Dry and wet dual-purpose pericardium puncture outfitTechnical Field
The invention relates to the field of medical appliances, in particular to a dry and wet pericardium puncture outfit.
Background
The pericardium is a layer of connective tissue membrane structure that adheres to the outer wall of the heart, and the space between the pericardium and the outer wall of the heart is called the pericardial space. Pericardial puncture surgery is the basis of a variety of cardiac intervention procedures, which are classified into wet pericardial puncture and dry pericardial puncture. The wet pericardium represents that pericardial effusion exists in the pericardial cavity, the pericardial cavity can be expanded, the distance between the pericardium and the ventricle is increased, and the pericardial effusion in the pericardial cavity can be extracted through the wet pericardial puncture, so that the problem that the heart is influenced by the pericardial effusion of a patient is avoided. The dry pericardium represents that pericardial effusion does not exist in the pericardial cavity, and the purpose of the dry pericardium puncture is to establish a surgical channel, so that the subsequent mapping, ablation, implantation of a pacing electrode wire on the outer wall of the heart and the like in the aspect of electrophysiology heart diseases are facilitated.
The existing pericardium puncture tool is basically a scattered puncture set, a doctor needs to use the puncture set next to each other during operation, the operation is complex, the learning curve of the doctor can be increased, parts required by the dry pericardium puncture set and the wet pericardium puncture set are different, different tools are required to be prepared for different puncture operations, extra preparation work is added, and clinical emergency operation is inconvenient.
At present, some manufacturers design some integrated puncture devices, but the design structure is complex, the cost is high, the operation difficulty is high, the failure rate of the complex structure is higher, the function is single, and two kinds of puncture operations can not be realized.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provide a dry and wet pericardial puncture device, which combines a puncture needle and a puncture guide wire through a multi-cavity tube to form an integrated structure, is suitable for dry and wet pericardial puncture and can be operated only through different use modes. The invention has simple structure and low operation difficulty, a doctor can simply and conveniently puncture, the operation can be completed without too much experience, the risk coefficient of the puncture method and process is lower, and the invention is convenient for more hospitals and doctors to use.
In order to achieve the above purpose, the invention adopts the following technical scheme:
the invention provides a dry and wet pericardium puncture outfit, which comprises:
A housing;
a multi-lumen tube disposed on the housing;
a puncture needle slidably disposed within one of the lumens of the multi-lumen tube;
a piercing guidewire slidably disposed in other lumens of the multilumen tubing.
Preferably, the method further comprises:
The puncture needle push button is slidably arranged on the shell and is connected with the puncture needle.
Preferably, a push button sliding hole is formed on the shell, and the puncture needle push button is in transition fit in the push button sliding hole.
Preferably, elastic protrusions are formed on the surface, attached to the sliding hole of the push button, of the push button of the puncture needle.
Preferably, a guide hole is formed on the puncture needle push button, and the guide hole is communicated with an inner hole of the puncture needle and used for inserting a guide wire.
Preferably, the method further comprises:
the guide wire pushing button is slidably arranged on the shell and is connected with the puncture guide wire.
Preferably, the housing is formed with a guide groove, and the guide wire push button is formed with a projection, and the projection is slidably fitted in the guide groove.
Preferably, the method further comprises:
and the two ends of the elastic piece are respectively connected with the guide wire push button and the shell.
Preferably, the guide wire pushing button further comprises a guide shaft, wherein a shaft hole is formed in the guide wire pushing button, and the guide shaft penetrates through the shaft hole and is fixed on the shell.
Preferably, the method further comprises:
The guide block is fixed on the shell, a guide hole is formed in the guide block, and the puncture needle and the puncture guide wire penetrate through the guide hole.
The invention has at least the following beneficial effects:
The puncture needle and the puncture guide wire are combined through the multi-cavity tube, and the puncture needle is designed into an integrated structure, is suitable for dry and wet pericardial puncture, and can be operated only through different use modes. The invention has simple structure and low operation difficulty, a doctor can simply and conveniently puncture, the operation can be completed without too much experience, the risk coefficient of the puncture method and process is lower, and the invention is convenient for more hospitals and doctors to use.
