JP2012135443A - Guide wire insertion device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a guide wire insertion device that reliably inserts a guide wire into a blood vessel by a simple insertion operation.SOLUTION: The guide wire insertion device 1 includes: a body 2 including a wire inserter 3 having a connector 6 connecting a puncture needle 30 with a forward end of a first flow channel 5 through which a guide wire GW is threaded, and an insertion port 7 formed at the rear end of the first flow channel 5 to allow the guide wire GW to be inserted, and a branch 4 branched from the wire inserter 3 and having a second flow channel 8 communicating with the first flow channel 5; a first valve 10 arranged at the rear end of the first flow channel 5 and holding the guide wire GW in a liquid-tight state; a blood storage unit 11 having a deformable and recoverable space 12 connected with the branch 4 and storing inflow blood; and a second valve 13 arranged at the rear end of the space 12 and blocking the outside air from entering the space 12. The branch 4 is bent so that the blood storage unit 11 side is nearly parallel with the insertion direction of the guide wire GW.

Description

  The present invention relates to a guide wire insertion tool used for inserting a guide wire into a blood vessel.

  Conventionally, the Seldinger method is used as a method for inserting a guide wire into a blood vessel. In the Serzinga method, first, a puncture needle is punctured into a blood vessel, and after confirming that the tip of the puncture needle is located in the blood vessel, a guide wire is inserted through the puncture needle to a desired position in the blood vessel.

  As a guide wire insertion tool used in such a Serzinga method, Patent Document 1 is composed of a cylindrical body in which an injection cylinder is fitted on one end side and a puncture needle is fitted on the other end side. A guide wire insertion tool is described in which a guide wire is inserted through a valve body and a through hole is formed so that the guide wire can be inserted to the tip of the puncture needle without removing the syringe barrel.

JP 2004-121514 A

  In such a guide wire insertion tool, first, the distal end portion of the guide wire is positioned through the valve body, and the plunger of the injection cylinder fitted to the cylindrical body is pulled to apply a negative pressure while The puncture needle fitted in the puncture body is punctured, and it is confirmed by the backflow (flashback) of blood inside the syringe barrel that the tip of the puncture needle is located in the blood vessel. After confirming the flashback, in order to insert the guide wire into the puncture needle, hold the syringe barrel with one hand so that the tip of the puncture needle stays in the blood vessel, and guide the inside of the cylindrical body with the other hand. An operation of inserting the wire into the puncture needle is performed. In addition, an operation may be performed in which the syringe barrel is changed to the other hand and a guide wire is inserted with the punctured hand. Therefore, since the guide wire insertion operation is performed with both hands, the guide wire insertion tool moves until the guide wire is inserted into the blood vessel, and the position of the tip of the puncture needle is displaced from the inside of the blood vessel. There is a problem that it cannot be inserted into a blood vessel. In addition, as described above, since the guide wire insertion operation needs to be performed with both hands, there is a problem that the insertion operation is complicated.

  Accordingly, the present invention was devised to solve the above-described problem, and provides a guide wire insertion tool that can reliably perform an operation for inserting a guide wire into a blood vessel and is simple in the operation. Is an issue.

  In order to solve the above problems, a guide wire insertion tool according to the present invention is used to connect a puncture tool and insert a guide wire into a blood vessel, and the guide wire is inserted into a cylindrical body. A flow path is formed, a connecting portion for connecting the puncture device is formed on the front end side of the first flow path, and an insertion port for inserting the guide wire is formed at the rear end of the first flow path. A main body having a wire insertion part, a branch part in which a second flow path communicating with the first flow path is formed inside a cylindrical body branched from the wire insertion part, and after the first flow path A first valve body portion that is disposed on the end side and holds the guide wire in a liquid-tight state when the guide wire is inserted; and blood that is connected to the branch portion and flows into the inside from the second flow path. A blood containing part in which a deformable and reversible space part is formed; A second valve body portion that is arranged on the rear end side of the space portion and blocks the intrusion of outside air into the space portion, and the blood storage portion side of the branch portion is substantially parallel to the insertion direction of the guide wire. It is bent so as to become.

