WO2014157450A1 - 超音波下穿刺補助具およびそれを用いた超音波下穿刺方法 - Google Patents
超音波下穿刺補助具およびそれを用いた超音波下穿刺方法 Download PDFInfo
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- WO2014157450A1 WO2014157450A1 PCT/JP2014/058740 JP2014058740W WO2014157450A1 WO 2014157450 A1 WO2014157450 A1 WO 2014157450A1 JP 2014058740 W JP2014058740 W JP 2014058740W WO 2014157450 A1 WO2014157450 A1 WO 2014157450A1
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- puncture
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3401—Puncturing needles for the peridural or subarachnoid space or the plexus, e.g. for anaesthesia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
- A61B8/0841—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
- A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00349—Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/30—Surgical pincettes without pivotal connections
- A61B2017/306—Surgical pincettes without pivotal connections holding by means of suction
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
- A61B2017/3413—Needle locating or guiding means guided by ultrasound
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0891—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/42—Details of probe positioning or probe attachment to the patient
Definitions
- the present invention relates to an ultrasonic puncture assisting device, an ultrasonic puncture method using the same, and the like. More specifically, the present invention relates to an ultrasonic puncture assisting tool used when performing nerve block or blood vessel puncture, and an ultrasonic puncture method using the same.
- Nerve block refers to a treatment method that blocks pain transmission by injecting a local anesthetic directly into the nerve or a nearby tissue using a needle or the like with respect to the nerve causing pain (non-patent document) 1, 2).
- injections are made at various sites such as the rectus abdominis sheath and transversus abdominis fascia, and the landmark method and the energization stimulation method have been conventionally used as the method.
- the technique of performing nerve block while performing ultrasonic examination is becoming mainstream.
- Nerve block requires very high skill for injection to the target site, so it must be performed by a specialist anesthesiologist. However, even when performed by an anesthesiologist, a surgical error such as penetrating the target site may occur. For example, as the number of patients receiving anticoagulant therapy increases, the importance of trunk block is increasing, but there are some cases of complications such as peritoneal puncture and associated abdominal organ puncture. It is.
- blood vessel puncture is often performed while performing an ultrasonic examination, and includes, for example, emergency situations such as emergency outpatient clinics.
- emergency situations such as emergency outpatient clinics.
- the patient may be in a serious condition due to bleeding, etc., so even a practitioner such as an anesthesiologist who excels in vascular puncture technology should perform vascular puncture while performing an ultrasound examination for safety. It is usually done.
- a surgical error may occur even while performing ultrasonic examination to confirm the target blood vessel.
- an ultrasonic puncture assisting device capable of preventing an operation error or the like when performing nerve block or blood vessel puncture under ultrasonic examination, and ultrasonic puncture using the same. It is an issue to provide methods and the like.
- the inventors as one of the causes of peritoneal puncture and false puncture, excluding technical immaturity, are blood vessels, fascia, muscle bodies (hereinafter referred to as “blood vessels etc.” for short) ). That is, when blood vessel puncture is performed while performing an ultrasonic inspection, a blood vessel or the like that is a target site is searched while an ultrasonic probe is pressed onto the surface of the target site. Since blood vessels and the like are soft tissues, it is conceivable that they will be narrowed by crimping the probe, and the inventors consider that this narrowing tends to cause puncture mistakes such as needles. It was.
- the inventors verified this narrowing and confirmed that the blood vessels and the like were narrowed by the compression of the target site surface. Furthermore, the inventors have discovered that by pulling the surface of the target site, the width of the blood vessel or the like is widened, and the needle can be easily punctured. Based on this discovery, the inventors can widen the width of blood vessels, etc., if nerve block or blood vessel puncture can maintain the traction of the surface of the target site without damaging the probe crimping. The idea was that it was possible to prevent puncture errors such as needles. The inventors have come up with an unprecedented technical idea of an ultrasonic puncture aid that embodies this and an ultrasonic puncture method using the same.
