JP2020022679A - Hemostatic device - Google Patents

Abstract

To provide a hemostatic device which can suppress a positional deviation of a pressing member relative to a site where bleeding should be stopped when movements of a hand of a patient or the like occur during a procedure to stop bleeding.SOLUTION: A hemostatic device 10 includes a covering part 20 arranged on a puncture site t of a hand H and a pressing part 30 arranged inside the covering part 20. The pressing part includes a pressing member 40 for pressing the puncture site and a supporting member 50 positioned between the covering part and the pressing member. The pressing member includes a recessed part 44 which can be arranged on a protruding part g1 formed on an outer surface of the hand. The pressing member is movable relative to the supporting member while being connected to the supporting member in a state where the pressing member presses the puncture site.SELECTED DRAWING: Figure 1A

Description

  The present invention relates to a hemostatic device.

  As one of the catheter procedures, a blood vessel (e.g., a radial artery) of a patient's arm is punctured, and various medical elongate bodies are introduced into the blood vessel through a puncture site formed in the blood vessel of the patient's arm. Techniques for performing treatment or treatment on a site are known (see Patent Document 1 below). For example, a catheter procedure utilizing the radial artery is called a transradial artery approach.

  The radial artery running on the arm of the human body is connected to the palm artery bypassing the hand side. Therefore, at present, as a new technique of the transradial artery approach, a catheter technique by dTRA (distal transradial approach) that punctures a palm artery (including the distal radial artery) located in the hand and performs treatment through the puncture site is known. Attempted.

JP 2008-119517 A

  A blood vessel such as a palm artery located in the hand is located in a place where there are many movable parts such as a finger. Therefore, when the operator stops the puncture site of the blood vessel located in the hand after the catheterization procedure, if the patient spreads or grasps the hand, the shape of the hand changes and the existing hemostasis for the arm or leg is used. In the device, a pressing member (expansion member or the like) for applying a pressing force to the puncture site may be displaced from the puncture site. When the pressing member (expansion member or the like) is displaced from the puncture site, it is difficult to appropriately maintain the pressure on the puncture site.

  The present invention has been made in view of the above-described problems, and has as its object to provide a hemostatic device that can appropriately maintain pressure on a puncture site even when hand movement or the like occurs.

  The hemostatic device according to the present invention has a covering portion arranged at a site where a hemostasis of a hand is to be performed, and a pressing portion arranged inside the covering portion, and the pressing portion defines the site at which the hemostasis is to be performed. It has a pressing member for pressing, a support member located between the covering portion and the pressing member, and the pressing member has a concave portion that can be arranged on a convex portion formed on the outer surface of the hand. The pressing member is relatively movable with respect to the support member while being connected to the support member in a state in which the pressing member presses the site to stop bleeding.

  According to the hemostatic device according to the present invention, the pressing member presses a part of the hand to stop bleeding in a state where the concave portion of the pressing member is arranged on the convex portion formed on the outer surface of the hand. Further, according to the hemostatic device of the present invention, the movement of the pressing member is not easily transmitted to the supporting member and the covering portion because the pressing member is relatively movable with respect to the supporting member. For this reason, in the hemostatic device of the present invention, even if a hand movement or the like occurs, only the pressing member moves in accordance with the movement of the convex portion formed on the outer surface of the hand. Therefore, the hemostatic device according to the present invention can suppress the displacement of the pressing member with respect to the site where the hemostasis is to be performed, even if the patient's hand moves during the hemostasis. Therefore, the hemostatic device according to the present invention can appropriately maintain pressure on the puncture site even when hand movement or the like occurs.

It is a perspective view when the hemostatic device concerning embodiment of this invention is seen from the side which covers the back of a hand. It is a perspective view when the hemostatic device concerning embodiment of this invention is seen from the side which covers a palm. It is a perspective view showing the 1st press member and the support member with which the press part of the hemostatic device concerning the embodiment of the present invention is provided. It is a top view which shows the 1st press member and support member with which the press part of the hemostatic device which concerns on embodiment of this invention is provided. It is an expanded sectional view of the area | region enclosed with the broken line 2C of FIG. 2A. It is a perspective view showing the 2nd pressing member with which the pressing part of the hemostatic device concerning the embodiment of the present invention is provided. It is a figure used for explanation of the example of use of the hemostatic device concerning an embodiment of the present invention, and is a top view showing the state where a medical long object was inserted in a blood vessel of a patient's hand. FIG. 5 is a plan view showing a state where the hemostatic device is attached to the patient's hand from the state of FIG. 4. FIG. 6 is a plan view showing a state in which the hemostatic device is attached to the patient's hand from the state of FIG. 5. FIG. 7 is a plan view showing a state where the medical elongate body is removed from the state of FIG. 6 and hemostasis is being performed by a hemostatic device. FIG. 8 is a cross-sectional view taken along line 8A-8A in FIG. 6. FIG. 8 is a sectional view taken along line 8B-8B in FIG. 7.

  Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. The following description does not limit the technical scope and the meaning of the terms described in the claims. In addition, the dimensional ratios in the drawings are exaggerated for convenience of description, and may be different from the actual ratios.

  1A to 8B are views for explaining a hemostatic device 10 according to an embodiment of the present invention. In FIG. 8A, the elongated medical body S is omitted.

  For example, as shown in FIG. 4, the hemostatic device 10 includes a radial artery (for example, a snuff) of a palm artery (deep palm artery) that runs on the instep Hb side of a hand H located on the finger side of the patient's forearm A. A medical elongate body S (for example, an introducer) indwelled at a puncture site t (corresponding to a site to stop bleeding) formed in an artery around the box or a distal radial artery running on the fingertip side of the snuff box) When the sheath tube is removed, it can be used to stop the puncture site t.

