CN119055336A - Auxiliary device and method for cardiovascular interventional puncture - Google Patents
Auxiliary device and method for cardiovascular interventional puncture Download PDFInfo
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- CN119055336A CN119055336A CN202411472654.4A CN202411472654A CN119055336A CN 119055336 A CN119055336 A CN 119055336A CN 202411472654 A CN202411472654 A CN 202411472654A CN 119055336 A CN119055336 A CN 119055336A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3415—Trocars; Puncturing needles for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00778—Operations on blood vessels
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
- A61B2017/12004—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord for haemostasis, for prevention of bleeding
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0801—Prevention of accidental cutting or pricking
- A61B2090/08021—Prevention of accidental cutting or pricking of the patient or his organs
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Abstract
The invention relates to the technical field of cardiovascular puncture assistance, in particular to an auxiliary device and method for cardiovascular interventional puncture. Including the support body, support body sliding connection has the movable block, support body fixedly connected with mounting bracket, the movable block is provided with the sheath pipe, mounting bracket sliding connection has the slip post of symmetric distribution, symmetric distribution the equal fixedly connected with U-shaped frame of opposite side of slip post, U-shaped frame with fixedly connected with first elastic element between the mounting bracket, symmetric distribution the equal swivelling joint of opposite side of U-shaped frame has the extrusion wheel. According to the invention, the sheath tube is limited by the symmetrically distributed extrusion wheels, so that the sheath tube is always supported on one side of the sheath tube, which is close to a patient, in the process of inserting the sheath tube into the brachial artery of the patient, and the unstable (tremble) of the sheath tube caused by the overlarge distance between the hand-held point and the puncture point of medical staff in the process of inserting the sheath tube is prevented, thereby bringing injury to the patient.
Description
Technical Field
The invention relates to the technical field of cardiovascular puncture assistance, in particular to an auxiliary device and method for cardiovascular interventional puncture.
Background
Cardiovascular interventional puncture is a minimally invasive surgery, is mainly applied to diagnosis and treatment of heart and vascular diseases, is performed by puncturing the skin of a patient, and moves to a focus through a vascular cavity (brachial artery and the like) by using various minimally invasive instruments (a sheath tube is used as a communicating tool inside and outside the patient), and then processes the focus, wherein the cardiovascular interventional puncture is usually operated under radioscopy or image guidance, and has the advantages of small wound, quick recovery, short hospitalization time and the like, so that the cardiovascular interventional puncture has become an important operation mode in modern medicine.
The existing cardiovascular interventional puncture is mostly carried out by a physician with abundant experience, and the tail of the sheath is usually held by the hand in the process of inserting the sheath into the blood vessel of a patient, so that in the process of inserting the sheath into the blood vessel of the patient, the sheath has the phenomenon of vibration caused by uneven stress and resistance applied by the tissue of the patient in the process of inserting due to a certain distance between the sheath and a puncture, and the phenomenon can cause unnecessary injury to the patient.
Disclosure of Invention
In order to overcome the defect that the existing cardiovascular interventional puncture technology has the vibration phenomenon caused by uneven stress of a sheath tube in the process of inserting the sheath tube into a blood vessel of a patient and resistance applied by tissue of the patient in the inserting process, the invention provides an auxiliary device and a method for cardiovascular interventional puncture.
According to the technical scheme, the auxiliary device for cardiovascular intervention puncture comprises a frame body, the frame body is connected with a moving block in a sliding manner, one side, away from the moving block, of the frame body is fixedly connected with a mounting frame, the moving block is provided with a sheath tube, one side, away from the frame body, of the mounting frame is connected with symmetrically distributed sliding columns in a sliding manner, the opposite sides of the sliding columns are fixedly connected with U-shaped frames, first elastic elements are fixedly connected between the U-shaped frames and the mounting frame, the opposite sides of the U-shaped frames are symmetrically distributed, extrusion wheels are respectively and rotatably connected with the opposite sides of the U-shaped frames, the outer side of the extrusion wheels is a soft layer, the soft layer of the extrusion wheels is used for being fully contacted with adjacent areas of the sheath tube, one side, close to the moving block, of the frame body is provided with a cleaning mechanism used for scraping the sheath tube, and one side, close to the moving block, of the frame body is provided with a plugging mechanism used for guaranteeing sealing between the sheath tube and an external instrument.
In addition, it is particularly preferred that the cleaning mechanism comprises a moving part which is symmetrically distributed, the moving part which is symmetrically distributed is slidably connected to one side, close to the sheath, of the frame, a limit post which is symmetrically distributed is fixedly connected to one side, close to the frame, of the moving part, a first extrusion part is fixedly connected to one side, far away from the moving part, of the moving part, a scraping part is symmetrically distributed to the opposite side, and is fixedly connected to the opposite side, of the first extrusion part, the scraping part is in contact with the adjacent first extrusion part, the scraping part is in contact with the sheath, a first groove, a second groove and a third groove are formed in one side, far away from the frame, of the moving part, the first groove, the second groove and the third groove are in limit fit with the adjacent limit post on the moving part, the second groove is communicated with the adjacent first groove and the adjacent third groove, the first groove is communicated with the adjacent third groove through the straight groove, the first groove is in contact with the elastic plate, and the elastic plate is fixedly connected to the first groove.
Furthermore, it is particularly preferred that the third groove is an inclined groove for causing the scraping member to apply the same force to the sheath in the areas of different thickness.
