe is installed behind the installation sleeve ring and is tightly jacked through the jackscrew, and the jackscrew can be one or uniformly distributed in a.
The lower swing rod group comprises a lower main swing rod and a lower slave swing rod, a shaft hole transversely penetrates through the lower portion of the fixing seat, a first locking rod is installed in a matched sleeved mode, a first locking nut A is connected to the first locking rod in a threaded mode, two sides of the rear end of the lower main swing rod are respectively provided with the shaft hole and hinged to the first locking rod, and locking or releasing is achieved through the first locking nut A. As shown in fig. 3 and 4, two sides of the front end of the lower main swing rod are respectively provided with a shaft hole, a cylindrical rotating body is clamped between the shaft holes at the two sides, two ends of the cylindrical rotating body respectively extend outwards to form a first locking shaft, the locking shafts at the two sides penetrate through the shaft holes at the two sides of the rear end of the lower main swing rod, the lower part is respectively provided with a shaft hole from the two sides of the rear end of the swing rod and is hinged on the first locking shaft, and the first locking shafts at the two sides are respectively locked or released through a locking nut B.
The upper swing rod group comprises an upper main swing rod and an upper slave swing rod, a shaft hole is transversely arranged above the fixing seat in a penetrating mode and is matched with a second locking rod in a sleeved mode, a second locking rod is connected to the second locking rod in a threaded mode, two sides of the rear end of the upper main swing rod are respectively provided with the shaft hole and hinged to the second locking rod, and locking or releasing is achieved through the second locking rod. As shown in fig. 3 and 4, two sides of the front end of the upper main swing rod are respectively provided with a shaft hole, a cylindrical rotating body is clamped between the shaft holes of the two sides, two ends of the cylindrical rotating body respectively extend outwards to form a second locking shaft, the locking shafts of the two sides penetrate through the shaft holes of the two sides of the rear end of the upper main swing rod, the upper part is respectively provided with the shaft holes from the two sides of the rear end of the swing rod and is hinged on the second locking shaft, and the two locking shafts of the two sides are respectively locked or released through a locking nut D.
In addition, the length of the lower main swing rod is the same as that of the lower slave swing rod, and the length of the upper main swing rod is the same as that of the upper slave swing rod. Meanwhile, as shown in fig. 1 and 2, a laser is installed at the hinged position of the lower main swing rod and the lower slave swing rod, as shown in fig. 3 and 4, a sliding rod or a sliding sleeve is installed at the hinged position of the upper main swing rod and the upper slave swing rod, and the sliding sleeve or the sliding rod is fixedly connected with the rear side of the laser in a matching and sleeving manner.
The above locking nut A, B, C, D may be used alternatively. For example, as shown in fig. 5, after the lower swing link group is fixed, only the locking nuts C and D are selected to be used, so that only the upper swing link group is adjusted, and at this time, the direction of the guide sleeve assembly can be changed by taking the lower steering pin shaft as a rotation center. For example, as shown in fig. 6, after the upper swing link group is fixed, only the locking nuts a and B are selected to be used, so that only the lower swing link group is adjusted, and at this time, the direction of the guide sleeve assembly can be changed by taking the upper steering pin shaft as a rotation center. For example, the upper swing link group and the lower swing link group shown in fig. 7 are not fixed, at this time, the guide sleeve can be held by hand to adjust any angle and height, and finally, after the guide sleeve is placed at the optimal guide height and guide position, the guide sleeve is locked by only selectively using the locking nuts a and B and the locking nuts C and D. Among the above various regulation modes, can be close to the puncture injection point as far as possible with the output of uide bushing through removing pendulum rod group and latched position to can shorten pjncture needle unsettled distance, can guarantee the stability of pjncture needle by the at utmost, solve the puncture precision and be difficult to handle the accuse, puncture process causes damage internal organs scheduling problem because of the error easily.
The guide sleeve assembly comprises a tubular guide sleeve, a lower end fixing sleeve and an upper end fixing sleeve are fixedly sleeved at the front end and the rear end of the guide sleeve respectively, radial lower end steering pin shafts are symmetrically fixed on two sides of the lower end fixing sleeve, and radial upper end steering pin shafts are symmetrically fixed on two sides of the upper end fixing sleeve. Meanwhile, a lower shaft hole is formed in the lower portion of the front end of the swing rod, an upper shaft hole is formed in the upper portion of the front end of the swing rod, and the upper shaft hole and the lower shaft hole are respectively matched and sleeved with the upper steering pin shaft and the lower steering pin shaft. Or the lower end fixing sleeve and the upper end fixing sleeve sleeved outside the guide sleeve can respectively slide along the guide sleeve and are locked and fixed.
