WO2022068202A1 - 医用锁扣及医用锁结装置 - Google Patents

医用锁扣及医用锁结装置 Download PDF

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Publication number
WO2022068202A1
WO2022068202A1 PCT/CN2021/091873 CN2021091873W WO2022068202A1 WO 2022068202 A1 WO2022068202 A1 WO 2022068202A1 CN 2021091873 W CN2021091873 W CN 2021091873W WO 2022068202 A1 WO2022068202 A1 WO 2022068202A1
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WO
WIPO (PCT)
Prior art keywords
medical
lock
push rod
locking
wire
Prior art date
Application number
PCT/CN2021/091873
Other languages
English (en)
French (fr)
Inventor
李阳
梁伟林
张庭超
Original Assignee
杭州德晋医疗科技有限公司
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
Priority claimed from CN202011062838.5A external-priority patent/CN114305551A/zh
Priority claimed from CN202022220707.7U external-priority patent/CN214017664U/zh
Application filed by 杭州德晋医疗科技有限公司 filed Critical 杭州德晋医疗科技有限公司
Publication of WO2022068202A1 publication Critical patent/WO2022068202A1/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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials

Definitions

  • the present application relates to the technical field of medical devices, and in particular, to a medical lock and a medical lock device provided with the medical lock.
  • the prior art discloses a medical lock, in which a hollow inner cavity is arranged in the main body of the lock, and the locking pin moves axially along the inner cavity, so that the gap between the locking pin and the inner surface of the inner cavity is gradually reduced. A suture passing through the lumen is secured. However, since the gap between the suture thread is gradually narrowed by the locking pin and the inner surface of the lumen, the suture thread is squeezed between the two to complete the locking knot.
  • the suture thread It will be continuously pulled, which will easily cause relative movement between the locking pin and the lock body, increase the gap between the locking pin and the inner surface of the inner cavity, and cause the locking force to the suture to decrease or even The phenomenon that the suture is loosened from the lock and the lock falls off, causing a certain risk to the human body.
  • the technical problem to be solved by the present application is to provide a medical lock and a medical lock device provided with the medical lock in view of the defects of the prior art.
  • the present application first provides a medical lock for locking medical wires, including a lock body, a wire locking member, a push rod, and a position locking structure; the wire locking member is movably arranged on the In the lock body, the distal end of the push rod abuts the lock wire member to drive the lock wire member to move in the lock lock body, so that the medical wire is clamped to the lock lock between the main body and the locking wire member; when the medical wire is clamped, the position locking structure pushes against or pulls the push rod to keep the locking wire member and the locking main body relative position.
  • the present application also provides a medical locking device, comprising at least the medical lock and a manipulation assembly, the manipulation assembly is detachably connected to the proximal end of the push rod, and the manipulation assembly is used to control the push rod action, and the control assembly is separated from the proximal end of the push rod after the relative position of the push rod and the lock body remains unchanged.
  • the push rod drives the lock wire to move in the lock body to prevent After the medical wire is clamped between the locking main body and the locking wire member, the position locking structure can keep pushing against or pulling the push rod, and the distal end of the push rod pushes against the push rod.
  • the locking wire is connected to the locking wire, so that the relative position of the locking wire and the locking main body can be prevented from changing, and the gap between the locking wire and the locking main body for clamping the medical wire can be maintained. , effectively preventing the medical wire from loosening from between the locking wire member and the lock body, so as to achieve firm locking of the medical wire.
  • FIG. 1 is a schematic structural diagram of the first embodiment of the medical locking device of the present application.
  • FIG. 2 is a schematic three-dimensional structural diagram of the first embodiment of the medical lock in FIG. 1 .
  • FIG. 3 is a schematic exploded perspective view of the medical lock in FIG. 2 .
  • FIG. 4 is a schematic three-dimensional structural diagram of the lock body in FIG. 3 from a viewing angle.
  • FIG. 5 is a cross-sectional view of the lock body and the stopper in FIG. 3 .
  • FIG. 6 is a schematic view of the end structure of the medical lock in FIG. 2 after the stopper is omitted.
  • FIG. 7 is a side view of the initial state of the medical lock in FIG. 2 .
  • FIG. 8 is a side view of the medical lock in FIG. 2 in a locked state.
  • FIG. 9 is a sectional view of the initial state of the medical lock in FIG. 2 .
  • FIG. 10 is a cross-sectional view of the medical lock in FIG. 2 in a locked state.
  • FIG. 11 is a schematic three-dimensional structural diagram of the handle shell of the medical locking device in FIG. 1 .
  • FIG. 12 is a schematic three-dimensional structural diagram of the handle case in FIG. 11 after removing its upper case.
  • FIG. 13 is a cross-sectional view taken along line XIII-XIII in FIG. 1 .
  • FIG. 14 is a cross-sectional view of the steering assembly of FIG. 12 .
  • FIG. 15 is a schematic three-dimensional structural diagram of the limiting assembly in FIG. 12 .
  • FIG. 16 is a schematic three-dimensional structural diagram of the medical lock and part of the first inner core and part of the second inner core in FIG. 13 .
  • FIG. 17-26 are schematic diagrams of the use process of the medical locking device provided in the first embodiment of the present application, wherein FIG. 17 is a schematic diagram of a tricuspid valve with sutures sewed; FIG. 19 is a schematic diagram of the medical locking device in FIG. 18 .
  • Fig. 20 illustrates that the medical locking device approaches the tricuspid valve along the suture;
  • Fig. 22 is an enlarged cross-sectional view of the structure of the distal end portion of the medical locking device in Fig. 21;
  • FIG. 24 is an enlarged cross-sectional view of the structure of the distal end portion of the medical locking device in FIG. 23 ;
  • FIG. 26 is an enlarged schematic view at XXVI in FIG. 25 .
  • FIG. 27 is a schematic three-dimensional structural diagram of the second embodiment of the medical lock of the present application.
  • FIG. 28 is an exploded perspective view of the medical lock in FIG. 27 .
  • FIG. 29 is a side view of the initial state of the medical lock in FIG. 27 .
  • FIG. 30 is a side view of the locked state of the medical lock in FIG. 27 .
  • FIG. 31 is a cross-sectional view of the initial state of the medical lock in FIG. 27 .
  • FIG. 32 is a cross-sectional view of the medical lock in FIG. 27 in a locked state.
  • FIGS. 34 , 36 and 38 illustrate the state of the distal end of the medical locking device.
  • 35 and FIG. 37 respectively illustrate the operation states on the handle case corresponding to FIGS. 34 , 36 and 38 .
  • proximal end refers to the end that is far away from the operator during the surgical operation
  • proximal end refers to the end that is close to the operator during the surgical operation
  • proximal end in this application is relative to the distal distance from the operator ( The distance between the surgeon and the surgeon is relatively short, and after the device is assembled, each of the components includes a proximal end and a distal end, wherein the proximal end of each component is closer to the operator than the distal end.
  • Axial refers to the direction of the central axis of the device, and the radial direction is the direction perpendicular to the central axis. Unless otherwise defined, all technical and scientific terms used in this application have the same meaning as commonly understood by one of ordinary skill in the technical field to which this application belongs. The common terms used in the specification of the present application are only for the purpose of describing specific embodiments, and should not be construed as limitations of the present application.
  • an element when an element is referred to as being “disposed on” another element, the element can be directly connected to the other element or indirectly connected to the other element through one or more connecting elements.
  • an element When an element is referred to as being “connected to” another element, it can be directly connected to the other element or connected to the other element through one or more connecting elements.
  • the medical locking device 100 includes a medical lock 20 , a handle shell 40 , a manipulation component 50 , a support tube component 70 , and a limit component 80 .
  • the medical lock 20 is used to lock the medical thread 300 (the medical thread 300 can be a suture used for suturing an incision or a breach, or a suture used for edge-to-edge repair of the heart valve, or used as an artificial tendon.
  • the repair thread of the cable can also be a suture implanted on the internal tissue of the human body such as the valve ring, etc.
  • the material of the medical thread 300 includes but is not limited to PTFE, e-PTFE, PET, UHMWPE, etc.), and the medical lock 20 includes The buckle body 21 , the locking wire member 23 , the push rod 25 and the position locking structure 27 , the locking wire member 23 is movably arranged in the locking buckle body 21 , the distal end of the push rod 25 abuts the locking wire member 23 , and the control assembly 50 controls the push rod 25 act to drive the locking wire member 23 to move in the locking main body 21, so that the medical wire 300 is clamped between the locking main body 21 and the locking wire member 23;
  • the position locking structure 27 pushes against the push rod 25 to keep the relative position of the wire lock member 23 and the lock wire member 21 unchanged.
  • the distal end of the control assembly 50 is detachably connected with the proximal end of the push rod 25 , the proximal end extends out of the handle shell 40 , and the control assembly 50 is connected to the push rod 25 after the relative position of the locking wire 23 and the locking body 21 remains unchanged. separation.
  • the support tube assembly 70 extends distally from the handle shell 40 for accommodating the medical lock 20 , the manipulation assembly 50 and the limiting assembly 80 .
  • the distal end of the limit assembly 80 is detachably connected with the lock body 21 , and the proximal end extends out of the handle shell 40 for cooperating with the limit structure provided on the lock body 21 to drive the lock wire 23 on the push rod 25 During the movement within the lock body 21, the lock body 21 is prevented from moving.
  • the medical lock 20 and the medical lock device 100 are provided with the position locking structure 27 , the push rod 25 drives the lock wire 23 to move in the lock body 21 so that the medical wire 300 is clamped between the lock body 21 and the lock body 21 .
  • the position locking structure 27 can keep pushing against the push rod 25 , and the distal end of the push rod 25 abuts against the wire locking member 23 .
  • the lock body 21 is provided with an accommodating space 210 and a threading slot 211 communicating with the accommodating space 210 .
