CN116439800A - Vascular puncture system - Google Patents

Abstract

The invention provides a vascular puncture system which comprises a puncture catheter, a puncture needle and an auxiliary device, wherein an open slot is formed in the side face of the insertion end of the puncture catheter, the puncture needle is arranged in the open slot, the tail of the puncture needle is hinged with the insertion end of the puncture catheter, the needle head of the puncture needle is opposite to the insertion end of the puncture catheter, the auxiliary device is arranged between the puncture needle and the puncture catheter, and the puncture needle is controlled to spring and fold to retract through the auxiliary device. The invention aims at providing a simple and reliable vascular puncture system for a complex operation process when a blood vessel with special requirements or special positions is required to be punctured, and the blood vessel puncture system can enter a target blood vessel puncture position along a natural vascular pipeline from a relatively easy body surface blood vessel, so that the purpose of puncturing the blood vessel is achieved, the operation technical difficulty is greatly reduced, the accuracy of the puncture operation is improved, and the complex or difficult-to-realize vascular puncture technology is simplified.

Description

Vascular puncture system

Technical Field

The invention relates to the technical field of medical vascular puncture, in particular to a vascular puncture system.

Background

With the progress of medical technology, the vascular puncture technology is widely applied to puncture catheter placement, angiography, interventional therapy and the like. In order to relieve pain of patients, reduce puncture complications and improve prognosis of patients, the puncture needs to have the highest puncture success rate, the lowest puncture times and the lowest puncture damage. In general, simple superficial vascular puncture techniques are not difficult.

With the development of medical technology and ideas, better therapeutic technology methods and devices are continuously emerging, but the following vascular puncture technology requirements are gradually improved: some treatments require puncturing of specific blood vessels, such as changing access patterns of more and more cardiac pacemaker lead wire placement, from subclavian venous access, which is prone to complications, to axillary and even cephalic venous access, which are less prone to complications, and the most severe complications of cardiac pacemakers are pacemaker pocket infections, which are associated with excessive instrument manipulations such as repeated punctures of tissue lesions, localized hemorrhages, etc., which are prone to bacterial infections; some treatments require special vascular puncture sites, such as transcatheter aortic valve replacement (Transcatheter Aortic Valve Replacement, TAVR), which, due to the relatively large diameter of the surgical instruments used, require precise puncture of the proximal femoral artery at the median location to reduce postoperative complications; some treatments require two or more vascular punctures in Sup>A particular areSup>A, such as the venous arterial mode (V-Sup>A mode) epicardial pulmonary oxygenation (Extracorporeal Membrane Oxygenation, ECMO) technique, requiring separate vascular puncture cannulations in the narrow areas of the ipsilateral femoral vein and femoral artery. In these cases, vascular puncturing, particularly rapid and smooth vascular puncturing, has become very difficult, particularly in patients with obesity, age-related skin laxity, large vascular variability, low peripheral blood pressure, or shock. This typically requires more invasive skin incisions or ultrasound guidance with higher hardware requirements, nor does it guarantee that a puncture will succeed without internal bleeding.

At present, the vascular puncture technology adopts a forward puncture method, namely, a specific part of a vascular segment to be punctured is firstly determined, then a puncture needle is advanced along the vascular direction from a proper position on the body surface, whether the puncture needle reaches the vascular cavity is judged according to the blood return condition in the needle head of the puncture needle, and thus, repeated attempts are carried out until success, and a guide wire is arranged along the puncture needle after success so as to be beneficial to subsequent operation. The blood vessel puncture method is only applicable to a relatively superficial part with definite fixed body surface positioning or body surface palpable and blood vessel beating. The method is not suitable for blood vessels at other deep parts, blood vessels with weak arterial pulsation and dispersion, blood vessels with undefined body surface positioning marks and large blood vessel shape variability, blood vessels with extremely strict requirements on tissue injury around puncture, blood vessels with puncture points at specific sites on the peripheral path of the blood vessels, and the like.

There is a reverse vascular puncture device for interventional use, which is disclosed in CN201210475559.0, and is configured to insert a puncture channel from a relatively easy vascular puncture site, then to pass through a horizontal plane or sagittal plane where a heart of a human body is located along a vascular access, to a target vascular puncture site, and to deliver a puncture needle along the puncture channel, wherein the puncture direction is toward the advancing direction side of a puncture system, and to puncture from the inside of a blood vessel to the outside of the blood vessel until skin is punctured. Although the difficult problem of direct puncture from the target vascular position is solved, the travel distance of the puncture needle is greatly increased, the puncture needle spans from the left side to the right side or spans from the foot side to the head side, the puncture path is long, the vascular corner is twisted more, the propulsion is not easy to conduct, the risk is relatively large, the instrument design is complex, and the operation steps are complex.