In addition, particularly preferred, the plugging mechanism comprises an air bag, the air bag is arranged on one side of the sheath pipe, which is close to the moving block, the moving block is fixedly connected with a middle pipe on one side, which is far away from the frame body, the middle pipe is communicated with the air bag, a piston plate is connected in a sliding manner in the middle pipe, a compression medium is filled between the middle pipe and the piston plate, one side, which is far away from the sheath pipe, of the piston plate is fixedly connected with a moving rod, one end, which is far away from the piston plate, of the moving rod is fixedly connected with a limiting frame, the limiting frame is provided with a through groove, the frame body is fixedly connected with a fixing frame, one side, which is close to the moving block, is fixedly connected with a rack through a bracket, the spur gear is in transmission fit with the rack, a first limiting cylinder is arranged at the eccentric position of the spur gear, the first limiting cylinder is in limit fit with a through groove of the limiting frame, the spur gear is fixedly connected with a limiting block, and the limiting block is in limit fit with the fixing frame.
In addition, particularly preferred still include the oppression mechanism that is used for stopping bleeding to patient's puncture, oppression mechanism set up in the mounting bracket is kept away from one side of support body, oppression mechanism including the dead lever of symmetric distribution, the symmetric distribution the dead lever all fixed connection in the mounting bracket is kept away from one side of support body, the symmetric distribution the dead lever is sliding connection has the movable box jointly, keep away from the symmetric distribution in the movable box one side fixedly connected with mounting of dead lever, the movable box is kept away from the symmetric distribution one side fixedly connected with protection pad of dead lever, the mounting is close to one side fixedly connected with rubber sheet of protection pad, one side that the movable box is close to the rubber sheet is provided with the clamping assembly that is used for making it closely laminate with the patient, one side that the movable box is close to the symmetric distribution the dead lever is provided with the adjusting assembly that is used for changing everywhere pressure of rubber sheet.
In addition, particularly preferred, the clamping assembly comprises symmetrically distributed rotating plates, the symmetrically distributed rotating plates are all rotationally connected to one side, close to the rubber sheet, of the movable box, a third elastic element is fixedly connected between the rotating plates and the movable box, the rotating plates are fixedly connected with clamping plates, one clamping plate is provided with a binding belt, the other clamping plate is rotationally connected with a winding wheel, the winding wheel is in contact fit with the binding belt, and the winding wheel is fixedly connected with a first knob.
In addition, particularly preferred, the adjusting part is including the intermediate plate, intermediate plate sliding connection in move in the incasement keep away from one side of mounting, intermediate plate with fixedly connected with fourth elastic element between the mounting, it has the threaded rod to remove the case screw thread hookup, the threaded rod is kept away from one side rotation of removing the case is connected with the second knob, the second knob is close to one side of threaded rod is provided with annular array's recess, threaded rod sliding connection has annular array's spacing arch, spacing arch with the equal spacing cooperation of second knob and last adjacent recess, spacing arch with fixedly connected with fifth elastic element between the threaded rod, one side that the intermediate plate is close to the mounting fixedly connected with second extrusion, second extrusion with mounting sliding connection, the mounting is provided with first cavity, second cavity, third cavity and annular array's intermediate channel, the second extrusion is in first cavity, second cavity, third cavity and annular array's intermediate channel all are filled with the intermediate channel.
In addition, it is particularly preferable that the device further comprises a pressure transmission mechanism for changing the force of pressing the rubber sheet against the patient, the pressure transmission mechanism is arranged in the fixing piece, the pressure transmission mechanism comprises a moving plate, the moving plate is slidably connected in the first cavity on the fixing piece, the moving plate is located below the middle channel of the annular array, a first ring is slidably connected in the second cavity on the fixing piece, a second ring is slidably connected in the third cavity on the fixing piece, a sixth elastic element is fixedly connected between the moving plate and the fixing piece, a seventh elastic element of the annular array is fixedly connected between the first ring and the fixing piece, an eighth elastic element of the annular array is fixedly connected between the second ring and the fixing piece, the elastic coefficients of the sixth elastic element, the seventh elastic element and the eighth elastic element are gradually increased, and a force changing assembly for changing the tightening degree of the binding strap is arranged outside the moving box.
In addition, particularly preferred, the deformation component comprises an L-shaped rod, the L-shaped rod is slidably connected with the movable box, the L-shaped rod is provided with a second limiting column, the L-shaped rod is rotatably connected with the threaded rod, the movable box is rotatably connected with a sector plate, the clamping plate rotatably connected with the winding wheel is rotatably connected with a worm, the worm is in transmission connection with the winding wheel through a gear set, a connecting seat is fixedly connected with the clamping plate and close to the worm, the connecting seat is rotatably connected with a worm wheel, the worm wheel is meshed with the worm, one side of the sector plate, close to the worm wheel, is fixedly connected with a limiting rod, the limiting rod penetrates through an adjacent area of the movable box, the worm wheel is provided with a through hole, the through hole is in limiting fit with the limiting rod, and the sector plate is provided with a limiting groove, and the limiting groove is in limiting fit with the second limiting column of the L-shaped rod.
