JP2022036331A - Hemostatic device - Google Patents

Abstract

To provide a hemostatic device in which a part of a pressing member follows movements of the hand and can maintain a pressing force to a hemostatic region of the pressing member even when the movements of the hand or the like occur during hemostasis.SOLUTION: An expansion member 100 provided by a hemostatic device 10 has: a first area 101 which is provided for a cover member at a position where a center line c1 of an expansion member does not match a center line c2 of a cover member 200 and overlaps a fixing member 210 in a longitudinal direction of the cover member on the cover member; and a second area 102 arranged nearer an end side of hand H than the first area. The second area of the expansion member is held by the hand by a force smaller than a fixing force imparted by the fixing member to the first area in the state that the cover member fixes the expansion member to at least either a forearm part A or the hand.SELECTED DRAWING: Figure 6

Description

The present invention relates to a hemostatic device.

As one of the catheter procedures, a blood vessel in the patient's arm (for example, the radial artery) is punctured, and various medical long bodies are introduced into the blood vessel through the puncture site formed in the blood vessel in the patient's arm to cause a lesion. Techniques for treating or treating a site are known (see Patent Document 1 below). The catheter procedure utilizing the radial artery is called the transradial artery approach and is considered as a useful technique for, for example, coronary artery access and lower limb artery access.

The radial artery located in the arm of the human body is connected to the palmar artery that bypasses the hand side. Therefore, as a new approach to the transradial artery approach, the palmar artery (including the distal radial artery) is currently accessed from the anatomical snuff box located on the back of the hand or from a position around the snuff box, and its vascular access is performed. A catheter procedure using dTRA (distal artery approach), in which treatment is performed via a site, has been attempted.

Japanese Unexamined Patent Publication No. 2008-119517

Blood vessels such as palmar arteries located in the hand are located in places where there are many movable parts such as fingers. Therefore, when the patient spreads or holds the hand, the shape around the puncture site of the hand changes due to the movement of the hand. Therefore, when stopping bleeding at the puncture site of the hand, it is preferable that the pressing member arranged on the hand follows the movement of the hand and maintains appropriate pressure on the puncture site. That is, there is a demand for a hemostasis device in which the pressing member follows the movement of the hand and can effectively press and stop bleeding at the puncture site of the blood vessel located in the hand.

In view of the above problems, the present invention has a part of the pressing member following the movement of the hand even when the movement of the hand occurs during hemostasis, and the hemostasis of the pressing member is performed. The purpose is to provide a hemostatic device that can maintain the pressure on the site to be treated.

The hemostatic device according to the present invention includes a pressing member arranged at a portion of the patient's hand to stop bleeding, and a covering member covering at least a part of the pressing member with the pressing member covering the portion to be stopped bleeding. The covering member has a fixing member for fixing the pressing member to at least one of the arm and the hand while the pressing member covers the portion to be hemostasis. Is provided on the covering member at a position where the center line of the pressing member and the center line of the covering member do not coincide with each other, and overlaps the fixing member on the covering member in the longitudinal direction of the covering member. It has a region and a second region located closer to the tip of the hand than the first region, in which the covering member has the pressing member on at least one of the arm and the hand. In the fixed state, the fixing member is held against the hand with a force smaller than the fixing force applied to the first region. Here, "the second region is a fixing force applied to the first region by the fixing member in a state where the covering member fixes the pressing member to at least one of the patient's arm and the patient's hand. It is also held against the hand with a small force. " Since it is not tightened against the patient's skin, it means that when the patient moves the hand, the second region follows the movement of the hand more easily than the first region of the pressing member.

Further, the hemostatic device according to the present invention covers at least a part of the pressing member, which is arranged at the portion of the patient's hand to be stopped, and the pressing member covers the portion of the patient's hand to be stopped. The covering member comprises a covering member, and the covering member is a fixing member for fixing the pressing member to at least one of the patient's arm and the patient's hand while the pressing member covers the portion to be stopped. The pressing member is provided on the covering member at a position where the center line of the pressing member and the center line of the covering member do not coincide with each other, and the pressing member is provided on the covering member in the longitudinal direction of the covering member. It has a first region that overlaps the fixing member and a second region that is arranged on the tip end side of the hand with respect to the first region, and the covering member extends to the second region side. , Does not have the fixing member for fixing the pressing member to the hand.

In the hemostatic device according to the present invention, the first region of the pressing member is firmly fixed to at least one of the arm and the hand, and the second region of the pressing member is movable on the tip side of the hand with respect to the first region. It is held in the state of holding. Therefore, in the hemostatic device, when the patient moves his / her hand while the hemostatic device is attached to the patient, the first region of the pressing member prevents the pressing member from being displaced, and the second region of the pressing member moves the hand. Transforms to follow. Specifically, since the first region of the pressing member is fastened to the patient's skin by the fixing member via the covering member, when the patient moves his / her hand, the position of the pressing member with respect to the site to be stopped bleeding is displaced. To prevent. Further, since the second region of the pressing member is not fastened to the patient's skin by the fixing member via the covering member, the second region is deformed to follow the movement of the hand when the patient moves the hand. Therefore, the hemostatic device is a state in which the hemostatic device is attached to the patient, and when the patient moves the hand by deforming the second region of the pressing member so as to follow the movement of the patient's hand as described above. It is possible to suppress the force generated in the pressing member from being transmitted to the first region of the pressing member. Therefore, the hemostatic device can suitably prevent the first region of the pressing member from being displaced, and can maintain the pressing force of the pressing member on the site where hemostasis should be performed. Further, in the hemostatic device according to the present invention, the second region of the pressing member is not tightened to the patient's hand by the fixing member in a state where the hemostatic device is attached to the patient's hand. Therefore, the hemostatic device suppresses the movement of the hand from being restricted by the fixing member on the fingertip side of the patient while being worn on the patient's hand. Therefore, the patient is not excessively restricted in hand movement even when wearing a hemostatic device.

It is a figure which shows the hemostatic device which concerns on 1st Embodiment, and is the top view seen from the inner surface side of a covering member. It is sectional drawing of the hemostatic device along the arrow 2A-2A shown in FIG. 1, and is the figure which shows the state before expansion | expansion of an expansion member. FIG. 2 is a cross-sectional view of a hemostatic device corresponding to FIG. 2A, showing a state in which the expansion member is expanded. It is a side view of the hemostatic device seen from the direction of arrow 3A shown in FIG. It is a perspective view for demonstrating the use example of the hemostatic device which concerns on 1st Embodiment. It is a perspective view for demonstrating the use example of the hemostatic device which concerns on 1st Embodiment. It is a perspective view for demonstrating the use example of the hemostatic device which concerns on 1st Embodiment. It is sectional drawing which follows the arrow 7A-7A shown in FIG. 6, and is the figure which shows typically the state which the hemostatic device is attached to the patient. It is a figure which shows the hemostatic device which concerns on 2nd Embodiment, and is the top view seen from the inner surface side of the covering member. It is sectional drawing of the hemostatic device along the arrow 9A-9A shown in FIG. 8, and is the figure which shows the state before expansion | expansion of an expansion member. FIG. 9 is a cross-sectional view of a hemostatic device corresponding to FIG. 9A, showing a state in which the expansion member is expanded. It is a perspective view for demonstrating the use example of the hemostatic device which concerns on 2nd Embodiment. It is sectional drawing which follows the arrow 11A-11A shown in FIG. 10, and is the figure which shows typically the state which attached the hemostatic device to the patient's hand. It is a figure which shows the hemostatic device which concerns on 3rd Embodiment, and is the top view seen from the inner surface side of the covering member. It is sectional drawing of the hemostatic device along the arrow 13A-13A shown in FIG. 12, and is the figure which shows the state before expansion | expansion of an expansion member. It is sectional drawing of the hemostatic device corresponding to FIG. 13A, and is the figure which shows the expanded state of the expansion member. It is a perspective view for demonstrating the use example of the hemostatic device which concerns on 3rd Embodiment. It is sectional drawing which follows the arrow 15A-15A shown in FIG. 14, and is the figure which shows typically the state which attached the hemostatic device to the patient's hand. It is a figure which shows the hemostatic device which concerns on 4th Embodiment, and is the top view seen from the inner surface side of the covering member. It is sectional drawing of the hemostatic device along the arrow 17A-17A shown in FIG. 16, and is the figure which shows the state before expansion | expansion of an expansion member. It is sectional drawing of the hemostatic device corresponding to FIG. 17A, and is the figure which shows the expanded state of the expansion member. It is a figure which shows the hemostatic device which concerns on 5th Embodiment, and is the top view seen from the inner surface side of the covering member. It is a figure which shows the hemostatic device which concerns on 6th Embodiment, and is the top view seen from the inner surface side of the covering member. It is a figure which shows the hemostatic device which concerns on 7th Embodiment, and is the top view seen from the inner surface side of the covering member. It is a figure which shows the hemostatic device which concerns on 8th Embodiment, and is the top view seen from the inner surface side of the covering member. It is a figure which shows the shape example of a fixing member. It is a figure which shows the shape example of a fixing member.

Hereinafter, embodiments of the present invention will be described with reference to the attached 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 explanation and may differ from the actual ratios.