  • the pressure roller 230 and the medical wire 300 are inserted between the threading groove 211 and the pressure roller 230; during the movement of the push rod 25 from the proximal end of the lock main body 21 to the distal end of the lock main body 21, the pressure roller 230 is driven in the container. move in the installation space 210 to change the position relative to the lock body 21, so that the gap between the outer peripheral surface of the pressing roller 230 and the bottom surface of the threading groove 211 is gradually reduced until the medical thread 300 inserted in the gap is clamped .
  • the lock body 21 includes a distal end surface 212, a proximal end wall 213, two opposite first side walls 214 and two opposite second side walls 215 located between the distal end surface 212 and the proximal end wall 213.
  • the outer surfaces of the first side walls 214 are parallel and opposite planes, and the outer surfaces of the two second side walls 215 are opposite arc surfaces.
  • the accommodating space 210 is surrounded by two first side walls 214 , two second side walls 215 and a proximal end wall 213 , and the distal end of the accommodating space 210 penetrates the distal end surface 212 of the lock body 21 .
  • the threading slot 211 communicates with the accommodating space 210 .
  • the threading slot 211 is recessed downward from the inner surface of one of the second side walls 215 (shown in FIG. 4 ).
  • the sides are respectively provided with support tables 2150 .
  • the threading groove 211 extends in the axial direction, one end of the threading groove 211 penetrates the distal surface 212 of the main body 21 of the lock, and the other end of the threading groove 211 penetrates the gap 216 provided at the proximal end of the main body 21 of the lock, and the medical thread 300 passes through the threading groove After 211, it protrudes from the gap 216.
  • the lock body 21 is provided with two guide grooves 2140 aligned with each other corresponding to the two first side walls 214 .
  • the distal end of the 210 extends and gradually approaches the bottom surface of the support table 2150 and the threading slot 211 .
  • the thread locking member 23 further includes a roller 232 connected to the pressing roller 230 , and the roller 232 is matched with the guide groove 2140 .
  • the guide groove 2140 intersects with the distal end of the support table 2150 and then extends to the distal end along the support table 2150 and penetrates through the distal end surface 212 of the lock body 21 .
  • the outline of the guide groove 2140 is preferably an arc shape, and the arc shape is curved toward the side where the wire threading groove 211 is located.
  • the shape of the pressing roller 230 is generally cylindrical, and the pressing roller 230 is fixedly sleeved in the middle of the roller 232 .
  • the opposite end surfaces of the pressing roller 230 extend in the direction of the center line.
  • the opposite ends of the roller 232 are respectively connected with blocking pieces 234 , and the size of the blocking pieces 234 along the radial direction of the roller 232 is larger than the groove width of the guide groove 2140 , so as to prevent the locking wire 23 from being in the accommodating space 210 of the locking body 21 . Shake a lot.
  • the blocking pieces 234 at the opposite ends of the roller 232 can also be omitted.
  • a guide rail (not shown) may be provided on the side wall of the lock body 21 corresponding to the accommodating space 210 instead of the guide groove 2140 .
  • the distal end extends and gradually approaches the bottom surface of the threading groove 211, and the roller 23 is adapted to the guide rail.
  • two opposite guide rails are provided on the two first side walls 214 of the lock body 21 , and each guide rail extends from the proximal end of the accommodating space 210 away from the side of the notch 216 to the distal end of the accommodating space 210 . And gradually approach the threading slot 211 .
  • the opposite ends of the roller 232 can be rolled on the two guide rails, respectively.
  • the roller 232 rolls along the guide rail to drive the pressing roller 230 to roll, and the pressing roller 230 gradually approaches the bottom surface of the threading groove 211 so as to be inserted into the threading groove 211
  • the medical wire 300 is clamped between the pressing roller 230 and the bottom surface of the threading groove 211 .
  • the diameter of the pressing roller 230 , the diameter of the medical wire 300 , the height of the distal end of the guide groove 2140 , and the maximum height of the bottom surface of the threading groove 211 from the distal end of the guide groove 2140 Satisfaction: 0 ⁇ H1-H2/2-D1/2 ⁇ D2, wherein, H1 represents the maximum height value of the bottom surface of the threading groove 211 from the distal end of the guide groove 2140, H2 represents the height value of the distal end of the guide groove 2140, D1 represents the diameter value of the pressing roller, and D2 represents the diameter value of the medical wire.
  • the gap A between the position of the outer peripheral surface of the pressure roller 230 closest to the bottom surface of the threading groove 211 and the bottom surface of the threading groove 211 is equal to the width of the threading groove 211.
  • the maximum height value of the bottom surface from the distal end of the guide groove 2140 minus 1/2 of the height value of the distal end of the guide groove 2140 and 1/2 of the diameter value of the pressing roller 230, that is, A H1-H2/2-D1 /2;
  • A H1-H2/2-D1 /2;
  • the roller 232 When the push rod 25 pushes against the pressing roller 230 axially to the distal end, the roller 232 is guided by the guiding groove 2140 while rolling in the guide groove 2140 and approaches the bottom surface of the threading groove 211 , which drives the pressing roller 230 to the threading groove 211 The bottom surface approaches until the medical wire 300 in the threading groove 211 is locked between the outer peripheral surface of the pressing roller 230 and the bottom surface of the threading groove 211 .
  • spaced locking screw holes 2131 and limit screw holes 2133 are defined on the proximal end wall 213 of the lock main body 21 .
  • the locking screw holes 2131 is closer to the middle of the proximal wall 213 than the limiting screw hole 2133 .
  • the locking screw hole 2131 is coaxial with the lock body 21 .
  • the locking screw hole 2131 and the limiting screw hole 2133 both extend in the axial direction, and the locking screw hole 2131 communicates with the accommodating space 210 .
  • the push rod 25 includes a rod body 251 and a radial protrusion 253 disposed at the distal end of the rod body 251.
  • the diameter of the radial protrusion 253 is larger than the diameter of the rod body 251.
  • the rod body 251 is provided with a transmission thread 255, the transmission thread 255 and the lock
  • the locking screw holes 2131 on the main body 21 are screwed.
  • the axial force of 230 on the push rod makes the drive thread 255 on the push rod 25 and the thread on the locking screw hole 2131 squeeze each other to achieve self-locking, so as to maintain the relative relationship between the pressing roller 230 and the threading groove 211 position, even if the medical wire 300 is pulled, the position of the pressure roller 230 will not be changed, and the gap between the pressure roller 230 and the threading groove 211 can be clamped to clamp the medical wire 300, so as to prevent the medical wire 300 from loosening and keep the medical wire 300 in place. 300 firm lock knot. That is, in the present embodiment, the position locking structure 27 includes the locking screw hole 2131 on the lock main body 21 and the transmission thread 255 on the push rod 25 .
  • the position locking structure 27 further includes a stopper 29 to define the distal extreme position of the locking wire member 23 to stop the locking wire member 23 from disengaging from the locking main body 21 .
  • the stopper 29 includes a baffle plate 291 and blocking blocks 293 protruding on opposite sides of the proximal end surface of the baffle plate 291 .
  • the two blocking blocks 293 are respectively clamped into the distal openings of the two guide grooves 2140 of the lock body 21.
  • the blocking blocks 293 are used to stop the roller 232 from continuing to roll to the distal end in the guide groove 2140.
  • Plate 291 is used to define the distal extreme position of press roller 230 .
  • the baffle plate 291 is provided with a threading hole 295 , the threading hole 295 communicates with the threading groove 211 of the lock body 21 , and the medical thread 300 is inserted into the threading groove 211 after passing through the threading hole 295 .
  • the proximal end of the push rod 25 is also connected with a first joint 28 .
  • the first joint 28 is exposed outside the lock body 21 .
  • the proximal end surface of the push rod 25 is provided with a fixing hole 256 for fixedly connecting the first joint 28 .
  • the first joint 28 includes a connecting portion 281 and a fixing post 283 disposed at the distal end of the connecting portion 281 .
  • the fixing post 283 and the fixing hole 256 can be fixedly connected by means of screwing, welding or the like.
  • the connecting portion 281 is detachably connected to the distal end of the first inner core 51 in the manipulation assembly 50 described later.
  • the first joint 28 and the push rod 25 can also be integrally formed.
  • the limit screw holes 2133 on the lock body 21 and the two first side walls 214 form a limit structure, wherein the limit screw holes 2133 are screwed with the limit screws 83 at the distal end of the limit component 80 described later, so as to be in
  • the locking body 21 is prevented from moving axially;
  • Corresponding planes in the cavity fit together to prevent the locking body 21 from rotating when the push rod 25 drives the locking wire member 23 to move within the locking body 21 .
  • a group of medical wires 300 are inserted between the outer peripheral surface of the pressing roller 230 and the bottom surface of the threading groove 211, and the first joint 28 is driven to rotate, so that the push The rod 25 rotates relative to the locking screw hole 2131 and moves axially toward the distal end, and the radial protrusion 253 of the push rod 25 pushes against the push roller 230 to drive the wire locking member 23 along the guide groove 2140 toward the baffle 291 and the threading groove 211
  • the bottom surface of the pressure roller 230 moves, the gap between the outer peripheral surface of the pressing roller 230 and the bottom surface of the threading groove 211 gradually decreases until the medical wire 300 is clamped between the outer peripheral surface of the pressing roller 230 and the bottom surface of the threading groove 211;
  • the thread locking between the transmission thread 255 of the rod 25 and the locking screw hole 2131 can prevent the relative position of the locking body 21 and the locking wire 23 from changing, and prevent the medical wire 300
  • the locking body 21 , the locking wire member 23 and the push rod 25 can all be, but are not limited to, processed from biocompatible metal materials such as stainless steel, nickel-titanium, and pure titanium.
  • the handle shell 40 includes an upper shell 41 and a lower shell 42 which are matched with each other, and a front screw 43 threadedly engaged with the upper shell 41 and the lower shell 42 .
  • the outer tube fixing member 44 is fixedly installed in the inner cavity of the lower shell 42 , and the proximal end of the outer tube 75 in the support tube assembly 70 is fixedly connected with the outer tube fixing member 44 .
  • the handle housing 40 is provided with a first baffle 46 and a second baffle 47 arranged at intervals, and a third baffle 48 and a fourth baffle 49 arranged at intervals.