An auxiliary method for cardiovascular interventional puncture based on the auxiliary device for cardiovascular interventional puncture comprises the following steps:
S1, fixedly mounting the device on an operating table, integrally placing the device above a brachial artery of a patient, then moving a moving block and parts on the moving block rightwards, clamping and limiting a sheath tube by utilizing two extrusion wheels, and stably inserting the sheath tube into the brachial artery of the patient;
S2, extruding the through groove of the limiting frame by using the first limiting cylinder on the rotating spur gear, enabling the limiting frame, the moving rod and the piston plate to move downwards, pressing air at the lower part in the middle pipe into the air bag, and plugging the left end of the sheath pipe by the inflated air bag;
S3, after interventional puncture is completed, moving the moving block and the upper part thereof leftwards, extruding the adjacent moving parts by a limiting column of the moving block to enable the two moving parts to move oppositely, extruding the adjacent scraping parts by a first extrusion part which moves oppositely to enable the two scraping parts to be in close contact with the sheath, and removing blood of a patient adhered to the outer side of the sheath;
s4, deflecting the two rotating plates to enable the two clamping plates to fix the movable box and the upper parts thereof at the elbow of the patient, so that the rubber sheet is tightly attached to the puncture of the patient;
s5, rotating the second knob to enable the threaded rod and the movable box to move relatively, extruding hydraulic oil in the first cavity through the second extrusion piece, enabling the hydraulic oil entering the second cavity and the third cavity to extrude adjacent areas of the rubber sheet to different degrees, and accordingly extruding puncture areas of patients to different degrees;
s6, rotating the first knob to enable the winding wheel to wind the binding belt, and fastening the binding belt to different degrees according to patients with different body fat rates;
And S7, after the puncture of the patient heals, rotating the first knob to enable the winding wheel to release the binding belt, and then facing the rotating plates which are symmetrically distributed in a rotating way to enable the clamping plates which are symmetrically distributed to be separated from the patient.
Compared with the prior art, the invention has the advantages that the sheath tube is limited by the symmetrically distributed extrusion wheels, so that the sheath tube is always supported at one side close to a patient's brachial artery in the process of inserting the sheath tube, the unstable (vibration) of the sheath tube caused by overlarge distance between the hand-held points of medical staff and the puncture points in the process of inserting the sheath tube is prevented, the damage to the patient is caused, the symmetrically distributed scraping pieces are closely contacted with the adjacent areas of the sheath tube, the blood of the patient adhered on the outer side of the sheath tube is removed, the cleaning difficulty of the follow-up medical staff is reduced, the pressing force of the rubber sheet to the puncture opening area of the patient is gradually reduced from the middle to the outer side by the sixth elastic element, the seventh elastic element and the eighth elastic element with different elastic coefficients, so that the blood is prevented from gathering towards the puncture opening area of the patient when the patient is pressed, the blood is prevented from accidentally flowing out to cause additional damage to the patient, the patient is prevented from generating different relative movement distances between the threaded rod and the movable box, the tightness degree is changed, the patient is pressed differently, and the patient is prevented from being pressed by different body fat, and the patient is further improved.
Drawings
FIG. 1 is a schematic perspective view of the whole structure of the present invention;
FIG. 2 is a schematic perspective view of the frame and its upper parts;
FIG. 3 is a perspective cross-sectional view of the frame and its upper parts according to the present invention;
FIG. 4 is an exploded view of the frame and its upper parts in a three-dimensional configuration according to the present invention;
FIG. 5 is a schematic perspective view of the parts of the upper parts of the fixed frame and the movable block of the present invention;
FIG. 6 is a schematic perspective view of the mobile case of the present invention positioned over a patient's elbow;
FIG. 7 is a schematic perspective view of the mobile case and its upper parts according to the present invention;
FIG. 8 is a schematic perspective view of the threaded rod and the movable case of the present invention in relative motion;
FIG. 9 is a schematic perspective view of the moving plate and the fixing member of the present invention when they slide relatively;
FIG. 10 is a perspective cross-sectional view of the mobile case and its internal parts in accordance with the present invention;
FIG. 11 is an exploded view of the mobile case and its internal parts in a three-dimensional configuration according to the present invention;
FIG. 12 is a schematic perspective view of the L-shaped rod and the movable case of the present invention when sliding relatively;
fig. 13 is an exploded view of the L-shaped bar and its upper parts in a three-dimensional configuration according to the present invention.
In the figure: 1, a frame body, 2, a moving block, 3, a mounting frame, 4, a sheath tube, 5, a sliding column, 6, a U-shaped frame, 7, a first elastic member, 8, a pressing wheel, 901, a moving member, 902, a first pressing member, 903, a scraping member, 904, a first groove, 905, a second groove, 906, a third groove, 907, a second elastic member, 908, a one-way plate, 1001, an airbag, 1002, a middle tube, 1003, a piston plate, 1004, a moving rod, 1005, a limit frame, 1006, a fixed frame, 1007, a rack, 1008, a spur gear, 1009, a limit block, 1101, a fixed rod, 1102, a moving box, 1103, a fixed member, 1104, a protection pad, 1105, a rubber sheet, 1201, a rotating plate, 1202, a third elastic member, 1203, a holding plate, 1204, tie strap, 1205, reel, 1206, first knob, 1301, intermediate plate, 1302, fourth elastic element, 1303, threaded rod, 1304, second knob, 1305, limit bump, 1306, fifth elastic element, 1307, second extrusion, 1308, first cavity, 1309, second cavity, 1310, third cavity, 1311, intermediate channel, 1401, moving plate, 1402, first ring, 1403, second ring, 1404, sixth elastic element, 1405, seventh elastic element, 1406, eighth elastic element, 1501, L-shaped rod, 1502, sector plate, 1503, worm, 1504, gear set, 1505, connection block, 1506, worm gear, 1507, limit rod, 1508, through hole, 1509, limit slot.
Detailed Description
The objects, technical solutions and advantages of the present invention will become more apparent by the following detailed description of the present invention with reference to the accompanying drawings. It should be understood that the description is only illustrative and is not intended to limit the scope of the invention. In addition, in the following description, descriptions of well-known structures and techniques are omitted so as not to unnecessarily obscure the present invention.
In the existing cardiovascular interventional puncture process, as a certain distance exists between the sheath tube and the puncture port in the process of inserting the sheath tube into a patient blood vessel, the phenomenon of vibration of the sheath tube is caused due to uneven stress and resistance applied by patient tissues in the insertion process, and the phenomenon can cause unnecessary injury to the patient.
