CN111110988B

CN111110988B - A device for submerged placement of a drainage tube

Info

Publication number: CN111110988B
Application number: CN202010027264.1A
Authority: CN
Inventors: 郭建; 荆柳; 汪建军; 辛涛; 曹莉莉
Original assignee: First Affiliated Hospital of Shandong First Medical University
Current assignee: First Affiliated Hospital of Shandong First Medical University
Priority date: 2020-01-10
Filing date: 2020-01-10
Publication date: 2021-08-24
Anticipated expiration: 2040-01-10
Also published as: CN111110988A

Abstract

The invention discloses a device for submerged placement of a drainage tube, which solves the problems in the prior art that the drainage tube is easy to loosen, the indwelling time is short, and the submerged depth is limited. effect of risk. Its technical scheme is: comprising a vertical puncture needle and a lateral puncture needle, the vertical puncture needle comprises a first outer needle needle body and a first needle core arranged inside the first outer needle needle body, and the lateral puncture needle comprises The second outer needle body and the second needle core arranged inside the second outer needle body; after the first needle core is withdrawn from the first outer needle body, the second outer needle body can be at a set angle with the The needle body of the first outer needle is clamped; the needle body of the second outer needle is overlapped with the needle body of the first outer needle to form a channel for placing a drainage tube or a guide wire.

Description

Device for submerging drainage tube

Technical Field

The invention relates to the technical field related to medical instruments, in particular to a device for submerged placement of a drainage tube.

Background

At present, the method for puncturing and indwelling the drainage tube is widely applied clinically because of the advantages of minimal invasion, easy operation, low incidence of complications and complications, easy maintenance and the like. The method mainly comprises two methods: in a first mode, similar to a Seldinger' S method adopted for puncturing blood vessels, the blood vessel puncture needle punctures each layer of tissue from the body surface to reach a target cavity, the guide wire is pushed to the front section of the blood vessel to enter the target cavity through the needle cavity, the guide wire is fixed, the puncture needle is withdrawn along the guide wire, the dilator is withdrawn after the dilator is placed in the dilator along the guide wire to expand an inner cavity of the tissue, the drainage tube is placed in the drainage tube along the guide wire, and the guide wire is withdrawn after the front section of the drainage tube enters the target cavity. The mode is commonly used for closed drainage of pleural cavity, drainage of peritoneal cavity and the like, wherein the puncture needle is thinner than the drainage tube, the tail end of the drainage tube is often provided with a non-tubular expansion part and a side tube which are connected, and the drainage tube is a composite drainage tube. The second method comprises the following steps: the puncture needle punctures the body surface, punctures each layer of tissue, retreats from the needle core to the target cavity, pushes the drainage tube through the needle cavity to enable the front section of the drainage tube to enter the target cavity, fixes the drainage tube and withdraws the puncture needle along the drainage tube. This is commonly seen in lumbar cistern drainage, etc. Wherein the puncture needle is thicker than the drainage tube, and the drainage tube is a single drainage tube with the same front and back caliber. The puncture needles used in the two modes are straight needles and are both used for vertical or oblique puncture, and the two modes are the most widely applied general puncture tube placing method at home and abroad at present and have the characteristic of simple and convenient operation. However, the defect of short tube remaining time caused by limited subcutaneous creeping distance of the drainage tube exists, and even if methods such as pushing the skin at a puncture point are adopted to prolong the length of the drainage tube in a subcutaneous tissue layer, the effect is still limited. If other modes are adopted: on the basis of successful direct puncture tube placement, a skin incision is made beside an original skin puncture hole, and the tail section of a drainage tube at the original puncture hole is led out through the incision after a subcutaneous tunnel is poked by using vascular forceps. The method is only suitable for the drainage tube with one in two modes, and has the characteristics of large wound, limited side-opening distance and limited diving depth. The method is difficult to be used for the composite drainage tube with different front and back calibers.

