CN216022555U

CN216022555U - Percutaneous tracheotomy device

Info

Publication number: CN216022555U
Application number: CN202121733953.0U
Authority: CN
Inventors: 沈晓
Original assignee: Jinshan Hospital of Fudan University
Current assignee: Jinshan Hospital of Fudan University
Priority date: 2021-07-28
Filing date: 2021-07-28
Publication date: 2022-03-15
Anticipated expiration: 2031-07-28

Abstract

The utility model relates to a percutaneous tracheotomy device, which comprises an outer sleeve, a puncture needle and a guide wire; the outer sleeve is made of stainless steel materials and is integrally linear, outer sleeve scale marks are arranged on the outer wall of the outer sleeve, the head end of the outer sleeve is designed to be a spoon-shaped inclined surface, an outer sleeve connecting base is arranged at the tail end of the outer sleeve, a first mark part is arranged on the outer sleeve connecting base, and the position of the first mark part on the outer sleeve connecting base is used for indicating the direction of a guide wire guided by the spoon-shaped inclined surface at the head end of the outer sleeve; the tail end of the puncture needle is provided with a puncture needle connecting base, the outer wall of the puncture needle connecting base is provided with a second identification component, and the second identification component is matched with the first identification component; the outer wall of the guide wire is provided with guide wire scale marks. The utility model can realize accurate, safe and convenient implementation of the percutaneous tracheotomy.

Description

Percutaneous tracheotomy device

Technical Field

The utility model relates to the technical field of medical instruments, in particular to a percutaneous tracheotomy device.

Background

Tracheotomy is a common operation in clinic, and is suitable for severe patients who need mechanical ventilation for a long time and keep an airway unobstructed due to various causes. Compared with the traditional tracheotomy, the percutaneous tracheotomy has the advantages of small surgical wound, safe and simple operation and less related complications, the percutaneous tracheotomy is commonly used in clinic at present, the used instrument is a percutaneous tracheotomy kit, a blade, a puncture needle, an outer sleeve, a skin expander, a guide wire, a guide clamp and a disposable tracheal cannula are contained in the percutaneous tracheotomy, and the operation flow is as follows: (1) the blade cuts open the epidermis. (2) The puncture needle with the sleeve punctures the trachea (cartilage rings 3-4) through the incision, and the puncture needle is withdrawn after the puncture needle is in place, and the outer sleeve is reserved. (3) The guide wire is arranged in through the outer sleeve and is withdrawn from the outer sleeve. (4) And expanding the skin along the guide wire by using a skin expander, and further expanding the skin by using guide forceps. (5) The tracheal cannula is placed along the guide wire and fixed, and the air sac is inflated to complete the tracheotomy.

The disadvantages of the current percutaneous tracheotomy suit are that: (1) the outer sleeve of the puncture needle is made of plastic materials, the hardness is not enough, after the puncture needle is withdrawn, if a patient is choked, the trachea and the skin can be moved, the lumen of the sleeve can be crushed or bent, and the subsequent guide wire is difficult to insert. In addition, the head end of the outer sleeve lacks a direction guiding function, and the guide wire is placed into the trachea and possibly enters the head end by mistake, so that the tracheotomy fails. The outer sleeve has no scale marks, and the puncture depth cannot be accurately controlled. (2) The puncture needle head is a sharp inclined incision, and is easy to damage structures such as neck blood vessels and nerves around a puncture channel. (3) The guide wire also lacks scale marks, which leads to difficulty in accurately controlling the insertion depth of the guide wire.

Patent document CN209004141U, published japanese patent No. 2019.06.21, discloses a percutaneous tracheotomy puncture needle kit, which includes a tracheotomy tube with an arc-shaped bend, a guide wire, a pushing frame, a first arc-shaped puncture needle, an arc-shaped trocar and an injector; the bending radian of the first arc-shaped puncture needle is the same as that of the air-cut sleeve; the bending radian of the arc-shaped trocar is the same as that of the first arc-shaped puncture needle, and the arc-shaped trocar is sleeved outside the first arc-shaped puncture needle; the guide wire is connected with the pushing frame, the injector is connected with the first arc-shaped puncture needle, after the arc-shaped puncture needle and the arc-shaped trocar are punctured into the trachea, the arc-shaped puncture needle and the injector are taken out, and the pushing frame pushes the guide wire along the path of the arc-shaped trocar. Has the advantages that: through the first arc pjncture needle and the second arc pjncture needle that are the same with the radian of buckling of autogenous cutting sheathed tube, solved because the puncture route of linear type puncture syringe needle and the route of taking the trachea of radian to open the casing head conform to the degree poor, damage trachea back wall and even esophagus easily in the puncture process, to the relatively poor problem of going the seal wire retrograde to the oral cavity of the directional guide effect of guide wire even.