  Briefly referring to FIGS. 1A and 1B, the hemostatic device 10 is arranged such that the covering portion 20 is disposed at the puncture site t of the hand H, and is disposed inside the covering portion 20 (the side facing the body surface) and punctures. And a pressing portion 30 for pressing the portion t. Hereinafter, each part of the hemostatic device 10 will be described in detail.

[Coating part]
As shown in FIG. 6, the covering portion 20 is formed of a bag 21 arranged so as to wrap the hand H of the patient.

  In the following description, the fingertips of the fingers f1 to f5 (thumb f1, index finger f2, middle finger f3, ring finger f4, and little finger f5) when the hemostatic device 10 is attached to the patient's hand H in the covering portion 20 will be described. The side located on the side is referred to as the distal side, and the side located on the forearm A side (wrist side) when the hemostatic device 10 is mounted on the patient's hand H in the covering portion 20 is referred to as the proximal side.

  As shown in FIG. 1A, the bag body 21 includes an internal space 22 into which the hand H of the patient can be inserted, a first opening 23a from which the thumb f1 can project, and a second opening 23b from which the index finger f2 can project. The third opening 23c capable of projecting the middle finger f3, the fourth opening 23d capable of projecting the ring finger f4, the fifth opening 23e capable of projecting the little finger f5, and the hand H of the patient are inserted into the bag 21. And a sixth opening 24 through which the hand H passes.

  As shown in FIG. 1A, the first opening 23 a to the fifth opening 23 e are formed on the tip end side of the bag 21. The sixth opening 24 is formed on the base end side of the bag 21.

  As shown in FIG. 6, in a state where the hemostatic device 10 is attached to the hand H, the first opening 23 a exposes from the fingertip of the thumb f <b> 1 to the base while the bag 21 covers the puncture site t of the hand H. It is open. Therefore, when inserting the hand H into the bag 21, the user can easily make the thumb f1 protrude from the first opening 23a. In particular, when inserting the hand H into the bag body 21 in a state where the long medical body S is disposed around the base of the thumb f1 of the hand H, the user can move the thumb f1 and the medical device through the first opening 23a. Both of the long members S can be easily protruded. Further, the user can easily remove the long medical body S with the hemostatic device 10 attached to the hand H.

  As shown in FIG. 1A, the bag body 21 is connected to the sixth opening 24 on the side that covers the back Hb of the hand H, and extends from the sixth opening 24 to the tip side (the third opening 23 c and the fourth opening 23). It has a slit 25 formed toward 23d). Therefore, as shown in FIG. 5, when inserting the hand H into the bag 21, the user can easily insert the hand H from the sixth opening 24 into the bag 21 by expanding the slit 25. In particular, when inserting the hand H into the bag 21 in a state where the medical elongate body S is disposed on the hand H, the user can use both the hand H and the medical elongate body S through the sixth opening 24. Can be easily inserted into the bag 21.

  As shown in FIG. 5, the bag 21 has a connecting portion 26 that can connect the ends 21 a and 21 b of the bag 21 formed by the slits 25.

  In the present embodiment, the connecting portion 26 includes a first member 26 a disposed at one end 21 a of the bag 21 formed by the slit 25 and another end 21 b of the bag 21 formed by the slit 25. And a second member 26b arranged at the second position.

  In this embodiment, the first member 26a is configured by the male side (or female side) of the hook-and-loop fastener. In the present embodiment, the second member 26b is configured by the female side (or the male side) of the hook-and-loop fastener. The first member 26a is disposed outside the bag body 21 (the side opposite to the side facing the body surface). The second member 26 b is arranged inside the bag 21. When the first member 26a and the second member 26b are connected with the hand H inserted into the bag body 21, the hemostatic device 10 is attached to the hand H as shown in FIG.

  The first member 26a may be arranged inside the bag 21 and the second member 26b may be arranged outside the bag 21. Further, the connecting portion 26 is not limited to the hook-and-loop fastener, and may be configured by, for example, a snap, a button, a clip, a magnet, or the like.

  The bag body 21 may be formed of, for example, a resin material such as polyolefin such as polyvinyl chloride, polyethylene, and polypropylene, polyester such as polyethylene terephthalate (PET) and polybutylene terephthalate (PBT), silicone, and urethane. Further, the bag body 21 may be formed by, for example, producing a chemical fiber from the resin material and knitting the chemical fiber. Further, the bag body 21 may be formed by weaving natural fibers such as cotton, silk, and wool.

  The configuration of the covering portion is not limited to the above. For example, the covering body does not have the plurality of openings 23b to 23e for individually protruding the fingers f2 to f5 other than the thumb f1 as in the present embodiment, but the fingers f2 to f5 other than the thumb f1. It may have a single opening that projects together. Further, for example, the bag of the covering portion may cover the fingers f2 to f5 other than the thumb f1 up to the fingertip.

[Pressing part]
As illustrated in FIG. 1B, the pressing unit 30 includes a first pressing member 40 (corresponding to a pressing member) that presses the puncture site t, and a support member 50 positioned between the covering unit 20 and the first pressing member 40. A second pressing member 60 (corresponding to another pressing member) that includes a penetrating portion 61 into which the thumb f1 can be inserted and presses the body surface of the hand H, and a first injection member 42 connected to the first pressing member 40. And a second injection member 63 connected to the second pressing member 60. Hereinafter, each part of the pressing part 30 will be described.

(First pressing member)
As shown in FIG. 2A, the first pressing member 40 is used to position the first expanding member 41, which can be expanded and contracted by inflow and outflow of a fluid such as air, and the first expanding member 41 to the puncture site t. And a marker section 43. Hereinafter, each part of the first pressing member 40 will be described.

  First, the first expansion member 41 will be described.

