JP2020039815A - Hemostatic tool - Google Patents

Abstract

To provide a hemostatic tool capable of effectively performing astriction on a site to be stanched formed on a patient's hand.SOLUTION: A hemostatic tool 100 comprises: a coverage member 110 for covering an external surface of a patient's hand H; and a pressing member 150. The coverage member includes: a coverage part 127 for covering an external surface of the patient's hand; a fitting part 130 to be disposed on a thumb f1 of the patient; and a first fixation part 123a and second fixation part 123b that are disposed around a first hole 121a and second hole 121b located on the coverage part to expose portions of the external surface of the patient's hand and are capable of connecting with the pressing member 150. The pressing member can be connected to the first fixation part or second fixation part so as to cover the first hole or second hole in a state in which the first hole or second hole exposes a puncture site t formed on the patient's hand. In a state in which the pressing member is connected to the first fixation part or second fixation part, the pressing member is movable in a direction of inserting the first hole or second hole so as to press the puncture site.SELECTED DRAWING: Figure 3

Description

  The present invention relates to a hemostatic device.

  As one of the catheter procedures, a blood vessel (for example, a radial artery) of a patient's arm is punctured, and various medical elongated bodies are inserted 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). A catheter procedure utilizing the radial artery is called a transradial artery approach, and is considered as a useful technique for coronary artery access and lower limb artery access, for example.

  The radial artery located 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, the palmar artery (including the distal radial artery) is accessed from the anatomical snuff box located on the back side of the hand or from a position around the snuff box, and the vascular access is performed. A catheter procedure using dTRA (distal transradial approach) for performing treatment via a site has been attempted.

JP 2008-119517 A

  For example, when an operator such as a doctor (hereinafter referred to as an “operator”) uses an existing arm or leg hemostatic device to stop puncture of a palm artery located in the hand after a catheterization procedure In some cases, the size of the hemostatic device does not match the hand of the patient, so that the puncture site cannot be pressed properly. Further, the palmar artery is located at a portion where the bone near the thumb of the hand or the tendon of the hand runs finely. In such a hand part, the outer surface of the hand has a complicated shape including irregularities. Therefore, in the existing hemostatic device for an arm or a leg, when the pressing member for applying the compressive force is arranged at the puncture site, a gap is easily generated between the outer surface of the hand and the pressing member. Therefore, it is difficult for the surgeon to perform effective compression hemostasis when using the above hemostatic device.

  Therefore, an object of the present invention is to provide a hemostatic device capable of effectively compressing and stopping a hemostatic site formed on a patient's hand.

  A hemostatic device according to the present invention includes a covering member for covering an outer surface of a patient's hand, and a pressing member connectable to the covering member, wherein the covering member covers an outer surface of the patient's hand. A covering portion, a mounting portion arranged on the patient's finger, a hole located in the covering portion, and exposing a part of an outer surface of the hand of the patient, and a hole disposed around the hole; A fixing portion to which the pressing member can be connected, wherein the pressing member covers the hole in a state in which the hole exposes a portion of the hand to be subjected to hemostasis formed in the hand. The pressing member is connectable to a fixing portion, and the pressing member is movable in a direction in which the hole is inserted so as to press the portion to be hemostatically stopped in a state where the pressing member and the fixing portion are connected.

  According to the hemostatic device according to the present invention, when the pressing member applies a compressive force to a part to be subjected to hemostasis formed in the patient's hand, the mounting portion arranged on the patient's finger moves the hemostatic device relative to the patient's hand. Prevent displacement. Therefore, the above-described hemostatic device prevents a gap from being formed between the hemostatic device and the outer surface of the patient's hand even when the patient moves his / her finger, and the hole has a portion to stop the hemostasis. Can be maintained. Further, in the above hemostatic device, since the pressing member is a separate body separated from the covering member, the operator visually confirms that the hole is located at the site where the hemostasis is to be stopped, and then, in the hole of the covering member. A pressing member can be connected. Therefore, the above-mentioned hemostatic device can reliably press the hemostatic site located in the hole while maintaining the state in which the hole of the covering member is arranged in the site where hemostasis is to be performed. In the above hemostatic device, the pressing member covers the hole and moves in a direction to pass through the hole while the hole of the covering member exposes a portion of the patient's hand to be subjected to hemostasis. This presses the site to stop bleeding. Therefore, the above-mentioned hemostatic device can locally press the site to be subjected to hemostasis formed on the patient's hand by the pressing member, and thus can effectively perform hemostasis.

It is a perspective view showing a situation when the covering member of the hemostatic device according to the first embodiment is worn on the hand of the patient. It is a perspective view which expands and shows the press member and fixing part of the hemostatic device which concerns on 1st Embodiment. It is a perspective view showing a situation when a covering member and a press member of a hemostatic instrument concerning a 1st embodiment are attached to a patient's hand. It is the top view which looked at the hand of the patient with which the hemostatic device concerning 1st Embodiment was mounted | worn from the palm side. FIG. 5 is a partial sectional view taken along line 5-5 shown in FIG. 3. It is a perspective view showing the situation when the covering member of the hemostatic device according to the second embodiment is worn on the hand of the patient. It is a perspective view which expands and shows the press member and fixing part of the hemostatic device which concerns on 2nd Embodiment. It is a perspective view showing a situation when a covering member of a hemostatic device according to a third embodiment is attached to a patient's hand. It is a perspective view which expands and shows the press member and fixing part of the hemostatic device which concerns on 3rd Embodiment. It is a perspective view showing a situation when a covering member and a press member of a hemostatic instrument concerning a 3rd embodiment are attached to a patient's hand.

  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.

(1st Embodiment)
FIG. 1 to FIG. 5 are diagrams illustrating a configuration example of each part of the hemostatic device 100 according to the first embodiment and an example of use of the hemostatic device 100.

  The hemostatic device 100 is, for example, as shown in FIGS. 3 and 5, a palm artery (deep palm artery) running on the instep Hb side of a hand H (for example, a left hand) located on the finger side of the patient's forearm A. A puncture site t (corresponding to a “site to stop hemostasis”) formed on the radial artery side of B (for example, an artery around the anatomical snuff box, or a distal radial artery running on the fingertip side of the snuff box) When the sheath tube 410 of the introducer 400 (corresponding to a “medical device”) that has been indwelled is removed, it can be used to stop the puncture site t. The anatomical snuff box is a cavity of the hand located on the radial side of the forearm A when the patient spreads the thumb f1 of the hand H.