- the present invention has the following configuration.
- the first configuration of the present invention is provided with a traction mechanism that pulls the surface of a puncture target site such as skin under ultrasonic examination, thereby preventing narrowing of the puncture target site in nerve block or blood vessel puncture and the like.
- This is an ultrasonic puncture assisting device intended to assist.
- the traction mechanism includes a hollow member having a hollow inside and a suction path that can be connected to the vacuum suction device through the hollow member. This is an ultrasonic puncture aid.
- the traction mechanism further includes a puncture port for puncturing a needle or the like provided in the hollow member. It is a tool.
- a fourth configuration of the present invention is the ultrasonic puncture assisting device according to the second or third configuration, wherein the hollow member is made of a transparent or translucent material.
- a fifth configuration of the present invention is the ultrasonic puncture assisting device according to the second to fourth configurations, wherein the hollow member gradually spreads toward the human body contact surface.
- a sixth configuration of the present invention is the ultrasonic puncture assisting device according to any one of the first to fifth configurations, characterized by having a gripping portion.
- a seventh configuration of the present invention is the ultrasonic puncture assisting device according to the first configuration, wherein the traction mechanism includes a traction needle.
- An eighth configuration of the present invention is the ultrasonic puncture assisting device according to the first configuration, wherein the pulling mechanism includes an adhesion mechanism by adhesion.
- a ninth configuration of the present invention is the ultrasonic puncture assisting device according to the second to eighth configurations, further comprising an attachment mechanism that enables attachment to an ultrasonic probe.
- the present invention it is possible to provide an ultrasonic puncture assisting device that can prevent an operation error when performing a nerve block or blood vessel puncture under ultrasonic examination, and an ultrasonic puncture method using the same. It became. That is, by using the ultrasonic puncture assisting device of the present invention, it is possible to widen the width of the target site tissue when performing nerve block or blood vessel puncture, and it can be expected to prevent puncture mistakes.
- the perspective view which showed the example of the vacuum suction type ultrasonic puncture assistance tool Three views showing an example of a vacuum suction type ultrasonic puncture aid
- the figure which showed the usage example of the vacuum suction type ultrasonic puncture aid The figure which showed the example of a needle pulling type ultrasonic puncture auxiliary tool
- the figure which showed the example of a needle pulling type ultrasonic puncture auxiliary tool The figure which showed the example of a needle pulling type ultrasonic puncture auxiliary tool
- the figure which showed the example of the adhesive type ultrasonic puncture assistance tool Comparison of veins during towing and compression Figure showing beef used in the experimental example Tool assuming a traction needle Figure of ultrasonic inspection while towing Comparison of fascia during traction and compression
- the ultrasonic puncture aid (hereinafter simply referred to as “puncture aid”) of the present invention will be described with reference to the drawings.
- the puncture assisting device of the present invention has a traction mechanism that pulls the surface of a puncture target site such as skin as an essential component. This makes it possible to prevent narrowing of the puncture target site in nerve block or blood vessel puncture, and assist the puncture work under ultrasonic examination.
- the puncture assisting tool of the present invention is not limited to the traction mechanism, but may have other configurations. For example, a gripping part as shown in FIG. 1 or a fixing mechanism as shown at 32 in FIG.
- the traction mechanism is not particularly limited as long as the puncture target surface such as the skin can be pulled, and various configurations can be adopted. For example, a configuration in which the skin surface is pulled by using a needle, or a configuration in which the skin surface is pulled by vacuum suction or adhesion is used.
- the traction mechanism is preferably a vacuum suction type. As a result, it becomes possible to perform traction non-invasively, and it becomes easy to adjust the degree of traction, so that it has the effect of improving the handleability of the puncture assisting tool.
- FIG. 1 to FIG. 3 show an example of a vacuum suction type puncture assisting device 1 provided with a traction mechanism by vacuum suction.
- the vacuum suction type auxiliary tool 1 has a hollow member 11 and a suction path 12 as essential components.