  According to the above configuration, when the blood container is crushed, the puncture tool is punctured into the blood vessel in a state where the space part is deformed, and then the crushing of the blood container part is released, the negative pressure is generated in the space part due to the restoration of deformation. As a result, it is possible to easily confirm that blood flows backward (flash bag) from the puncture device to the space portion via the first flow path and the second flow path, and the tip of the puncture tool is located in the blood vessel. Further, after confirming the flash bag, when the guide wire inserted from the first valve body is inserted into the blood vessel via the first flow path and the puncture device, the branching portion is substantially parallel to the guide wire insertion direction. Therefore, the guide wire can be inserted by a hand holding the blood storage part connected to the branch part. As a result, since the guide wire can be inserted into the blood vessel not with both hands, and with the hand (one hand) holding the blood storage part without changing the hand holding the blood storage part, the guide wire insertion tool is It is possible to prevent the tip of the puncture device (puncture needle) from moving out of the blood vessel without moving.

  The guide wire insertion tool according to the present invention is a guide for placing the guide wire so as to extend from the rear end of the wire insertion portion so that the guide wire insertion tool inserts the guide wire into the insertion port. It is preferable to further include a part.

  According to the above configuration, since the guide portion is further provided, the guide wire moves smoothly inside the guide wire insertion tool and the guide wire insertion tool does not move, so that the tip of the puncture tool (puncture needle) is a blood vessel. It is possible to further prevent the shift from the inside.

  In the guide wire insertion tool according to the present invention, it is preferable that at least a part of the wire insertion portion, the branch portion, and the blood storage portion is made of a transparent material.

  According to the above configuration, since at least a part of the wire insertion portion, the branch portion, and the blood storage portion are made of a transparent material, it is easy to confirm the flashback and easily confirm the failure of blood vessel puncture by the puncture device. it can.

  The guide wire insertion tool according to the present invention is further characterized in that the guide wire insertion tool is further provided with a stopcock portion that is disposed in the branch portion and performs switching between opening and closing of the second flow path.

  According to the said structure, by further providing a stopcock part, a blood storage part can be deform | transformed reliably, the negative pressure which generate | occur | produces at the time of the restoration | restoration of a blood storage part becomes large, and it becomes easy to generate | occur | produce flashback. . As a result, failure of blood vessel puncture by the puncture device can be more easily confirmed. Further, after the flashback is confirmed, the second flow path is blocked by the stopcock portion, thereby preventing excessive blood from flowing into the guide wire insertion tool. As a result, when the guide wire insertion tool is removed from the guide wire and discarded after the guide wire insertion operation is completed, blood leakage from the guide wire insertion tool is less likely to occur, and the disposal work is facilitated.

  According to the guide wire insertion tool of the present invention, the flashback can be easily confirmed and the guide wire insertion operation can be performed with one hand, so that the tip of the puncture tool is not displaced from the inside of the blood vessel. The operation for insertion into the blood vessel can be performed reliably, and the operation can also be performed easily.

It is a front view which shows the structure of the guide wire insertion tool which concerns on this embodiment. It is a fragmentary sectional view which shows the structure of the main-body part of the guide wire insertion tool which concerns on this embodiment. It is a fragmentary sectional view which shows the structure of the blood accommodating part of the guide wire insertion tool which concerns on this embodiment. It is a perspective view which shows an example of the holding part (guide part) of the guide wire introduction tool which concerns on this embodiment. It is a disassembled perspective view which shows an example of the stopcock part of the guide wire insertion tool which concerns on this embodiment. It is a schematic diagram which shows one step of the usage method of the guide wire insertion tool which concerns on this embodiment. It is a schematic diagram which shows another one step of the usage method of the guide wire insertion tool which concerns on this embodiment. It is a schematic diagram which shows another one step of the usage method of the guide wire insertion tool which concerns on this embodiment. It is a schematic diagram which shows another one step of the usage method of the guide wire insertion tool which concerns on this embodiment.

