CN107157529A - The conveying device and its application method of simple ultrasound guidance atrial septal defect plugging device - Google Patents
The conveying device and its application method of simple ultrasound guidance atrial septal defect plugging device Download PDFInfo
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- CN107157529A CN107157529A CN201710593172.8A CN201710593172A CN107157529A CN 107157529 A CN107157529 A CN 107157529A CN 201710593172 A CN201710593172 A CN 201710593172A CN 107157529 A CN107157529 A CN 107157529A
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- 206010003664 atrial septal defect Diseases 0.000 title claims abstract description 34
- 208000035478 Interatrial communication Diseases 0.000 title claims abstract description 33
- 208000013914 atrial heart septal defect Diseases 0.000 title claims abstract description 33
- 238000002604 ultrasonography Methods 0.000 title claims abstract description 20
- 238000000034 method Methods 0.000 title claims abstract description 9
- 238000005452 bending Methods 0.000 claims abstract description 27
- 238000012546 transfer Methods 0.000 claims abstract description 18
- 239000000835 fiber Substances 0.000 claims abstract description 12
- 239000002184 metal Substances 0.000 claims abstract description 11
- 230000001746 atrial effect Effects 0.000 claims abstract description 6
- 210000002837 heart atrium Anatomy 0.000 claims description 42
- 210000003191 femoral vein Anatomy 0.000 claims description 9
- 238000005406 washing Methods 0.000 claims description 9
- 238000002592 echocardiography Methods 0.000 claims description 4
- 230000007547 defect Effects 0.000 claims description 3
- 230000003601 intercostal effect Effects 0.000 claims description 3
- 210000001562 sternum Anatomy 0.000 claims description 3
- 229910000831 Steel Inorganic materials 0.000 claims 1
- 239000010959 steel Substances 0.000 claims 1
- 238000006748 scratching Methods 0.000 abstract description 3
- 230000002393 scratching effect Effects 0.000 abstract description 3
- 208000027418 Wounds and injury Diseases 0.000 description 5
- 238000005516 engineering process Methods 0.000 description 5
- 210000001367 artery Anatomy 0.000 description 4
- 230000006378 damage Effects 0.000 description 4
- 210000001627 cerebral artery Anatomy 0.000 description 3
- 208000014674 injury Diseases 0.000 description 3
- 230000002285 radioactive effect Effects 0.000 description 3
- 210000001519 tissue Anatomy 0.000 description 3
- 206010001526 Air embolism Diseases 0.000 description 2
- VYPSYNLAJGMNEJ-UHFFFAOYSA-N Silicium dioxide Chemical compound O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 description 2
- 230000017531 blood circulation Effects 0.000 description 2
- 238000005259 measurement Methods 0.000 description 2
- 238000012544 monitoring process Methods 0.000 description 2
- 239000000741 silica gel Substances 0.000 description 2
- 229910002027 silica gel Inorganic materials 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 210000003462 vein Anatomy 0.000 description 2
- 238000004804 winding Methods 0.000 description 2
- 208000006017 Cardiac Tamponade Diseases 0.000 description 1
- 208000032170 Congenital Abnormalities Diseases 0.000 description 1
- 206010010356 Congenital anomaly Diseases 0.000 description 1
- 208000005189 Embolism Diseases 0.000 description 1
- 208000010496 Heart Arrest Diseases 0.000 description 1
- 206010058046 Post procedural complication Diseases 0.000 description 1
- 208000035965 Postoperative Complications Diseases 0.000 description 1
- 210000003157 atrial septum Anatomy 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000033228 biological regulation Effects 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 210000000038 chest Anatomy 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 238000012790 confirmation Methods 0.000 description 1
- 210000004351 coronary vessel Anatomy 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 238000007599 discharging Methods 0.000 description 1
- 230000009977 dual effect Effects 0.000 description 1
- 210000003017 ductus arteriosus Anatomy 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 208000025339 heart septal defect Diseases 0.000 description 1
- 230000023597 hemostasis Effects 0.000 description 1
- 210000005246 left atrium Anatomy 0.000 description 1
- 210000005240 left ventricle Anatomy 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000001681 protective effect Effects 0.000 description 1
- 230000004088 pulmonary circulation Effects 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- 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
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
- A61B2017/00623—Introducing or retrieving devices therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2063—Acoustic tracking systems, e.g. using ultrasound
-
- 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
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