  As shown in FIGS. 8A and 8B, the first expansion member 41 has an internal space 41a into which a fluid flows. As shown in FIG. 8B, the first expansion member 41 presses the puncture site t in the expanded state in which the hemostatic device 10 is attached to the patient's hand H and the first expansion member 41 is expanded.

  As shown in FIG. 2A, the first expanding member 41 has a substantially rectangular parallelepiped outer shape with rounded corners in the expanded state. However, the outer shape of the first expansion member 41 is not particularly limited.

  As shown in FIGS. 2A and 8B, the first expanding member 41 has a concave portion 44 that can be arranged in the convex portion g1 formed on the outer surface of the hand H in the expanded state. In the present embodiment, as shown in FIG. 4, an example will be described in which the convex portion g1 is a tendon of the extensor long thumb of the snuff box and its surrounding tissue. As shown in FIG. 8B, the first expansion member 41 is relatively movable with respect to the support member 50 while being connected to the support member 50 in a state where the first expansion member 41 is pressing the puncture site t. It is. Therefore, even if the movement of the hand H occurs, only the first pressing member 40 moves in accordance with the movement of the protrusion g1 formed on the outer surface of the hand H. Therefore, the hemostatic device 10 can suppress the displacement of the first pressing member 40 with respect to the puncture site t, even when the movement of the patient's hand H occurs during hemostasis. Therefore, the hemostatic device 10 can appropriately maintain pressure on the puncture site t even when hand movement or the like occurs.

  As shown in FIGS. 2A and 8B, the concave portion 44 is formed on the side of the first expansion member 41 facing the hand H when the hemostatic device 10 is mounted on the hand H. As shown in FIGS. 2A and 2B, the concave portion 44 is formed along a direction d2 intersecting with the moving direction d1 of the first expanding member 41. Therefore, the first pressing member 40 suitably maintains a state in which the concave portion 44 is arranged on the convex portion g1 extending along one direction such as a tendon, and the patient moves his / her finger to the left or right, or Can be moved following the movement of the convex portion g1 in a direction intersecting with the extending direction of the convex portion g1 by expanding or closing the hand H.

  As shown in FIG. 2B, the concave portion 44 is formed at a position separated from the center P of the first expansion member 41 in the movement direction d1 in plan view. In this specification, “plan view” means that when the hemostatic device 10 is attached to the hand H, the hemostatic device 10 is moved from the outer surface side (the opposite side to the body surface) to the inner surface side (the opposite side to the body surface). Side facing the body surface). That is, the first expanding member 41 has a first region A1 in which the concave portion 44 is arranged, a second region A2 and a third region A3 sandwiching the first region A1 in a plan view, and the second region A2 Is longer (L2> L3) than the dimension L3 of the third region along the moving direction d1. Thereby, as shown in FIG. 8B, the first expanding member 41 maintains the state in which the concave portion 44 is arranged on the convex portion g1 formed on the outer surface of the hand H (the state in which the concave portion 44 is caught), while maintaining the state of the first expanding member 41. The second region A2 of the member 41 can sufficiently press the puncture site t apart from the projection g1. However, the recess may be formed at the center P of the first expansion member 41 in a plan view.

  As shown in FIG. 8B, the dimension L2 of the second area A2 along the movement direction d1 (see FIG. 2B) is, in the present embodiment, the second area A2 covers the puncture site t while the second area A2 is The dimensions are set such that they can be arranged (snuff box) between one convex part g1 and another convex part g2 (tendon of extensor minor extensor muscle and its surrounding tissue). Therefore, the second area A2 of the first expansion member 41 can sufficiently press the puncture site t.

  The first expansion member 41 is not particularly limited as long as it is a flexible material. For example, polyvinyl chloride, polyethylene, polypropylene, polybutadiene, polyolefin such as ethylene-vinyl acetate copolymer (EVA), polyethylene terephthalate (PET), various thermoplastic elastomers such as polyester such as polybutylene terephthalate (PBT), polyvinylidene chloride, silicone, polyurethane, polyamide elastomer, polyurethane elastomer, polyester elastomer, or a combination thereof (blended resin, Polymer alloy, laminate, etc.).

  Next, the marker section 43 will be described.

  As shown in FIGS. 8A and 8B, the marker portion 43 is disposed on a surface of the first expansion member 41 facing the internal space 41a. Further, as shown in FIG. 2B, the marker section 43 is disposed substantially at the center of the second area A2 in plan view. However, the position where the marker portion 43 is arranged in the first expansion member 41 is not limited to the above. For example, the marker section 43 may be disposed on a surface of the first expansion member 41 that contacts the body surface.

  The covering portion 20 and the pressing portion 30 have transparency at least in a region overlapping with the marker portion 43 in plan view and the periphery thereof in a state where the support member 50 is in the second mode as described later. Here, “transmittance” means that by transmitting light, the inner surface side separating the object can be visually recognized from the outer surface side. That is, in the covering portion 20 and the pressing portion 30, at least the region overlapping the marker portion 43 in plan view and the periphery thereof are transparent, translucent, or colored transparent when the support member 50 is in the second mode. Therefore, the user can visually recognize the puncture site t and the marker portion 43, and can easily align the marker portion 43 with the puncture site t.

  As shown in FIG. 2B, it is preferable that the marker section 43 be composed of a transparent central portion and a colored linear frame surrounding the central portion. Accordingly, the user can place the marker section 43 at the puncture site t while confirming the puncture site t via the transparent central portion of the marker section 43. Therefore, the surgeon can easily position the first expansion member 41 at the puncture site t using the marker section 43. Note that the marker section 43 is not particularly limited as long as it is a configuration that can be used by the user to align the first expansion member 41 with the puncture site t. For example, the marker portion may not be provided with a frame portion and may be formed only with a colored central portion.