  Briefly, the hemostatic device 100 includes, as shown in FIGS. 1 to 3, a covering member 110 that covers the outer surface of the patient's hand H, and a pressing member 150 that can be connected to the covering member 110. I have.

  In the description of the present specification, the distal end side of the covering member 110 means a side on which the fingertips of the fingers f1 to f5 are arranged when the hemostatic device 100 is mounted on the patient's hand H. Further, the proximal end side of the covering member 110 means a side on which the forearm portion A (wrist) is arranged when the hemostatic device 100 is mounted on the hand H of the patient. In FIG. 4, the tip side of the covering member 110 is the upper side in the figure, and the base end side of the covering member 110 is the lower side in the figure.

  In each drawing of the present specification, the thumb of the patient's hand H is indicated by reference numeral f1, the index finger of the patient's hand H is indicated by reference numeral f2, the middle finger of the patient's hand H is indicated by reference numeral f3, and the ring finger of the patient's hand H is indicated. Is indicated by reference numeral f4, and the little finger of the patient's hand H is indicated by reference numeral f5. In addition, an inter-finger portion (finger-to-finger portion) located between the thumb f1 and the index finger f2 is indicated by a symbol fb.

<Coating member>
As shown in FIGS. 1 and 2, the covering member 110 is located on the covering portion 127 covering the outer surface of the hand H of the patient, the mounting portion 130 arranged on the thumb f1 of the patient, and the covering portion 127. And a plurality of holes 121a and 121b that expose a part of the outer surface of the hand H, and a plurality of holes that are arranged around the holes 121a and 121b and connect the pressing member 150. Fixing portions 123a and 123b.

  In the main body section 120 of the covering member 110, the covering section 127 and the mounting section 130 are integrally connected. Further, each of the holes 121a and 121b is located in the covering portion 127 and penetrates the covering portion 127.

  In the following description, the hole 121a located in the covering portion 127 is referred to as a first hole, and the fixing portion 123a disposed around the first hole 121a is referred to as a first fixing portion. Further, the hole 121b located in the covering portion 127 is defined as a second hole, and the fixing portion 123b disposed around the second hole 121b is defined as a second fixing portion. The first hole 121a and the second hole 121b have substantially the same configuration, and the first fixing portion 123a and the second fixing portion 123b have substantially the same configuration. Therefore, in the description of the second hole 121b and the second fixing portion 123b, the description of the contents overlapping with the first hole 121a and the first fixing portion 123a will be appropriately omitted.

  As shown in FIGS. 3 and 4, the covering portion 127 is a part of the back Hb of the patient's hand H when the covering member 110 is attached to the patient's hand H (hereinafter, also referred to as “attached state”). , A part of the palm Hp of the patient's hand H and a bag surrounding the wrist of the patient.

  The covering portion 127 has a distal opening 127a for projecting each of the index finger f2, the middle finger f3, the ring finger f4, and the little finger f5 toward the distal end of the covering member 110, and a forearm A toward the proximal end of the covering member 110. And a base end opening 127b for projecting the projection.

  The mounting portion 130 is arranged so as to cover a certain range from near the base of the thumb f1 to the fingertip side of the thumb f1. The mounting portion 130 is formed with a distal end opening 130a that allows the fingertip of the thumb f1 to protrude toward the distal end side of the covering member 110.

  As described above, in the mounted state, the hemostatic device 100 can cause each finger f2, f3, f4, f5 to protrude toward the distal end side of the covering member 110 via the distal end opening 127a of the covering portion 127, and The fingertip of the thumb f1 can be made to protrude toward the distal end of the covering member 110 via the distal end opening 130a of the mounting portion 130. Therefore, the patient can independently move each of the fingers f1, f2, f3, f4, and f5 even while the puncture site t is compressed and stopped. Thereby, the hemostatic device 100 can reduce the stress that the patient receives due to the inability to move the fingers f1, f2, f3, f4, f5 while the compression hemostasis is being performed.

  The covering portion 127 of the covering member 110 has a specific shape and size as long as it covers at least a part of the back Hb of the hand H and a part of the palm Hp of the hand H in the mounted state. Not limited. However, from the viewpoint of improving the fixing force of the covering member 110 to the hand H in the mounted state, the covering portion 127 covers the periphery of the wrist and a part of the wrist together with the back Hb of the hand H and the palm Hp of the hand H. It is preferably formed in a shape and a size that allow for this.

  The specific shape and size of the mounting portion 130 included in the covering member 110 are not limited as long as the mounting portion 130 is configured to cover at least a part of an arbitrary finger among the fingers f1 to f5. For example, the mounting unit 130 may have a structure that covers the entire thumb f1, or may have a structure that covers a part or the entirety of an arbitrary finger other than the thumb f1.

  As shown in FIG. 3, the covering member 110 has a hooking portion 128 arranged to cover the inter-finger portion fb between the thumb f1 and the index finger f2 in the mounted state. The hook 128 is integrally connected to the covering 127 and the mounting part 130.

  In the mounted state, the covering member 110 is arranged so that the covering portion 127 covers the back Hb and the palm Hp along the outer periphery of the hand H, and the mounting portion 130 covers a part of the thumb f1 along the outer periphery of the thumb f1. Are arranged as follows. Then, the hook portion 128 is disposed so as to cover the inter-finger portion fb of the hand H. As described above, the covering member 110 is fixed (held) to the hand H via the covering portion 127, the mounting portion 130, and the hook portion 128.

  As shown in FIGS. 1 and 3, the first hole 121a and the second hole 121b are configured to expose a part of the outer surface of the back Hb of the patient's hand H in the mounted state.

  The first hole 121a is located at the center of the back Hb of the hand H opposite to the outside of the back Hb of the hand H where the snuff box is located, with reference to the tendon (short extensor tendon) extending toward the fingertip of the thumb f1. It is located on the side. In addition, the first hole 121a is disposed closer to the distal end of the hand H than the second hole 121b. The second hole 121b is arranged in the snuff box.