(First Embodiment)
1 to 4 are views for explaining the hemostatic device 10 according to the first embodiment, and FIGS. 4 to 7 are views for explaining a usage example of the hemostatic device 10.

As shown in FIGS. 6 and 7, for example, the hemostatic device 10 runs on the instep Hb side of the hand (for example, the left hand) H located on the finger side of the patient's forearm (corresponding to the “arm”) A. The puncture site t ("hemostatic") formed on the radial artery side of the palmar artery (deep palm artery) B1 (for example, the artery around the anatomical snuff box or the distal radial artery running on the fingertip side of the snuff box). When removing the medical elongated body (for example, the sheath tube of the introducer 600) 610 that has been indwelled in the "site to be"), the puncture site t can be used to stop bleeding. The anatomical snuff box is a cavity of the hand H located on the radial side of the forearm A when the thumb is spread.

As shown in FIGS. 1 and 6, the hemostatic device 10 has a pressing member 100 arranged at the puncture site t and a coating covering at least a part of the pressing member 100 with the pressing member 100 covering the puncture site t. The member 200 and the member 200 are provided. Further, as shown in FIGS. 1 and 4, the covering member 200 is a fixing member that fixes the pressing member 100 to at least one of the forearm portion A and the hand H while the pressing member 100 covers the puncture site t. Has 210.

In the present embodiment, as shown in FIGS. 2A and 2B, the pressing member 100 is composed of an expansion member including a bag body 110 that can be expanded by injecting a fluid and an expansion space 115 surrounded by the bag body 110. is doing. Further, as shown in FIGS. 2A and 2B, the bag body 110 is connected to a support member 300 described later. The bag 110 may be connected to at least one of the covering member 200 and the support member 300 described later. In the following description, the pressing member 100 will be described as an expansion member 100.

In the description of the present specification, the tip end side of the patient's hand H means the side on which the fingertip of the hand H is arranged (left side in FIG. 1). Further, the "inner surface" in each part of the hemostatic device 10 is the surface on the side arranged so as to face the body surface of the patient when the hemostatic device 10 is attached to the patient, and the "outer surface" is the inner surface. The opposite surface (the surface that is not placed facing the body surface). Note that FIG. 1 is a plan view of the hemostatic device 10 as seen from the inner surface 200a side of the covering member 200.

As shown in FIGS. 1, 2A, and 2B, the expansion member 100 is provided on the covering member 200 at a position where the center line c1 of the expansion member 100 and the center line c2 of the covering member 200 do not coincide with each other. The center line c1 of the expansion member 100 is offset to the support member 300 side (left side in FIG. 1) provided on the covering member 200 with respect to the center line c2 of the covering member 200.

As shown in FIGS. 1 and 6, the expansion member 100 is a fixing member 210 on the covering member 200 (to the extent that the covering member 200 is continuous in the longitudinal direction of the covering member 200) and in the longitudinal direction of the covering member 200. It has a first region 101 that overlaps with the first region 101, and a second region 102 (see FIG. 6) that is arranged on the tip end side of the hand H with respect to the first region 101. That is, the first region 101 is a part of the expansion member 100 that overlaps with the fixing member 210 in the longitudinal direction of the covering member 200 in a range in which the covering member 200 is continuous in the long direction of the covering member 200.

The longitudinal direction of the covering member 200 is a direction along the arrows X1-X2 shown in FIG. Further, on the plan view shown in FIG. 1, the direction orthogonal to the longitudinal direction of the covering member 200 is defined as the width direction, and is indicated by arrows Y1-Y2.

The center line c2 of the covering member 200 is a linear virtual line passing through the center position in the width direction of the covering member 200.

The center line c1 of the expansion member 100 is a linear virtual line passing through the center position in the width direction (left-right direction in FIG. 1) of the expansion member 100, which is the same direction as the width direction of the covering member 200. The center line c1 of the expansion member 100 extends substantially parallel to the center line c2 of the covering member 200.

The expansion member 100 has a substantially rectangular shape on the plan view shown in FIG. Therefore, the width of the expansion member 100 is substantially constant along the longitudinal direction of the covering member 200.

The expansion member 100 may have a shape such as a circle, an ellipse, or a polygon on the plan view shown in FIG. When the expansion member 100 is formed in a shape having no substantially constant width along the longitudinal direction of the covering member 200 as described above, the center line c1 of the expansion member 100 is, for example, on the plan view shown in FIG. Can be defined by a straight line that passes through the center position in the width direction of the expansion member 100 and extends substantially parallel to the center line c2 of the covering member 200.

As shown in FIGS. 2A and 2B, the first region 101 of the expansion member 100 is one end in the width direction of the expansion member 100 with reference to the boundary portion b1 between the first region 101 and the second region 102 of the expansion member 100. It is provided on the unit 103 side. Further, the second region 102 of the expansion member 100 is provided on the other end portion 104 side in the width direction of the expansion member 100 with reference to the boundary portion b1.

In the present embodiment, the center line c1 of the expansion member 100 and the boundary portion b1 of the first region 101 and the second region 102 are arranged at overlapping positions on the plan view shown in FIG.

As shown in FIGS. 1 and 2B, the hemostatic device 10 has the patient's body surface (the body surface of the forearm A and the hand H) in a state where the hemostatic device 10 is attached to the patient and the expansion member 100 is expanded. It has a support member 300 that suppresses the expansion of the expansion member 100 in the direction away from the body surface).

The support member 300 is connected to the covering member 200 while covering the second region 102 of the expansion member 100.

In the present embodiment, the support member 300 is integrally formed with the covering member 200. As shown in FIG. 1, a portion of the covering member 200 extending so as to cover the second region 102 along the width direction of the expansion member 100 forms a support member 300. The support member 300 is arranged so as to cover the entire second region 102 along the width direction of the expansion member 100.

The support member 300 may be arranged so as to cover only a part of the second region 102. Further, the support member 300 may be formed of a member different from the covering member 200 as described later (see FIG. 23).

As shown in FIGS. 2A and 2B, the hemostatic device 10 is arranged between the support member 300 and the expansion member 100 (between the vertical directions shown in FIGS. 2A and 2B) and is connected to the support member 300. It has an auxiliary expansion member 400.

As shown in FIG. 2B, the auxiliary expansion member 400 has a space portion 415 communicating with the expansion space 115 of the expansion member 100, and a bag body 410 covering the space portion 415.

A communication hole 116 is formed in the bag body 110 of the expansion member 100. Further, a communication hole 416 is formed in the bag body 410 of the auxiliary expansion member 400. The expansion space 115 of the expansion member 100 and the space portion 415 of the auxiliary expansion member 400 communicate with each other through the communication holes 116 and 416.

As shown in FIG. 1, in the present embodiment, the length of the auxiliary expansion member 400 (the length along the longitudinal direction of the covering member 200) is substantially the same as the length of the expansion member 100 in the longitudinal direction. Further, the width of the auxiliary expansion member 400 (the width in the direction orthogonal to the longitudinal direction of the covering member 200) is shorter than the width of the expansion member 100. In the present embodiment, the width of the auxiliary expansion member 400 is approximately ½ of the width of the expansion member 100.

As shown in FIG. 1, the auxiliary expansion member 400 is arranged so as to overlap the second region 102 of the expansion member 100 and the support member 300 along the longitudinal direction of the covering member 200. Further, the auxiliary expansion member 400 is arranged so that the longitudinal direction of the auxiliary expansion member 400 is substantially parallel to the longitudinal direction of the covering member 200.

Looking at the arrangement relationship of each member in the entire hemostatic device 10, as shown in FIG. 2B, in the expansion member 100, the first region 101 and the covering member 200 overlap each other along the expansion direction of the expansion member 100. Further, in the expansion member 100, the second region 102, the auxiliary expansion member 400, and the support member 300 overlap each other along the expansion direction of the expansion member 100.

As shown in FIGS. 2A and 2B, the other end 104 in the width direction of the expansion member 100, the other end 404 in the width direction of the auxiliary expansion member 400, and the other end 304 in the width direction of the support member 300 are Connected to each other. The other end portions 104, 304, and 404 are the ends located on the left side of the members 100, 400, and 300 (the ends on the side where the covering member 200 is not arranged) in the plan view of FIG. be. The other end 104 in the width direction of the expansion member 100 and the other end 404 in the width direction of the auxiliary expansion member 400 are connected to the other end 304 in the width direction of the support member 300 at different positions close to each other. It may have been done. Further, in the present embodiment, the expansion member 100 and the auxiliary expansion member 400 are also connected to each other around the communication hole 116 of the expansion member 100 and around the communication hole 416 of the auxiliary expansion member 400.

As described above, the support member 300 is integrally formed with the covering member 200. Therefore, the expansion member 100 and the auxiliary expansion member 400 are connected to the covering member 200 via the support member 300 by being connected to the support member 300.