An embodiment of a guide wire insertion tool according to the present invention will be described with reference to the drawings.
As shown in FIG. 1, the guide wire insertion tool 1 is used to connect to the puncture tool 30 and insert the guide wire GW into the blood vessel. The guide wire insertion tool 1 mainly includes the main body 2 and the first valve body. Unit 10, blood storage unit 11, and second valve body unit 13.
Each configuration will be described below. In the present invention, the side connected to the puncture device is defined as the front side, and the opposite side is defined as the rear side.

  Here, the puncture device 30 is a conventionally known one that is used by puncturing a blood vessel, and includes, for example, a hollow puncture needle 31 having a sharp needle tip and a hub 32 to which the puncture needle 31 is joined. The hub 32 is formed with a lumen 32a (see FIG. 2) for connecting the guide wire insertion tool 1.

(Main body)
As shown in FIG. 2, the main body 2 has a wire insertion part 3 and a branch part 4.
The wire insertion part 3 is comprised from the cylindrical body, the 1st flow path 5 in which the guide wire GW is penetrated is formed in the inside of the cylindrical body, and the puncture tool 30 is connected to the front end side of the first flow path 5. A connection portion 6 is formed, and an insertion port 7 for inserting the guide wire GW is formed at the rear end of the first flow path 5. Moreover, it is preferable that the wire insertion part 3 is comprised with the cylindrical body made from a synthetic resin. Further, the connecting portion 6 is preferably one that is luer-fitted with the hub 32 of the puncture device 30 described above, and the connecting portion 6 is preferably a male luer portion, and the lumen 32a of the hub 32 is preferably a female luer portion.

  The branch portion 4 is configured by a cylindrical body branched from the wire insertion portion 3, and a second flow path 8 communicating with the first flow path 5 is formed inside the cylindrical body. Moreover, it is preferable that the branch part 4 is comprised with the cylindrical body made from a synthetic resin similarly to the wire penetration part 3. FIG. Further, the branch portion 4 branches from the wire insertion portion 3 to the rear end side at an angle of less than 90 degrees, preferably 15 to 55 degrees, and the rear end side of the branch portion 4 via the bent portion 9, that is, blood accommodation. It is preferable that the part 11 (refer FIG. 1) side takes the bent form which becomes substantially parallel to the insertion direction of the guide wire GW. And since the branch part 4 has the bending part 9, it becomes possible to perform holding | maintenance of the blood accommodating part 11, and extrusion operation of the guide wire GW with one hand in the case of insertion operation in the blood vessel of the guide wire GW, Since the guide wire insertion tool 1 does not move, the puncture needle 31 is prevented from shifting from within the punctured blood vessel, and the guide wire GW can be reliably inserted into the blood vessel.

(First valve body)
The first valve body portion 10 is disposed on the rear end side of the first flow path 5 formed in the wire insertion portion 3, preferably in contact with the insertion port 7, and guides when the guide wire GW is inserted. The wire GW is held liquid-tight. The first valve body 10 is preferably a so-called slit valve in which a slit 10b is formed at the center of a disc-shaped valve body 10a made of an elastic member. In the case of a slit valve, the valve main body 10a expanded by the guide wire GW inserted through the slit 10b holds the guide wire GW in a liquid-tight state by its elastic force.

(Blood storage part)
As shown in FIG. 3, the blood storage portion 11 is configured by a flexible container connected to the branch portion 4, and a space portion 12 for storing blood flowing from the second flow path 8 is formed inside the flexible container. It has been done. Here, the blood flowing in from the second flow path 8 flows back (flashback) from the puncture tool 30 to the second flow path 8 through the first flow path 5 when the blood vessel is punctured by the puncture tool 30. Means blood coming. Then, the backflow (flash bag) is generated when the space portion 12 becomes negative pressure due to the restoring force of deformation of the blood storage portion 11.