  • first baffle 46 and the second baffle 47 are arranged in the middle of the proximal end of the inner cavity of the lower shell 42
  • third baffle 48 and the fourth baffle 49 are arranged in the proximal middle of the inner cavity of the lower shell 42 adjacent to the middle.
  • the locking body 21 is movably passed through the distal end of the support tube assembly 70 ; the distal end of the control assembly 50 is detachably connected to the push rod 25 , and the proximal end extends out of the handle shell 40; the distal end of the limiting component 80 is screwed with the locking body 21, and the proximal end extends out of the handle shell 40.
  • the support tube assembly 70 includes a sleeve 71 , a connecting cylinder 73 and an outer tube 75 which are sequentially connected from the distal end to the proximal end.
  • the lock body 21 is movably passed through the sleeve 71 , the opposite sides of the sleeve 71 are provided with planes that fit with the outer surfaces of the two first side walls 14 of the lock body 21 , and the planes of the first side walls 14 are The flat surfaces in the sleeve 71 are in contact with each other to prevent the locking body 21 from rotating when the push rod 25 drives the locking wire member 23 to move in the locking body 21 .
  • the sleeve 71 has an inner cavity 711 extending through its distal end surface and proximal end surface in the axial direction.
  • the locking body 21 is placed in the inner cavity 711 of the sleeve 71 and can only slide axially in the inner cavity 711 .
  • the proximal end of the outer peripheral wall of the sleeve 71 is provided with a wire outlet notch 713 corresponding to the wire threading groove 211 , and the medical wire 300 in the wire threading groove 211 extends out of the support tube assembly 70 from the wire outlet notch 713 .
  • the distal end surface of the connecting cylinder 73 is fixedly attached to the proximal end surface of the sleeve 71 .
  • the connecting cylinder 73 is provided with a first through groove 731 and a second through groove 733 at intervals along the axial direction.
  • the middle part is aligned with the push rod 25
  • the second through slot 733 is aligned with the limit screw hole 2133 of the lock body 21 .
  • the proximal end of the connection barrel 73 is fixedly connected with the distal end of the outer tube 75 .
  • the outer tube 75 is a flexible tube with a supporting effect and can be bent, so as to facilitate insertion into the lumen of the human body.
  • the manipulation assembly 50 includes a first inner core 51 and a connecting rod 52 connected to the distal end of the first inner core 51 .
  • the first inner core 51 is movably inserted into the outer tube 75.
  • the first inner core 51 is flexible and bendable; the distal end of the connecting rod 52 is provided with a second The joint 521, the second joint 521 is detachably connected to the first joint 28 of the push rod 25, and further, the first joint 28 and the second joint 521 are respectively provided with complementary shapes of "Z" shape, "S" shape, tooth Concave-convex structure such as shape or wave shape.
  • first connector 28 and the second connector 521 are connected and inserted into the first through groove 731 of the connecting cylinder 73, the connection between the two is maintained; when the first connector 28 and the second connector 521 lose their peripheral connection When the envelope of the first through groove 731 is exposed, such as when the distal end of the sleeve 71 is exposed, the second joint 521 and the first joint 28 can be disengaged to release the connection between the two.
  • the control assembly 50 further includes a first control button 54 exposing the proximal end of the handle shell 40 and a first cylindrical member 55 detachably connected to the first control button 54 .
  • the first control button 54 is disposed on the first The proximal end of the barrel 55 .
  • the proximal end of the first inner core 51 moves through the outer tube 75 and the outer tube fixing member 44 and is then fixedly connected to the first control button 54 .
  • the first cylindrical member 55 When the relative positions of the first cylindrical member 55 and the first control button 54 are locked, the first cylindrical member 55 can rotate with the first control button 54 and move in the axial direction together; when the first cylindrical member 55 is opposite to the first control button 54 When the position is not locked, the first manipulation member 55 can move in the axial direction relative to the first cylindrical member 55 .
  • the first control button 54 includes a hollow housing 541 , a connecting post 543 axially extending in the housing 541 , and an end cap 545 disposed at the proximal end of the housing 541 and fixedly connected to the connecting post 543 .
  • An annular guide chute 546 is provided between the connecting post 543 and the housing 541 , and the proximal end of the first cylindrical member 55 is slidably inserted into the guide chute 546 in the axial direction.
  • a guide rod 551 is protruded from the distal end of the first cylindrical member 55 in the axial direction, and a sliding guide hole 553 is provided in the middle of the proximal end surface of the first cylindrical member 55 in the axial direction.
  • the connecting column 543 is slidably inserted into the sliding guide hole 553 Inside.
  • the proximal end of the first inner core 51 axially passes through the first cylindrical member 55 and is fixedly connected to the end cap 545 .
  • the guide rod 551 is movably embedded in the gaps respectively provided on the first baffle plate 46 and the second baffle plate 47 .
  • the guide rod 551 is provided with a first retaining ring 555 protruding in the circumferential direction.
  • the first cylindrical member 55 can rotate relative to the first baffle plate 46 and the second baffle plate 47 , and can be positioned between the first baffle plate 46 and the second baffle plate 47 In other words, the first retaining ring 555 can be blocked between the first baffle 46 and the second baffle 47 .
  • the casing 541 is provided with a screw hole 547 which communicates with the guide chute 546 along its radial direction.
  • the first control button 54 also includes a tightening screw 548 screwed into the screw hole 547.
  • the cylinder member 55 and the first control button 54 are fixed together to act synchronously. On the contrary, when the tightening screw 548 is loosened, the first cylinder member 55 and the first control button 54 can act respectively.
  • a displacement mark is further provided on the outer peripheral surface of the first cylindrical member 55 , and the displacement mark is used to display the axial movement amount of the first control knob 54 relative to the first cylindrical member 55 .
  • the distal end of the limiting component 80 is detachably connected to the lock body 21 , and the limiting component 80 cooperates with the limiting screw holes 2133 provided on the lock body 21 to
  • the push rod 25 drives the locking wire member 23 to move in the lock body 21
  • the lock body 21 is prevented from moving axially, and the limiting assembly 80 is connected to the lock before the manipulation assembly 50 is separated from the proximal end of the push rod 25 .
  • the buckle body 21 is separated so as not to hinder the medical lock 20 from being pushed out of the sleeve 71 .
  • the limiting assembly 80 includes a second inner core 81 and a limiting screw 83 connected to the distal end of the second inner core 81 , and the second inner core 81 is movably inserted into the outer tube 75 .
  • the second inner core 81 is flexible and bendable.
  • the limit screw 83 can be movably inserted into the second through groove 733 of the connecting cylinder 73 , and the limit screw 83 can be adapted and screwed with the limit screw hole 2133 of the lock main body 21 .
  • the limit screw 83 When the limit screw 83 is screwed into the limit screw hole 2133, the limit screw 83 can prevent the lock main body 21 from moving in the axial direction; after the limit screw 83 is released from the screw connection with the limit screw hole 2133, the lock main body 21 It can be driven by the push rod 25 to move in the axial direction.
  • the limiting assembly 80 further includes a second control button 84 exposing the proximal end of the handle shell 40 and a second cylindrical member 85 fixedly connected with the second control button 84 .
  • the proximal end of the second inner core 81 moves through the outer tube 75 and the outer tube fixing member 44 and is then fixedly connected to the second cylindrical member 85 or the second control button 84 .
  • the second cylindrical member 85 is movably embedded in the notches respectively provided on the third baffle plate 48 and the fourth baffle plate 49 .
  • the second cylindrical member 85 is provided with a second retaining ring 86 protruding in the circumferential direction.
  • the ring 86 is located between the third baffle 48 and the fourth baffle 49 .
  • the second cylindrical member 85 can rotate relative to the third baffle plate 48 and the fourth baffle plate 49, and can move axially between the third baffle plate 48 and the fourth baffle plate 49, that is, the second baffle ring 86 can stop the between the third baffle 48 and the fourth baffle 49 .
  • valve repairing of the tricuspid valve of the heart as an example to describe the use process of the medical locking device 100 provided by the first embodiment of the present application.
  • the tricuspid valve is a one-way "valve" between the right atrium (referred to as: RA) and the right ventricle (referred to as: RV), allowing blood to flow from the right atrium to the right ventricle.
  • RA right atrium
  • RV right ventricle
  • a normal healthy tricuspid valve has multiple chordae tendineae.
  • the leaflets of the tricuspid valve are divided into anterior leaflets, posterior leaflets and septal leaflets.
  • a plurality of medical wires with elastic spacers 310 (in this example can be referred to as the anterior leaflet, posterior leaflet and septal leaflet of the tricuspid valve) are implanted respectively.
  • suture) 300 the point contact between the suture 300 and the valve leaflet is transformed into a surface contact between the elastic gasket 310 and the valve leaflet, which can effectively reduce the risk of leaflet tearing; the free end of the suture 300 extends out of the body.
  • Step 1 As shown in FIG. 18 and FIG. 19 , pass a plurality of sutures 300 from the threading hole 295 into the threading slot 211 and out of the thread outlet notch 713 outside the patient's body.
  • the pressing roller 230 is close to the proximal end of the locking body 21; the first joint 28 and the second joint 521 are inserted into the first through groove 731 of the connecting cylinder 73; the limit screw 83 is screwed with the limit screw hole 2133 ;
  • the tightening screw 548 is tightened, the first cylinder 55 and the first control button 54 are fixed together; the first retaining ring 555 is attached to the first baffle 46; combine.
  • Step 2 As shown in FIG. 20 , and referring to FIGS. 21 and 22 , with the guidance of the suture 300 , the distal end of the support tube assembly 70 is pushed into the right atrium of the heart through the interventional path (eg, femoral vein, inferior vena cava) , move closer to the leaflet of the tricuspid valve, adjust the tightness of the suture 300 on each leaflet at the same time, and at the same time determine the lightest state of tricuspid regurgitation by ultrasound, when this state is reached, rotate the first control knob 54
  • the first inner core 51 , the connecting rod 52 and the push rod 25 are driven to rotate, so that the radial protrusion 253 at the distal end of the push rod 25 abuts the push roller 230 , and the roller 232 faces the baffle 291 and the threading groove 211 along the guide groove 2140 the bottom surface of the pressing roller 230 and the bottom surface of the threading groove 211 gradually decrease until the thread 300 is clamped between the outer
  • the second stopper 47 indicates that the medical lock 20 has locked the suture 300 .
