技术领域technical field
本发明涉及医用内窥镜的引导装置，具体是一种具有安全标识的经皮肾镜导丝。The invention relates to a guiding device for a medical endoscope, in particular to a percutaneous nephroscopic guide wire with a safety mark.
背景技术Background technique
经皮肾镜和经皮肾造瘘技术都是在泌尿外科领域内常用的治疗方法。经皮肾镜经常用于治疗肾内大于2厘米肾结石。治疗时首先使用穿刺针从皮肤穿刺到有结石肾盏、肾盂内，然后将一个J型导丝通过穿刺针放置到有结石的肾盏或肾盂内，去除穿刺针，通过导丝使用F8-F24的筋膜扩张器逐渐由细到粗扩张皮肾通道，在皮肤和肾内结石之间建立一个保留经皮肾镜治疗镜鞘的通道，最后通过该通道将结石粉碎并取出。以往该通道的建立是采用X线和B超两种定位和监测方法，X线定位和监测筋膜扩张器逐层扩张的准确性强，不会造成扩张过深或过浅等误损伤发生。但采用X线定位设备昂贵，又会造成病人和医生放射性伤害。所以目前很多医院都采用B超定位的方法，但该方法对于监测筋膜扩张器的扩张深度不准确，医生多是凭借个人的经验和手感来判断筋膜扩张器的扩张深度，有时扩张过深会造成肾脏损伤大出血的并发症，也会由于扩张过浅，重复扩张而导致扩张通道丢失的风险。Both percutaneous nephroscopy and percutaneous nephrostomy techniques are commonly used in the field of urology. Percutaneous nephroscopy is often used to treat kidney stones larger than 2 cm in the kidney. During the treatment, first use a puncture needle to puncture into the renal calyx and renal pelvis with stones from the skin, then place a J-shaped guide wire through the puncture needle into the renal calices or renal pelvis with stones, remove the puncture needle, and use F8-F24 through the guide wire The fascial dilator gradually expands the skin-renal channel from thin to thick, and establishes a channel between the skin and the intrarenal stone to retain the sheath of the percutaneous nephroscopic treatment. Finally, the stone is crushed and taken out through this channel. In the past, the channel was established using X-ray and B-ultrasound positioning and monitoring methods. The accuracy of X-ray positioning and monitoring of the layer-by-layer expansion of the fascial expander will not cause accidental damage such as too deep or too shallow expansion. However, X-ray positioning equipment is expensive, and it will cause radiation damage to patients and doctors. Therefore, many hospitals currently use the B-ultrasound positioning method, but this method is not accurate for monitoring the expansion depth of the fascial expander. Doctors mostly rely on personal experience and hand feeling to judge the expansion depth of the fascial expander, and sometimes the expansion is too deep. It will cause complications of kidney damage and massive hemorrhage, as well as the risk of loss of the expansion channel due to shallow expansion and repeated expansion.
目前市售的经皮肾镜导丝由不锈钢导丝制成，包括芯丝和外层的绕丝弹簧，导丝的末端呈“J”形。此类导丝分有三种不同构造，1.不锈钢J型导丝，仅在导丝的末端5厘米左右的长度带有外层的绕丝弹簧。2.带有PTFE涂层的J型导丝，包括芯丝和外层的绕丝弹簧，但在导丝的表面带有PTFE涂层的J型导丝，涂层的作用是可以增加导丝的光滑度。3.非全涂层PTFE的J型导丝，在带有PTFE涂层的J型导丝末端有5-7厘米距离里的绕丝弹簧没有PTFE涂层，该款导丝的设计是为了在使用筋膜扩张器的时候增加末端的摩擦力和手感。The current commercially available percutaneous nephroscopic guide wire is made of stainless steel guide wire, including a core wire and an outer coiled wire spring, and the end of the guide wire is in a "J" shape. This type of guide wire has three different structures. 1. The stainless steel J-shaped guide wire has an outer layer of wire-wrapped spring only at the end of the guide wire about 5 cm in length. 2. The J-type guide wire with PTFE coating, including the core wire and the outer wire spring, but the J-type guide wire with PTFE coating on the surface of the guide wire, the function of the coating is to increase the guide wire smoothness. 3. J-type guide wire with non-full coating PTFE. There is no PTFE coating in the wire spring at the end of the J-type guide wire with PTFE coating at a distance of 5-7 cm. Increase the friction and feel of the end when using the fascial expander.