Aiming at the defects, the existing blood vessel puncture tool is urgently needed to be improved, so that the tool can be better suitable for blood vessels at difficult puncture sites of an organism, and various defects in the existing puncture technology are overcome. Therefore, it is necessary to design a puncture system and a puncture method which can be convenient and quick.

Disclosure of Invention

Aiming at the problem that the existing blood vessel puncture tool is only suitable for the relative superficial part with definite fixed body surface positioning or body surface capable of being touched and blood vessel beating, the invention provides a puncture needle hinged with a puncture catheter, the direction of the puncture needle is opposite to the puncture direction of the puncture catheter, and the skin is punctured by the hinged puncture needle to realize the blood vessel puncture system for inserting a guide wire.

The invention solves the technical problems by adopting a scheme that the vascular puncture system comprises a puncture catheter, a puncture needle and an auxiliary device, wherein an open slot is formed in the side surface of the penetrating end of the puncture catheter, the puncture needle is arranged in the open slot, the needle tail of the puncture needle is hinged with the penetrating end of the puncture catheter, the needle head of the puncture needle is opposite to the penetrating end of the puncture catheter, a guide wire cavity is formed in the puncture needle, openings at two ends of the guide wire cavity are respectively formed in the side surfaces of the needle head and the needle body of the puncture needle, the auxiliary device is arranged between the puncture needle and the puncture catheter, and the puncture needle is controlled to bounce and fold to retract through the auxiliary device; the puncture needle comprises a needle body and a needle sleeve, wherein the needle sleeve is hinged on the puncture catheter, the needle body is sleeved in the needle sleeve, and openings of the guide wire cavity are respectively positioned at the needle point of the needle body and the side face of the needle body; the needle sleeve of the puncture needle extends towards the penetrating end of the puncture catheter to form an extension section, and a tail end limiting base is fixed below the extension section.

Further, auxiliary device includes torsional spring and tractive wire, and wherein the torsional spring is installed between needle cover and puncture pipe, and the puncture pipe sets up the wire chamber along the pipe shaft, and the wire chamber sets up inboard opening in the needle cover below, wears to overlap the tractive wire in the wire chamber, and the inner of tractive wire is connected on the needle cover.

Further, auxiliary device includes preceding wire and back wire, sets up two parallel wire chambeies in the puncture pipe, and the outside opening in two wire chambeies is located the outer tip of puncture pipe, and the inboard opening in two wire chambeies corresponds pjncture needle articulated position both sides respectively, and preceding wire and back wire are worn the cover respectively in the wire chambeies, and preceding wire connects the needle cover, and back wire connects the extension of pjncture needle.

Further, the side of the extension section facing the puncture catheter is provided as a bevel.

Further, chamfer inclined planes are arranged at two ends of the open groove.

Further, the guide wire cavity is a tube cavity with the size smaller than the inner diameter of the puncture catheter, and is fixed in the catheter.

Further, the needle body is provided with external threads, the needle sleeve is provided with internal threads, and the needle body is sleeved in the needle sleeve through the threads.

The invention has the beneficial effects that: the invention aims to provide a vascular puncture system for a complex operation process, which aims at the condition that a vascular puncture with special requirements or special positions is needed, and the vascular puncture system enters from a relatively easy body surface blood vessel and enters a target vascular puncture position to fulfill the purpose of puncturing the blood vessel, thereby greatly reducing the operation technical difficulty, improving the accuracy of the puncture operation and simplifying the complex or difficult-to-realize vascular puncture technology.

The vascular puncture system of the invention, the puncture needle moves to the vascular target puncture point along with the catheter, the puncture needle is sprung open to form a certain angle with the help of the auxiliary device, and then the catheter and the puncture needle are retracted, so that the puncture needle punctures from the inside of the blood vessel to the outside of the blood vessel layer by layer and is outside the body. Compared with the prior puncturing method, the vascular puncturing system can puncture the blood vessel with high puncturing difficulty, the blood vessel with little puncturing tissue injury requirement and the blood vessel at the special part which is not suitable for puncturing. The traditional concept of vascular puncture is changed, the puncture difficulty is greatly reduced, the puncture with high difficulty is simple and easy to implement, and certain unpunchable blood vessels have the possibility of puncture. Simultaneously, the puncture injury and puncture complications are reduced, so that the pain of a patient is relieved, the economic burden is reduced, and even the prognosis of the patient is directly influenced.

