CN110960298B - Subcutaneous tunnel establishment tool in tunnel type PICC (peripherally inserted central catheter) catheterization and use method thereof - Google Patents

Abstract

Translated fromChinese

本发明公开了隧道式PICC置管术中皮下隧道建立用具及其使用方法，主要涉及皮下隧道建立技术领域。包括隧道针和针内推杆；所述针管靠近针头的一侧设有柱形腔和弹簧腔，所述柱形腔和弹簧腔之间设有限位凸环；所述针头后端设有球面部、第一柱体部、第二柱体部和限位凸缘；所述限位凸缘与限位凸环之间的腔室为弹簧腔，所述弹簧腔内设有复位弹簧；所述球面部外端与针管末端之间设有可弯曲折叠的密封套垫；所述针内推杆滑动连接设置在针管内，所述针内推杆内端与限位凸缘接触，所述针内推杆外端穿出针管设有按座。本发明的有益效果在于：它在皮下隧道建立、PICC导管穿过皮下隧道过程中避免皮下组织或者血管受到损伤；实现PICC导管更加快速的穿过皮下隧道。

The invention discloses a subcutaneous tunnel establishment appliance in a tunnel-type PICC cannulation operation and a use method thereof, and mainly relates to the technical field of subcutaneous tunnel establishment. It includes a tunnel needle and a push rod in the needle; the side of the needle tube close to the needle is provided with a cylindrical cavity and a spring cavity, and a limiting convex ring is arranged between the cylindrical cavity and the spring cavity; the rear end of the needle is provided with a spherical surface part, the first cylinder part, the second cylinder part and the limit flange; the cavity between the limit flange and the limit convex ring is a spring cavity, and a return spring is arranged in the spring cavity; A bendable and foldable sealing sleeve is arranged between the outer end of the spherical surface and the end of the needle tube; the inner needle push rod is slidably connected and arranged in the needle tube, the inner end of the needle inner push rod is in contact with the limiting flange, the The outer end of the inner push rod of the needle passes through the needle tube and is provided with a press seat. The beneficial effect of the present invention is that it avoids damage to subcutaneous tissue or blood vessels during the establishment of the subcutaneous tunnel and the passage of the PICC catheter through the subcutaneous tunnel, and enables the PICC catheter to pass through the subcutaneous tunnel more quickly.

Description

Translated fromChinese

隧道式PICC置管术中皮下隧道建立用具及其使用方法Subcutaneous tunnel establishment device and method of use in tunneling PICC catheterization

技术领域technical field

本发明涉及皮下隧道建立技术领域，具体是隧道式PICC置管术中皮下隧道建立用具及其使用方法。The invention relates to the technical field of subcutaneous tunnel establishment, in particular to a subcutaneous tunnel establishment appliance in tunnel-type PICC catheterization and a method for using the same.

背景技术Background technique

经外周静脉置入中心静脉导管(PICC)做为一种安全、方便的静脉通路，已在临床广泛的应用，尤其对于需要化疗或输注高渗性、刺激性液体的患者来说，PICC更是首选的方式，但是由于一些限制条件，如预置管静脉管径过小、血管解剖位置不佳、皮肤极度松弛等因素，导致许多患者不能顺利地置入PICC或置入后发生导管相关性并发症的风险过高，而隧道式PICC置入技术的应用，很好地解决了这一难题。As a safe and convenient venous access, peripherally inserted central catheter (PICC) has been widely used in clinical practice, especially for patients who need chemotherapy or infusion of hypertonic and irritating fluids, PICC is more effective. It is the preferred method, but due to some limitations, such as the small diameter of the vein in the preset catheter, the poor anatomical position of the blood vessel, and the extreme relaxation of the skin, many patients cannot successfully implant the PICC or have catheter-related after implantation. The risk of complications is too high, and the application of tunneled PICC implantation technology solves this problem well.

如说明书附图图7所示，隧道式PICC是指经外周静脉置入中心静脉导管的一种新技术，与常规PICC的区别是：通过建立一个皮下隧道，使血管穿刺点与导管出口有一定的距离，并将导管出口转移到更适宜、更有利的位置，隧道式PICC置入技术的应用普遍地降低了血栓形成的风险。As shown in Figure 7 of the accompanying drawings, tunneled PICC refers to a new technology for placing central venous catheters through peripheral veins. The difference from conventional PICCs is that by establishing a subcutaneous tunnel, the vascular puncture point and the catheter outlet have a certain relationship. The use of tunneled PICC implantation technology generally reduces the risk of thrombosis.