中国专利CN 2683042 Y公开了“一种带有刻度的穿刺针针头”，其是在普通穿刺针头的基础上，增加了刻度标记。从针尖处始作为“0”刻度的起点，且不同长度单位的的刻度用不同的颜色及不同长短来表示，解决了现有穿刺针头因没有刻度，在穿刺过程中仅凭操作者的估计而缺乏精确度的问题，从而使穿刺操作更加数字化、准确化。Chinese patent CN 2683042 Y discloses "a puncture needle with a scale", which is based on an ordinary puncture needle with a scale mark added. The starting point of the "0" scale starts from the needle tip, and the scales of different length units are represented by different colors and different lengths. The problem of lack of precision makes the puncture operation more digital and accurate.
发明内容Contents of the invention
本发明就是为了解决由于经皮肾镜导丝不具备长度标识，导致B超定位时监测筋膜扩张器的扩张深度不准确，造成肾脏损伤大出血，或导致扩张通道丢失的问题，而提供一种具有安全标识的经皮肾镜导丝。The present invention aims to solve the problem of inaccurate monitoring of the dilation depth of the fascial dilator during B-ultrasound positioning due to the absence of a length mark on the guide wire of the percutaneous nephroscope, resulting in massive hemorrhage due to kidney damage, or loss of dilation channels, and provides a Percutaneous nephroscopic guidewire with safety logo.
本发明是按照以下技术方案实现的。The present invention is realized according to the following technical solutions.
一种具有安全标识的经皮肾镜导丝，包括末端是J形绕丝弹簧1，后部是导丝体2的原色不锈钢经皮肾镜导丝3；或不锈钢芯丝和外层绕丝弹簧结合后，全涂覆PTFE涂层12的J型经皮肾镜导丝4；或不锈钢芯丝和外层绕丝弹簧结合后，末端的J形绕丝弹簧1是原色不锈钢的非全涂覆PTFE涂层的经皮肾镜导丝5，而始自J形绕丝弹簧1末端形成有标示长度的图形标识。A percutaneous nephroscopic guide wire with a safety mark, including a J-shaped coiled wire spring 1 at the end and a primary color stainless steel percutaneous nephroscopic guide wire 3 with a guide wire body 2 at the rear; or a stainless steel core wire and an outer coiled wire After the spring is combined, the J-shaped percutaneous nephroscopic guide wire 4 that is fully coated with PTFE coating 12; or after the stainless steel core wire and the outer coiled wire spring are combined, the J-shaped coiled wire spring 1 at the end is a non-full coating of primary color stainless steel The percutaneous nephroscopic guide wire 5 covered with PTFE coating is formed with a graphic mark indicating the length from the end of the J-shaped coiled wire spring 1 .
所述的具有安全标识的经皮肾镜导丝，以J形绕丝弹簧末端为0，每厘米形成一个单环标识带，每到5、10、15、20、以及21、22、23厘米(筋膜扩张器的长度)处形成一个加宽标识带The percutaneous nephroscopic guide wire with safety marks has a J-shaped coiled wire spring whose end is 0, forming a single-ring identification band every centimeter, and every 5, 10, 15, 20, and 21, 22, 23 centimeters (the length of the fascial dilator) to form a widened identification band
所述的具有安全标识的经皮肾镜导丝，其以J形绕丝弹簧末端为0，每厘米形成一个单环标识带，而在5厘米处形成有并排双环标识带，10厘米处形成有三环标识带，15厘米处形成有四环标识带，20厘米处有五环标识带，21、22、23厘米处分别形成有三个加宽标识带。The percutaneous nephroscopic guide wire with safety marks has a J-shaped coiled wire spring whose end is 0, forming a single-ring marking band every centimeter, and forming a side-by-side double-ring marking band at 5 centimeters, and forming a double-ring marking band at 10 centimeters. There are three-ring identification belts, four-ring identification belts at 15 centimeters, five-ring identification belts at 20 centimeters, and three widening identification belts at 21, 22, and 23 centimeters.
