Atrial septal puncture assembly and atrial septal puncture methodTechnical field
The present invention relates to technical field of medical instruments, be specifically related to a kind of atrial septal puncture assembly and atrial septal puncture method.
Background technology
The heart of the mankind comprises right ventricle, right atrium, left ventricle and left atrium.Right atrium and upper vein chamber and lower venous lumen are fluid communications.Right atrium and right ventricle separate by Tricuspid valve.Right atrium by Interatrial every separating with left atrium.In operation, left atrium is the most difficult to get access, and it is impossible for entering left atrium by pulmonary vein, from left ventricle close to being difficult, may cause encountering difficulties in catheter positioning.Thus, enter prevailing method that left atrium uses be by between atrium every puncture.
Nineteen fifty-nine Ross etc. reports the animal experiment study of atrial septal puncture art, and the same year, atrial septal puncture art was applied to clinical by Cope and Ross etc. first.The atrial septal puncture art at initial stage, adopt the method through conduit puncture needle Direct perforantes interatrial septum, right room, nineteen sixty Brockenbrough and Brawnwald etc. is improved above-mentioned atrial septal puncture method, introduce guide wire technology first, puncture needle is improved to the gradually thin pyramidal structure of far-end simultaneously, adds the safety of operation.Mullins in 1977 etc. are configured with epitheca for transseptal catheterization, further increase operability and the safety of atrial septal puncture art.
Through the exploration effort for many years of clinician, classical Ross method atrial septal puncture method obtains continuous improvement, improves the safety of operation and shortens operating time.But because X ray image is flat image, accurately can not reflect and accurately judge the position in the direction of puncture needle and heart, whether fossa ovalis is positioned at when can not determine puncture, puncture needle too points to front and then may to puncture aorta, too to the rear, the free wall perforation of right room can be caused, and cardiac perforation and cardiac tamponade are the most severe complications of atrial septal puncture, still there is hidden danger in safety.In addition, whole operation process is sent into from long steel wire, withdraw from, puncture needle is sent into, determine site of puncture, lancet puncture interatrial septum, convergent divergent channel puncture sheath puncture and withdraw from the step such as puncture needle and convergent divergent channel, complex steps, expends doctor's a lot of time.
Also there is awkward design defect in traditional puncture needle.Can not be too sharp for security consideration needle point, and needle point is excessively blunt, be then difficult to realize puncture.When puncture needle is when penetrating and by convergent divergent channel, because convergent divergent channel has somatological macrobending shape, stainless needle point can inevitably scrape wisps of material in the convergent divergent channel of macromolecular material, and these materials once enter in the chambers of the heart are washed away by blood flow, there is the possibility forming thromboembolism.And because fossa ovalis wall is thin, when convergent divergent channel is with lancet puncture fossa ovalis, a tent like may be ejected, realize puncture and will constantly advance puncture needle and convergent divergent channel, penetrate the moment of fossa ovalis at convergent divergent channel, the resistance of fossa ovalis wall to convergent divergent channel discharges rapidly, due to thrust inertia, puncture needle continues previous movement together with convergent divergent channel, has the risk that direct insertion even punctures atrial walls.
Intracardiac echocardiography (ICE) guides in real time and carries out atrial septal puncture, the anatomical position of fossa ovalis can be judged exactly, the patient that interatrial septum anatomical structure is special such as to be particularly suitable for merging after the plump and atrioseptopexy of interatrial septum aneurysm of membranous septum, spacer portion.Although ICE can and guide the traffic direction of atrial septal puncture needle end by accurate measurements, thus accurate location atrial septal puncture point, effectively avoid and reduce the risk of operation, due to apparatus expensive, a lot of hospital does not have condition and is equipped with.Meanwhile, ICE is used can not to solve above-mentioned loaded down with trivial details piercing step consuming time and the puncture difficulty to complicated interatrial septum.
Summary of the invention
The object of the present invention is to provide a kind of novel atrial septal puncture assembly and atrial septal puncture method, there is the function melting puncture, simplify surgical operation step, and the signal of telecommunication of endocardial can be provided in real time and monitor blood pressure in real time.
For achieving the above object and other relevant objects, the invention provides a kind of atrial septal puncture assembly: comprise catheter sheath and convergent divergent channel, described convergent divergent channel laminating is arranged in described catheter sheath, and one end of described convergent divergent channel is fixed with multiple electrode.
Further, described electrode is conial ring shape.
