JP2017131612A - Deep venipuncture instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To solve the following problem: in a deep venipuncture operation, the actual puncture needle may not be pierced into a vein though a test puncture was successfully performed for the reason that the test puncture needle is withdrawn after a vein is determined, and the actual puncture need cannot advance through the same path as the test puncture needle.SOLUTION: A trocar is mounted to a tip end opening of a T-shaped tube, the tip end opening of the T-shaped tube being male, and both the tail end opening and the side opening are female. A 22G stainless tube is then secured to the tail end opening of the T-shaped tube, the 22G stainless tube having a length that its tip end protrudes a few millimeters from the tip end of the trocar when it is inserted into the T-shaped tube through the tail end opening, and the stainless tube being provided with a bent section. A guide wire is indwelt inside a deep vein through a 22G test puncture needle and the guide wire is used as a guide shaft to reliably guide a puncture needle into the deep vein.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a deep vein puncture device that guides a puncture needle into a vein using a guide wire introduced into the vein through a thin test puncture needle of 22G or less as a guide shaft.

Conventionally, when a catheter is indwelled in a deep vein, first, a test puncture is performed with a thin test puncture needle of 22G or less to confirm the direction and depth of the deep vein, and then the test puncture needle is once removed, and then a thick mantle type puncture needle The main puncture is performed, and the catheter is guided into the vein through the outer tube lumen of the main puncture needle. However, even if the position of the vein is confirmed with the test puncture needle and the main puncture is performed in the same distance direction, the main puncture needle may not be inserted into the vein. The reason is that the test puncture needle is withdrawn once after confirming the vein, and the trajectory through which the test puncture needle has passed is not preserved, so that this puncture needle cannot travel the same path as the test puncture needle. .
Serious accidents in deep vein puncture are mostly arterial hemorrhage caused by accidental puncture of the artery with a thick main puncture needle and pneumothorax caused by erroneous puncture of the lung during subclavian vein puncture. This occurs because the needle is inserted blindly. On the other hand, even if the artery is punctured with a test puncture needle of 22G or less, there is no risk of massive arterial bleeding, and even if the lung is punctured, it rarely develops to a serious pneumothorax.
Confirmation of intravenous insertion of the test puncture needle is visually confirmed by sucking blood into the syringe. Thinner needles are safer for test puncture needles, but when puncturing with a test puncture needle of 22G or less, the blood backflow into the syringe is insufficient, so the 22G needle is optimal for the test puncture needle .

  The problem to be solved is that when performing deep vein puncture, the puncture needle cannot follow the same path through which the test puncture needle has passed.

Means to solve the problem

  The present invention, when performing deep vein puncture, temporarily places a guide wire in a vein through a test puncture needle, guides the puncture needle into the vein using the guide wire as a guide shaft, and The main purpose is to confirm that the tip of the needle has been inserted into the vein by aspirating the connected syringe and visually confirming the backflow of blood in the syringe.

Effect of the invention

  According to the deep vein puncture device of the present invention, the puncture needle is guided into the deep vein through the same path through which the test puncture needle has passed, and the fact that the puncture needle has been inserted into the vein It is confirmed by visually recognizing the backflow of blood.

(Example 1) (a) Sketch of branch tube Aa (b) Sketch of main puncture needle Ba (c) Sketch of guide tube Ca (d) Side view combining the whole of Example 1 (Example 1) (a) The partial expanded sectional view which shows the relationship between the front-end | tip of this puncture needle which gave the backcut, and a guide tube. (B) End view in Xa-X'a cross section. (Example 1) (a) Side view of a syringe connected to a deep vein puncture device. (B) The side view which connected the syringe to the deep vein puncture device and sucked blood. (A) Use explanatory drawing of this invention. (B) Use explanatory drawing of this invention. (C) Use explanatory drawing of this invention. (D) Use explanatory drawing of this invention. (E) Use explanatory drawing of this invention. Other guide pipes (a) The partial perspective view of the guide pipe which attached the guide pipe rod. (B) Perspective view of guide tube rod. (C) The partial side view which shows the relationship between the guide tube which attached the guide tube rod, and this puncture needle. (D) End view of the guide tube and the puncture needle at the Xc-Xc ′ cut surface. Other guide pipes (a) Development view of guide pipe rods. (B) A partial side surface of the guide tube to which the guide tube rod is attached. (C) The partial side view which shows the relationship between the guide tube which attached the guide tube rod, and this puncture needle. (D) End view of the guide tube and the puncture needle at the Xd-Xd ′ cut surface. (Example 2) (a) An exploded sketch of the branch pipe Ag. (B) An exploded longitudinal sectional view of the branch pipe Ag. (C) The sketch showing the longitudinal cross-section which assembled the branch pipe Ag. (D) The side view which combined the whole Example 2. FIG.

