WO2020067164A1 - Instrument hémostatique - Google Patents

Instrument hémostatique Download PDF

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Publication number
WO2020067164A1
WO2020067164A1 PCT/JP2019/037614 JP2019037614W WO2020067164A1 WO 2020067164 A1 WO2020067164 A1 WO 2020067164A1 JP 2019037614 W JP2019037614 W JP 2019037614W WO 2020067164 A1 WO2020067164 A1 WO 2020067164A1
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WO
WIPO (PCT)
Prior art keywords
expansion member
region
expansion
hand
covering
Prior art date
Application number
PCT/JP2019/037614
Other languages
English (en)
Japanese (ja)
Inventor
遼 岡村
和田　哲
Original Assignee
テルモ株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by テルモ株式会社 filed Critical テルモ株式会社
Publication of WO2020067164A1 publication Critical patent/WO2020067164A1/fr

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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
    • A61B17/132—Tourniquets
    • A61B17/135—Tourniquets inflatable
    • 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
    • A61B17/132—Tourniquets
    • A61B17/1322—Tourniquets comprising a flexible encircling member
    • A61B17/1325—Tourniquets comprising a flexible encircling member with means for applying local pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0042—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping
    • A61B2017/00455—Orientation indicators, e.g. recess on the handle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00902—Material properties transparent or translucent
    • A61B2017/00907—Material properties transparent or translucent for light

Definitions

  • the present invention relates to a hemostatic device.
  • a blood vessel e.g., a radial artery
  • various medical elongate bodies are introduced into the blood vessel through a puncture site formed in the blood vessel of the patient's arm.
  • Techniques for performing treatment or treatment on a site are known (see Patent Document 1 below).
  • a catheter procedure utilizing the radial artery is called a transradial artery approach, and is considered as a useful technique for coronary artery access and lower limb artery access, for example.
  • the radial artery located on the arm of the human body is connected to the palm artery bypassing the hand side. Therefore, at present, as a new technique of the transradial artery approach, the palmar artery (including the distal radial artery) is accessed from the anatomical snuff box located on the back side of the hand or from a position around the snuff box, and the vascular access is performed.
  • a catheter procedure using dTRA (distal transradial approach) for performing treatment through a site has been attempted.
  • 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 his hand or grasps his hand, the shape around the puncture site of the hand changes due to the movement of the hand. Therefore, when stopping 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 an appropriate pressure on the puncture site. In other words, there is a need for a hemostatic device in which the pressing member follows the movement of the hand and can effectively perform pressure hemostasis on a puncture site of a blood vessel located in the hand.
  • An object of the present invention is to provide a hemostatic device capable of maintaining a compressive force on a site to be performed.
  • a hemostatic device includes a pressing member disposed at a site of a patient's hand where hemostasis is to be performed, and a covering member that covers at least a part of the pressing member in a state where the pressing member covers the site where the hemostasis is to be performed.
  • the covering member has a fixing member for fixing the pressing member to at least one of the arm and the hand in a state where the pressing member covers the site to stop bleeding, and the pressing member Is provided on the covering member at a position where the center line of the pressing member does not coincide with the center line of the covering member, and the first member overlaps the fixing member in the longitudinal direction of the covering member on the covering member.
  • the second region is formed by fixing the pressing member to at least one of the arm of the patient and the hand of the patient with the covering member fixed to the first region by the fixing force applied by the fixing member to the first region. Is also held against the hand with a small force.
  • the covering member has the pressing member fixed to at least one of the arm and the hand, and the second region of the pressing member is fixed by the fixing member via the covering member. Since it is not tightened against the patient's skin, it means that when the patient moves his hand, the second region follows the hand movement more easily than the first region of the pressing member and moves more easily.
  • the hemostatic device covers at least a part of the pressing member in a state where the pressing member is disposed at a site where the hemostasis of the patient's hand is to be performed and the pressing member covers the site where the hemostasis is to be performed.
  • a covering member wherein the covering member fixes the pressing member to at least one of the arm of the patient and the hand of the patient in a state where the pressing member covers the site to stop bleeding.
  • the pressing member is provided on the covering member at a position where the center line of the pressing member does not match the center line of the covering member, and on the covering member in the longitudinal direction of the covering member.
  • 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 closer to the tip of the hand than the first region. Is held in the state of having. Therefore, when the patient moves his / her hand with the hemostatic device attached to the patient, the first region of the pressing member prevents displacement of the pressing member and the second region of the pressing member moves the hand. Deform to follow. Specifically, the first region of the pressing member is fastened to the patient's skin via the covering member by the fixing member. To prevent.
  • the hemostatic device is mounted on the patient. Is 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 portion where hemostasis is to be performed.
  • the second region of the pressing member is not fastened to the patient's hand by the fixing member in a state where the hemostatic device is mounted on the patient's hand. For this reason, the hemostatic device suppresses the movement of the hand on the fingertip side of the patient from being restricted by the fixing member when the device is mounted on the patient's hand. Therefore, the patient is not excessively restricted in hand movement even when the hemostatic device is worn.
  • FIG. 2 is a cross-sectional view of the hemostatic device, taken along arrows 2A-2A shown in FIG. 1, showing a state before an expansion member is expanded.
  • FIG. 2B is a cross-sectional view of the hemostatic device corresponding to FIG. 2A, showing a state where an expanding member is expanded.
  • FIG. 3 is a side view of the hemostatic device viewed from the direction of arrow 3A shown in FIG. 1. It is a perspective view for explaining the example of use of the hemostatic device concerning a 1st embodiment. It is a perspective view for explaining the example of use of the hemostatic device concerning a 1st embodiment.
  • FIG. 7 is a sectional view taken along arrows 7A-7A shown in FIG. 6, schematically showing a state in which a hemostatic device is attached to a patient. It is a figure showing the hemostatic device concerning a 2nd embodiment, and is the top view seen from the inner surface side of a covering member.
  • FIG. 9 is a cross-sectional view of the hemostasis device along an arrow 9A-9A shown in FIG. 8, showing a state before an expansion member is expanded.
  • FIG. 9B is a cross-sectional view of the hemostasis device corresponding to FIG. 9A, showing a state where an expansion member is expanded.
  • FIG. 11 is a cross-sectional view taken along the arrow 11A-11A shown in FIG. 10, schematically showing a state in which the hemostatic device is attached to a patient's hand. It is a figure showing the hemostatic device concerning a 3rd embodiment, and is a top view seen from the inner surface side of a covering member.