如说明书附图图6所示，结合图A→图B→图C的术中操作顺序来解析现有的皮下隧道建立方法。As shown in FIG. 6 of the accompanying drawing of the description, the existing subcutaneous tunnel establishment method is analyzed in combination with the intraoperative operation sequence of FIG. A→FIG.B→FIG.C.

图A：首先在图A中的a处用手术钳夹住肤层，用手术刀在a处皮肤上切开一个小口；然后在图A中的b处用手术钳夹住肤层，用手术刀在b处皮肤上切开一个小口；a→b之间即要建立皮下隧道。Figure A: First clamp the skin layer with surgical forceps at a in Figure A, and use a scalpel to make a small incision in the skin at a; then clamp the skin layer with surgical forceps at b in Figure A, and use a surgical The knife cuts a small incision in the skin at b; a subcutaneous tunnel is to be established between a→b.

然后就实心隧道针从a→b进行皮下穿刺，隧道针在穿刺过程中要细心缓慢、匀速进针，避免隧道针针头刺破皮内组织引起组织损伤，避免术后感染，而且也需要尽量避免刺破皮下血管引起失血。但是在整个过程中，在保证缓慢匀速进针前提下，还要保证针头刺入方向从而避免针头刺破皮内组织或皮下血管，这对手术医师的要求很高。Then the solid tunnel needle is used for subcutaneous puncture from a to b. The tunnel needle should be inserted carefully, slowly and at a constant speed during the puncture process to avoid tissue damage caused by the tunnel needle puncturing the intradermal tissue and postoperative infection, and it is also necessary to avoid as much as possible Punctures blood vessels under the skin causing blood loss. However, in the whole process, under the premise of ensuring slow and uniform needle insertion, the direction of needle penetration should also be ensured so as to avoid the needle puncturing the intradermal tissue or subcutaneous blood vessels, which imposes high requirements on the surgeon.

图B：隧道针从a→b刺穿后，再将PICC导管末端套入到隧道针外侧，然后沿着隧道针的导向，缓慢、匀速进管从a→b穿过，在此过程中PICC导管末端棱边就可能会划破皮下组织或者血管。Figure B: After the tunnel needle is pierced from a→b, insert the end of the PICC catheter into the outside of the tunnel needle, and then follow the guide of the tunnel needle, slowly and uniformly enter the cannula and pass through a→b. During this process, the PICC The edge of the catheter end may puncture the subcutaneous tissue or blood vessels.

图C：PICC导管a→b刺穿后，就将隧道针从b侧从皮下隧道抽出，将PICC导管抽出。Figure C: After the PICC catheter a→b is punctured, the tunnel needle is withdrawn from the subcutaneous tunnel from the b side, and the PICC catheter is withdrawn.

后续的书中操作在图中没有显示，叙述如下：将血管内导丝拔出后插入带撕脱鞘的扩张管；然后将PICC导管置入到扩张管内，也就置入到了血管内；然后一边向扩张管内进一步缓慢置入PICC导管，一遍撕开撕脱鞘；PICC导管完全置入到扩张管内后，撕脱鞘刚好完全拆下。The subsequent operations in the book are not shown in the figure, and are described as follows: after the intravascular guide wire is pulled out, a dilation tube with a tear sheath is inserted; then the PICC catheter is placed in the dilation tube, which is also placed in the blood vessel; then While further slowly inserting the PICC catheter into the dilation tube, tear the avulsion sheath once; after the PICC catheter is completely inserted into the dilation tube, the avulsion sheath is just completely removed.

以上就是隧道式PICC置管术手术过程，在皮下隧道建立过程中，隧道针刺入过程中，在保证缓慢匀速进针前提下，还要保证针头刺入方向从而避免针头刺破皮内组织或皮下血管，这对手术医师的要求很高。而且PICC导管缓慢、匀速进管从a→b穿过，在此过程中PICC导管末端棱边就可能会划破皮下组织或者血管。这是一个需要解决的问题。我的这个设计就是对隧道式PICC置管术中皮下隧道建立的技术改进。他能大大降低手术难度，避免皮下组织或者血管受到损伤。The above is the surgical procedure of tunnel-type PICC catheterization. During the establishment of the subcutaneous tunnel and the insertion of the tunnel needle, on the premise of ensuring slow and uniform needle insertion, the direction of needle insertion should also be ensured to prevent the needle from puncturing the intradermal tissue or Subcutaneous blood vessels, which are very demanding on the surgeon. Moreover, the PICC catheter is slowly and uniformly fed through the tube from a to b. During this process, the edge of the end of the PICC catheter may cut the subcutaneous tissue or blood vessels. This is a problem that needs to be solved. This design of mine is a technical improvement on the establishment of a subcutaneous tunnel in tunneled PICC catheterization. It can greatly reduce the difficulty of surgery and avoid damage to subcutaneous tissue or blood vessels.