  The shape of the marker portion 43 is not particularly limited, and includes, for example, a circle, a triangle, a square, and the like. In the present embodiment, the marker 43 has a square shape.

  The material of the marker portion 43 is not particularly limited, and examples thereof include an oily colorant such as ink, a resin kneaded with a dye, and the like.

  The color of the marker portion 43 is not particularly limited as long as the color can align the first extension member 41 with the puncture site t, but is preferably green. By using a greenish color, the user can easily visually recognize the marker portion 43 on blood or skin, so that it is easier to position the first expansion member 41 at the puncture site t.

  The method of providing the marker portion 43 on the first expansion member 41 is not particularly limited. For example, a method of printing the marker portion 43 on the first expansion member 41, a method of fusing the marker portion 43 to the first expansion member 41, a method of forming the marker portion For example, a method of applying an adhesive to one surface of the first extension member 43 and attaching the first extension member 41 to the first extension member 41 may be used.

(Support member)
As shown in FIG. 2A, the supporting member 50 includes a connecting member 51 connected to the first pressing member 40, a storage space 52 in which a part of the connecting member 51 is movable, and a storage member 53 forming the storage space 52. And Hereinafter, each part of the support member 50 will be described in detail.

  First, the connecting member 51 will be described.

  In the present embodiment, the connecting member 51 includes a first movable member 54 movable in the storage space 52, a second movable member 55 separated from the first movable member 54 and movable in the storage space 52, and a first movable member 55. And a connecting member 56 for connecting the first pressing member 40 to the member 54 and the second moving member 55.

  In the present embodiment, the first moving member 54 and the second moving member 55 are configured by spheres. Therefore, the first moving member 54 and the second moving member 55 can reduce the contact area with the storage member 53 and can easily move in the storage space 52. However, the first moving member 54 and the second moving member 55 may be constituted by columns or the like.

  In the present embodiment, the connection member 56 is configured by a linear element. The connecting member 56 is fixed to the first expanding member 41 while connecting the first moving member 54 and the second moving member 55.

  The connecting member 56 is connected to the first moving member 54 and the second moving member 55 so that the first moving member 54 and the second moving member 55 can rotate with respect to the connecting member 56. Therefore, the first moving member 54 and the second moving member 55 can move while rotating in the storage space 52. Since the rolling frictional force is smaller than the sliding frictional force, the first moving member 54 and the second moving member 55 are compared with the case where the first moving member 54 and the second moving member 55 slide (slide) with respect to the storage member 53. The member 55 can reduce the frictional force between the member 55 and the storage member 53. Therefore, the first moving member 54 and the second moving member 55 can easily move in the storage space 52. However, the first moving member 54 and the second moving member 55 may slide with respect to the storage member 53.

  As shown in FIG. 2B, the connection member 56 is fixed to the first expansion member 41 at a position where the connection member 51 overlaps the concave portion 44 (the first area A1 of the first pressing member 40) in plan view. The dimension of the connecting member 51 along the moving direction d1 matches the dimension L1 of the recess 44 along the moving direction d1. The connecting member 51 is colored. Therefore, the connecting member 51 can function as a marker portion indicating the position of the concave portion 44.

  Further, as described later, the covering portion 20 and the pressing portion 30 have transparency at least in a region overlapping with the connecting member 51 in the plan view in a state where the support member 50 is in the second mode and the periphery thereof. Therefore, the user can visually recognize the connecting member 51 and the convex portion g1, and can easily align the concave portion 44 with the convex portion g1 by using the connecting member 51 as a marker indicating the position of the concave portion 44. .

  As shown in FIGS. 2A and 2B, the storage member 53 extends along the movement direction d1 of the first pressing member 40.

  As shown in FIG. 2A, the storage member 53 extends along the movement direction d1 and is separated in the thickness direction d3 of the first expansion member 41 from the upper plate portion 53a and the lower plate portion 53b; And side plate portions 53c and 53d connected to both ends in the movement direction d1 (longitudinal direction) of the lower plate portion 53b. The upper plate portion 53a, the lower plate portion 53b, and the side plate portions 53c, 53d form a storage space 52 in which the first moving member 54 and the second moving member 55 can move.

  The lower plate portion 53b has a groove 53e into which a part of the first moving member 54 and a part of the second moving member 55 can be inserted. The groove 53e of the lower plate 53b extends along the movement direction d1. Similarly to the lower plate portion 53b, the upper plate portion 53a has a groove (not shown) into which a part of the first moving member 54 and a part of the second moving member 55 can be inserted. The groove of the upper plate portion 53a extends along the movement direction d1, similarly to the groove 53e of the lower plate portion 53b. Therefore, the storage member 53 can prevent the first moving member 54 and the second moving member 55 from being displaced in the direction d2 intersecting the moving direction d1.

  The storage member 53 has a first mode in which the first expansion member 41 can move relatively to the support member 50 (see FIG. 8B), and the first expansion member 41 cannot move relatively to the support member 50. It has a second mode (see FIG. 8A). The storage member 53 shifts from the second mode to the first mode when the first expansion member 41 expands.

