CN219921175U - Auxiliary puncture device for lumbar anesthesia - Google Patents

Auxiliary puncture device for lumbar anesthesia Download PDF

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Publication number
CN219921175U
CN219921175U CN202321164781.9U CN202321164781U CN219921175U CN 219921175 U CN219921175 U CN 219921175U CN 202321164781 U CN202321164781 U CN 202321164781U CN 219921175 U CN219921175 U CN 219921175U
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China
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puncture
positioner
fixed
auxiliary
fixing
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CN202321164781.9U
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白岚
张文超
张依
蔡楠
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Beijing Jishuitan Hospital
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Beijing Jishuitan Hospital
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Abstract

The utility model discloses a lumbar anesthesia auxiliary puncture device which comprises a mounting bracket and a mounting table, wherein the mounting bracket is used for fixing a puncture guide plate, the mounting bracket is provided with an adjusting module for adjusting the puncture guide plate in the X/Y/Z axial direction and fastening the position, the fixing base plate is provided with an adapting groove for fixedly mounting the puncture guide plate, the puncture guide plate is provided with a puncture channel slot hole adapting to a puncture path, the mounting table is used for fixing the mounting bracket, and the mounting table is provided with a posture positioning module for fixing the posture position.

Description

Auxiliary puncture device for lumbar anesthesia
Technical Field
The utility model relates to the field of medical anesthesia, in particular to a lumbar anesthesia auxiliary puncture device.
Background
The lumbar anesthesia is spinal anesthesia, local anesthetics are injected into the subarachnoid space, and act on spinal nerve roots to enable corresponding parts to generate anesthesia, namely the subarachnoid space is blocked, the lower position, the middle position and the upper position of lumbar anesthesia can be distinguished according to the distance from navel, namely when the parts are selected, gaps of 3/4, 2/3 and 4/5 of the waist are generally selected as puncture parts of lumbar anesthesia, so that spinal nerves and spinal cord can be prevented from being damaged, and meanwhile, the method for performing surgical anesthesia on the lower abdomen, lower limbs and basin can be achieved;
spinal cord injury caused in the lumbar anesthesia puncture process can cause paraplegia when severe, and is the most serious complication of lumbar anesthesia. Spinal cord injury manifests as a lumbar anesthesia with a breakthrough in the dura mater, a palpable pain, or a loss of consciousness. The clinical manifestations after that are mostly sensory/motor separation, sensory disturbance on one side, motor disturbance on the opposite side, sensory (shallow)/sensory (deep) separation. Or when the spinal cord cone is damaged, single nerve dysfunction can be caused, the symptoms include biceps femoris paralysis, thigh rear and saddle area sensory loss, urination and defecation function damage and the like are presented;
in the current general operation, the lumbar anesthesia is positioned mainly by the experience of an anesthesiologist, and because of the difference of the obesity degree, lumbar morphology and physiological structure of different patients, the positioning is inaccurate due to the mode of coarse positioning according to experience, the situation of repeated positioning is required, certain influence is brought to the operation time and operation risk, in some cases, the anesthesiologist needs to puncture and position according to the lumbar vertebra of the patients and the combination experience, and because of the difference of the morphology differences of the patients in CT and operation, the lumbar vertebra morphology of the lumbar vertebra in the operation in CT state is also different, thus the uncertainty in the actual positioning is increased.
Meanwhile, in the existing positioning puncture process, under the condition of adopting CT and combining experience, a puncture positioning point is determined, and due to physiological characteristics such as skin and fat layer elasticity, displacement is easily caused in the puncture process, the determined puncture point, puncture path and angle cannot be ensured, and the difficulty is increased for the risk of puncture.
Disclosure of Invention
The utility model aims to overcome the defects in the prior art and provide the lumbar anesthesia auxiliary puncture device which is convenient for adjusting and positioning the puncture guide plate.
The utility model solves the problems by adopting the following technical scheme: the utility model provides a puncture outfit is assisted to lumbar anesthesia, includes installing support and the mount table that is used for puncture baffle fixed, the installing support be provided with the regulation module and be used for puncture baffle at the three axial regulation of X/Y Z and the position fastening, the mount table be used for fixed mounting support, the mount table be provided with the body appearance location module and be used for the fixed of body appearance position.