An auxiliary device for cardiovascular interventional puncture, as shown in fig. 1-4, comprises a frame body 1, wherein the frame body 1 is in sliding connection with a moving block 2, the right side of the frame body 1 is fixedly connected with a mounting frame 3, the middle part of the moving block 2 is provided with a sheath tube 4, the upper side of the mounting frame 3 is in sliding connection with two sliding columns 5 which are distributed front and back symmetrically, the two sliding columns 5 are utilized to clamp the sheath tube 4 together, the stability of the sheath tube 4 in the skin puncturing process of a patient is ensured, the sheath tube 4 is prevented from being dithered due to overlarge distance between a hand-held point and a puncture point in the skin inserting process of the hand-held sheath tube 4, thereby injury to the patient is avoided, U-shaped frames 6 are fixedly connected to opposite sides of the two sliding columns 5, a first elastic element 7 is a spring, the first elastic element 7 is used for resetting the adjacent U-shaped frames 6, the opposite sides of the two U-shaped frames 6 are both rotationally connected with an extrusion wheel 8, the outer side of the extrusion wheel 8 is made of rubber material, and a sealing mechanism is arranged on the opposite sides of the adjacent frame body 1, and is used for fully cleaning the sheath tube 4.
As shown in fig. 2-4, the cleaning mechanism comprises two moving parts 901 which are symmetrically distributed back and forth, the two moving parts 901 are both connected to the upper side of the frame body 1 in a sliding manner, the lower side of the moving block 2 is fixedly connected with two limit posts which are symmetrically distributed back and forth, the right side of the moving part 901 is fixedly connected with a first extrusion part 902, the opposite sides of the two first extrusion parts 902 are arched, the opposite sides of the two first extrusion parts 902 are respectively provided with comb teeth, teeth on the two first extrusion parts 902 are staggered with each other, the opposite sides of the two first extrusion parts 902 are fixedly connected with a scraping part 903, the scraping part 903 is in press fit with the adjacent first extrusion parts 902, the scraping part 903 is in contact fit with the sheath tube 4, the two scraping parts 903 are extruded through the opposite movement of the two first extrusion parts 902, the two scraping parts 903 are caused to deform and are tightly fit with the sheath tube 4, in this way, in the process of the relative movement of the sheath tube 4 and the scraping piece 903, the scraping piece 903 cleans the blood of a patient adhered on the sheath tube 4, so that the working strength of cleaning of subsequent medical staff is reduced, a first groove 904, a second groove 905 and a third groove 906 are arranged on the upper side of the moving piece 901, the first groove 904, the second groove 905 and the third groove 906 are in limit fit with adjacent limit posts on the moving block 2, so that the two moving pieces 901 move oppositely and back, the first groove 904, the adjacent second groove 905 and the adjacent third groove 906 are connected end to end, the distance between the two second grooves 905 and the distance between the two third grooves 906 are gradually reduced from left to right, the first groove 904 and the adjacent third groove 906 are communicated through straight grooves, a second elastic element 907 is fixedly connected between the moving piece 901 and the frame body 1, the second elastic element 907 is a spring, and is used for resetting the adjacent moving piece 901, the moving piece 901 is fixedly connected with a unidirectional plate 908, the direction of the unidirectional plate 908 is allowed to pass from the first groove 904 to the adjacent second groove 905, and the unidirectional plate 908 is positioned in the adjacent first groove 904.
As shown in fig. 1 and 5, the plugging mechanism comprises an air bag 1001, the air bag 1001 is arranged at the left side of a sheath tube 4, a middle tube 1002 communicated with the air bag 1001 is fixedly connected at the upper side of a moving block 2, a piston plate 1003 is slidably connected in the middle tube 1002, a compressed medium is filled between the middle tube 1002 and the piston plate 1003, the compressed medium is air, the air is injected into the air bag 1001 by utilizing the relative movement between the piston plate 1003 and the middle tube 1002, the air bag 1001 is inflated and closely contacted with an external instrument penetrating through the sheath tube 4, so as to prevent blood outflow in the sheath tube 4, a moving rod 1004 is fixedly connected at the upper side of the piston plate 1003, a limiting frame 1005 is fixedly connected at the upper end of the moving rod 1004, a through groove is arranged at the limiting frame 1005, the through groove is a horizontal straight groove, a fixing frame 1006 is fixedly connected at the rear part of the upper side of the frame body 1, the upper part of the inner side of the fixed frame 1006 is provided with two areas with different heights, the left part is higher than the right part, the left part of the inner side of the fixed frame 1006 is fixedly connected with a rack 1007, the upper side of the moving block 2 is rotationally connected with a spur gear 1008 in transmission fit with the rack 1007 through a bracket, a first limit cylinder in limit fit with a through groove of the limit frame 1005 is arranged at the upper eccentric part of the spur gear 1008, the through groove of the limit frame 1005 is extruded when the first limit cylinder of the spur gear 1008 rotates, the limit frame 1005 moves up and down, the left side of the spur gear 1008 is fixedly connected with a limit block 1009 in limit fit with the fixed frame 1006, and the limit block 1009 is limited by the area of the right part of the inner side of the fixed frame 1006, so that the spur gear 1008 does not rotate any more, and the expansion degree of the air bag 1001 is ensured.