  • FIG. 13 is a cross-sectional view of the hemostatic device, taken along arrows 13A-13A shown in FIG. 12, showing a state before an expansion member is expanded.
  • FIG. 13B is a cross-sectional view of the hemostatic device corresponding to FIG. 13A, showing a state where an expanding member is expanded.
  • FIG. 15 is a cross-sectional view taken along arrows 15A-15A shown in FIG. 14, schematically showing a state in which a hemostatic device is attached to a patient's hand. It is a figure showing the hemostatic device concerning a 4th embodiment, and is a top view seen from the inner surface side of a covering member.
  • FIG. 17 is a sectional view of the hemostatic device, taken along arrows 17A-17A shown in FIG. 16, showing a state before the expansion member is expanded.
  • FIG. 17B is a cross-sectional view of the hemostasis device corresponding to FIG. 17A, showing a state where the expansion member is expanded.
  • FIGS. 1 to 4 are diagrams for explaining the hemostatic device 10 according to the first embodiment, and FIGS. 4 to 7 are diagrams for explaining an example of use of the hemostatic device 10.
  • the hemostatic device 10 travels on the instep Hb side of a hand (for example, left hand) H located closer to the finger than a forearm (corresponding to “arm”) A of the patient.
  • Puncture site t (“haemostasis”) formed on the radial artery side of palmar artery (deep palm artery) B1 (eg, an anatomical artery around the snuff box or a distal radial artery running on the fingertip side of the snuff box)
  • 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.
  • the hemostatic device 10 includes a pressing member 100 disposed at the puncture site t, and a cover that covers at least a part of the pressing member 100 in a state where the pressing member 100 covers the puncture site t. And a member 200.
  • the covering member 200 is a fixing member that fixes the pressing member 100 to at least one of the forearm A and the hand H in a state where the pressing member 100 covers the puncture site t. 210.
  • the pressing member 100 is configured by an expanding member including a bag body 110 expandable by injecting a fluid, and an expansion space 115 surrounded by the bag body 110. doing. 2A and 2B, the bag body 110 is connected to a support member 300 described later. Note that the bag 110 may be connected to at least one of the covering member 200 and a support member 300 described below. In the following description, the pressing member 100 will be described as the expanding member 100.
  • the tip side of the patient's hand H means the side where the fingertip of the hand H is arranged (the left side in FIG. 1).
  • the “inner surface” in each part of the hemostatic device 10 is a surface that is arranged to face the patient's body surface 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 disposed facing the body surface).
  • FIG. 1 is a plan view of the hemostatic device 10 viewed from the inner surface 200a side of the covering member 200.
  • the extension member 100 is provided on the covering member 200 at a position where the center line c1 of the extension member 100 does not match the center line c2 of the covering member 200.
  • the center line c1 of the extension member 100 is offset from the center line c2 of the covering member 200 toward the support member 300 provided on the covering member 200 (left side in FIG. 1).
  • the extension member 100 is fixed on the covering member 200 (in a range where the covering member 200 is continuous in the longitudinal direction of the covering member 200) in the longitudinal direction of the covering member 200.
  • a second region 102 (see FIG. 6) that is located closer to the distal end of the hand H than the first region 101. That is, the first region 101 is a part of the extension member 100 that overlaps the fixing member 210 in the longitudinal direction of the covering member 200 in a range where the covering member 200 is continuous in the longitudinal direction of the covering member 200.
  • the longitudinal direction of the covering member 200 is a direction along the arrow X1-X2 shown in FIG.
  • a direction orthogonal to the longitudinal direction of the covering member 200 is defined as a 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 of the covering member 200 in the width direction.
  • the center line c1 of the extension member 100 is a linear imaginary line passing through the center of the extension member 100 in the width direction (the left-right direction in FIG. 1) 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, for example, a shape such as a circle, an ellipse, and a polygon on the plan view shown in FIG. As described above, when the expansion member 100 is formed in a shape that does not have a substantially constant width along the longitudinal direction of the covering member 200, the center line c1 of the expansion member 100 is, for example, a plan view shown in FIG. At the center of the expansion member 100 in the width direction and extends substantially parallel to the center line c2 of the covering member 200.
  • the first region 101 of the expansion member 100 is formed at one end in the width direction of the expansion member 100 with reference to a boundary b1 between the first region 101 and the second region 102 of the expansion member 100. It is provided on the part 103 side.
  • the second region 102 of the expansion member 100 is provided on the other end 104 side of the expansion member 100 in the width direction with reference to the boundary portion b1.
  • the center line c1 of the expansion member 100 and the boundary b1 between the first area 101 and the second area 102 are arranged at overlapping positions on the plan view shown in FIG.
  • the hemostatic device 10 is mounted on the patient and the expansion member 100 is expanded, and the body surface of the patient (the body surface of the forearm A or the hand H) is expanded. (A body surface of the body).
  • the supporting member 300 is connected to the covering member 200 while covering the second region 102 of the expanding member 100.
  • the support member 300 is formed integrally with the covering member 200. As shown in FIG. 1, a portion where the covering member 200 extends so as to cover the second region 102 along the width direction of the expanding member 100 forms a supporting member 300. The support member 300 is disposed so as to cover the entire second region 102 along the width direction of the expansion member 100.
  • the support member 300 may be disposed so as to cover only a part of the second region 102. Further, the support member 300 can be configured as a member separate from the covering member 200 as described later (see FIG. 23).
  • the hemostatic device 10 is disposed between the support member 300 and the expansion member 100 (between the vertical direction shown in FIGS. 2A and 2B) and connected to the support member 300.
  • the auxiliary expansion member 400 is provided.
  • the auxiliary expansion member 400 has a space 415 communicating with the expansion space 115 of the expansion member 100, and a bag 410 that covers the space 415.
  • a communication hole 116 is formed in the bag 110 of the expansion member 100.
  • a communication hole 416 is formed in the bag 410 of the auxiliary expansion member 400.
  • the expansion space 115 of the expansion member 100 and the space 415 of the auxiliary expansion member 400 communicate with each other via the communication holes 116 and 416.
  • the length of the auxiliary expanding member 400 (the length along the longitudinal direction of the covering member 200) is substantially the same as the length of the expanding member 100 in the longitudinal direction.
  • the width of the auxiliary expansion member 400 (the width in a 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 ⁇ of the width of the expansion member 100.