发明内容SUMMARY OF THE INVENTION

本发明的目的在于提供隧道式PICC置管术中皮下隧道建立用具，它在皮下隧道建立、PICC导管穿过皮下隧道过程中避免皮下组织或者血管受到损伤；同时能够实现PICC导管更加快速的穿过皮下隧道。The purpose of the present invention is to provide a device for establishing a subcutaneous tunnel in tunneling PICC catheterization, which can avoid damage to subcutaneous tissue or blood vessels during the process of establishing the subcutaneous tunnel and passing the PICC catheter through the subcutaneous tunnel; Subcutaneous tunnel.

本发明为实现上述目的，通过以下技术方案实现：The present invention is achieved by the following technical solutions in order to achieve the above object:

隧道式PICC置管术中皮下隧道建立用具，包括隧道针和针内推杆；Subcutaneous tunnel establishment equipment in tunnel PICC catheterization, including tunnel needle and needle push rod;

所述隧道针包括针管和针头，所述针管靠近针头的一侧设有柱形腔和弹簧腔，所述柱形腔和弹簧腔之间设有限位凸环；The tunnel needle includes a needle tube and a needle head, the side of the needle tube close to the needle head is provided with a cylindrical cavity and a spring cavity, and a limiting convex ring is arranged between the cylindrical cavity and the spring cavity;

所述针头后端设有球面部、第一柱体部、第二柱体部和限位凸缘；所述球面部外端的截面积大于针管管径，所述球面部内端连接在第一柱体部一端，所述第一柱体部滑动连接在柱形腔内，所述第二柱体部一端连接在第一柱体部上，所述第二柱体部能穿过限位凸环，所述限位凸缘与第二柱体部末端连接，所述限位凸缘与限位凸环之间的腔室为弹簧腔，所述弹簧腔内设有复位弹簧；The rear end of the needle is provided with a spherical surface, a first cylindrical body, a second cylindrical body and a limiting flange; the cross-sectional area of the outer end of the spherical surface is larger than the diameter of the needle tube, and the inner end of the spherical surface is connected to the first column One end of the body part, the first cylindrical body part is slidably connected in the cylindrical cavity, one end of the second cylindrical body part is connected to the first cylindrical body part, and the second cylindrical body part can pass through the limiting convex ring , the limit flange is connected with the end of the second cylinder part, the cavity between the limit flange and the limit convex ring is a spring cavity, and a return spring is arranged in the spring cavity;

所述球面部外端与针管末端之间设有可弯曲折叠的密封套垫；A bendable and foldable sealing sleeve is arranged between the outer end of the spherical surface and the end of the needle tube;

所述针内推杆滑动连接设置在针管内，所述针内推杆内端与限位凸缘接触，所述针内推杆外端穿出针管设有按座。The inner needle push rod is slidably connected and arranged in the needle tube, the inner end of the inner needle push rod is in contact with the limiting flange, and the outer end of the inner needle push rod passes through the needle tube and is provided with a press seat.

还包括持管钳，所述持管钳顶部设有指环，所述持管钳底部设有夹持环座。It also includes a pipe holder, the top of the pipe holder is provided with a finger ring, and the bottom of the pipe holder is provided with a clamping ring seat.

所述隧道针后端设有环形槽，所述环形槽与夹持环座相配合适应。An annular groove is provided at the rear end of the tunnel needle, and the annular groove is matched with the clamping ring seat.

一种隧道式PICC置管术中皮下隧道建立用具的使用方法，包括以下步骤：A method for using a device for establishing a subcutaneous tunnel in a tunnel-type PICC cannulation operation, comprising the following steps:

S1,术中辅助医生用手向后拉拽待建立皮下隧道两侧的患者皮肤，以保证待建立皮下隧道处的皮肤的紧致不疏松；S1, during the operation, the assistant doctor pulls the patient's skin on both sides of the subcutaneous tunnel to be established backward by hand, so as to ensure that the skin at the subcutaneous tunnel to be established is firm and not loose;

S2,用手术钳夹住肤层，用手术刀在待建立皮下隧道两侧的皮肤上分别切开一个小口，两个小口之间进行皮下隧道的建立；S2, clamp the skin layer with surgical forceps, use a scalpel to cut a small incision on the skin on both sides of the subcutaneous tunnel to be established, and establish a subcutaneous tunnel between the two small incisions;

S3,手持隧道针的针管后端，针头对准一侧的切口处，对隧道针预穿刺1cm左右的深度，穿刺位置在表皮与皮内组织之间；S3, hold the back end of the needle tube of the tunnel needle, the needle is aimed at the incision on one side, and the tunnel needle is pre-punctured to a depth of about 1 cm, and the puncture position is between the epidermis and the intradermal tissue;