The two puncture tube placing methods have the condition that the indwelling effect of the drainage tube is not ideal: the drainage tube is difficult to maintain, particularly, the retained drainage tube of an ascites patient is poor in stability, easy to loosen and easy to seep due to low protein edema and loose tissues of the abdominal wall, the nursing difficulty is increased, and the medical workload is increased by frequently changing the medicine of the wound and even puncturing the tube again. The key is that the defect of the retention mode causes the drainage tube to be easy to loosen, seep liquid and even to be infected in a retrograde direction, and as a result, the drainage maintaining time is shortened, the risk of infection in the retrograde direction is increased, and the treatment effect is finally influenced. For the retention mode of cutting the skin beside the puncture hole, using a vascular forceps to puncture the hole to establish a subcutaneous tunnel and then leading out the drainage tube in a submerged manner, the problem of large wound and poor retention effect exists if the incision is enlarged due to limited depth of the submerged manner, and the risk of increasing the looseness of the drainage tube, the seepage around the tube and the infection is also faced.

Disclosure of Invention

In order to overcome the defects of the prior art, the invention provides a device for the submerged placement of a drainage tube, which has the effects of long retention time of the drainage tube, good stability and reduction of infection risk.

The invention adopts the following technical scheme:

a device for placing a drainage tube in a sneak way comprises a vertical puncture needle and a lateral puncture needle, wherein the vertical puncture needle comprises a first outer needle body and a first needle core arranged in the first outer needle body, and the lateral puncture needle comprises a second outer needle body and a second needle core arranged in the second outer needle body;

after the first needle core is withdrawn from the first outer needle body, the second outer needle body can be clamped with the first outer needle body at a set angle; the second outer needle body is lapped with the first outer needle body to form a channel for placing a drainage tube or a guide wire.

Furthermore, the first outer needle body comprises a guide part and a first holding part which are connected into a whole, and one end of the guide part, which is far away from the first holding part, is provided with a guide groove with a set length.

Further, the guide groove is provided along the axial direction of the guide portion.

Furthermore, one end of the guiding part, which is far away from the first holding part, is provided with an arc-shaped tip.

Further, the first needle core is inserted into the first outer needle body and the end part of the first needle core is contacted with the arc-shaped tip.

Furthermore, the first holding part is provided with a sight.

Furthermore, one end of the second outer needle body is provided with a second holding part, and the other end of the second outer needle body is provided with an opening for the second needle core to extend out.

Further, the opening has an upper lip and a lower lip disposed opposite each other.

Further, the upper lip extension length is greater than the lower lip extension length.

Further, the second holding part is provided with a transverse handle.

Compared with the prior art, the invention has the beneficial effects that:

(1) the lateral puncture needle is in lap joint with the vertical puncture needle at a certain angle, and the drainage tube or the guide wire enters the vertical first outer needle body from the inclined second outer needle body, so that the creeping distance is prolonged; the retention time of the drainage tube is prolonged, the drainage tube is not easy to loosen, the damage to the human body is small, and the infection risk is reduced;

(2) according to the invention, the first outer needle body is provided with the guide groove, the end part of the second outer needle body is provided with the opening, and the second outer needle body can be stably clamped on the inner side of the first outer needle body through the matching of the opening and the guide groove, so that a drainage tube or a guide wire can be smoothly placed in;

(3) the opening at the end part of the second outer needle body is provided with an upper lip and a lower lip, and the extension length of the upper lip is greater than that of the lower lip, so that the drainage tube or the guide wire is guided, and the drainage tube or the guide wire smoothly enters the first outer needle body from the second outer needle body.

Drawings

The accompanying drawings, which are incorporated in and constitute a part of this application, illustrate embodiments of the application and, together with the description, serve to explain the application and are not intended to limit the application.

