CN113520539B - Catheter sheath for central venous catheter and auxiliary device - Google Patents

Abstract

The invention discloses a catheter sheath for central venous intubation and an auxiliary device thereof, including the catheter sheath and the auxiliary device. The belt and the catheter sheath can be torn apart along the tear belt, and the inner wall of the tapered cylindrical body is preset with a through groove; the driving wheel can move forward and backward along the axle groove under the pull of the driving rack; when the When the driving rack is pulled toward the catheter sheath tip, the driving wheel rotates from inside to outside, and the teeth of the driving wheel engage with the teeth on the inner wall of the catheter sheath and force the catheter sheath to pass through the tapered channel of the auxiliary device body and tear ; When the driving rack is pulled towards the catheter sheath tail, the teeth of the driving wheel will disengage from the inner wall of the catheter sheath.

Description

Introducer sheath and auxiliary device for central venous catheterization

technical field

The invention belongs to the technical field of medical consumables, and in particular relates to a catheter sheath for central venous intubation and an auxiliary device.

Background technique

Central venous catheterization is an essential treatment method for emergency resuscitation, critically ill patients, and intraoperative monitoring and treatment of major operations. It mainly punctures the internal jugular vein, external jugular vein, subclavian vein, and femoral vein through the skin, and then inserts various catheters To the large blood vessel cavity or heart cavity, use it to measure various physiological parameters, and also provide a direct and convenient access for treatment. It is mainly applicable to: 1. Patients who need long-term parenteral nutrition or intravenous antibiotics. 2. Critically ill patients, acute circulatory failure, renal failure and other patients who need to monitor central venous pressure. 3. Patients with a heart placed in the jugular vein and a pacemaker.

The surgical consumables currently used in central venous catheterization generally include puncture needles, catheters, tear-off sheaths, skin expanders, tunnel needles, guide wires, etc., wherein the tear-off sheaths are used for subcutaneous insertion after the expander expands the skin The central vein is shaped as a passageway for a catheter with a soft texture. After the catheter is inserted, the catheter sheath is destroyed and taken out.

Compared with temporary catheterization, long-term catheterization also needs to set up a subcutaneous tunnel under the patient's skin. Setting up a subcutaneous tunnel is equivalent to setting up a skin barrier to reduce the risk of wound infection of central vein or catheter access. For the subcutaneous tunnel, at the same time, in order to take into account the aesthetics, the entrance of one end of the subcutaneous tunnel is generally set under the skin near the clavicle, which makes the shape of the subcutaneous tunnel and the entrance of the central vein A-shaped, which is not conducive to the extraction and avulsion of the conventional avulsion sheath. Next, it will be described in conjunction with the accompanying drawings:

Figure 1 shows the situation after the temporary tube is placed. The incision of the temporary tube is close to the patient's large jugular vein, and the distance from the incision to the vascular puncture port is short, so the risk of infection is high. For the operation of changing the temporary catheter to a long-term catheter, as shown in Figure 2, firstly, a subcutaneous tunnel A is made, and a subcutaneous tunnel about 15 cm long is opened under the patient's skin with a tunnel needle, and the long-term catheter is passed through the subcutaneous tunnel A. Since the temporary catheter inserted before still remains in the central vein, the guide wire is first inserted into the central vein along the catheter, and then the temporary catheter is taken out, inserted into the skin expander, and then the avulsed sheath is expanded along the skin expander Then insert the end of the long-term catheter into the central vein along the channel of the tear-off sheath. After the catheter is inserted into the blood vessel, the catheter exposed outside the skin must be buried subcutaneously, which requires the surgeon While pulling out and tearing the tear off sheath, continue to push the catheter into the tear off sheath. When the tear off sheath is completely pulled out and torn off, the long-term catheter can be fully inserted under the skin. Under normal circumstances, the doctor usually pulls out the sheath and inserts the long-term catheter at the same time. This process requires extremely high skill from the doctor. If the operation is not done properly, the catheter may fail and the patient may feel more pain.

Contents of the invention

The main purpose of the present invention is to provide a catheter sheath for central venous intubation, the catheter sheath can be pulled out and separated conveniently, and at the same time facilitates the simultaneous insertion of long-term catheters.