  • the auxiliary expansion member 400 is disposed 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.
  • the auxiliary expansion member 400 is arranged such that the longitudinal direction of the auxiliary expansion member 400 is substantially parallel to the longitudinal direction of the covering member 200.
  • the first region 101 and the covering member 200 overlap in the expansion direction of the expansion member 100.
  • the second region 102, the auxiliary expansion member 400, and the support member 300 overlap in the expansion direction of the expansion member 100.
  • 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 ends 104, 304, and 404 are ends located on the left side (ends on which the covering member 200 is not disposed) of the members 100, 400, and 300 in the plan view of FIG. is there.
  • 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 be.
  • the expansion member 100 and the auxiliary expansion member 400 are connected to each other also around the communication hole 116 of the expansion member 100 and around the communication hole 416 of the auxiliary expansion member 400.
  • the support member 300 is formed integrally with the covering member 200. Therefore, the expansion member 100 and the auxiliary expansion member 400 are connected to the support member 300, and thus are connected to the covering member 200 via the support member 300.
  • the bag 110 of the expansion member 100 is formed of two sheet-like members.
  • the bag body 110 can be formed, for example, by joining the outer peripheral edges of two sheet-shaped members in a state where an expansion space 115 is formed between two sheet-shaped members formed in a substantially rectangular shape. it can.
  • the bag 410 of the auxiliary expansion member 400 can be formed of two joined substantially rectangular sheet-like members.
  • the expansion member 100 and the auxiliary expansion member 400 have one side located on the outer periphery of the expansion member 100 (one side located on the other end portion 104 in the width direction shown in FIG. 2B) and one side located on the outer periphery of the auxiliary expansion member 400 (FIG. 2B). Are connected to the support member 300.
  • the bag 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 expands, the vicinity of the center position (near the boundary part b1) of the expansion member 100 is higher than the one end 103 and the other end 104 of the expansion member 100 in the width direction. In the vertical direction (the 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, when the auxiliary expansion member 400 is expanded, the vicinity of the center position of the auxiliary expansion member 400 in the width direction (the left-right direction in FIG.
  • 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, and a state in which a compressive force is applied to the puncture site t. It can be suitably maintained.
  • the joining method of the sheet-like members forming the extension member 100 and the joining method of the sheet-like members forming the auxiliary extension member 400 are not particularly limited. For example, fusion or adhesion 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. For example, fusion or adhesion can be adopted. Further, a 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. 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-like 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 into which a fluid can flow is formed.
  • 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 of the covering member 200 in the width direction are not connected.
  • the hemostatic device 10 has a marker portion 117 for positioning the expansion member 100 with respect to the puncture site t.
  • the marker portion 117 is disposed at a position corresponding to a boundary portion b1 between the first region 101 of the expansion member 100 and the second region 102 of the expansion member 100.
  • the marker portion 117 is disposed at a position corresponding to a substantially central position in the longitudinal direction and the width direction of the expanding member 100 (a central position in the vertical direction and the horizontal direction in FIG. 1).
  • the marker portion 117 can be arranged on, for example, the inner surface of the surface (inner surface) on the side arranged to face the body surface of the expansion member 100.
  • the marker portion 117 is, for example, an inner surface or an outer surface of a surface (outer surface) opposite to a surface of the expanding member 100 facing the body surface of the expanding member 100, and an inner surface of the supporting member 300. It is also possible to arrange it on the surface or the outer surface.
  • the marker portion 117 is attached to the one end portion of the auxiliary expansion member 400. 403 may be arranged on the outer surface.
  • the marker part 117 is composed of, for example, a transparent central part and a colored linear frame surrounding the central part.
  • the surgeon can place the marker portion 117 at the puncture site t while confirming the puncture site t via the transparent central portion of the marker portion 117. Therefore, the surgeon can easily arrange the boundary portion b1 between the first region 101 and the second region 102 at the puncture site t using the marker portion 117.
  • the marker portion 117 may be formed, for example, only with a colored central portion without a frame portion.
  • the specific shape and color of the marker portion 117, the method of forming the marker portion 117 on the expansion member 100, and the like are not particularly limited.
  • a portion of the expansion member 100, the covering member 200, the support member 300, and the auxiliary expansion member 400 that overlaps the marker portion 117 in a plan view and its surroundings are translucent or colored and transparent. Thereby, even in a state where the marker portion 117 is superimposed on the puncture site t, the surgeon can visually recognize the puncture site t from the outer surface side of the covering member 200 and the outer surface side of the support member 300 (FIG. 6). See).
  • 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.
  • a fluid for example, a gas such as air
  • 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.
  • a fluid for example, a gas such as air
  • the injection section 500 includes a flexible tube 501, a bag 503 disposed 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 503 (see FIG. (Not shown).
  • the other end of the tube 501 opposite to the one end where the bag portion 503 is arranged is connected to the expansion member 100.
  • 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-like members forming the bag 110 of the expansion member 100, for example.
  • a convex portion that partially protrudes outward from the sheet-like member may be formed in a portion of the bag body 110 that sandwiches the tube 501. Good.
  • the lumen of the tube 501 communicates with the expansion space 115 of the expansion member 100.
  • the injection unit 500 is configured such that the tube 501 is connected to one end of the support member 300 in the longitudinal direction in a state where the other end of the tube 501 is connected to the expansion member 100 (the upper end in FIG. 1). Are drawn from.
  • the tube 501 is positioned on the side of the patient's hand H (in the direction in which the hand H extends) when the hemostatic device 10 is mounted on the patient, as described above. (See FIG. 5). Therefore, when the hemostatic device 10 is mounted on a patient, it is possible to prevent the tube 501 from interfering with the introducer 600.
  • the tube 501 may be disposed so as to be drawn out from the other end (the lower end in FIG. 1) of the support member 300 in the longitudinal direction, as shown in an embodiment (see FIG. 12) described later.
  • the surgeon or the like inserts the tip of the syringe (not shown) into the connector 505 of the injection part 500, opens the check valve, and pushes the pusher of the syringe. By pushing, the air in the syringe 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 of the auxiliary expansion member 400. 415.
  • the auxiliary expansion member 400 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 part 500 that communicates 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 surgeon or the like can easily visually confirm that the expansion member 100 and the auxiliary expansion member 400 can be pressurized without air leakage. When the expansion member 100 and the auxiliary expansion member 400 are to be contracted, the front cylinder portion of the syringe is inserted into the connector 505 of the injection section 500, and the pusher of the syringe is pulled to release the air inside the expansion member 100 and the auxiliary expansion. The air in the member 400 is discharged to the syringe.