When the device is needed to assist cardiovascular interventional puncture (taking puncture of a brachial artery of a patient as an example), medical staff installs the device on an operating table firstly, and enables the device to be integrally located in an area above the brachial artery of the patient, then the medical staff moves the moving block 2 rightwards, the moving block 2 starts to slide rightwards along the frame body 1, the moving block 2 drives the sheath 4 to move rightwards together, when the sheath 4 moves rightwards to be in contact with two extrusion wheels 8, the sheath 4 starts to extrude the two extrusion wheels 8 along with the continuous rightwards movement of the moving block 2, then the two extrusion wheels 8 start to move backwards, the extrusion wheels 8 drive the adjacent U-shaped frames 6 to move together, the U-shaped frames 6 drive the adjacent sliding columns 5 to move together, and the sliding columns 5 compress the adjacent first elastic elements 7, so that the sheath 4 is always supported on one side close to the patient in the process of inserting the brachial artery of the patient, and the sheath 4 is prevented from being unstable (vibrating) due to the fact that the distance between the hand-held point and the puncture point of the medical staff is too large in the inserting process.
In the process of moving the moving block 2 rightwards, two limit posts of the moving block 2 slide in adjacent first grooves 904 respectively, when the limit posts of the moving block 2 move rightwards to be in contact with adjacent one-way plates 908, as the moving block 2 continues to move rightwards, the limit posts of the moving block 2 pass through the adjacent one-way plates 908 rightwards, after interventional puncture is finished, medical staff moves the moving block 2 leftwards, the moving block 2 drives the sheath tube 4 to move leftwards together, the sheath tube 4 is gradually pulled out of a patient body, the limit posts of the moving block 2 start to squeeze the adjacent one-way plates 908, the limit posts of the moving block 2 slide in adjacent second grooves 905, the two one-way plates 908 start to move oppositely under the squeezing action of the adjacent limit posts on the moving block 2 respectively, the moving member 901 compresses the adjacent two second elastic elements 907, the moving member 901 drives the adjacent first extrusion members 902 to move together, the two first extrusion members 902 start to extrude the two scraping members 903 together, the scraping members 903 deform and are tightly attached to the adjacent areas of the sheath tube 4, so that blood of a patient adhered on the outer side of the sheath tube 4 is removed, the cleaning difficulty of subsequent medical staff is reduced, along with the continuous leftward movement of the moving block 2, the limit column of the moving block 2 enters the adjacent third groove 906, in the subsequent leftward movement process of the moving block 2, the limit column of the moving block 2 further extrudes the adjacent moving member 901, the two moving members 901 keep moving oppositely, the change of the outer diameter of the sheath tube 4 (the outer side of the sheath tube is conical) is adapted, when the moving block 2 moves leftwards to the original position, the limit column of the moving block 2 loses extrusion on the adjacent third groove 906, the two moving parts 901 start to move back under the elastic force of the adjacent second elastic elements 907.
In the process of moving the moving block 2 rightwards, the moving block 2 drives the intermediate pipe 1002 and the straight gear 1008 to move rightwards together, the intermediate pipe 1002 drives the moving rod 1004 to move rightwards together through the piston plate 1003, the sheath pipe 4 drives the air bag 1001 to move rightwards together, the straight gear 1008 starts to roll along the rack 1007, the straight gear 1008 rotates clockwise (in the front view direction), the first limiting cylinder on the straight gear 1008 is driven by the straight gear 1008 to rotate clockwise together with the limiting block 1009, the first limiting cylinder of the straight gear 1008 starts to slide in the through groove of the limiting frame 1005, meanwhile, the first limiting cylinder of the straight gear 1008 presses downwards against the through groove of the limiting frame 1005, the limiting frame 1005 starts to move downwards, the limiting frame 1005 drives the piston plate 1003 to move downwards together through the moving rod 1004, the piston plate 1003 presses air on the lower side of the piston plate 1003, and the pressed air enters the air bag 1001, the balloon 1001 begins to expand and block the left end of the sheath 4, along with the movement block 2 continuously moves rightwards, after the spur gear 1008 moves rightwards to be separated from the rack 1007, the spur gear 1008 stops rotating, after the limiting block 1009 moves rightwards to be in contact with the adjacent area of the fixed frame 1006, the limiting block 1009 is limited by the area (slightly higher than the area on the left upper side) on the inner side of the fixed frame 1006, namely, the spur gear 1008 does not rotate in the subsequent rightward movement process, so that the blocking effect of the expansion balloon 1001 on the left end of the sheath 4 is ensured, the phenomenon that blood in a patient overflows from the sheath 4 when a subsequent medical staff passes through the sheath 4 by an interventional puncture instrument is avoided, the normal operation of interventional puncture is influenced, and after the interventional puncture on the patient is completed, the medical staff moves the movement block 2 and parts on the movement block to the left, so that the sheath 4 pulls out the brachial artery of the patient.
After the existing cardiovascular interventional puncture is completed, the puncture opening of a patient needs to be manually pressed, the puncture opening needs to be healed for a long time, and the condition that the puncture opening is unstable is manually pressed, so that the working strength of medical staff is increased, and the normal healing of the puncture opening is also influenced.
Embodiment 2 based on embodiment 1, as shown in fig. 1 and 6-11, the device further comprises a compression mechanism for stopping bleeding of the puncture of the patient, the compression mechanism is arranged on the upper side of the mounting frame 3, the compression mechanism comprises two fixing rods 1101 which are symmetrically distributed around, the two fixing rods 1101 are fixedly connected to the upper side of the mounting frame 3, the two fixing rods 1101 are slidably connected with a movable box 1102 together, the lower side of the movable box 1102 is fixedly connected with a fixing piece 1103, the lower side of the movable box 1102 is fixedly connected with a protection pad 1104, the lower side of the fixing piece 1103 is fixedly connected with a rubber sheet 1105, the lower side of the rubber sheet 1105 is provided with a hemostatic sheet (used for stopping bleeding and sterilizing the puncture of the patient), the rubber sheet 1105 is used for stopping bleeding of the puncture of the patient, so that the working strength of medical staff is reduced, the lower part of the movable box 1102 is provided with a clamping assembly used for enabling the clamping assembly to be tightly attached to the elbow region of the patient, and the upper side of the movable box 1102 is provided with an adjusting assembly used for changing the pressure of the rubber sheet 1105.
