JP4490771B6 - Medical measuring instrument - Google Patents

Description

The present invention relates to a medical measuring instrument.

  As a method of administering nutrition to patients who cannot take nutrition orally, enteral nutrition management by percutaneous endoscopic gastrostomy (hereinafter abbreviated as PEG) is frequently performed. In order to carry out this PEG, a catheter kit having a fistula button is used. This catheter kit is used for percutaneously replenishing a patient with nutrition or a drug solution from outside the body into the stomach.

  To place a catheter (especially a fistula button), measure the length of the constructed fistula or the fistula formed, and measure the thickness of the internal tissue to place the catheter that matches the fistula length. A measuring instrument is used.

  As a measuring instrument for measuring the thickness of the internal tissue used when the catheter kit having a fistula button is placed in the body, for example, to form a through-hole penetrating the abdominal wall and stomach wall of a patient and simultaneously measure the fistula length In particular, in addition to tubes, scales, and cannulas (shafts), there are devices composed of dilators, handles, and obturators for forming fistulas (for example, patents) Reference 1).

Since the measuring instrument described above is composed of a plurality of parts, the molding and assembling steps are complicated.
Furthermore, although the internal tissue can be measured at the time of fistula construction with the measuring instrument described above, the length of the fistula already formed in a patient or the like cannot be measured.

USP 5356382

  An object of the present invention is to provide a medical measuring instrument that can accurately measure the thickness of an internal tissue when replacing a fistula button.

Such an object is achieved by the present invention described in the following (1) to (5) .
(1) A medical measuring instrument used for measuring the thickness of a living tissue through which a button penetrates when a fistula button is exchanged, comprising a rod-shaped support portion and one surface of the support portion A scale part provided along the longitudinal direction and a latching part , which is a projecting piece latched on the living tissue, formed in a direction projecting with respect to the longitudinal direction on the distal end side of the support part , are integrated. The guide wire guide portion for guiding the guide wire is provided on the surface of the support portion on the side from which the latch portion protrudes, by a groove formed along the longitudinal direction. The medical measuring instrument is characterized in that a hole into which the guide wire can be inserted is formed on an extension line of the guide wire guide part .
(2) The medical measuring instrument according to (1), wherein the hooking portion is a protruding piece that protrudes in a direction substantially perpendicular to the support portion.
(3) The medical measuring instrument according to (1) or (2), wherein the groove is formed between a pair of protrusions provided along the longitudinal direction on the surface of the support portion. .
(4) The guide wire guiding unit, the medical measurement device according to any one of the scale part of the support part (1) to the surface and is formed on the surface opposite that provided (3) .
( 5 ) The medical measuring instrument according to any one of (1) to (4) , wherein a grip portion is formed on a proximal end side of the support portion.

ADVANTAGE OF THE INVENTION According to this invention, when exchanging a fistula button, the thickness of an internal structure | tissue can be measured correctly and the medical measuring instrument with easy manufacture can be provided.
Further, when the hooking portion is a protruding piece that protrudes in a direction substantially perpendicular to the support portion, for example, the stomach wall inner surface or the like can be hooked, and the thickness of the living tissue can be measured more accurately. it can.
In addition, when the latching portion further has a hole into which a guide wire can be inserted, the guide wire can be passed through the medical measuring instrument, and the medical measuring instrument can be easily inserted into an appropriate position. can do.
Moreover, when the said holding | grip part which has a width | variety larger than a fistula is formed in the base end side of the said support part, it can prevent that the said medical measuring instrument will be inserted in a body accidentally.

Hereinafter, the present invention will be described in detail based on preferred embodiments shown in the accompanying drawings.
FIG. 1 is a perspective view showing a medical measuring instrument of the present invention. FIG. 2 is a side view of the medical measuring instrument of the present invention. FIG. 3 is a rear view of the medical measuring instrument of the present invention.

  Hereinafter, each component will be described.

The medical measuring instrument (medical measuring instrument) of the present invention is used when the fistula button is replaced. Specifically, the fistula button penetrates when the fistula button is replaced. It is used for measuring the thickness of living tissue (for example, the sum of stomach wall and abdominal wall).
As shown in FIGS. 1 to 4, the medical measuring instrument 1 includes a rod-shaped support portion 2, a scale portion 21 provided on one surface of the support portion 2 along the longitudinal direction, and a distal end side of the support portion 2. The latching portion 3 is provided, and the gripping portion 4 is provided on the base end side of the support portion 2.

