WO2017059598A1 - 可清理出血点渗血的止血夹 - Google Patents

可清理出血点渗血的止血夹 Download PDF

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Publication number
WO2017059598A1
WO2017059598A1 PCT/CN2015/091669 CN2015091669W WO2017059598A1 WO 2017059598 A1 WO2017059598 A1 WO 2017059598A1 CN 2015091669 W CN2015091669 W CN 2015091669W WO 2017059598 A1 WO2017059598 A1 WO 2017059598A1
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Prior art keywords
tube
clip
bleeding
injection port
flexible
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PCT/CN2015/091669
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English (en)
French (fr)
Inventor
时百明
Original Assignee
杭州安杰思医学科技有限公司
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Application filed by 杭州安杰思医学科技有限公司 filed Critical 杭州安杰思医学科技有限公司
Priority to CN201580050115.4A priority Critical patent/CN107072669B/zh
Priority to PCT/CN2015/091669 priority patent/WO2017059598A1/zh
Publication of WO2017059598A1 publication Critical patent/WO2017059598A1/zh

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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
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M3/00—Medical syringes, e.g. enemata; Irrigators
    • A61M3/02—Enemata; Irrigators
    • A61M3/0279—Cannula; Nozzles; Tips; their connection means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B2017/12004—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for haemostasis, for prevention of bleeding
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/007—Auxiliary appliance with irrigation system

Definitions

  • the invention belongs to the field of medical instruments, and particularly relates to a hemostatic clip capable of clearing bleeding at a bleeding point for treating a wound surface by a medium capable of transporting a liquid or the like.
  • the stomach and intestines of the organism often cause bleeding due to various diseases or accidental injuries or damage after endoscopic treatment.
  • drugs are usually sprayed, or high-frequency electricity, laser, argon burning, hemostasis, and hemostatic clips are used.
  • Mechanical compression and hemostasis are used for treatment.
  • hemostasis mechanical compression of hemostasis is more reliable for the treatment of active bleeding caused by non-varicose veins, and has also been approved by doctors and patients; hemostatic clips can also have a certain effect on mucosal damage of the digestive tract, using it to clamp the mucosa
  • the injury can promote wound healing and avoid open surgery.
  • hemostasis is used to stop bleeding, only the bleeding point that can be clearly observed under endoscopy can be clamped and pressed to stop bleeding.
  • hemostasis cannot be used to stop bleeding.
  • the hemostatic clip enters the bleeding point may not be clear. Coupled with the natural peristalsis of the digestive tract, it is difficult to find a clear bleeding point in this case, and it can only be stopped by repeated attempts, which not only extends The operation time also increased the labor intensity of the doctor.
  • the hemostatic clip disclosed in Chinese Patent No. 200980123274 can be repeatedly opened and closed by the handle control.
  • the elongated portion of the clip and the conveyor is a coil spring tube structure, and the outer side of the coil spring tube is provided with a polymer sheath tube, which does not have The injection port is set and the medium cannot be injected to flush the lesion.
  • the ligation device In the ligation device of Japanese Laid-Open Patent Publication No. 2004-121485, only a pair of arms having a force to be expanded are recorded.
  • the ligation device embeds the pressing tube on the clip to close the pair of arms to hold the living tissue, and maintains the pair of arms in the closed state by the pressing tube, thereby ligating the living tissue, which is not related to the patent.
  • the hemostatic clip can be used to treat the bleeding tissue.
  • the object of the present invention is to provide a surface flushing of the lesion after the hemostatic clip is inserted into the forceps to clear the bleeding point, and then quickly clip the bleeding point. Hold the hemostatic clip so that the bleeding point can be accurately stopped.
  • the present invention adopts the following technical solutions.
  • the invention provides a hemostatic clip capable of clearing bleeding at a bleeding point, characterized in that it comprises: a clip, a conveying part, a control part, and a osmotic serum part;
  • the clip includes a pair of clips and a tightening tube that gathers the clips
  • the conveying portion includes a mandrel, a flexible tube, the mandrel is inserted into the flexible tube, a front end of the flexible tube is connected with a rear end of the tightening tube, and a front end of the mandrel and the clip Slice backend connection;
  • the control portion is coupled to the flexible tube and a rear end of the mandrel;
  • the osmotic serum portion includes an injection port, a medium passage communicating with the injection port, and an outlet, the injection port being located on the conveying portion, and the outlet being disposed at a front end of the medium passage.