In the present embodiment, the bag body 110 of the expansion member 100 is formed of two sheet-shaped members. The bag body 110 can be formed, for example, by joining the outer peripheral edges of the two sheet-shaped members in a state where the expansion space 115 is formed between the two sheet-shaped members formed in a substantially rectangular shape. can. Similar to the bag body 110 of the expansion member 100, the bag body 410 of the auxiliary expansion member 400 can also be formed of two sheet-like members having a substantially rectangular shape joined together. The expansion member 100 and the auxiliary expansion member 400 have one side located on the outer circumference of the expansion member 100 (one side located at the other end 104 in the width direction shown in FIG. 2B) and one side located on the outer circumference of the auxiliary expansion member 400 (FIG. 2B). One side located at the other end 404 in the width direction shown in the above) is connected to the support member 300.

The bag body 110 of the expansion member 100 is formed by joining the outer peripheral portions of the two sheet-shaped members as described above. Therefore, when the expansion member 100 is expanded, the vicinity of the center position of the expansion member 100 (near the boundary portion b1) is higher than the one end portion 103 and the other end portion 104 in the width direction of the expansion member 100. It expands greatly in the vertical direction (vertical direction in FIG. 2B). Further, the bag body 410 of the auxiliary expansion member 400 is formed by joining the outer peripheral portions of the two sheet-shaped members as described above. Therefore, in the auxiliary expansion member 400, when the auxiliary expansion member 400 is expanded, the vicinity of the center position in the width direction of the auxiliary expansion member 400 (horizontal direction in FIG. 2B) is the one end portion 403 and the other end in the width direction of the auxiliary expansion member 400. Compared with the part 404, it expands greatly in the height direction. Therefore, when the expansion member 100 and the auxiliary expansion member 400 are expanded, as shown in FIG. 2B, the vicinity of the other end portion 104 in the width direction of the expansion member 100 and the vicinity of the other end portion 404 in the width direction of the auxiliary expansion member 400. A gap g is formed between them. When the hemostatic device 10 is attached to the patient and the expansion member 100 and the auxiliary expansion member 400 are expanded, the expansion member 100 and the auxiliary expansion member 400 maintain the state in which the compression force is applied to the puncture site t, while maintaining the above-mentioned gap. It can be moved via g. Therefore, the expansion member 100 and the auxiliary expansion member 400 can be deformed so as to follow the shape of the patient's hand H when the patient moves the hand H or the like, and a state in which a pressing force is applied to the puncture site t. It can be suitably maintained.

The method of joining the sheet-shaped members forming the expansion member 100 and the method of joining the sheet-shaped members forming the auxiliary expansion member 400 are not particularly limited, and for example, fusion or bonding can be adopted. Further, the method of connecting the expansion member 100, the auxiliary expansion member 400, and the support member 300 is not particularly limited, and for example, fusion or adhesion can be adopted. Further, the method of connecting the periphery of the communication hole 116 of the expansion member 100 and the periphery of the communication hole 416 of the auxiliary expansion member 400 is not particularly limited, and for example, fusion or adhesion can be adopted.

The expansion member 100 and the auxiliary expansion member 400 are not limited to a structure in which a plurality of sheet-shaped members are joined. The expansion member 100 and the auxiliary expansion member 400 may be formed of, for example, one bag-shaped member in which a space through which a fluid can flow can flow.

As shown in FIG. 2B, one end 103 in the width direction of the expansion member 100, one end 403 in the width direction of the auxiliary expansion member 400, and one end 203 in the width direction of the covering member 200 are not connected.

As shown in FIGS. 1 and 2B, the hemostatic device 10 has a marker portion 117 for aligning the expansion member 100 with respect to the puncture site t. The marker portion 117 is arranged at a position corresponding to the boundary portion b1 between the first region 101 of the expansion member 100 and the second region 102 of the expansion member 100. Further, the marker portion 117 is arranged at a position corresponding to a substantially center position (center position in the vertical direction and the horizontal direction in FIG. 1) in the longitudinal direction and the width direction of the expansion member 100.

As shown in FIG. 2B, the marker portion 117 can be arranged, for example, on the inner surface of the surface (inner surface) on the side of the expansion member 100 facing the body surface. However, the marker portion 117 is, for example, the inner surface of the surface (outer surface) opposite to the side surface of the expansion member 100 facing the body surface of the expansion member 100, the outer surface thereof, and the inner surface of the support member 300. It can also be placed on the surface, outer surface, or the like. Further, when the center position of the expansion member 100 and the one end portion 403 of the auxiliary expansion member 400 are arranged so as to overlap each other on the cross-sectional views shown in FIGS. 2A and 2B, the marker portion 117 is the one end portion of the auxiliary expansion member 400. It may be placed on the outer surface of the 403.

The marker portion 117 is preferably composed of, for example, a transparent central portion and a colored linear frame portion surrounding the central portion. Thereby, the operator can arrange the marker portion 117 at the puncture site t while confirming the puncture site t through the transparent central portion of the marker portion 117. Therefore, the operator can easily arrange the boundary portion b1 between the first region 101 and the second region 102 at the puncture site t by using the marker portion 117. The marker portion 117 may be formed only by a colored central portion, for example, without having a frame portion. Further, the specific shape and color of the marker portion 117, the method of forming the marker portion 100 on the expansion member 100, and the like are not particularly limited.

In the expansion member 100, the covering member 200, the support member 300, and the auxiliary expansion member 400, the portion overlapping the marker portion 117 in a plan view and its surroundings are preferably translucent or colored transparent. As a result, the operator can visually recognize the puncture site t from the outer surface side of the covering member 200 or the outer surface side of the support member 300 even when the marker portion 117 is superposed on the puncture site t (FIG. 6). See).

As shown in FIG. 1, the hemostatic device 10 operates to inject a fluid (for example, a gas such as air) into the expansion member 100 and the auxiliary expansion member 400, and to discharge the fluid from the expansion member 100 and the auxiliary expansion member 400. It has an injection unit 500 for doing so.

The injection portion 500 includes a flexible tube 501, a bag portion 503 arranged at one end of the tube 501 so as to communicate with the lumen of the tube 501, and a check valve connected to the bag portion 503 (FIG. FIG. It has a tubular connector 505 and a built-in (not shown).

As shown in FIG. 1, the tube 501 is connected to the expansion member 100 at the other end on the opposite side to the one end where the bag portion 503 is arranged. The other end of the tube 501 can be connected to the bag 110 with an adhesive or the like while being sandwiched between two sheet-shaped members forming the bag 110 of the expansion member 100, for example. The sheet-shaped member forming the expansion member 100 may have a convex portion that partially protrudes outward from the sheet-shaped member, for example, in a portion of the bag 110 that sandwiches the tube 501. good.

In the injection section 500, the tube 501 is connected to the expansion member 100 so that the lumen of the tube 501 communicates with the expansion space 115 of the expansion member 100.

As shown in FIG. 1, the injection portion 500 has a tube 501 on the one end side (upper end side in FIG. 1) of the support member 300 in a state where the other end of the tube 501 is connected to the expansion member 100. Is drawn from. In the hemostatic device 10, the tube 501 of the injection portion 500 is arranged as described above, so that when the hemostatic device 10 is attached to the patient, the tube 501 is on the side of the patient's hand H (in the direction in which the hand H extends). Placed on the intersecting side) (see Figure 5). Therefore, it is possible to prevent the tube 501 from interfering with the introducer 600 when the hemostatic device 10 is attached to the patient. As shown in the embodiment (see FIG. 12) described later, the tube 501 may be arranged so as to be pulled out from the other end side (lower end side in FIG. 1) of the support member 300 in the longitudinal direction.

When expanding the expansion member 100 and the auxiliary expansion member 400, the surgeon or the like inserts the tip cylinder portion of the syringe (not shown) into the connector 505 of the injection portion 500, opens the check valve, and pushes the syringe pusher. Push to inject air in the syringe into the expansion space 115 of the expansion member 100. When air is injected into the expansion space 115 of the expansion member 100, the expansion member 100 expands. Further, the air injected into the expansion space 115 of the expansion member 100 passes through the communication hole 116 formed in the expansion member 100 and the communication hole 416 formed in the auxiliary expansion member 400, and the space portion of the auxiliary expansion member 400. It flows into 415. When air flows into the space 415 of the auxiliary expansion member 400, the auxiliary expansion member 400 expands. When the expansion member 100 and the auxiliary expansion member 400 expand, the bag portion 503 of the injection portion 500 communicating with the expansion space 115 of the expansion member 100 via the tube 501 expands. By confirming the expansion of the bag portion 503, the operator or the like can easily visually confirm that the expansion member 100 and the auxiliary expansion member 400 can be pressurized without leaking air. When the expansion member 100 and the auxiliary expansion member 400 are contracted, the tip cylinder portion of the syringe is inserted into the connector 505 of the injection portion 500, and the pusher of the syringe is pulled to pull the air and the auxiliary expansion in the expansion member 100. The air in the member 400 is discharged to the syringe.

As shown in FIG. 6, the covering member 200 is formed of a flexible band-shaped member that can be wound around the outer circumference of the vicinity of the wrist located on the distal end side of the forearm portion A substantially once. As shown in FIG. 3, a first fixing portion 211 constituting the fixing member 210 is arranged on the inner surface 200a of one end portion (upper end portion in FIG. 1) 201 in the longitudinal direction of the covering member 200. Further, a second fixing portion 212 constituting the fixing member 210 is arranged on the outer surface 200b of the other end portion (lower end portion in FIG. 1) 202 in the longitudinal direction of the covering member 200.

