CN109350197A - The accurate Needle localization support system of intracranial hematoma Minimally invasive puncture - Google Patents
The accurate Needle localization support system of intracranial hematoma Minimally invasive puncture Download PDFInfo
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- CN109350197A CN109350197A CN201811532577.1A CN201811532577A CN109350197A CN 109350197 A CN109350197 A CN 109350197A CN 201811532577 A CN201811532577 A CN 201811532577A CN 109350197 A CN109350197 A CN 109350197A
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- 230000004807 localization Effects 0.000 title claims abstract description 15
- 206010059491 Intracranial haematoma Diseases 0.000 title claims abstract description 13
- 210000003128 head Anatomy 0.000 claims abstract description 51
- 210000000744 eyelid Anatomy 0.000 claims abstract description 41
- 210000004209 hair Anatomy 0.000 claims description 13
- NIXOWILDQLNWCW-UHFFFAOYSA-N acrylic acid group Chemical group C(C=C)(=O)O NIXOWILDQLNWCW-UHFFFAOYSA-N 0.000 claims description 3
- 230000000149 penetrating effect Effects 0.000 claims 1
- 230000000284 resting effect Effects 0.000 claims 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims 1
- 238000000034 method Methods 0.000 description 14
- 238000002591 computed tomography Methods 0.000 description 11
- 238000010586 diagram Methods 0.000 description 9
- 208000032843 Hemorrhage Diseases 0.000 description 8
- 230000002146 bilateral effect Effects 0.000 description 8
- 210000000695 crystalline len Anatomy 0.000 description 6
- 208000034158 bleeding Diseases 0.000 description 5
- 230000000740 bleeding effect Effects 0.000 description 5
- 210000000613 ear canal Anatomy 0.000 description 5
- 206010008111 Cerebral haemorrhage Diseases 0.000 description 4
- 239000008280 blood Substances 0.000 description 4
- 210000004369 blood Anatomy 0.000 description 4
- 210000004556 brain Anatomy 0.000 description 4
- 230000000694 effects Effects 0.000 description 4
- 210000001061 forehead Anatomy 0.000 description 4
- 206010008190 Cerebrovascular accident Diseases 0.000 description 3
- 210000000133 brain stem Anatomy 0.000 description 3
- 230000002490 cerebral effect Effects 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- 238000002627 tracheal intubation Methods 0.000 description 3
- 208000006011 Stroke Diseases 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 230000008030 elimination Effects 0.000 description 2
- 238000003379 elimination reaction Methods 0.000 description 2
- 210000003625 skull Anatomy 0.000 description 2
- 230000002123 temporal effect Effects 0.000 description 2
- 206010018852 Haematoma Diseases 0.000 description 1
- 206010018985 Haemorrhage intracranial Diseases 0.000 description 1
- 208000008574 Intracranial Hemorrhages Diseases 0.000 description 1
- 206010030113 Oedema Diseases 0.000 description 1
- 229910000831 Steel Inorganic materials 0.000 description 1
- 241000746998 Tragus Species 0.000 description 1
- 210000004227 basal ganglia Anatomy 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 210000001638 cerebellum Anatomy 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 230000004064 dysfunction Effects 0.000 description 1
- 210000004055 fourth ventricle Anatomy 0.000 description 1
- 230000006698 induction Effects 0.000 description 1
- 210000001259 mesencephalon Anatomy 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 239000007769 metal material Substances 0.000 description 1
- 230000002441 reversible effect Effects 0.000 description 1
- 210000001154 skull base Anatomy 0.000 description 1
- 239000011097 solid fiberboard Substances 0.000 description 1
- 239000010959 steel Substances 0.000 description 1
- 230000002459 sustained effect Effects 0.000 description 1
Classifications
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
- A61B2017/3405—Needle locating or guiding means using mechanical guide means
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Pathology (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Accommodation For Nursing Or Treatment Tables (AREA)
Abstract
The invention belongs to technical field of medical instrument, specifically disclose a kind of accurate Needle localization support system of intracranial hematoma Minimally invasive puncture, it includes two accurate eyelid retractors for including support device, and support device includes bottom plate, supporting plate and the first side plate vertical and relatively set on the bottom plate and the second side plate；Two sliding eyes are respectively equipped at intervals on first side plate and the second side plate, and the two top is equipped with top plate, each top plate is equipped with stud corresponding with sliding eye, two nuts are arranged on stud；The supporting plate includes head planker and pillow planker, the head splint both sides opposite with pillow planker are equipped with two symmetrical connecting plates, sliding eye is equipped on each connecting plate, each stud passes through the sliding eye that is correspondingly connected on plate, while each connecting plate corresponding sliding eye and positioned at two nuts across side plate on.Patients head flexible, standard can be carried out level and fixed by the support system, to improve the accuracy of intracranial hematoma microtrauma puncture.