In order to achieve the above-mentioned purpose, the present application adopts the following technical scheme: an catheter sheath for central venous intubation and its auxiliary device, including the catheter sheath and the auxiliary device, the catheter sheath is in the shape of an elongated conical tube, and the conical catheter sheath body There are two sets of tearing bands arranged symmetrically on the top, and the catheter sheath can be torn apart along the tearing bands, and the inner wall of the catheter sheath is provided with at least two groups of symmetrically arranged and continuous teeth; the auxiliary device includes a hollow cone-shaped The body, the cone-shaped body is detachably installed with a catheter driving wheel set; the cone-shaped body is provided with a hollow tapered channel along its wall surface for the catheter sheath to pass through; the inner wall of the cone-shaped body is preset There are through slots; the catheter driving wheel set includes a wheel set mounting seat composed of front and rear parts, two mutually meshing driving wheels and a driving rack that pulls the driving wheel to rotate are installed vertically in the mounting seat, and the top of the driving wheel and the bottom are provided with wheel shafts, the wheel shafts are inserted into the wheel shaft grooves on the mounting seat, and the wheel shaft grooves are strip-shaped; the upper part of the wheel body of the driving wheel is provided with teeth surrounding the driving wheel; When pulled, it can move back and forth along the axle groove; when the driving rack is pulled toward the sheath tip of the catheter sheath, the driving wheel rotates from inside to outside, and the teeth of the driving wheel engage with the teeth on the inner wall of the catheter sheath and force the catheter The sheath passes through the tapered channel of the auxiliary device body and tears; when the drive rack is pulled towards the catheter sheath tail, the teeth of the drive wheel disengage from the inner wall of the catheter sheath.

Further, the mounting seat includes two detachable front and rear parts, and the front and rear parts of the mounting seat are connected in a detachable buckling manner.

Still further, the auxiliary device also includes a handle arranged on the tapered cylindrical body and a pressing handle articulated on the driving rack, pressing the pressing handle makes the driving rack move to the sheath tip of the catheter sheath, thereby driving The drive wheels turn inboard and advance the catheter into the introducer sheath.

Furthermore, two cutting edges, upper and lower, are provided at the front of the mounting seat of the auxiliary device. When the catheter sheath passes through the channel of the auxiliary device, the cutting blades directly cut off the tear groove of the catheter sheath.

Preferably, a unidirectional rotating guide roller set is provided at the front of the mounting base, and the guide roller set includes two vertically arranged roller bodies, the top and bottom of the roller bodies are inserted into the roller grooves, and the roller grooves are oriented toward The "eight" shape of the sheath tip of the catheter sheath; when the driving rack is pulled toward the sheath tip of the catheter sheath 1, the guide rollers move along the roller grooves to both sides to provide a guiding space for the catheter to pass. When the driving rack guides When the tube sheath moves towards the tail of the sheath, the catheter will follow the trend to drive the guide roller to move towards the tail of the sheath, thereby generating a clamping force on the catheter.

Beneficial effect

The central venous catheter sheath and auxiliary device provided by the present invention pioneered the problem of tearing and pulling out of the catheter sheath that the prior art could not solve, and greatly reduced the physical exertion of the doctor in removing the sheath during the operation. , the auxiliary device provided by the present invention is simple and convenient to operate, the process of tearing and pulling out is even and gentle, the success rate is high, the pain of the patient is relieved, and the infection risk of the doctor's operation is reduced.

Description of drawings

In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the drawings that need to be used in the description of the embodiments will be briefly introduced below. Obviously, the drawings in the following description are only some embodiments of the present invention. For those skilled in the art, other drawings can also be obtained based on these drawings without creative effort.

Figure 1 is a schematic diagram after the temporary tube is placed;

Figure 2 is a schematic diagram after long-term tube placement;

Fig. 3 is the schematic diagram of the catheter sheath of the embodiment;

Fig. 4 is the overall perspective view of embodiment;

Fig. 5 is a partial schematic diagram (cutting edge) of the auxiliary device of the embodiment;

Fig. 6 is the schematic diagram of embodiment auxiliary device;

Fig. 7 is a sectional view of the auxiliary device of the embodiment;

Fig. 8 is the mounting seat of the auxiliary device of the embodiment;

Fig. 9 is a perspective view of the embodiment.