Patent document CN212466120U, bulletin day 2021.02.05 discloses a controllable type pjncture needle of special degree of depth of percutaneous trachea incision, including syringe, needle body, buckle, the needle body setting is in syringe one end, and the buckle rotates the cover and establishes on the needle body, and the buckle is the elastic component, is provided with the needle body through-hole on the buckle, and the needle body through-hole is oval, and oval minor axis length is less than the external diameter of needle body, and oval major axis is greater than the external diameter of needle body, and the needle body through-hole is used for fixing the position at the needle body. Has the advantages that: solves the problem that the rear wall of the trachea is easy to be damaged in the puncture process of the puncture needle.

However, the above technical solutions do not completely solve all the drawbacks of the aforementioned percutaneous tracheotomy kit, and there is a need for a percutaneous tracheotomy device that can keep the puncture lumen unobstructed, strictly control the guide wire direction correctly, control the puncture depth, reduce the damage in the puncture process, and control the insertion depth of the guide wire, and no relevant report is found at present.

Disclosure of Invention

The utility model aims to provide a percutaneous tracheotomy device aiming at the defects in the prior art.

It is a further object of the present invention to provide an improved instrument kit for percutaneous tracheotomy.

In order to achieve the first purpose, the utility model adopts the technical scheme that:

a percutaneous tracheotomy device comprises an outer cannula and a puncture needle; the outer sleeve is made of stainless steel materials and is integrally linear, outer sleeve scale marks are arranged on the outer wall of the outer sleeve, the head end of the outer sleeve is designed to be a spoon-shaped inclined surface, an outer sleeve connecting base is arranged at the tail of the outer sleeve, a first mark part is arranged on the outer sleeve connecting base, and the position of the first mark part on the outer sleeve connecting base is used for indicating the trend of a guide wire guided by the spoon-shaped inclined surface at the head end of the outer sleeve; the tail end of the puncture needle is provided with a puncture needle connecting base, the outer wall of the puncture needle connecting base is provided with a second identification component, and the second identification component is matched with the first identification component.

As a preferred example, the percutaneous tracheotomy device further comprises a guide wire.

More preferably, the guide wire is provided with guide wire scale marks on the outer wall.

More optionally, the guide wire scale marks are annular red lines, and the annular red lines are arranged at positions 5cm away from the head end of the guide wire.

As another preferable example, the outer sleeve is provided with an outer sleeve tube body, a side wall of one side of the outer sleeve tube body is longer than a side wall of the other side of the outer sleeve tube body, and a longer side wall is bent in a spoon shape.

As another preferred example, the scale marks of the outer sleeve are stripes which are arranged between black and white, and the distance between every two adjacent stripes is 1 cm.

As another preferred example, the head end of the puncture needle is conical, and the side wall of the puncture needle is provided with a puncture needle body through hole.

As another preferred example, the second identification component and the first identification component are in a matching manner of a bump and a groove.

More preferably, the projection is rectangular, triangular, trapezoidal or semicircular.

In order to achieve the second object, the utility model adopts the technical scheme that:

an improved instrument set for percutaneous tracheotomy, comprising a percutaneous tracheotomy device as described in any one of the above, in addition to a blade, a skin expander, a guide forceps and a tracheal cannula.

The utility model has the advantages that:

1. the outer sleeve is made of stainless steel, so that the outer sleeve cannot be extruded by peripheral tissues to cause the blockage or the stenosis of a tube cavity after the puncture needle is withdrawn, the channel is always smooth, and the subsequent guide wire is more smoothly and conveniently placed; the rigid structure also ensures that the shift of the outer cannula or the change of the puncture direction caused by the patient's choking, the movement of the skin and the air passage, etc. during the operation can not happen.

2. The spoon type inclined plane design of outer tube head end can guide the seal wire trend, and its inclined plane direction corresponds with first identification part on the outer tube connection base, and the operation person of being convenient for knows the spoon type inclined plane direction of outer tube head end through observing first identification part, and then ensures the directional trachea below in inclined plane, can not miss when the seal wire puts into and slide into the head end direction.