  Specifically, when the blood storage unit 11 is crushed by hand, the space 12 is deformed, and when the crushing is released, a deformation restoring force is generated, and the space 12 becomes negative pressure. Therefore, the constituent material of the blood storage part 11 is a flexible material that can be easily crushed and can easily obtain a restoring force from the crushing, specifically, a synthetic resin such as polyvinyl chloride or polyethylene. preferable. Further, the blood containing part 11 is preferably a spindle-shaped one, and the inner volume is preferably about 2.5 ml.

(Second valve body)
As shown in FIG. 3, the second valve body portion 13 is disposed on the rear end side of the space portion 12 of the blood storage portion 11 and blocks the intrusion of outside air into the space portion 12. The second valve body 13 is preferably a so-called slit valve in which a slit 13b is formed at the center of a disc-shaped valve body 13a made of an elastic member. In the case of the slit valve, the blood containing part 11 is crushed by a force larger than the elastic force of the valve main body part 13a, whereby the slit 13b is opened by the internal pressure of the space part 12, and air is discharged from the space part 12. Is done. And when crushing of the blood storage part 11 is cancelled | released, the slit 13b is closed by the elastic force of the valve main-body part 13a, and the penetration | invasion of the external air to the space part 12 is interrupted | blocked. Further, the space 12 of the blood accommodating part 11 becomes negative pressure due to the discharge of air from the slit 13 b of the second valve body part 13 and the restoring force of the blood accommodating part 11.

As shown in FIGS. 1 and 2, the guide wire insertion tool 1 according to the present embodiment preferably further includes a guide portion 14 in addition to the above configuration.
(Guide part)
The guide portion 14 is provided so as to extend from the rear end of the wire insertion portion 3 and place the guide wire GW in order to insert the guide wire GW into the insertion port 7 of the wire insertion portion 3. The guide portion 14 is a holding portion in which a plate-like body 15 extending from the rear end of the wire insertion portion 3 and a through hole (not shown) through which the guide wire GW is inserted at a predetermined position of the plate-like body 15 are formed. And those having 16 are preferred. The plate-like body 15 may have a groove (not shown) formed on the surface thereof.

  The guide portion 14 preferably has a holding portion 17 as shown in FIG. The holding unit 17 includes a roller 18 that pushes the guide wire GW through rotation and movement, and a pair of roller holding units 19 and 19 that are erected on both sides of the support unit 20 so as to sandwich the roller 18. Since the roller 18 has a non-slip 18b formed on the surface thereof, the operator's finger is difficult to slip. The pair of roller holding portions 19, 19 is formed with a roller guide hole 19 a that holds the roller shaft 18 a of the roller 18 and moves the roller 18 in the guide wire GW insertion direction, that is, the longitudinal direction of the roller holding portion 19. ing.

  In the guide wire insertion tool 1 according to the present embodiment, it is preferable that at least a part of the wire insertion part 3, the branch part 4, and the blood storage part 11 are made of a transparent material. Here, at least in part, the wire insertion part 3 is partially made of a transparent material, the branch part 4 is partly made of a transparent material, and the blood storage part 11 is partly made of a transparent material. To include. From the viewpoint of confirmation of blood backflow (flashback), it is most preferable that all of the wire insertion part 3, the branch part 4 and the blood storage part 11 are made of a transparent material. As the transparent material, for example, a synthetic resin such as polyvinyl chloride or polyethylene is used.

  As shown in FIG. 1, the guide wire insertion tool 1 according to this embodiment preferably further includes a stopcock portion 21 in addition to the above-described configuration. The stopcock part 21 is arrange | positioned at the branch part 4, and switches the opening and closing of the 2nd flow path 8 (refer FIG. 2).

  As shown in FIG. 5, the stopcock portion 21 is inserted into the stopcock body 22 having two ports 24a and 24b formed on the outer periphery of the cylindrical portion 23, and rotatably inserted into the cylindrical portion 23, and corresponds to the ports 24a and 24b. It is preferable to include a cock 25 having a body portion 26 in which a flow path 27 is formed. In such a stopcock portion 21, the cock 25 is rotated by the lever 28 to open and close the flow path between the ports, that is, to open and close the second flow path 8 (see FIG. 2) of the guide wire insertion tool 1. Can be switched.