Detailed ways

The following will clearly and completely describe the technical solutions in the embodiments of the present invention with reference to the accompanying drawings in the embodiments of the present invention. Obviously, the described embodiments are only some, not all, embodiments of the present invention. Based on the embodiments of the present invention, all other embodiments obtained by persons of ordinary skill in the art without creative efforts fall within the protection scope of the present invention.

Example 1

As shown in Figures 3-8, the catheter sheath for central venous intubation and its auxiliary device include a catheter sheath 1 and an auxiliary device 2. The catheter sheath 1 is an elongated conical cylinder 1a. There are two groups of tearing bands 1b that are thinned symmetrically. Applying an external force to the catheter sheath can cause the catheter sheath to tear along the tearing bands 1b. The inner wall of the catheter sheath 1 is provided with at least one set of opposite arrangements and continuous teeth 1c; the auxiliary device 2 is used to assist the catheter sheath 1 and further send it into the catheter 3 after most of the catheter 3 is inserted, which includes a hollow cone-shaped body 2a, and the lower part of the body 2a is provided with a flat fitting surface 2a1 (for fitting the skin), the body 2a is hollow inside and is detachably installed with a catheter driving wheel set 2b; the body 2a is detachable into a symmetrically designed left half and a right half, and the two parts are connected by buckle; The body 2a is provided with a hollow tapered cylindrical channel 2a2 along its wall surface, and the catheter sheath 1 can be inserted into the body 2a along the tapered cylindrical channel; the inner wall of the body is preset with alveoli 2a3 for the teeth of the catheter sheath to pass through; The catheter driving wheel set 2b includes a detachable wheel set mounting seat 2b1, two mutually meshing driving wheels 2b2 and a driving rack 2b3 that pulls the driving wheel 2b2 to rotate are installed in the mounting seat 2b1, and the top of the driving wheel 2b2 is and the bottom is provided with a wheel shaft, the wheel shaft is inserted into the wheel shaft groove 2b11 on the mounting seat, the wheel shaft groove 2b11 is in the shape of a strip, the upper part of the driving wheel 2b2 is provided with teeth 2b21 surrounding the driving wheel, the teeth of the two driving wheels 2b2 Teeth 2b21 mesh with each other; the upper part of the driving wheel 2b2 is also provided with a gear 2b22, the gear 2b22 meshes with the driving rack 2b3, and the driving wheel 2b2 can move forward and backward along the axle groove 2b11 under the pull of the driving rack 2b3. When the driving rack 2b3 is pulled toward the catheter sheath tip, the driving wheel 2b2 rotates from inside to outside, and the teeth of the driving wheel 2b2 engage with the teeth 1c on the inner wall of the catheter sheath 1 to force the catheter sheath 1 to move outward and pass through. Through the tapered channel of the auxiliary device body, the catheter sheath 1 is expanded and torn during the passage; when the driving rack 2b3 is pulled towards the tail of the catheter sheath 1, the teeth of the driving wheel 2b2 are disengaged again The engagement with the teeth on the inner wall of the introducer sheath 1 is repeated so that the introducer sheath 1 can be gradually pulled out from the patient's skin, torn, and the catheter can also be sent into the patient's body synchronously.

Considering that the driving wheel set 2b may inadvertently cause the guide tube 3 to be pulled out by the driving wheel set 2b during the process of moving backward along the axle groove, therefore, the present invention provides a one-way rotating The guide roller set 2b4, the guide roller set 2b4 includes two vertically arranged roller bodies 2b41, the top and bottom of the roller body 2b41 are inserted into the roller column groove 2b42, and the roller column groove 2b42 is in the shape of a "eight" facing the sheath tip of the catheter sheath type, when the driving rack 2b3 is pulled toward the sheath tip of the catheter sheath 1, the guide roller group 2b4 moves to both sides along the roller groove 2b42 to provide a guiding space for the catheter to pass, and when the driving rack 2b3 is pulled toward the sheath tail of the catheter sheath 1 When moving in the same direction, the catheter 3 will drive the guide roller 1 to move toward the sheath tail, thereby generating a certain degree of clamping force. Under action, it cannot move along the catheter sheath 1 tail end.