  The purpose of inserting the puncture needle into the vein through the path through which the 22G test puncture needle has passed, and confirming that the puncture needle has been inserted into the vein by visually confirming the backflow of blood in the syringe. This was achieved with a simple structure.

The present invention includes a branch tube A, a main puncture needle B, and a guide tube C.
Fig.1 (a)-(c) is an exploded view of Example 1, FIG.1 (d) is the side view which assembled the whole. The first embodiment includes a branch tube Aa, a main puncture needle Ba, and a guide tube Ca. The branch pipe Aa is a T-shaped tube provided with a locking portion Aa1 made of a female luer at the head, a locked portion Aa2 made of a male luer at the tail, and a locking portion Aa3 made of a female luer on the side surface. The puncture needle Ba is an 18G to 14G injection needle, and is an inner needle of a mantle type puncture needle that is combined with the mantle Da as shown in FIG. The guide tube Ca is a 22G stainless steel thin tube provided with a locked portion Ca2 made of male luer at the head end and a bent portion Ca6 in the guide tube body Ca3. As shown in FIG. 1 (d), the length of the guide tube Ca is such that the guide tube Ca is inserted from the locking portion Aa1 of the branch tube Aa and the locked portion of the guide tube Ca is inserted into the locking portion Aa1 of the branch tube Aa. When Ca2 is inserted and fixed, the guide tube tip Ca4 of the guide tube Ca is projected from the tip of the main puncture needle tip Ba4. Practically, the total length of the guide tube Ca may be determined so as to protrude about 5 to 10 mm. The guide tube C may be a thin tube made of a hard material other than metal.

  FIG. 2A is an enlarged view of the distal end portions of the puncture needle Ba and the guide tube Ca. As shown in FIG. 2A, the puncture needle needle tip Ba4 is provided with a backcut Ba5 on the blade tip. Further, the guide tube Ca is bent at a longitude at a bent portion Ca6. Therefore, when the guide tube Ca is inserted into the main puncture needle Ba, the guide tube body Ca3 is pressed against the inner wall of the main puncture needle tube Ba at the tip of the main puncture needle. Accordingly, since the surface of the guide tube body Ca3 and the backcut Ba5 tip of the puncture needle blade tip are in close contact with each other and there is no level difference, tissue damage during puncture can be prevented. FIG. 2B is an end view at the Xa-Xa ′ cut surface, and shows a gap Ra between the puncture needle Ba and the guide tube Ca. FIG. 2 (b) shows the gap Ra when the puncture needle is 16G and the test puncture needle is 22G. The area of the gap Ra is larger than the cross-sectional area of the lumen of the 22G test puncture needle. The passage of venous blood when sucked is smooth. When the bent portion Ca6 is gently curved, the guide wire easily passes therethrough.

In FIG. 3A, the guide tube Ca is inserted into the branch pipe Aa, the locked portion Ca2 of the guide tube Ca is inserted and fixed into the locking portion Aa1 of the branch tube Aa, and the locked portion Aa2 of the branch tube Aa. FIG. 6 is a side view in which the present puncture needle needle base Ba1 is fitted and fixed, and the syringe Sa is connected to the locking portion Aa3 of the branch pipe Aa. The syringe Sa, the branch tube Aa, and the puncture needle Ba form a hollow circuit and are connected in an airtight manner.
FIG. 3B is a view in which blood is sucked from the tip of the puncture needle Ba by applying a negative pressure to the syringe Sa. If the syringe Sa is pulled while the tip of the puncture needle Ba is in the vein, the venous blood is sucked into the syringe Sa. Therefore, if the syringe Sa is pulled and venous blood is visually recognized in the syringe Sa, it is proved that the tip of the puncture needle Ba is in the vein.

  As the branch pipe, a Y-shaped tube can be used instead of the T-shaped tube.

  The guide wire G is a thin metal or synthetic resin wire that can be loosely inserted into the guide tube body Ca3. The guide wire has flexibility, and the guide wire tip G1 is used for soft or J-type conventional medical treatment. It is the same structure as the guide wire.