所述的具有安全标识的经皮肾镜导丝，其特征在于：其以J形绕丝弹簧末端为0，分别在距末端20、21、22、23厘米(筋膜扩张器的长度)处形成有加宽标识带。The described percutaneous nephroscopic guide wire with safety mark is characterized in that: it is 0 at the end of the J-shaped winding wire spring, respectively at 20, 21, 22, and 23 centimeters (the length of the fascia dilator) from the end A widened identification band is formed.
这样设计的本发明，1.可以直接观察到扩张目标距皮肤的距离。2.使用筋膜扩张器时可以准确观察和掌握扩张的深度，避免过深会造成肾脏损伤出血，或过浅时需要重新扩张的重复操作。3.在很大程度上提高了经皮肾镜和经皮肾造瘘手术的精准性和安全性。The present invention designed in this way, 1. The distance between the expansion target and the skin can be directly observed. 2. When using the fascia expander, the depth of expansion can be accurately observed and mastered, avoiding the repeated operation of re-expanding if it is too deep, which will cause kidney damage and bleeding, or if it is too shallow. 3. The accuracy and safety of percutaneous nephroscopy and percutaneous nephrostomy have been greatly improved.
附图说明Description of drawings
图1是原色不锈钢经皮肾镜导丝三种型号的不同刻度标识示意图；Figure 1 is a schematic diagram of different scale markings of three types of primary color stainless steel percutaneous nephroscopic guide wires;
图2.是全涂覆PTFE涂层的经皮肾镜导丝三种型号不同刻度标识示意图；Figure 2 is a schematic diagram of different scale markings of three types of percutaneous nephroscopic guide wires fully coated with PTFE coating;
图3是非全涂覆PTFE涂层的经皮肾镜导丝三种型号不同刻度标识示意图。Fig. 3 is a schematic diagram of different scale markings of three types of percutaneous nephroscopic guide wires not fully coated with PTFE coating.
图中：1.J形绕丝弹簧 2.导丝体In the figure: 1. J-shaped wire-wound spring 2. Guide wire body
3.原色不锈钢经皮肾镜导丝 4.全涂覆PTFE涂层的经皮肾镜导丝3. Natural color stainless steel percutaneous nephroscopic guide wire 4. Fully coated percutaneous nephroscopic guide wire with PTFE coating
5.非全涂覆PTFE涂层的经皮肾镜导丝5. Non-full PTFE-coated percutaneous nephroscopic guide wire
6.单环标识带 7.双环标识带6. Single ring identification tape 7. Double ring identification tape
8.三环标识带 9.四环标识带8. Three-ring identification tape 9. Four-ring identification tape
10.五环标识带 11.加宽标识带10. Five-ring identification belt 11. Widen identification belt
12.涂层。12. Coating.
具体实施方式Detailed ways
下面结合附图及实施例对本发明作进一步说明。The present invention will be further described below in conjunction with the accompanying drawings and embodiments.
一种具有安全标识的经皮肾镜导丝，包括末端是J形绕丝弹簧1，后部是导丝体2的原色不锈钢经皮肾镜导丝3；或不锈钢芯丝{未图示}和外层绕丝弹簧(未图示)结合后，全涂覆PTFE涂层12的J型经皮肾镜导丝4；或不锈钢芯丝(未图示)和外层绕丝弹簧(未图示)结合后，末端的J形绕丝弹簧1是原色不锈钢的非全涂覆PTFE涂层的经皮肾镜导丝5，而始自J形绕丝弹簧1末端形成有标示长度的图形标识。A percutaneous nephroscopic guide wire with a safety mark, including a primary color stainless steel percutaneous nephroscopic guide wire 3 with a J-shaped wire-wound spring 1 at the end and a guide wire body 2 at the rear; or a stainless steel core wire {not shown} After being combined with the outer layer of coiled wire spring (not shown), the J-type percutaneous nephroscope guide wire 4 fully coated with PTFE coating 12; or the stainless steel core wire (not shown) and the outer layer of coiled wire spring (not shown) After being combined, the J-shaped coiled wire spring 1 at the end is a percutaneous nephroscopic guide wire 5 that is not fully coated with PTFE coating in primary color stainless steel, and a graphic mark indicating the length is formed from the end of the J-shaped coiled wire spring 1 .