  • the conveying portion further includes a transition tube connecting the rear end of the flexible tube and the front end of the control portion, and a portion of the rear end of the flexible tube and the outside of the transition tube for the A portion of the rear end of the flexible tube and a sheath tube through which the transition tube extends.
  • the injection port is located on the sheath tube, and a gap between the inner side wall of the sheath tube and the outer side wall of the transition tube forms the medium passage.
  • the transition tube is provided with a through hole portion, and when the medium is injected from the injection port, the medium enters between the transition tube and the mandrel through the medium passage and the through hole portion.
  • the conveying portion is further provided with a conveying pipe sleeved outside the clip and the flexible pipe such that the clip and the flexible pipe penetrate therethrough.
  • the injection port is located on the conveying pipe, and the medium passage is formed between the inner wall of the conveying pipe and the outer wall of the flexible pipe.
  • the conveying portion further comprises a conveying pipe, the injection port is located on the conveying pipe, the conveying pipe is located outside the flexible pipe, and the conveying pipe is at least partially connected to the flexible pipe, the conveying The tube itself acts as the medium channel.
  • the flexible tube interior comprises a barrier layer and a spring tube disposed in sequence from the inside to the outside.
  • the disadvantages of the existing hemostatic clip for the difficulty of accurately clamping the diffuse hemorrhagic lesion can be overcome, and the lesion can be effectively flushed after the clip is inserted into the endoscope instrument channel to clarify
  • the bleeding point can effectively clamp the bleeding point effectively, avoiding the great pain caused by the large-area clamping clip caused by the unclear bleeding point, and avoiding the prolongation of the operation time and the excessive use of the clip.
  • Figure 1 is a cross-sectional view showing the open structure of the clip of the first embodiment
  • Figure 2 is a cross-sectional view showing the injection structure of the clip of Embodiment 1;
  • Figure 3 is a schematic structural view of a connecting assembly of a clip
  • FIG. 4 is a schematic structural view of a clip of Embodiment 2;
  • Figure 5 is a cross-sectional view showing the positional relationship between the flexible pipe and the conveying pipe and the mandrel in the second embodiment
  • Figure 6 is a schematic structural view showing a modification of the clip of the second embodiment
  • Figure 7 is a schematic structural view of a clip of Embodiment 3.
  • Figure 8 is a cross-sectional view showing a positional relationship between the flexible pipe and the conveying pipe and the mandrel in Embodiment 3;
  • Fig. 9 is a cross-sectional view showing another positional relationship between the flexible pipe and the conveying pipe and the mandrel in the third embodiment.
  • a hemostatic clip capable of clearing bleeding at a bleeding point includes a clip 1, a delivery portion 2, a osmotic serum portion, and a control portion 5.
  • the clip 1 includes a pair of clips 11 and a tightening tube 12 that can press and clamp the clips.
  • the clip 11 can clamp the living tissue, and can be made of an elastic metal material or a polymer material having a certain hardness and strength; the tightening tube 12 presses and clamps the tail end of the clip and finally forces the clip to completely close. Hold the tissue.
  • the assembly method of the clip 11 and the tightening tube 12 can be carried out in a conventional manner in the existing hemostatic clip, as long as the function of tightening the clip by the tightening tube 12 can be achieved, for example, the clip can be set to the rear.
  • the end arm portion is thin and the distal arm portion is thick, so that a stop portion can be formed at the junction of the clip piece 11 and the tightening tube 12, so that the retaining portion can hold the tightening portion after the clip piece 11 is in a certain position.
  • the back end of the tube It is also possible to provide a side lug at the rear end of the clip 11, and a hooking hole is provided on the inner wall of the tightening tube 12, and when the clip 11 is released, the side lug can be hung in the hanging hole to prevent the clip 11 from being The tightening tube 12 is detached.
  • the front end of the tightening tube 12 may further be provided with a collecting hole for collecting the clip 11, and a blocking member traversing the collecting hole is further provided at the front end, the blocking member can separate the clip; and the clip is prevented from being The hole of the collecting hole is detached.
  • the conveying portion 2 includes a mandrel 21 and a flexible tube 22, and the mandrel 21 penetrates into the flexible tube 22.