FIG. 1 is a top view of a vertical puncture needle according to a first embodiment of the present invention;

FIG. 2 is a side view of a vertical lancet of a first embodiment of the present invention;

FIG. 3(a) is a sectional view taken along line A-A of FIG. 2, FIG. 3(B) is a sectional view taken along line B-B of FIG. 2, FIG. 3(C) is a sectional view taken along line C-C of FIG. 2, and FIG. 3(D) is a sectional view taken along line D-D of FIG. 2;

FIG. 4 is a longitudinal cross-sectional view of a vertical puncture needle according to a first embodiment of the present invention;

FIG. 5 is a side view of a first outer needle body in accordance with a first embodiment of the present invention;

FIG. 6 is a side view of a first needle core in accordance with a first embodiment of the invention;

FIG. 7 is a top plan view of a lateral needle in accordance with a first embodiment of the present invention;

FIG. 8 is a side view of a lateral needle in accordance with a first embodiment of the present invention;

FIG. 9 is a bottom view of the lateral needle of the first embodiment of the present invention;

FIG. 10 is a longitudinal cross-sectional view of a lateral puncture needle according to a first embodiment of the present invention;

FIG. 11 is a bottom view of the outer needle body of the lateral puncture needle in accordance with the first embodiment of the present invention;

FIG. 12 is a side elevational view of the side lancet core of the first embodiment of the present invention;

FIG. 13 is a top plan view of the lateral needle core of the first embodiment of the present invention;

FIG. 14 is a bottom view of the side piercing needle core of the first embodiment of the present invention;

FIGS. 15(a) -15(c) are schematic views illustrating the operation of the vertical puncture needle according to the first embodiment of the present invention;

FIG. 16 is a schematic view of the operation of the lateral needle in proximity to the vertical needle in accordance with a first embodiment of the present invention;

fig. 17 is a schematic view showing the overlapping of the lateral puncture needle and the vertical puncture needle according to the first embodiment of the present invention;

FIG. 18 is a schematic view of the first embodiment of the present invention;

FIG. 19 is a schematic view of the second outer needle body of the first embodiment of the present invention after its withdrawal;

FIG. 20 is a schematic view of the first outer needle body withdrawal operation according to the first embodiment of the present invention;

FIG. 21(a) is a schematic view of a conventional drainage tube insertion;

FIG. 21(b) is a schematic view of the submerged entry of a draft tube according to the first embodiment of the present invention;

wherein, 1, a first outer needle body, 11, a first holding part, 12, a guiding part, 13, an arc-shaped tip, 14, a sight, 15 and a guiding groove; 2. a first needle core 21, a first matching part 22 and a first needle core main body; 3. a second outer needle body 31, a second outer needle body 32, a second holding part 33, an opening 34, a transverse handle 35, an upper lip 36 and a lower lip; 4. a second core, 41, a second core body, 42, a second mating portion.

Detailed Description

It should be noted that the following detailed description is exemplary and is intended to provide further explanation of the disclosure. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs.

It is noted that the terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of example embodiments according to the present application. As used herein, the singular forms "a", "an", and/or "the" are intended to include the plural forms as well, and it should be understood that when the terms "comprises" and/or "comprising" are used in this specification, they specify the presence of stated features, steps, operations, devices, components, and/or combinations thereof;

for convenience of description, the words "up", "down", "left" and "right" in this application, if any, merely indicate correspondence with the directions of up, down, left and right of the drawings themselves, and do not limit the structure, but merely facilitate the description of the invention and simplify the description, and do not indicate or imply that the referenced device or element must have a particular orientation, be constructed and operated in a particular orientation, and therefore should not be construed as limiting the application. Furthermore, the terms "first" and "second" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance.

The first embodiment is as follows:

the present invention will be described in detail with reference to fig. 1 to 21, and specifically, the structure is as follows:

the embodiment discloses a device that drainage tube sneak went into, including perpendicular pjncture needle and side direction pjncture needle, perpendicular pjncture needle includes first outer needle body 1 and locates first outer needle body 1 inside first nook closing member 2, side direction pjncture needle includes the outer needle body 3 of second and locates the second outer needle body 3 inside second nook closing member 4 of second. After the first needle core 2 is withdrawn from the first outer needle body 1, the second outer needle body 3 can be clamped with the first outer needle body 1 in a set angle; the second outer needle body 3 and the first outer needle body 1 are lapped to form a channel for placing a drainage tube or a guide wire.