所述的具有安全标识的经皮肾镜导丝，参照附图1-3中A型，其以J形绕丝弹簧1末端为0，每厘米形成一个单环标识带6，每到5、10、15、20、以及21、22、23厘米(筋膜扩张器的长度)处形成一个加宽标识带11。The described percutaneous nephroscopic guide wire with safety marks, with reference to type A in the accompanying drawings 1-3, has a J-shaped coiled wire spring 1 whose end is 0, forming a single-ring identification band 6 every centimeter, every 5, A widening identification band 11 is formed at 10, 15, 20, and 21, 22, and 23 centimeters (the length of the fascia dilator).
所述的具有安全标识的经皮肾镜导丝，参照附图1-3中B型，其以J形绕丝弹簧1末端为0，每厘米形成一个单环标识带6，而在5厘米处形成有双环标识带7，10厘米处形成有三环标识带8，15厘米处形成有四环标识带9，20厘米处有五环标识带10，21、22、23厘米处分别形成有三个加宽标识带11。The described percutaneous nephroscopic guide wire with safety marks, referring to Type B in the accompanying drawings 1-3, has a J-shaped winding wire spring 1 whose end is 0, and forms a single-ring identification band 6 every centimeter, and at 5 centimeters A double-ring logo tape 7 is formed at 10 centimeters, a three-ring logo tape 8 is formed at 10 centimeters, a four-ring logo tape 9 is formed at 15 centimeters, a five-ring logo tape 10 is formed at 20 centimeters, and three rings are formed at 21, 22 and 23 centimeters. A widened identification band 11.
所述的具有安全标识的经皮肾镜导丝，参照附图1-3中C型，其以J形绕丝弹簧1末端为0，分别在距末端20、21、22、23厘米(筋膜扩张器的长度)处形成有加宽标识带11。Described percutaneous nephroscopic guide wire with safety mark, with reference to type C in accompanying drawing 1-3, it is 0 with J-shaped coiled wire spring 1 end, respectively at 20, 21, 22, 23 centimeters apart from the end (muscle The length of the membrane dilator) is formed with a widened identification band 11.
所述的具有安全标识的经皮肾镜导丝，所述单环标识带6幅宽2毫米；加宽标识带11幅宽5毫米；B型导丝中的双环标识带7，三环标识带8，四环标识带9，五环标识带10，其中每环标识带的幅宽与带间距均为1mm或2mm。上述各种标识带均呈360度环绕导丝的环状标识。The percutaneous nephroscopic guide wire with safety marks, the single-ring identification band 6 with a width of 2 mm; the widened identification band 11 with a width of 5 mm; the double-ring identification band 7 in the B-type guide wire, and the three-ring identification Band 8, four-ring identification band 9, five-ring identification band 10, wherein the width and band spacing of each ring identification band are 1mm or 2mm. The above-mentioned various identification bands are in the form of ring-shaped identifications that surround the guide wire at 360 degrees.
所述的具有安全标识的经皮肾镜导丝，所述经皮肾镜导丝的直径是.035″，即.0889毫米，附图中其A、B、C三种导丝型号的长度分别为60、80、100厘米。Described percutaneous nephroscopic guide wire with safety mark, the diameter of described percutaneous nephroscopic guide wire is . They are 60, 80, 100 cm respectively.
本发明设计是在上述三款不同结构的经皮肾镜导丝上，使用激光打标机打上刻度标识，上述标识在没有涂层的原色不锈钢经皮肾镜导丝表面显示为黑色标识；在有色涂层12的表面显示白色标识，即不锈钢原色标识，使其更便于观察、使用。The design of the present invention is to use a laser marking machine to mark a scale mark on the above-mentioned three types of percutaneous nephroscopic guide wires with different structures. The surface of the colored coating 12 shows a white mark, that is, the primary color mark of stainless steel, making it easier to observe and use.
应用本发明手术时，使用筋膜扩张器逐级扩张通道宽度，每次扩张到看见导丝第一个标识时，即为一次提示，筋膜扩张器距离导丝末端还有1厘米，见到第二个标识时，说明扩张器前端已经抵达导丝的末端，此时需要更换更粗一级的扩张器，直到全部完成扩张通道宽度为止。When using the present invention for surgery, use the fascia dilator to expand the channel width step by step. Every time you expand until the first mark of the guide wire is seen, it is a prompt.The fascia dilator is still 1 cm away from the end of the guide wire. The second mark indicates that the front end of the dilator has reached the end of the guide wire. At this time, a thicker dilator needs to be replaced until the channel width is fully expanded.