The shell is provided with the push button sliding hole, the puncture needle push button is in transition fit in the push button sliding hole, the peripheral diameter of the puncture needle push button is slightly larger than that of the push button sliding hole, and when the puncture needle push button is positioned in the push button sliding hole, the periphery of the puncture needle push button is extruded and deformed, so that the puncture needle push button can be fixed at any position in the push button sliding hole, a doctor pushes the puncture needle push button to any position, and the puncture needle push button can be fixed by loosening hands.
The shell of the invention is provided with the guide groove, the guide wire push button is provided with the lug which can be matched in the guide groove in a sliding way, and under the limit and guide effects of the guide groove, the guide wire push button is not easy to shake in the process of pushing by doctors, thereby improving the success rate of the operation.
According to the invention, the puncture needle and the puncture guide wire are fixed through the guide block, so that the stability of the puncture needle and the puncture guide wire in the sliding process can be ensured, and the success rate of operation is improved.
When the guide wire push button pushes out the puncture guide wire outwards, the elastic piece is compressed, and when the head end of the puncture guide wire passes through the pericardium and is curled into a pigtail shape, the guide wire push button is loosened, and the guide wire push button and the puncture guide wire move in the opposite direction under the rebound action of the elastic piece, so that the head end of the puncture guide wire props against and supports the pericardium, and the gap between the pericardium and the outer wall of the heart is enlarged, thereby facilitating subsequent operation.
Drawings
Fig. 1 is a schematic structural view of a pericardium puncture outfit for both dry and wet use in an unpunctured state according to an embodiment of the present invention;
fig. 2 is a schematic structural view of a pericardium puncture outfit for both dry and wet use in a puncture state according to an embodiment of the present invention;
Fig. 3 is a schematic structural view of a pericardium puncture outfit for both dry and wet use in a state of inserting a guide wire according to an embodiment of the present invention;
FIG. 4 is an exploded view of a wet and dry pericardial puncture outfit according to an embodiment of the present invention;
FIG. 5 is a schematic view of the structure of a multi-lumen tube, a puncture needle and a puncture guide wire of the pericardium puncture outfit in an unpunctured state according to the embodiment of the invention;
FIG. 6 is a schematic view of the structure of a multilumen tubing, a puncture needle and a puncture guide wire of the pericardium puncture outfit in a puncture state according to the embodiment of the invention;
fig. 7 is a schematic view of a part of a dry/wet pericardium puncture outfit in an unpunctured state according to an embodiment of the present invention;
fig. 8 is a schematic structural view of a part of a casing of a pericardial puncture outfit for both dry and wet use according to an embodiment of the present invention;
fig. 9 is a schematic structural view of a casing of a pericardial puncture outfit for both dry and wet use according to an embodiment of the present invention;
FIG. 10 is a schematic structural view of a dry pericardium;
FIG. 11 is a schematic structural view of a wet pericardium;
fig. 12 is a schematic structural view of a multi-lumen tube of the pericardium puncture outfit for both dry and wet use according to an embodiment of the present invention when reaching the dry pericardium;
FIG. 13 is a schematic view of the structure of a puncture guide wire of a dry/wet pericardium puncture device according to an embodiment of the present invention when puncturing dry pericardium;
FIG. 14 is an enlarged view of a of FIG. 13;
FIG. 15 is a schematic view showing the structure of a puncture guide wire of a wet-dry pericardial puncture outfit according to an embodiment of the present invention when the puncture guide wire starts to bend;
FIG. 16 is an enlarged view of b of FIG. 15;
FIG. 17 is a schematic view of the structure of the puncture guide wire of the pericardium puncture outfit for both dry and wet use according to the embodiment of the invention when the puncture guide wire is gradually formed;
FIG. 18 is an enlarged view of c in FIG. 17;
fig. 19 is a schematic view of the structure of the puncture needle of the dry/wet pericardium puncture device according to the embodiment of the present invention when puncturing dry pericardium;
FIG. 20 is an enlarged view of d in FIG. 19;
fig. 21 is a schematic view of the structure of the dry/wet pericardial puncture device according to the embodiment of the present invention when a guide wire is inserted;
fig. 22 is an enlarged view of e in fig. 21;