  The rod-shaped support part 2 is inserted into a fistula formed in the patient. Therefore, the maximum width of the support portion 2 is preferably smaller than the size of the formed fistula. For example, when an 8 mm fistula is formed, the maximum width of the support portion 2 is preferably 8 mm or less. Thereby, the medical measuring instrument 1 can be inserted with low invasion (low burden).

The support portion 2 is plate-shaped, and a scale portion 21 is provided on one surface, and a guide wire guide portion 22 is provided on the other surface.
As described above, since the medical measuring instrument 1 is used by being inserted into the formed fistula, the maximum width of the support portion 2 is not particularly limited, but is preferably 2 to 8 mm, particularly preferably 3 to 7 mm. When the maximum width is less than the lower limit value, the operability of the medical measuring instrument 1 may be lowered, and when the upper limit value is exceeded, the fistula may be damaged during insertion.

  Although the length of the support part 2 is not specifically limited, 5-100 mm is preferable and especially 10-80 mm is preferable. When the length is less than the lower limit, it may be difficult to measure the thickness of the living tissue when the patient is obese, and when the length exceeds the upper limit, the operability of the medical measuring instrument 1 is degraded. There is a case.

  Although the corner | angular part of the support part 2 is not specifically limited, It is preferable that it is chamfered or rounded. Thereby, the damage of the fistula which arises at the time of insertion of the medical measuring tool 1 can be reduced more.

On one surface of the support portion 2, a scale portion 21 is formed as shown in FIG.
The scale part 21 is used, for example, to measure the total thickness of the stomach wall and the abdominal wall when replacing the fistula button. When replacing the fistula button, it is necessary to select a fistula button having an appropriate length so that the stomach wall and the abdominal wall are in close contact with each other. That is, when a fistula button shorter than the thickness of the stomach wall and abdominal wall is attached, the nutrient channel attached to the fistula button is not inserted into the stomach. May not be accurately injected into the stomach and may cause peritonitis.
On the other hand, when a fistula button longer than the thickness of the stomach wall and abdominal wall is worn, the fistula button has many portions protruding outside the body, which may impede the life of the patient.
Therefore, it is necessary to measure the thickness of the stomach wall and the abdominal wall in advance and select a fistula button having an appropriate length.

Each scale 211 of the scale part 21 is formed from the boundary part 31 between the support part 2 and the hook part 3 toward the base end side (upper side in FIG. 4). Each scale 211 represents the length from the boundary 31 in mm units.
Each scale 211 may be formed at any interval, but is preferably formed in units of 5 mm from 5 to 100 mm, and most preferably in units of 5 mm from 10 to 80 mm. This is because the length of the formed fistula is usually in the range of 5 to 100 mm, and it is practical to form the scale within the range.

A guide wire guide portion 22 for guiding the guide wire is formed on the surface of the support portion 2 opposite to the surface on which the scale portion 21 is provided. The guide wire guide part 22 has a function of facilitating insertion of a guide wire which will be described later.
Moreover, after inserting the medical measuring instrument 1 into the fistula, if the guide wire is unexpectedly removed from the patient's fistula, etc., the guide wire is inserted along the guide wire guide portion 22 to accurately The guide wire can be repositioned at a target site in the patient's body.

The guide wire guide 22 is a groove 221.
The groove 221 is formed between the protrusions 222 and 223 provided along the longitudinal direction of the support portion 2.

  The height of the protrusions 222 and 223 (that is, the depth of the groove 221) is not particularly limited, but is preferably 0.4 to 1.5 mm, and particularly preferably 0.7 to 1.2 mm. When the height is within the above range, the guide wire is particularly excellent in guiding. Note that the heights of the protrusions 222 and the protrusions 223 may be the same or different.

  Although the space | interval (namely, width | variety of the groove | channel 221) of the protrusion part 222 and the protrusion part 223 will not be specifically limited if it is a space | interval which can insert a guide wire, 0.4-1.5mm is preferable, Especially 0.7- 1.2 mm is preferred. When the distance is within the range, guide wire guidance is particularly excellent.