  The first hole 121a and the second hole 121b have a circular planar shape (a shape when viewed in plan). In the mounted state, the first hole 121a and the second hole 121b surround a part of the outer surface of the back Hb of the hand H as shown in FIG. Therefore, the first hole 121a and the second hole 121b expose a part of the outer surface of the back Hb of the hand H to the outside of the covering member 110. In addition, in each figure, the code | symbol S shows a part of outer surface of the back Hb of the hand H exposed to the exterior of the covering member 110 by each hole 121a, 121b.

  The number of the holes provided in the covering member 110, the planar shape, the area of the outer surface of the hand where the holes are exposed, and the like are not particularly limited.

  The first fixing portion 123a and the second fixing portion 123b are integrally formed with the covering portion 127 so that they cannot be separated from the covering portion 127. As shown in FIG. 5, the first fixing portion 123a is fixed to the covering portion 127 surrounding the first hole 121a while forming the first hole 121a. Similarly, the second fixing portion 123b is fixed to the covering portion 127 surrounding the second hole 121b while forming the second hole 121b.

  As shown in FIG. 2, the first fixing portion 123a has a hollow ring-shaped outer shape. A screw groove 124 is formed on the inner peripheral surface of the first fixing portion 123a. The screw groove 124 is used to connect the pressing member 150 to the first fixing portion 123a.

  The first fixing portion 123a has substantially the same planar shape as the first hole portion 121a. In the present embodiment, since the first hole 121a has a circular planar shape, the first fixing portion 123a also has a circular planar shape.

  As shown in FIGS. 4 and 5, the main body 120 of the covering member 110 has a first hole 121 a and a second hole 121 with the hand H interposed therebetween in a state where the covering member 110 is arranged on the outer surface of the patient's hand H. A support member 160 made of a material harder than the covering member 110 is provided on the side facing the portion 121b.

  As shown in FIGS. 3 and 5, the first hole 121 a is formed in a portion 120 a of the main body 120 of the covering member 110 facing the back Hb of the patient's hand H. As shown in FIG. 5, the support member 160 is disposed on the inner surface of the main body 120 of the covering member 110 at a portion 120 b facing the palm Hp of the patient's hand H.

  The support member 160 supports the hand H on the palm Hp side of the hand H when the pressing member 150 applies a pressing force to the puncture site t from the outer surface side of the back Hb of the hand H. Accordingly, the hemostatic device 100 can press and stop the puncture site t with the hand H sandwiched between the pressing member 150 and the support member 160. Therefore, the pressing force applied by the pressing member 150 to the puncture site t can be increased.

  The planar shape of the support member 160 is not particularly limited, but can be formed, for example, in an elliptical shape as shown in FIG. The thickness of the support member 160 (the vertical dimension in FIG. 5) is such that the support member 160 supports the patient's hand H from the side opposite to the pressing direction of the pressing member 150, and the pressing member 150 punctures the hand H. There is no particular limitation as long as it is possible to increase the pressing force applied to the site t. The position where the support member 160 is arranged is not particularly limited as long as the support member 160 overlaps at least the first hole 121a and the second hole 121b in a plan view shown in FIG.

  The material forming the covering member 110 (the covering portion 127 and the mounting portion 130 of the covering member 110) is not particularly limited, and examples thereof include polyvinyl chloride, polyethylene, polypropylene, polybutadiene, and ethylene-vinyl acetate copolymer (EVA). Polyolefins, polyesters such as polyethylene terephthalate (PET) and polybutylene terephthalate (PBT), various thermoplastic elastomers such as polyvinylidene chloride, silicone, polyurethane, polyamide, polyamide elastomer, polyurethane elastomer, polyester elastomer, or any combination thereof Resin materials such as blended resins, polymer alloys, and laminates. Further, as a material for forming the covering member 110, a fabric such as a woven fabric, a knitted fabric, or a nonwoven fabric may be used. For example, the fabric can be composed of synthetic fibers processed from natural fibers or resin materials, or filament yarns, spun yarns, blended yarns, twisted yarns, and processed yarns made of these fibers. As the chemical fiber, for example, a polyamide-based synthetic resin, a polyester-based synthetic resin, a polyurethane-based synthetic resin, a polyacrylonitrile-based synthetic resin, a polyolefin-based synthetic resin, a cellulose-based fiber, or the like can be used. The covering member 110 is preferably formed of a resin material that can be deformed so as to be in close contact with the outer surface of the patient's hand H in order to increase the fixing force to the patient's hand H in the mounted state. As such a material, for example, silicone or urethane can be used.

  The support member 160 can be formed of a material harder than the covering member 110. Examples of the material forming the support member 160 include polypropylene (PP), polycarbonate (PC), other hard plastics, and metal materials.

  The material forming each of the fixing portions 123a and 123b is not particularly limited, and examples thereof include polyvinyl chloride, polyethylene, polypropylene, polybutadiene, polyolefin such as ethylene-vinyl acetate copolymer (EVA), polyethylene terephthalate (PET), and polyolefin. Various thermoplastic elastomers such as polyester such as butylene terephthalate (PBT), polyvinylidene chloride, silicone, polyurethane, polyamide, polyamide elastomer, polyurethane elastomer, polyester elastomer, or any combination thereof (blended resin, polymer alloy, laminated Resin material).

<Pressing member>
As shown in FIGS. 3 and 5, the pressing member 150 has a first hole 121 a (or a second hole 121 b) surrounding the puncture site t formed in the patient's hand H, and the pressing member 150 is in the third position. The first hole 121a (or the second hole 121b) is covered with the first hole 121a (or the second hole 121b) while being connected to the first fixing portion 123a (or the second hole 123b). It is configured to be able to move in the insertion direction (the vertical direction in FIG. 1). Thereby, the pressing member 150 can press the puncture site t surrounded by the first hole 121a (or the second hole 121b).

  In the present embodiment, the pressing member 150 can be connected to the fixing portions 123a and 123b arranged around any one of the plurality of holes 121a and 121b formed in the covering portion 127. That is, the pressing member 150 can be connected to both the first fixing portion 123a arranged around the first hole 121a and the second fixing portion 123b arranged around the second hole 121b. .

  The pressing member 150 includes a pressing portion 151 that presses the puncture site t as illustrated in FIGS. 2 and 5, and a direction perpendicular to the first hole 121 a with the pressing member 150 connected to the first fixing portion 123 a ( It has a shaft portion 153 that can move in a direction parallel to the center axis c1 of the pressing member 150) and a grip portion 155 provided on the shaft portion 153 on a side opposite to the pressing portion 151.