fig. 23 is a schematic structural view of the dry and wet pericardium puncture outfit according to an embodiment of the present invention when withdrawn;
fig. 24 is an enlarged view of f in fig. 23;
FIG. 25 is a schematic view of the structure with only the guide wire left;
FIG. 26 is a schematic view showing the structure of the multi-lumen tube of the puncture needle of the wet and dry pericardium puncture outfit according to the embodiment of the present invention when reaching the wet pericardium;
fig. 27 is a schematic view of the structure of a puncture needle of a wet and dry pericardium puncture device according to an embodiment of the present invention when puncturing wet pericardium;
Fig. 28 is an enlarged view of g in fig. 27;
Reference numeral 1, a shell; 2, a multi-cavity tube, 3, a puncture needle, 4, a puncture guide wire, 5, an upper shell, 6, a lower shell, 7, a lock ring, 8, a fixed shaft, 9, a concave part, 10, a puncture needle push button, 11, a push button sliding hole, 12, an elastic bulge, 13, a guide hole, 14, a guide wire, 15, a guide wire push button, 16, a sliding hole, 17, a guide groove, 18, a bump, 19, an elastic piece, 20, a guide shaft, 21, a guide block, 22, a fixed sleeve, 23, pericardium, 24, a heart outer wall, 25 and a pericardium cavity.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention more clear, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings of the embodiments of the present invention. It will be apparent that the described embodiments are some, but not all, embodiments of the invention. All other embodiments, which are obtained by a person skilled in the art based on the described embodiments of the invention, fall within the scope of protection of the invention.
Unless defined otherwise, technical or scientific terms used herein should be given the ordinary meaning as understood by one of ordinary skill in the art to which this invention belongs. The terms "first," "second," and the like, as used herein, do not denote any order, quantity, or importance, but rather are used to distinguish one element from another. Likewise, the terms "a" or "an" and the like do not denote a limitation of quantity, but rather denote the presence of at least one. The terms "connected" or "connected," and the like, are not limited to physical or mechanical connections, but may include electrical connections, whether direct or indirect. "upper", "lower", "left", "right", etc. are used merely to indicate a relative positional relationship, which changes accordingly when the absolute position of the object to be described changes.
Embodiments of the present invention are specifically described below with reference to the accompanying drawings.
As shown in fig. 1-3, an embodiment of the present invention provides a pericardial puncture outfit for both dry and wet use, which comprises a housing 1, a multi-lumen tube 2, a puncture needle 3, and a puncture guide wire 4. The multilumen tubing 2 is disposed over the housing 1, the introducer needle 3 is slidably disposed within one of the lumens of the multilumen tubing 2, and the piercing guidewire 4 is slidably disposed within the other lumen of the multilumen tubing 2.
As shown in fig. 4 to 9, a cavity for accommodating each component is formed inside the housing 1, and one end of the multi-lumen tube 2 is fixed inside the housing 1 while the other end passes out of the housing 1. The shell can be divided into an upper shell 5 and a lower shell 6, the upper shell 5 and the lower shell 6 can be disassembled, and the upper shell 5 and the lower shell 6 are fixed together through a lock ring 7 or a fixed shaft 8, so that the structure is convenient to install and maintain. The shell 1 is provided with a concave part 9 which is convenient for a doctor to grasp. The outer shell is also provided with a fixing sleeve 22, and one end of the multi-cavity tube 2 is fixed in the fixing sleeve 22. The multi-cavity tube 2 is internally provided with a plurality of cavities, and the number, the shape and the arrangement mode of the cavities are selected according to actual needs. For example, if the number of the puncture needles 3 is one and the number of the puncture guide wires 4 is two, three cavities of the multi-cavity tube 2 are arranged, the shapes of the cavities are matched with the puncture needles 3 and the puncture guide wires 4, the cavities for inserting the puncture needles 3 can be arranged in the middle, and the two cavities for inserting the puncture guide wires 4 are arranged at two sides. The puncture guide wire 4 can be a nickel titanium flat wire, the head end of the puncture guide wire is a sharp pigtail, the puncture guide wire can be in a straightened state when completely contracted in the multi-cavity tube 2, the puncture guide wire can be automatically rolled into the pigtail when released, the pericardium 23 can be propped up after the pericardium 23 is punctured, and the puncture guide wire can timely rotate after the puncture guide wire is punctured, so that the effect of not damaging other tissues can be achieved.