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- Health & Medical Sciences (AREA)
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- Life Sciences & Earth Sciences (AREA)
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Abstract
The present invention relates to a kind of conveying device and its application method of simple ultrasound guidance atrial septal defect plugging device, including sheath and sheath core, sheath and sheath core are hollow structure, sheath core is installed in sheath, the endoporus of sheath core is used to install seal wire, sheath includes tube wall, transfer passage and handle, the endoporus of sheath is transfer passage, tube wall includes the termination being sequentially connected, identification section, elastic bending section and hard tube body, handle is connected with hard tube body, termination is soft termination, the identification section of tube wall is wrapped with sheet metal, the front end of elastic bending section is provided with the traction fiber that can be slided along tube wall, the present invention is the soft termination for being provided for preventing from scratching chambers of the heart wall in the front end of sheath, mark sheet metal is set on the sheath tube wall being connected with soft termination, scale is provided with the pipe shaft of sheath, by the position and direction for marking the convenient display sheath head end accurate under echocardiogram environment of sheet metal, avoid wearing out or scratching atrial wall.
Description
Technical field
The invention belongs to medical auxiliary apparatus technical field, and in particular to a kind of simple ultrasound guidance atrial septal defect is used
The conveying device and its application method of plugging device.
Background technology
Atrial septal defect is the interval hypoplasia between left atrium, and that leaves that defect causes that blood flow can communicate is congenital
Deformity, at present, the treatment for atrial septal defect human body are mainly treated using Closure of Atrial Septal Defect.At present, room
Every the defect percutaneous transcatheter closure mainly percutaneous percutaneous transcatheter closure under radioactive ray, the operation is clinically common technology, the operation need not open chest,
Extracorporal circulatory system can be avoided, has the advantages that wound is small, recover fast, determined curative effect, still, the operation has to rely on large-scale image and set
It is standby, and the radioactive ray that large-scale influence equipment is produced, larger injury can be generated to patient and medical personnel.
With the development of medical technology, at present, medical personnel develop simple ultrasound guidance atrial septal defect and percutaneously sealed
Stifled art, the operation is the new technology occurred recently, and a small number of severe heart centers are carried out at home, is following atrial septal defect envelope
The developing direction of stifled art, while the technology avoids surgery wound, turn avoid application and the radioactive ray pair of large-scale image documentation equipment
The human injury that medical personnel and patient bring.
At present, the percutaneous percutaneous transcatheter closure concrete operation step of simple ultrasound guidance atrial septal defect is：Femoral vein is punctured to insert
Femoral vein sheath, with right heart catheter under seal wire cooperation, inferior caval vein is passed through by right heart catheter and its interior seal wire from femoral vein
Into atrium dextrum, seal wire, the depth of regulation right heart catheter front end and direction are then retreated slightly, right heart catheter is passed through atrial septum
Defect enters atrium sinistrum, after echocardiogram determines that the front end of right heart catheter enters atrium sinistrum, promotes seal wire forward again,
The front end of seal wire is set also to enter atrium sinistrum, now, then the approximate depth that mark right heart catheter enters in human body retains seal wire and move back
Go out right heart catheter.Then the delivery sheath with sheath core, the depth reference right heart catheter of the entrance of delivery sheath are sent into along seal wire
Into the depth of human body, after echocardiogram determines that delivery sheath enters atrium sinistrum, sheath core and seal wire are exited, retains conveying sheath
Pipe is in atrium sinistrum, and now, " double track sign " of delivery sheath can be seen in echocardiogram, but can not accurately show delivery sheath head end
Position and direction.The angle and depth of fixed hollow delivery sheath, by the atrial septal defect plugging device loaded, by hollow
Delivery sheath enters atrium sinistrum, by ductus arteriosus occluder atrial septal defect, installs plugging device backed off after random delivery sheath.