Preferably: the installing support including being used for fixing unable adjustment base, Z axle alignment jig, the Y axle mount in bed body both sides, two sets of alignment jig are used for fixing in the both sides of the bed body respectively, Z axle alignment jig be X axial slip setting on unable adjustment base and fixed through the bolt piece, Y axle mount adopt telescopic link and fixed through the bolt piece, Y axle mount one end rotate with the top of Z axle alignment jig and be connected and carry out the position fastening through the bolt fastener, the Y axle mount other end be provided with the bar cell body, the bar cell body on be provided with the regulating block, the regulating block be the lateral sliding setting on the vice spout of bar cell body bottom and pass through bolt piece fastening position, the both sides of installing support be provided with slider and bar cell body adaptation and spacing fixedly through the L type spacing head of regulating block front end.
Preferably: the Y-axis fixing frame is provided with an auxiliary supporting piece, the auxiliary supporting piece comprises an auxiliary supporting rod, a sliding sleeve and a supporting rod, the sliding sleeve is arranged on the auxiliary supporting rod in a sliding sleeve mode and is fastened in position through a bolt fastener, the supporting rod is fixed in the sliding sleeve, and the other end of the auxiliary supporting rod is provided with a plug sleeve in fit connection with the side portion of the fixing substrate.
Preferably: the body posture positioning module comprises a head positioner, a body positioner, a double-arm positioner, a knee positioner and a foot positioning inner device, wherein the head positioner, the body positioner, the double-arm positioner, the knee positioner and the foot positioning inner device are fixed on a supporting substrate through detachable structure adaptation.
Preferably: the head positioner, the body positioner, the double-arm positioner, the knee positioner and the foot positioning inner device are arranged on the mounting table through the magic tape structure.
Preferably: the body positioner is provided with an arc concave surface, the upper end surface of the body positioner is provided with an inverted V-shaped inclined surface, the body positioner is composed of a first positioning part and a second positioning part, the first positioning part is composed of hard supports and soft supports, and the second positioning part is composed of an air bag with an adaptive shape.
Compared with the prior art, the utility model has the following advantages and effects: the lumbar anesthesia auxiliary puncture device can be used for non-contact position adjustment and positioning of the puncture guide plate, meanwhile, the posture position of a patient in the puncture process can be kept consistent, the puncture guide plate is positioned through the lumbar anesthesia auxiliary puncture device, and compared with the traditional use mode that the puncture guide plate is attached to the skin, the lumbar anesthesia auxiliary puncture device can eliminate the problem that the puncture path is deviated due to displacement caused by skin softness.
Drawings
Fig. 1 is a schematic structural view of an auxiliary lumbar anesthesia puncture device according to an embodiment of the present utility model.
Fig. 2 is a schematic structural diagram of an adjusting module according to an embodiment of the utility model.
Fig. 3 is a schematic structural diagram of an adjusting module according to an embodiment of the utility model.
FIG. 4 is a schematic diagram illustrating the use of a fixed substrate according to an embodiment of the present utility model.
Fig. 5 is a schematic diagram of a posture positioning module according to an embodiment of the present utility model.
Figure number: the device comprises a fixed base plate 101, an adjusting module 102, a main calibration hole 103, a puncture channel slot 104, a head positioner 105, a body positioner 106, a double-arm positioner 107, a knee positioner 108, a foot positioner 109, a supporting base plate 110, an arc concave 111, a first positioning part 112, a second positioning part 113, a fixed base 114, a Z-axis adjusting frame 115, a Y-axis fixing frame 116, a strip-shaped groove 117, an adjusting block 118, a limiting head 119, a sliding block 131, a secondary supporting rod 120, a sliding sleeve 121, a supporting rod 122, a plug sleeve 123, a mounting plate 124, a puncture guide plate 125 and a secondary calibration hole 126.
Detailed Description
The present utility model will be described in further detail by way of examples with reference to the accompanying drawings, which are illustrative of the present utility model and not limited to the following examples.
Referring to fig. 1-5, the lumbar anesthesia auxiliary puncture device of the embodiment comprises a mounting bracket and a mounting table, wherein the mounting bracket is used for fixing a puncture guide plate 125, the mounting bracket is provided with an adjusting module 102 for adjusting and fixing the puncture guide plate 125 in the X/Y/Z directions, the mounting bracket is adapted to be connected with a fixing substrate 101, the fixing substrate 101 is provided with an adapting groove for fixedly mounting the puncture guide plate 125, the puncture guide plate 125 is provided with a puncture channel slot 104 adapting a puncture path, the mounting table is used for fixing the mounting bracket, and the mounting table is provided with a posture positioning module for fixing the posture.
Based on the problems mentioned in the background art, in the embodiment, the patient acquires the 3D medical image through the posture positioning module under the condition of fixing the posture, determines the puncture path in the 3D medical image through the three-dimensional software of the computer and determines the set position of the puncture guide plate 125, and in the puncture operation, the patient resumes the posture again on the mounting table through the posture positioning module and adjusts and fixes the position of the puncture guide plate 125 through the adjusting module 102, so that the puncture guide plate 125 is positioned in the image to determine the placement position, thereby realizing the puncture and ensuring the good puncture path.