  The pressing portion 151 is disposed at one end of the shaft portion 153 (the lower end in FIG. 5). At one end of the shaft portion 153, an insertion portion 153a and a head portion 153b for connecting the pressing portion 151 to the shaft portion 153 are provided. The grip 155 is disposed at the other end of the shaft 153 (the upper end in FIG. 5).

  The pressing portion 151 is formed separately from the shaft portion 153. As shown in FIG. 5, the pressing portion 151 has an insertion hole 151a through which the insertion portion 153a of the shaft portion 153 is inserted, and a storage portion 151b in which the head 153b of the shaft portion 153 is stored.

  As shown in FIG. 5, the shaft portion 153 includes a thread groove formed on the outer peripheral surface on the other end side of the shaft portion 153 with respect to the insertion portion 153a. The screw groove formed on the shaft portion 153 is configured to be screwable with the screw groove 124 formed on the inner peripheral surface of the first fixing portion 123a.

  The screw groove 124 of the first fixing portion 123a can be configured by, for example, a female screw. The thread groove of the shaft portion 153 can be configured with, for example, a male screw. Note that the thread groove 124 of the first fixing portion 123a may be formed by a male screw, and the screw groove of the shaft portion 153 may be formed by a female screw.

  The gripper 155 can be used as a handle for the operator to grip with his / her fingers when the pressing member 150 presses and stops the puncture site t. The grip 155 is formed separately from the shaft 153.

  The surgeon performs the following operation when compressing and stopping the puncture site t using the pressing member 150.

  The operator grips the grip 155 and rotates the shaft 153 in one rotation direction (for example, clockwise). When the operator rotates the shaft portion 153, the shaft portion 153 approaches the outer surface of the back Hb of the hand H of the patient while rotating along the screw groove 124 of the first fixing portion 123a. When the shaft portion 153 approaches the outer surface of the back Hb of the patient's hand H, and the pressing portion 151 arranged at one end of the shaft portion 153 comes into contact with the puncture site t formed on the back Hb of the patient's hand H, The compression hemostasis by the pressing member 150 is started. The surgeon rotates the shaft 153 in a state where the pressing portion 151 is in contact with the puncture site t formed on the back Hb of the patient's hand H, and moves the pressing portion 151 to the outer surface of the back Hb of the patient's hand H. By moving the puncture site t further, a greater pressing force can be applied to the puncture site t. As described above, the operator can start the compression hemostasis on the puncture site t by the pressing member 150 by a simple operation of rotating the shaft portion 153.

  When reducing the compressive force on the puncture site t, the operator rotates the shaft 153 in the other rotation direction (for example, counterclockwise). When the surgeon rotates the shaft portion 153 in the other rotation direction, the pressing portion 151 disposed at one end of the shaft portion 153 moves in a direction away from the outer surface of the back Hb of the patient's hand H. The pressing member 150 can reduce the pressing force applied to the puncture site t by the pressing unit 151 by moving the pressing unit 151 in a direction away from the outer surface of the back Hb of the patient's hand H.

  In the present embodiment, the pressing portion 151 is connected to the shaft portion 153 so that the rotation of the shaft portion 153 is not transmitted to the pressing portion 151. As shown in FIG. 5, the insertion hole 151a of the pressing portion 151 has a larger width (dimension in the horizontal direction in FIG. 5) than the insertion portion 153a of the shaft portion 153. The housing 151b of the pressing portion 151 has a larger width than the head 153b of the shaft 153. Therefore, when the insertion portion 153a of the shaft portion 153 is inserted through the insertion hole 151a of the pressing portion 151, and the head portion 153b of the shaft portion 153 is inserted through the housing portion 151b of the pressing portion 151, the insertion portion 153a and the pressing portion A gap is formed between the pressing member 151 and the head 151b. The pressing portion 151 can prevent the friction between the pressing portion 151 and the shaft portion 153 from occurring when the shaft portion 153 rotates, by forming the gap. Therefore, when the shaft 153 rotates, the surgeon can suppress the rotation of the shaft 153 from being transmitted to the pressing portion 151, and suppress the rotation of the pressing portion 151 accompanying the rotation of the shaft 153. it can.

  The pressing member 150 is configured such that a portion arranged to overlap the puncture site t of the pressing member 150 in a state where the pressing member 150 is connected to the first fixing portion 123a (or the second fixing portion 123b) is transparent. . By configuring the pressing member 150 in this manner, the surgeon can press the pressing member 150 from above (on the side where the grip 155 is arranged) from above the pressing member 150 in a state where the pressing member 150 is connected to the first fixing portion 123a. By looking into 150, it is possible to visually check the position and state of puncture site t via pressing member 150.

  In the present embodiment, as shown in FIG. 5, the pressing member 150 includes a pressing portion 151, a shaft portion 153, and a grip portion 155. Therefore, in a state where the pressing member 150 is connected to the first fixing portion 123a, the pressing portion 151 is provided in order to allow an operator to visually check the puncture site t from above the pressing member 150. In the shaft portion 153 and the gripping portion 155, a portion axially overlapping the central axis c1 of the pressing member 150 and a portion around the central axis c1 of the pressing member 150 (the periphery in plan view) are configured to be transparent.

  The range of the transparent part of the pressing member 150 is not particularly limited as long as the surgeon looks into the puncture site t via the pressing member 150 and can visually confirm the puncture site t. . The pressing member 150 is not limited to be transparent as long as the puncture site t can be visually confirmed as described above, and may be, for example, translucent.

  The pressing portion 151 can be made of, for example, an elastically deformable material such as a resin. When the pressing portion 151 is made of an elastically deformable material such as a resin, the pressing portion 151 contacts the outer surface of the upper Hb of the patient's hand H and presses the puncture site t, thereby reducing the burden on the patient. Can be reduced. When the pressing portion 151 is made of an elastically deformable material, when the pressing portion 151 is attached to the head portion 153b of the shaft portion 153, the pressing portion 151 is deformed and the head portion is inserted into the insertion hole 151a of the pressing portion 151. 153b can be inserted. Therefore, it is possible to easily insert the head 153b of the shaft portion 153 into the housing portion 151b of the pressing portion 151. In addition, the shape of the pressing portion 151 can effectively apply a compressive force to the puncture site t and, in order to prevent an excessive load from being applied to the patient during the compression hemostasis, for example, It is preferable that the distal end located on the side in contact with the puncture site t has a rounded curved shape (see FIG. 5).