本发明中的A、C型导丝，在它的20-23厘米处设计的四个加宽标识带；在B型导丝20厘米处的五环标识带、21-23厘米处的三个加宽标识带，都是为了应对不同长度的进模扩张器而设计的。A, C type guide wire among the present invention, four widening identification bands designed at its 20-23 centimeter place; Five ring identification bands at 20 centimeters place of B type guide wire, three at 21-23 centimeter place The widened identification bands are all designed to cope with different lengths of die expanders.
已经完成的200多例手术中，均采用本发明将通道扩张至F24(8mm)的标准通道，较比以往的微通道，小通道大大缩短了手术时间，提高了术后的无石率，没有发生一例因为出血而需要输血，和因为出血而需要做肾动脉栓塞。大大提高了经皮肾镜手术的精准性和安全性。明显减少手术出血和器官损伤的并发症。In more than 200 cases of operations that have been completed, the channel is expanded to the standard channel of F24 (8mm) by the present invention. Compared with the previous microchannel, the small channel greatly shortens the operation time and improves the postoperative stone-free rate. There was one case requiring blood transfusion due to hemorrhage and renal artery embolization due to hemorrhage. Greatly improved the accuracy and safety of percutaneous nephroscopic surgery. Significantly reduce surgical bleeding and complications of organ damage.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202310720449.4ACN116672579A (en) | 2023-06-16 | 2023-06-16 | Percutaneous nephroscope guide wire with safety mark |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202310720449.4ACN116672579A (en) | 2023-06-16 | 2023-06-16 | Percutaneous nephroscope guide wire with safety mark |
| Publication Number | Publication Date |
|---|---|
| CN116672579Atrue CN116672579A (en) | 2023-09-01 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202310720449.4APendingCN116672579A (en) | 2023-06-16 | 2023-06-16 | Percutaneous nephroscope guide wire with safety mark |
| Country | Link |
|---|---|
| CN (1) | CN116672579A (en) |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5084022A (en)* | 1989-10-04 | 1992-01-28 | Lake Region Manufacturing Company, Inc. | Graduated guidewire |
| CN105169547A (en)* | 2015-10-09 | 2015-12-23 | 江苏耀华医疗器械科技有限公司 | J-type touchable percutaneous kidney guide wire |
| CN209033480U (en)* | 2017-10-11 | 2019-06-28 | 郑明友 | Superslide zebra guide wire with scale |
| KR102337067B1 (en)* | 2021-06-25 | 2021-12-07 | 전남대학교산학협력단 | Medical midline catheter |
| CN215822057U (en)* | 2021-08-05 | 2022-02-15 | 大连市妇女儿童医疗中心(集团) | Guide catheter with MARK point suitable for ultrasonic guided cardiac intervention |
| CN220237539U (en)* | 2023-06-16 | 2023-12-26 | 天津辰宇医疗科技有限公司 | Percutaneous nephroscope guide wire with safety mark |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5084022A (en)* | 1989-10-04 | 1992-01-28 | Lake Region Manufacturing Company, Inc. | Graduated guidewire |
| CN105169547A (en)* | 2015-10-09 | 2015-12-23 | 江苏耀华医疗器械科技有限公司 | J-type touchable percutaneous kidney guide wire |
| CN209033480U (en)* | 2017-10-11 | 2019-06-28 | 郑明友 | Superslide zebra guide wire with scale |
| KR102337067B1 (en)* | 2021-06-25 | 2021-12-07 | 전남대학교산학협력단 | Medical midline catheter |
| CN215822057U (en)* | 2021-08-05 | 2022-02-15 | 大连市妇女儿童医疗中心(集团) | Guide catheter with MARK point suitable for ultrasonic guided cardiac intervention |
| CN220237539U (en)* | 2023-06-16 | 2023-12-26 | 天津辰宇医疗科技有限公司 | Percutaneous nephroscope guide wire with safety mark |
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| PB01 | Publication | ||
| PB01 | Publication | ||
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