A hooking portion 3 is provided on the distal end side (lower side in FIG. 1) of the support portion 2.
For example, in the case of FIG. 6, the latching portion 3 is latched by coming into contact with the stomach wall inner surface 61 around the fistula 9.

The latching portion 3 is formed of a projecting piece that projects in a direction substantially perpendicular to the support portion 2. Thereby, the medical measuring instrument 1 can be reliably latched to an internal biological tissue.
The protruding length of the latching portion 3 (the size of the projecting piece) is not particularly limited as long as it does not damage the fistula and can be reliably latched, but is formed by the support portion 2 and the latching portion 3. The maximum width is preferably 2 to 8 mm, particularly 3 to 7 mm. Thereby, it is excellent in the balance of the function which latches an internal biological tissue reliably, and the insertion property of the medical measuring tool 1. FIG.

  The bent portion 33 of the latching portion 3 is particularly preferably rounded. Although the curvature radius of the bending part 33 is not specifically limited, R0.1-R5 is preferable and especially R2-R4 is preferable. When the radius of curvature is within the above range, irritation to the fistula when the medical measuring instrument 1 is inserted into the fistula can be particularly reduced.

  It is preferable that other portions of the latching portion 3 are chamfered or rounded. Thereby, the damage of the fistula which arises at the time of insertion of the medical measuring tool 1 can be reduced more.

Furthermore, it is preferable that a hole 32 into which a guide wire can be inserted as required is formed in the latching portion 3. Thereby, the medical measuring instrument 1 can be reliably inserted using a guide wire. Therefore, the fistula length can be measured more accurately, the size error can be reduced in the placement of the fistula button performed thereafter, and the burden on the patient, the stress on the operator, and the shortening of the operation time can be expected.
The hole 32 is formed on an extension line of the guide wire guide portion 22 of the hook portion 3. Thereby, insertion of a guide wire can be made easy.

  Although the diameter of the hole 32 is not specifically limited, 0.4-1.5 mm is preferable and 0.7-1.2 mm is especially preferable. When the diameter is within the above range, it is particularly excellent in inserting a 0.035 'inch guide wire.

On the base end side (upper side in FIG. 1) of the support portion 2, a grip portion 4 is formed.
The grip portion 4 has a flat plate shape having a width larger than the width of the support portion 2. Thereby, the erroneous operation of the medical measuring instrument 1 can be prevented (can be prevented from being erroneously inserted into the body).
The grip portion 4 has a concave portion at the center of one surface thereof. Thereby, the medical measuring instrument 1 can be reliably grasped.

The maximum width of the grip portion 4 is not particularly limited, but is preferably larger than the size of the formed fistula. Thereby, it can prevent reliably that the medical measuring tool 1 enters into a body accidentally.
Specifically, the maximum width of the grip portion 4 is preferably 8 to 24 mm, and particularly preferably 12 to 20 mm. When the maximum width is less than the lower limit value, the function of preventing the erroneous operation of the medical measuring instrument 1 may be reduced, and when the upper limit value is exceeded, the operability may be reduced.

The medical measuring instrument 1 of the present invention is characterized in that the above-described support portion 2, the latch portion 3, and the grip portion 4 are integrally formed. Thereby, the number of parts constituting the medical measuring instrument 1 can be reduced. Furthermore, since it is configured integrally, it can be easily molded by injection molding or the like, and the productivity of the medical measuring instrument 1 can be improved.
Moreover, since it is comprised integrally, the intensity | strength of the medical measuring tool 1 can be improved, and it does not arise that the front-end | tip part of the medical measuring tool 1 is damaged in the body by it.

  Examples of the material constituting the medical measuring instrument 1 include resin materials such as vinyl chloride resin, polycarbonate resin, ABS resin, polyacetal resin, polyamide resin, polypropylene resin, and polyethylene resin, and metals such as stainless steel. Materials and the like.

  Moreover, as a method of manufacturing the medical measuring instrument 1, the method of manufacturing the above-mentioned resin material by injection molding, the method of manufacturing the above-mentioned metal material by casting, etc. are mentioned.

Next, the operation of the medical measuring instrument 1 will be described with reference to FIGS. Specifically, a method for measuring the thickness of the internal tissue when the gastrostomy button 5 is replaced will be described.
[1] As shown in FIG. 4, first, the guide wire 7 is inserted into the lumen of the gastrostoma button 5, and the guide wire 7 is placed inside the stomach 6.