Specifically, the first outer needle body 1 comprises a guide part 12 and a first holding part 11 which are connected into a whole, and the guide part 12 and the first holding part 11 are both hollow structures so as to be inserted into the first needle core 2. The guide portion 12 is generally cylindrical, and has an arc-shaped tip 13 (the longitudinal section is circular arc, and the end portion of the transverse section is tapered) at the end thereof away from the first holding portion 11. The first needle core 2 is inserted from the end of the first grip part 11 to be in contact with the curved tip 13.

The guide part 12 is provided with a guide groove 15 with a set length along the axial direction (from one end of the guide part 12 far away from the first holding part 11 to the direction close to the first holding part 11), and the length of the guide groove 15 is determined according to the actual operation requirement. As shown in fig. 3(c) and 3(d), the cross section of the guide groove 15 is circular arc. As shown in fig. 3(a), the first grip 11 is provided with a sight 14, and the direction of the sight 14 is perpendicular to the axial direction of the first outer needle body 1.

As shown in fig. 3(a) -3(d) and fig. 4, the first needle core 2 has a needle cavity inside. Specifically, as shown in fig. 6, the first needle core 2 has a first needle core main body 22 and a first fitting portion 21 connected as a whole, and the end of the first fitting portion 21 has a circular projection. After the first needle core 2 is matched with the first outer needle body 1, the circular convex block of the first matching part 21 is positioned outside the first holding part 11 so as to exit the first needle core 2.

The second outer needle body 3 is provided with a second holding part 32 and a second outer needle body 31 which are connected into a whole, the second holding part 32 and the second outer needle body 31 are hollow, the second outer needle body 31 is integrally cylindrical, and transverse handles 34 are symmetrically arranged on the outer side of the second holding part 32.

The second outer needle body 31 has an opening 33 at an end thereof remote from the second grip portion 32, and as shown in fig. 10 and 11, the opening 33 has an upper lip 35 and a lower lip 36 which are oppositely disposed. The sections of the upper lip 35 and the lower lip 36 are both arc-shaped, and the extension length of the upper lip 35 is longer than that of the lower lip 36, so that the drainage tube or the guide wire can smoothly enter the first outer needle body 1 from the opening 33 of the second outer needle body 3, and the drainage tube or the guide wire can be guided.

The second core 4 is constructed as shown in fig. 12 to 14 and includes a second core body 41 and a second fitting portion 42, and in this embodiment, the second core body 41 is formed in a cylindrical shape as a whole, and has one end integrally connected to the second fitting portion 42 and the other end having a tapered tip. The second fitting portion 42 is a cylindrical structure having a diameter larger than that of the second stylet body 41, the second stylet body 41 is inserted into the second outer needle body 31 and its end portion protrudes from the opening 33, and the second fitting portion 42 is located outside the second holding portion 32.

The working principle of the embodiment is as follows:

as shown in FIGS. 15(a) -15(c), the vertical puncture needle is passed through the body until the leading end enters the target lumen, the first outer needle body 1 of the vertical puncture needle is kept stationary, and the first needle core 2 is withdrawn. As shown in fig. 16, the lateral puncture needle is inserted into the body from a position corresponding to the vertical puncture needle (set according to the actual drainage position) so that the front end of the lateral puncture needle approaches the first outer needle body 1, and the first outer needle body 1 is kept in place during this process. The lateral puncture needle punctures along the direction towards the first outer needle body 1, and the lateral puncture needle finely adjusts the direction with the sight 14 as the direction when approaching the first outer needle body 1.