  Therefore, the user moves to the puncture site t or the convex part g1 of the first pressing member 40 in a state where the storage member 53 is in the first mode and the first pressing member 40 cannot relatively move with respect to the support member 50. Work such as positioning and mounting of the camera can be performed. Therefore, the user can easily attach the hemostatic device 10 to the patient's hand H. Further, when the first pressing member 40 expands, the support member 50 shifts to the second mode, so that during the hemostasis, the first pressing member 40 moves relative to the support member 50 in accordance with the movement of the convex part g1. Can be moved to

  As shown in FIG. 8A, the storage member 53 has a bent portion 57 in which the storage space 52 is bent in the second mode as compared with the first mode of the storage member 53. A part of the connecting member 51 is disposed at the bent portion 57 in the second embodiment of the support member 50. In the present embodiment, the first moving member 54 and the second moving member 55 are arranged so as to sandwich the bent portion 57. Therefore, in the second embodiment of the storage member 53, the first pressing member 40 cannot move relative to the support member 50. As described above, the transition between the first mode and the second mode can be controlled by the shape of the storage space 52 of the support member 50 and the positional relationship between the connecting members 51, so that the transition between the first mode and the second mode can be easily controlled.

  As shown in FIG. 8B, when the first expansion member 41 expands, the storage member 53 shifts to the first configuration. More specifically, the storage space 52 is flatter than the second configuration of the storage member 53, following the shape of the first expansion member 41 when expanded. Therefore, in the first mode of the storage member 53, the first moving member 54 and the second moving member 55 can move in the storage space 52. Therefore, the first pressing member 40 connected to the first moving member 54 and the second moving member 55 can move relatively to the support member 50 in the first mode of the storage member 53.

  As shown in FIG. 2C, the upper plate portion 53a of the storage member 53 has a slit 58. The lower plate portion 53b of the storage member 53 has a bending guide portion 59 at a position facing the slit 58. The bending guide portion 59 is not particularly limited, but can be configured by, for example, a groove or a fold formed by bending the lower plate portion 53b in advance. Note that FIGS. 2A, 2C, 8B, and the like show examples in which the bending guide portion 59 is configured by a groove. As described above, since the storage member 53 has the slit 58 and the bending guide portion 59, the storage member 53 can easily form the bent portion 57 in the second mode of the storage member 53 as shown in FIG. 8A.

  The storage member 53 is preferably made of a material that is higher in hardness than the first expansion member 41 and a second expansion member 62 described later and that is flexible enough to form the bent portion 57. Examples of such a material include, but are not particularly limited to, acrylic resin, polyvinyl chloride, polyethylene, polypropylene, polyolefin such as polybutadiene, polystyrene, poly- (4-methylpentene-1), polycarbonate, ABS resin, and polystyrene. Polyester such as methyl methacrylate (PMMA), polyacetal, polyacrylate, polyacrylonitrile, polyvinylidene fluoride, ionomer, acrylonitrile-butadiene-styrene copolymer, polyethylene terephthalate (PET), polybutylene terephthalate (PBT), butadiene-styrene copolymer Polymers, aromatic or aliphatic polyamides, fluorine resins such as polytetrafluoroethylene, silicone, polyurethane, polyamide elastomers, polyurethane Elastomer, various thermoplastic elastomers such as polyester elastomer or a combination thereof optionally (blend resins, polymer alloys, laminates, etc.). By forming the storage member 53 from a material having a higher hardness than the first expansion member 41 and a second expansion member 62 described later, the storage member 53 is sandwiched between the expanded first expansion member 41 and the second expansion member 62. In this state, the storage space 52 can be maintained. When the storage member 53 is made of a material having a higher hardness than the first expansion member 41, the storage member 53 can support the first expansion member 41 and appropriately press the puncture site t.

(Second pressing member)
As shown in FIG. 3, the second pressing member 60 has a second expanding member 62 that can expand and contract by the inflow and outflow of the fluid.

  As shown in FIGS. 8A and 8B, the second expansion member 62 has an internal space 62a into which a fluid flows.

  As shown in FIG. 1B, the second expanding member 62 is disposed inside the covering portion 20. The second expanding member 62 is arranged near the first opening 23 a of the bag 21 of the covering portion 20.

  As shown in FIG. 3, the second expansion member 62 has a through portion 61 through which the thumb f1 can be inserted in the present embodiment. As shown in FIG. 1B, the first pressing member 40 and the support member 50 are disposed in the through portion 61. Therefore, the second expanding member 62 covers the first pressing member 40 and the supporting member 50, and suppresses the separation of the first pressing member 40 and the supporting member 50 from the puncture site t (the lifting of the first pressing member 40). Thus, the pressing force of the first pressing member 40 on the puncture site t can be appropriately applied to the puncture site t. In addition, since the second pressing member 60 can also fix the palm side of the thumb ball or the like facing the puncture site t at the time of expansion, the first pressing member 40 can be appropriately fixed to the puncture site t.

  The second expansion member 62 is not particularly limited, but can be formed of, for example, the same material as the material of the first expansion member 41.

(Injection member)
The first injection member 42 is configured to be able to inject a fluid into the first expansion member 41.

  As shown in FIG. 2A, the first injection member 42 has flexibility and is connected to the tube 42a connected to the first expansion member 41, a bag 42b connected to the tube 42a, and connected to the bag 42b. Tubular connector 42c. The lumen of the tube 42a communicates with the internal space 41a of the first expansion member 41. The internal space of the bag body 42b communicates with the lumen of the tube 42a. The connector 42c has a check valve (not shown) that allows the fluid to be injected into the bag 42b and suppresses the leakage of the fluid inside the bag 42b.

  The check valve is opened by inserting the front cylindrical portion of the syringe (not shown) into the connector 42c. When the pusher of the syringe is pressed in this state, the fluid in the syringe is injected into the first expansion member 41. Thereby, the first expansion member 41 expands. As the first expansion member 41 expands, the bag body 42b communicating with the first expansion member 41 via the tube 42a expands. Therefore, the user can visually confirm that the first injecting member 42 can pressurize the first expanding member 41 without leaking the fluid. After the fluid is injected into the first expansion member 41, the syringe barrel is removed from the connector 42c, thereby closing the check valve and suppressing leakage of the fluid.