The puncture needle adopts a two-section structure, after the puncture needle punctures the blood vessel wall and stretches out, the needle body and the needle sleeve are separated, the needle body slowly falls off along the guide wire, the needle sleeve is folded into the puncture catheter through the auxiliary device and is pulled out along with the puncture catheter, the whole operation process is simple and reliable, and the difficulty of blood vessel puncture and guide wire implantation is greatly reduced.

Drawings

Fig. 1 is a schematic structural view of an embodiment of the present invention.

Fig. 2 is a process schematic of the embodiment shown in fig. 1.

Fig. 3 is a schematic structural view of another embodiment of the present invention.

Fig. 4 is a process schematic of the embodiment shown in fig. 3.

Reference numerals in the drawings: the puncture catheter comprises a puncture catheter 1, a wire cavity 2, a traction wire 3, a needle sleeve 4, a needle body 5, a wire cavity 6, a tail end limiting base 7, a torsion spring 8, a front wire 9, a rear wire 10 and an extension section 11.

Description of the embodiments

The invention will be further described with reference to the drawings and examples.

Example 1: in order to facilitate deep blood vessels, blood vessels with weak arterial pulsation and dispersion, blood vessels with undefined body surface positioning marks, blood vessels with increased blood vessel shape variation, blood vessels with extremely strict requirements on tissue damage around puncture, and puncture points of blood vessels at special positions such as blood vessels at specific sites on the peripheral path of the blood vessels. As shown in fig. 1, the vascular puncture system of the present invention comprises a puncture catheter 1 for puncturing, wherein the puncture catheter 1 is used for being inserted into a blood vessel of a patient to puncture, one end of the puncture catheter 1, which is used for being inserted into the blood vessel, is provided with an open slot, a puncture needle with the opposite direction to the puncture direction of the puncture catheter 1 is arranged in the open slot, one end of the puncture needle, which faces to the insertion end of the puncture catheter 1, is used as the tail end, the tail end is hinged with the puncture catheter 1 through a pin shaft, and the puncture needle can rotate around the pin shaft of the hinged part, so that the tip of the puncture needle is tilted upwards, and an included angle is formed between the puncture needle and the puncture catheter 1.

The puncture needle is provided with a guide wire cavity 6, the guide wire cavity 6 is provided with an outer side opening at the needle point of the puncture needle, the needle body of the puncture needle is provided with an inner side opening near the hinging point, and the guide wire is sleeved into the guide wire cavity 6 and is placed into a blood vessel of a patient along the guide wire cavity 6.

A torsion spring 8 is arranged between the puncture needle and the puncture catheter 1, one end of the torsion spring 8 is connected to the needle body of the puncture needle, the other end of the torsion spring is fixed on the puncture catheter 1, and the puncture needle is jacked up through the torsion spring 8.

The puncture catheter 1 is also provided with a wire cavity 2, the wire cavity 2 can be arranged in the catheter wall, the wire cavity 2 can also be an independent pipe cavity with the size smaller than the inner diameter of the catheter, the pipe cavity is fixed in the catheter, the inner side outlet of the wire cavity 2 is arranged below the puncture needle, the traction wire 3 is sleeved in the wire cavity 2 in a penetrating way, the position of the traction wire 3 is limited by the wire cavity 2, and the inner end of the traction wire 3 is connected to the puncture needle.

As shown in fig. 2, the traction wire 3 is tensioned, so that the puncture needle overcomes the elasticity of the torsion spring 8 and is combined into the puncture catheter 1, the puncture catheter 1 is used for conveying the puncture needle into a target blood vessel, the traction wire 3 is loosened, the puncture needle is sprung open under the action of the torsion spring 8, the tail end limiting base 7 below the puncture needle controls the sprung open angle of the puncture needle, and the puncture needle is prevented from being sprung out too much.

The puncture catheter 1 is pulled back to drive the puncture needle to puncture the blood vessel wall reversely, the needle tip of the puncture needle extends out of the blood vessel, at the moment, the guide wire is sleeved into the guide wire cavity 6 of the puncture needle, and the guide wire extends out of the blood vessel from the inner opening of the puncture needle.