In this embodiment, the product is used to locate the puncture guide plate 125, so that the problem of the puncture path deviation caused by displacement due to skin softness can be eliminated compared with the traditional use mode of attaching the puncture guide plate 125 to skin.
In this embodiment, the puncture guide 125 may be obtained by modeling 3D printing, for example, by: s1: placing an X-ray imaging marker at the lumbar vertebra position of a patient (the marker is attached to the corresponding position of the lumbar part of the patient by adopting an annular hollow metal sheet, in CT scanning, the metal gasket can cause artifacts of a marked part, a marked point is reflected in an image, after CT scanning is finished, in order to prevent the metal gasket from shifting to cause the difference from an initial calibration position, a marker pen which is not easy to erase, such as a Mark pen, is adopted to fill the mark in a central hole of the metal gasket, so that the initial marking position can be conveniently found in the subsequent operation process, and the implementation of guide plate positioning in operation is convenient), and acquiring the medical digital imaging data of CT or MRI of the patient under a fixed position;
s2: importing a DICOM file of medical digital imaging data by using engineering reconstruction software, and acquiring a data model with three-dimensional space parameters of vertebral bones, skin, blood vessels and markers; simulating a puncture channel in the data model according to the distribution characteristics of vertebral bones, skin and blood vessels to obtain a three-dimensional data model containing design parameters, and importing the three-dimensional data model into reverse engineering software in an STI (shallow trench isolation) mode;
s3: establishing a three-dimensional reference system designed by the puncture guide plate 125 by taking the position of the marker as an origin in reverse engineering software, establishing the puncture guide plate 125 on a three-dimensional data model based on the established three-dimensional reference system, taking the horizontal plane of the highest contact point of the puncture guide plate 125 with skin as a reference plane designed by the end face of the bottom of the puncture guide plate 125, establishing a puncture channel hole of the puncture guide plate 125 on an extension line of a simulated puncture channel, and generating a puncture guide plate 125 model;
s4, three-dimensional data of the puncture guide plate 125 model of the reverse engineering software are imported into a 3D printer, and the puncture guide plate 125 is manufactured.
In this embodiment, at least 2 groups of markers are arranged at the lumbar vertebra position, in the three-dimensional reference system, the markers at the front side of the body are used as the origin, the markers are attached to the waist corresponding positions of the patient by using annular hollow metal sheets, wherein engineering reconstruction software adopts any one of MIMICS, E3D, 3Dslicer and 3D document, and reverse engineering software adopts any one of 3MATIC, designX and E3D.
In this product, the posture positioning module is configured to ensure that the posture of the patient is kept substantially consistent with the posture of the patient in the lumbar anesthesia operation during the puncture guide 125 establishment process, so as to avoid the overlarge difference between the lumbar morphology position relationship in CT and the morphology position relationship in the puncture operation, and to affect the restoration of the reference frame established during the modeling process. The detachable structure of the magic tape is convenient to detach and withdraw the positioner from the operating table after lumbar anesthesia is completed, so that corresponding operation is continued without transferring.
Because of all differences of different forms of the lumbar spine, in order to conveniently obtain the spine form of the patient with relatively better adapting puncture, the body positioner 106 is provided with an arc concave surface 111, the upper end surface is arranged in an inverted V-shaped inclined plane, the body positioner 106 is composed of a first positioning part 112 and a second positioning part 113, the first positioning part 112 is formed by hard support and soft support, the second positioning part is formed by an air bag with adapting shape, the lower part of the body (waist and hip) is supported by the inflation amount of the air bag, as shown in the figure, the height of the lower part of the body can be adjusted by adjusting the inflation amount of the air bag, so that the stretching form of the lumbar vertebra is adapted and adjusted, a doctor can find a relatively suitable stretching position according to experience, the air bag is adjusted to be in a vacuum state in the initial operation of the operation, then the gas is flushed, the body is stopped after the proper body position, and the body parts are positioned in the arm fixing device, the head fixing device, the body positioner 106, the knee fixing device 108 and the foot fixing device are positioned at the same position in the palm position in the lumbar anesthesia operation, and the inflation ratio is kept after the inflation amount is adjusted, so that the inflation amount of the air bag is always adjusted.