From the foregoing, the percutaneous percutaneous transcatheter closure of atrial septal defect of existing simple ultrasound guidance has the following disadvantages：It is first
First, in order to which delivery sheath is sent into atrium sinistrum, it is necessary to set up " track " of delivery sheath by right heart catheter and seal wire, and logical
Cross during delivery sheath pushes plugging device to atrium sinistrum, there can be air in hollow delivery sheath unavoidably, push plugging device
During, air can enter atrium sinistrum unavoidably, and the gas into atrium sinistrum can enter left ventricle with blood flow, cause coronal dynamic
The fatal risk of arteries and veins and cerebral artery gas embolism, such a phenomenon has relevant report in clinical practice.Secondly, with sheath core
Delivery sheath by atrial septum lack enter atrium sinistrum after, echocardiogram is only capable of seeing " double track sign " of delivery sheath, but nothing
Method accurately shows the position and direction of delivery sheath head end, and the front end of sheath core is typically exposed outside delivery sheath, and sheath core
Matter is harder, and the position and direction of the head end of delivery sheath are not known, and there is the risk that left atrial wall was worn out or scratched in sheath core front end,
Potential safety hazard is brought to operation.Furthermore, after plugging device is installed, when echocardiogram is short from double rooms, four chambers and main artery
Axial section, judge plugging device position it is good on surrounding tissue without influence after, wirerope can be conveyed by rotate counterclockwise plugging device and released
Plugging device is put, to avoid rotation wirerope winding atrium dextrum inner tissue, delivery sheath head end need to be placed in and close on the right umbrella disk of plugging device
Position, plays a protective role, but because current delivery sheath head end develops not good enough under echocardiogram, many feels by patient
To complete, the degree of accuracy is not high, and artificial sense datum directly determines the success or failure of operation, clinically once has in conveying wirerope winding atrium
Organize and cause the report for discharging plugging device failure.The presence of drawbacks described above, easily increases postoperative complication（Such as：Infect, go out
Blood, cardiac tamponade, cardiac arrest, open-chest surgery are even dead）, cause extended hospital stay, hospitalization cost increase and produce
Raw doctor-patient dispute.
The content of the invention
In summary, in order to overcome the shortcomings of prior art problem, the invention provides a kind of simple ultrasonic guidance servant quarters
The conveying device and its application method of septal defect plugging device, it is to be provided for preventing from scratching chambers of the heart wall in the front end of sheath
Soft termination, set on the sheath tube wall being connected with soft termination and be provided with scale on mark sheet metal, the pipe shaft of sheath, pass through mark
The position and direction of the convenient display sheath head end accurate under echocardiogram environment of sheet metal, it is to avoid wear out or scratch atrium
Wall.
In order to solve the above technical problems, the technical solution adopted by the present invention is：
A kind of conveying device of simple ultrasound guidance atrial septal defect plugging device, wherein：It is described including sheath and sheath core
Sheath and sheath core are hollow structure, and sheath core is installed in sheath, and the endoporus of described sheath core is used to install seal wire, described sheath
Pipe includes tube wall, transfer passage and handle, and the endoporus of described sheath is to set open-work in transfer passage, described handle, thoroughly
Hole connects transfer passage, is provided with check valve in described open-work, termination that described tube wall includes being sequentially connected, identification section,
Elastic bending section and hard tube body, described handle is connected with hard tube body, and described termination is soft termination, the mark of described tube wall
Section is wrapped with sheet metal, and the front end of described elastic bending section is provided with the traction fiber that can be slided along tube wall, described hand
Bend operating apparatus is provided with handle, bend operating apparatus pulls elastic bending section to bend by traction fiber, on described handle
It is provided with exhaust washing pipe, exhaust washing pipe connection transfer passage.
Technical scheme may also is that realization：Valve is provided with described exhaust washing pipe.
Technical scheme may also is that realization：Described bend operating apparatus include sliding block, chute and
Hook plate, described sliding block is moved along chute, and the middle part of described hook plate is hinged with sliding block, and one end of hook plate is provided with grab, institute
Torsion spring is provided with the jointed shaft that the sliding block stated is hinged with chute, the both sides of described chute are provided with zigzag neck, described
Hook plate on grab hook be stuck in neck, one end of described sliding block and traction fiber is connected.