  • the covering member 200 is formed of a flexible band-shaped member that can be wound substantially one round along the outer circumference near the wrist located on the tip side of the forearm portion A.
  • a first fixing portion 211 constituting the fixing member 210 is disposed on an inner surface 200 a of one end portion (upper end portion in FIG. 1) 201 of the covering member 200 in the longitudinal direction.
  • a second fixing portion 212 constituting the fixing member 210 is disposed on the outer surface 200b of the other end portion (lower end portion in FIG. 1) 202 of the covering member 200 in the longitudinal direction.
  • the first fixing portion 211 and the second fixing portion 212 are formed in a rectangular shape having long sides extending in the longitudinal direction of the covering member 200 on the plan view shown in FIG.
  • the first fixing portion 211 can be configured on the female side (or the male side) of the hook-and-loop fastener
  • the second fixing portion 212 can be configured on the male side (or the female side) of the hook-and-loop fastener, for example. it can.
  • the hook-and-loop fastener is a fastener that can be attached and detached from the surface, and is, for example, Magic @ Tape (registered trademark) or Velcro (registered trademark).
  • the specific structure of the fixing member 210 is not particularly limited as long as the fixing member 210 can fix the covering member 200 to at least one of the forearm portion A and the hand H of the patient.
  • a frame member or the like through which one longitudinal end 201 of the member 200 or the other longitudinal end 202 of the covering member 200 passes may be used.
  • the center line c2 of the covering member 200 is the center position of the fixing member 210 (the first fixing portion 211 and the second fixing portion 212) (the center position in the width direction of the fixing member 210). Center position in the left-right direction). Therefore, when the hemostatic device 10 is mounted on a patient, the fixing force of the fixing member 210 fixing the first region 101 of the expansion member 100 to the patient extends over substantially the entire first region 101 of the expansion member 100.
  • “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 moves the first region 101 of the expansion member 100 through the covering member 200 to the patient. A force that tightens against the skin.
  • the center line c2 of the covering member 200 is defined as 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 of the fixing member 210 in the width direction. That is, the center line c2 of the covering member 200 is not affected by the shape of the fixing member 210 in the plan view illustrated in FIG.
  • the center line c2 of the covering member 200 is, for example, a portion where the extension member 100 of the covering member 200 is arranged.
  • the shape of the fixing member 210 is not limited to a rectangle as shown in FIG. 1 as described in a modified example (see FIGS. 22 and 23) described later.
  • the material used for the covering member 200 is not particularly limited, for example, polyvinyl chloride, polyethylene, polypropylene, polybutadiene, polyolefin such as ethylene-vinyl acetate copolymer (EVA), polyethylene terephthalate (PET), polybutylene terephthalate ( PBT), various thermoplastic elastomers such as polyvinylidene chloride, silicone, polyurethane, polyamide elastomer, polyurethane elastomer, polyester elastomer, nylon, nylon elastomer, or any combination thereof (blend resin, polymer alloy, Laminated body).
  • EVA ethylene-vinyl acetate copolymer
  • PET polyethylene terephthalate
  • PBT polybutylene terephthalate
  • various thermoplastic elastomers such as polyvinylidene chloride, silicone, polyurethane, polyamide elastomer, polyurethane elastomer, polyester elasto
  • the material used for the support member 300 is not particularly limited, but when the support member 300 is formed integrally with the covering member 200, the same material as the above-described covering member 200 can be exemplified.
  • the material used for the support member 300 is preferably harder than the material used for the covering member 200.
  • materials include, for example, acrylic resins, polyvinyl chloride (especially rigid polyvinyl chloride), polyethylene, polypropylene, polyolefins such as polybutadiene, polystyrene, poly- (4-methylpentene-1), polycarbonate, ABS resin, Polymethyl methacrylate (PMMA), polyacetal, polyacrylate, polyacrylonitrile, polyvinylidene fluoride, ionomer, acrylonitrile-butadiene-styrene copolymer, polyester such as polyethylene terephthalate (PET), polybutylene terephthalate (PBT), butadiene-styrene Examples thereof include copolymers, aromatic or aliphatic polyamides, and fluorine-based resins such as polytetrafluoroethylene.
  • the hemostatic device 10 can be provided with a bag (pocket) at a portion where the support member 300 is arranged.
  • the support member 300 is, for example, a curved plate-like member (for example, a plate-like 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) that can be inserted into the bag portion. Can be configured. Further, the support member 300 may be fixed to the covering member 200 by sticking it to the surface of the covering member 200 with an adhesive or the like as shown in an embodiment described later (see FIG. 21).
  • 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 (the length in the vertical direction in FIG. 1) and the width of the expansion member 100 (the length in the horizontal direction in FIG. 1) are determined when the hemostatic device 10 is attached to the patient. There is no particular limitation as long as a pressing force can be applied to t. Further, the length and width in the longitudinal direction of the first region 101 and the second region 102 of the expansion member 100 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.
  • the length and width of the covering member 200 are not particularly limited as long as the covering member 200 can be fixed to at least one of the forearm A and the hand H of the patient in a state where the covering member 200 is attached.
  • the width of the covering member 200 is preferably shorter than the width of the expanding member 100 as shown in FIG.
  • the puncture site t of the hand H is formed at a position close to the stalk-like projection S of the ulna in the direction from the forearm A to the fingertip side (FIG. 5). See). Therefore, when the width of the covering member 200 is formed to be shorter than the width of the expanding member 100, when the hemostatic device 10 is attached to the patient as shown in FIGS. Can be arranged so as to be hooked on the stalk S of the ulna of the patient.
  • FIG. 4 shows a state where a part of the sheath tube 610 has been pulled out from the puncture site t after the above procedure has been completed.
  • the surgeon or the like arranges the boundary portion b1 between 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.
  • the surgeon or the like can easily arrange the boundary portion b1 at the puncture site t by checking the positions of the marker portion 117 and the puncture site t.
  • the surgeon or the like can arrange the first region 101 on the forearm A side and the second region 102 on the tip side of the hand H with reference to the vicinity of the puncture site t.
  • 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 fixes the hemostatic device 10 to the forearm A and the hand H of the patient using the fixing member 210 provided on the covering member 200.