The first fixing portion 211 and the second fixing portion 212 are formed in a rectangular shape having a long side extending in the longitudinal direction of the covering member 200 on the plan view shown in FIG.

The first fixing portion 211 may be configured, for example, on the female side (or male side) of the hook-and-loop fastener, and the second fixing portion 212 may be configured, for example, on the male side (or female side) of the hook-and-loop fastener. can. The hook-and-loop fastener is a fastener that is removable in terms of surface, and is, for example, Magic Tape (registered trademark) or Velcro (registered trademark). The structure of the fixing member 210 is not particularly limited as long as the covering member 200 can be fixed to at least one of the forearm portion A and the hand H of the patient, and the fixing member 210 is, for example, a snap, a button, a clip, or a covering. It may be a frame member or the like through which one end 201 in the longitudinal direction of the member 200 or the other end 202 in the longitudinal direction of the covering member 200 is passed.

As shown in FIG. 1, the center line c2 of the covering member 200 is the center position of the fixing member 210 (first fixing portion 211, second fixing portion 212) (center position in the width direction of the fixing member 210, and is the center position in the width direction of FIG. It is placed so as to overlap with the center position in the left-right direction of. Therefore, when the hemostatic device 10 is attached to the patient, the fixing force for fixing the first region 101 of the expansion member 100 to the patient extends to substantially the entire first region 101 of the expansion member 100. Here, the "fixing force by which the fixing member 210 fixes the first region 101 of the expansion member 100 to the patient" means that the fixing member 210 holds the first region 101 of the expansion member 100 to the patient via the covering member 200. It is the force that tightens against the skin.

The center line c2 of the covering member 200 is defined by a line passing through the center position in the width direction of the covering member 200 (the center position in the left-right direction in FIG. 1). The center line c2 of the covering member 200 does not have to pass through the center position in the width direction of the fixing member 210. That is, the center line c2 of the covering member 200 is not affected by the shape of the fixing member 210 or the arrangement of the center position of the fixing member 210 on the plan view shown in FIG. Further, when the covering member 200 does not have a rectangular shape having substantially the same width along the longitudinal direction, the center line c2 of the covering member 200 is, for example, in a portion where the expansion member 100 of the covering member 200 is arranged. , Can be defined by a line passing through the center position in the width direction of the covering member 200.

The shape of the fixing member 210 is not limited to a rectangle as shown in FIG. 1, as will be described in a modification described later (see FIGS. 22 and 23).

The material used for the covering member 200 is not particularly limited, but is, for example, a polyolefin such as polyvinyl chloride, polyethylene, polypropylene, polybutadiene, ethylene-vinyl acetate copolymer (EVA), polyethylene terephthalate (PET), polybutylene terephthalate (polybutylene terephthalate). Polyethylene such as PBT), polyvinyl chloride, silicone, polyurethane, polyamide elastomer, polyurethane elastomer, various thermoplastic elastomers such as polyester elastomer, nylon, nylon elastomer, or any combination thereof (blended resin, polymer alloy, etc.) Laminates, etc.).

The material used for the support member 300 is not particularly limited, but when the support member 300 is integrally formed with the covering member 200, the same material as the covering member 200 can be exemplified.

When the support member 300 is composed of a member different from the covering member 200, the material used for the support member 300 is preferably harder than the material used for the covering member 200. Such materials include, for example, acrylic resins, polyvinyl chlorides (particularly hard polyvinyl chlorides), polyethylenes, polypropylenes, polyolefins such as polybutadienes, polystyrenes, poly- (4-methylpentene-1), polycarbonates, ABS resins, etc. Polyesters such as polymethylmethacrylate (PMMA), polyacetal, polyacrylate, polyacrylonitrile, polyvinylidene fluoride, ionomer, acrylonitrile-butadiene-styrene copolymer, polyethylene terephthalate (PET), polybutylene terephthalate (PBT), butadiene-styrene. Examples thereof include copolymers, aromatic or aliphatic polyamides, fluororesins such as polytetrafluoroethylene, and the like. When the support member 300 is made of a hard material as described above, the hemostatic device 10 may be provided with a bag portion (pocket) at a portion where the support member 300 is arranged. The support member 300 is, for example, a curved plate-shaped member that can be inserted into the bag portion (a plate-shaped member having an inner surface that is convexly curved along the shape of the body surface of the forearm portion A or the hand H). Can be configured with. Further, the support member 300 may be fixed to the covering member 200 by being attached to the surface of the covering member 200 with an adhesive or the like, as shown in the embodiment described later (see FIG. 21).

As the material used for the expansion member 100 and the auxiliary expansion member 400, for example, the same materials as those exemplified as the material of the covering member 200 can be exemplified.

The length of the expansion member 100 in the longitudinal direction (length in the vertical direction in FIG. 1) and the width of the expansion member 100 (length in the horizontal direction in FIG. 1) are the puncture sites when the hemostatic device 10 is attached to the patient. The pressure is not particularly limited as long as it can be applied to t. Further, the length and width of the first region 101 and the second region 102 of the expansion member 100 in the longitudinal direction are not particularly limited. Further, the length and width of the auxiliary expansion member 400 in the longitudinal direction are not particularly limited. Further, the length and width of the support member 300 in the longitudinal direction are not particularly limited.

Further, the length and width of the covering member 200 are not particularly limited as long as they can be fixed with the covering member 200 attached to at least one of the forearm portion A and the hand H of the patient. However, as shown in FIG. 1, the width of the covering member 200 is preferably shorter than the width of the expanding member 100. The radial artery side of the palmar artery (deep palmar artery) B running on the instep Hb side of the hand H located on the finger side of the patient's forearm A (for example, the artery around the anatomical snuff box or the snuff box) When puncturing the distal radial artery running on the fingertip side, the puncture site t of the hand H is formed at a position close to the pedicle S of the ulnar bone in the direction from the forearm A toward the fingertip side (FIG. 5). See). Therefore, when the width of the covering member 200 is formed shorter than the width of the expanding member 100, when the hemostatic device 10 is attached to the patient as shown in FIGS. 5 and 6, the surgeon performs the width direction of the covering member 200. One end 203 of the patient can be arranged so as to be hooked on the styloid process S of the patient's ulna. By arranging the covering member 200 as described above when the hemostatic device 10 is attached to the patient, it is possible to suitably prevent the hemostatic device 10 from being displaced.

Next, an example of using the hemostatic device 10 will be described with reference to FIGS. 4 to 7.

In FIG. 4, various procedures are performed by inserting the sheath tube 610 of the introducer 600 into the distal radial artery side of the palmar artery B via the puncture site t formed on the instep Hb of the patient's hand (left hand) H. It shows the finished state. Further, FIG. 4 shows a state in which a part of the sheath tube 610 is pulled out from the puncture site t after the above procedure is completed.

When starting hemostasis, the surgeon or the like arranges the boundary portion b1 of the first region 101 and the second region 102 of the expansion member 100 so as to overlap the puncture site t, as shown in FIGS. 4 and 5. At this time, the surgeon or the like can easily arrange the boundary portion b1 at the puncture site t by confirming the positions of the marker portion 117 and the puncture site t. As a result, the surgeon or the like can arrange the first region 101 on the forearm portion A side and the second region 102 on the tip end side of the hand H with reference to the vicinity of the puncture site t.

Next, as shown in FIG. 5, the surgeon or the like winds the covering member 200 around the wrist located on the distal end side of the forearm portion A of the patient. The surgeon or the like uses the fixing member 210 provided on the covering member 200 to fix the hemostatic device 10 to the forearm portion A and the hand H of the patient.

When the hemostatic device 10 is attached to the patient, the surgeon or the like arranges the outer peripheral edge of one end 203 in the width direction of the covering member 200 so as to be hooked on the styloid process S of the patient's ulna, as shown in FIG. be able to. By arranging the covering member 200 in this way, it is possible to suitably prevent the covering member 200 from being displaced from the ulnar styloid process S to the forearm portion A side when the hemostatic device 10 is attached to the patient. ..

Next, the surgeon or the like uses the injection unit 500 (see FIG. 1) and the syringe (not shown) to expand the expansion member 100 and the auxiliary expansion member 400. When the expansion member 100 and the auxiliary expansion member 400 expand, the expansion member 100 applies a compression force to the puncture site t.

Next, as shown in FIG. 6, the surgeon or the like removes the sheath tube 610 of the introducer 600 from the puncture site t while maintaining the state in which the expansion member 100 applies a pressing force to the puncture site t. .. After removing the sheath tube 610 of the introducer 600 from the puncture site t, the surgeon or the like may further inject air into the expansion member 100 to increase the compression force applied to the puncture site t. Even after the sheath tube 610 is removed from the puncture site t, the expansion member 100 continues to apply a compressive force to the puncture site t by maintaining the expanded state of the expansion member 100.

The hemostatic device 10 attached to the patient is indicated by the circumferential direction (arrows r1 and r2 in FIGS. 6 and 7) in the vicinity of the wrist where the first region 101 of the expansion member 100 is located on the distal end side of the forearm portion A together with the covering member 200. It is a direction, and is fixed in a wound state along the direction connecting the back Hb side of the hand and the palm side of the hand). Therefore, the first region 101 of the expansion member 100 is tightened to the vicinity of the forearm portion A (near the wrist) of the forearm portion A and the hand H by the fixing member 210 provided on the covering member 200.