S4,然后夹持环座夹持在环形槽内使持管钳夹持隧道针，医生的食指和中指穿过指环施力，使持管钳稳稳的夹持住隧道针，拇指对针内推杆外端的按座进行按压；S4, then clamp the ring seat in the annular groove so that the tube holder clamps the tunnel needle, the doctor's index finger and middle finger apply force through the ring, so that the tube holder can firmly hold the tunnel needle, and the thumb is aligned with the inside of the needle. Press the seat at the outer end of the push rod;

S5,按压按座后，针内推杆向针管内移动，从而推动限位凸缘、第二柱体部、第一柱体部、球面部、针头的结合体向远离针管的一侧刺探，针头刺探的行程等于按压按座后针内推杆向针管内移动的形成，刺探后此行程内的表皮与皮内组织之间分离，S5, after pressing the seat, the push rod in the needle moves into the needle tube, thereby pushing the combination of the limiting flange, the second cylinder part, the first cylinder part, the spherical part, and the needle to probe to the side away from the needle tube, The stroke of the needle probe is equal to the movement of the push rod in the needle into the needle tube after pressing the seat. After the probe, the epidermis and the intradermal tissue in this stroke are separated.

S6,然后松开按座，限位凸缘、第二柱体部、第一柱体部、球面部、针头的结合体在复位瘫痪的最用下恢复状态，使内端第一柱体部与限位凸环接触限位，球面部与针管末端接触限位；S6, then release the pressing seat, the combination of the limiting flange, the second cylinder part, the first cylinder part, the spherical part, and the needle is restored to the state under the most use of the reset paralysis, so that the first cylinder part at the inner end is restored. Contact limit with the limit convex ring, the spherical surface and the end of the needle contact limit;

S7,然后向内推动隧道针，使隧道针移动步骤S5所述的行程距离；S7, then push the tunnel needle inward to make the tunnel needle move the stroke distance described in step S5;

S8,重复步骤S4-S5-S6-S7，保证每重复一次步骤使隧道针能移动一定的距离，直到隧道针的针头从另一侧的切口处伸出；S8, repeat steps S4-S5-S6-S7, ensure that every repeating step makes the tunnel needle move a certain distance, until the needle of the tunnel needle sticks out from the incision on the other side;

S9,针头从另一侧的切口处伸出后，继续向内推动隧道针，直到靠近针头一侧的针管端从另一侧的切口处伸出2～3cm；S9, after the needle protrudes from the incision on the other side, continue to push the tunnel needle inward until the end of the needle tube close to the side of the needle protrudes 2-3 cm from the incision on the other side;

S10,然后将针内推杆从针管内取出；S10, then take out the push rod in the needle from the needle tube;

S11,然后将PICC导管的一端穿插到针管内；直到PICC导管的管头不能在针管内继续深插；S11, then insert one end of the PICC catheter into the needle tube; until the tube head of the PICC catheter cannot be inserted further into the needle tube;

S12,然后将整个隧道针从另一侧的切口处全部拉出，隧道针从另一侧的切口处全部拉出后PICC导管的管头暴露，从而顺利的将PICC导管穿过皮下隧道。S12, then the entire tunnel needle is completely pulled out from the incision on the other side. After the tunnel needle is completely pulled out from the incision on the other side, the tube head of the PICC catheter is exposed, so that the PICC catheter can be passed through the subcutaneous tunnel smoothly.

对比现有技术，本发明的有益效果在于：Compared with the prior art, the beneficial effects of the present invention are:

如上述技术方案所述的装置和使用方法，每按压一次按座，隧道针就能移动一定的距离，而且这个距离是一定的，从而保证匀速进针。通过多次重复按压按座的方式进行皮下隧道的建立。这样一来，医生的注意力只需要集中在针头的刺探行驶方向上即可，从而更好的避免针头刺破皮内组织或皮下血管。而且，与现有的技术不同的是，本技术中PICC导管是从隧道针针管内部穿过的，而不是套在隧道针外部，这样就避免了PICC导管末端棱边划破皮下组织或者血管的可能性，从而使PICC导管更加快速的穿过皮下隧道。According to the device and method of use described in the above technical solution, the tunnel needle can move a certain distance every time the pressing seat is pressed, and the distance is constant, thereby ensuring the needle feeding at a constant speed. The subcutaneous tunnel is established by repeatedly pressing the seat. In this way, the doctor's attention only needs to focus on the probing direction of the needle, so as to better avoid the needle puncturing the intradermal tissue or subcutaneous blood vessels. Moreover, different from the existing technology, the PICC catheter in this technology is passed through the inside of the tunnel needle, rather than being sheathed outside the tunnel needle, so as to prevent the edge of the PICC catheter from cutting the subcutaneous tissue or blood vessels. possibility, thereby allowing the PICC catheter to pass through the subcutaneous tunnel more quickly.