In order to facilitate understanding of the present embodiment, an installation structure of the puncture guide plate 125 is specifically provided in the present embodiment, where the puncture guide plate 125 is installed on the fixed substrate 101, and by means of consistency of arrangement of each component of the posture positioning device, the posture of the patient in the CT process and the puncture process is kept substantially always, so that the posture of the lumbar vertebra of the patient is substantially consistent, and since the puncture guide plate 125 in the fixed substrate 101 is set based on the three-dimensional reference system established by the position of the marker, the manner of recovering the reference system by adopting the device in the lumbar puncture process is as follows: the posture positioning device is adopted to restore the posture, the fixed substrate 101 is fixed on the adjusting module 102, as the adjusting module 102 can adjust in the X/Y/Z three axial directions, firstly, a certain height is lifted, the vertical falling point of the main calibration holes 103 corresponds to the set point of the marker, wherein the marker is at least provided with 2 groups, then two groups of main calibration holes 103 are adapted to adapt to the axial positioning of the spine, as shown in the figure, the height of the fixed substrate 101 is lowered after the calibration is finished, the lower end face of the fixed substrate 101 is fixed after the highest point of the skin of the lumbar anesthesia region, the reference frame is restored, and as the simulated puncture channel is obtained based on the actual physiological structure of a patient, the epidural puncture needle punctures along the puncture channel direction, is not influenced by the skin displacement and the operation shake of an operator, so that the puncture success rate is higher, and the risk of puncture is reduced in the 3D simulation process, and the method is particularly suitable for patients with obesity, spinal deformity and the like to use in lumbar anesthesia operation.
In this embodiment, the adjustable fixing frame includes a fixing base 114 for fixing two sides of a bed body, a Z-axis adjusting frame 115, a Y-axis fixing frame 116, two groups of adjusting brackets are respectively used for fixing two sides of the bed body, the Z-axis adjusting frame 115 is arranged on the fixing base 114 in an X-axis sliding manner and is fixed through a bolt piece, the Y-axis fixing frame 116 is fixed through a telescopic rod and a bolt piece, one end of the Y-axis fixing frame 116 is rotatably connected with the top of the Z-axis adjusting frame 115 and is fastened through a bolt fastener (the rotation setting is mainly used for adapting certain lumbar side bending deformities or body type bending deflection, etc.), the fixing base is rotated, after the fixing base 101 deflects, the main calibration hole 103 is matched with the position of a marker), the other end of the Y-axis fixing frame 116 is provided with a strip-shaped groove body 117, the strip-shaped groove body 117 is provided with an adjusting block 118, the adjusting block 118 is arranged on a pair of sliding side sliding manner at the bottom of the strip-shaped groove body 117 and is fastened through a bolt piece, two sides of the fixing frame 116 are rotatably connected with the top of the Z-axis fixing frame 115 through a bolt piece, the two sides of the fixing frame are provided with a pair of supporting rod 121, the fixing frame is provided with a pair of supporting rod 121, and is provided with a pair of supporting rod 121 through a pair of supporting rod piece 121, and is provided with a pair of supporting rod 120, and is provided with a supporting rod 120 through a sliding sleeve piece 122, and the supporting rod 120 is fixed through the supporting rod 120.
In this embodiment, as shown in fig. 2, the fixing substrate 101 specifically includes a mounting plate 124 and a puncture guide plate 125, the mounting plate 124 is formed by vertically connecting a transverse plate and a longitudinal plate in an L shape, a slot body for mounting the puncture guide plate 125 is disposed on the mounting plate 124, the puncture guide plate 125 is adapted to the slot body, the lower end surface of the puncture guide plate 125 is flush with the lower end surface of the transverse plate, and the central symmetry line of the main calibration hole 103 coincides with the central symmetry of the puncture guide plate 125.
In this embodiment, the main calibration hole 103 on the installation guide plate is arranged front and back in two groups, the front side of the installation guide plate and the end part of the auxiliary support rod 120 are respectively provided with the auxiliary calibration hole 126, the main calibration hole 103 and the auxiliary calibration hole 126 are both adapted with laser pens for providing point light source marks, the arrangement of the structure is mainly for facilitating medical staff to intuitively find whether a patient has an initiative to generate a displacement operation body position deviation reference system (because the positioning module 101 is not easy to see from the main calibration hole 103 after falling), the auxiliary calibration holes are specifically arranged on the rear side of the installation support and the end part of the connecting rod, the laser pens are placed on the auxiliary calibration holes, mark points are adopted on the point light sources of the laser pens, and reset is carried out according to the mark points after stopping operation when any point light source falls.
The foregoing description of the utility model is merely exemplary of the utility model. Those skilled in the art may make various modifications or additions to the described embodiments or substitutions, without departing from the scope of the utility model as defined in the accompanying claims.