  • the surgeon When the surgeon or the like attaches the hemostatic device 10 to a patient, as shown in FIG. 5, the surgeon arranges the outer peripheral edge of one end portion 203 of the covering member 200 in the width direction so as to be hooked on the pedicle S of the ulna of the patient. be able to.
  • the covering member 200 By disposing the covering member 200 in this manner, when the hemostatic device 10 is mounted on a patient, it is possible to suitably prevent the covering member 200 from being displaced from the stalk-shaped projection S of the ulna toward the forearm A side. .
  • the surgeon or the like expands the expansion member 100 and the auxiliary expansion member 400 using the injection section 500 (see FIG. 1) and a syringe (not shown).
  • the expansion member 100 and the auxiliary expansion member 400 expand, the expansion member 100 applies a pressing force to the puncture site t.
  • the surgeon or the like removes the sheath tube 610 of the introducer 600 from the puncture site t while maintaining a state in which the expanding member 100 applies a compressive force to the puncture site t. .
  • the surgeon or the like may further inject air into the expansion member 100 to increase the pressing force applied to the puncture site t.
  • the expansion member 100 keeps applying a compressive force to the puncture site t by maintaining the expanded member 100 in the expanded state.
  • the hemostatic device 10 attached to the patient has a circumferential direction near the wrist where the first region 101 of the expanding member 100 is located on the tip side of the forearm portion A together with the covering member 200 (indicated by arrows r1 and r2 in FIGS. 6 and 7).
  • Direction (the direction connecting the back of the hand Hb side and the palm side of the hand). Therefore, the first region 101 of the expansion member 100 is fastened to the vicinity of the forearm A and the vicinity of the forearm A of the hand H (near the wrist) by the fixing member 210 provided on the covering member 200.
  • the position at which the expansion member 100 is fixed to the patient's limb is not particularly limited.
  • the expansion member 100 may be fixed to one of the forearm A and the hand H, or the expansion member 100 may be fixed to both the forearm A and the hand H.
  • the hemostatic device 10 Before the hemostatic device 10 is attached to the patient, the hemostatic device 10 is configured such 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 a state in which the hemostatic device 10 is mounted on the patient, the second region 102 of the expansion member 100 is disposed closer to the distal end of the hand H than the fixing member 210 in the longitudinal direction of the covering member 200. Thus, the force applied by the fixing member 210 provided on the covering member 200 to 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.
  • the second region 102 of the expansion member 100 is movable to follow the movement of the finger of the hand H of the patient. Therefore, when the patient moves the finger, the movement of the finger becomes difficult to be transmitted from the second area 102 to the first area 101.
  • the expansion member 100 can suppress the entire expansion member 100 from moving along with the movement of the finger.
  • the expansion member 100 can suitably maintain the state where the first region 101 of the expansion member 100 is fixed to the forearm A of the patient. Therefore, the hemostatic device 10 can stably maintain a state in which the compressive force is effectively applied from the expansion member 100 to the puncture site t.
  • the auxiliary expansion member 400 is disposed between the expansion member 100 and the support member 300 (see FIG. 2B). Therefore, when the expanding member 100 expands, the auxiliary expanding member 400 suppresses the floating of the expanding member 100 from the body surface of the patient. Therefore, the expanding member 100 can effectively apply a compressive force to the puncture site t in a state where the expanding member 100 is expanded.
  • the auxiliary expansion member 400 is disposed 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 a 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 palm artery B located on the patient's hand H is meandering 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 can press the expansion member 100 over a wide range in the circumferential direction of the hand H.
  • the hemostatic device 10 is effective for the expansion member 100 on the distal radial artery side of the palm artery B. It becomes possible to apply a compressive force.
  • the other end 404 in the width direction of the auxiliary extension member 400 is connected to the support member 300, and one end 403 in the width direction of the auxiliary extension member 400 is connected to the support member 300. No (see FIG. 2B). Therefore, in a state where the hemostatic device 10 is mounted on the hand H of the patient and the auxiliary expansion member 400 is expanded, one end 403 of the auxiliary expansion member 400 in the width direction is the other end of the auxiliary expansion member 400 in the width direction.
  • the end portion 404 is used as a fulcrum, and is easily deformed following the movement of the hand H of the patient.
  • the auxiliary expansion member 400 can effectively prevent the expansion member 100 from rising from the body surface of the patient.
  • 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. Accordingly, 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 Suppress expansion in the direction away from. Therefore, the expansion member 100 can effectively apply a compressive force to the vicinity of the puncture site t even when the patient performs an operation such as gripping the hand H in a state where the expansion member 100 is expanded. .
  • the expansion member 100 is connected to the support member 300 (see FIG. 2B). Therefore, when the expansion member 100 expands, the expansion member 100 can be prevented from being displaced from the support member 300.
  • the auxiliary expansion member 400 is connected to the support member 300. Therefore, when the auxiliary expansion member 400 expands, the auxiliary expansion member 400 can be prevented from being displaced from the support member 300.
  • the second region 102 of the expansion member 100 is fastened to the patient's skin by the covering member 200. Absent.
  • the expansion member 100 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.
  • the hemostatic device 10 includes the expansion member (pressing member) 100 disposed at the puncture site t of the patient's hand H and the expansion member 100 with the expansion member 100 covering the puncture site t. And a covering member 200 that covers at least a part thereof, wherein 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 extension member 100 covers the puncture site t.
  • the fixing member 210 is provided.
  • the extension member 100 is provided on the covering member 200 at a position where the center line c1 of the extension member 100 does not coincide with the center line c2 of the covering member 200, and the fixing member is disposed on the covering member 200 in the longitudinal direction of the covering member 200.
  • the first region 101 includes a first region 101 overlapping with the second region 210 and a second region 102 disposed closer to the distal end of the hand H than the first region 101 is.
  • the second region 102 of the expanding member 100 is smaller than the fixing force applied by the fixing member 210 to the first region 101 when the covering member 200 fixes the expanding member 100 to at least one of the forearm A and the hand H. It is held against the hand H with a small force.
  • the hemostatic device 10 includes an expansion member (pressing member) 100 disposed at the puncture site t of the patient's hand H, and the expansion member 100 with the expansion member 100 covering the puncture site t. And a covering member 200 that covers at least a part thereof, wherein 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 extension member 100 covers the puncture site t.
  • the fixing member 210 is provided.