Technical scheme may also is that realization：The stroke of described sliding block and the length of elastic bending section
It is identical, it is 80 ~ 100mm.
Technical scheme may also is that realization：The length of described termination is 3 ~ 10mm.
Technical scheme may also is that realization：The length of described identification section is 8 ~ 12mm.
Technical scheme may also is that realization：Graduation mark is provided with the outer wall of described sheath.
Technical scheme may also is that realization：The angle of bend of described elastic bending section is 0 ~ 90 °.
A kind of application method of the conveying device of simple ultrasound guidance atrial septal defect plugging device, wherein：Including with
Lower step：
A, puncture femoral vein indwelling femoral vein sheath；
B, the body using the graduation mark measurement femoral venous puncture point outside the sheath of conveying device to the intercostal of human body right border of sternum the 3rd
Table distance, the length entered according to the range estimation sheath in body；
C, using right heart catheter seal wire sent into human body atrium dextrum；
D, exit right heart catheter and retain seal wire, then using the sheath of seal wire conveyer belt sheath core, until the length estimated in step；
E, determined using echocardiogram sheath identification section position, it is ensured that the termination of sheath is located at upper 1/3 in atrium dextrum
Position；
F, fixed conveying device, exit seal wire and sheath core；
G, the plugging device loaded by the transfer passage of sheath to atrium dextrum conveying convey wirerope, until plugging device is located at sheath
Tip position；
H, operation bend operating apparatus, push hook plate, grab is departed from neck, promote sliding block, sliding block is moved along chute, draw
Dynamic traction fiber, makes the elastic bending section bending of sheath, then under echocardiogram environment, and the double room tangent planes of observation heart are pulled
The handle of sheath, makes the preceding of sheath rectify to atrial septal defect position；
J, pushing sheath tube handle, under echocardiogram environment, are observed before the identification section of sheath front end, clear view to sheath
End enters atrium sinistrum by atrial septal defect, and observation identification section enters the depth of atrium sinistrum in the position of atrium sinistrum, monitoring sheath,
Prevent sheath front end from injuring left atrial wall；
The conveying wirerope for being mounted with plugging device in i, fixed sheath, pushing sheath tube, discharges the left umbrella disk of plugging device, then overall
Conveying wirerope and delivery sheath are retreated, left umbrella disk is close to the room next door of atrium sinistrum, it is then fixed to convey wirerope and retreat
Sheath, discharges the right umbrella disk of plugging device, completes echocardiography in atrial septal defect.
Beneficial effects of the present invention are：
1st, the termination of sheath of the invention is soft termination, and soft termination can be made of flexible preferably rubber or silica gel material, soft
The setting of termination can effectively prevent that termination scratches blood vessel or heart wall in sheath course of conveying, it is to avoid operation is made to human body
Into extra injury.
2nd, the anterior of sheath of the invention sets coated metal piece, the presence of sheet metal on identification section, the outer wall of identification section
Sheath head position can be gone out in accurate identification under ultrasound environments, so as to facilitate medical personnel's observation operation.
3rd, the present invention can send into plugging device in the transfer passage that atrium dextrum can be into sheath, in course of conveying,
Plugging device arranges the air contained in sheath to atrium dextrum, it is to avoid air causes coronary artery and cerebral artery gas into atrium sinistrum
The fatal risk of embolism.
Brief description of the drawings
Fig. 1 is structural representation of the invention；
Fig. 2 is bend operating apparatus structural representation of the present invention;
Fig. 3 is Fig. 2 of the present invention A-A schematic cross-sectional views.
Embodiment
The present invention is described in further detail below in conjunction with the accompanying drawings.