  • the limit screw 83 is kept screwed with the limit screw hole 2133 to prevent the lock main body 21 from moving to the distal end in the axial direction.
  • Step 3 Referring to FIG. 21 and FIG. 22 , rotate the second control knob 84 to drive the second inner core 81 to rotate, and the second inner core 81 drives the limit screw 83 to rotate relative to the lock body 21 until the limit screw 83 is disengaged Screw connection with the limit screw hole 2133. At this time, the second retaining ring 86 moves from the third baffle 48 to abut against the fourth baffle 49 .
  • Step 4 As shown in Figures 23 and 24, loosen the tightening screw 548 to release the relative locking between the first control button 54 and the first cylinder 55, and push the first control button 54 to the distal end to drive the
  • the first inner core 51 moves toward the distal end in the axial direction, the first inner core 51 pushes against the push rod 25 and the entire medical lock 20 and exposes the sleeve 71 , the outer envelope of the first joint 28 and the second joint 521 disappears, The connection between the first connector 28 and the second connector 521 is released.
  • the medical locking device 100 is withdrawn, and the suture 300 outside the medical locking buckle 20 is cut off by using the thread cutting device.
  • the medical lock 20 and the sutures 300 locked by it are indwelled in the heart.
  • the leaflets of the tricuspid valve are pulled toward each other by a plurality of sutures 300 to complete the edge pairing. Edge repair.
  • the medical locking buckle and the medical locking device can also be used for the repair of the tricuspid valve chordae tendineae (the medical thread is used as an artificial chordae tendineae, one end of the medical thread is sewn on the valve leaflet, and the other end is pierced on the ventricular wall or the papillary muscle anchored on the anchors and locked by medical locks), mitral valve edge-to-edge repair, mitral valve chordae tendineae repair, annuloplasty (multiple anchors are anchored into the annulus tissue, and medical threads are connected in series with each anchor At the proximal end, the medical thread is tightened to reduce the valve area and then locked with a medical lock), as well as the locking and fixing of the medical thread during other surgical procedures such as simple incision or suture.
  • the structure of the medical lock 20a provided in the second embodiment of the present application is similar to that of the first embodiment, but the position locking structure 27a of the medical lock 20a in the second embodiment
  • the structure of the position locking structure 27 in the first embodiment is slightly different.
  • the structure of the manipulation assembly 50 a of the second embodiment of the medical locking device is also slightly different from that of the manipulation assembly 50 of the first embodiment.
  • the position locking structure 27a includes a through hole 2135 which penetrates through the lock body 21a in the axial direction for the push rod 25a to move through.
  • the radial protrusion 253 surrounds the distal end of the rod body 251 of the push rod 25 a, and the outer diameter of the radial protrusion 253 is larger than the diameter of the rod body 251 .
  • the through hole 2135 penetrates the proximal end wall 213 of the lock body 21a in the axial direction and communicates with the accommodating space 210.
  • the diameter of the through hole 2135 is greater than or equal to the diameter of the rod body 251, but smaller than the diameter of the radial protrusion 253.
  • the radially protruding portion 253 can be movably inserted into the through hole 2135 , and the radially protruding portion 253 can stop in the through hole 2135 to prevent the push rod 25 a from separating from the locking body 21 a from the through hole 2135 .
  • the compression elastic member 275 is preferably a compression spring.
  • the compression spring 275 When the proximal end of the push rod 25a is not pulled by an external force, the compression spring 275 will automatically pop open, and the radial protrusion 253 at the distal end of the self-driving push rod 25a pushes against the push roller 230 to drive the wire locking member 23 along the guide groove 2140 moves toward the baffle 291 and the bottom surface of the threading groove 211, and the gap between the outer peripheral surface of the pressing roller 230 and the bottom surface of the threading groove 211 gradually decreases until the medical wire 300 is clamped between the outer peripheral surface of the pressing roller 230 and the threading groove 211.
  • the distance between the first baffle 46 at the proximal end of the first baffle ring 555 of the manipulation assembly 50 a and the second baffle 47 at the distal end is smaller than that in the first embodiment.
  • the distance between the first baffle 46 and the second baffle 47 in this second embodiment is equal to or slightly larger than the axial thickness of the first baffle ring 555 , the first baffle 46 and the second baffle 47 It is used for axially positioning the first retaining ring 555 to prevent the first cylindrical member 55 from being driven to move in the axial direction when the compression spring 275 is opened.
  • a displacement amount mark 557 is provided on the outer peripheral surface of the first cylindrical member 55 , and the displacement amount mark 557 includes numbers "0", "1" and "2" at intervals from the proximal end to the distal end.
  • the medical locking device of the second embodiment when the medical locking device of the second embodiment is in the initial state, the numbers “0”, “1” and “2” on the displacement indicator 557 are exposed outside the first control button 54 .
  • the tightening screw 548 is tightened, the first cylindrical member 55 and the first control button 54 are fixed together, the compression elastic member 275 is in a compressed state, and the locking wire member 23 is located at the proximal end of the guide groove 2140 .
  • the position between the first control button 54 and the first cylindrical member 55 can also be relatively limited or released through the cooperation of the positioning rod and the positioning hole between the first control button 54 and the first cylindrical member 55 Specifically, the outer peripheral surface of the first cylindrical member 55 is provided with a first positioning hole in the radial direction, and the outer peripheral wall of the first control button 54 is provided with a second positioning hole corresponding to the first positioning hole.
  • the positioning rod is inserted into the first positioning hole
  • the first control button 54 and the first cylindrical member 55 are in the hole and the second positioning hole, the position between the first control button 54 and the first cylinder member 55 is relatively limited;
  • the knob 54 is axially movable relative to the first cylinder member 55 .
  • a tension elastic member such as a tension spring can also be used to replace the compression elastic member 275 in the above-mentioned second embodiment.
  • the stretch elastic member when the stretch elastic member is used, the stretch elastic member is no longer provided in the accommodating space 210 of the lock body 21a, but is set outside the accommodating space 210.
  • One end still abuts the portion of the lock body 21a on the periphery of the through hole 2135, and the other end extends proximally and is connected to the proximal end of the push rod 25a, such as by welding.
  • the stretch elastic member When the push rod 25a is subjected to an external force towards the proximal end, the stretch elastic member is stretched open; when the external force on the push rod 25a is released, the stretch elastic member automatically shrinks, and is driven from the far side of the push rod 25a.
  • the end pressing roller 230 drives the thread locking member 23 to move along the guide groove 2140 toward the baffle plate 291 and the bottom surface of the threading groove 211. 300 is clamped between the outer peripheral surface of the pressing roller 230 and the bottom surface of the threading groove 211; after that, since the proximal end of the push rod 25a is always pulled by the stretching elastic member toward the distal end, it can prevent the lock body 21a from contacting the lock.
  • the relative position of the wire member 23 is changed to prevent the medical wire 300 from being released between the wire locking member 23 and the locking body 21a. That is, in this embodiment, when the medical wire is clamped, the position locking structure pulls the push rod 25a to maintain the relative position of the wire locking member 23 and the lock main body 21a.