3. The whole body of the outer sleeve pipe is in a straight line shape, the puncture needle is still perpendicular to the skin during percutaneous puncture, force is exerted more conveniently, and the puncture needle is perpendicular to the trachea, is easier to puncture the trachea and is not easy to slide.

4. The outer sleeve scale marks are arranged on the outer wall of the outer sleeve pipe body, and each grid is 1cm long in a black-white alternating mode, so that an operator can accurately control the puncture depth in the puncture process.

5. The head end of the puncture needle is changed into a conical shape from a beveled surface, so that the cutting damage of the cut surface of the puncture needle to the neck tissue can be reduced, the adjacent blood vessels or nerves of the puncture channel of the neck are not easy to be damaged, and complications such as hemorrhage, nerve damage and the like in the operation are reduced. The side wall of the tip end is provided with a puncture needle body through hole, and the puncture needle body through hole is designed to facilitate air extraction verification after the puncture needle is punctured into a trachea.

6. The guide wire is also provided with guide wire scale marks, each 5cm of guide wire is provided with an annular red line mark, and the implantation depth of the guide wire can be accurately controlled in the operation process of an operator, so that the condition that the guide wire is too deep or too shallow is avoided.

Drawings

FIG. 1 is a schematic structural view of a percutaneous tracheotomy device of the utility model.

Fig. 2 is a partially enlarged view of a in fig. 1.

FIG. 3 is a schematic structural view of the tail end of the outer sleeve.

Fig. 4 is a partially enlarged view of B in fig. 1.

Fig. 5 is a first schematic view of the assembly of the outer cannula and the needle.

Fig. 6 is a second schematic view of the assembly of the outer cannula and the introducer needle.

FIG. 7 is a schematic view showing the construction of an outer cannula connection base and a puncture needle connection base in accordance with example 2.

Detailed Description

The following detailed description of the present invention will be made with reference to the accompanying drawings.

The reference numerals and components referred to in the drawings are as follows:

1. outer sleeve

11. Outer sleeve pipe body 12, outer sleeve tail end

111. Scale mark 121 of outer sleeve and handle of outer sleeve

122. Outer sleeve connection base 123 first identification component

2. Puncture needle

21. Puncture needle body 22, puncture needle tail end

221. Puncture needle connection base 222, puncture needle handle

223. Second identification part 211, puncture needle body through hole

3. Guide wire

31. Guide wire scale mark

Example 1

Referring to fig. 1, fig. 1 is a schematic structural view of a percutaneous tracheotomy device of the utility model. The percutaneous tracheotomy device comprises an outer sleeve 1, a puncture needle 2 and a guide wire 3. The outer sleeve 1 is provided with an outer sleeve pipe body 11 and an outer sleeve tail end 12. The outer sleeve pipe body 11 is made of stainless steel materials and is integrally linear, outer sleeve scale marks 111 are arranged on the outer wall of the outer sleeve pipe body, the outer sleeve scale marks 111 are black and white stripes, and the distance between every two adjacent stripes is 1 cm.

Referring to fig. 2, fig. 2 is a partial enlarged view of a in fig. 1. The head end of the outer sleeve pipe body 11 is designed to be a spoon-shaped inclined plane. In fig. 7 (fig. 7 is a second assembly view of the outer cannula and the puncture needle), it can be seen that the side wall of one side of the outer cannula tube 11 is longer than the side wall of the other side, and the longer side wall is bent in a spoon shape.

Referring to fig. 3, fig. 3 is a schematic structural view of the tail end of the outer sleeve. The outer cannula end 12 includes an outer cannula handle 121 and an outer cannula connection base 122. The outer sleeve connecting base 122 is located in the center of the outer sleeve handle 121 and is of a cylindrical groove-shaped structure, a first identification part 123 is arranged on the wall of the outer sleeve connecting base, and the first identification part 123 is a strip-shaped notch. The position of the first identification part 123 on the outer sleeve connecting base 122 is used for indicating the direction of the guide wire 3 guided by the scoop-shaped inclined surface at the head end of the outer sleeve pipe body 11.

Referring again to fig. 1, the puncture needle 2 is provided with a puncture needle body 21 and a puncture needle tail 22. The whole puncture needle body 21 is in a linear shape. The puncture needle tail end 22 is provided with a puncture needle connecting base 221 and a puncture needle handle 222. The puncture needle connecting base 221 is connected with the puncture needle body 21 and is a cylinder, the outer wall of the puncture needle connecting base is provided with a second identification part 223, and the second identification part 223 is a strip-shaped block protruding out of the outer wall of the puncture needle connecting base 221.