In this embodiment, a laser is installed at a hinged position of a lower main swing rod and a lower slave swing rod, the laser can swing along with the swinging of a guide sleeve, as shown in fig. 2, a sliding sleeve is installed at a hinged position of the lower main swing rod and the lower slave swing rod, a sliding rod is fixedly connected to the upper end of the laser, and the sliding rod is sleeved in the sliding sleeve, so that the angle of the laser is constrained by the sliding rod and the sliding sleeve, the swinging amplitude of the laser is half of the swinging amplitude of the guide sleeve, namely, the straight line of the laser is located on a central line between the guide sleeve and the axis of a B-mode ultrasonic probe, and the projection extension line of the laser passes through the tail end of a puncture point located in an abdominal cavity, namely. So that the laser can be used as a reference for the puncture direction and position.
As shown in figure 1, the guide sleeve is arranged by arranging a lower shaft hole at the front end of the lower driven swing rod and an upper shaft hole at the front end of the upper driven swing rod, and the upper shaft hole and the lower shaft hole are respectively matched and sleeved with the upper steering pin shaft and the lower steering pin shaft. Thereby can drive the uide bushing and rotate when upper pendulum rod subassembly or lower part pendulum rod subassembly motion, set up location angle and arbitrary height in the appropriate scope according to the B ultrasonic probe, puncture is implemented to the angle that inserts the angle that the back syringe needle of location is the same all the time, makes the target location can be located the route of syringe needle, reduces the operation degree of difficulty of puncture operation, ensures that any operation doctor can both improve the accuracy nature of operation. And can realize the definite of multiple regulation syringe needle puncture position through adjusting the angle of insertion of the syringe needle of uide bushing to human body, convenient to use distinguishes that the operation goes on smoothly.
When the abdominal cavity puncture operation is carried out, the local part of the puncture point is disinfected conventionally, the puncture point corresponding to the extending direction of the guide sleeve is used as the center for disinfection, the diameter is about 15 cm, and the disinfection is carried out twice. After the operation instrument is checked and various preparation operations before the operation are carried out, the chest puncture needle is connected with the liquid-extracting injector, and a switch between the chest puncture needle and the liquid-extracting injector is closed to ensure that the chest puncture needle is closed tightly and air-tight. The skin of the puncture part is fixed by the left hand of an operator, the puncture needle is inserted into the guide sleeve by the right hand, the puncture point is only required to be pushed forwards to puncture the abdominal wall through the anesthesia part, when the resistance feeling of the needle point disappears suddenly, the needle point penetrates through the peritoneal wall layer, the device is not required to be fixed by the vascular clamp after the puncture needle passes through the vascular clamp under the supporting effect of the guide sleeve, the operation is simple, and the participation of auxiliary personnel is reduced. The device can adapt to the problem that the abdominal cavity area is large, and the optimal angle and position are difficult to select. Can fix a position the position that the position sleeve pipe extends to enough far through pendulum rod subassembly and latched position, through characteristics such as realization puncture angle span after the B ultrasonic scanning location is big, can make transmission angle reduce moreover, can realize the selection of puncture angle on a large scale promptly, the puncture selected point is more, but the puncture is carried out the selection angle more.
Example 2: on the basis of embodiment 1, the lower main swing rod, the lower slave swing rod, the upper main swing rod and the upper slave swing rod respectively comprise left side rods and right side rods and are fixed into a whole through a middle connecting rod, and when the lock rods and the lock nuts corresponding to the adjacent swing rods are connected, the tail ends of the side rods on the two sides are provided with shaft holes, and a lock nut supporting sleeve is additionally arranged between the shaft holes of the side rods on the two sides. The purpose of this design is to keep each pendulum rod end to have moderate degree elasticity, after addding the lock mother and supporting the cover, the lock mother supports the cover and constitutes locking structure together with corresponding locking lever and lock mother, and is more firm. As can be seen from fig. 1 and 2, in the adjusting device, no matter the guide sleeve is adjusted to any angle and height, two supporting points are always present for restraining the guide sleeve, and the stability of the guide sleeve can be improved by fixing the two supporting points from the two ends of the guide sleeve.
Example 3: on the basis of the embodiment 1, further, the lower end fixing sleeve and the upper end fixing sleeve sleeved outside the guide sleeve can respectively slide along the guide sleeve and are locked and fixed. The mode can be adjusted to fixed cover of lower extreme and the fixed cover of upper end respectively, has essentially enlarged uide bushing swing angle scope.