Further, the mounting seat 2b1 includes two detachable front and rear parts, and the front and rear parts of the mounting seat are connected by detachable buckling.

Further, the auxiliary device also includes a handle arranged on the tapered cylindrical body and a pressing handle articulated on the driving rack, pressing the pressing handle makes the driving rack move toward the sheath tip of the catheter sheath, thereby driving the driving rack. The wheels rotate inwardly and advance the catheter into the introducer sheath.

It should be noted that the axle grooves of the driving wheel are arranged symmetrically on both sides of the center line of the auxiliary device. Since the main body of the auxiliary device is trumpet-shaped, when the driving wheel moves along the wheel axis to the tail of the catheter sheath, the teeth of the driving wheel and the teeth of the catheter sheath Teeth disengaged.

The method of use of the present invention is as follows: firstly, an auxiliary device is socketed at the tail of the catheter sheath, the catheter sheath is pushed by the auxiliary device so that most of it is inserted into the patient's skin, the catheter is passed through the driving wheel and the guide roller of the auxiliary device and along the The introducer sheath is advanced into the patient, and preparation for removal of the introducer sheath begins.

In the process of pressing the pressing handle of the catheter sheath auxiliary device, the front part of the pressing will drive the driving rack to move from the tail of the catheter sheath to the catheter sheath tip. During the movement, the driving wheel set will move to the catheter sheath tip during the pulling process. Move, when the axle of the driving wheel set moves to the front dead center, the teeth of the driving wheel mesh with the teeth on the inner wall of the catheter sheath, press the rear section, the driving wheel rotates, and drive the teeth of the catheter sheath to move backward, expand and tear Eventually, the introducer sheath passing through the assist device is torn in two and pulled out of the patient's skin as the drive wheel turns.

Of course, a single press cannot completely tear the catheter sheath and pull it out. It needs repeated pressing-recovery-pressing. The recovery process is the process in which the pressing handle will drive the rack to move in the opposite direction. During this process, The driving gear will be pulled towards the end of the alveolar. During this process, the teeth of the driving gear will disengage from the teeth on the inner wall of the catheter sheath, and the pulling effect on the catheter sheath will be temporarily lost, thus preventing the catheter sheath from being pulled by the teeth. The strip reverses and advances against the patient's skin.

In this repeated process, the present invention also has another ingenuity, that is, in the process of tearing and pulling the introducer sheath, the final implantation of the catheter is carried out synchronously, although before starting to pull out the introducer sheath, the user has already put the Most of the catheters are buried under the patient's skin and blood vessels through the catheter sheath, but because the catheter needs to be completely buried under the skin and not exposed to the outside, it is necessary to further insert the catheter into the skin. This action was originally performed manually by the doctor. Surgical gloves are inconvenient to operate, and it is very easy to cause the gloves to break and cause the risk of infection. Therefore, the present invention sets a one-way rotating guide roller set in the auxiliary device. When the driving wheel set is pulled by the rack to rotate inward In the process, the drive wheel set squeezes and drives the catheter to move into the catheter sheath. At this time, the guide roller group moves to the front end of the roller groove due to the drive of the catheter, and the gap between the guide rollers increases, and the catheter can pass freely; When the bar moves to the end of the catheter sheath, the driving wheel set moves toward the end of the catheter sheath. Since the teeth of the driving wheel and the teeth on the inner wall of the catheter sheath are disengaged, the driving wheel set can automatically rotate, and the pulling force applied to the catheter is eliminated. At the same time, due to the design of the one-way rotating guide roller set, when the guide tube tends to pull outward, the guide roller set moves to the proximal end of the roller groove under the action of friction between the guide tube and the roller body surface. The catheter is gradually clamped, and because the guide roller group can only rotate in one direction, the resistance to moving the catheter outward (the tail of the catheter sheath) is very large. Features that are pulled out.