[2] As shown in FIG. 5, the gastrostoma button 5 is removed while the guide wire 7 is left in place.

[3] Next, the hole 32 provided in the latching part 3 of the medical measuring instrument 1 is passed through one end side of the guide wire 7 placed in place. Then, the medical measuring instrument 1 is inserted into the fistula 9 (generated when the gastrostomy button 5 is removed) so that the guide wire 7 follows the guide wire guide portion 22. Thus, since the medical measuring instrument 1 is inserted along the guide wire 7, it is easily guided to an appropriate position. Furthermore, since the maximum width of the medical measuring instrument 1 (the support part 2 or the hooking part 3) is smaller than the fist hole 9, the fist hole 9 is not damaged.

[4] The medical measuring instrument 1 is pushed through the fistula 9 and slowly pulled when the tip enters the stomach 6. Then, as shown in FIG. 6, the latching portion 3 of the medical measuring instrument 1 is brought into contact with the stomach wall inner surface 61 around the fistula 9 and latched. The length of the fistula 9 from the stomach wall inner surface 61 to the outer surface of the abdominal wall 8 is read from the scale portion 21 of the medical measuring instrument 1 while the latching portion 3 is latched on the stomach wall inner surface 61. Thereby, the length of the fistula 9 can be measured accurately.

[5] When the measurement of the length of the fistula 9 is completed, the medical measuring instrument 1 is removed with the guide wire 7 in place.

[6] Finally, the gastrostomy button 5 suitable for the measured length of the fistula 9 is inserted. At this time, an indwelling guide wire 7 is used. After the gastrostoma button 5 is formed again, the guide wire 7 is removed.
In this way, the gastrostomy button 5 having the optimum length can be placed again.

As mentioned above, although the medical measuring instrument of this invention was demonstrated based on embodiment of illustration, this invention is not limited to this.
For example, the configuration, shape, and the like of the support portion, the latching portion, and the gripping portion can be replaced with any configuration that can produce the same function.

  The medical measuring instrument of the present invention can improve the performance of an instrument for measuring tissue length used, for example, in percutaneous endoscopic gastrostomy. Especially when replacing the fistula button, the thickness of the abdominal wall may change due to the patient's growth during placement of the fistula button, and the change was confirmed by measuring the fistula length and matched the fistula length. It is preferably used to select a fistula button.

It is a perspective view which shows the medical measuring tool of this invention. It is a side view of the medical measuring tool of the present invention. It is a rear view of the medical measuring tool of this invention. It is a schematic diagram explaining the usage method of the medical measuring device of this invention. It is a schematic diagram explaining the usage method of the medical measuring device of this invention. It is a schematic diagram explaining the usage method of the medical measuring device of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Medical measuring instrument 2 Support part 21 Scale part 211 Scale 22 Guide wire guide part 221 Groove 222 Projection part 223 Projection part 3 Latch part 31 Boundary part 32 Hole 33 Bending part 4 Gripping part 5 Gastrostomy button 6 Gastric 61 inner surface of stomach wall 7 guide wire 8 abdominal wall 9 fistula

Claims (5)

A medical measuring instrument used for measuring the thickness of a living tissue penetrating the button when replacing the fistula button,
A rod-shaped support ,
A scale part provided along the longitudinal direction on one surface of the support part ;
A hooking portion , which is a protruding piece hooked on the living tissue, formed in a direction protruding with respect to the longitudinal direction on the distal end side of the support portion , is integrally configured ,
On the surface of the support portion on the side from which the latching portion protrudes, a guide wire guide portion for guiding a guide wire is provided by a groove formed along the longitudinal direction,
The medical measuring instrument according to claim 1, wherein a hole into which the guide wire can be inserted is formed on an extension line of the guide wire guide portion .   The medical measuring instrument according to claim 1, wherein the latching portion is a protruding piece that protrudes in a direction substantially perpendicular to the support portion. The medical measuring instrument according to claim 1 or 2, wherein the groove is formed between a pair of protrusions provided along the longitudinal direction on the surface of the support part . The guide wire guiding portion, the medical measurement device according to any one of the to the scale portion of the support portion claims 1 plane and is formed on the opposite side in which three. The medical measuring instrument according to any one of claims 1 to 4 , wherein a grip portion is formed on a proximal end side of the support portion.

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