综上所述，通过使用本装置，在皮下隧道建立、PICC导管穿过皮下隧道过程中能够更好的避免皮下组织或者血管受到损伤；同时能够实现PICC导管更加快速的穿过皮下隧道。To sum up, by using the device, the subcutaneous tissue or blood vessels can be better prevented from being damaged during the establishment of the subcutaneous tunnel and the passage of the PICC catheter through the subcutaneous tunnel; at the same time, the PICC catheter can be passed through the subcutaneous tunnel more quickly.

附图说明Description of drawings

附图1是本发明结构示意图。Figure 1 is a schematic structural diagram of the present invention.

附图2是本发明中隧道针结构示意图。Figure 2 is a schematic view of the structure of the tunnel needle in the present invention.

附图3是本发明中持管钳结构示意图。FIG. 3 is a schematic view of the structure of the pipe holding wrench in the present invention.

附图4是本发明中隧道针的针头未刺探伸出时结构示意图。FIG. 4 is a schematic structural diagram of the tunnel needle in the present invention when the needle head of the tunnel needle is not protruded by probing.

附图5是本发明中隧道针的针头刺探伸出后结构示意图。FIG. 5 is a schematic diagram of the structure of the tunnel needle in the present invention after the needle probe is protruded out.

附图6是现有技术中皮下隧道建立方法步骤图。FIG. 6 is a step diagram of a method for establishing a subcutaneous tunnel in the prior art.

附图7是隧道式PICC建立图解。Figure 7 is a diagram illustrating the establishment of a tunneled PICC.

附图中所示标号：Symbols shown in the attached drawings:

1、隧道针；2、针内推杆；3、针管；4、针头；5、柱形腔；6、弹簧腔；7、限位凸环；8、球面部；9、第一柱体部；10、第二柱体部；11、限位凸缘；12、复位弹簧；13、密封套垫；14、按座；15、持管钳；16、指环；17、夹持环座；18、环形槽。1. Tunnel needle; 2. Push rod inside the needle; 3. Needle tube; 4. Needle; 5. Cylindrical cavity; 6. Spring cavity; 7. Limiting convex ring; 8. Spherical part; 9. First cylindrical part ; 10, the second cylinder part; 11, the limit flange; 12, the return spring; 13, the sealing sleeve; 14, the press seat; 15, the pipe clamp; 16, the finger ring; , annular groove.

具体实施方式Detailed ways

下面结合具体实施例，进一步阐述本发明。应理解，这些实施例仅用于说明本发明而不用于限制本发明的范围。此外应理解，在阅读了本发明讲授的内容之后，本领域技术人员可以对本发明作各种改动或修改，这些等价形式同样落于本申请所限定的范围。The present invention will be further described below in conjunction with specific embodiments. It should be understood that these examples are only used to illustrate the present invention and not to limit the scope of the present invention. In addition, it should be understood that after reading the teaching content of the present invention, those skilled in the art can make various changes or modifications to the present invention, and these equivalent forms also fall within the scope defined by the present application.

本发明所述是隧道式PICC置管术中皮下隧道建立用具，主体结构包括隧道针1和针内推杆2；如说明书附图图4或图5的五倍放大图所示，所述隧道针1包括针管3和针头4，所述针管3靠近针头4的一侧设有柱形腔5和弹簧腔6，所述柱形腔5和弹簧腔6之间设有限位凸环7；所述针头4后端设有球面部8、第一柱体部9、第二柱体部10和限位凸缘11；所述球面部8外端的截面积大于针管3管径，所述球面部8内端连接在第一柱体部9一端，所述第一柱体部9滑动连接在柱形腔5内，所述第二柱体部10一端连接在第一柱体部9上，所述第二柱体部10能穿过限位凸环7，所述限位凸缘11与第二柱体部10末端连接，所述限位凸缘11与限位凸环7之间的腔室为弹簧腔6，所述弹簧腔6内设有复位弹簧12；所述球面部8外端与针管3末端之间设有可弯曲折叠的密封套垫13，密封套垫13的设计，保证了隧道针1整体内部的密封性。The present invention is a device for establishing a subcutaneous tunnel in tunnel-type PICC catheterization. The main structure includes atunnel needle 1 and an innerneedle push rod 2; Theneedle 1 includes aneedle tube 3 and aneedle head 4, the side of theneedle tube 3 close to theneedle head 4 is provided with acylindrical cavity 5 and aspring cavity 6, and a limitingconvex ring 7 is arranged between thecylindrical cavity 5 and thespring cavity 6; The rear end of theneedle 4 is provided with aspherical portion 8, a firstcylindrical portion 9, a secondcylindrical portion 10 and a limitingflange 11; the cross-sectional area of the outer end of thespherical portion 8 is larger than the diameter of theneedle tube 3, and thespherical portion 8. The inner end is connected to one end of the firstcylindrical portion 9, the firstcylindrical portion 9 is slidably connected to thecylindrical cavity 5, and one end of the secondcylindrical portion 10 is connected to the firstcylindrical portion 9, so The secondcylindrical portion 10 can pass through the limitingconvex ring 7 , the limitingflange 11 is connected to the end of the secondcylindrical portion 10 , and the cavity between the limitingflange 11 and the limitingconvex ring 7 is The chamber is aspring cavity 6, and thespring cavity 6 is provided with areturn spring 12; between the outer end of thespherical surface 8 and the end of theneedle tube 3, a flexible and foldable sealingsleeve 13 is provided. The design of the sealingsleeve 13 ensures that The sealing performance of the entire interior of thetunnel needle 1 is improved.