- the hollow member 11 has a puncture port 13 for puncturing a needle or the like and a cavity portion 14, and a grip portion 15 for gripping is provided.
- the suction path 12 is connected to a suction device by a tube or the like, and is sucked under reduced pressure by the suction device. Then, by applying the hollow member 11 to the human body surface or the like, the human body surface can be pulled. When the surface of the human body is pulled, blood vessels such as veins existing under the surface are expanded, so that puncture is easy to perform. In this state, it is possible to secure a blood vessel or the like by puncturing a needle from the puncture port while confirming an ultrasonic image.
- the hollow member has a wide contact area with the human body. For this reason, it is possible to adopt a configuration that gradually expands as shown in FIG. If the contact area with the human body is small, it cannot be pulled sufficiently unless it is pulled with a fairly strong pressure. As a result, the possibility of feeling pain in the towed portion or internal bleeding increases. These problems can be avoided by increasing the contact area with the human body.
- the hollow member is preferably made of a transparent or translucent material.
- a transparent or translucent material is not particularly limited, but for example, a material such as silicon or polystyrene can be used.
- the hollow member is preferably provided with a puncture port.
- a puncture port thereby, it is possible to puncture a needle or the like from the puncture port, so that there are more options for puncturing, and the effect of improving the handleability of the puncture assisting tool is obtained.
- the puncture ports may be provided in the vertical direction at intervals enough to pass the needle. Further, the number of puncture ports is not necessarily one, and a plurality of puncture ports may be provided.
- the puncture assisting device shown in FIGS. 4 to 6 is an example of a puncture assisting device provided with a traction mechanism using a needle.
- the puncture assisting device includes a bent needle at the tip of the traction mechanism, and the handle is pulled up. Towing can be performed by rotating 43 or the like.
- the puncture assisting device shown in FIG. 7 is an example of a puncture assisting device provided with a traction mechanism by adhesion, and by adhering the skin surface with a sucker-like adhesive surface at the tip of the traction mechanism, rotating the adjustment mechanism 53, etc. Towing can be performed.
- the puncture assisting device of the present invention can include a fixing mechanism for attaching to the ultrasonic probe.
- a fixing mechanism for attaching to the ultrasonic probe As a result, attachment to the ultrasonic probe becomes possible, and the auxiliary tool can be handled while operating the ultrasonic probe, so that the convenience of the operator is improved.
- the ultrasonic probe to be attached is not particularly limited as long as it can be used for blood vessel puncture or nerve block treatment, and various ultrasonic probes can be used. Typical examples of such an ultrasonic probe include a linear probe, and other examples include a convex probe and a hockey stick probe.
- the fixing mechanism is not particularly limited as long as it can be fixed to the ultrasonic probe, but it is necessary to select the fixing mechanism in consideration of various viewpoints such as the shape and material of the ultrasonic probe to be used.
- various fixing means such as an inset type, a magic tape (registered trademark) type, and an adhesive type are used alone or in combination.
- a fixing mechanism (not shown) that winds the grip 15 with Velcro (registered trademark) in FIG.
- the fixing mechanism 32 shown in FIG. 5 and the fixing mechanism 52 shown in FIG. 7 are examples of an adhesive fixing mechanism, and an example in which a rod-like fixing mechanism is fixed to a linear probe by adhesion.
- the fixing mechanism 42 shown in FIG. 6 is an example of a fitting type fixing mechanism, and is an example in which a rectangular fixing mechanism is fixed by being fitted into a linear probe.
- the ultrasonic puncture method for puncturing a needle or the like for nerve block or blood vessel puncture can prevent narrowing of the target puncture site, Furthermore, since the width of the target puncture site can be increased, it is possible to prevent puncture mistakes. Moreover, the same effect can be acquired also by using the ultrasonic probe with which the ultrasonic puncture assistance tool of this invention was equipped beforehand.
- FIG. 8 shows an example of an image obtained by ultrasonic inspection.