  • the front end of the flexible tube 22 is connected to the rear end of the tightening tube 12, and the front end of the mandrel 21 and the rear end of the clip 11
  • the control portion 5 is connected to the flexible tube 22 and the rear end of the mandrel 21, and the osmotic portion includes an injection port 41 and a medium passage and an outlet communicating with the injection port 41.
  • the injection port 41 is located on the conveying portion 2, and the outlet portion is disposed.
  • the mandrel 21 may have a conduit therein, and the mandrel and the conduit have a seamless connection structure.
  • connection component 3 can have multiple implementations as long as it is a structure that can deform and deform under a certain tensile force.
  • an implementation of a connection component is exemplified.
  • the connecting component 3 includes a fixing member 31 connected to the flexible tube 22, a rotating shaft 33 that is sleeved in the fixing member 31 at the rear end portion, and a sleeve 32.
  • the sleeve 32 is connected with the rear end of the tightening tube, and the shaft is connected.
  • the inner rear end of the sleeve 32 is provided with a step 322, and the outer front end of the rotating shaft 33 is provided with a protruding portion, and the step 322 is disposed between the protruding portion and the fixing member 31 with a clearance fit.
  • connection between the front end of the mandrel 21 and the rear end of the clip 11 forms a structure that can be broken or deformed; preferably, the front end of the mandrel is provided with a pulling head 211, which can be connected to the clip by the pulling head 211, and pulls the head and
  • the connecting position of the clip is a structure that can be broken or deformed, and the pulling head can be broken under a certain pulling force to be separated from the clip.
  • the pull head and the clip can be connected by a frangible sheath or a clip, and under the pulling of the mandrel, the structure is broken to separate the pull head from the clip.
  • the conveying portion 2 further includes a transition tube 23 connecting the rear end of the flexible tube 22 and the front end of the control portion 5, and a portion of the rear end of the flexible tube 22 and a portion of the outer end of the transition tube 23 for the flexible rear portion of the flexible tube 22 and The sheath tube 24 through which the transition tube 23 passes.
  • the injection port 41 is located on the sheath tube 24, and the inner side wall of the sheath tube 24 and the transition tube 23 are outside.
  • the gap between the side walls forms a medium passage.
  • the transition pipe 23 is provided with a through hole portion 231 such that when the medium is injected into the injection port 41, the medium enters between the inner side wall of the transition pipe 23 and the outer side wall of the mandrel 21 through the medium passage and the through hole portion 231.
  • the outlet is placed at the front end of the tightening tube.
  • the inside of the flexible tube 22 includes an insulating layer 221 and a spring tube 222 which are sequentially disposed from the inside to the outside.
  • the rear end of the flexible tube 22 is connected to the fixing member 25 and inserted into the inner hole of the sheath tube 24, and the inner hole of the front end of the sheath tube
  • the blocking cap 241 is inserted to block the fixing member 25 from coming out of the flexible tube 22.
  • the sealing member 251 is disposed between the fixing member 25 and the blocking cap 241 to be sleeved outside the insulating layer of the flexible tube, and is disposed at the rear end of the transition tube 23.
  • the liquid or the like can be injected from the injection port through the syringe, and the liquid immediately enters the medium passage and enters the gap between the transition tube 23 and the mandrel 21 through the through hole 231, and then flows into the mandrel 21 and the flexible tube 22.
  • the gap between the inner holes when the liquid flows out from the outlet of the front end of the tightening tube to the position of the clip, continues to flow along the clip under the pressure of the rear end until the liquid is ejected, because the shape of the clip has a certain guiding effect, the liquid Will continue to flow along the two clips respectively, when the clip is in the edge closed state as shown in Figure 2, the two liquid streams will merge into a new larger liquid flow, and will spray a certain distance (this depends on In the pressure of the medium), the liquid flow can be used to effectively spray and clean the bleeding point to achieve the purpose of clearing the bleeding point.
  • the control unit 5 of the present invention includes a body 51 , an operating rod 52 penetrating the body 51 , a sliding handle 53 connected to the operating rod 52 , and an operating handle 54 fixed to the rear end of the body 51 .
  • the front end of the flexible tube 22 is fixedly connected to the front end of the body 51, and the rear end of the mandrel 21 is connected to the front end of the operating rod 52.
  • the sliding handle 53 can drive the operating rod 52 to move back and forth to drive the mandrel 21 to move along the flexible tube 22.