When hemostasis is performed using the hemostasis device 10, the position where the expansion member 100 is fixed to the limb of the patient is not particularly limited. For example, the expansion member 100 may be fixed to one of the forearm portion A and the hand H, or the expansion member 100 may be fixed to both the forearm portion A and the hand H.

Further, in the state before the hemostatic device 10 is attached to the patient, the hemostatic device 10 is configured so that the second region 102 of the expansion member and the fixing member 210 provided on the covering member 200 do not overlap in the longitudinal direction. ing. Therefore, in the state where the hemostatic device 10 is attached to the patient, the second region 102 of the expansion member 100 is arranged on the tip end side of the hand H with respect to the fixing member 210 in the longitudinal direction of the covering member 200. As a result, the force exerted by the fixing member 210 provided on the covering member 200 on the second region 102 of the expansion member 100 is smaller than the fixing force applied by the fixing member 210 to the first region 101 of the expansion member 100. Therefore, with the hemostatic device 10 attached to the patient, the second region 102 of the expansion member 100 can be moved to follow the movement of the finger of the patient's hand H. Therefore, when the patient moves the finger, the movement of the finger is difficult to be transmitted from the second region 102 side to the first region 101 side. As a result, the expansion member 100 can suppress the movement of the entire expansion member 100 along with the movement of the finger when the patient moves the hand H while the hemostatic device 10 is attached to the patient. Thereby, the expansion member 100 can suitably maintain a state in which the first region 101 of the expansion member 100 is fixed to the forearm portion A of the patient. Therefore, the hemostatic device 10 can stably maintain a state in which the compression force is effectively applied to the puncture site t from the expansion member 100.

Further, the auxiliary expansion member 400 is arranged between the expansion member 100 and the support member 300 (see FIG. 2B). Therefore, the auxiliary expansion member 400 suppresses the expansion member 100 from floating from the patient's body surface when the expansion member 100 expands. Therefore, the expansion member 100 can effectively apply a compression force to the puncture site t in a state where the expansion member 100 is expanded.

Further, the auxiliary expansion member 400 is arranged so as to overlap the second region 102 of the expansion member 100 and the support member 300 along the longitudinal direction of the covering member 200 (see FIG. 1). Therefore, as shown in FIG. 7, when the hemostatic device 10 is attached to the patient, the auxiliary expansion member 400 is arranged over a wide range in the circumferential direction of the hand H. The distal radial artery side of the palmar artery B located in the patient's hand H is tortuous along the circumferential direction of the patient's hand H, depending on the patient. Since the auxiliary expansion member 400 is arranged over a wide range in the circumferential direction of the hand H as described above, the auxiliary expansion member 400 may press the expansion member 100 over a wide range in the circumferential direction of the hand H. can. Therefore, the hemostatic device 10 is effective on the distal radial artery side of the palm artery B even when the distal radial artery side of the palm artery B located in the patient's hand H is tortuous. It becomes possible to apply oppressive force.

Further, in the auxiliary expansion member 400, the other end portion 404 in the width direction of the auxiliary expansion member 400 is connected to the support member 300, and the one end portion 403 in the width direction of the auxiliary expansion member 400 is connected to the support member 300. No (see Figure 2B). Therefore, when the hemostatic device 10 is attached to the patient's hand H and the auxiliary expansion member 400 is expanded, the one end portion 403 side in the width direction of the auxiliary expansion member 400 is other than the width direction of the auxiliary expansion member 400. With the end 404 side as the fulcrum, it easily deforms following the movement of the patient's hand H. Therefore, in the hemostatic device 10, when the patient wearing the hemostatic device 10 performs an action such as grasping the hand H and the hand H is bent, the one end portion 403 side in the width direction of the auxiliary expansion member 400 has the shape of the hand H. Curves to follow. As a result, the auxiliary expansion member 400 can effectively prevent the expansion member 100 from floating from the patient's body surface even when the patient performs an action such as grasping the hand H.

Further, when the expansion member 100 and the auxiliary expansion member 400 are expanded, the support member 300 presses the second region 102 of the expansion member 100 from the outer surface side of the auxiliary expansion member 400. As a result, the support member 300 allows the second region 102 of the expansion member 100 to be deformed along the longitudinal direction of the covering member 200, while the second region 102 of the expansion member 100 is the body surface of the patient's hand H. Suppresses expansion away from. Therefore, the expansion member 100 can effectively apply a compression force to the vicinity of the puncture site t even when the patient performs an operation such as grasping the hand H in the expanded state of the expansion member 100. ..

Further, in the present embodiment, the expansion member 100 is connected to the support member 300 (see FIG. 2B). Therefore, when the expansion member 100 is expanded, it is possible to prevent the expansion member 100 from being displaced from the support member 300. Similarly, the auxiliary expansion member 400 is connected to the support member 300. Therefore, when the auxiliary expansion member 400 is expanded, it is possible to prevent the auxiliary expansion member 400 from being displaced from the support member 300. Further, in a state where the hemostatic device 10 is attached to the patient's hand H and the auxiliary expansion member 400 is expanded, the second region 102 of the expansion member 100 is fastened to the patient's skin by the covering member 200. do not have. In the present embodiment, since the expansion member 100 is connected to the support member 300, it is possible to prevent the second region 102 of the expansion member 100 from being displaced with respect to the support member 300.

As described above, the hemostatic device 10 according to the present embodiment includes the expansion member (pressing member) 100 arranged at the puncture site t of the patient's hand H, and the expansion member 100 in a state where the expansion member 100 covers the puncture site t. A covering member 200 that covers at least a part thereof is provided, and the covering member 200 fixes the expansion member 100 to at least one of the forearm portion A and the hand H in a state where the expansion member 100 covers the puncture site t. It has a fixing member 210 to be used. The expansion member 100 is provided on the covering member 200 at a position where the center line c1 of the expansion member 100 and the center line c2 of the covering member 200 do not coincide with each other, and is a fixing member on the covering member 200 in the longitudinal direction of the covering member 200. It has a first region 101 that overlaps with 210, and a second region 102 that is arranged on the tip end side of the hand H with respect to the first region 101. The second region 102 of the expansion member 100 is larger than the fixing force applied to the first region 101 by the fixing member 210 in a state where the covering member 200 fixes the expansion member 100 to at least one of the forearm portion A and the hand H. It is held against the hand H with a small force.

Further, in the hemostatic device 10 according to the present embodiment, the expansion member (pressing member) 100 arranged at the puncture site t of the patient's hand H and the expansion member 100 are covered with the puncture site t. A covering member 200 that covers at least a part thereof is provided, and the covering member 200 fixes the expansion member 100 to at least one of the forearm portion A and the hand H in a state where the expansion member 100 covers the puncture site t. It has a fixing member 210 to be used. The expansion member 100 is provided on the covering member 200 at a position where the center line c1 of the expansion member 100 and the center line c2 of the covering member 200 do not coincide with each other, and is a fixing member on the covering member 200 in the longitudinal direction of the covering member 200. It has a first region 101 that overlaps with 210, and a second region 102 that is arranged on the tip end side of the hand H with respect to the first region 101. The covering member 200 does not have a fixing member 210 for fixing the expansion member 100 to the hand H in the region extending to the second region 102 side.

In the hemostatic device 10 configured as described above, the first region 101 of the expansion member 100 is firmly fixed to at least one of the forearm portion A and the hand H, and the second region 102 of the expansion member 100 is the first. It is held in a state of being movable on the tip side of the hand H with respect to the region 101. Therefore, in the hemostatic device 10, when the patient moves the hand H while the hemostatic device 10 is attached to the patient, the first region 101 of the expansion member 100 prevents the expansion member 100 from being displaced, and the expansion member 100 Since the second region 102 is not tightened to the surface of the hand H by the fixing member 210 as compared with the first region 101 of the expansion member 100, the second region 102 is deformed to follow the movement of the patient's hand H. In the hemostatic device 10, the patient hands H by deforming the second region 102 of the expansion member 100 so as to follow the movement of the patient's hand H as described above while the hemostatic device 10 is attached to the patient. It is possible to suppress the force generated when moving the member 100 from being transmitted to the first region 101 of the expansion member 100. Therefore, the hemostatic device 10 can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force on the puncture site t of the expansion member 100. Further, the hemostatic device 10 does not tighten the second region 102 of the expansion member 100 to the patient's hand H by the fixing member 210 in a state where the hemostatic device 10 is attached to the patient's hand H. Therefore, the hemostatic device 10 suppresses the movement of the hand H from being restricted by the fixing member 210 on the fingertip side of the patient in a state of being attached to the patient's hand H. Therefore, the patient is not excessively restricted in the movement of the hand H even when the hemostatic device 10 is worn.

Further, the pressing member 100 is an expansion member 100 including a bag body 110 that can be expanded by injecting a fluid and an expansion space 115 surrounded by the bag body 110. Therefore, the surgeon or the like controls the injection of the fluid into the expansion space 115 of the expansion member 100 and the discharge of the fluid from the expansion space 115 of the expansion member 100, so that the expansion member 100 is applied to the puncture site t. The pressure applied can be easily adjusted.