The puncture needle adopts two-section design, including needle body 5 and needle cover 4, needle cover 4 articulates on puncture pipe 1, needle body 5 suit is in needle cover 4, the opening of seal wire chamber 6 is located the needle point department of needle body 5 and the needle body side of needle body 5 respectively, the seal wire wears to cover into seal wire chamber 6 and stretches into after in the blood vessel, take down needle body 5 from needle cover 4, and take out needle body 5 from the blood vessel, the inner of seal wire is detained in the blood vessel this moment, needle body 5 outwards takes out along the seal wire, take off from the outer end of seal wire, the seal wire is accomplished the implantation in the blood vessel, taut tractive wire 3 makes needle cover 4 compress into puncture pipe 1 again, take out puncture pipe 1 and accomplish the seal wire implantation operation.

For further visual illustration, taking armpit venipuncture as an example when a cardiac pacemaker lead is placed, after the patient is ready for operation, the patient is in a recumbent position, the left upper limb is straightened and abducted by 90 degrees, after disinfection and towel spreading, the conventional elbow median venipuncture is placed into a vascular sheath, a catheter with a vascular puncture needle is sent into the vascular sheath along the vascular sheath, a proper length is sent according to the measured vascular length, whether the puncture needle reaches the armpit vein target position can be positioned by X rays, and the catheter is rotated to enable the puncture needle to be opposite to the surface of the puncture skin. At this point the site to be punctured around the axillary vein is sterilized and locally anesthetized. The auxiliary device is operated to change the puncture needle from the folded state to the spring-open state with a certain angle, namely, the pulling wire 3 is loosened to make the puncture needle spring out under the action of the torsion spring 8, and at the moment, the catheter connected with the puncture needle is retracted by using proper force to make the puncture needle puncture the blood vessel inner membrane layer by layer until reaching the skin surface. At this time, the assistant feeds the guide wire along the outer opening of the tip of the puncture needle, and feeds the guide wire along the cavity of the puncture needle from the inner opening of the body tail joint part to the inside of the axillary vein cavity. The fixed guide wire is kept motionless in the armpit vein, the needle body 5 is taken down from the needle sleeve 4, the needle body 5 is pulled outwards along the guide wire under the condition of keeping the guide wire not moving until the needle body 5 is separated from the guide wire, the lead 3 is pulled tightly, and the sprung needle sleeve 4 is changed into an initial folded state under the action of the pull force of the lead. At this time, the catheter and the needle sheath 4 can be withdrawn, and then another vascular sheath can be placed along the guide wire, thereby completing the subsequent cardiac pacemaker placement process.

Example 2: because the torsion spring 8 belongs to a tiny component, the risk of falling and blocking during the operation increases the unsafe factors of the operation, and therefore, on the basis of the embodiment 1, an auxiliary device for controlling the ejection and folding of the puncture needle is further modified, and the scheme is a parallel scheme of the embodiment 1, so that the use of the torsion spring 8 can be avoided, and the operation risk is reduced.

As shown in FIG. 3, the puncture needle is also designed in two sections, the needle sleeve 4 continues to extend to the penetrating end of the puncture catheter 1 to form an extension section 11 after passing through the hinge point, the extension section 11 is pointed, one surface of the extension section 11 facing the puncture catheter 1 is provided with an inclined surface, and the inclined surface cooperates with the tail end limiting base 7 below to limit the ejection angle of the puncture needle.

Two parallel wire lumens 2 are arranged in the puncture catheter 1, and the inner openings of the two wire lumens are respectively positioned at two sides of the hinging part, a front wire 9 and a rear wire 10 are respectively sleeved in the two wire lumens 2, the front wire 9 is connected with the needle sleeve 4 through an opening facing the puncture needle sleeve 4, and the rear wire 10 is connected with the extension section 11 through an opening facing the extension section 11.

As shown in fig. 4, the front guide wire 9 is pulled, the rear guide wire 10 is loosened, the puncture needle is folded in the puncture catheter 1, and the puncture catheter 1 is pushed forward to the target puncture vascular site at the moment; the front guide wire 9 is loosened, the rear guide wire 10 is pulled tightly, the puncture needle is ejected out, the puncture catheter 1 is pulled back, the puncture needle reversely punctures the vascular wall until the skin surface is punctured, and the insertion of the guide wire is completed by using the extended puncture needle.