  The material forming the pressing member 150 (the pressing portion 151, the shaft portion 153, and the grip portion 155) is not particularly limited. For example, when a part of the pressing member 150 is configured to be transparent or translucent as in the present embodiment. Known resin materials such as natural rubber (NR), acrylonitrile-butadiene rubber (NBR), styrene-butadiene rubber (SBR), and ethyl methacrylate graft polymer (MG) can be used. When the pressing member 150 is not formed to have a transparent or translucent portion, for example, the shaft portion 153 and the grip portion 155 of the pressing member 150 may be made of a known metal material. Even in the case of such a configuration, it is preferable that the pressing portion 151 is formed of an elastically deformable resin material in consideration of the burden on the patient's body when compressing and stopping the blood.

  Next, a usage example of the hemostatic device 100 will be described. Hereinafter, an example of a procedure for attaching the hemostatic device 100 to the hand (left hand) H of the patient on which the puncture site t is formed and an example of a hemostatic procedure will be described.

  The operator attaches the covering member 110 to the patient's hand H before forming the puncture site t on the back Hb of the patient's hand H. Specifically, the surgeon inserts each of the fingers f1 to f5 into the inside of the covering member 110 via the proximal opening 127b of the covering portion 127. Next, the surgeon causes the fingers f <b> 2 to f <b> 5 of the patient to protrude toward the distal end of the covering member 110 via the distal end opening 127 a of the covering 127. Further, the surgeon causes the thumb f1 to protrude toward the distal end side of the covering member 110 via the distal end opening 130a of the mounting section 130. The operator causes the fingers f1 to f5 to protrude toward the distal end side of the covering member 110 as described above, and arranges the hook 128 on the inter-finger portion fb between the thumb f1 and the index finger f2 of the patient's hand H.

  Next, as shown in FIG. 1, the surgeon forms a puncture site t on the outer surface of the back Hb of the hand H exposed to the outside of the covering member 110 through the first hole 121a or the second hole 121b. Then, the sheath tube 410 of the introducer 400 is inserted into the palmar artery B (see FIG. 5) through the puncture site t. In the illustrated example, a puncture site t is formed on the outer surface of the back Hb of the hand H exposed to the outside of the covering member 110 via the first hole 121a. The surgeon may form a puncture site t on the outer surface of the back Hb of the hand H exposed to the outside of the covering member 110 via the second hole 121b.

  An operator uses the introducer 400 to deliver a treatment device (for example, a catheter device such as a balloon catheter) to a treatment target site of a patient, and performs various treatments. After performing the treatment using the treatment device, the operator removes the treatment device outside the living body. After removing the treatment device outside the living body, the operator pulls out a part of the sheath tube 410 of the introducer 400 from the palmar artery B.

  Next, as shown in FIG. 3, the surgeon connects the pressing member 150 to the first fixing portion 123a arranged around the first hole 121a. The operator rotates the pressing member 150 in a state in which a part of the sheath tube 410 of the introducer 400 is inserted into the puncture site t, so that the pressing portion 151 of the pressing member 150 is moved to the back Hb of the hand H of the patient. Get closer to the outer surface. The surgeon rotates the pressing member 150 until the pressing portion 151 of the pressing member 150 contacts the puncture site t. When the pressing unit 151 moves until it comes into contact with the puncture site t, it starts compressive hemostasis (see FIG. 5).

  The surgeon adjusts the position of the pressing portion 151 so that the pressing portion 151 of the pressing member 150 applies a desired pressing force to the puncture site t, and then introduces the introducer 400 from the palmar artery B through the puncture site t. Of the sheath tube 410 is completely removed. 3 and 5 show a state after the sheath tube 410 of the introducer 400 has been completely removed from the puncture site t.

  The surgeon moves the pressing member 150 so that the pressing portion 151 of the pressing member 150 approaches the body surface of the patient's hand H while performing the compression and hemostasis with the hemostatic device 100, so that the puncture site t is removed. To increase the pressing force applied. In addition, the surgeon moves the pressing member 150 so that the pressing portion 151 of the pressing member 150 is separated from the body surface of the patient's hand H while performing the compression hemostasis using the hemostatic device 100, so that the puncture site t Can be reduced. Thus, the surgeon can easily adjust the pressing force applied by the pressing portion 151 to the puncture site t by adjusting the relative position of the pressing portion 151 with respect to the instep Hb of the patient.

  Further, as described above, when the shaft 153 rotates, the pressing member 150 is configured so that the rotation of the shaft 153 is not transmitted to the pressing portion 151. Therefore, when the shaft portion 153 is rotated to apply a compressive force to the puncture site t, the rotation of the pressing portion 151 accompanying the rotation of the shaft portion 153 can be suppressed. The hemostatic device 100 can prevent the skin of the instep Hb of the hand H of the patient coming into contact with the pressing portion 151 from being caught by the rotation of the pressing portion 151 and twisted by suppressing the rotation of the pressing portion 151.

  The pressing member 150 connected to the first fixing portion 123a covers the first hole 121a formed in the covering member 110, and moves the puncture site t formed in the region located in the first hole 121a. Oppress. Therefore, the pressing member 150 comes into contact with the back Hb of the patient's hand H in a relatively narrow range around the puncture site t and the periphery thereof. Thereby, the pressing member 150 can locally apply a compressive force to a part of the back Hb of the hand H.

  The hemostatic device 100 is held in a state where the covering member 110 is mounted on the hand H of the patient and the mounting portion 130 is hooked on the thumb f1. Therefore, the hemostatic device 100 can increase the fixing force of the covering member 110 to the patient's hand H, and can prevent the hemostatic device 100 from being displaced from the patient's hand H. Further, the hemostatic device 100 can further increase the fixing force of the covering member 110 to the patient's hand H by the hook portion 128 arranged in the inter-finger portion fb of the patient's hand H.