  • control unit can be used to drive the delivery portion to insert the hemostatic clip through the endoscopic instrument channel and reach the lesion, draw physiological saline in the syringe and connect the injection saline with the injection port.
  • the hemostatic clip of the embodiment 2 is improved on the basis of the embodiment 1, and the delivery portion 2 is further provided with a delivery tube 26 which is sleeved on the outside of the clip 1 and the flexible tube 22.
  • a clip 1 and a flexible tube 22 extend therethrough.
  • the injection port 41 is located at the rear end of the delivery tube 26, and the medium passage is formed between the inner wall of the delivery tube 26 and the outer wall of the flexible tube 22, and the outlet is located at the front end of the inner wall of the delivery tube 26.
  • the rear end of the conveying pipe 26 is provided with a sealing member 261 for sealing the conveying pipe 26 and the insulating layer 221 outside the flexible pipe 22 to prevent the medium such as liquid from splashing toward the handle end.
  • the sealing material is made of elastic material such as silica gel or rubber TPU, and the inner hole is substantially stepped, and can be tightly fitted and sealed with the outer diameter of the conveying pipe, and the small hole is sealed with the outer insulating layer 221 of the flexible pipe.
  • a blocking member 262 may be further disposed between the rear end of the conveying pipe and the sealing member 261 .
  • the blocking member 262 is provided with a small hole structure through which the flexible pipe 22 is penetrated. The medium such as liquid is further blocked from being sprayed toward the handle end.
  • the hemostatic clip of Embodiment 3 is improved on the basis of Embodiment 1, as shown in Fig. 7, the delivery portion 2 further includes a delivery tube 26', the injection port 41 is located on the delivery tube 26', and the delivery tube 26' is located in the flexible tube 22 outside.
  • the delivery tube 26' can be provided as a separate hollow channel, which itself acts as a media channel, can be used to transport media such as liquids, and can also be used to access guided instruments to guide the hemostatic clip into more difficult to reach lesion locations or smaller. Hemostasis is performed in the body cavity.
  • the transfer tube 26' is connected to the insulating layer of the flexible tube 22, which may be integrally formed by itself or joined together by bonding, welding or the like.
  • the injection port 41 communicates with the delivery tube 26' of the individual channel. When the injection port is connected with the syringe of the medium such as physiological saline, the medium is injected through the syringe, and the medium is moved from the vicinity of the clip under the continuous pressure of the medium channel.
  • the outlet of the front end of the delivery tube is ejected and continues to flow along the clip to reach the location of the lesion and flush it to clarify the bleeding point.
  • the angle and position of the clip 1 are adjusted by the control unit 5, whereby the bleeding point of the lesion can be effectively clamped.
  • the delivery tube 26' can also be placed in contact with the outside of the flexible tube 22; or as shown in Figure 9, a portion of the delivery tube 26' can be coupled to the flexible tube 22, such as by other components.
  • the flexible tube 22 is joined together at the end of the clip 1 such that the ejection medium is substantially parallel to the clip to control the direction and position of the medium to the lesion.
  • the disadvantages of the existing hemostatic clip for the difficulty of accurately clamping the diffuse hemorrhagic lesion can be overcome, and the lesion can be effectively flushed after the clip is inserted into the endoscope instrument channel to clarify
  • the bleeding point can effectively clamp the bleeding point effectively, avoiding the great pain caused by the large area clamping of the wound due to the unclear bleeding point, and avoiding the prolongation of the operation time and the excessive clip.