  The second injection member 63 is configured to be able to flow to the second expansion member 62.

  As shown in FIG. 3, the second injection member 63 has flexibility and is connected to the tube 63a connected to the second expansion member 62, the bag 63b connected to the tube 63a, and connected to the bag 63b. Tubular connector 63c. The lumen of the tube 63a communicates with the internal space 62a of the second expansion member 62. The internal space of the bag 63b communicates with the lumen of the tube 63a. The connector 63c has a check valve (not shown) that allows the fluid to be injected into the bag body 63b and suppresses the leakage of the fluid inside the bag body 63b.

  The check valve is opened by inserting the front cylindrical portion of the syringe (not shown) into the connector 63c. When the pusher of the syringe is pressed in this state, the fluid in the syringe is injected into the second expansion member 62. Thereby, the second expanding member 62 expands. As the second expanding member 62 expands, the bag 63b communicating with the second expanding member 62 via the tube 63a also expands. Therefore, the user can visually confirm that the second injecting member 63 can pressurize the second expanding member 62 without leaking the fluid. After the fluid is injected into the second expansion member 62, when the front cylinder portion of the syringe is removed from the connector 63c, the check valve closes and the leakage of gas is suppressed.

[Example of use]
Next, an example of use of the hemostatic device 10 will be described with reference to FIGS.

  When starting the hemostasis, the user inserts the patient's hand H through the sixth opening 24 with the slit 25 of the covering portion 20 expanded as shown in FIGS. 4 and 5.

  Next, the user aligns the concave portion 44 of the first pressing member 40 with the convex portion g1 formed on the outer surface of the hand H, as shown in FIG. 8A. At this time, the user can use the connecting member 51 as a marker portion indicating the position of the concave portion 44. Further, the user positions the first pressing member 40 at the puncture site t. At this time, the user can use the marker part 43 to position the first pressing member 40 to the puncture site t.

  When aligning the first pressing member 40 with the projection g1 and the puncture site t, the storage member 53 of the support member 50 is in the second form, and the first pressing member 40 is relatively positioned with respect to the support member 50. I can't move. This can prevent the first pressing member 40 from inadvertently moving during the alignment, so that the user can easily and easily attach the hemostatic device 10 to the patient's hand H.

  Next, as shown in FIG. 6, the user connects the first member 26a and the second member 26b of the connecting portion 26 of the covering portion 20.

  Next, the user inserts the front end of the syringe (not shown) into the first injection member 42 of the first pressing member 40 to expand the first expansion member 41 of the first pressing member 40. Thereby, as shown in FIG. 8B, the first expanding member 41 applies a pressing force toward the puncture site t. At this time, the support member 50 shifts from the second mode to the first mode. Therefore, the first pressing member 40 can move relatively to the support member 50.

  Next, the user applies a syringe to the second injection member 63 of the second pressing member 60 while maintaining the state where the first expanding member 41 of the first pressing member 40 applies a compressive force to the puncture site t. The second expansion member 62 of the second pressing member 60 is expanded by inserting a front cylindrical portion (not shown). At this time, the user expands the second expanding member 62 to such an extent that the first expanding member 41 can be temporarily fixed to the puncture site t. Here, the degree that can be temporarily fixed is, for example, in a step of removing the medical elongated body S such as a sheath tube of an introducer from the puncture site t, which will be described later, does not hinder the removal of the medical elongated body S, In addition, it means the degree to which the displacement of the first expanding member 41 with respect to the puncture site t can be suppressed.

  Next, as shown in FIG. 7, the user removes the medical elongated body S such as a sheath tube of the introducer from the puncture site t.

  Next, as shown in FIG. 8B, the user further expands the second expanding member 62 of the second pressing member 60. At this time, the user expands the second expanding member 62 to such an extent that the first expanding member 41 can appropriately apply a compressive force to the puncture site t. As described above, the second expanding member 62 can be used to adjust the pressing force on the puncture site t after the medical elongated body S is removed from the puncture site t. In addition, the second pressing member 60 covers the first pressing member 40 and the supporting member 50, and suppresses the separation of the first pressing member 40 and the supporting member 50 from the puncture site t (the lifting of the first pressing member 40). Thus, the pressing force of the first pressing member 40 on the puncture site t can be appropriately applied to the puncture site t. Moreover, since the second pressing member 60 can also fix the palm side facing the puncture site t during expansion, the first pressing member 40 can be appropriately fixed to the puncture site t.

  The user adjusts the amount of fluid to be injected into the first expanding member 41 of the first pressing member 40 and the second expanding member 62 of the second pressing member 60 according to the degree of progress of the hemostasis and the elapsed time, so that the pressing is performed. The pressing force of the part 30 on the puncture site t may be adjusted.

  During the hemostasis, even if the patient spreads his hand or grasps his hand to change the shape of the hand, only the first pressing member 40 moves in accordance with the movement of the convex part g1. Therefore, even when the patient's hand H is movable, the hemostatic device 10 can prevent the first pressing member 40 from being displaced with respect to the puncture site t. Therefore, the hemostatic device 10 can appropriately maintain the pressure on the puncture site t even when the hand H moves or the like.

  After the hemostasis is completed, the user contracts the first expanding member 41 of the first pressing member 40 and the second expanding member 62 of the second pressing member 60, and then connects the first member 26a and the second member 26b. Is released, and the hemostatic device 10 is removed from the hand H. When removing the hemostatic device 10, the first expanding member 41 of the first pressing member 40 and the second expanding member 62 of the second pressing member 60 do not have to be contracted.

  The example of using the hemostatic device 10 has been described above, but the method of using the hemostatic device 10 is not limited to the above. For example, the hemostatic device 10 may be attached to the hand H after removing the medical elongated body S such as a sheath tube of the introducer from the puncture site t.