Further, one end of described convergent divergent channel is fixed with two electrodes.
Further, the distance between described two electrodes is 0.5mm ~ 3mm.
Further, the internal diameter being positioned at the electrode at described convergent divergent channel edge is 0.08mm ~ 02.0mm.
Further, described electrode is spherical shape.
Further, the diameter of described electrode is 0.08mm ~ 2.0mm.
Further, the material of described electrode is platinum, gold or platinumiridio.
Further, in described platinumiridio, the content of iridium is 5% ~ 15%.
Further, each electrode is connected with wire.
Further, the other end of described convergent divergent channel is connected with the first haemostatic valve, and the catheter sheath adjacent with the other end of described convergent divergent channel is connected with the second haemostatic valve.
Further, described second haemostatic valve is connected with extension tube and three-way valve.
Further, described first haemostatic valve is connected with cable and plug.
Further, described wire is connected with described cable and plug by the first haemostatic valve.
Accordingly, the present invention also provides a kind of atrial septal puncture method, comprising: long draw point is sent into, withdrawn from; Determine site of puncture; Atrial septal puncture assembly puncture interatrial septum; Described atrial septal puncture method uses above-mentioned atrial septal puncture assembly.
Compared with prior art, the beneficial effect of atrial septal puncture assembly provided by the present invention is:
1, the present invention is fixed with electrode in one end of convergent divergent channel, can carry out melting puncture, make convergent divergent channel can not eject tent like when myocardium by fossa ovalis, realize puncture safely and fast, eliminate the use of puncture needle simultaneously, thus simplify surgical operation step, not only save operating time, and save the expense of puncture needle; Further, electrode can abut in chambers of the heart inwall, extracts the signal of telecommunication of chambers of the heart inside, is accurately determined the position of fossa ovalis, improve the safety of puncture by the signal of telecommunication;
2, the second haemostatic valve of the present invention is connected with extension tube, can be connected monitor blood pressure in real time with pressure sensing devices, thus the successful information of feedback puncture accurately;
3, the wire on electrode of the present invention is connected with cable and plug by the first haemostatic valve, can be connected with signal generator, thus Received signal strength generator export energy, directly by energy in site of puncture, improve puncture safety.
Accompanying drawing explanation
The structural representation of the atrial septal puncture assembly that Fig. 1 provides for one embodiment of the invention.
In the atrial septal puncture assembly that Fig. 2 provides for one embodiment of the invention, convergent divergent channel is connected with the enlarged diagram of one end of electrode.
Detailed description of the invention
For enabling above-mentioned purpose of the present invention, feature and advantage become apparent more, are described in detail the specific embodiment of the present invention below in conjunction with accompanying drawing.When describing the embodiment of the present invention in detail, for convenience of explanation, general ratio partial enlargement disobeyed by schematic diagram, should in this, as limitation of the invention.
Atrial septal puncture assembly of the present invention can be widely used in multiple fields; be particularly useful for various medical devices technical field; be illustrated below by preferred embodiment; certain the present invention is not limited to this specific embodiment, and the general replacement known by one of ordinary skilled in the art is encompassed in protection scope of the present invention undoubtedly.
Please refer to Fig. 1, the structural representation of its atrial septal puncture assembly provided for one embodiment of the invention.As shown in Figure 1, described atrial septal puncture assembly 10 comprises catheter sheath 14 and convergent divergent channel 13, and described convergent divergent channel 13 laminating is arranged in described catheter sheath 14, and one end of described convergent divergent channel 13 is fixed with multiple electrode.
In the present embodiment, described electrode is conial ring shape, and one end of described convergent divergent channel 13 is fixed with two electrodes 11,12, specifically please refer to Fig. 2, described electrode 11,12 is connected with wire 23,24, can transmission electrode 11,12 extract electrocardiosignal to monitoring recorder.The internal diameter of described electrode 11 is 0.08mm ~ 2.0mm, such as 0.08mm, 0.1mm, 0.5mm, 1.0mm, 1.5mm, 2.0mm.It should be noted that, described electrode also can be other shape well known by persons skilled in the art, and such as, in another embodiment, described electrode is spherical shape, and its diameter is 0.08mm ~ 2.0mm.
The material of described electrode 11,12 is platinum, gold or platinumiridio, and in described platinumiridio, the content of iridium is 5% ~ 15%, such as 5%, 10%, 15%, be preferably 10%.Distance between described electrode 11 and electrode 12 is 0.5mm ~ 3mm.