As shown in Figure 1, Figure 2, Figure 3 shows, a kind of conveying device of simple ultrasound guidance atrial septal defect plugging device, including
Sheath 1 and sheath core 2, described sheath 1 and sheath core 2 is hollow structure, and sheath core 2 is installed in sheath 1, described sheath core 2
Endoporus is used to install to be provided with graduation mark on seal wire, the outer wall of sheath 1, and described sheath 1 includes tube wall 3, transfer passage 4 and hand
Handle 5, the endoporus of described sheath 1 is that open-work 6 is set in transfer passage 4, described handle 5, the connection transfer passage 4 of open-work 6, institute
Check valve 7 is provided with the open-work 6 stated, described tube wall 3 includes the termination 8 being sequentially connected, identification section 9, elastic bending section 10
And hard tube body 11, described handle 5 is connected with hard tube body 11, and described termination 8 is soft termination, and its length is 5mm, using softness
Rubber or silica gel be made, the identification section 9 of described tube wall 3 is wrapped with sheet metal 91, and the length of described identification section 9 is
10mm, the angle of bend of elastic bending section is 0 ~ 90 °, and the front end of elastic bending section 10 is provided with can be along leading that tube wall 3 is slided
Draw and bend operating apparatus is provided with silk 12, described handle 5, bend operating apparatus pulls elastic bending section by traction fiber 12
It is provided with exhaust washing pipe 13, the exhaust connection transfer passage 4 of washing pipe 13, exhaust washing pipe 13 and sets on 10 bendings, described handle 5
There is valve 14.The length of sheath 1 of the present invention can design plurality of specifications, be selected according to the need for difference.
Bend operating apparatus includes sliding block 15, chute 16 and hook plate 17, and described sliding block 15 is moved along chute 16, described
The middle part of hook plate 17 is hinged with sliding block 15, and one end of hook plate 17 is provided with grab 18, what described sliding block 15 was hinged with chute 16
Torsion spring 19 is provided with jointed shaft, the both sides of described chute 16 are provided with the card on zigzag neck 20, described hook plate 17
The hook of hook 18 is stuck in neck 20, and described sliding block 15 is connected with one end of traction fiber 12.The stroke of sliding block 15 and elastic bending section
10 length is identical, is 100mm.
A kind of application method of the conveying device of simple ultrasound guidance atrial septal defect plugging device, wherein：Including with
Lower step：
A, puncture femoral vein indwelling femoral vein sheath；
B, the body using the graduation mark measurement femoral venous puncture point outside the sheath 1 of conveying device to the intercostal of human body right border of sternum the 3rd
Table distance, the depth entered according to the range estimation sheath 1 in body；
C, using right heart catheter seal wire sent into human body atrium dextrum；
D, exit right heart catheter and retain seal wire, then using the sheath 1 of seal wire conveyer belt sheath core 2, until the length estimated in step b
Degree；
E, determined using echocardiogram sheath 1 identification section 9 position, it is ensured that on the termination 8 of sheath 1 is located in atrium dextrum
1/3 position；
The termination 8 that ensure that sheath 1 by step d and step e is located at upper 1/3 position, Dual positioning in atrium dextrum, it is ensured that
The degree of accuracy of operation, it is to avoid the damage of termination 8 atrial wall of sheath 1.The identification section of step d delivered lengths and Echocardiography
Mutually confirm 9 position, it is ensured that the termination 8 of sheath 1 is located at upper 1/3 position in atrium dextrum.
F, fixed conveying device, exit seal wire and sheath core 2；
G, the plugging device loaded by the transfer passage 4 of sheath 1 to atrium dextrum conveying convey wirerope, until plugging device is located at sheath
The position of termination 8 of pipe 1；The operation is completed in atrium dextrum, and a small amount of gas enters pulmonary circulation, vital sign is not influenceed,
Simplify current clinically operation and must be set up so-called " track " step, it also avoid gas and cause coronal into atrium sinistrum
The fatal risk of artery and cerebral artery gas embolism.
H, operation bend operating apparatus, push hook plate 17, grab 18 is departed from neck 20, promote sliding block 15, make sliding block
15 move along chute 16, pull traction fiber 12, bend the elastic bending section 10 of sheath 1, then under echocardiogram environment,
The double room tangent planes of heart are observed, the handle 5 of sheath 1 is pulled, the preceding of sheath 1 is rectified to atrial septal defect position；The cunning of the present invention
The length of the stroke of block 15 and elastic bending section 10 is identical, is 100mm, and with the angle of bend of elastic bending section 10 for 0 ~
90 °, by limit sliding block 15 stroke and elastic bending section 10 angle of bend, make elastic bending section 10 in safe range
Flexural deformation.