所述针内推杆2滑动连接设置在针管3内，所述针内推杆2内端与限位凸缘11接触，所述针内推杆2外端穿出针管3设有按座14。The innerneedle push rod 2 is slidably connected and arranged in theneedle tube 3 , the inner end of the needleinner push rod 2 is in contact with the limitingflange 11 , and the outer end of the needleinner push rod 2 passes through theneedle tube 3 and is provided with apress seat 14 .

本装置还包括持管钳15，所述持管钳15顶部设有指环16，所述持管钳15底部设有夹持环座17。所述隧道针1后端设有环形槽18，所述环形槽18与夹持环座17相配合适应。夹持环座17夹持在环形槽18内使持管钳15夹持隧道针1，医生的食指和中指穿过指环16施力，使持管钳15稳稳的夹持住隧道针1，拇指对针内推杆2外端的按座14进行按压。The device further includes apipe holding wrench 15 , afinger ring 16 is provided on the top of thepipe holding wrench 15 , and aclamping ring seat 17 is provided on the bottom of thepipe holding wrench 15 . Anannular groove 18 is provided at the rear end of thetunnel needle 1 , and theannular groove 18 is adapted to fit with the clampingring seat 17 . The clampingring seat 17 is clamped in theannular groove 18 so that thetube holding forceps 15 can hold thetunnel needle 1, and the doctor's index finger and middle finger pass through thefinger ring 16 to apply force, so that thetube holding forceps 15 can hold thetunnel needle 1 stably. The thumb presses thepressing seat 14 at the outer end of the innerneedle push rod 2 .

一种隧道式PICC置管术中皮下隧道建立用具的使用方法，包括以下步骤：A method for using a device for establishing a subcutaneous tunnel in a tunnel-type PICC cannulation operation, comprising the following steps:

S1,术中辅助医生用手向后拉拽待建立皮下隧道两侧的患者皮肤，以保证待建立皮下隧道处的皮肤的紧致不疏松；S1, during the operation, the assistant doctor pulls the patient's skin on both sides of the subcutaneous tunnel to be established backward by hand, so as to ensure that the skin at the subcutaneous tunnel to be established is firm and not loose;

S2,用手术钳夹住肤层，用手术刀在待建立皮下隧道两侧的皮肤上分别切开一个小口，两个小口之间进行皮下隧道的建立；S2, clamp the skin layer with surgical forceps, use a scalpel to cut a small incision on the skin on both sides of the subcutaneous tunnel to be established, and establish a subcutaneous tunnel between the two small incisions;

S3,手持隧道针1的针管3后端，针头4对准一侧的切口处，对隧道针1预穿刺1cm左右的深度，穿刺位置在表皮与皮内组织之间；S3, hold the back end of theneedle tube 3 of thetunnel needle 1, theneedle 4 is aligned with the incision on one side, and thetunnel needle 1 is pre-punctured to a depth of about 1 cm, and the puncture position is between the epidermis and the intradermal tissue;

S4,然后夹持环座17夹持在环形槽18内使持管钳15夹持隧道针1，医生的食指和中指穿过指环16施力，使持管钳15稳稳的夹持住隧道针1，拇指对针内推杆2外端的按座14进行按压；S4, then theclamping ring seat 17 is clamped in theannular groove 18 so that thepipe holding forceps 15 hold thetunnel needle 1, and the doctor's index finger and middle finger apply force through thefinger ring 16, so that thepipe holding forceps 15 firmly hold thetunnel Needle 1, the thumb presses thepress seat 14 at the outer end of the needleinner push rod 2;