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Abstract

一种医用锁扣(20)包括锁扣主体(21)、锁线件(23)、推杆(25)以及位置锁定结构(27)。锁线件(23)活动设置于锁扣主体(21)内；推杆(25)的远端抵接锁线件(23)。推杆(25)驱动锁线件(23)在锁扣主体(21)内运动以使得医用线(300)被夹紧于锁扣主体(21)与锁线件(23)之间，位置锁定结构(27)能够保持抵顶或牵拉推杆(25)，推杆(25)的远端又抵接锁线件(23)，从而能够防止锁线件(23)与锁扣主体(21)的相对位置发生变化，保持锁线件(23)与锁扣主体(21)之间得以夹紧医用线(300)的间隙，有效防止医用线(300)从锁线件(23)与锁扣主体(21)之间松脱，从而实现对医用线(300)的牢固锁结。还同时公开了相应的医用锁结装置(100)。

Description

医用锁扣及医用锁结装置 技术领域
本申请涉及医疗器械技术领域，尤其涉及一种医用锁扣及设置有所述医用锁扣的医用锁结装置。
背景技术
在手术中经常需要对医用线(如缝合线、用作人工腱索的修复线、对瓣膜做缘对缘修复的修复线等)进行打结并固定的操作步骤，传统外科手术是在开刀直视条件下操作，通常由医生手动打结。但是随着技术的进步，各种微创手术及介入手术日益普遍，例如腔镜下手术、经导管介入手术等，这类手术只需在患者身体上切开较小的操作窗口，由此将内窥镜或介入导管等器械伸入患者体内，到达预定位点进行治疗。在这类手术中，如需对患者体内的医用线进行打结或固定操作，通常需要操作者通过较小的操作窗口，在患者体外进行远程操作来对患者体内的医用线进行打结。
现有技术公开了一种医用锁扣，在锁扣主体内设置中空的内腔，锁定销沿内腔轴向运动，使得锁定销与所述内腔的内表面之间的间隙逐渐变小来固定穿设在该内腔中的缝合线。然而，由于缝合线是靠锁定销与所述内腔的内表面之间间隙逐渐变小，把缝合线挤压在二者之间完成锁结，在手术操作过程中及手术完成后，缝合线会被不断地拉扯，容易使锁定销与所述锁扣主体之间发生相对运动，使锁定销与所述内腔的内表面之间的间隙增大，导致对缝合线的锁结力下降甚至发生缝合线从锁扣中松脱、锁扣脱落的现象，对人体造成一定的风险。
发明内容
有鉴于此，本申请要解决的技术问题在于，针对现有技术的缺陷，提供一种医用锁扣及设置有所述医用锁扣的医用锁结装置。
为了解决上述技术问题，本申请首先提供了一种医用锁扣，用于锁紧医用线，包括锁扣主体、锁线件、推杆，以及位置锁定结构；所述锁线件活动设置于所述锁扣主体内，所述推杆的远端抵接所述锁线件，以驱动所述锁线件在所述锁扣主体内运动，使得所述医用线被夹紧于所述锁扣主体与所述锁线件之间；在所述医用线被夹紧的状态下，所述位置锁定结构抵顶或牵拉所述推杆，以保持所述锁线件与所述锁扣主体的相对位置。
本申请还提供了一种医用锁结装置，至少包括所述医用锁扣以及操控组件，所述操控组件与所述推杆的近端可拆卸连接，所述操控组件用于控制所述推杆的动作，且所述操控组件在所述推杆与所述锁扣主体的相对位置保持不变后与所述推杆的近端分离。
本申请提供的医用锁扣及设置有所述医用锁扣的医用锁结装置，由于设置有所述位置锁定结构，在所述推杆驱动所述锁线件在所述锁扣主体内运动以使得所述医用线被夹紧于所述锁扣主体与所述锁线件之间后，所述位置锁定结构能够保持抵顶或牵拉所述推杆，所述推杆的远端又抵接所述锁线件，从而能够防止所述锁线件与所述锁扣主体的相对位置发生变化，保持所述锁线件与所述锁扣主体之间得以夹紧所述医用线的间隙，有效防止所述医用线从所述锁线件与所述锁扣主体之间松脱，从而实现对所述医 用线的牢固锁结。
附图说明
为了更清楚地说明本申请实施例的技术方案，下面将对实施方式中所需要使用的附图作简单地介绍，显而易见地，下面描述中的附图是本申请一些实施方式，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其他的附图。
图1是本申请的医用锁结装置的第一实施例的结构示意图。
图2是图1中医用锁扣的第一实施例的立体结构示意图。
图3是图2中的医用锁扣的立体分解示意图。
图4是图3中的锁扣主体在一视角下的立体结构示意图。
图5是图3中的锁扣主体与止挡件的剖视图。
图6是图2中的医用锁扣省略止挡件后的端部结构示意图。
图7是图2中的医用锁扣的初始状态的侧视图。
图8是图2中的医用锁扣的锁紧状态的侧视图。
图9是图2中的医用锁扣的初始状态的剖视图。
图10是图2中的医用锁扣的锁紧状态的剖视图。
图11是图1中的医用锁结装置的手柄壳的立体结构示意图。
图12是图11中的手柄壳除去其上壳后的立体结构示意图。
图13是图1中沿XIII-XIII线的剖视图。
图14是图12中的操控组件的剖视图。
图15是图12中的限位组件的立体结构示意图。
图16是图13中的医用锁扣与部分第一内芯及部分第二内芯的立体结构示意图。
图17-图26是本申请第一实施例提供的医用锁结装置的使用过程示意图，其中图17为三尖瓣瓣膜上缝有缝线的示意图；图19是图18中医用锁结装置的远端部分结构的剖视放大图；图20示意出了该医用锁结装置沿缝线接近三尖瓣瓣膜；图22是图21中医用锁结装置的远端部分结构的剖视放大图；图24是图23中医用锁结装置的远端部分结构的剖视放大图；图26是图25中XXVI处的放大示意图。
图27是本申请的医用锁扣的第二实施例的立体结构示意图。
图28是图27中的医用锁扣的立体分解示意图。
图29是图27中的医用锁扣的初始状态的侧视图。
图30是图27中的医用锁扣的锁紧状态的侧视图。
图31是图27中的医用锁扣的初始状态的剖视图。
图32是图27中的医用锁扣的锁紧状态的剖视图。
图33-图38是本申请第二实施例提供的医用锁结装置的使用过程示意图；其中，图34、图36、图38示意出了该医用锁结装置远端的状态，图33、图35、图37分别示意出了对应于图34、图36、图38的手柄壳上的操作状态。
具体实施方式
下面将结合本申请实施例中的附图，对本申请实施例中的技术方案进行清楚、完整地描述，显然，所描述的实施例仅仅是本申请一部分实施例，而不是全部的实施例。基于本申请中的实施例，本领域普通技术人员在没有付出创造性劳动前提下所获得的所有其他实施例，都属于本申请保护的范围。
在本申请的描述中，需要说明的是，术语“上”、“下”、“内”、“外”等指示的方位或位置关系为基于附图所示的方位或位置关系，仅是为了便于描述本申请和简化描述，而不是指示或者暗示所指的装置或者元件必须具有特定的方位、以特定的方位构造和操作，因此不能理解为对本申请的限制。此外，术语“第一”、“第二”等仅用于描述目的，而不能理解为指示或暗示相对重要性。
为了更加清楚地描述导线锁定系统及导线锁定装置的结构，本申请所述的限定术语“近端”、“远端”及“轴向”为介入医疗领域惯用术语。具体而言，“远端”表示手术操作过程中远离操作人员的一端；“近端”表示手术操作过程中靠近操作人员的一端；本申请中的所述近端相对于远端距离操作者(外科医生)的距离较近，装置组装后，其中的每个部件均包括近端与远端，其中每个部件的近端相对远端距离操作者较近。“轴向”指装置中轴线所在方向，径向为与中轴线垂直的方向。除非另有定义，本申请所使用的所有的技术和科学术语与属于本申请的技术领域的技术人员通常理解的含义相同。本申请在说明书中所使用的惯用术语只是为了描述具体实施例的目的，并不能理解为对本申请的限制。
需要说明的是，当元件被称为“设置于”另一个元件时，该元件可以直接地连接在另一个元件上，也可以通过一个或者多个连接元件间接地连接在另一个元件上。当一个元件被称为是“连接于”另一个元件，它可以是直接地连接到另一个元件上，或者通过一个或者多个连接元件连接到另一元件上。
请参阅图1至图3及图7至图10，本申请第一实施例的医用锁结装置100包括医用锁扣20、手柄壳40、操控组件50、支撑管组件70，以及限位组件80。医用锁扣20用于锁紧医用线300(医用线300可以是单纯用于缝合切口或破口的缝线，也可以是用于对心脏瓣膜做缘对缘修复的缝线、用作人工腱索的修复线、还可以是植入在瓣环等人体内部组织上的缝线等，医用线300的材料包括但不限于PTFE、e-PTFE、PET、UHMWPE等)，医用锁扣20包括锁扣主体21、锁线件23、推杆25及位置锁定结构27，锁线件23活动设置于锁扣主体21内，推杆25的远端抵接锁线件23，操控组件50控制推杆25动作，以驱动锁线件23在锁扣主体21内运动，使得医用线300被夹紧于锁扣主体21与锁线件23之间；位置锁定结构27与推杆25相配合，在医用线300被锁扣主体21和锁线件23夹紧的状态下，位置锁定结构27抵顶推杆25，以保持锁线件23与锁扣主体21的相对位置不变。操控组件50的远端与推杆25的近端可拆卸连接、近端延伸出手柄壳40，且操控组件50在锁线件23与锁扣主体21的相对位置保持不变后与推杆25分离。支撑管组件70自手柄壳40向远端延伸，用于容置医用锁扣20、操控组件50及限位组件80。限位组件80的远端与锁扣主体21可拆卸连接、近端延伸出手柄壳40，用于与设于锁扣主体21上的限位结构配合，以在推杆25驱动锁线件23在锁扣主体21内运动的过程中，防止锁扣主体21运动。
该医用锁扣20及医用锁结装置100，由于设置有位置锁定结构27，在推杆25驱动锁线件23在锁扣主体21内运动以使得医用线300被夹紧于锁扣主体21与锁线件23之间后，位置锁定结构27能够保持抵顶推杆25，推杆25的远端又抵接锁线件23，即使医用线300受到牵拉，也能够防止锁线件23与锁扣主体21的相对位置发生变化，锁扣主体21与锁线件23之间不会松动，保持锁线件23与锁扣主体 21之间得以夹紧医用线300的间隙，有效防止医用线300从锁线件23与锁扣主体21之间松脱，从而实现对医用线300的牢固锁结。