After the guide wire is placed, the front guide wire 9 is pulled, the rear guide wire 10 is loosened, the puncture needle or needle sleeve 4 is folded, and the puncture catheter 1 is withdrawn to complete the guide wire placement.

Example 3: on the basis of embodiment 1 or embodiment 2, the needle body 5 is provided with external threads, the needle sleeve 4 is provided with internal threads, and the needle body 5 is sleeved in the needle sleeve through threads.

The needle body 5 and the needle sleeve 4 can be sleeved more stably by utilizing the threads, in the puncturing process, the needle body 5 and the needle sleeve 4 need to move in a certain distance in a blood vessel, and if the combination between the needle body 5 and the needle sleeve is loosened, the needle body 5 is easily separated from the needle sleeve, so that the needle body is detained in the blood vessel, and medical accidents are caused. In order to make the puncture safer and more reliable, the needle body and the needle sleeve are sleeved through threaded connection in the embodiment.

The foregoing has outlined the basic principles, features, and advantages of the present invention. It will be understood by those skilled in the art that the present invention is not limited to the embodiments described above, and that the above embodiments and descriptions are merely illustrative of the principles of the present invention, and various changes and modifications may be made therein without departing from the spirit and scope of the invention, which is defined by the appended claims.

Claims (7)

1. The vascular puncture system is characterized by comprising a puncture catheter (1), a puncture needle and an auxiliary device, wherein an open slot is formed in the side face of the penetrating end of the puncture catheter (1), the puncture needle is arranged in the open slot, the tail of the puncture needle is hinged with the penetrating end of the puncture catheter (1), and the needle head of the puncture needle faces in the direction opposite to the penetrating end of the puncture catheter (1);

the puncture needle is provided with a guide wire cavity (6), and openings at two ends of the guide wire cavity (6) are respectively arranged on the side surfaces of the needle head and the needle body of the puncture needle;

an auxiliary device is arranged between the puncture needle and the puncture catheter (1), and the puncture needle is controlled to spring and fold to retract through the auxiliary device;

the puncture needle comprises a needle body (5) and a needle sleeve (4), wherein the needle sleeve (4) is hinged on the puncture catheter (1), the needle body (5) is sleeved in the needle sleeve (4), and the opening of the guide wire cavity (6) is respectively positioned at the needle point of the needle body (5) and the side face of the needle body (5);

the needle sleeve (4) of the puncture needle extends towards the penetrating end of the puncture catheter (1) to form an extension section (11), and a tail end limiting base (7) is fixed below the extension section (11).

2. Vascular puncture system according to claim 1, characterized in that the auxiliary device comprises a torsion spring (8) and a pull wire (3), wherein the torsion spring (8) is mounted between the needle sheath (4) and the puncture catheter (1), the puncture catheter (1) is provided with a wire cavity (2) along the catheter shaft, the wire cavity (2) is provided with an inner opening below the needle sheath (4), the pull wire (3) is sleeved in the wire cavity (2), and the inner end of the pull wire (3) is connected to the needle sheath (4).

3. The vascular puncture system according to claim 1, wherein the auxiliary device comprises a front wire (9) and a rear wire (10), two parallel wire cavities (2) are arranged in the puncture catheter (1), the outer openings of the two wire cavities (2) are positioned at the outer end part of the puncture catheter (1), the inner openings of the two wire cavities (2) respectively correspond to two sides of the hinging part of the puncture needle, the front wire (9) and the rear wire (10) respectively penetrate through the wire cavities (2), the front wire (9) is connected with the needle sleeve (4), and the rear wire (10) is connected with the extension section (11) of the puncture needle.

4. A vascular puncture system according to claim 2 or 3, characterized in that the side of the extension (11) facing the puncture catheter (1) is provided as a bevel.

5. A vascular puncture system according to claim 2 or 3, wherein the open slot is provided with chamfer bevels at both ends.

6. A vascular puncture system according to claim 2 or 3, characterized in that the guidewire lumen (2) is a lumen of a size smaller than the inner diameter of the puncture catheter, the guidewire lumen (2) being fixed within the catheter.

7. The vascular puncture system according to claim 1, wherein the needle body (5) is provided with an external thread and the needle sheath (4) is provided with an internal thread, the needle body (5) being threadedly engaged in the needle sheath.