- the left image in FIG. 8 is an image obtained by performing a normal ultrasonic probe crimping operation without pulling. When compressed with an ultrasonic probe, it can be easily confirmed that the veins collapse and narrow.
- the central image in FIG. 8 is an image when the traction is not performed and the vein is not easily crushed. In this case, it is possible to prevent the vein from narrowing by gently touching the probe, tilting the bed, lowering the head, or setting the ventilator to “breathing” and angering the vein. . As a result, it can be confirmed that the veins are wider than when the ultrasonic probe is crimped. 4).
- the right image in FIG. 8 is an image when pulled. By pulling the skin surface vertically and applying an ultrasonic probe, the luminal structure is maintained, and the distance in the puncture direction is increased compared to the central image.
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Abstract
Description
すなわち,超音波による検査を行いながら血管穿刺を行う場合,超音波ブローブを目的部位表面に圧着させながら,目的部位である血管等の探索を行う。血管等は軟性の組織であるので,プローブの圧着により,狭小化してしまうことが考えられ,この狭小化により,針等の穿刺のミスが生じやすくなっているのではないかと発明者らは考えた。
発明者らは,この発見をもとに,神経ブロックや血管穿刺を行う際,検査によるプローブの圧着を損なわずに,目的部位表面の牽引を維持することができれば,血管等の幅を広げることが可能となり,ひいては針等の穿刺ミスを防止することができることに着想した。発明者らは,この着想から,これを具現化する超音波下穿刺補助具ならびにこれを用いた超音波下穿刺方法という,従来になかった技術的思想に想到したものである。
本発明の第一の構成は,超音波検査の下,皮膚などの穿刺目的部位表面を牽引する牽引機構を備えることにより,神経ブロックや血管穿刺における穿刺目的部位の狭小化等を防止し,穿刺を補助することを目的とする超音波下穿刺補助具である。
本発明の第三の構成は,前記牽引機構が,さらに中空部材に設けられた針等を穿刺するための穿刺用口を有することを特徴とする第二の構成に記載の超音波下穿刺補助具である。
本発明の第四の構成は,前記中空部材が,透明ないし半透明素材からなることを特徴とする第二又は第三の構成に記載の超音波下穿刺補助具である。
本発明の第六の構成は,把持部を有することを特徴とする第一から第五の構成に記載の超音波下穿刺補助具である。
本発明の第八の構成は,前記牽引機構が,粘着による粘着機構を備えることを特徴とする第一の構成に記載の超音波下穿刺補助具である。
本発明の第九の構成は,超音波プローブへの取り付けを可能とする,取り付け機構をさらに備えることを特徴とする第二ないし第八の構成に記載の超音波下穿刺補助具である。
減圧吸引式補助具1は,中空部材11ならびに吸引路12を必須の構成としている。中空部材11は,針等を穿刺するための穿刺用口13,空洞部14を有し,把持するための把持部15が設けられている。
吸引路12はチューブ等で吸引装置につながれており,吸引装置により減圧吸引される。そして,中空部材11を人体表面等にあてることにより,人体表面を牽引することが可能となる。人体表面が牽引されると,その下に存在する静脈等の血管が拡張するため,穿刺が行いやすい状態となる。この状態下,超音波の画像を確認しながら,穿刺口から針を穿刺し,血管等を確保することが可能となる。
人体との接触面積が狭い場合,かなり強い圧力で牽引しなければ十分に牽引することができない。そのため,牽引した部分に痛みを感じたり,内出血したりするなどの可能性が高まってしまう。これらの問題について,人体との接触面積を広くすることにより,回避することができる。
このような透明ないし半透明素材として,特に限定する必要はないが,例えば,シリコンやポリスチレン等の素材を用いることができる。