In order to realize the reciprocating movement of the pressing handle more conveniently, it is necessary to set a return spring between the pressing handle and the fixed handle. The setting of the returning spring can make the pressing handle automatically return to its original state after being pressed. This recovery process is realized spontaneously. The process of driving the rack to move towards the tail of the catheter sheath.

Furthermore, the above-mentioned design is that the catheter sheath is gradually expanded and torn during the process of being pulled through the auxiliary device, so that the catheter sheath can be pulled out from the patient's skin. The front part of the installation seat of the device is provided with upper and lower two cutting edges. When the catheter sheath passes through the channel of the auxiliary device, the cutting blade can directly cut off the tear groove of the catheter sheath.

The above-mentioned embodiments are merely examples to clearly illustrate the present invention, and not to limit the implementation. For those of ordinary skill in the art, other changes or changes in different forms can be made on the basis of the above description. It is not necessary and impossible to exhaustively list all the embodiments here. However, the obvious changes or variations derived therefrom are still within the protection scope of the present invention.

Claims (3)

1. Introducer sheath for central venous intubation and auxiliary device thereof, comprising an introducer sheath and an auxiliary device, characterized in that: the catheter sheath is elongated in the shape of a conical tube, and two cone-shaped sheaths are symmetrically arranged on the sheath body of the catheter sheath. A set of tearing bands, the catheter sheath can be torn along the tearing band; the inner wall of the catheter sheath is provided with at least two groups of symmetrically arranged and continuous teeth; the auxiliary device includes a hollow cone-shaped body, a cone-shaped A catheter drive wheel set is detachably installed in the body; the conical body is provided with a hollow conical channel along its wall surface for the catheter sheath to pass through; the inner wall of the conical body is preset with a through groove; The catheter driving wheel set includes a wheel set mounting seat composed of front and rear parts, two mutually meshing driving wheels and a driving rack that pulls the driving wheel to rotate are installed vertically in the wheel set mounting seat, the top of the driving wheel and The bottom is provided with a wheel shaft, and the wheel shaft is inserted into the wheel shaft groove on the wheel set mounting seat, and the wheel shaft groove is strip-shaped; the upper part of the wheel body of the driving wheel is provided with teeth surrounding the driving wheel; It can move back and forth along the axle groove under the pull of the drive rack; when the drive rack is pulled toward the catheter sheath tip, the drive wheel rotates from inside to outside, and the teeth of the drive wheel mesh with the teeth on the inner wall of the catheter sheath and force The catheter sheath passes through the tapered channel of the auxiliary device body and is torn; when the driving rack is pulled toward the catheter sheath tail, the teeth of the driving wheel are disengaged from the inner wall of the catheter sheath, and the wheel set The mounting seat includes two detachable front and rear parts, and the front and rear parts of the wheel set mounting seat are connected by a detachable buckle; The front part of the wheel set mounting seat is provided with a one-way rotating guide roller set. The guide roller set includes two vertically arranged roller bodies. The top and bottom of the roller body are inserted into the roller groove. The "eight" shape of the sheath tip; when the driving rack is pulled toward the sheath tip of the catheter sheath, the guide rollers move to both sides along the roller grooves to provide a guiding space for the catheter to pass through; when the driving rack pulls toward the catheter sheath When moving in the direction of the sheath tail, the catheter will follow the trend to drive the guide roller to move towards the sheath tail, thereby generating a clamping force on the catheter. 2. The catheter sheath for central venous intubation and its auxiliary device according to claim 1, characterized in that: the auxiliary device also includes a handle arranged on the tapered cylindrical body and a movable hinge hinged on the driving rack. Pressing the handle, pressing the pressing handle makes the driving rack move toward the sheath tip of the catheter sheath, thereby driving the catheter driving wheel set to rotate inwardly and sending the catheter into the catheter sheath. 3. The catheter sheath for central venous intubation and its auxiliary device according to claim 2, characterized in that: the front part of the wheel set mounting seat of the auxiliary device is provided with two cutting edges, upper and lower, when the catheter sheath is worn When passing through the channel of the auxiliary device, the cutting edge directly cuts off the tear groove of the introducer sheath.

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