Referring to fig. 4, fig. 4 is a partial enlarged view of B in fig. 1. The head end of the puncture needle body 21 is conical, and a puncture needle body through hole 211 is formed in the side wall.

Referring to fig. 1 again, the outer wall of the guide wire 3 is provided with a guide wire scale mark 31, the guide wire scale mark 31 is an annular red line, an annular red line is arranged at a position 5cm away from the head end of the guide wire 3, two annular red lines are arranged at a position 10cm away from the head end of the guide wire 3, and so on.

The utility model relates to a percutaneous tracheotomy device and a using method thereof applied to percutaneous tracheotomy, wherein the using method comprises the following steps:

(1) the blade cuts open the epidermis.

(2) The puncture needle 2 is inserted into the outer cannula 1 until the puncture needle connection base 221 falls into the outer cannula connection base 122, and the second identification part 223, i.e. the bar-shaped block, on the puncture needle connection base 221 is adjusted to be clamped with the first identification part 123, i.e. the bar-shaped notch, on the outer cannula connection base 122 (see fig. 5-6, fig. 5 is a first assembly schematic diagram of the outer cannula and the puncture needle, and fig. 6 is a second assembly schematic diagram of the outer cannula and the puncture needle). Then the puncture needle with the outer sleeve punctures the trachea (3 rd to 4 th cartilage rings) through the incision, when the puncture needle is inserted, the first identification part 123 on the outer sleeve 1 is positioned at the lower end of the trachea, namely one side of the chest, when the puncture needle punctures, the puncture depth is known by observing the scale identification 111 of the outer sleeve, when the puncture needle feels in place, the tail end of the puncture needle 2 is connected with the injector filled with normal saline for suction, if the head end of the puncture needle 2 really enters the trachea, the gas can enter the normal saline of the injector through the through hole 211 of the puncture needle body to form bubbles under the suction effect, the successful puncture is indicated after the bubbles are observed, the puncture needle 2 is withdrawn, and the outer sleeve 1 is reserved.

(3) The guide wire 3 is placed in the outer sleeve 1, the guide wire placing depth is known by observing the guide wire scale marks 31 on the guide wire 3 in the placing process, the head end of the guide wire 3 can go into the lower end of the trachea under the guidance of the spoon-shaped inclined plane at the head end of the outer sleeve pipe body 11, and the guide wire exits from the outer sleeve 1.

(4) The skin is dilated along the guide wire 3 by a skin dilator, and then further dilated by a guide clamp.

(5) The tracheal cannula is arranged along the guide wire 3 and fixed, and the air sac is inflated to complete the tracheotomy.

Example 2

The percutaneous tracheotomy device of the embodiment is basically the same as that of the embodiment 1, except that: the first identification part 123 on the wall of the outer cannula connection base 122 is a trapezoidal notch, and the second identification part 223 on the outer wall of the puncture needle connection base 221 is an inverted trapezoidal block matched with the first identification part 123 (see fig. 7, fig. 7 is a schematic structural view of the outer cannula connection base and the puncture needle connection base of embodiment 2).

In this embodiment, the first identification part 123 and the second identification part 223 are not limited to the connection manner of the strip-shaped notch and the strip-shaped block, but may be any other connection manner, such as a trapezoid notch and an inverted trapezoid block, a triangle notch and a triangle block, etc. that are matched with each other.

Example 3

An improved kit for percutaneous tracheotomy, comprising an outer cannula 1 as described in example 1 or 2, a puncture needle 2 and a guide wire 3. Also comprises a blade, a skin expander, a guide clamp and a tracheal cannula. The kit contains all surgical instruments required by percutaneous tracheotomy, is matched for use and is more convenient.