As shown in fig. 17, the relative positional relationship is determined by the contact between the side puncture needle and the first outer needle body 1 of the vertical puncture needle when the vertical puncture needle is kept stationary and the side puncture needle approaches the needle body. When the front end of the lateral puncture needle reaches the first outer needle body 1, the second needle core 4 is retracted, the first outer needle body 1 is clamped by the side teeth (the side teeth are formed by the connecting ends of the upper lip 35 and the lower lip 36) on the two sides of the front end of the second outer needle body 3, and the lateral puncture needle is in place at the moment.

The second outer needle body 3 is maintained to clamp the first outer needle body 1, the condition of the front end of the lateral puncture needle is detected by the second needle core 4, the relation between the two needles is confirmed, and the possible tissue incarceration condition at the front end of the lateral puncture needle is relieved. The second needle core 4 is withdrawn, and the second outer needle body 3 is guided into a drainage tube or a guide wire. As shown in FIG. 18, after the catheter or the guide wire is in place, the second outer needle body 3 is withdrawn while maintaining the position of the first outer needle body 1 and the catheter or the guide wire.

After the second outer needle body 3 is withdrawn, the operation is different for different drainage tubes as shown in fig. 19. As shown in fig. 20, for the drainage tube (single type) with the same front and back caliber, shape and structure, the first outer needle body 1 can be withdrawn after the drainage tube is in place, the drainage tube is placed into the target lacuna, and then the operations of fixing, connecting, binding and the like are carried out, thus completing the placement of the drainage tube. For example: for the drainage tubes with the same whole caliber similar to the lumbar cistern drainage, the first outer needle body 1 is withdrawn to finish the tube placement. For the drainage tube (composite type) with inconsistent front and back caliber, shape and structure, the guide wire is required to be kept in place and the first outer needle body 1 is withdrawn, then the drainage tube is placed into the target cavity by the guide wire, and the subsequent operation (expanding skin along the guide wire and placing the drainage tube) is completed.

The creeping distance of the drainage tube inserted by the device of the embodiment is shown in fig. 21(b), while the creeping distance of the prior art is zero, as shown in fig. 21 (a); therefore, the embodiment solves the problems of easy looseness, seepage and even retrograde infection of the drainage tube and the like caused by the defects of the indwelling mode by increasing the sneak distance, prolongs the indwelling time of the drainage tube and has good stability.

The above description is only a preferred embodiment of the present application and is not intended to limit the present application, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, improvement and the like made within the spirit and principle of the present application shall be included in the protection scope of the present application.

Claims

1. A device for putting a drainage tube into a submerged manner is characterized by comprising a vertical puncture needle and a lateral puncture needle, wherein the vertical puncture needle comprises a first outer needle body and a first needle core arranged in the first outer needle body, and the lateral puncture needle comprises a second outer needle body and a second needle core arranged in the second outer needle body;

after the first needle core is withdrawn from the first outer needle body, the second outer needle body can be clamped with the first outer needle body at a set angle; the second outer needle body is clamped with the first outer needle body to form a channel for placing a drainage tube or a guide wire;

the first outer needle body comprises a guide part and a first holding part which are connected into a whole, one end of the guide part, which is far away from the first holding part, is provided with a guide groove with a set length, and the guide groove is arranged along the axis direction of the guide part.

2. The device of claim 1 wherein the end of the guide portion distal from the first gripping portion has an arcuate tip.

3. The device of claim 2 wherein the first needle is inserted inside the first outer needle body and the first needle end contacts the curved tip.

4. The device of claim 1, wherein the first gripping portion is provided with a sight.

5. The device of claim 1, wherein the second outer needle body has a second grip at one end and an opening for the second hub to extend through at the other end.

6. The device of claim 5 wherein said opening has oppositely disposed upper and lower lips.

7. The device of claim 6 wherein said upper lip extension is greater than said lower lip extension.

8. The device of claim 5 wherein said second gripping portion has a transverse handle.