具体地，请一并参阅图2至图4，锁扣主体21内开设有容置空间210及连通容置空间210的穿线槽211，锁线件23包括活动容置于容置空间210内的压辊230，医用线300穿装于穿线槽211与压辊230之间；推杆25自锁扣主体21的近端向锁扣主体21的远端的运动过程中，驱动压辊230在容置空间210中运动，以变换相对于锁扣主体21的位置，使得压辊230的外周面与穿线槽211的底面之间的间隙逐渐减小，直至夹紧穿装于间隙中的医用线300。
锁扣主体21包括远端面212、近端壁213、以及位于远端面212与近端壁213之间的相对的两个第一侧壁214及相对的两个第二侧壁215，两个第一侧壁214的外表面为平行相对的平面，两个第二侧壁215的外表面为相对的圆弧面。容置空间210由两个第一侧壁214、两个第二侧壁215及近端壁213围成，且容置空间210的远端贯穿锁扣主体21的远端面212。穿线槽211与容置空间210相连通，具体地，穿线槽211自其中一第二侧壁215的内表面向下凹陷(图4所示)，锁扣主体21内于穿线槽211相对的两侧分别设有支撑台2150。穿线槽211沿轴向延伸，穿线槽211的一端穿通锁扣主体21的远端面212，穿线槽211的另一端穿通设于锁扣主体21的近端的缺口216，医用线300经穿线槽211后从缺口216伸出。
本实施例中，锁扣主体21对应于两第一侧壁214上设有两相互对正的导槽2140，导槽2140自容置空间210的近端远离缺口216的一侧向容置空间210的远端延伸并逐渐趋近于支撑台2150及穿线槽211的底面。锁线件23还包括连接于压辊230的滚轴232，滚轴232与导槽2140相适配。进一步地，导槽2140与支撑台2150的远端相交后沿支撑台2150向远端延伸并穿通锁扣主体21的远端面212。导槽2140的轮廓优选为弧形，该弧形朝向穿线槽211所在的一侧弯曲。压辊230的形状概呈圆柱形，压辊230固定套设于滚轴232的中部，压辊230与滚轴232共轴心线，即滚轴232相对的两端分别沿压辊230的轴心线方向延伸出压辊230相对的两端面。滚轴232相对的两端分别连接有挡片234，挡片234沿滚轴232径向的尺寸大于导槽2140的槽宽，以防止锁线件23在锁扣主体21的容置空间210内大幅晃动。
在一些其他实施例中，由于压辊230的直径已大于导槽2140的宽度，滚轴232相对两端的挡片234也可以省略。
在一些其他实施例中，锁扣主体21对应于容置空间210的侧壁上可以设置导轨(未图示)来代替导槽2140，导轨自容置空间210的近端向容置空间210的远端延伸并逐渐趋近于穿线槽211的底面，滚轴23与所述导轨适配。进一步地，锁扣主体21的两个第一侧壁214上设有相对的两个导轨，每一导轨自容置空间210的近端远离缺口216的一侧向容置空间210的远端延伸并逐渐趋近于穿线槽211。滚轴232相对的两端分别可滚动设于两个导轨上，滚轴232沿导轨滚动，带动压辊230滚动，且压辊230逐渐接近穿线槽211的底面，使得穿设于穿线槽211内的医用线300被夹紧于压辊230与穿线槽211的底面之间。
请一并参阅图5及图6，压辊230的直径值、医用线300的直径值、导槽2140的远端的高度值、穿线槽211的底面距导槽2140的远端的最大高度值满足：0≤H1-H2/2-D1/2≤D2，其中，H1表示穿线槽211的底面距导槽2140的远端的最大高度值，H2表示导槽2140的远端的高度值，D1表示所述压辊的直径值，D2表示所述医用线的直径值。具体地，在压辊230与穿线槽211的底面夹紧医用线300时， 压辊230的外周面最靠近穿线槽211底面的部位与穿线槽211的底面之间的间隙A等于穿线槽211的底面距导槽2140的远端的最大高度值减去导槽2140的远端的高度值的1/2和压辊230的直径值的1/2，即有A＝H1-H2/2-D1/2；为了使压辊230的外周面与穿线槽211的底面牢固地夹紧穿装于间隙A中的医用线300，间隙A的直不能大于医用线300的直径值。压辊230沿其轴向的长度值W1小于或等于穿线槽211的宽度值W2，从而压辊230可以无障碍地进入穿线槽211内。当推杆25沿轴向向远端抵推压辊230时，滚轴232在导槽2140内边滚动边受导槽2140引导而向穿线槽211底面趋近，带动压辊230向穿线槽211底面趋近，直至穿线槽211内的医用线300被锁固于压辊230的外周面与穿线槽211的底面之间。
如图2、图3、图5、图9及图10所示，本实施例中，锁扣主体21的近端壁213上开设间隔的锁定螺孔2131及限位螺孔2133，锁定螺孔2131较限位螺孔2133更靠近近端壁213的中部位置，优选地，锁定螺孔2131与锁扣主体21共轴。锁定螺孔2131及限位螺孔2133均沿轴向延伸，锁定螺孔2131连通容置空间210。推杆25包括杆体251及设于杆体251远端的径向凸出部253，径向凸出部253的直径大于杆体251的直径，杆体251上设有传动螺纹255，传动螺纹255与锁扣主体21上的锁定螺孔2131螺接。当旋转推杆25时，传动螺纹255在锁定螺孔2131内螺旋运动，推杆25相对于锁扣主体21发生同步的轴向移动，推动着压辊230向远端运动，且压辊230逐渐靠近穿线槽211的底面，直至压辊230与穿线槽211之间的医用线300被二者压紧；此后，停止旋转推杆25，推杆25远端因抵推压辊230而受到压辊230对推杆的轴向作用力，使得推杆25上的传动螺纹255与锁定螺孔2131上的螺牙之间相互挤压而实现自锁，从而能够保持压辊230与穿线槽211的相对位置，即使医用线300受到牵拉，也不会改变压辊230的位置，保持压辊230与穿线槽211之间得以夹紧医用线300的间隙，防止医用线300松脱，保持对医用线300的牢固锁结。即，本实施例中，位置锁定结构27包括锁扣主体21上的锁定螺孔2131及推杆25上的传动螺纹255。
位置锁定结构27还包括止挡件29，以限定锁线件23的远端极限位置，止挡锁线件23脱离锁扣主体21。如图2及图3所示，止挡件29包括挡板291及凸设于挡板291近端面相对两侧的卡块293，挡板291的近端面抵接锁扣主体21的远端面212，两个卡块293分别卡入锁扣主体21的两个导槽2140的远端开口中，卡块293用于止挡滚轴232在导槽2140内继续向远端滚动，挡板291用于限定压辊230的远端极限位置。进一步地，挡板291上开设有穿线孔295，穿线孔295连通锁扣主体21的穿线槽211，医用线300经穿线孔295后穿装于穿线槽211中。
进一步地，如图3所示，推杆25的近端还连接有第一接头28，在推杆25安装于锁扣主体21后，第一接头28暴露于锁扣主体21之外。具体地，推杆25的近端面设有用于固定连接第一接头28的固定孔256。第一接头28包括连接部281及设于连接部281远端的固定柱283，固定柱283与固定孔256可以通过螺接、焊接等方式固定连接。连接部281与后述操控组件50中的第一内芯51的远端可拆卸连接。在其他实施例中，第一接头28与推杆25也可以一体成型。
锁扣主体21上的限位螺孔2133与两个第一侧壁214构成限位结构，其中的限位螺孔2133与后述限位组件80远端的限位螺杆83螺接，以在推杆25驱动锁线件23在锁扣主体21内运动的过程中，防止锁扣主体21发生轴向移动；两个第一侧壁214的平面与后述支撑管组件70的套筒71内腔中的相应平面相贴合，以在推杆25驱动锁线件23在锁扣主体21内运动的过程中，防止锁扣主体21发生转动。
请一并参阅图7至图10，使用该医用锁扣20时，将一组医用线300穿装于压辊230外周面与穿线 槽211的底面之间，驱动第一接头28旋转，使推杆25相对于锁定螺孔2131边旋转边沿轴向朝远端移动，推杆25的径向凸出部253抵推压辊230带动锁线件23沿导槽2140朝向挡板291及穿线槽211的底面运动，压辊230的外周面与穿线槽211的底面之间的间隙逐渐减小，直至医用线300被夹紧于压辊230外周面与穿线槽211的底面之间；此后，由于推杆25的传动螺纹255与锁定螺孔2131之间螺纹锁定，能防止锁扣主体21与锁线件23的相对位置发生变化，避免医用线300从锁线件23与锁扣主体21之间松脱。
本实施例中，锁扣主体21、锁线件23及推杆25均可以但不限定由不锈钢、镍钛、纯钛等具有生物相容性的金属材料加工而成。
如图11及图12所示，手柄壳40包括相互对合的上壳41与下壳42，以及与上壳41和下壳42螺纹配合的前旋件43。下壳42内腔中固定安装有外管固定件44，支撑管组件70中外管75的近端与外管固定件44固定连接。手柄壳40内设置间隔设置的第一挡板46及第二挡板47，以及间隔设置的第三挡板48及第四挡板49。具体地，第一挡板46及第二挡板47设于下壳42内腔近端的中部，第三挡板48及第四挡板49设于下壳42内腔近端邻近中部处。
请一并参阅图1、及图11至图16：锁扣主体21活动穿设于支撑管组件70的远端；操控组件50的远端与推杆25可拆卸连接，近端延伸出手柄壳40；限位组件80的远端与锁扣主体21螺接，近端延伸出手柄壳40。
具体的，支撑管组件70包括自远端向近端依次连接的套筒71、连接筒73及外管75。锁扣主体21活动穿设于套筒71内，套筒71相对的两侧设有与锁扣主体21的两第一侧壁14的外表面贴合的平面，第一侧壁14的平面与套筒71内的平面贴合，以在推杆25驱动锁线件23在锁扣主体21内运动的过程中，防止锁扣主体21发生转动。套筒71具有沿轴向延伸穿通其远端面及近端面的内腔711，锁扣主体21置于套筒71的内腔711中，且仅能够在内腔711中沿轴向滑动。套筒71外周壁的近端对应穿线槽211处开设出线缺口713，穿线槽211内的医用线300自出线缺口713延伸出支撑管组件70。连接筒73的远端面固定贴合于套筒71的近端面，连接筒73沿轴向间隔设置有第一通槽731及第二通槽733，第一通槽731位于连接筒73的中部且对准推杆25，第二通槽733对准锁扣主体21的限位螺孔2133。连接筒73的近端与外管75的远端固定连接。在本实施中，外管75为具有支撑效果、且能弯曲的柔性管，以便于介入人体管腔。