  • the extension member 100 is provided on the covering member 200 at a position where the center line c1 of the extension member 100 does not coincide with the center line c2 of the covering member 200, and the fixing member is disposed on the covering member 200 in the longitudinal direction of the covering member 200.
  • the first region 101 includes a first region 101 overlapping with the second region 210 and a second region 102 disposed closer to the distal end of the hand H than the first region 101 is.
  • the covering member 200 does not have the fixing member 210 for fixing the expansion member 100 to the hand H in a region extending to the second region 102 side.
  • the first region 101 of the expanding member 100 is firmly fixed to at least one of the forearm A and the hand H, and the second region 102 of the expanding member 100 is It is held in a state having mobility on the tip side of the hand H with respect to the area 101. Therefore, when the patient moves the hand H with the hemostatic device 10 attached to the patient, the first region 101 of the expanding member 100 prevents the expansion member 100 from being displaced and Since the second region 102 is not tightened to the surface of the hand H by the fixing member 210 than the first region 101 of the expansion member 100, the second region 102 is deformed so as to follow the movement of the patient's hand H.
  • the hemostatic device 10 When the hemostatic device 10 is attached to the patient, the second region 102 of the expansion member 100 is deformed so as to follow the movement of the patient's hand H as described above. Is 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 of the expansion member 100 on the puncture site t. In the hemostatic device 10, the second region 102 of the expansion member 100 is not fastened to the patient's hand H by the fixing member 210 in a state where the hemostatic device 10 is mounted on the patient's hand H.
  • the hemostatic device 10 suppresses the movement of the hand H on the fingertip side of the patient from being restricted by the fixing member 210 in a state of being mounted on the patient's hand H. Therefore, the movement of the hand H is not excessively restricted even when the patient wears the hemostatic device 10.
  • the pressing member 100 is an expansion member 100 including a bag body 110 expandable by injecting a fluid, and an expansion space 115 surrounded by the bag body 110. Therefore, the surgeon or the like operates 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 applies the expansion member 100 to the puncture site t.
  • the pressing force to be applied can be easily adjusted.
  • the hemostatic device 10 includes a support member 300 that suppresses expansion of the expanding member 100 in a direction away from the patient's body surface. Is more preferred.
  • the support member 300 prevents the second region 102 of the expansion member 100 from expanding in a direction away from the patient's body surface. Compression force can be effectively applied to this.
  • the support member 300 presses the surface of the bag 110 toward the patient's skin when the expansion member 100 expands, so that the support member 300 has an effect on the puncture site t. Compression force can be given to the user.
  • the hemostatic device 10 has the support member 300 which suppresses expansion of the expansion member 100 in the direction away from the patient's body surface.
  • 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 110 of the expansion member 100 is connected to the support member 300. Therefore, when the expansion member 100 expands, the expansion member 100 is suppressed from expanding in the direction away from the patient's body surface when the expansion member 100 expands, so that the puncture site t is effectively prevented. Compression force can be applied.
  • the support member 300 since the support member 300 is connected to the covering member 200, the support member 300 can be prevented from being displaced from the covering member 200 in a state where the hemostatic device 10 is attached to the patient. Further, since the expansion member 100 is connected to the support member 300, when the expansion member 100 expands, the second region 102 of the expansion member 100 can be prevented from being displaced from the support member 300.
  • the hemostatic device 10 is provided 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 includes a space 415 that communicates with the expansion space 115 of the expansion member 100, and a bag 410 that covers the space 415.
  • the auxiliary expansion member 400 suppresses the floating of the expansion member 100 from the body surface of the patient between the expansion member 100 and the support member 300. Therefore, the expansion member 100 is effective for the puncture site t while allowing the second region 102 of the expansion member 100 to deform along the longitudinal direction of the covering member 200 in a state where the expansion member 100 is expanded. Compression force can be applied to the body.
  • the auxiliary expansion member 400 since the auxiliary expansion member 400 is connected to the support member 300, when the auxiliary expansion member 400 expands, the auxiliary expansion member 400 can be prevented from being displaced from the support member 300.
  • 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, the auxiliary expansion member 400 is arranged over a wide range in the circumferential direction of the hand H when the hemostatic device 10 is mounted on the patient. Therefore, even when the distal radial artery side of the palm artery B located in the hand H of the patient is meandering along the circumferential direction of the hand H, the hemostatic device 10 allows the auxiliary expansion member 400 to move to the palm artery B. It can be arranged 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 expands can effectively apply a compressive force to the distal radial artery side of the palmar artery B.
  • hemostatic device 10 has marker portion 117 for positioning expansion member 100 with respect to puncture site t.
  • the marker portion 117 is disposed at a position corresponding to a 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 places the expansion member 100 at the puncture site t, the operator confirms the position of the marker portion 117, and thereby the boundary portion b1 between the first region 101 and the second region 102 of the expansion member 100 punctures the puncture site. t can be easily aligned.
  • the surgeon or the like can arrange the first region 101 of the expansion member 100 on the forearm A side when viewed from the puncture site t.
  • the region 102 can be arranged on the tip side of the hand H when viewed from the puncture site t. Therefore, the surgeon 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.
  • FIGS. 8, 9A, and 9B are diagrams for explaining the hemostatic device 10A according to the second embodiment
  • FIGS. 10 and 11 are diagrams 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.
  • the auxiliary expansion member 400A extends along a direction intersecting with the longitudinal direction of the covering member 200 (the width direction of the covering member 200 and the direction of arrow Y1-Y2 in the drawing).
  • the first region 101 of the expansion member 100, the second region 102 of the expansion member 100, and the support member 300 are disposed so as to overlap.
  • the length of the auxiliary extension member 400A along the longitudinal direction of the covering member 200 is approximately 2 of the length of the extension member 100 along the longitudinal direction of the covering member 200.
  • the auxiliary expansion member 400 ⁇ / b> A is arranged closer to the end 105 of the expansion member 100 located on the one end 201 side of the covering member 200 in the longitudinal direction.
  • the auxiliary expansion member 400A is arranged such that the extension direction (the 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.
  • the other end 104 in the width direction of the expansion member 100, the other end 404 of the auxiliary expansion member 400A, and the other end 304 in the width direction of the support member 300 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 be.
  • the expansion member 100 and the auxiliary expansion member 400A are also connected to each other also 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 cover 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 of the covering member 200 in the width direction are not connected.
  • the surgeon or the like positions the marker portion 117 disposed 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 at the puncture site t.