4A to 4E are explanatory views showing the usage.
(1) First, as shown in FIG. 1 (a), the deep vein V is punctured with a 22G test puncture needle Na.
(2) Next, the guide wire G is temporarily placed in the deep vein V through the test puncture needle Na as shown in FIG.
(3) Next, as shown in FIG. 3C, the guide wire tail end G1 is inserted from the guide tube tip Ca4 into the guide tube Ca.
(4) Subsequently, when the venipuncture device is advanced along the guide wire G as shown in FIG. 4D, the puncture needle tip Ba4 is guided by the guide wire G and inserted into the vein V lumen. .
{Circle around (5)} Finally, if the main puncture needle Ba is removed while leaving the outer tube Da, as shown in FIG. 5E, the outer tube Da is in a state where the distal end is placed in the vein V.
(6) If the venous catheter is inserted through the mantle tube Da, the venous catheter is placed in the deep vein.

The guide wire G is made of a hard synthetic resin having an appropriate flexibility at the tip, or a synthetic resin or metal guide wire having a soft tip and a hard portion at the other end.
In the present invention, when performing the puncturing operation along the guide wire G placed in the vein, the guide wire G does not contact the cutting edge at the tip of the puncture needle. Therefore, since the guy wire G does not come into contact with the puncture needle blade edge Ba4 during the puncture operation and is not damaged, it is possible to use a single yarn having an appropriate hardness made of a synthetic resin that is not made of metal as a guide wire. it can.

  5 (a) to 5 (d) show other guide tube Cc structures. The guide tube Cc is a 22G stainless steel thin tube, and is attached to the tube body Cc3 by welding or bonding. FIG. 5B is a sketch of 鰭 Cc6. As shown in FIG. 5C, the guide tube Cc is supported in the main puncture needle tube body Bc3 so as to be in close contact with the main puncture needle tube body Bc by the flange Cc6. Therefore, the puncture needle tip Bc4 and the guide tube tube Cc3 can be brought into close contact with each other without any step. FIG. 5D is an end view showing the relationship between the main puncture needle Bc and the guide tube Cc, and a gap Rc is formed between the main puncture needle tube Bc3 and the guide tube tube Cc3.鰭 Cc6 can be made of synthetic resin.

  FIGS. 6A to 5D show other structures of the guide tube Cd. The guide tube Cd is a 22G stainless steel thin tube having a flange Cd6 as shown in FIG. 5B by pressing a stainless steel sheet as shown in FIG. is there. As shown in FIG. 5C, the guide tube Cd is supported in the main puncture needle tube Bd3 so as to be in close contact with the main puncture needle tube Bd by the collar Cd6. Therefore, the puncture needle tip Bd4 and the guide tube tube Cd3 can be brought into close contact with each other without any step. FIG. 5D is an end view showing the relationship between the main puncture needle Bd and the guide tube Cd, and a gap Rd is formed between the main puncture needle tube Bd3 and the guide tube tube Cd3.

  FIGS. 7A to 7C are schematic views of the branch pipe Ag in the second embodiment. FIG. 7D is a side view in which the main puncture needle Bg is connected to the branch pipe Ag and the guide pipe Cg is further attached. It is. The branch pipe Ag according to the second embodiment includes a cup Ag10 and a plug Ag11. As shown in the sketch of FIG. 7A and the longitudinal sectional view of FIG. 7B, the cup Ag10 is a bottomed cylindrical body provided with a locked portion Ag2 made of male luer on the bottom. The plug Ag11, as shown in the sketch of FIG. 7 (a) and the longitudinal sectional view of FIG. 7 (b), is a columnar shape that vertically penetrates a locking portion Ag1 made of a female luer and a connecting cylinder Ag7 made of a female luer. Is the body. As shown in FIG. 7C, the plug Ag11 is inserted into the tube of the cup Ag10 so that it can be fixed in an airtight manner. The cup Ag10 and the plug Ag11 may be hermetically sealed with a sealing material or mechanically coupled hermetically. When the cup Ag10 and the plug Ag11 are connected, the locked portion Ag2 of the cup Ag10 and the locking portion Ag1 of the plug Ag11 are arranged and fixed on the same straight line. When the guide tube Cg is inserted from the locking portion Ag1 of the plug Ag11, the guide tube Cg protrudes from the locked portion Ag2 of the cup Ag10 and is fixed. FIG. 7D is a side view in which the second embodiment is assembled. The plug Ag11 and the cup Ag10 are connected, the puncture needle Bg is connected to the locked portion Ag2 of the cup Ag10, and the locking portion Ag1 of the plug Ag11 is connected. It is the side view which inserted the guide tube Cg, inserted and fixed the latching | locking part Cg2 of the guide tube Cg, and connected syringe Sg to the connection cylinder Ag7 of plug Ag11. Since the connection tube Ag7 of the main puncture needle Bg and the plug Ag11 forms a closed circuit, if the syringe Sg connected to the connection tube Ag7 is sucked while the main puncture needle tip Bg4 is in the vein, the connection tube Ag7 is inserted into the syringe Sg. It is confirmed that blood is aspirated and the puncture needle tip Bg4 is present in the vein.