  Next, an example of a method for using the guide wire insertion tool according to the present embodiment will be described with reference to FIGS. The configuration of the guide wire insertion tool will be described with reference to FIGS. 1 to 3 as appropriate. The guide wire insertion tool 1 will be described as including a stopcock portion 21 at the branch portion 4.

(1) As shown in FIG. 6, the guide wire insertion tool 1 is connected to the puncture tool 30 before the puncture operation. Next, the distal end portion of the guide wire GW is inserted into the first valve body portion 10 that is in contact with the insertion port 7 and is positioned in the wire insertion portion 3. And the blood accommodating part 11 is crushed by hand. At this time, it is preferable that the stopcock portion 21 is closed and the crushing pressure is larger than the elastic force of the second valve body portion 13. As a result, the blood containing part 11 is crushed, that is, the space part 12 is reliably deformed.

(2) As shown in FIG. 7, the puncture device 30 is punctured into a blood vessel at a predetermined position, for example, a central venous blood vessel.

(3) As shown in FIG. 8, the stopcock portion 21 is opened, the crushing of the blood storage portion 11 is released, and the deformation of the space portion 12 is restored. Then, it is visually confirmed that blood flows backward (flashback) from the puncture device 30 to the blood storage unit 11 via the first flow path 5 and the second flow path 8. If flashback cannot be confirmed, repeat from step (1).

(4) As shown in FIG. 9, when the flashback is confirmed, the stopcock portion 21 is closed. In this state, the guide wire GW positioned in the wire insertion part 3 is pushed toward the puncture tool 30 with the hand holding the blood storage part 11, and the guide wire GW is inserted into the blood vessel.

  Although the insertion of the guide wire GW into the blood vessel is completed as described above, in a normal procedure, the puncture tool 30 and the guide wire insertion tool 1 are removed from the guide wire GW while leaving the guide wire GW in the blood vessel. And the guide wire GW is placed in the blood vessel. Next, a catheter (not shown) is inserted into the blood vessel along the guide wire GW. Then, the guide wire GW is removed while leaving the catheter, and the catheter is placed in the blood vessel.

DESCRIPTION OF SYMBOLS 1 Guide wire insertion tool 2 Main-body part 3 Wire insertion part 4 Branch part 5 1st flow path 6 Connection part 7 Insertion port 8 2nd flow path 9 Bending part 10 1st valve body part 11 Blood accommodating part 12 Space part 13 2nd Valve body part 14 Guide part 21 Stopcock part GW Guide wire

Claims (4)

A guide wire insertion tool used to connect a puncture device and insert a guide wire into a blood vessel,
A first flow path through which the guide wire is inserted is formed inside the cylindrical body, a connecting portion for connecting the puncture device is formed on the front end side of the first flow path, and a rear end of the first flow path A wire insertion part in which an insertion port for inserting the guide wire is formed, and a branch part in which a second flow path communicating with the first flow path is formed inside a cylindrical body branched from the wire insertion part; A main body having
A first valve body portion disposed on the rear end side of the first flow path and holding the guide wire in a liquid-tight manner when the guide wire is inserted;
A blood storage part connected to the branch part, in which a deformable and recoverable space part for storing blood flowing in from the second flow path is formed;
A second valve body portion disposed on the rear end side of the space portion and blocking intrusion of outside air into the space portion;
The guide wire insertion tool, wherein the branch portion is bent so that the blood storage portion side is substantially parallel to an insertion direction of the guide wire.   The guide wire insertion tool further includes a guide portion that extends from a rear end of the wire insertion portion and places the guide wire so that the guide wire is inserted into the insertion port. Item 2. A guidewire insertion tool according to Item 1.   The guide wire insertion tool according to claim 1 or 2, wherein at least a part of the wire insertion part, the branch part, and the blood storage part is made of a transparent material.   The said guide wire insertion tool is further arrange | positioned at the said branch part, and is further equipped with the stopcock part which switches the opening and closing of the said 2nd flow path, The Claim 1 thru | or 3 characterized by the above-mentioned. The guide wire insertion tool described in 1.

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