操控组件50包括第一内芯51及连接于第一内芯51远端的连接杆52。具体地，第一内芯51活动穿装于外管75内，为适应介入人体的需要，本实施例中，第一内芯51为柔性可弯曲的；连接杆52的远端设有第二接头521，第二接头521与推杆25的第一接头28可拆卸连接，进一步地，第一接头28与第二接头521上分别设有形状互补的“Z”形、“S”形、齿形或波浪形等的凹凸结构。当第一接头28与第二接头521连接后并被穿装于连接筒73的第一通槽731中时，二者的连接关系得以保持；当第一接头28与第二接头521失去外围的第一通槽731的包络时，如外露出套筒71的远端时，第二接头521与第一接头28之间便可以脱离，以解除二者的连接。
如图14所示，操控组件50还包括外露出手柄壳40近端的第一操控钮54及与第一操控钮54可拆卸连接的第一筒件55，第一操控钮54设置于第一筒件55的近端。第一内芯51的近端活动穿过外管75及外管固定件44后固定连接于第一操控钮54。当第一筒件55与第一操控钮54相对位置锁定时，第一 筒件55能随第一操控钮54转动并一同沿轴向移动；当第一筒件55与第一操控钮54相对位置不锁定时，第一操控件55相对于第一筒件55能沿轴向移动。具体地，第一操控钮54包括中空的外壳541、沿轴向延伸设置于外壳541内的连接柱543，以及设置于外壳541的近端并固定连接于连接柱543的端盖545。连接柱543与外壳541之间设有环形的导滑槽546，第一筒件55的近端沿轴向可滑动地插接于导滑槽546内。第一筒件55的远端沿轴向凸设导杆551，第一筒件55的近端面的中部沿轴向设有导滑孔553，连接柱543滑动地插接于导滑孔553内。第一内芯51的近端沿轴向穿过第一筒件55并固定连接于端盖545。导杆551活动嵌设于分别设于第一挡板46及第二挡板47上的缺口内，导杆551上设置沿周向凸出的第一挡圈555，第一挡圈555位于第一挡板46及第二挡板47之间，从而第一筒件55可相对于第一挡板46与第二挡板47旋转，以及可在第一挡板46与第二挡板47之间轴向移动，即第一挡圈555可止挡于第一挡板46与第二挡板47之间。外壳541沿其径向设有连通导滑槽546的螺孔547，第一操控钮54还包括螺接于螺孔547中的紧固螺钉548，当旋紧该紧固螺钉548时，第一筒件55与第一操控钮54被固定在一起以同步动作，反之，当旋松该紧固螺钉548时，第一筒件55与第一操控钮54可分别动作。优选地，第一筒件55的外周面上还设有位移量标识，所述位移量标识用于显示第一操控钮54相对于第一筒件55沿轴向的移动量。
如图12、图13及图15所示，限位组件80的远端可拆卸连接于锁扣主体21，限位组件80与设于锁扣主体21上的限位螺孔2133相配合，以在推杆25驱动锁线件23在锁扣主体21内运动的过程中，防止锁扣主体21发生轴向移动，且限位组件80在操控组件50与推杆25的近端分离之前与锁扣主体21分离，以不阻碍医用锁扣20被推出套筒71。具体地，限位组件80包括第二内芯81及连接于第二内芯81远端的限位螺杆83，第二内芯81活动穿装于外管75内。为适应介入人体的需要，本实施例中，第二内芯81为柔性可弯曲的。限位螺杆83可活动地穿装于连接筒73的第二通槽733中，且限位螺杆83能与锁扣主体21的限位螺孔2133适配螺接。当限位螺杆83螺接于限位螺孔2133时，限位螺杆83能防止锁扣主体21沿轴向移动；限位螺杆83解除与限位螺孔2133的螺接后，锁扣主体21能被推杆25带动着沿轴向移动。
限位组件80还包括外露出手柄壳40近端的第二操控钮84及与第二操控钮84固定连接的第二筒件85，第二操控钮84位于第二筒件85的近端。第二内芯81的近端活动穿过外管75及外管固定件44后固定连接于第二筒件85或第二操控钮84。第二筒件85活动嵌设于分别设于第三挡板48及第四挡板49上的缺口内，第二筒件85上设置沿周向凸出的第二挡圈86，第二挡圈86位于第三挡板48及第四挡板49之间。第二筒件85可相对于第三挡板48与第四挡板49旋转，以及可在第三挡板48与第四挡板49之间轴向移动，即第二挡圈86可止挡于第三挡板48与第四挡板49之间。
请参阅图17至图26，以下以心脏三尖瓣的瓣膜修复术为例，说明本申请第一实施例提供的医用锁结装置100的使用过程。
三尖瓣为右心房(简称：RA)和右心室(简称：RV)之间的单向“阀门”，可以保证血液从右心房流向右心室。正常健康的三尖瓣具有多根腱索。三尖瓣的瓣叶分为前叶、后叶和隔叶，右心室处于舒张状态时，三者处于张开状态，血液从右心房流向右心室；右心室处于收缩状态时，腱索被拉伸，保证各瓣叶不会被血流冲到心房侧，各瓣叶闭合良好，从而保证血液从右心室经过肺动脉瓣(简称：PV)流向肺动脉。若三尖瓣出现病变，当右心室处于收缩状态时，各瓣叶关闭不全，血流的冲力会进一步导致 瓣叶脱入右心房，造成血液返流。
如图17所示，在使用该医用锁结装置100之前，首先向三尖瓣的前叶、后叶和隔叶分别植入多根带有弹性垫片310的医用线(此例中可称为缝线)300，缝线300与瓣叶之间的点接触被转变为弹性垫片310与瓣叶之间的面接触，可有效降低瓣叶撕裂的风险；缝线300的自由端延伸出体外。
第一步：如图18与图19所示，在患者体外把多根缝线300自穿线孔295穿入穿线槽211，并从出线缺口713穿出。此时，压辊230靠近锁扣主体21的近端；第一接头28与第二接头521穿装于连接筒73的第一通槽731中；限位螺杆83与限位螺孔2133螺接；紧固螺钉548被旋紧，第一筒件55与第一操控钮54固定在一起；第一挡圈555与第一挡板46贴合；第二挡圈86与第三挡板48贴合。
第二步：如图20所示，并参照图21与图22，借助缝线300的引导，将支撑管组件70的远端经介入路径(如股静脉、下腔静脉)推入心脏右心房，向三尖瓣的瓣叶移动靠近，同时调节各瓣叶上缝线300的松紧度，同时通过超声确定三尖瓣返流最轻的状态，当到达该状态时，旋转第一操控钮54带动第一内芯51、连接杆52及推杆25转动，使得推杆25远端的径向凸出部253抵推压辊230，滚轴232沿导槽2140朝向挡板291及穿线槽211的底面运动，使得压辊230的外周面与穿线槽211的底面之间的间隙逐渐减小，直至缝线300被夹紧于压辊230的外周面与穿线槽211的底面之间，推杆25上的传动螺纹255与锁扣主体21的锁定螺孔2131之间形成自锁；此时，第一筒件55的第一挡圈555自第一挡板46沿轴向移动至抵顶第二挡板47，表明医用锁扣20已锁紧缝线300。该步骤的执行过程中，限位螺杆83与限位螺孔2133保持螺接，以防止锁扣主体21沿轴向向远端移动。
第三步：参照图21与图22，旋转第二操控钮84以带动第二内芯81转动，第二内芯81带动限位螺杆83相对于锁扣主体21旋转，直至限位螺杆83脱离与限位螺孔2133的螺接。此时，第二挡圈86自第三挡板48运动至抵接第四挡板49。
第四步：如图23与图24所示，旋松紧固螺钉548，以解除第一操控钮54与第一筒件55之间的相对锁定，向远端推动第一操控钮54以带动第一内芯51沿轴向朝远端移动，第一内芯51抵推推杆25及整个医用锁扣20外露出套筒71，第一接头28与第二接头521的外围包络消失，解除第一接头28与第二接头521的连接。
此后，撤出该医用锁结装置100，再使用切线装置切断医用锁扣20外的缝线300。如图25与图26所示，医用锁扣20及被其锁紧的缝线300留置在心脏内，此时，三尖瓣的各瓣叶被多根缝线300拉向彼此，完成缘对缘修复。
可以理解的是，以上仅以三尖瓣的缘对缘修复为例，说明了该医用锁扣及医用锁结装置的使用过程。该医用锁扣及医用锁结装置也可用于三尖瓣腱索修复(将医用线用作人工腱索，医用线一端缝在瓣叶上，另一端穿设在锚定于心室壁或乳头肌的锚钉上并被医用锁扣锁紧)、二尖瓣缘对缘修复、二尖瓣腱索修复、瓣环成形(多个锚钉锚入瓣环组织，医用线串连各锚钉的近端，收紧医用线以缩小瓣口面积之后使用医用锁扣锁紧)、以及单纯的切口或破口缝合等其他手术过程中的医用线的锁紧和固定。
请一并参阅图27至图32，本申请的第二实施例提供的医用锁扣20a的结构与第一实施例的结构相似，但第二实施例中的医用锁扣20a的位置锁定结构27a与第一实施例中的位置锁定结构27的结构略有不同。结合图33至图38，医用锁结装置的第二实施例的操控组件50a与第一实施例中的操控组件50的结构也略有不同。
具体地，如图27至图32所示，该第二实施例中，位置锁定结构27a包括沿轴向穿通锁扣主体21a以供推杆25a活动穿过的通孔2135、设于推杆25a的远端上的径向凸出部253，以及套设在推杆25a上的压缩弹性件275，压缩弹性件275的两端分别抵接径向凸出部253及锁扣主体21a上位于通孔2135的外围的部位。径向凸出部253围绕推杆25a的杆体251的远端，径向凸出部253的外径大于杆体251的直径。通孔2135沿轴向贯通锁扣主体21a的近端壁213并连通容置空间210，通孔2135的直径大于或等于杆体251的直径，但小于径向凸出部253的直径，从而杆体251能活动地穿装于通孔2135中，且径向凸出部253能够止挡于通孔2135，以防止推杆25a从通孔2135脱离锁扣主体21a。本实施例中，压缩弹性件275优选压缩弹簧。当推杆25a的近端不受外力牵拉时，该压缩弹簧275即自动弹开，自驱动推杆25a远端的径向凸出部253抵推压辊230带动锁线件23沿导槽2140朝向挡板291及穿线槽211的底面运动，压辊230的外周面与穿线槽211的底面之间的间隙逐渐减小，直至医用线300被夹紧于压辊230外周面与穿线槽211的底面之间；此后，由于推杆25a远端的径向凸出部253始终受到压缩弹簧朝向远端的抵推力，能防止锁扣主体21a与锁线件23的相对位置发生变化，避免医用线300从锁线件23与锁扣主体21a之间松脱。