The puncture needle 3 and the puncture guide wire 4 are combined through the multi-cavity tube 2, and are designed into an integrated structure, so that the puncture needle is suitable for dry and wet pericardial puncture, and can be operated only through different use modes. The invention has simple structure and low operation difficulty, a doctor can simply and conveniently puncture, the operation can be completed without too much experience, the risk coefficient of the puncture method and process is lower, and the invention is convenient for more hospitals and doctors to use.
In a preferred scheme of the embodiment, the pericardium puncture outfit with both dry and wet functions further comprises a puncture needle push button 10, wherein the puncture needle push button 10 is slidably arranged on the shell 1, and the puncture needle push button 10 is connected with the puncture needle 3. The puncture needle push button 10 can be connected with the puncture needle 3 in an adhesive manner, and the puncture needle 3 can be inserted and pulled out by pushing or pulling, so that the operation is simple and convenient.
In a preferred embodiment of the present embodiment, the housing 1 is formed with a push button sliding hole 11, and the puncture needle push button 10 is fit in the push button sliding hole 11 in a transition manner. The push button slide hole 11 on the shell 1 corresponds to the multi-cavity tube 2, the push button slide hole 11 and the puncture needle push button 10 can be arranged into a cylinder shape, the peripheral diameter of the puncture needle push button 10 is slightly larger than that of the push button slide hole 11, when the puncture needle push button 10 is positioned in the push button slide hole 11, the peripheral structure of the puncture needle push button 10 is extruded and deformed, so that the puncture needle push button 10 can be fixed at any position in the push button slide hole 11, that is, a doctor pushes the puncture needle push button 10 to any position, and the fixing can be realized by loosening hands.
In a preferred embodiment of the present embodiment, the outer peripheral structure of the push button 10 is an elastic protrusion 12 that is attached to the surface of the sliding hole 11 of the push button. The protrusions on the surface of the puncture needle push button 10 can be arranged to surround one circle of the puncture needle push button, and a plurality of circles can be arranged to ensure that the puncture needle push button can be tightly fixed at any position. The surface of the push button slide hole 11 can be provided with a groove matched with the elastic bulge 12.
In a preferred embodiment of the present embodiment, the puncture needle push button 10 is formed with a guide hole 13, and the guide hole 13 communicates with the inner hole of the puncture needle 3 for inserting a guide wire 14. The guide hole 13 can be designed into a cone Lu Erkong, so that a doctor can use a syringe to clean or suck pericardial effusion during operation.
In a preferred scheme of the embodiment, the pericardium puncture outfit for dry and wet use further comprises a guide wire push button 15, wherein the guide wire push button 15 is slidably arranged on the shell 1, and the guide wire push button 15 is connected with the puncture guide wire 4. The guide wire push button 15 can be arranged on the side surface of the shell 1, a sliding hole 16 is formed in the side surface of the shell 1, one part of the guide wire push button 15 is positioned outside the shell 1, the other part of the guide wire push button passes through the sliding hole 16 to be connected with the guide wire inside, and a doctor can conveniently operate the guide wire push button 15.
In a preferred version of this embodiment, the housing 1 is formed with a guide slot 17 and the guidewire push button 15 is formed with a projection 18, the projection 18 slidably fitting within the guide slot 17. The guide groove 17 and the protruding block 18 can be arranged in an upper and a lower mode, and under the limiting and guiding effects of the guide groove 17, shaking is not easy to occur in the process that a doctor pushes the guide wire push button 15, so that the success rate of an operation is improved.