J, pushing sheath tube 1 handle 5, under echocardiogram environment, the identification section 9 of observation sheath 1 front end, clear view
Atrium sinistrum is entered by atrial septal defect to the front end of sheath 1, observation identification section 9 enters left in the position of atrium sinistrum, monitoring sheath 1
The depth in atrium, prevents the front end of sheath 1 from injuring left atrial wall；
The conveying wirerope for being mounted with plugging device in i, fixed sheath 1, pushing sheath tube 1, discharges the left umbrella disk of plugging device, then whole
Body retreats conveying wirerope and delivery sheath 1, left umbrella disk is close to the room next door of atrium sinistrum, after then fixing conveying wirerope simultaneously
Sheath 1 is moved back, the right umbrella disk of plugging device is discharged, echocardiography in atrial septal defect is completed.
After right umbrella disk release is finished, under open in-heart operation under pulsating environment, cut by double rooms, four chambers, main artery short axle etc.
Face, observation plugging device position, form and the influence to surrounding tissue after confirmation is errorless, adjusts the depth of sheath 1, make sheath 1
Head end is adjacent to the right umbrella disk of plugging device, and this operates under echocardiogram environment, can accurately seen by the sheet metal 91 of identification section 9
Judgement is examined, then rotation conveying wirerope release plugging device, after echocardiogram reaffirms that plugging device position and form are good, is moved back
Go out sheath 1 and wirerope, point of puncture hemostasis by compression, pressure dressing complete operation.
It is noted that described above implement to be to the illustrative and not limiting of technical solution of the present invention, art
The equivalent substitution of those of ordinary skill or the other modifications made according to prior art, as long as not exceeding technical solution of the present invention
Thinking and scope, should be included within interest field of the presently claimed invention.
Claims (8)
1. a kind of conveying device of simple ultrasound guidance atrial septal defect plugging device, it is characterised in that：Including sheath（1）And
Sheath core（2）, described sheath（1）And sheath core（2）It is hollow structure, sheath core（2）It is installed on sheath（1）Interior, described sheath core
（2）Endoporus be used for install seal wire, described sheath（1）Including tube wall（3）, transfer passage（4）And handle（5）, described sheath
Pipe（1）Endoporus be transfer passage（4）, described handle（5）Interior setting open-work（6）, open-work（6）Connect transfer passage（4）, institute
The open-work stated（6）Inside it is provided with check valve（7）, described tube wall（3）Including the termination being sequentially connected（8）, identification section（9）, bullet
Property bending section（10）And hard tube body（11）, described handle（5）With hard tube body（11）Connection, described termination（8）For soft termination,
Described tube wall（3）Identification section（9）It is wrapped with sheet metal（91）, described elastic bending section（10）Front end be provided with energy
Enough along tube wall（3）The traction fiber of slip（12）, described handle（5）On be provided with bend operating apparatus, bend operating apparatus leads to
Cross traction fiber（12）Pull elastic bending section（10）Bending, described handle（5）On be provided with exhaust washing pipe（13）, it is vented washing pipe
（13）Connect transfer passage（4）.
2. the conveying device of simple ultrasound guidance atrial septal defect plugging device according to claim 1, its feature exists
In：Described exhaust washing pipe（13）On be provided with valve（14）.
3. the conveying device of simple ultrasound guidance atrial septal defect plugging device according to claim 1, its feature exists
In：Described bend operating apparatus includes sliding block（15）, chute（16）And hook plate（17）, described sliding block（15）Along chute（16）
Mobile, described hook plate（17）Middle part and sliding block（15）It is hinged, hook plate（17）One end be provided with grab（18）, described cunning
Block（15）With chute（16）Torsion spring is provided with the jointed shaft being hinged（19）, described chute（16）Both sides be provided with zigzag
Neck（20）, described hook plate（17）On grab（18）Hook is stuck in neck（20）Interior, described sliding block（15）With traction fiber
（12）One end connection.