  After a certain period of time has elapsed since the start of hemostasis, the surgeon gradually reduces the pressing force of the pressing member 150, and confirms that hemostasis at the puncture site t is properly performed. As described above, since the pressing member 150 is formed so that the portion overlapping the puncture site t of the pressing member 150 is transparent, the surgeon may press the puncture site t while the pressing member 150 is performing compression bleeding. , The hemostasis state of the puncture site t can be easily confirmed visually.

  After the end of hemostasis at the puncture site t, the operator sufficiently weakens the pressing force of the pressing member 150. Thereafter, the operator removes the hemostatic device 100 from the patient's hand H.

  Hereinafter, the operation and effect of the present embodiment will be described.

  The hemostatic device 100 according to the present embodiment includes a covering member 110 that covers the outer surface of the patient's hand H, and a pressing member 150 that can be connected to the covering member 110. The covering member 110 covers the outer surface of the patient's hand H, the mounting part 130 arranged on the patient's thumb f1, and the covering part 127, and covers a part of the outer surface of the patient's hand H. It has a first hole 121a and a second hole 121b to be exposed, and first fixing portions 123a and 123b which are arranged around the holes 121a and 121b and to which the pressing member 150 can be connected. Further, the pressing member 150 is configured such that the first hole 121a (or the second hole 121b) exposes the puncture site t formed in the hand H of the patient, and the first hole 121a (or the second hole 121). 121b) can be connected to the first fixing portion 123a (or the second fixing portion 123b) so as to cover the same. The pressing member 150 presses the first hole 121a (or the second hole) so as to press the puncture site t in a state where the pressing member 150 and the first fixing portion 123a (or the second fixing portion 123b) are connected. 121b) can be moved in the insertion direction.

  According to the hemostatic device 100 configured as described above, when the pressing member 150 applies a compressive force to the puncture site t formed in the patient's hand H, the mounting portion 130 arranged on the patient's thumb f1 stops bleeding. The device 100 is prevented from being displaced with respect to the patient's hand H. Therefore, even when the patient moves the hand H or each of the fingers f1 to f5, the hemostatic device 100 prevents a gap from being formed between the hemostatic device 100 and the outer surface of the patient's hand H. The state where the one hole 121a (or the second hole 121b) is arranged at the puncture site t can be maintained. Further, in the hemostatic device 100, since the pressing member 150 is separate from the covering member 110, the first hole 121a (or the second hole 121b) is visually arranged by the operator at the puncture site t. After confirming, the pressing member 150 can be connected to the first hole 121a (or the second hole 121b) of the covering member 110. Therefore, the hemostatic device 100 maintains the first hole 121a (or the second hole 121b) of the covering member 110 at the puncture site t while maintaining the state where the first hole 121a (or the second hole 121b). 1) can be reliably pressed. Further, in the hemostatic device 100, when the first hole 121a (or the second hole 121b) of the covering member 110 exposes the puncture site t formed in the patient's hand H, the pressing member 150 The puncture site t is pressed by moving in the direction in which the first hole 121a (or the second hole 121b) is inserted while covering the portion 121a (or the second hole 121b). Therefore, the hemostatic device 100 can locally press the puncture site t formed in the patient's hand H by the pressing member 150, and thus can effectively perform compression and hemostasis.

  Further, the pressing member 150 includes a pressing portion 151 for pressing the puncture site t and a first hole 121a or a second hole 121 in a state where the pressing member 150 is connected to the first fixing portion 123a or the second fixing portion 123b. And a shaft portion 153 movable in a direction perpendicular to 121b. The pressing portion 151 is connected to the shaft portion 153 so that the rotation of the shaft portion 153 is not transmitted. Since the pressing member 150 is configured as described above, the hemostatic device 100 accompanies the rotation of the shaft portion 153 when the surgeon rotates the shaft portion 153 to apply a compressive force to the puncture site t. Thus, the rotation of the pressing portion 151 can be suppressed. In this manner, the hemostatic device 100 prevents the skin of the instep Hb of the patient's hand H coming into contact with the pressing portion 151 from being caught by the rotation of the pressing portion 151 and twisted by the rotation of the pressing portion 151 being suppressed. Can be prevented.

  Further, the covering member 110 has a plurality of holes of a first hole 121a and a second hole 121b. The pressing member 150 can be connected to each of the fixing portions 123a and 123b arranged around an arbitrary one of the holes 121a and 121b. Therefore, the surgeon can selectively perform compression hemostasis by the pressing member 150 on the puncture site t formed in the region where the first hole 121a is located or the region where the second hole 121b is located. The operator selectively forms the puncture site t in the area where each of the holes 121a and 121b is located in accordance with the contents of the procedure, the anatomical structure of the body for each patient, and the like, to the palmar artery B. The optimal puncture site t can be selected at the time of access. Therefore, when the hemostatic device 100 is used for a dTRA procedure, its convenience is further improved.

  In addition, the covering member 110 is disposed on the outer surface of the hand H of the patient, with the covering member 110 facing the first hole 121a or the second hole 121b across the hand H. It has a support member 160 formed of a harder material. Therefore, when the hemostatic device 100 applies a compressive force to the hand H by the pressing member 150 connected to the first fixing portion 123a or the second fixing portion 123b, the supporting member opposes the pressing member 150 across the hand H. The member H can support the hand H. Thereby, the hemostatic device 100 can increase the pressing force applied by the pressing member 150 to the puncture site t.

  Further, the pressing member 150 is transparent at a portion arranged so as to overlap with the puncture site t in a state where the pressing member 150 is connected to the first fixing portion 123a or the second fixing portion 123b. Therefore, while the compression hemostasis is being performed by the pressing member 150, the operator visually looks at the hemostatic state of the puncture site t by looking into the portion overlapping the puncture site t of the press member 150 from the upper side of the pressing member 150. It can be easily confirmed.

  Next, another embodiment of the hemostatic device according to the present invention will be described. In the following description of the second embodiment and the third embodiment, a detailed description of the configuration and the like already described in the first embodiment will be omitted. The contents of the second and third embodiments that are not particularly described can be the same as those of the first embodiment.

(2nd Embodiment)
FIG. 6 is a perspective view illustrating a state where the covering member 110 of the hemostatic device 200 according to the second embodiment is mounted on the hand H of the patient. FIG. 7 is an enlarged perspective view illustrating a peripheral portion of a fixing portion (first fixing portion 223a) included in the hemostatic device 200 according to the second embodiment.