穿刺用口は,図1等に示すように,縦方向であって,針が通る程度の間隔で設ければよい。また,穿刺用口は1つである必要は必ずしもなく,複数設けても構わない。
取り付けられる超音波プローブについては,血管穿刺や神経ブロック施術に用いうる限り特に限定する必要は無く,種々の超音波プローブを用いることができる。このような超音波プローブとして,典型的にはリニアプローブが挙げられ,そのほか,コンベックスプローブ,ホッケースティックプローブなどが挙げられる。
例えば,図1において把持部15をマジックテープ(登録商標)で巻きつけるような固定機構(不図示)などが挙げられる。その他,図5に示す固定機構32,および図7に示す固定機構52は,粘着式固定機構の例であり,棒状の固定機構が,粘着により,リニアプローブに固定されている例である。また,図6に示す固定機構42は,はめ込み式による固定機構の例であり,長方形状の固定機構が,リニアプローブに嵌めこまれることにより,固定されている例である。
また,本発明の超音波下穿刺補助具を,予め備えた超音波プローブを用いることによっても,同様の効果を得ることができる。
1.図8に超音波検査を行った画像例を示す。
2.図8の左画像は,牽引を行わず,通常の超音波プローブの圧着作業により撮像を行った画像である。超音波プローブにより圧迫すると,簡単に静脈は潰れ,狭小化することが確認できる。
3.図8の中央画像は,牽引を行わず,静脈が潰れにくいようにした際の画像である。この場合,プローブをそっと当てたり,ベッドを傾け頭を下げたり,人工呼吸器を「息堪え」状態に設定して静脈を怒張させるなどして,静脈が狭小化しないようすることが可能となる。結果,超音波プローブ圧着時よりも,静脈の幅が広いことが確認できる。
4.図8の右画像は,牽引した際の画像である。皮膚面を垂直方向に牽引して超音波プローブを当てることで,管腔構造が維持され,穿刺方向の距離が,中央画像と比較しても,増していることが分かる。
<実験方法>
1.測定対象として,市販されている冷凍牛肉の塊(図9)を購入し,25℃の室温に戻して使用した。
2.牛肉表面に筋膜を有する任意の7カ所を選び,超音波プローブを接触させ,その周囲に先端を曲げた長い注射針を筋膜に刺し,垂直方向に牽引した(図10,11)。
3.牽引した状態で,任意の深さの筋線維の構造体を選択し,筋肉表面から構造体までの深さを計測し,牽引深度とした(図12,左)。
4.次に,筋線維の構造体を超音波画像上で目視確認しながら,牽引を緩め,そのまま,プローベで圧迫した。
5.圧迫した状態で再度,筋肉表面から構造体までの深さを計測し,圧迫深度とした(図9,右)。
6.任意の7カ所で計測し,牽引深度-圧迫深度の差が最大のものと最小のものを除外し,残りの5カ所の計測値を用いて,統計処理した。統計処理としては,対応のあるWilcoxonの符号付き順位検定を使用した。
1.結果を表1に示す。
2.5カ所の牽引深度-圧迫深度の差は,平均: 7. 46 mm,中央値: 7.2 mm,標準偏差: 0.93,最大値: 8.8 mm,最小値: 6.6 mmであり,高度に有意であった(P < 0.01)。
3.この結果から,体幹のブロックの際に牽引を併用することは,安全性を高めることが出来る可能性が示された。
<実験方法>
伝達麻酔を受け,かつ,中心静脈穿刺を行う患者を対象として,実験例1と同様,血管の拡張度合いについて測定を行った。なお,患者の同意が得られなかった場合,もしくは担当医師が不適当と判断した患者は,実験を行わず除外した。
1.結果を表2に示す。
2.いずれの症例においても,減圧吸引を行ったときの方が,血管幅は拡張していた。
3.この結果から,減圧吸引を行いながら超音波検査を行うことにより,血管幅が拡張し,血管穿刺等が行いやすくなることが強く示唆された。
Claims (9)
- 超音波検査の下,皮膚などの穿刺目的部位表面を牽引する牽引機構を備えることにより,神経ブロックや血管穿刺における穿刺目的部位の狭小化等を防止し,穿刺を補助することを目的とする超音波下穿刺補助具
- 前記牽引機構が,中が空洞の中空部材と,前記中空部材を通じて減圧吸引装置に接続が可能な吸引路とからなることを特徴とする請求項1に記載の超音波下穿刺補助具
- 前記牽引機構が,さらに中空部材に設けられた針等を穿刺するための穿刺用口を有することを特徴とする請求項2に記載の超音波下穿刺補助具
- 前記中空部材が,透明ないし半透明素材からなることを特徴とする請求項2又は3に記載の超音波下穿刺補助具
- 前記中空部材が,人体接触面に向けて漸次広がっていくことを特徴とする請求項2から4に記載の超音波下穿刺補助具
- 把持部を有することを特徴とする請求項1ないし5に記載の超音波下穿刺補助具
- 前記牽引機構が,牽引針を備えることを特徴とする請求項1に記載の超音波下穿刺補助具
- 前記牽引機構が,粘着による粘着機構を備えることを特徴とする請求項1に記載の超音波下穿刺補助具
- 超音波プローブへの取り付けを可能とする,取り付け機構をさらに備えることを特徴とする請求項2ないし8に記載の超音波下穿刺補助具
Priority Applications (2)