4. the conveying device of simple ultrasound guidance atrial septal defect plugging device according to claim 3, its feature exists
In：Described sliding block（15）Stroke and elastic bending section（10）Length it is identical, be 80 ~ 100mm.
5. the conveying device of simple ultrasound guidance atrial septal defect plugging device according to claim 1, its feature exists
In：Described termination（8）Length be 3 ~ 10mm.
6. the conveying device of simple ultrasound guidance atrial septal defect plugging device according to claim 1, its feature exists
In：Described identification section（9）Length be 8 ~ 12mm.
7. the conveying device of simple ultrasound guidance atrial septal defect plugging device according to claim 1, its feature exists
In：Described sheath（1）Outer wall on be provided with graduation mark.
8. the conveying device of the simple ultrasound guidance atrial septal defect plugging device as described in any one of claim 1 ~ 7 makes
With method, it is characterised in that：Comprise the following steps：
A, puncture femoral vein indwelling femoral vein sheath；
B, the sheath using conveying device（1）Outer graduation mark measures femoral venous puncture point to the intercostal of human body right border of sternum the 3rd
Body surface distance, according to the range estimation sheath（1）Into the length in body；
C, using right heart catheter seal wire sent into human body atrium dextrum；
D, exit right heart catheter retain seal wire, then utilize seal wire conveyer belt sheath core（2）Sheath（1）, until being estimated in step b
Length；
E, using echocardiogram determine sheath（1）Identification section（9）Position, it is ensured that sheath（1）Termination（8）Positioned at the right heart
Upper 1/3 position in room；
F, fixed conveying device, exit seal wire and sheath core（2）；
G, pass through sheath（1）Transfer passage（4）The plugging device loaded is conveyed to atrium dextrum and conveys wirerope, until plugging device position
In sheath（1）Termination（8）Position；
H, operation bend operating apparatus, push hook plate（17）, make grab（18）With neck（20）Depart from, promote sliding block（15）, make
Sliding block（15）Along chute（16）It is mobile, pull traction fiber（12）, make sheath（1）Elastic bending section（10）Bending, then super
Under sound cardiogram environment, the double room tangent planes of observation heart pull sheath（1）Handle（5）, make sheath（1）It is preceding rectify to room
Every defect location；
J, pushing sheath tube（1）Handle（5）, under echocardiogram environment, observe sheath（1）The identification section of front end（9）, it is clear
It was observed that sheath（1）Front end enters atrium sinistrum by atrial septal defect, observes identification section（9）Position in atrium sinistrum, monitors sheath
Pipe（1）Into the depth of atrium sinistrum, sheath is prevented（1）Front end injures left atrial wall；
I, fixed sheath（1）, pushing sheath tube（1）The interior conveying wirerope for being mounted with plugging device, discharges the left umbrella disk of plugging device, so
It is overall afterwards to retreat conveying wirerope and delivery sheath（1）, left umbrella disk is close to the room next door of atrium sinistrum, then fixed conveying steel
Cable simultaneously retreats sheath（1）, the right umbrella disk of plugging device is discharged, echocardiography in atrial septal defect is completed.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710593172.8A CN107157529A (en) | 2017-07-20 | 2017-07-20 | The conveying device and its application method of simple ultrasound guidance atrial septal defect plugging device |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710593172.8A CN107157529A (en) | 2017-07-20 | 2017-07-20 | The conveying device and its application method of simple ultrasound guidance atrial septal defect plugging device |
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| CN111513776A (en) * | 2020-04-30 | 2020-08-11 | 广东海思卡尔医疗科技有限公司 | Conveying device of plugging device |
| CN113384308A (en) * | 2021-06-02 | 2021-09-14 | 上海捍宇医疗科技股份有限公司 | Hook connection type pierceable plugging device system for conveying room wall through catheter |
| CN113397602A (en) * | 2021-05-21 | 2021-09-17 | 深圳市赛禾医疗技术有限公司 | Intracardiac three-dimensional ultrasonic imaging catheter and system and cardiac three-dimensional model construction method |
| CN114733038A (en) * | 2021-01-07 | 2022-07-12 | 北京大学第三医院 | Medical catheter for blocking defect position in congenital heart disease |
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Application publication date: 20170915 |