If an injection needle of 22G or less is used when performing deep vein puncture, even if the needle tip is accidentally inserted into an artery, hemostasis is naturally stopped, so that no major bleeding occurs. Further, even if the tip of the 22G needle is inserted into the lung, the amount of air leakage is small, and the insertion hole is naturally closed. On the other hand, the presently used puncture needle has a thickness of 20 G or more, and there is a risk of serious accidents occurring when an artery or lung is erroneously punctured. According to the present invention, the test puncture is performed with a 22G thin test puncture needle, and this puncture needle advances following the trajectory of the test puncture needle. Therefore, there is no risk that the puncture needle travels through the wrong route. On the other hand, the venous pressure is low unlike the arterial pressure, and even if the puncture needle is inserted into the vein, venous blood does not flow back unless negative pressure is applied to the syringe. In the present invention, it is possible to positively confirm that the tip of the puncture needle has been inserted into the vein by sucking and visually confirming venous blood with a syringe. Therefore, in the present invention, if the test puncture is successful, the tip of the puncture needle is safely and reliably inserted into the target vein.
If the deep vein puncture device of the present invention is used under an echo guide, deep vein puncture can be performed more safely.

Aa, Ag Branch pipes Aa1, Aa3, Ag1 Locking part Aa2, Af2 Locked part Ag7 Connecting cylinder Ag10 Cup Ag11 Plug Ba, Bc, Bd, Bg Main puncture needle Ba1, Bg1 Main puncture needle base Ba3, Bc3, Bd3 , Bg3 puncture needle tube Ba4, Bc4, Bd4, Bg4 puncture needle tip Ba5, Bc5, Bd5, Bg5 Backcut Bla Blood Ca, Cc, Cd, Cg Guide tube Ca2, Cg2 Locked portion Ca3, Cc3, Cd3 Guide Tubes Ca4, Cc4, Cd4, Cg4 Guide tube tip Ca6 Bending part Cc6, Cd6 鰭 Cc7, Cd7 Slope Da Outer coat Da3 Split line G Guide wire G1 Guide wire tail end G2 Guide wire tip Na Test puncture needles Ra, Rc, Rd Gap Sa, Sg Syringe V vein

Claims (8)

  Locked portion and locking portion arranged on a straight line, a trifurcated branch tube having a side tube on the side surface, a puncture needle connectable to the locked portion, and locked to the locking portion 22G having a length that protrudes a few millimeters or more from the distal end of the main puncture needle connected to the locked portion of the branch tube when inserted into the branched tube from the locked portion. A deep vein puncture device comprising a tubule.   The deep vein puncture device according to claim 1, wherein the branch tube is a T-shaped tube in which the locked portion is a male luer and the locking portion and the side tube are female lures.   The deep vein puncture device according to claim 1, wherein the branch tube is a Y-shaped tube in which the locked portion is a male luer and the locking portion and the side tube are female lures.   A cylindrical cup having a locked portion made of a male luer on the bottom, and an arrangement that can be inserted and fixed in an airtight manner in the cup, and is arranged in a straight line with the locked portion of the cup when inserted and fixed in the cup. The deep vein puncture device according to claim 1, further comprising: a plug provided through the stopper and provided with a locking portion made of a female luer separately from the locked portion.   The deep vein puncture device according to claim 1, wherein the guide tube is provided with a bent portion.   The deep vein puncture device according to claim 1, wherein a scissors are attached to the guide tube.   5. The deep vein puncture device according to claim 1, wherein a heel is attached to the guide tube by press working.   The deep vein puncture device according to claim 1, comprising a branch tube, a guide tube, and a mantle-type puncture needle.

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