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JP2015508654A JP6168535B2 (ja) | 2013-03-29 | 2014-03-27 | 超音波下穿刺補助具 |
US14/780,250 US9918738B2 (en) | 2013-03-29 | 2014-03-27 | Ultrasound-guided puncture assist device and ultrasound-guided puncture method using the same |
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JP2013071417 | 2013-03-29 | ||
JP2013-071417 | 2013-03-29 |
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WO2014157450A1 true WO2014157450A1 (ja) | 2014-10-02 |
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PCT/JP2014/058740 WO2014157450A1 (ja) | 2013-03-29 | 2014-03-27 | 超音波下穿刺補助具およびそれを用いた超音波下穿刺方法 |
Country Status (3)
Country | Link |
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US (1) | US9918738B2 (ja) |
JP (1) | JP6168535B2 (ja) |
WO (1) | WO2014157450A1 (ja) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
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CN107280739A (zh) * | 2017-07-31 | 2017-10-24 | 北京大学深圳医院 | 超声引导神经阻滞辅助支架 |
EP3359051A4 (en) * | 2015-10-05 | 2019-08-07 | Maracaja, Luiz | ULTRASONIC DISTANCE DEVICE |
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WO2015095342A1 (en) * | 2013-12-20 | 2015-06-25 | Soma Access Systems, Llc | Skin adhesive device for use in medical procedures |
CN107510493A (zh) * | 2017-07-31 | 2017-12-26 | 大连医科大学附属第二医院 | 超声引导下中心静脉穿刺支架 |
CN109223133A (zh) * | 2018-11-07 | 2019-01-18 | 遵义医学院附属医院 | 超声引导经皮穿刺骨定位装置 |
US11690649B2 (en) | 2019-12-13 | 2023-07-04 | Tautona Group IP Holding Company, LLC | Retractor apparatus and methods for use |
CN113456186B (zh) * | 2021-07-12 | 2022-08-23 | 南充市中心医院 | 一种基于超声智能识别的神经阻滞系统 |
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- 2014-03-27 JP JP2015508654A patent/JP6168535B2/ja not_active Expired - Fee Related
- 2014-03-27 WO PCT/JP2014/058740 patent/WO2014157450A1/ja active Application Filing
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CN107280739B (zh) * | 2017-07-31 | 2023-05-02 | 北京大学深圳医院 | 超声引导神经阻滞辅助支架 |
Also Published As
Publication number | Publication date |
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US9918738B2 (en) | 2018-03-20 |
JP6168535B2 (ja) | 2017-07-26 |
JPWO2014157450A1 (ja) | 2017-02-16 |
US20160051279A1 (en) | 2016-02-25 |
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