[Action]
As described above, the hemostatic device 10 according to the present embodiment has the covering portion 20 arranged at the puncture site t of the hand H and the pressing portion 30 arranged inside the covering portion 20. The pressing portion 30 has a first pressing member 40 that presses the puncture site t, and a support member 50 that is located between the covering portion 20 and the first pressing member 40. The first pressing member 40 has a concave portion 44 that can be arranged on the convex portion g1 formed on the outer surface of the hand H. The first pressing member 40 is relatively movable with respect to the supporting member 50 while being connected to the supporting member 50 in a state where the first pressing member 40 is pressing the puncture site t.

  According to the hemostatic device 10, the first pressing member 40 presses the puncture site t of the hand H in a state where the concave portion 44 is arranged on the convex portion g1 formed on the outer surface of the hand H. According to the hemostatic device 10, the movement of the first pressing member 40 is transmitted to the supporting member 50 and the covering portion 20 because the first pressing member 40 is relatively movable with respect to the supporting member 50. Hateful. Therefore, in the hemostatic device 10, even if the movement of the hand H occurs, only the first pressing member 41 moves in accordance with the movement of the projection g1 formed on the outer surface of the hand H. Therefore, the hemostatic device 10 can suppress the displacement of the first pressing member 40 with respect to the puncture site t even when the patient's hand H moves during the hemostasis. Therefore, the hemostatic device 10 can appropriately maintain the pressure on the puncture site t even when the hand H moves or the like.

  Further, the concave portion 44 is formed along a direction d2 intersecting with the moving direction d1 of the first pressing member 40. Therefore, the first pressing member 40 suitably maintains a state in which the concave portion 44 is arranged on the convex portion g1 extending along one direction such as a tendon, and the patient moves his / her finger to the left or right, or Can be moved following the movement of the convex portion g1 in a direction intersecting with the extending direction of the convex portion g1 by expanding or closing the hand H.

  The pressing portion 30 includes a penetrating portion 61 into which the thumb f1 of the hand H can be inserted, and further includes a second pressing member 60 that presses the body surface of the hand H. The first pressing member 40 and the support member 50 are located in the through portion 61. The second pressing member 60 is located inside the covering portion 20 and can be expanded and contracted by inflow and outflow of a fluid. Therefore, the second pressing member 60 covers the first pressing member 40 and the supporting member 50, and suppresses the separation of the first pressing member 40 and the supporting member 50 from the puncture site t (the lifting of the first pressing member 40). Thus, the pressing force on the puncture site t by the first pressing member 40 can be appropriately applied to the puncture site t. In addition, since the second pressing member 60 can also fix the palm side facing the puncture site t during expansion, the first pressing member 40 can be appropriately fixed to the puncture site t.

  Further, the first pressing member 40 can expand and contract by the inflow and outflow of the fluid. The support member 50 has a first configuration in which the first pressing member 40 can move relatively to the support member 50 and a second configuration in which the first pressing member 40 cannot move relatively to the support member 50. Have. The support member 50 shifts from the second mode to the first mode when the first pressing member expands. Therefore, in the first embodiment, since the first pressing member 40 can be prevented from relatively moving with respect to the support member 50, the hemostatic device can be easily attached to the patient. In addition, when the first pressing member 40 expands, the support member 50 shifts to the second configuration. Therefore, during hemostasis, the first pressing member 40 moves relative to the support member 50 in accordance with the movement of the projection g1. Can be moved to

  Further, the support member 50 has a connecting member 51 connected to the first pressing member 40 and a storage space 52 in which a part of the connecting member 51 can move. The second embodiment of the support member 50 has a bent portion 57 in which the storage space 52 is bent as compared with the first embodiment of the support member 50. A part of the connecting member 51 is disposed at the bent portion 57 in the second embodiment of the support member 50. Since the transition between the first mode and the second mode can be controlled by the shape of the storage space 52 of the support member 50 and the positional relationship between the connecting members 51, the transition between the first mode and the second mode can be easily controlled.

  The connecting member 51 includes a first moving member 54 movable in the storage space 52, a second moving member 55 separated from the first moving member 54 and movable in the storage space 52, a first moving member 54 and a second moving member 54. It has a connecting member 56 connected to the moving member 55 and the first pressing member 40. The first moving member 54 and the second moving member 55 are arranged so as to sandwich the bent portion 57 in the second embodiment of the support member 50. Therefore, since the first moving member 54 and the second moving member 55 are hooked on the bent portion 57, the support member 50 can suitably prevent the first pressing member 40 from moving in the second mode.

  Further, the first pressing member 40 has a marker portion (connecting member 51) indicating the position of the concave portion 44, and the covering portion 20 and the pressing portion 30 have a region overlapping with at least the marker portion (connecting member 51) in plan view. It has transparency around it. Therefore, the user can easily align the concave portion 44 with the convex portion g1 formed on the outer surface of the hand H by the marker portion (the connecting member 51).

  Further, the concave portion 44 is formed at a position separated from the center of the first pressing member 40 in a plan view. Therefore, the first pressing member 40 can sufficiently press the puncture site t separated from the convex portion g1 while maintaining the state in which the concave portion 44 is arranged on the convex portion g1 formed on the outer surface of the hand H. it can.

  As described above, the hemostatic device according to the present invention has been described through the embodiments. However, the present invention is not limited to the contents described in the specification, and can be appropriately changed based on the description in the claims. is there.

  For example, in the above embodiment, the hemostatic device for stopping the puncture site formed on the back of the left hand is illustrated, but the hemostatic device according to the present invention is configured as a device for stopping the puncture site formed on the back of the right hand. Is also good.