As shown in fig. 7-9, the clamping assembly includes two rotating plates 1201 symmetrically distributed around, the two rotating plates 1201 are both rotatably connected to the lower part of the outer side of the moving box 1102, a third elastic element 1202 is fixedly connected between the rotating plates 1201 and the moving box 1102, the third elastic element 1202 is a torsion spring and is used for resetting the adjacent rotating plates 1201, a clamping plate 1203 is fixedly connected to the lower side of the rotating plates 1201, the clamping plate 1203 on the front side is provided with a binding belt 1204, the middle part of the clamping plate 1203 on the rear side is rotatably connected with a winding wheel 1205 in contact with the binding belt 1204, the binding belt 1204 is wound by the rotating winding wheel 1205, and the left side of the winding wheel 1205 is fixedly connected with a first knob 1206.
As shown in fig. 7-11, the adjusting assembly comprises an intermediate plate 1301, the intermediate plate 1301 is slidably connected to the upper side in the moving box 1102, a fourth elastic element 1302 is fixedly connected between the intermediate plate 1301 and the fixing element 1103, the fourth elastic element 1302 is a spring and is used for resetting the intermediate plate 1301, a threaded rod 1303 is screwed on the upper side of the moving box 1102, a second knob 1304 is rotatably connected to the upper side of the threaded rod 1303, a plurality of annular array grooves are arranged on the inner side of the second knob 1304, a plurality of annular array limiting protrusions 1305 are slidably connected to the threaded rod 1303, the limiting protrusions 1305 are in limit fit with the second knob 1304 and adjacent grooves on the second knob 1304, a fifth elastic element 1306 is fixedly connected between the limiting protrusions 1305 and the threaded rod 1303 by limiting between the limiting protrusions 1305 and the adjacent grooves on the second knob 1304, the fifth elastic element 1306 is a spring, and is used for resetting the adjacent limiting protrusion 1305, the lower side of the middle plate 1301 is fixedly connected with a second extrusion member 1307 which is in sliding connection with the fixing member 1103, the fixing member 1103 is provided with a first cavity 1308, a second cavity 1309, a third cavity 1310 and four middle channels 1311 in annular array, the second extrusion member 1307 slides in the first cavity 1308, the second cavity 1309, the third cavity 1310 and the four middle channels 1311 are filled with transmission media, the transmission media are hydraulic oil, the middle channels 1311 are communicated with the first cavity 1308, the second cavity 1309 and the third cavity 1310, the hydraulic oil in the first cavity 1308, the second cavity 1309 and the third cavity 1310 extrudes the rubber sheet 1105 in the adjacent area through the relative sliding between the second extrusion member 1307 and the fixing member 1103, so that the rubber sheet 1105 expands, and compress the puncture of the patient.
In order to reduce the working strength of the subsequent medical staff, the binding belt 1204 is wound by the winding wheel 1205, so that the hemostatic sheet at the lower side of the rubber sheet 1105 is tightly attached to the puncture opening of the patient, thereby avoiding the hemorrhage of the puncture opening of the patient, and simultaneously, the pressing step of the subsequent medical staff is reduced, the detailed steps are as follows, when the medical staff finishes the interventional puncture and pulls out the brachial artery of the patient from the sheath tube 4, the medical staff firstly moves the movable box 1102 to the upper side of the elbow of the patient, then the medical staff pinch the two rotating plates 1201, the two rotating plates 1201 start to rotate oppositely, the third elastic element 1202 is deformed, the rotating plates 1201 drive the adjacent clamping plates 1203 to rotate together, then the medical staff integrally places the device at the puncture position, adjusts the positions of the two clamping plates 1203 to the region of the elbow of the patient, then the medical staff releases the two rotating plates 1201, the rotating plate 1201 starts to reversely rotate under the torsion force of the adjacent third elastic element 1202, the third elastic element 1202 drives the adjacent clamping plates 1203 to rotate together, the two clamping plates 1203 clamp the elbow of a patient, then a medical staff winds the binding band 1204 around the elbow of the patient and then adheres to the outer side of the winding wheel 1205 (sticking buckle connection), then the medical staff clockwise rotates the first knob 1206 (left view direction), the first knob 1206 drives the winding wheel 1205 to rotate together clockwise, the rotating winding wheel 1205 starts to wind the binding band 1204 until the hemostatic sheet wound on the lower side of the rubber sheet 1105 is tightly attached to the puncture port of the patient, then the medical staff pulls out the sheath tube 4 from the brachial artery of the patient by leftwards moving the moving block 2 and leftwards moves the frame body 1, the frame body 1 drives the mounting frame 3 to leftwards move together, the mounting frame 3 drives the two fixing rods 1101 to leftwards move together, the fixed bar 1101 and the moving case 1102 slide relatively until the fixed bar 1101 is disengaged from the moving case 1102.
After the two clamping plates 1203 clamp the elbows of the patient, the medical staff rotates the second knob 1304 anticlockwise (in the overlook direction), the second knob 1304 drives the threaded rod 1303 to rotate anticlockwise through the limiting protrusions 1305, the threaded rod 1303 and the middle plate 1301 rotate relatively, then the threaded rod 1303 starts to move downwards under the action of the threads of the moving box 1102, the threaded rod 1303 drives the middle plate 1301 to move downwards together, the middle plate 1301 compresses the fourth elastic element 1302, the middle plate 1301 drives the second extrusion 1307 to move downwards together, the second extrusion 1307 extrudes hydraulic oil in the first cavity 1308, the hydraulic oil in the first cavity 1308 enters the second cavity 1309 and the third cavity 1310 through the adjacent middle channel 1311, the hydraulic oil in the second cavity 1309 and the hydraulic oil in the third cavity 1310 start to extrude adjacent areas of the rubber sheet respectively, the corresponding areas of the rubber sheet expand, the force applied to the elbows of the patient is the tension of the rubber sheet 1105 expand, the stress area of the patient is reduced, discomfort of the patient is reduced, the fifth elastic element 1306 does not press the second knob 1304, the second knob 1304 stops rotating anticlockwise when the fifth elastic element 1306 does not provide enough force to press the second knob 1304, and the second knob 1304 stops rotating anticlockwise, and the second knob 1304 stops rotating, and the medical staff stops rotating, and the second knob 1304 stops rotating.