Further, in the case of the expansion member 100 having the expandable bag body 110, the hemostatic device 10 has a support member 300 that suppresses the expansion of the expansion member 100 in the direction away from the patient's body surface. Is preferable. In such a configuration, when the expansion member 100 is expanded, the support member 300 is prevented from expanding in the direction away from the patient's body surface in the second region 102 of the expansion member 100, so that the support member 300 is located at the puncture site t. On the other hand, the oppressive force can be effectively applied. Further, since the expansion member 100 is the bag body 110, the support member 300 presses the surface of the bag body 110 toward the skin side of the patient when the expansion member 100 is expanded, which is effective for the puncture site t. It is possible to apply oppressive force.

Further, the hemostatic device 10 has a support member 300 that suppresses the expansion of the expansion member 100 in a direction away from the body surface of the patient. The support member 300 is connected to the covering member 200 while covering the second region 102 of the expansion member 100, and the bag body 110 of the expansion member 100 is connected to the support member 300. Therefore, when the expansion member 100 is expanded, the expansion member 100 is prevented from expanding in the direction in which the second region 102 of the expansion member 100 is separated from the patient's body surface, so that the expansion member 100 is effective for the puncture site t. The oppressive force can be applied. Further, since the support member 300 is connected to the covering member 200, it is possible to prevent the support member 300 from being displaced from the covering member 200 when the hemostatic device 10 is attached to the patient. Further, since the expansion member 100 is connected to the support member 300, it is possible to prevent the second region 102 of the expansion member 100 from being displaced from the support member 300 when the expansion member 100 is expanded.

Further, the hemostatic device 10 is arranged between the support member 300 and the expansion member 100, and has an auxiliary expansion member 400 connected to the support member 300. The auxiliary expansion member 400 has a space portion 415 communicating with the expansion space 115 of the expansion member 100, and a bag body 410 covering the space portion 415. The auxiliary expansion member 400 suppresses the expansion member 100 from floating from the patient's body surface between the expansion member 100 and the support member 300 when the auxiliary expansion member 400 expands. Therefore, the expansion member 100 is effective for the puncture site t while allowing the second region 102 of the expansion member 100 to be deformed along the longitudinal direction of the covering member 200 in the expanded state of the expansion member 100. Can be applied with oppressive force. Further, since the auxiliary expansion member 400 is connected to the support member 300, it is possible to prevent the auxiliary expansion member 400 from being displaced from the support member 300 when the auxiliary expansion member 400 is expanded.

Further, the auxiliary expansion member 400 is arranged so as to overlap the second region 102 of the expansion member 100 and the support member 300 along the longitudinal direction of the covering member 200. Therefore, in the auxiliary expansion member 400, the auxiliary expansion member 400 is arranged over a wide range in the circumferential direction of the hand H in a state where the hemostatic device 10 is attached to the patient. Therefore, even when the distal radial artery side of the palmar artery B located in the patient's hand H is tortuous along the circumferential direction of the hand H, the hemostatic device 10 can use the auxiliary expansion member 400 of the palmar artery B. It can be placed so as to overlap the distal radial artery side. Therefore, the expansion member 100 pressed by the auxiliary expansion member 400 when the auxiliary expansion member 400 is expanded can effectively apply a compression force to the distal radial artery side of the palmar artery B.

Further, the hemostatic device 10 has a marker portion 117 for aligning the expansion member 100 with respect to the puncture site t. The marker portion 117 is arranged at a position corresponding to the boundary portion b1 between the first region 101 of the expansion member 100 and the second region 102 of the expansion member 100. Therefore, when the operator or the like arranges the expansion member 100 at the puncture site t, the operator or the like confirms the position of the marker portion 117 to puncture the boundary portion b1 between the first region 101 and the second region 102 of the expansion member 100. It can be easily aligned with t. As a result, when the hemostatic device 10 is attached to the patient, the surgeon or the like can arrange the first region 101 of the expansion member 100 on the forearm portion A side as viewed from the puncture site t, and the second expansion member 100 can be arranged. The region 102 can be arranged on the tip side of the hand H when viewed from the puncture site t. Therefore, the operator or the like can easily arrange the hemostatic device 10 on the patient by the marker portion, and can effectively apply the pressing force of the expansion member 100 to the puncture site t.

(Second Embodiment)
Next, the hemostatic device 10A according to the second embodiment of the present invention will be described. In the description of the second embodiment, detailed description of the configuration and the like already described in the first embodiment will be omitted. Further, the contents not particularly explained in the description of the second embodiment can be the same as those of the first embodiment.

8, 9A and 9B are diagrams for explaining the hemostatic device 10A according to the second embodiment, and FIGS. 10 and 11 are views for explaining a usage example of the hemostatic device 10A.

The hemostatic device 10A according to the second embodiment is different from the hemostatic device 10 according to the first embodiment in the arrangement of the auxiliary expansion member 400A.

As shown in FIG. 8, the hemostatic device 10A is provided along a direction in which the auxiliary expansion member 400A intersects the longitudinal direction of the covering member 200 (the width direction of the covering member 200 and the arrow Y1-Y2 directions in the drawing). It is arranged so as to overlap the first region 101 of the expansion member 100, the second region 102 of the expansion member 100, and the support member 300.

The length along the longitudinal direction of the covering member 200 of the auxiliary expansion member 400A is approximately ½ of the length along the longitudinal direction of the covering member 200 of the expansion member 100. Further, the auxiliary expansion member 400A is arranged closer to the end portion 105 side of the expansion member 100 located on the one end portion 201 side in the longitudinal direction of the covering member 200. The auxiliary expansion member 400A is arranged so that the extending direction (left-right direction in FIG. 8) of the auxiliary expansion member 400A is orthogonal to the longitudinal direction of the covering member 200 on the plan view shown in FIG.

As shown in FIGS. 9A and 9B, the other end 104 of the expansion member 100 in the width direction, the other end 404 of the auxiliary expansion member 400A, and the other end 304 of the support member 300 in the width direction are connected to each other. ing. The other end 104 in the width direction of the expansion member 100 and the other end 404 in the width direction of the auxiliary expansion member 400A are connected to the other end 304 in the width direction of the support member 300 at different positions close to each other. It may have been done. Further, the expansion member 100 and the auxiliary expansion member 400A are also connected to each other around the communication hole 116 of the expansion member 100 and around the communication hole 416 of the auxiliary expansion member 400A.

The expansion member 100 and the auxiliary expansion member 400A are connected to the covering member 200 via the support member 300 by being connected to the support member 300. One end 103 in the width direction of the expansion member 100, one end 403 of the auxiliary expansion member 400A, and one end 203 in the width direction of the covering member 200 are not connected.

As shown in FIG. 9B, when the expansion member 100 and the auxiliary expansion member 400A are expanded, there is a gap between the vicinity of the other end portion 104 in the width direction of the expansion member 100 and the vicinity of the other end portion 404 of the auxiliary expansion member 400A. g is formed.

Next, an example of using the hemostatic device 10A will be described with reference to FIGS. 10 and 11.

As shown in FIG. 10, the surgeon or the like positions the marker portion 117 arranged at the position corresponding to the boundary portion b1 between the first region 101 of the expansion member 100 and the second region 102 of the expansion member 100 at the puncture site t. Together, the expansion member 100 is placed on the patient's forearm A and hand H. The surgeon or the like uses the fixing member 210 to fix the expansion member 100 to the patient.

As described above, the auxiliary expansion member 400A is arranged so that the auxiliary expansion member 400A is closer to the end 105 side of the expansion member 100 located on the one end 201 side in the longitudinal direction of the covering member 200 (see FIG. 8). .. Therefore, in the state where the expansion member 100 is fixed to the patient, the auxiliary expansion member 400A is located on the outer side of the hand H in the circumferential direction (the side indicated by the arrow r2 in FIGS. 10 and 11) as shown in FIGS. 10 and 11. It is arranged on the side where the patient's torso is arranged when the instep Hb side of the hand H is the upper surface side of the hand H).

As shown in FIG. 11, depending on the site of the hand H of the patient to be hemostasis, the palmar artery B located in the hand H and the vein (cephalic vein) V run in parallel. Further, the vein V is inside the palmar artery B in the circumferential direction (the side indicated by the arrow r1 in FIGS. 10 and 11), and when the instep Hb side of the hand H is the upper surface side of the hand H, the patient It is running on the side opposite to the side where the fuselage is placed). When the auxiliary expansion member 400A is arranged outside the circumferential direction of the hand H when hemostasis is performed as in the hemostatic device 10A according to the present embodiment, the direction in which the expansion member 100 applies a compression force is the palmar artery B. Since it is directed to the side, the dilator 100 can intensively apply a compressive force to the palmar artery B. Therefore, the expansion member 100 and the auxiliary expansion member 400B can effectively apply the compression force to the palmar artery B while suppressing the application of an excessive compression force to the vein V.