  The hemostatic device 200 according to the second embodiment differs from the hemostatic device 100 according to the first embodiment in the structure of the fixing portion.

  As shown in FIGS. 7 and 8, the first fixing portion 223a disposed around the first hole portion 121a includes a convex portion 225 surrounding the first hole portion 121a and a palm artery (living body lumen) B of the patient. And an insertion portion 225a through which a part of the introducer 400 to be detained can be inserted.

  The convex portion 225 protrudes from the outer surface of the covering portion 127 in a height direction separated from the covering portion 127. The insertion portion 225a is formed by a cutout in which a part of the wall of the protrusion 225 is cut out in the circumferential direction. A screw groove 224 for connecting the shaft 153 of the pressing member 150 is formed on the inner peripheral surface of the projection 225. Note that the second fixing portion 223b disposed around the second hole 121b has substantially the same configuration, operation, and effect as the first fixing portion 223a. Therefore, a detailed description of the second fixing portion 223b is omitted.

  When the operator uses the hemostatic device 200, as shown in FIGS. 7 and 8, the introducer 400 is inserted through the insertion portion 225a to the puncture site t formed in the region where the first hole 121a is located. I can guide you. Therefore, the surgeon can easily insert the introducer 400 into the palmar artery B via the puncture site t even when the covering member 110 is worn on the patient. In addition, when the puncture site t is pressed and stopped by the pressing member 150, the introducer 400 can be easily removed from the puncture site t via the insertion portion 225a.

  In the hemostatic device 200, a screw groove 224 for connecting the pressing member 150 to the convex portion 225 projecting from the covering portion 127 is formed. The screw groove 224 has an entire length corresponding to the protruding length of the protrusion 225. Accordingly, the range in which the thread groove 224 of the convex portion 225 and the shaft portion 153 of the pressing member 150 are screwed becomes longer, so that the pressing member 150 can be more reliably fixed to the first fixing portion 223a. Thereby, the hemostatic device 200 can prevent the pressing member 150 from being accidentally dropped from the first fixing portion 223a.

  The angle range (center angle) θ1 at which the insertion portion 225a is formed in the convex portion 225 is, for example, 90 ° to 120 ° when the planar shape of the convex portion 225 is a perfect circle. However, the shape of the insertion section 225a is not particularly limited as long as a part of the introducer 400 can be guided to the puncture site t via the insertion section 225a. The shape of the convex part 225 is not particularly limited as in the case of the insertion part 225a.

  When a plurality of fixing portions 223a and 223b are provided on the covering member 110 as in the present embodiment, the insertion portion 225a can be formed only on an arbitrary fixing portion.

  As described above, in the hemostatic device 200 according to the present embodiment, the first fixing portion 223a includes the convex portion 225 surrounding the first hole 121a and a part of the introducer 400 to be placed in the palm artery B of the patient. And an insertion portion 225a through which the. Therefore, the surgeon inserts the introducer 400 into the palmar artery B via the puncture site t formed in the region where the first hole 121a is located, with the covering member 110 attached to the patient, and Introducer 400 can be easily removed from puncture site t.

(Third embodiment)
FIG. 8 is a perspective view illustrating a state where the covering member 110 of the hemostatic device 300 according to the third embodiment is mounted on the patient's hand H. FIG. 9 is an enlarged perspective view showing a peripheral portion of a hole (first hole 121a) of the hemostatic device 300 according to the third embodiment. FIG. 10 is a perspective view illustrating a state in which hemostasis is performed at the puncture site t using the hemostatic device 300 according to the third embodiment.

  The hemostatic device 300 according to the third embodiment differs from the hemostatic device 100 according to the first embodiment and the hemostatic device 200 according to the second embodiment in the structure of the fixing portion.

  As shown in FIGS. 8 and 9, the fixing portion 323 provided in the hemostatic device 300 is configured to be connectable and separable from the main body 120 of the covering member 110.

  As shown in FIG. 9, the fixing portion 323 includes a convex portion 325 having a thread groove 324 formed on an inner peripheral surface thereof, and an insertion portion 325 a through which a part of the introducer 400 to be placed in the palm artery B of the patient can be inserted. And

  The insertion portion 325a is formed by cutting out a part of the bottom surface side (the surface side facing the main body 120 of the covering member 110 in FIG. 9) of the projection 325. The angle range (center angle) θ1 at which the insertion portion 325a is formed in the convex portion 325 is, for example, 90 ° to 120 ° when the planar shape of the convex portion 325 is a perfect circle.

  The fixing portion 323 is provided with a first connection portion 328 that can be connected to and separated from the body portion 120 of the covering member 110. The first connecting portion 328 is arranged along the bottom surface of the fixing portion 323 (the bottom surface of the convex portion 325). Around the first hole 121a of the main body 120 of the covering member 110, a second connecting portion 329a for connecting the fixing portion 323 to the main body 120 via the first connecting portion 328 is provided. I have. Similarly, a second connection portion 329b for connecting the fixing portion 323 to the main body 120 via the first connection portion 328 is provided around the second hole 121b of the main body 120 of the covering member 110. ing.

  The first connection part 328 and the second connection part 329a, 329b may be formed of, for example, a magnet that enables the first connection part 328 and the second connection part 329a (or the second connection part 329b) to be connected and separated by magnetic force. Can be. However, the specific configuration of the first connection portion 328 and the second connection portion 329a (or the second connection portion 329b) is not particularly limited as long as the fixing portion 323 can be connected to and separated from the covering member 110. For example, as another configuration of the first connection portion 328 and the second connection portions 329a and 329b, a hook-and-loop fastener or a mechanical connection mechanism of a fitting type can be used. The hook-and-loop fastener is a fastener that can be attached and detached in terms of surface, and is, for example, Magic Tape (registered trademark) or Velcro (registered trademark).

  When the operator performs hemostasis using the hemostatic device 300 according to the third embodiment, as illustrated in FIG. 9, the operator is formed in a region where the first hole 121a (or the second hole 121b) is located. With the sheath tube 410 of the introducer 400 inserted into the puncture site t, the fixing part 323 is made to approach the first hole 121a. The surgeon approaches the fixing portion 323 to the first hole portion 121a, thereby maintaining the state in which the sheath tube 410 of the introducer 400 is inserted into the puncture site t, and fixing the fixing portion 323 to the main body of the covering member 110. 120 can be connected. When connecting the fixing portion 323 to the main body 120 of the covering member 110, the surgeon adjusts the orientation of the fixing portion 323 so that the position of the insertion portion 325 a overlaps the sheath tube 410. The surgeon can prevent the protrusion 325 from interfering with the sheath tube 410 by arranging the insertion portion 325a as described above.