In the preferred scheme of the embodiment, the pericardium puncture outfit for dry and wet use also comprises an elastic piece 19, and two ends of the elastic piece 19 are respectively connected with the guide wire push button 15 and the shell 1. The elastic element 19 can be provided with two, the guide wire push button 15 is connected with the elastic element 19, when the guide wire push button 15 pushes out the puncture guide wire 4 outwards, the elastic element 19 is compressed, when the head end of the puncture guide wire 4 passes through the pericardium 23 and curls into a pigtail shape, the guide wire push button 15 is loosened, the guide wire push button 15 and the puncture guide wire 4 move in the opposite direction under the rebound action of the elastic element 19, so that the head end of the puncture guide wire 4 props against and supports the pericardium 23, and the gap between the pericardium 23 and the outer wall 24 of the heart is enlarged, thereby facilitating subsequent operation. The elasticity of the elastic member 19 can be determined based on the experience of the doctor and a number of experiments. The elastic member 19 may be a spring.
In a preferred aspect of the present embodiment, the pericardial puncture outfit for both dry and wet use further includes a guide shaft 20, a shaft hole is formed in the guide wire push button 15, and the guide shaft 20 passes through the shaft hole and is fixed to the housing 1. Under the limiting and guiding actions of the guide shaft 20, the stability of the guide wire push button 15 in the sliding process is further improved. The guide shaft 20 and the shaft hole may be provided in two. The elastic piece 19 can be of a hollow structure, the guide shaft 20 can be inserted into the elastic piece 19, the elastic piece 19 and the guide shaft 20 can be arranged in the guide groove 17, and the layout greatly saves the occupied space of the components.
In a preferred scheme of the embodiment, the pericardium puncture outfit for dry and wet use further comprises a guide block 21, wherein the guide block 21 is fixed on the shell 1, a guide hole is formed in the guide block 21, and the puncture needle 3 and the puncture guide wire 4 penetrate through the guide hole. Because the inner space of the shell 1 is longer, the lengths of the puncture needle 3 and the puncture guide wire 4 exposed out of the multi-cavity tube 2 are longer, the puncture needle 3 and the puncture guide wire 4 are further fixed through the guide block 21, the stability of the puncture needle 3 and the puncture guide wire 4 in the sliding process can be ensured, and the success rate of the operation is improved.
The following describes the operation of puncturing by the wet and dry pericardial puncture outfit of the present embodiment.
Before puncture, preparation work is required, namely, the puncture part is sterilized, then the local anesthesia is carried out on the puncture part, then the thoracocentesis is carried out by using a short sheath (not shown), and the short sheath is retained at the thoracic position. The dry pericardial structure and wet pericardial structure are shown in fig. 10-11.
After preparation, either a dry pericardial puncture or a wet pericardial puncture may be performed. As shown in fig. 12-25, the procedure for performing dry pericardial puncture is:
The method comprises the steps of holding a shell 1, feeding a multi-cavity tube 2 to the edge of a pericardium 23 along a retained short sheath, feeding the head end of the multi-cavity tube 2 to a puncture point of the pericardium 23 until the head end contacts with the puncture point, pushing a puncture guide wire 4 to a certain distance towards the puncture point, enabling the head end of the puncture guide wire 4 to be inserted into the pericardium 23, continuously bending and forming the head end of the puncture guide wire 4 in the process of being inserted into the pericardium 23, finally supporting the pericardium 23, enabling a space to be reserved between the pericardium 23 and an outer wall 24 of the heart, pushing the puncture needle 3 to be inserted into the pericardium 23 for a preset distance, and enabling a guide wire 14 for establishing an operation channel to penetrate into the pericardium 23 along an inner hole of the puncture needle 3, and sequentially withdrawing the puncture needle 3, the puncture guide wire 4 and the multi-cavity tube 2.
As shown in fig. 26-28, the wet pericardial puncture procedure is performed as follows:
The first step of holding the housing 1 and feeding the multi-lumen tube 2 along the retained short sheath all the way to the edge of the pericardium 23, and then feeding the head end of the multi-lumen tube 2 to the puncture site of the pericardium 23 until the head end contacts the puncture site, the second step of pushing the puncture needle 3 a certain distance toward the puncture site so that the puncture needle 3 is inserted into the pericardial cavity 25, and the third step of sucking pericardial effusion along the inner hole of the puncture needle 3 by a tool such as a syringe.
The above examples are provided to further illustrate the invention and do not limit the invention to these specific embodiments. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present invention should be construed as being within the protection scope of the present invention.