  • the expansion member 100 is placed on the forearm A and the hand H of the patient.
  • the surgeon or the like uses the fixing member 210 to fix the expansion member 100 to the patient.
  • the auxiliary expansion member 400A is arranged such that the auxiliary expansion member 400A is positioned closer to the end portion 105 of the expansion member 100 located on the one end portion 201 side of the covering member 200 in the longitudinal direction (see FIG. 8). . Therefore, in a state where the expansion member 100 is fixed to the patient, the auxiliary expansion member 400A is positioned on the outer side in the circumferential direction of the hand H (the side indicated by the arrow r2 in FIGS. When the upper Hb side of the hand H is set to the upper surface side of the hand H, the hand H is disposed on the side where the torso of the patient is disposed).
  • the palm artery B and the vein (cephalic vein) V located on the hand H are running in parallel depending on the site of the hand H of the patient to be subjected to hemostasis.
  • the vein V is located on the inner side in the circumferential direction of the hand H than the palmar artery B (the side indicated by the arrow r1 in FIGS. 10 and 11). (The side opposite to the side where the fuselage is located).
  • the expansion member 100 when performing the hemostasis, if the auxiliary expansion member 400A is arranged outside the hand H in the circumferential direction, the direction in which the expansion member 100 applies the compression force is the palm artery B Since the expansion member 100 is directed to the side, the expansion member 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 a compression force to the palmar artery B while suppressing applying an excessive compression force to the vein V.
  • the hemostatic device 10A similarly to the hemostatic device 10 according to the first embodiment, when the hemostatic device 10A is attached to a patient, the first region 101 of the expansion member 100 is attached to the covering member 200.
  • the second region 102 of the expansion member 100 can be deformed so as 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 of the expansion member 100 on the puncture site t.
  • FIGS. 12, 13A, and 13B are diagrams for explaining the hemostatic device 10B according to the third embodiment
  • FIGS. 14 and 15 are diagrams 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.
  • the auxiliary expansion member 400A extends along a direction intersecting with the longitudinal direction of the covering member 200 (the width direction of the covering member 200, the direction of arrow Y1-Y2 in the figure).
  • the first region 101 of the expansion member 100, the second region 102 of the expansion member 100, and the support member 300 are disposed so as to overlap.
  • the length of the auxiliary extension member 400B along the longitudinal direction of the covering member 200 is approximately ⁇ of the length of the extension member 100 along the longitudinal direction of the covering member 200.
  • the auxiliary expansion member 400B is arranged closer to the end 106 of the expansion member 100 located on the other end 202 side of the covering member 200 in the longitudinal direction.
  • the auxiliary extension member 400B is arranged such that the extension direction (the left-right direction in FIG. 12) of the auxiliary extension member 400B is orthogonal to the longitudinal direction of the covering member 200 on the plan view shown in FIG.
  • the other end 104 in the width direction of the expansion member 100, the other end 404 of the auxiliary expansion member 400B, and the other end 304 in the width direction of the support member 300 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 be.
  • 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 the communication hole 416 of the auxiliary expansion member 400B.
  • the expansion member 100 and the auxiliary expansion member 400B are connected to the cover 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 of the covering member 200 in the width direction are not connected.
  • the surgeon or the like aligns the marker portion 117 disposed at the boundary 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 expansion member 100 is placed on the forearm A and the hand H of the patient.
  • the surgeon or the like uses the fixing member 210 to fix the expansion member 100 to the patient.
  • the auxiliary expansion member 400B is disposed such that the auxiliary expansion member 400B is positioned close to the end 106 of the expansion member 100 located on the other end 202 side of the covering member 200 in the longitudinal direction (see FIG. 12). ). Therefore, in a state where the expansion member 100 is fixed to the patient, the auxiliary expansion member 400B is positioned inside the hand H in the circumferential direction (the side indicated by the arrow r1 in FIGS. 14 and 15) as shown in FIGS. Placed in
  • the palmar artery B located on the hand H and the nerve (shallow radial nerve) N run in parallel. Further, the nerve N travels outside the palm artery B in the circumferential direction of the hand H (on the side indicated by the arrow r2 in FIGS. 14 and 15).
  • the expansion member 100 when performing the hemostasis, if the auxiliary expansion member 400B is disposed inside the hand H in the circumferential direction, the direction in which the expansion member 100 applies the pressing force is the palm artery B Since the expansion member 100 is directed to the side, the expansion member 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 a compression force to the palmar artery B while suppressing applying an excessive compression force to the nerve N.
  • the hemostatic device 10B when the hemostatic device 10B is attached to a patient, the first region 101 of the expansion member 100 is attached to the covering member 200.
  • the second region 102 of the expansion member 100 can be deformed so as 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 of the expansion member 100 on the puncture site t.
  • FIGS. 16, 17A, and 17B are views showing a hemostatic device 10C according to the fourth embodiment.
  • the hemostatic device 10C according to the fourth embodiment does not include an auxiliary expanding member. In such a point, it differs from the hemostatic device 10 according to the first embodiment.
  • 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 provided in the injection section 500 is connected to the expansion member 100.
  • a method for connecting the tube 501 to the expansion member 100 a method similar to the method for connecting the tube 501 to the auxiliary expansion member 400 described in the first embodiment can be adopted.
  • 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 mounted on a patient.
  • the second region 102 of the expansion member 100 can be deformed so as 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 of the expansion member 100 on the puncture site t.
  • the hemostatic device 10C since the hemostatic device 10C includes the support member 300 that suppresses expansion of the expansion member 100 in a direction away from the patient's body surface, 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 patient's body surface, and a compression force can be effectively applied 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, when the expansion member 100 expands, the second region 102 of the expansion member 100 can be prevented from being displaced from the support member 300.
  • FIG. 18 is a diagram showing a hemostatic device 10D according to the fifth embodiment.
  • the hemostatic device 10D according to the fifth embodiment does not include the auxiliary expansion member and the support member. In such a point, it differs from the hemostatic device 10 according to the first embodiment.
  • the tube 501 provided in the injection section 500 is connected to the expansion member 100.
  • 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.
  • 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 mounted on a patient.
  • the second region 102 of the expansion member 100 can be deformed so as 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 of the expansion member 100 on the puncture site t.
  • FIG. 19 is a diagram showing a hemostatic device 10E according to the sixth embodiment.
  • the hemostatic device 10E is at a position where the center line c1 of the expansion member 100 and the boundary b1 between the first area 101 and the second area 102 are shifted.