S5,按压按座14后，针内推杆2向针管3内移动，从而推动限位凸缘11、第二柱体部10、第一柱体部9、球面部8、针头4的结合体向远离针管3的一侧刺探，针头4刺探的行程等于按压按座14后针内推杆2向针管3内移动的形成，刺探后此行程内的表皮与皮内组织之间分离，S5, after pressing theseat 14, thepush rod 2 in the needle moves into theneedle tube 3, thereby pushing the combination of the limitingflange 11, thesecond cylinder part 10, thefirst cylinder part 9, thespherical part 8 and theneedle 4 Probing to the side away from theneedle tube 3, the probing stroke of theneedle 4 is equal to the formation of thepush rod 2 in the needle moving into theneedle tube 3 after pressing thepress seat 14. After probing, the epidermis and the intradermal tissue in this stroke are separated,

S6,然后松开按座14，限位凸缘11、第二柱体部10、第一柱体部9、球面部8、针头4的结合体在复位瘫痪的最用下恢复状态，使内端第一柱体部9与限位凸环7接触限位，球面部8与针管3末端接触限位；S6, then release thepressing seat 14, the combination of the limitingflange 11, thesecond cylinder part 10, thefirst cylinder part 9, thespherical part 8, and theneedle 4 is restored to the state under the most use of the reset paralysis, so that the internal Thefirst cylinder part 9 of the end is in contact with the limitingconvex ring 7, and thespherical part 8 is in contact with the end of theneedle tube 3;

S7,然后向内推动隧道针1，使隧道针1移动步骤S5所述的行程距离；S7, then push thetunnel needle 1 inward to make thetunnel needle 1 move the travel distance described in step S5;

S8,重复步骤S4-S5-S6-S7，保证每重复一次步骤使隧道针1能移动一定的距离，直到隧道针1的针头4从另一侧的切口处伸出；S8, repeat steps S4-S5-S6-S7, ensure that every repeating step enables thetunnel needle 1 to move a certain distance, until theneedle 4 of thetunnel needle 1 protrudes from the incision on the other side;

S9,针头4从另一侧的切口处伸出后，继续向内推动隧道针1，直到靠近针头4一侧的针管3端从另一侧的切口处伸出2～3cm；S9, after theneedle 4 protrudes from the incision on the other side, continue to push thetunnel needle 1 inward until the end of theneedle tube 3 close to the side of theneedle 4 protrudes 2-3 cm from the incision on the other side;

S10,然后将针内推杆2从针管3内取出；S10, then take out thepush rod 2 in the needle from theneedle tube 3;

S11,然后将PICC导管的一端穿插到针管3内；直到PICC导管的管头不能在针管3内继续深插；S11, then insert one end of the PICC catheter into theneedle tube 3; until the tube head of the PICC catheter can not continue to be deeply inserted in theneedle tube 3;

S12,然后将整个隧道针1从另一侧的切口处全部拉出，隧道针1从另一侧的切口处全部拉出后PICC导管的管头暴露，从而顺利的将PICC导管穿过皮下隧道。S12, then pull out theentire tunnel needle 1 from the incision on the other side. After thetunnel needle 1 is completely pulled out from the incision on the other side, the tube head of the PICC catheter is exposed, so that the PICC catheter can be passed through the subcutaneous tunnel smoothly. .

如上述技术方案所述的装置和使用方法，每按压一次按座14，隧道针1就能移动一定的距离，而且这个距离是一定的，从而保证匀速进针。通过多次重复按压按座14的方式进行皮下隧道的建立。这样一来，医生的注意力只需要集中在针头4的刺探行驶方向上即可，从而更好的避免针头4刺破皮内组织或皮下血管。而且，与现有的技术不同的是，本技术中PICC导管是从隧道针1针管3内部穿过的，而不是套在隧道针1外部，这样就避免了PICC导管末端棱边划破皮下组织或者血管的可能性，从而使PICC导管更加快速的穿过皮下隧道。According to the device and using method described in the above technical solution, each time thepressing seat 14 is pressed, thetunnel needle 1 can move a certain distance, and the distance is fixed, so as to ensure the needle feeding at a constant speed. The subcutaneous tunnel is established by repeatedly pressing the base 14 for many times. In this way, the doctor's attention only needs to be focused on the probing direction of theneedle 4, so as to better prevent theneedle 4 from puncturing the intradermal tissue or subcutaneous blood vessels. Moreover, different from the prior art, in the present technology, the PICC catheter is passed through the inside of thetunnel needle 1 and theneedle tube 3 instead of being sheathed outside thetunnel needle 1, so as to avoid the edge of the PICC catheter from cutting the subcutaneous tissue. Or the possibility of blood vessels, allowing the PICC catheter to pass through the subcutaneous tunnel more quickly.