如图33、图35及图37所示，位于操控组件50a的第一挡圈555近端的第一挡板46与远端的第二挡板47之间的间距小于第一实施例中的第一挡板46与第二挡板47之间的间距。具体地，该第二实施例中的第一挡板46与第二挡板47之间的间距等于或略大于第一挡圈555的轴向厚度，第一挡板46和第二挡板47用于轴向定位第一挡圈555，以防止第一筒件55在压缩弹簧275弹开时被带动着沿轴向移动。第一筒件55的外周面上设有位移量标识557，位移量标识557包括自近端向远端依次间隔地数字“0”、“1”及“2”。
如图33及图34所示，第二实施例的医用锁结装置处于初始状态时，位移量标识557上的数字“0”“1”及“2”暴露于第一操控钮54之外。初始状态即紧固螺钉548被旋紧，第一筒件55与第一操控钮54固定在一起，压缩弹性件275处于被压缩状态，锁线件23位于导槽2140的近端。
如图35及图36所示，第二实施例中的医用锁扣处于锁线状态时，紧固螺钉548被旋松，压缩弹性件275自动弹开，带动第一操控钮54沿轴向向远端移动，位移量标识557上的数字“0”已被第一操控钮54覆盖，数字“1”及“2”暴露于第一操控钮54之外，压缩弹性件275自驱动推杆25抵推压辊230至锁紧医用线300，且压缩弹性件275继续保持对压辊230的弹性抵顶。
如图37及图38所示，继续向远端推动第一操控钮54至位移量标识557上的数字“1”被第一操控钮54覆盖，而数字“2”暴露，第一操控钮54带动第一内芯51沿轴向朝远端移动，第一内芯51抵推推杆25a及整个医用锁扣20a外露出套筒71，第一接头28与第二接头521的外围包络消失，即可解除第一接头28与第二接头521的连接。
在其他实施例中，第一操控钮54与第一筒件55之间也可以通过定位杆与定位孔的配合使第一操控钮54与第一筒件55之间的位置相对限定或解除限定；具体地，第一筒件55的外周面沿径向开设第一定位孔，第一操控钮54的外周壁开设对应第一定位孔的第二定位孔，当定位杆插接于第一定位孔及第二定位孔中时，第一操控钮54与第一筒件55之间的位置相对限定；当抽出插接于第一定位孔及第二定位孔中的定位杆时，第一操控钮54可相对于第一筒件55沿轴向移动。
可以理解的是，在其它实施例中，还可以使用拉伸弹性件如拉伸弹簧来代替上述第二实施例中的压 缩弹性件275。对照图29至图32，当使用拉伸弹性件时，拉伸弹性件不再设于锁扣主体21a的容置空间210内，而是设于容置空间210之外，拉伸弹性件的一端仍抵接所述锁扣主体21a上位于通孔2135的外围的部位，另一端则向近端延伸并连接至所述推杆25a的近端，如通过焊接固定连接。当推杆25a受到朝向近端的外力作用时，该拉伸弹性件被拉伸开；当推杆25a所受的外力解除时，该拉伸弹性件即自动收缩，自驱动推杆25a的远端抵推压辊230带动锁线件23沿导槽2140朝向挡板291及穿线槽211的底面运动，压辊230的外周面与穿线槽211的底面之间的间隙逐渐减小，直至医用线300被夹紧于压辊230外周面与穿线槽211的底面之间；此后，由于推杆25a的近端始终受到拉伸弹性件朝向远端的牵拉力，能防止锁扣主体21a与锁线件23的相对位置发生变化，避免医用线300从锁线件23与锁扣主体21a之间松脱。即，该实施例中，在所述医用线被夹紧的状态下，位置锁定结构牵拉所述推杆25a，以保持锁线件23与锁扣主体21a的相对位置。
以上是本申请实施例的实施方式，应当指出，对于本技术领域的普通技术人员来说，在不脱离本申请实施例原理的前提下，还可以做出若干改进和润饰，这些改进和润饰也视为本申请的保护范围。

Claims (17)

  1. 一种医用锁扣，用于锁紧医用线，其特征在于，包括：
    锁扣主体；
    锁线件，所述锁线件活动设置于所述锁扣主体内；
    推杆，所述推杆的远端抵接所述锁线件，以驱动所述锁线件在所述锁扣主体内运动，使得所述医用线被夹紧于所述锁扣主体与所述锁线件之间；
    以及位置锁定结构，在所述医用线被夹紧的状态下，所述位置锁定结构抵顶或牵拉所述推杆，以保持所述锁线件与所述锁扣主体的相对位置。
  2. 根据权利要求1所述的医用锁扣，其特征在于，所述锁扣主体内开设有容置空间以及连通所述容置空间的穿线槽，所述锁线件包括活动容置于所述容置空间内的压辊，所述医用线穿设于所述穿线槽与所述压辊之间；所述推杆自所述锁扣主体的近端向所述锁扣主体的远端运动的过程中，驱动所述压辊在所述容置空间中运动使得所述压辊与所述穿线槽的底面之间的间隙逐渐减小。
  3. 根据权利要求2所述的医用锁扣，其特征在于，所述锁扣主体对应于所述容置空间的侧壁上设有导轨或导槽，所述导轨或导槽自所述容置空间的近端向所述容置空间的远端延伸并逐渐趋近于所述穿线槽的底面；所述锁线件还包括连接于所述压辊两侧的滚轴，所述滚轴与所述导轨或导槽适配。
  4. 根据权利要求3所述的医用锁扣，其特征在于，所述压辊的直径值、所述医用线的直径值、所述导槽或导轨的远端的高度值、所述穿线槽的底面距所述导槽或导轨的远端的最大高度值满足：0≤H1-H2/2-D1/2≤D2，其中，H1表示所述穿线槽的底面距所述导槽或导轨的远端的最大高度值，H2表示所述导槽的远端的高度值，D1表示所述压辊的直径值，D2表示所述医用线的直径值。
  5. 根据权利要求1所述的医用锁扣，其特征在于，所述推杆的近端连接第一接头，所述第一接头暴露于所述锁扣主体之外。
  6. 根据权利要求1所述的医用锁扣，其特征在于，所述锁扣主体上设有限位结构，在所述推杆驱动所述锁线件在所述锁扣主体内运动的过程中，所述限位结构用于防止所述锁扣主体运动。
  7. 根据权利要求1-6任意一项所述的医用锁扣，其特征在于，所述位置锁定结构包括沿轴向穿通所述锁扣主体的螺孔，以及设于所述推杆至少部分外表面上的传动螺纹，所述传动螺纹与所述螺孔适配。
  8. 根据权利要求7所述的医用锁扣，其特征在于，所述位置锁定结构还包括连接于所述锁扣主体远端的止挡件，所述止挡件限定所述锁线件的远端的极限位置。
  9. 根据权利要求1-6任意一项所述的医用锁扣，其特征在于，所述位置锁定结构包括沿轴向穿通所述锁扣主体以供所述推杆活动穿过的通孔以及套设在所述推杆上的弹性件，所述弹性件的一端抵接所述通孔的外围，另一端抵接所述推杆的远端或者连接所述推杆的近端。
  10. 根据权利要求9所述的医用锁扣，其特征在于，所述位置锁定结构还包括连接于所述锁扣主体远端的止挡件，所述止挡件限定所述锁线件的远端的极限位置。
  11. 一种医用锁结装置，其特征在于，包括如权利要求1-10任意一项所述的医用锁扣以及操控组件，所述操控组件与所述推杆的近端可拆卸连接，所述操控组件用于控制所述推杆的动作，且所述操控组件在所述推杆与所述锁扣主体的相对位置保持不变后与所述推杆的近端分离。
  12. 根据权利要求11所述的医用锁结装置，其特征在于，还包括限位组件，所述限位组件可拆卸连 接于所述锁扣主体，所述限位组件与设于所述锁扣主体上的限位结构相配合，以在所述推杆驱动所述锁线件在所述锁扣主体内运动的过程中，防止所述锁扣主体发生轴向移动，且所述限位组件在所述操控组件与所述推杆的近端分离之前与所述锁扣主体分离。
  13. 根据权利要求12所述的医用锁结装置，其特征在于，还包括支撑管组件，所述锁扣主体活动穿设于所述支撑管组件的远端内，所述操控组件及所述限位组件活动穿设于所述支撑管组件内并延伸出所述支撑管组件的近端。
  14. 根据权利要求13所述的医用锁结装置，其特征在于，所述支撑管组件包括自远端向近端依次连接的套筒、连接筒及外管；所述锁扣主体活动穿设于所述套筒内，所述套筒与设于所述锁扣主体上的限位结构相配合，以在所述推杆驱动所述锁线件在所述锁扣主体内运动的过程中，防止所述锁扣主体发生转动；所述连接筒内设置包绕所述操控组件的远端的腔道。
  15. 根据权利要求14所述的医用锁结装置，其特征在于，所述操控组件包括第一内芯及连接于所述第一内芯远端的连接杆，所述连接杆的远端与所述推杆的近端可拆卸连接；所述限位组件包括第二内芯及连接于所述第二内芯远端的限位螺杆，设于所述锁扣主体上的限位结构包括沿轴向设置的限位螺孔，所述限位螺杆与所述限位螺孔螺接。
  16. 根据权利要求15所述的医用锁结装置，其特征在于，所述操控组件还包括固定连接所述第一内芯的近端的第一操控钮以及套设于所述第一内芯外并与所述第一操控钮可拆卸连接的第一筒件；所述限位组件还包括固定连接所述第二内芯的近端的第二操控钮以及套设于所述第二内芯外并与所述第二操控钮固定连接的第二筒件。
  17. 根据权利要求16所述的医用锁结装置，其特征在于，还包括手柄壳，所述外管的近端固定连接至所述手柄壳内，所述第一内芯及第二内芯在所述手柄壳内延伸；
    所述第一筒件的部分设于所述手柄壳内，所述第一筒件上设置第一挡圈，所述手柄壳内间隔设置第一挡板及第二挡板，所述第一挡圈位于所述第一挡板与第二挡板之间；
    所述第二筒件的部分设于所述手柄壳内，所述第二筒件上设置第二挡圈，所述手柄壳内间隔设置第三挡板及第四挡板，所述第二挡圈位于所述第三挡板与第四挡板之间。
PCT/CN2021/091873 2020-09-30 2021-05-06 医用锁扣及医用锁结装置 WO2022068202A1 (zh)

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