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Abstract

一种可清理出血点渗血的止血夹，其包括：夹子（1）、输送部（2）、控制部（5）、渗血清理部；所述夹子（1）包括一对夹片（11）和将所述夹片（11）收拢的收紧管（12）；所述输送部（2）包括芯轴（21）、柔性管（22），所述芯轴（21）贯穿于所述柔性管（22）内，所述柔性管（22）的前端与所述收紧管（12）的后端相连接，所述芯轴（21）的前端与所述夹片（11）后端连接；所述控制部（5）与所述柔性管（22）和所述芯轴（21）的后端连接，所述渗血清理部包括注入口（41）、与所述注入口（41）连通的介质通道和出口，所述注入口（41）位于所述输送部（2）上，所述出口设置在所述介质通道的前端。

Description

可清理出血点渗血的止血夹 技术领域
本发明属于医疗器械领域，特别涉及一种可运输液体等介质对创面进行处理的可清理出血点渗血的止血夹。
背景技术
生物的胃、肠道经常会因各种疾病或意外损伤或内镜治疗后损伤导致出血，对于活动性出血一般进行药物喷洒，或者采用高频电、激光、氩气灼烧止血方法、止血夹子机械压迫止血等方法进行治疗。其中止血夹子机械压迫止血对于非静脉曲张造成的活动性出血治疗效果较为可靠，并也已经得到医生和患者的认可；止血夹还可对消化道的粘膜损伤有一定的作用，采用其夹住粘膜损伤口可以促进伤口愈合，避免开腹手术。但是目前如果用止血夹进行止血，仅可以对內镜下可以明确观察到的出血点进行夹持压迫止血，对于不是十分明确的出血部位便无法使用止血夹进行止血，如果硬要使用止血夹进行止血，只能用内窥镜钳道注入生理盐水对疑似出血部位进行冲洗以便看清出血点并大致记住方位，并迅速从钳道插入止血夹，在这期间，出血点还会不断渗血，当止血夹进入后可能出血点已经看不清楚了，再加上消化道的自然蠕动，很难在这种情况下找到明确的出血点，也只能通过反复尝试来进行止血，这样不仅延长了手术时间，还增加了医生的劳动强度。
中国200980123274公开的止血夹夹片可以通过手柄控制使夹片反复张开和闭合，夹子与输送器连接的细长部分为螺旋弹簧管结构，螺旋弹簧管外侧设置有高分子鞘管，其并没有设置注入口，无法使介质注入对病灶进行冲洗。
在日本特开2004-121485号公报的结扎装置中，仅记录了夹子具有受到力会扩开的一对臂。此外，该结扎装置将按压管包嵌在夹子上以使一对臂闭合来把持活体组织，并利用按压管将一对臂保持在闭合状态，由此对活体组织进行结扎，该专利并未涉及到止血夹可以对出血组织进行出血点冲洗的处理。
发明内容
鉴于现有的止血夹产品没有使出血点暴露的功能，本发明的目的在于提供一种在止血夹插入钳道后，可以对病灶进行表面冲洗以明确出血点，然后快速的对出血点进行夹持的止血夹，以便能准确地对出血点进行止血操作。
为达到上述目的，本发明采用了以下技术方案。
本发明提供一种可清理出血点渗血的止血夹，其特征在于，包括：夹子、输送部、控制部、以及渗血清理部；
所述夹子包括一对夹片和将所述夹片收拢的收紧管；
所述输送部包括芯轴、柔性管，所述芯轴贯穿于所述柔性管内，所述柔性管的前端与所述收紧管的后端相连接，所述芯轴的前端与所述夹片后端连接；
所述控制部与所述柔性管和所述芯轴的后端连接；
所述渗血清理部包括注入口、与所述注入口连通的介质通道和出口，所述注入口位于所述输送部上，所述出口设置在所述介质通道的前端。
可选地，所述输送部还包括连接所述柔性管的后端和所述控制部前端的过渡管、以及套设于所述柔性管的部分后端和所述过渡管的外部供所述柔性管的部分后端和所述过渡管贯穿的鞘管。
进一步，所述注入口位于所述鞘管上，所述鞘管内侧壁与所述过渡管外侧壁之间的空隙形成所述介质通道。
可选地，所述过渡管设有通孔部，当从所述注入口注入介质时，介质通过介质通道和所述通孔部进入所述过渡管与所述芯轴之间。
可选地，所述输送部还设有输送管，所述输送管套设于所述夹子和所述柔性管外部使得所述所述夹子和所述柔性管贯穿其中。