Claims (6)

1. An auxiliary puncture device for lumbar anesthesia, which is characterized in that: including installing support and mount table that is used for puncture baffle fixed, the installing support be provided with the regulation module and be used for puncture baffle at three axial regulation of X/Y Z and position fastening, the fixed base plate is connected in the installing support adaptation, fixed base plate be provided with the adaptation groove and be used for fixed mounting puncture baffle, puncture baffle be provided with the puncture passageway slotted hole of adaptation puncture route, the mount table be used for the fixed mounting support, the mount table be provided with the body position location module and be used for the fixed of body position.
2. The lumbar anesthesia auxiliary puncture device according to claim 1, wherein: the installing support including being used for fixing unable adjustment base, Z axle alignment jig, the Y axle mount in bed body both sides, two sets of alignment jig are used for fixing in the both sides of the bed body respectively, Z axle alignment jig be X axial slip setting on unable adjustment base and fixed through the bolt piece, Y axle mount adopt telescopic link and fixed through the bolt piece, Y axle mount one end rotate with the top of Z axle alignment jig and be connected and carry out the position fastening through the bolt fastener, the Y axle mount other end be provided with the bar cell body, the bar cell body on be provided with the regulating block, the regulating block be the lateral sliding setting on the vice spout of bar cell body bottom and pass through bolt piece fastening position, the both sides of installing support be provided with slider and bar cell body adaptation and spacing fixedly through the L type spacing head of regulating block front end.
3. The lumbar anesthesia auxiliary puncture device according to claim 2, wherein: the Y-axis fixing frame is provided with an auxiliary supporting piece, the auxiliary supporting piece comprises an auxiliary supporting rod, a sliding sleeve and a supporting rod, the sliding sleeve is arranged on the auxiliary supporting rod in a sliding sleeve mode and is fastened in position through a bolt fastener, the supporting rod is fixed in the sliding sleeve, and the other end of the auxiliary supporting rod is provided with a plug sleeve in fit connection with the side portion of the fixing substrate.
4. The lumbar anesthesia auxiliary puncture device according to claim 2, wherein: the body posture positioning module comprises a head positioner, a body positioner, a double-arm positioner, a knee positioner and a foot positioning inner device, wherein the head positioner, the body positioner, the double-arm positioner, the knee positioner and the foot positioning inner device are fixed on a supporting substrate through detachable structure adaptation.
5. The lumbar anesthesia auxiliary puncture device according to claim 4, wherein: the head positioner, the body positioner, the double-arm positioner, the knee positioner and the foot positioning inner device are arranged on the mounting table through the magic tape structure.
6. The lumbar anesthesia auxiliary puncture device according to claim 5, wherein: the body positioner is provided with an arc concave surface, the upper end surface of the body positioner is provided with an inverted V-shaped inclined surface, the body positioner is composed of a first positioning part and a second positioning part, the first positioning part is composed of hard supports and soft supports, and the second positioning part is composed of an air bag with an adaptive shape.
CN202321164781.9U 2023-05-15 2023-05-15 Auxiliary puncture device for lumbar anesthesia Active CN219921175U (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN202321164781.9U CN219921175U (en) 2023-05-15 2023-05-15 Auxiliary puncture device for lumbar anesthesia

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202321164781.9U CN219921175U (en) 2023-05-15 2023-05-15 Auxiliary puncture device for lumbar anesthesia

Publications (1)

Publication Number Publication Date
CN219921175U true CN219921175U (en) 2023-10-31

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Application Number Title Priority Date Filing Date
CN202321164781.9U Active CN219921175U (en) 2023-05-15 2023-05-15 Auxiliary puncture device for lumbar anesthesia

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CN (1) CN219921175U (en)

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