After the puncture of the patient heals, the medical staff rotates the first knob 1206 anticlockwise (left view direction), the first knob 1206 drives the winding wheel 1205 to rotate anticlockwise together, the winding wheel 1205 releases the wound binding band 1204 thereon until the adhesion area between the winding wheel 1205 and the binding band 1204 is exposed, then the medical staff removes the binding band 1204 from the winding wheel 1205, then the medical staff rotates the second knob 1304 clockwise (overlook direction), the second knob 1304 drives the threaded rod 1303 to rotate clockwise through the plurality of limiting protrusions 1305, the threaded rod 1303 starts to move upwards relative to the movable box 1102, the threaded rod 1303 drives the second extrusion 1307 to move upwards through the middle plate 1301 (the compressed fourth elastic element 1302 provides assistance for the reset of the middle plate 1301), the second extrusion 1307 starts to extract hydraulic oil in the second cavity 1309 and the third cavity 1310, then the expanded rubber sheet gradually resets, then the medical staff pinch the two clamping plates 1203 to lose the clamping of the patient's elbow, and then the medical staff moves the movable box 1102 and the upper parts thereof.
The existing compression device only compresses the puncture of a patient to a uniform degree, so that blood in a compressed area can be gathered towards the puncture, the probability of outflow of blood exists, and the healing effect of the puncture is affected.
Example 3: on the basis of embodiment 2, as shown in fig. 9 and 10, the device further comprises a pressure transmission mechanism for changing the compression force of the rubber sheet 1105 on the patient, the pressure transmission mechanism is arranged at the lower part in the fixed piece 1103, the pressure transmission mechanism comprises a moving plate 1401, the moving plate 1401 is slidably connected in a first cavity 1308 on the fixed piece 1103, the moving plate 1401 is positioned below four middle channels 1311, a first ring 1402 is slidably connected in a second cavity 1309 on the fixed piece 1103, a second ring 1403 is slidably connected in a third cavity 1310 on the fixed piece 1103, a sixth elastic element 1404 is fixedly connected between the moving plate 1401 and the fixed piece 1103, the sixth elastic element 1404 is a spring for resetting the moving plate 1401, four seventh elastic elements 1405 of an annular array are fixedly connected between the first ring 1402 and the fixed piece 1103, the seventh elastic element 1405 is a spring, and is used for resetting the first ring 1402, four eighth elastic elements 1406 in an annular array are fixedly connected between the second ring 1403 and the fixing piece 1103, the eighth elastic elements 1406 are springs, and are used for resetting the second ring 1403, the elastic coefficients of the sixth elastic element 1404, the seventh elastic element 1405 and the eighth elastic element 1406 are gradually increased, so that when the rubber sheet 1105 is expanded, the expansion degree of the rubber sheet 1105 is gradually reduced from the middle to the outer, and the compression of the expanded rubber sheet 1105 to the puncture area is maximized, and further, the situation that when the puncture area of a patient is compressed, blood is gathered to the puncture, and the blood accidentally flows out, and extra injury to the patient is caused is avoided, and a force changing component for changing the tightening degree of the binding belt 1204 is arranged outside the moving box 1102.
As shown in fig. 7, fig. 12 and fig. 13, the deformation force assembly comprises an L-shaped rod 1501 rotationally connected with a threaded rod 1303, the L-shaped rod 1501 is slidingly connected at the rear part of a moving box 1102, a second limit cylinder is arranged at the lower end of the L-shaped rod 1501, a sector plate 1502 is rotationally connected at the lower part of the rear side of the moving box 1102, a worm 1503 is rotationally connected at the rear side of the middle part of a rear clamping plate 1203, the worm 1503 is in transmission connection with a winding wheel 1205 through a gear set 1504, the gear set 1504 consists of two meshed spur gears, the two spur gears are fixedly connected with the winding wheel 1205 and the worm 1503 respectively, a connecting seat 1505 is rotationally connected with a worm wheel 1506 meshed with the worm 1503 at the upper part of the rear side of the rear clamping plate 1203, a limit rod 1507 is fixedly connected at the upper part of the rear side of the sector plate 1502, a neighboring area of the moving box 1102 is penetrated by the limit rod 1507, the limit rod 1501508 is limited by the limit rod 1507, the sector plate 1502 stops after rotating a certain angle, the worm wheel 1502 is provided with a second limit cylinder 1509 which is matched with the sector plate 1509, and an included angle is extruded between the sector plate 1501 and the second limit cylinder 1509 which is opposite to the sector plate 1509.