综上所述，通过使用本装置，在皮下隧道建立、PICC导管穿过皮下隧道过程中能够更好的避免皮下组织或者血管受到损伤；同时能够实现PICC导管更加快速的穿过皮下隧道。To sum up, by using the device, the subcutaneous tissue or blood vessels can be better prevented from being damaged during the establishment of the subcutaneous tunnel and the passage of the PICC catheter through the subcutaneous tunnel; at the same time, the PICC catheter can be passed through the subcutaneous tunnel more quickly.

Claims (3)

Translated fromChinese

1.隧道式PICC置管术中皮下隧道建立用具，其特征在于：包括隧道针(1)和针内推杆(2)；1. A device for establishing a subcutaneous tunnel in tunnel-type PICC cannulation, characterized in that it comprises a tunnel needle (1) and a push rod (2) in the needle;所述隧道针(1)包括针管(3)和针头(4)，所述针管(3)靠近针头(4)的一侧设有柱形腔(5)和弹簧腔(6)，所述柱形腔(5)和弹簧腔(6)之间设有限位凸环(7)；The tunnel needle (1) comprises a needle tube (3) and a needle head (4), the side of the needle tube (3) close to the needle head (4) is provided with a cylindrical cavity (5) and a spring cavity (6), the column A limiting convex ring (7) is arranged between the cavity (5) and the spring cavity (6);所述针头(4)后端设有球面部(8)、第一柱体部(9)、第二柱体部(10)和限位凸缘(11)；所述球面部(8)外端的截面积大于针管(3)管径，所述球面部(8)内端连接在第一柱体部(9)一端，所述第一柱体部(9)滑动连接在柱形腔(5)内，所述第二柱体部(10)一端连接在第一柱体部(9)上，所述第二柱体部(10)能穿过限位凸环(7)，所述限位凸缘(11)与第二柱体部(10)末端连接，所述限位凸缘(11)与限位凸环(7)之间的腔室为弹簧腔(6)，所述弹簧腔(6)内设有复位弹簧(12)；The rear end of the needle head (4) is provided with a spherical part (8), a first cylinder part (9), a second cylinder part (10) and a limiting flange (11); The cross-sectional area of the end is larger than the diameter of the needle tube (3), the inner end of the spherical portion (8) is connected to one end of the first cylindrical portion (9), and the first cylindrical portion (9) is slidably connected to the cylindrical cavity (5). ), one end of the second cylinder part (10) is connected to the first cylinder part (9), the second cylinder part (10) can pass through the limiting convex ring (7), the limiting The position flange (11) is connected to the end of the second cylinder part (10), the cavity between the position limit flange (11) and the position limit convex ring (7) is a spring cavity (6), the spring A return spring (12) is arranged in the cavity (6);所述球面部(8)外端与针管(3)末端之间设有可弯曲折叠的密封套垫(13)；Between the outer end of the spherical portion (8) and the end of the needle tube (3), a bendable and foldable sealing sleeve gasket (13) is provided;所述针内推杆(2)滑动连接设置在针管(3)内，所述针内推杆(2)内端与限位凸缘(11)接触，所述针内推杆(2)外端穿出针管(3)设有按座(14)。The inner needle push rod (2) is slidably connected and arranged in the needle tube (3), the inner end of the inner needle push rod (2) is in contact with the limiting flange (11), and the outer needle inner push rod (2) is in contact with the limiting flange (11). A press seat (14) is provided at the end of the needle tube (3) passing through it.2.根据权利要求1所述隧道式PICC置管术中皮下隧道建立用具，其特征在于：还包括持管钳(15)，所述持管钳(15)顶部设有指环(16)，所述持管钳(15)底部设有夹持环座(17)。2. The device for establishing a subcutaneous tunnel in tunnel-type PICC catheterization according to claim 1, characterized in that it further comprises a pipe-holding forceps (15), wherein a finger ring (16) is provided on the top of the pipe-holding forceps (15), so that the A clamping ring seat (17) is arranged at the bottom of the pipe holding wrench (15).3.根据权利要求1所述隧道式PICC置管术中皮下隧道建立用具，其特征在于：所述隧道针(1)后端设有环形槽(18)，所述环形槽(18)与夹持环座(17)相配合适应。3. The device for establishing a subcutaneous tunnel in tunnel-type PICC catheterization according to claim 1, characterized in that: an annular groove (18) is provided at the rear end of the tunnel needle (1), and the annular groove (18) is connected with the clip The ring holder (17) is adapted to fit.

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