  Further, for example, in the above-described embodiment, an example has been described in which the convex portion of the hand on which the concave portion is arranged is the tendon of the extensor long finger of the thumb around the snuff box and its surrounding tissue (convex portion g1). However, the convex portion of the hand on which the concave portion is arranged may be the tendon of the extensor minor extensor around the snuff box and its surrounding tissue (convex portion g2).

  Further, for example, in the above-described embodiment, the configuration in which the injection members 42 and 63 are provided in the first pressing member 40 and the second pressing member 60 has been described. However, the injection member is provided in the first pressing member and the second pressing member. 42 and 63 may not be provided. When the injection member is not provided in the first pressing member and the second pressing member, for example, the first pressing member and the second pressing member are expanded to a predetermined size in a manufacturing stage before being used for hemostasis. Can be prepared.

  Further, for example, in the above embodiment, the example in which the first pressing member 40 includes the first expanding member 41 has been described. However, the configuration of the first pressing member is not particularly limited as long as a concave portion that can be arranged on the convex portion formed on the outer surface of the hand is formed and a portion to stop bleeding is pressed. The first pressing member is, for example, a member made of a resin material such as plastic or a gel which is pressed into a hand so as to apply a surface pressure, a water content is reduced as time passes, and the pressing force is gradually reduced. Including a gel containing a gel, an elastic material such as a sponge-like substance, an aggregate of fibers such as cotton, metal, and a member having a predetermined three-dimensional shape (such as a sphere, an ellipsoid, and a triangular pyramid). May be combined as appropriate.

  Further, for example, in the above-described embodiment, the example in which the hemostatic device 10 has both the first pressing member 40 and the second pressing member 60 has been described, but the hemostatic device 10 does not need to have the second pressing member 60. You may.

  Further, for example, in the above-described embodiment, an example in which the support member has the first mode and the second mode has been described, but the support member may not have the second mode. When the supporting member does not have the second configuration, the connecting member may not have the bent portion. When the supporting member does not have the second mode, the number of moving members included in the connecting member may be one. When the support member does not have the second configuration, the first pressing member 40 can move at the time of positioning the puncture site and the outer surface of the hand with the convex portion. Therefore, in this case, the covering portion 20 and the pressing portion 30 may have transparency at least in the movable range of the marker portion 43 and the movable range of the marker (the connecting member 51) indicating the position of the concave portion 44 in plan view. preferable.

  Further, for example, in the above-described embodiment, an example in which the support member 50 includes the storage space 52 and the storage member 53 that forms the storage space 52 has been described. However, the configuration of the supporting member is not particularly limited as long as the first pressing member is movably supported. For example, the support member may be configured by a rail to which the first pressing member is connected and the first moving member is movable.

  Further, for example, in the above-described embodiment, an example has been described in which the connecting member 51 functions as a marker portion indicating the position of the concave portion 44. However, the marker portion indicating the position of the concave portion does not necessarily need to be formed by the connecting member. For example, the marker portion indicating the position of the concave portion may be configured similarly to the marker portion 43 for positioning to the puncture site.

10 hemostatic devices,
20 coating part,
30 pressing part,
40 a first pressing member (corresponding to a pressing member);
44 recess,
50 support members,
51 connecting member (corresponding to a marker portion indicating the position of the concave portion),
52 storage space,
54 first moving member,
55 second moving member,
56 connecting members,
57 bend,
60 a second pressing member (corresponding to another pressing member);
61 penetration,
H hand,
d1 moving direction,
d2 direction crossing the direction of movement,
f1 to f5 fingers,
g1 convex parts formed on the body surface of the hand,
t Puncture site (corresponding to the site to stop bleeding).

Claims (8)

A covering portion to be placed on a site to stop bleeding of the hand,
And a pressing portion disposed inside the covering portion,
The pressing portion has a pressing member that presses the portion to be stopped, and a support member positioned between the covering portion and the pressing member,
The pressing member has a concave portion that can be arranged on a convex portion formed on the outer surface of the hand,
The hemostasis device, wherein the pressing member is relatively movable with respect to the support member while being connected to the support member in a state where the pressing member is pressing the portion to be stopped.   The hemostatic device according to claim 1, wherein the recess is formed along a direction intersecting a moving direction of the pressing member. The pressing portion further includes another pressing member that includes a penetrating portion into which the finger of the hand can be inserted and presses the body surface of the hand,
The support member and the pressing member are located in the penetrating portion,
The hemostatic device according to claim 1, wherein the other pressing member is located inside the covering portion, and is capable of expanding and contracting by inflow and outflow of a fluid. The pressing member can expand and contract by inflow and outflow of a fluid,
The support member has a first mode in which the pressing member can move relative to the support member, and a second mode in which the pressing member cannot move relatively to the support member,
The hemostatic device according to any one of claims 1 to 3, wherein the support member shifts from the second configuration to the first configuration when the pressing member expands. The support member has a connection member connected to the pressing member, and a storage space in which a part of the connection member is movable,
The second form of the support member has a bent portion in which the storage space is bent as compared to the first form of the support member,
The hemostatic device according to claim 4, wherein a part of the connection member is disposed at the bent portion in the second configuration of the support member. A first moving member movable in the storage space, a second moving member separated from the first moving member and movable in the storage space, the first moving member, and the second moving member; A connection member for connecting the member and the pressing member,
The hemostasis device according to claim 5, wherein the first moving member and the second moving member are arranged so as to sandwich the bent portion in the second form of the support member. The pressing portion further has a marker portion indicating a position of the concave portion,
The hemostatic device according to claim 5, wherein the covering portion and the pressing portion have transparency in at least a region overlapping the marker portion and a periphery thereof in a plan view.   The hemostatic device according to any one of claims 1 to 7, wherein the recess is formed at a position separated from a center of the pressing member in a plan view.