In order to improve the compression effect on the patient puncture, the rubber sheet 1105 is gradually compressed from the middle to the outside, so that the similar compression is performed on the patient puncture area, the blood in the compressed area is prevented from gathering towards the puncture due to the fact that the excessive compression area is compressed at the same time, and accidental bleeding is caused, the detailed steps are as follows, in the process that the second extrusion 1307 moves downwards and extrudes hydraulic oil in the first cavity 1308, the elastic coefficients of the sixth elastic element 1404, the seventh elastic element 1405 and the eighth elastic element 1406 are gradually increased, and the hydraulic oil force in the same cavity is the same, so that the compression amount of the sixth elastic element 1404, the seventh elastic element 1405 and the eighth elastic element 1406 is gradually reduced (sufficient elastic force is needed to be provided through sufficient deformation, so that the hydraulic force is overcome), namely the downward movement amount of the moving plate 1401, the first ring 1402 and the second ring 1403 is gradually reduced, that the deformation of the rubber sheet 1105 from the outer side is gradually reduced, and the force applied to the patient puncture area in the middle is maximum, so that the additional damage to the blood is caused to the patient puncture is avoided when the patient puncture area is compressed, and the accidental bleeding is caused.
In order to increase the application range of the device, the relative movement amount between the L-shaped rod 1501 and the movable box 1102 is utilized to determine the winding degree of the follow-up winding wheel 1205 on the binding belt 1204, so that the tightness degree of the binding belt 1204 is matched with patients with different body fat rates, the detailed steps are as follows, in the process of moving the threaded rod 1303 downwards (the area of the rubber sheet 1105 extruded by hydraulic oil begins to expand, because of different body fat rates of the patients, the resistance applied to the expansion process of the rubber sheet 1105 is different, until the resistance of the rubber sheet 1105 makes it not expand any further, the threaded rod 1303 rotates relatively to the L-shaped rod 1501, but the threaded rod 1303 drives the L-shaped rod 1501 to move downward together, the L-shaped rod 1501 slides relatively to the moving case 1102, the second limit cylinder of the L-shaped rod 1501 begins to press the limit groove 1509 downward, the sector plate 1502 rotates counterclockwise (in the backward direction), the sector plate 1502 drives the limit rod 1507 to rotate counterclockwise together, and the limit rod 1507 begins to slide in the through hole 1508.
In the clockwise rotation process (left view direction) of the winding wheel 1205, the winding wheel 1205 drives the worm 1503 to rotate anticlockwise through the gear set 1504, the worm 1503 drives the worm wheel 1506 to rotate clockwise (rear view direction), the winding wheel 1205 continuously winds the binding band 1204 in the process, when the worm wheel 1506 rotates clockwise to be limited by the limiting rod 1507, the winding wheel 1205 stops rotating clockwise, different relative movement distances between the threaded rod 1303 and the movable box 1102 are caused by different resistance of tissues of the puncture mouth area of a patient with different body fat rate to the expansion process of the rubber sheet 1105, and the tightness degree of the binding band 1204 is changed, so that different compression forces are applied to the patient with different body fat rates, and the comfort degree of the patient is improved on the premise of ensuring effective compression hemostasis (the fat of the patient with high body fat plays a part of hemostasis, so that the patient with low body fat is slightly compressed, and no additional hemostasis measure is needed, so that the compression force is correspondingly improved).
Example 4 an assisting method for cardiovascular interventional puncture based on the above assisting device for cardiovascular interventional puncture based on the example 3 as shown in fig. 1 to 13, comprising the steps of:
S1, fixedly mounting the device on an operating table, integrally placing the device above a brachial artery (above an elbow) of a patient, then moving a moving block 2 and parts on the moving block to the right, and clamping and limiting a sheath tube 4 by utilizing two extrusion wheels 8, so that the sheath tube 4 is stably inserted into the brachial artery of the patient;
S2, the rotating straight gear 1008 utilizes a first limit cylinder on the straight gear 1008 to extrude a through groove of the limit frame 1005, so that the limit frame 1005, the movable rod 1004 and the piston plate 1003 move downwards, air at the lower part in the middle pipe 1002 is pressed into the air bag 1001, and then the left end of the sheath pipe 4 is blocked by the inflated air bag 1001;
S3, after interventional puncture is completed, moving the moving block 2 and parts on the moving block to the left, extruding adjacent moving parts 901 by a limiting column of the moving block 2, enabling the two moving parts 901 to move oppositely, extruding adjacent scraping parts 903 by a first extrusion part 902 which moves oppositely, enabling the two scraping parts 903 to be in close contact with the sheath tube 4, and removing blood of a patient adhered to the outer side of the sheath tube 4;
S4, deflecting the two rotating plates 1201 to enable the two clamping plates 1203 to fix the movable box 1102 and the upper parts thereof at the elbow of the patient, so that the rubber sheet 1105 is tightly attached to the puncture of the patient;
S5, rotating the second knob 1304 to enable the threaded rod 1303 and the movable box 1102 to move relatively, and then extruding hydraulic oil in the first cavity 1308 through the second extrusion piece 1307 to enable the hydraulic oil entering the second cavity 1309 and the third cavity 1310 to extrude adjacent areas of the rubber sheet 1105 to different degrees, so as to extrude puncture areas of patients to different degrees;
s6, rotating the first knob 1206 to enable the winding wheel 1205 to wind the binding band 1204, and fastening the binding band 1204 to different degrees according to patients with different body fat rates;
And S7, after the puncture of the patient heals, rotating the first knob 1206 to enable the winding wheel 1205 to release the binding belt 1204, and then oppositely rotating the two rotating plates 1201 to enable the two clamping plates 1203 to be separated from the patient.
The embodiments of the present invention have been described in detail with reference to the drawings, but the present invention is not limited to the above embodiments, and various changes can be made within the knowledge of those skilled in the art without departing from the spirit of the present invention.
Claims (10)
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| CN202411472654.4A CN119055336A (en) | 2024-10-22 | 2024-10-22 | Auxiliary device and method for cardiovascular interventional puncture |
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| CN202411472654.4A CN119055336A (en) | 2024-10-22 | 2024-10-22 | Auxiliary device and method for cardiovascular interventional puncture |
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