Further, in the hemostatic device 10A according to the second embodiment, similarly to the hemostatic device 10 according to the first embodiment, the first region 101 of the expansion member 100 is attached to the covering member 200 in a state where the hemostatic device 10A is attached to the patient. The second region 102 of the expansion member 100 can be deformed to follow the movement of the patient's hand H while being firmly fixed to the patient by the provided fixing member 210. Therefore, the hemostatic device 10A can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force on the puncture site t of the expansion member 100.

(Third Embodiment)
Next, the hemostatic device 10B according to the third embodiment of the present invention will be described. In the description of the third embodiment, the detailed description of the configuration already described in each of the above-described embodiments will be omitted. Further, the contents not particularly explained in the description of the third embodiment can be the same as those of each of the above-described embodiments.

12, 13A and 13B are diagrams for explaining the hemostatic device 10B according to the third embodiment, and FIGS. 14 and 15 are views for explaining a usage example of the hemostatic device 10B.

The hemostatic device 10B according to the third embodiment is different from the hemostatic device 10A according to the second embodiment in the arrangement of the auxiliary expansion member 400B.

As shown in FIG. 12, the hemostatic device 10B has the auxiliary expansion member 400A along the direction in which the auxiliary expansion member 400A intersects the longitudinal direction of the covering member 200 (the width direction of the covering member 200 and the arrow Y1-Y2 directions in the drawing). It is arranged so as to overlap the first region 101 of the expansion member 100, the second region 102 of the expansion member 100, and the support member 300.

The length along the longitudinal direction of the covering member 200 of the auxiliary expansion member 400B is approximately ½ of the length along the longitudinal direction of the covering member 200 of the expansion member 100. Further, the auxiliary expansion member 400B is arranged closer to the end 106 side of the expansion member 100 located on the other end 202 side in the longitudinal direction of the covering member 200. The auxiliary expansion member 400B is arranged so that the extending direction (left-right direction in FIG. 12) of the auxiliary expansion member 400B is orthogonal to the longitudinal direction of the covering member 200 on the plan view shown in FIG.

As shown in FIGS. 13A and 13B, the other end 104 of the expansion member 100 in the width direction, the other end 404 of the auxiliary expansion member 400B, and the other end 304 of the support member 300 in the width direction are connected to each other. ing. The other end 104 in the width direction of the expansion member 100 and the other end 404 in the width direction of the auxiliary expansion member 400B are connected to the other end 304 in the width direction of the support member 300 at different positions close to each other. It may have been done. Further, the expansion member 100 and the auxiliary expansion member 400B are also connected to each other around the communication hole 116 of the expansion member 100 and around the communication hole 416 of the auxiliary expansion member 400B.

The expansion member 100 and the auxiliary expansion member 400B are connected to the covering member 200 via the support member 300 by being connected to the support member 300. One end 103 in the width direction of the expansion member 100, one end 403 of the auxiliary expansion member 400B, and one end 203 in the width direction of the covering member 200 are not connected.

As shown in FIG. 13B, when the expansion member 100 and the auxiliary expansion member 400B are expanded, there is a gap between the vicinity of the other end portion 104 in the width direction of the expansion member 100 and the vicinity of the other end portion 404 of the auxiliary expansion member 400B. g is formed.

Next, an example of using the hemostatic device 10B will be described with reference to FIGS. 14 and 15.

As shown in FIG. 14, the surgeon or the like aligns the marker portion 117 arranged at the boundary portion b1 between the first region 101 of the expansion member 100 and the second region 102 of the expansion member 100 with the puncture site t. The extension member 100 is placed on the patient's forearm A and hand H. The surgeon or the like uses the fixing member 210 to fix the expansion member 100 to the patient.

As described above, the auxiliary expansion member 400B is arranged so that the auxiliary expansion member 400B is closer to the end 106 side of the expansion member 100 located on the other end 202 side in the longitudinal direction of the covering member 200 (see FIG. 12). ). Therefore, in the state where the expansion member 100 is fixed to the patient, the auxiliary expansion member 400B is inside the circumferential direction of the hand H (the side indicated by the arrow r1 in FIGS. 14 and 15) as shown in FIGS. 14 and 15. Placed in.

As shown in FIG. 15, depending on the site of the hand H of the patient to be stopped, the palmar artery B located in the hand H and the nerve (radial nerve superficial branch) N run in parallel. Further, the nerve N runs outside the palmar artery B in the circumferential direction (the side indicated by the arrow r2 in FIGS. 14 and 15). When the auxiliary expansion member 400B is arranged inside the circumferential direction of the hand H when hemostasis is performed as in the hemostatic device 10B according to the present embodiment, the direction in which the expansion member 100 applies a compression force is the palmar artery B. Since it is directed to the side, the dilator 100 can intensively apply a compressive force to the palmar artery B. Therefore, the expansion member 100 and the auxiliary expansion member 400B can effectively apply the compression force to the palmar artery B while suppressing the application of the excessive compression force to the nerve N.

Further, in the hemostatic device 10B according to the third embodiment, the first region 101 of the expansion member 100 is attached to the covering member 200 in a state where the hemostatic device 10B is attached to the patient, similarly to the hemostatic device 10 according to the first embodiment. The second region 102 of the expansion member 100 can be deformed to follow the movement of the patient's hand H while being firmly fixed to the patient by the provided fixing member 210. Therefore, the hemostatic device 10B can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force on the puncture site t of the expansion member 100.

(Fourth Embodiment)
Next, the hemostatic device 10C according to the fourth embodiment of the present invention will be described. In the description of the fourth embodiment, the detailed description of the configuration already described in each of the above-described embodiments will be omitted. Further, the contents not particularly explained in the description of the fourth embodiment can be the same as those of the above-described embodiments.

16, FIG. 17A, and FIG. 17B are views showing the hemostatic device 10C according to the fourth embodiment.

As shown in FIG. 16, the hemostatic device 10C according to the fourth embodiment does not include an auxiliary expansion member. In that respect, it differs from the hemostatic device 10 according to the first embodiment.

As shown in FIGS. 17A and 17B, the other end 104 in the width direction of the expansion member 100 and the other end 304 in the width direction of the support member 300 are connected to each other. The expansion member 100 is connected to the covering member 200 via the support member 300 by being connected to the support member 300.

One end 103 in the width direction of the expansion member 100 and one end 203 in the width direction of the covering member 200 are not connected.

The tube 501 included in the injection section 500 is connected to the expansion member 100. As a method of connecting the tube 501 to the expansion member 100, the same method as the method of connecting the tube 501 to the auxiliary expansion member 400 described in the first embodiment can be adopted.

In the hemostatic device 10C according to the fourth embodiment, similarly to the hemostatic device 10 according to the first embodiment, the first region 101 of the expansion member 100 is provided on the covering member 200 in a state where the hemostatic device 10C is attached to the patient. The second region 102 of the expansion member 100 can be deformed to follow the movement of the patient's hand H while being firmly fixed to the patient by the fixing member 210. Therefore, the hemostatic device 10C can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force on the puncture site t of the expansion member 100.

Further, since the hemostatic device 10C has a support member 300 that suppresses the expansion of the expansion member 100 in the direction away from the body surface of the patient, when the expansion member 100 expands, the second region 102 of the expansion member 100 Can be suppressed from expanding in the direction away from the body surface of the patient, and can effectively apply a compressive force to the puncture site t. Further, since the support member 300 is connected to the covering member 200, it is possible to prevent the support member 300 from being displaced from the covering member 200 when the hemostatic device 10C is attached to the patient. Further, since the expansion member 100 is connected to the support member 300, it is possible to prevent the second region 102 of the expansion member 100 from being displaced from the support member 300 when the expansion member 100 is expanded.

(Fifth Embodiment)
Next, the hemostatic device 10D according to the fifth embodiment of the present invention will be described. In the description of the fifth embodiment, the detailed description of the configuration already described in each of the above-described embodiments will be omitted. Further, the contents not particularly explained in the description of the fifth embodiment can be the same as those of the above-described embodiments.

FIG. 18 is a diagram showing a hemostatic device 10D according to the fifth embodiment.

As shown in FIG. 18, the hemostatic device 10D according to the fifth embodiment does not include an auxiliary expansion member and a support member. In that respect, it differs from the hemostatic device 10 according to the first embodiment.

The tube 501 included in the injection section 500 is connected to the expansion member 100. Further, the expansion member 100 is connected to the covering member 200. The expansion member 100 can be connected to the covering member 200 at an arbitrary position in the first region 101 of the expansion member 100, for example.

In the hemostatic device 10D according to the fifth embodiment, similarly to the hemostatic device 10 according to the first embodiment, the first region 101 of the expansion member 100 is provided on the covering member 200 in a state where the hemostatic device 10D is attached to the patient. The second region 102 of the expansion member 100 can be deformed to follow the movement of the patient's hand H while being firmly fixed to the patient by the fixing member 210. Therefore, the hemostatic device 10D can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force on the puncture site t of the expansion member 100.

(Sixth Embodiment)
Next, the hemostatic device 10E according to the sixth embodiment of the present invention will be described. In the description of the sixth embodiment, the detailed description of the configuration already described in each of the above-described embodiments will be omitted. Further, the contents not particularly explained in the description of the sixth embodiment can be the same as those of the above-described embodiments.

FIG. 19 is a diagram showing a hemostatic device 10E according to the sixth embodiment.