  As described above, according to the hemostatic device 300 according to the present embodiment, since the fixing portion 323 is configured to be connectable and separable from the main body portion 120 of the covering member 110, any timing during the procedure using the hemostatic device 100 is possible. Thus, the fixing portion 323 can be connected to the covering member 110. For example, in a state where the covering member 110 is mounted on the patient's hand H, the operator can remove the fixing portion 323 from the covering member 110 until the compression hemostasis by the pressing member 150 starts. By removing the fixing portion 323 from the covering member 110, the surgeon can easily perform a procedure such as puncturing or inserting the introducer 400 into the region where the first hole 121a or the second hole 121b is located. it can. Therefore, the procedure using the hemostatic device 300 can be further smoothly performed.

  When a plurality of holes 121a and 121b are provided in the covering member 110 as in the present embodiment, the second connection portion can be arranged only around an arbitrary hole. The formation of the insertion portion 325a in the fixing portion 323 can be omitted as appropriate, and an insertion portion having the same shape as the insertion portion 225a shown in the second embodiment may be formed in the fixing portion 323. .

  The present invention is not limited to the embodiments described above, and various modifications can be made in accordance with the scope of the claims.

  In each embodiment, screwing by a screw groove is exemplified as a connection form of the pressing member to the fixing part. However, in the above connection form, in a state where the pressing member is connected to the fixing part, the pressing member is connected to the puncture site. The pressing force is not limited as long as possible. For example, as a connection form of the pressing member to the fixing portion, a mechanical mechanism such as a fitting type can be adopted. When a connection mode other than the connection mode using the screw groove is adopted, the connection mode is configured such that the magnitude of the pressing force applied by the pressing member to the puncture site can be reversibly adjusted. Alternatively, it may be configured to apply a constant pressing force to the puncture site.

  Further, in each embodiment, an example has been described in which the hole is provided on the back side of the covering member (the surface on the back side of the covering member), but the hole is provided on the palm side of the covering member. (The surface of the covering member on the palm side). When the hole is provided in the portion of the covering member that is arranged on the palm side of the hand, the surgeon can perform various treatments on the blood vessel running on the palm side of the hand using the hemostatic device. . Moreover, the surgeon can stop the puncture site formed on the palm side of the hand by using the hemostatic device. In the case where the hole is provided in the portion of the covering member which is arranged on the palm side, when the hemostatic device is provided with the supporting member, the supporting member may be provided in the portion of the covering member which is arranged on the back side of the hand. it can.

  The specific structure of the pressing member is not particularly limited as long as the pressing member can apply a pressing force to the puncture site formed on the hand. For example, the pressing member may be configured by an expanding member that can expand and contract with the injection and discharge of the fluid.

  Further, in each embodiment, the use example in stopping the puncture site formed in the left hand of the patient has been described. However, the hemostatic device can also be used in performing surgery on the right hand of the patient. In this case, the positional relationship and the like of each part (for example, the hole and the fixed part) of the hemostatic device can be appropriately changed so that the puncture site formed in the right hand of the patient can be stopped.

100, 200, 300 hemostatic device,
110 covering member,
120 body part of the covering member,
121a 1st hole part (hole part),
121b 2nd hole part (hole part),
123a, 223a first fixing portion (fixing portion),
123b, 223b second fixing part (fixing part),
124, 224, 324 screw groove,
127 covering part,
128 hooks,
130 mounting part,
150 pressing member,
151 pressing part,
151a insertion hole,
151b accommodation section,
153 shaft part,
153a insertion part,
153b head,
155 gripper,
160 support members,
225 convex part,
225a, 325a insertion portion,
323 fixing part,
324 screw groove,
328 first connection part,
329a, 329b second connection part,
400 introducer (medical device),
410 sheath tube,
A Forearm,
B palmar artery (living body lumen),
H hand,
Hb back of hand,
Hp palm of hand,
c1 the central axis of the pressing member,
f1 thumb (finger),
t Puncture site (site to stop bleeding).

Claims (7)

A covering member for covering the outer surface of the patient's hand,
A pressing member connectable to the covering member,
The covering member includes a covering portion that covers an outer surface of the patient's hand, a mounting portion disposed on the patient's finger, and a part of the outer surface of the patient's hand that is located on the covering portion. And a fixing portion that is arranged around the hole portion and that can connect the pressing member,
The pressing member is connectable to the fixing portion so as to cover the hole in a state where the hole exposes a portion to be stopped formed in the hand.
The hemostasis device, wherein the pressing member is movable in a direction in which the hole is inserted so as to press the portion to be hemostatically stopped in a state where the pressing member and the fixing portion are connected. The pressing member has a pressing portion that presses the site to be stopped, and a shaft portion that is movable in a direction perpendicular to the hole in a state where the pressing member is connected to the fixing portion,
The hemostatic device according to claim 1, wherein the pressing portion is connected to the shaft portion so that rotation of the shaft portion is not transmitted.   The said fixing part has a convex part which surrounds the said hole part, and the insertion part which can insert a part of medical device indwelling in the living body lumen of the said patient, The insertion part of Claim 1 or Claim 2 characterized by the above-mentioned. Hemostatic device. The covering member has a plurality of the holes,
The hemostatic device according to any one of claims 1 to 3, wherein the pressing member is connectable to the fixing portion disposed around any one of the plurality of holes. .   In a state where the covering member is disposed on the outer surface of the hand of the patient, the supporting member is formed of a material harder than the covering member on a side facing the hole with the hand therebetween. The hemostatic device according to any one of claims 1 to 4, further comprising a member.   The pressure member according to any one of claims 1 to 5, wherein, in a state in which the pressure member is connected to the fixing portion, a portion that is arranged to be overlapped with the portion to be stopped is transparent or translucent. The hemostatic device as described.   The hemostatic device according to any one of claims 1 to 6, wherein the fixing portion is connectable to and detachable from the covering member.