进一步，所述注入口位于所述输送管上，所述介质通道形成于所述输送管内壁与所述柔性管外壁之间。
可选地，所述输送部还包括输送管，所述注入口位于所述输送管上，所述输送管位于所述柔性管外部，所述输送管至少部分地与柔性管相连，所述输送管自身作为所述介质通道。
可选地，所述柔性管内部包含由内向外依次设置的隔缘层和弹簧管。
采用本发明的技术方案，可以克服现有的止血夹所存在的对有弥漫性出血病灶不易准确夹持的缺点，在夹子插入到内窥镜器械通道后还可以对病灶进行有效的冲洗以明确出血点，从而可以准确地对出血点进行有效的夹持，避免因出血点不明确而导致大面积夹持夹子给患者造成的极大痛苦，还可以避免手术时间的延长以及夹子被过多使用给患者所带来的经济压力。
附图说明
图1为实施例1的夹子的张开结构剖示图；
图2为实施例1的夹子的喷射结构剖示图；
图3为夹子的连接组件结构示意图；
图4为实施例2的夹子的结构示意图；
图5为表示实施例2中的柔性管与输送管、芯轴的位置关系的横截面视图；
图6为实施例2的夹子的一种变形例的结构示意图；
图7为实施例3的夹子的结构示意图；
图8为实施例3中的柔性管与输送管、芯轴的一种位置关系的横截面视图；
图9为实施例3中的柔性管与输送管、芯轴的另一种位置关系的横截面视图。
具体实施方式
下面结合附图来详细说明本发明的结扎装置的较佳的实施方式，但本发明并不局限于这些实施方式。
实施例1
参见图1所示，本发明的一种可以清理出血点渗血的止血夹，包括夹子1、输送部2、渗血清理部和控制部5。
其中，夹子1包括一对夹片11和可将夹片压迫收拢的收紧管12。夹片11可对生物体组织进行夹闭，可采用弹性金属材料或具有一定硬度和强度的高分子材料等制成；收紧管12对夹片尾端进行压迫收拢并最终迫使夹片完全闭合从而夹持住组织。夹片11与收紧管12的组装方式可采用现有止血夹中的常规方式，只要能实现使收紧管12将夹片压迫收拢的功能即可，比如：可将夹片设置为后 端臂部细、远端臂部粗的结构，这样在夹片11与收紧管12的相接处可以形成止动部，使得收纳夹片11到一定位置后止动部能顶住收紧管的后端。还可以在夹片11的后端部设置侧凸耳，在收紧管12的内壁上设置挂接孔，当释放夹片11后侧凸耳能挂在挂接孔中以阻止夹片11从收紧管12脱落。此外，收紧管12的前端还可以设置用于收拢夹片11的收拢孔，在该前端还设有横贯该收拢孔的阻挡件，阻挡件可将夹片分隔开；同时防止夹片从该收拢孔的孔口脱落出去。
输送部2包括芯轴21和柔性管22，芯轴21贯穿于柔性管22内，柔性管22的前端与收紧管12的后端相连接，芯轴21的前端与夹片11的后端连接；控制部5与柔性管22和芯轴21的后端连接，渗血清理部包括注入口41、和与注入口41连通的介质通道和出口，注入口41位于输送部2上，出口设置在介质通道的前端。芯轴21内可含有导管，芯轴与导管为无缝隙连接结构。
应予说明，收紧管12的后端与柔性管22的前端可通过连接组件3相连接；该连接组件在一定拉力下可以发生破坏使得收紧管与柔性管分离；在本发明中，连接组件可具有多个实现方式，只要是能在一定拉力下发生变形破坏的结构均可。下面，例举一种连接组件的实现方式。
如图3所示，连接组件3包括与柔性管22连接的固定件31、后端部分套接于固定件31内的转轴33、轴套32，轴套32与收紧管后端连接，轴套32的内侧后端设有台阶322，转轴33的外侧前端设有突起部，台阶322间隙配合地设置在该突起部与固定件31之间。
应予说明，芯轴21前端与夹片11后端的连接处形成可破坏或变形的结构；优选地，芯轴前端设置有拉动头211，可通过拉动头211与夹片相连接，拉动头与夹片的连接位置为可破坏或变形的结构，可实现在一定拉力下破坏拉动头从而与夹片分离。比如，拉动头与夹片之间可以通过易破碎的鞘钉或夹子相连接，在芯轴的拉动下，该结构发生破坏从而使得拉动头与夹片分离。
进一步，输送部2还包括连接柔性管22的后端和控制部5前端的过渡管23、以及套设于柔性管22的部分后端和过渡管23的外部供柔性管22的部分后端和过渡管23贯穿的鞘管24。