In the percutaneous tracheotomy device of the present invention, it should be noted that: the outer sleeve 1 is made of stainless steel, so that the outer sleeve 1 cannot be extruded by peripheral tissues to cause the blockage or the stenosis of a tube cavity after the puncture needle 2 is withdrawn, the channel is always smooth, and the subsequent guide wire 3 is more smoothly and conveniently placed; the rigid structure also ensures that the displacement of the outer cannula 2 or the change of the puncture direction caused by the patient's choking, skin and airway movement, etc. during the operation can not occur. The design of spoon type inclined plane at 1 head end of outer tube can guide 3 trends of seal wire, and its inclined plane direction corresponds with first sign part 123 on outer tube connection base 122, and the operator of being convenient for knows the spoon type inclined plane direction of 2 head ends of outer tube through observing first sign part 123, and then ensures the directional trachea below in inclined plane, can not miss when seal wire 3 puts into and slide in the head end direction. The whole outer sleeve pipe body 11 is in a straight line shape, the puncture needle 2 is still perpendicular to the skin during percutaneous puncture, force is exerted more conveniently, and the puncture needle is perpendicular to the trachea, penetrates into the trachea more easily and is not easy to slide. The outer sleeve scale mark 111 is arranged on the outer wall of the outer sleeve pipe body 11, and each grid is 1cm long in a black-white alternating mode, so that an operator can accurately control the puncture depth in the puncture process. The head end of the puncture needle 2 is changed into a conical shape from a beveled surface, so that the cutting damage of the cut surface of the puncture needle to neck tissues can be reduced, the adjacent blood vessels or nerves of the puncture channel of the neck are not easy to be damaged, and complications such as hemorrhage, nerve damage and the like in the operation are reduced. The side wall of the tip end is provided with a puncture needle body through hole 211, and the design of the puncture needle body through hole 211 ensures that the puncture needle 2 is convenient for air extraction verification after being punctured into a trachea. The guide wire 3 is also provided with guide wire scale marks 31, each 5cm of guide wire is provided with an annular red mark, and the implantation depth of the guide wire 3 can be accurately controlled in the operation process of an operator, so that over-depth or over-shallow is avoided.

As used herein, the terms "cephalic end" and "caudal end" are used in the order of insertion, with cephalic end referring to the end of the device that enters the body first and caudal end opposite to cephalic end. The terms "center," "upper," "lower," "left," "right," "vertical," "horizontal," "inner," "outer," and the like are used in the orientation or positional relationship indicated in the drawings for convenience in describing the utility model and for simplicity in description, and do not indicate or imply that the referenced device or element must have a particular orientation, be constructed and operated in a particular orientation, and are therefore not to be construed as limiting the utility model. Furthermore, the terms "first," "second," and "third" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.

The above description is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, several modifications and additions can be made without departing from the method of the present invention, and these modifications and additions should also be regarded as the protection scope of the present invention.

Claims

1. A percutaneous tracheotomy device, which is characterized by comprising an outer cannula (1) and a puncture needle (2); the outer sleeve (1) is made of stainless steel materials and is integrally linear, outer sleeve scale marks (111) are arranged on the outer wall of the outer sleeve, the head end of the outer sleeve (1) is designed to be a spoon-shaped inclined surface, an outer sleeve connecting base (122) is arranged at the tail of the outer sleeve (1), a first mark part (123) is arranged on the outer sleeve connecting base (122), and the position of the first mark part (123) on the outer sleeve connecting base (122) is used for indicating the trend of a guide wire (3) guided by the spoon-shaped inclined surface at the head end of the outer sleeve; the tail end of the puncture needle (2) is provided with a puncture needle connecting base (221), the outer wall of the puncture needle connecting base (221) is provided with a second identification component (223), and the second identification component (223) is matched with the first identification component (123).

2. The percutaneous tracheotomy device according to claim 1, further comprising a guide wire (3).

3. Percutaneous tracheotomy device according to claim 2, characterized in that the guide wire (3) is provided with guide wire scale markings (31) on its outer wall.

4. A percutaneous tracheotomy device according to claim 3, characterised in that the guide wire scale markings (31) are annular red lines provided every 5cm from the head end of the guide wire (3).

5. Percutaneous tracheotomy device according to claim 1, characterized in that the outer cannula (1) is provided with an outer cannula tube (11), the outer cannula tube (11) being longer on one side than on the other side, and the longer side being bent in a spoon-like manner.

6. The percutaneous tracheotomy device according to claim 1, wherein the outer cannula scale markings (111) are alternating black and white stripes, with a 1cm spacing between adjacent stripes.

7. A percutaneous tracheotomy device according to claim 1, characterised in that the puncture needle (2) is conical at its tip and is provided with a puncture needle body through hole (211) in its side wall.

8. The percutaneous tracheotomy device according to claim 1, wherein the second identification means (223) and the first identification means (123) are a bump and groove mating.

9. The percutaneous tracheotomy device according to claim 8, wherein the tab is rectangular, triangular, trapezoidal or semicircular.