The hemostatic device 10E is located at a position where the center line c1 of the expansion member 100 and the boundary portion b1 of the first region 101 and the second region 102 are displaced from each other. The expansion member 100 is arranged at a position where the center line c1 of the expansion member 100 is displaced from the one end 203 in the width direction of the covering member 200 to the other end 204 side (left side in FIG. 19) in the width direction.

The marker portion 117 is arranged at a position corresponding to the second region 102 located between the center line c1 of the expansion member 100 along the longitudinal direction of the covering member 200 and the first region 101. In the present embodiment, the marker portion 117 is arranged at the center position of the expansion member 100 (center position in the longitudinal direction and the width direction on the plan view of FIG. 19).

Like the hemostatic device 10E according to the present embodiment, the expansion member 100 may be arranged at a position where the center line c1 of the expansion member 100 is deviated from the boundary portion b1 of the first region 101 and the second region 102. Even in such a configuration, the hemostatic device 10E can prevent the first region 101 of the expansion member 100 from being displaced in the state of being attached to the patient, and can prevent the expansion member 100 from being displaced to the puncture site t of the expansion member 100. The oppressive force can be maintained.

Further, when the center line c1 of the expansion member 100 is arranged at a position shifted to the other end portion 204 side in the width direction of the covering member 200 as in the hemostatic device 10E according to the present embodiment, the marker portion 117 When the hemostatic device 10E is attached to the patient by arranging the hemostatic device 10E at a position corresponding to the second region 102 located between the center line c1 of the expansion member 100 along the longitudinal direction of the covering member 200 and the first region 101. , The vicinity of the center position of the expansion member 100 can be easily arranged with respect to the puncture site t. As a result, the expansion member 100 can effectively apply a compression force to the puncture site t arranged at the center position of the expansion member 100.

The arrangement of the expansion member 100 and the arrangement of the marker portion 117 shown in the sixth embodiment can be adopted by any of the hemostatic devices described in the first to fifth embodiments.

(7th Embodiment)
Next, the hemostatic device 10F according to the seventh embodiment of the present invention will be described. In the description of the seventh embodiment, the detailed description of the configuration already described in each of the above-described embodiments will be omitted. Further, the contents not particularly explained in the description of the seventh embodiment can be the same as those of the above-described embodiments.

FIG. 20 is a diagram showing a hemostatic device 10F according to the seventh embodiment.

As shown in FIG. 20, in the hemostatic device 10F according to the seventh embodiment, a recess 201F curved in the width direction of the covering member 200 is formed at one end 203 in the width direction of the covering member 200F. In the hemostatic device 10F, even when the recess 201F as described above is formed in the covering member 200, the expansion member (pressing member) 100 overlaps the fixing member 210 on the covering member 200F in the longitudinal direction of the covering member 200F. As long as it has one region 101 and a second region 102 arranged on the tip side of the hand H with respect to the first region 101, pressure hemostasis is performed using the hemostatic device 10F as in each of the above-described embodiments. While increasing the mobility of the patient's finger by the second region 102 during the process, it is possible to exert the effect of preventing the first region 101 from being displaced.

(8th Embodiment)
Next, the hemostatic device 10G according to the eighth embodiment of the present invention will be described. In the description of the eighth embodiment, the detailed description of the configuration already described in each of the above-described embodiments will be omitted. Further, the contents not particularly explained in the description of the seventh embodiment can be the same as those of the above-described embodiments.

FIG. 21 is a diagram showing a hemostatic device 10G according to the eighth embodiment.

As shown in FIG. 21, in the hemostatic device 10G according to the eighth embodiment, the support member 300G is formed separately from the covering member 200. The support member 300G can be connected to the covering member 200, for example, with an adhesive or the like. Even when the support member 300G is formed separately from the covering member 200 and is retrofitted to the covering member 200, the support member 300G supports the second region 102 of the expansion member 100 from the outer surface side of the expansion member 100. Thereby, the expansion of the expansion member 100 in the direction away from the body surface of the patient can be suppressed.

(Example of shape of fixing member)
The fixing member 210 described in each of the above-described embodiments has a substantially rectangular shape having long sides along the longitudinal direction of the covering member 200. However, as long as the shape of the fixing member 210 can be provided on the covering member 200 and a desired fixing force for fixing the first region 101 of the expansion member (pressing member) 100 to the limb of the patient can be applied. , Not particularly limited.

As shown in FIG. 22, the fixing member 210 may have an arch shape. Further, as shown in FIG. 23, the fixing member 210 may have a shape such that a notch is formed in a part of a circle. Although only the first fixing portion 211 of the fixing member 210 is illustrated in FIGS. 22 and 23, the second fixing portion 212 can also be formed in the shape shown in FIGS. 22 and 23. Further, the fixing member 210 may be connected to the first fixing portion 211 and the second fixing portion 212, and for example, the shape of the first fixing portion 211 and the shape of the second fixing portion 212 may be different.

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

In the description of the embodiment, a hemostatic device for stopping bleeding at the puncture site formed on the back of the left hand has been exemplified, but the hemostatic device includes a puncture site formed on the back of the right hand, a puncture site formed on the palm of the right hand, and a left hand. It can also be used to stop bleeding at the puncture site formed on the palm. When the hemostatic device is used other than the back of the left hand, the position of the auxiliary expansion member shown in the second embodiment or the third embodiment is appropriately changed to a position where the auxiliary expansion member can exert a desired effect. be able to.

Further, the pressing member is not limited to the expansion member described in each embodiment. The pressing member is composed of, for example, a mechanical member whose pushing amount to the hand can be changed by an external operation such as rotation, a resin material such as plastic pushed into the hand so as to apply surface pressure, a gel, or the like. Members, members containing gel whose water content decreases with the passage of time and gradually reduces the compression force, elastic materials such as sponge-like substances, aggregates of fibers such as cotton, metals, It is also possible to configure a member having a predetermined three-dimensional shape (spherical, ellipsoid, triangular pyramid, etc.), a combination thereof, or the like.

10, 10A, 10B, 10C, 10D, 10E, 10F, 10G hemostatic device,
100 expansion member (pressing member),
101 First area,
102 Second area,
103 One end of the expansion member in the width direction,
104 The other end of the expansion member in the width direction,
110 bag body,
115 expansion space,
117 marker part,
200, 200F covering member,
200a Inner surface of covering member,
200b Outer surface of the covering member,
201 One end in the longitudinal direction of the covering member,
202 The other end of the covering member in the longitudinal direction,
203 One end of the covering member in the width direction,
204 The other end of the covering member in the width direction,
210 fixing member,
211 First fixed part,
212 2nd fixed part,
300, 300G support member,
304 The other end of the support member in the width direction,
400, 400A, 400B auxiliary expansion member,
403 One end of the auxiliary expansion member,
404 The other end of the auxiliary expansion member,
410 bag body,
415 Space part,
500 injection part,
600 introducer,
610 Sheath tube,
b1 The boundary between the first region and the second region,
c1 center line of expansion member,
c2 The center line of the covering member,
g gap,
A Forearm (arm),
B palm artery,
H hand,
Hb back of hand,
S styloid process,
N nerve,
V vein,
t Puncture site (site to stop bleeding).

Claims (7)

A pressing member placed at the site where bleeding should be stopped in the patient's hand,
A covering member that covers at least a part of the pressing member in a state where the pressing member covers the hemostasis portion is provided.
The covering member has a fixing member for fixing the pressing member to at least one of the patient's arm and the patient's hand while the pressing member covers the hemostasis site.
The pressing member is provided on the covering member at a position where the center line of the pressing member and the center line of the covering member do not coincide with each other, and on the covering member, with the fixing member in the longitudinal direction of the covering member. It has a first region that overlaps and a second region that is arranged on the tip side of the hand with respect to the first region.
In the second region, the pressing member is fixed to at least one of the arm and the hand by the covering member, and the pressing member is applied to the hand with a force smaller than the fixing force applied to the first region by the fixing member. Hemostasis device that is held. The hemostatic device according to claim 1, wherein the pressing member is an expansion member including a bag body that can be expanded by injecting a fluid and an expansion space surrounded by the bag body. Further having a support member that suppresses the expansion of the expansion member in a direction away from the body surface of the patient.
The support member is connected to the covering member while covering the second region.
The hemostatic device according to claim 2, wherein the bag body of the expansion member is connected to the support member. It has an auxiliary expansion member that is arranged between the support member and the expansion member and is connected to the support member.
The hemostatic device according to claim 3, wherein the auxiliary expansion member has a space portion communicating with the expansion space of the expansion member and a bag body covering the space portion. The hemostatic device according to claim 4, wherein the auxiliary expansion member is arranged so as to overlap the second region and the support member along the longitudinal direction of the covering member. The hemostatic device according to claim 4, wherein the auxiliary expansion member is arranged so as to overlap the first region, the second region, and the support member along a direction intersecting the longitudinal direction of the covering member. .. Further having a marker portion for aligning the pressing member with respect to the hemostasis site.
The marker portion is located at the boundary between the first region and the second region, or in the second region located between the center line of the pressing member along the longitudinal direction of the covering member and the first region. The hemostatic device according to any one of claims 1 to 6, which is arranged at a corresponding position.

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