在本实施例中，注入口41位于鞘管24上，鞘管24内侧壁与过渡管23的外 侧壁之间的空隙形成介质通道。过渡管23设有通孔部231，这样当向注入口41注入介质时，介质通过介质通道和通孔部231进入过渡管23的内侧壁与芯轴21的外侧壁之间。出口设置在收紧管前端。
优选地，柔性管22内部包含由内向外依次设置的隔绝层221和弹簧管222，柔性管22的后端与固定件25连接并插入到鞘管24的内孔中，在鞘管前端内孔装入阻挡帽241来阻挡固定件25从柔性管22中脱出，固定件25和阻挡帽241之间设置有密封件251来套接于柔性管的隔绝层外侧，在过渡管23的后端设置有密封件252，这样可以与鞘管内孔组成密封结构，当需要采用该止血夹注入液体等介质清洗伤口时，可以防止介质向柔性管外喷射。
当需要注入介质时，可以通过针筒从注入口注射液体等，液体立即进入介质通道并通过通孔231进入过渡管23与芯轴21之间的间隙，随后流入芯轴21与柔性管22的内孔之间的间隙，当液体从收紧管前端的出口流出到达夹子位置时，在后端压力作用下继续沿夹子流动，直到液体喷射出来，由于夹片的形状有一定的导向作用，液体会继续分别沿两个夹片继续流动，当夹片处于如图2所示的边闭合状态时，两股液体流会汇合成新的更大的液体流，并会喷射一定的距离(这取决于介质的压力)，这样就可利用液体流对出血点进行有效的喷射、清洗，达到明确出血点的目的。
进一步，如图1所示，本发明的控制部5包括本体51、贯穿于本体51的操作杆52、连接于操作杆52上的滑动手柄53以及固定于本体51后端的操作柄54，滑动手柄53可前后滑动地套设于本体51上，柔性管22的后端固定连接于本体51的前端，芯轴21的后端与操作杆52的前端连接。滑动手柄53可带动操作杆52前后运动从而带动芯轴21沿柔性管22移动。
当在手术中需要对出血病灶进行夹闭止血时，可以利用控制部带动输送部将止血夹通过内窥镜器械通道插入并到达病灶，在注射器中抽生理盐水并与注入口连接推注生理盐水对病灶进行冲洗，当出血点已经明确并且夹子的角度及位置合适时，拉动滑动手柄53带动芯轴21及夹片对病灶处的组织进行有效的夹持和压迫，当夹子准确夹住出血点时，向后端拉动滑动手柄带动芯轴向后端移动使得芯轴与夹子脱离，并且收紧管与柔性管也脱离，最终夹子成功释放从而 持续对组织进行压迫达到止血的目的。如果调整夹子对准出血点时间过长，出血点又不明确了，还可以对病灶再次进行冲洗，直到满足夹子夹持的角度及位置要求后再进行夹持，这样可以保证在施夹前病灶位置的出血点是明确的，就可以对出血点进行最为有效的夹持了，避免在出血点不明确的情况下进行盲目的夹持。
实施例2
参见图4、5所示，实施例2的止血夹在实施例1的基础上做了改进，输送部2还设有输送管26，输送管26套设于夹子1和柔性管22的外部使得夹子1和柔性管22贯穿其中。在该实施例中，注入口41位于输送管26的后端，介质通道形成于输送管26的内壁与柔性管22的外壁之间，出口位于输送管26的内壁前端。
此外，输送管26的后端设置有密封件261使输送管26和柔性管22外侧的隔绝层221密封，防止液体等介质向手柄端喷溅。该密封件材质为硅胶或橡胶TPU等弹性材料，其内孔大致成台阶状，可与输送管外径紧配并密封，其小孔与柔性管的外侧隔绝层221密封。
如图6所示，可选地，在输送管的后端与密封件261之间还可以设置阻挡件262，阻挡件262设置有小孔结构，其内贯穿有柔性管22，该种结构可以进一步阻挡液体等介质向手柄端喷射。
当需要对出血部位进行清洗时，先在注射器内抽入生理盐水等需要的介质，将其与注入口连接并推注，介质会沿输送管26与柔性管22和夹子1所形成的空隙流淌，并在持续压力作用下从输送管26的前端出口喷出，喷出的介质就可对病灶进行必要的冲洗，冲洗结束后将输送管26向后端拉动或将柔性管22向前端推动，使夹露出于输送管26的端部，即可控制手柄使夹子张开，同时调整好角度和位置对准病灶出血点进行夹持，如果调整的时间过长出血点又看不见了，可重新使夹子1外露于输送管26的端部，对出血部位重新进行清洗。