Please continue to refer to Fig. 1, the other end of described convergent divergent channel 13 is connected with the first haemostatic valve 17, and the catheter sheath 14 adjacent with the other end of described convergent divergent channel 13 is connected with the second haemostatic valve 15; Described second haemostatic valve 15 is connected with extension tube, extension tube is equipped with three-way valve 16, and described three-way valve 16 can Bonding pressure sensing apparatus, the blood pressure in monitoring Surgicenter room, thus the successful information of feedback puncture accurately.
Described first haemostatic valve 17 is connected with cable and two plugs 18,19, described cable is connected with the wire 23,24 in Fig. 2, the signal of telecommunication transmitted from electrode 11 and electrode 12 outputs to signal generator by wire, cable and plug 18,19, meanwhile, signal generator also can export energy to electrode 11,12 by plug 18,19 and cable, wire 23,24.Identical with described second haemostatic valve 15, described first haemostatic valve 17 is also connected with extension tube, extension tube is equipped with three-way valve 20, for Bonding pressure sensing apparatus, the blood pressure in monitoring Surgicenter room, thus the successful information of feedback puncture accurately.
According to atrial septal puncture assembly provided by the present invention, owing to being fixed with electrode 11,12 in one end of described convergent divergent channel 13, after puncture enters right atrium, electrode 11,12 can abut in chambers of the heart inwall, the signal of telecommunication of chambers of the heart inside can be extracted, feed back to electrocardio equipment by the wire be connected under electrode 11,12, thus judge the position of electrode 11,12 in the chambers of the heart.Importantly, when electrode 11,12 is positioned at site of puncture fossa ovalis, except other phenomenon technology, operative doctor can judge whether to arrive puncture position by electrocardiosignal, avoid only relying on X ray image is this cannot the puncture risks that causes of intuitive judgment puncture position.
The present invention also provides a kind of and uses above-mentioned atrial septal puncture assembly to carry out the method for atrial septal puncture, comprising: long draw point is sent into, withdrawn from; Determine site of puncture; Atrial septal puncture assembly puncture interatrial septum.Compared with prior art, eliminate the use of Interaurcular septum puncture needle, decrease the feeding of Interaurcular septum puncture needle and the step such as to withdraw from, simplifying operation.
Owing to being fixed with electrode 11,12 in one end of described convergent divergent channel 13, electrode 11,12 can be abutted in puncture fossa ovalis position by operation.By the connection wire 23,24 under electrode 11,12, energy device (such as ablation apparatus), can act on fossa ovalis place by ablation energy by electrode 11,12, and fossa ovalis is formed aperture necessary in atrial septal puncture operation.And in the operation of traditional atrial septal puncture, realize this aperture by puncture needle.Compare traditional atrial septal puncture operation, use atrial septal puncture assembly of the present invention and atrial septal puncture method, coordinate the long draw point penetrated at first, realize atrial septal puncture, save the use of Interaurcular septum puncture needle, simplify operation.Convergent divergent channel 13 due to described atrial septal puncture assembly has and melts puncture function, does not need to use puncture needle, and puncture needle can be avoided to scrape bits.Melt puncture function because convergent divergent channel 13 has again, convergent divergent channel, ejecting tent like by during fossa ovalis cardiac muscle, realizes puncturing safely and fast.
In sum, the present invention is fixed with electrode in one end of convergent divergent channel, can carry out melting puncture, make convergent divergent channel can not tent like be ejected by during fossa ovalis cardiac muscle, realize puncturing safely and fast, eliminate the use of puncture needle simultaneously, thus simplify surgical operation step, not only save operating time, and save the expense of puncture needle, puncture needle can also be avoided to scrape bits; Further, electrode can abut in chambers of the heart inwall, extracts the signal of telecommunication of chambers of the heart inside, is accurately determined the position of fossa ovalis, improve the safety of puncture by the signal of telecommunication; Second haemostatic valve of the present invention is connected with extension tube, can be connected monitor blood pressure in real time with pressure sensing devices, thus the successful information of feedback puncture accurately; Wire on electrode of the present invention is connected with cable and plug by the first haemostatic valve, can be connected with signal generator, thus Received signal strength generator export energy, directly by energy in site of puncture, improve puncture safety.
Foregoing description is only the description to present pre-ferred embodiments, any restriction not to the scope of the invention, and any change that the those of ordinary skill in field of the present invention does according to above-mentioned disclosure, modification, all belong to the protection domain of claims.