  • the expansion member 100 is disposed at a position where the center line c1 of the expansion member 100 is shifted from the one end 203 in the width direction of the covering member 200 toward the other end 204 in the width direction (left side in FIG. 19).
  • the marker section 117 is disposed at a position corresponding to the second area 102 located between the center line c1 of the expansion member 100 along the longitudinal direction of the covering member 200 and the first area 101.
  • the marker portion 117 is arranged at the center position of the expansion member 100 (the center position in the longitudinal direction and the width direction in the plan view of FIG. 19).
  • the expansion member 100 may be arranged at a position where the center line c1 of the expansion member 100 is shifted from the boundary b1 between the first region 101 and the second region 102. Even in the case of such a configuration, the hemostatic device 10E can prevent the first region 101 of the expansion member 100 from being displaced in a state where the hemostatic device 10E is worn on the patient, and can prevent the first member 101 from moving to the puncture site t of the expansion member 100. Can maintain pressure.
  • the marker portion 117 is used. 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, so that the hemostatic device 10E is attached to the patient.
  • the vicinity of the center position of the expansion member 100 can be easily arranged with respect to the puncture site t.
  • the expansion member 100 can effectively apply a compressive 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 in any of the hemostatic devices described in the first to fifth embodiments.
  • FIG. 20 is a diagram showing a hemostatic device 10F according to the seventh embodiment.
  • a concave portion 201F that is concavely curved in the width direction of the covering member 200 is formed at one end portion 203 of the covering member 200F in the width direction.
  • 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.
  • FIG. 21 is a diagram showing a 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 by an adhesive or the like, for example. Even when the supporting member 300G is formed separately from the covering member 200 and is attached to the covering member 200, the supporting member 300G supports the second region 102 of the expanding member 100 from the outer surface side of the expanding member 100. Thereby, expansion of the expansion member 100 in a direction away from the patient's body surface can be suppressed.
  • the fixing member 210 described in each of the above-described embodiments has a substantially rectangular shape having a long side 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 expanding member (pressing member) 100 to the patient's limb can be applied. Is not particularly limited.
  • the fixing member 210 may have an arch shape as shown in FIG. Further, as shown in FIG. 23, the fixing member 210 may have a shape in which a notch is formed in a part of a circle. 22 and 23 illustrate only the first fixing portion 211 of the fixing member 210, the second fixing portion 212 can also be formed in the shape illustrated in FIGS. The fixing member 210 only needs to be able to connect the first fixing portion 211 and the second fixing portion 212. For example, the shape of the first fixing portion 211 and the shape of the second fixing portion 212 may be different.
  • the hemostatic device according to the present invention has been described 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 in the claims. is there.
  • a hemostatic device for stopping a puncture site formed on the back of the left hand is exemplified. It can also be used to stop the puncture site or the like formed on the palm.
  • the hemostatic device is used for a part other than the back of the left hand, the position of the auxiliary expansion member shown in the second or third embodiment is appropriately changed to a position where the auxiliary expansion member can exhibit a desired effect. be able to.
  • the pressing member is not limited to the expansion member described in each embodiment.
  • the pressing member is formed of, for example, a mechanical member capable of changing the amount of pressing against the hand by an external operation such as rotation, a resin material such as plastic or the like, which is pressed against the hand to apply a surface pressure, or a gel.
  • Member a member containing a gel whose water content decreases with time to gradually reduce the compression force, an elastic material such as a sponge-like substance, an aggregate of fibers such as cotton (cotton), a metal,
  • a member having a predetermined three-dimensional shape (such as a sphere, an ellipsoid, or a triangular pyramid) or a combination of these members may be used.
  • expansion member pressing member
  • 101 first area 101 first area
  • 102 second area 103 one end in the width direction of the expansion member
  • 104 the other end in the width direction of the expansion member
  • 110 bags 115 expansion space, 117 marker part, 200, 200F covering member, 200a inner surface of the covering member, 200b outer surface of the covering member, 201 one end in the longitudinal direction of the covering member, 202 the other end in the longitudinal direction of the covering member, 203 one end in the width direction of the covering member;
  • 204 the other end in the width direction of the covering member 210 fixing member, 211 first fixed part, 212 second fixing part, 300, 300G support member, 304

Abstract

Le problème décrit par la présente invention est de fournir un instrument hémostatique apte, même en cas de mouvement ou analogue d'une main, pendant que l'hémostase est effectuée, à avoir une partie d'un élément de pression afin de suivre le mouvement de la main de façon à permettre à l'élément de pression de maintenir une force de compression exercée sur un site soumis à une hémostase. La solution selon l'invention porte sur un instrument hémostatique (10) qui est équipé d'un élément d'expansion (100) qui est disposé sur un élément de couverture (200) à une position où la ligne centrale (c1) de l'élément d'expansion n'est pas alignée avec la ligne centrale (c2) de l'élément de couverture, et qui a, sur l'élément de couverture, une première région (101) chevauchant un élément de fixation (210) dans la direction longitudinale de l'élément de couverture, et une seconde région (102) disposée plus près d'un côté d'extrémité distale de la main (H) que la première région. La seconde région de l'élément d'expansion est retenue sur la main à l'aide d'une force inférieure à une force de fixation communiquée à la première région par l'élément de fixation, tandis que l'élément de couverture maintient l'élément d'expansion fixé à la partie d'avant-bras et/ou à la main.
PCT/JP2019/037614 2018-09-26 2019-09-25 Instrument hémostatique WO2020067164A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2018-180210 2018-09-26
JP2018180210A JP2022036331A (ja) 2018-09-26 2018-09-26 止血器具

Publications (1)

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WO2020067164A1 true WO2020067164A1 (fr) 2020-04-02

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JP (1) JP2022036331A (fr)
WO (1) WO2020067164A1 (fr)

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5968072A (en) * 1993-12-20 1999-10-19 Medical Wraps, Inc. Method and apparatus for cold compression treatment of wounds
US20170224357A1 (en) * 2016-02-10 2017-08-10 Robert Tremaine Whalen Barrel Inflatable Belt

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5968072A (en) * 1993-12-20 1999-10-19 Medical Wraps, Inc. Method and apparatus for cold compression treatment of wounds
US20170224357A1 (en) * 2016-02-10 2017-08-10 Robert Tremaine Whalen Barrel Inflatable Belt

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