实施例3
实施例3的止血夹在实施例1的基础上做了改进，如图7所示，输送部2还包括输送管26’，注入口41位于输送管26’上，输送管26’位于柔性管22的外部。
输送管26’可以设置成单独的中空通道，其自身便作为介质通道，可以用于运输液体等介质，也可用于通入引导的器械以引导止血夹进入更难以到达的病灶位置或更狭小的体腔内进行止血操作。输送管26’与柔性管22的隔绝层相连，其可为本身一体的结构或经粘接、焊接等过程连接在一起。注入口41与单独腔道的输送管26’联通，当注入口连接有生理盐水等介质的针筒后，通过针筒推注介质，介质沿介质通道在持续的压力作用下从位于夹子附近(输送管前端)的出口喷出并沿夹子继续流动，从而到达病灶位置并对其进行冲洗以明确出血点。当病灶处的出血点明确后通过控制部5调整夹子1的角度及位置，由此可以对病灶的出血点进行有效的夹持。
参见图8所示，也可以将输送管26’与柔性管22的外侧接触设置；或如图9所示，使得输送管26’的一部分与柔性管22连接，比如通过其他零件使输送管26’和柔性管22在夹子1端连接在一起，使喷射介质与夹片大致平行以便控制介质对病灶的冲洗方向和位置。
采用本发明的技术方案，可以克服现有的止血夹所存在的对有弥漫性出血病灶不易准确夹持的缺点，在夹子插入到内窥镜器械通道后还可以对病灶进行有效的冲洗以明确出血点从而可以准确地对出血点进行有效的夹持，避免因出血点不明确而导致大面积夹持伤口由此给患者造成的极大痛苦，还可以避免手术时间的延长及夹子被过多使用给患者所带来的经济压力。
本说明书实施例所述的内容仅仅是对发明构思的实现形式的列举，本发明的保护范围不应当被视为仅限于实施例所陈述的具体形式，本发明的保护范围也及于本领域技术人员根据本发明构思所能够想到的等同技术手段。

Claims (8)

  1. 一种可清理出血点渗血的止血夹，其特征在于，包括：夹子、输送部、控制部、以及渗血清理部；
    所述夹子包括一对夹片和将所述夹片收拢的收紧管；
    所述输送部包括芯轴、柔性管，所述芯轴贯穿于所述柔性管内，所述柔性管的前端与所述收紧管的后端相连接，所述芯轴的前端与所述夹片后端连接；
    所述控制部与所述柔性管和所述芯轴的后端连接；
    所述渗血清理部包括注入口、与所述注入口连通的介质通道和出口，所述注入口位于所述输送部上，所述出口设置在所述介质通道的前端。
  2. 根据权利要求1所述的可清理出血点渗血的止血夹，其特征在于，所述输送部还包括连接所述柔性管的后端和所述控制部前端的过渡管、以及套设于所述柔性管的部分后端和所述过渡管的外部供所述柔性管的部分后端和所述过渡管贯穿的鞘管。
  3. 根据权利要求2所述的可清理出血点渗血的止血夹，其特征在于，所述注入口位于所述鞘管上，所述鞘管内侧壁与所述过渡管外侧壁之间的空隙形成所述介质通道。
  4. 根据权利要求2或3所述的可清理出血点渗血的止血夹，其特征在于，所述过渡管设有通孔部，当从所述注入口注入介质时，介质通过所述介质通道和所述通孔部进入所述过渡管与所述芯轴之间。
  5. 根据权利要求1所述的可清理出血点渗血的止血夹，其特征在于，所述输送部还设有输送管，所述输送管套设于所述夹子和所述柔性管外部使得所述所述夹子和所述柔性管贯穿其中。
  6. 根据权利要求4所述的可清理出血点渗血的止血夹，其特征在于，所述注入口位于所述输送管上，所述介质通道形成于所述输送管内壁与所述柔性管外壁之间。
  7. 根据权利要求1所述的可清理出血点渗血的止血夹，其特征在于， 所述输送部还包括输送管，所述注入口位于所述输送管上，所述输送管位于所述柔性管外部，所述输送管至少部分地与柔性管相连，所述输送管自身作为所述介质通道。
  8. 根据权利要求1所述的可清理出血点渗血的止血夹，其特征在于，所述柔性管内部包含由内向外依次设置的隔缘层和弹簧管。
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