Description
[technical field]
The present invention relates to technical field of medical instrument, in particular to a kind of intracranial hematoma Minimally invasive puncture is fixed with precisely puncturing
Position support system.
[background technique]
Cerebral apoplexy is first reason for now resulting in human death, is spy with high incidence, high mortality, high disability rate
Point, midbrain hemorrhage disease incidence are annual (60~80) people/100,000, account for about the 20%~30% of whole cerebral apoplexies in China, suddenly
The survivor that property phase case fatality rate is up to 30%~40%, > 30% leaves dysfunction；American-European countries's adult's cerebral hemorrhage accounts for entirely
The 10%~20% of portion's cerebral apoplexy, case fatality rate 23%~52%.
Based on surgery operation of opening cranium is big to patients with cerebral hemorrhage wound, risk is high, rapidly the induction of reduction local pressure goes out again
The limitation that blood or oedema aggravate, minimally invasive hematoma drainage are increasingly clinical pay attention to and applied to clinic.Minimally invasive hemotoncus drainage side
Method is mostly used greatly under CT guidance in the past using 3D-slicer software localization method, and this method simulates the blood of patient on mobile phone
Swollen situation is positioned, but also needs to be transformed into patient in actual operation, it is also desirable to again setting-out positioning etc., accuracy compared with
It is low.It based on this, improves soft channel stereotaxic technique and finds broad application in minimally invasive hemotoncus drainage method, technique needs soft
Channel drainage tube enters encephalic relatively long distance (basal ganglia area hemorrhage needs 12cm or so), needs precise positioning, especially third
The ventricles of the brain, fourth ventricle, brain stem drainage do not allow repeatedly to puncture, otherwise damage is big, and effect is poor, especially with greater need for precise positioning
Brain stem punctures, and does not allow failure.However, there is its puncture accuracy rate of the doctor of many years clinical experience still not high, beginner is just lower
?.Main or puncture and intubation position inaccuracy, needs repeatedly to puncture, repeatedly checks CT in surgical procedure.Because of patients head position
It sets and is not fixed, the standard aspect inaccuracy of CT scan causes each CT scan scanning result inconsistent, it is difficult to which accurate determine punctures
Plane, and even if puncture plane has been determined, if this plane cannot be perpendicular to operation bed surface (horizontal plane), in puncture and intubation process
Middle pipeline can be biased to basis cranii or calvarium, equally will cause and set that pipe accuracy rate is low, and set pipe every time and be exactly one and new set pipe again
Process, repeatedly puncture so that patient, assistant, CT technician's fatigue, and lead to hemorrhage increased risk, family members distrust etc.
Problem.
[summary of the invention]
In view of above content, it is necessary to provide intracranial hematoma Minimally invasive puncture accurate Needle localization support system, the essence
Quasi- Needle localization support system can flexibly be fixed patients head as horizontal, so that the left and right sides of patients head and upper and lower two
The equal relative level in side, and make by the plane of patient's corner of the eyes line perpendicular to operation planar, to effectively improve patient's brain hemotoncus
The precision and set the precision of pipe that maximum level determines, and then effectively improve the elimination effect of patient's brain hemotoncus.
In order to achieve the above objectives, the technical scheme adopted by the invention is that:
A kind of accurate Needle localization support system of intracranial hematoma Minimally invasive puncture, including the first accurate eyelid retractor and second
Accurate eyelid retractor, the first accurate eyelid retractor and the second accurate eyelid retractor include support device and restraint strap, described
Support device includes bottom plate, the first side plate, the second side plate and supporting plate, and first side plate and second side plate are oppositely arranged
In on the bottom plate and vertical with the bottom plate, and first side plate and/or second side plate being capable of the relatively described bottom plates
It horizontally slips；It being spaced apart and is set there are two the first sliding eye on first side plate, first sliding eye is arranged along the vertical direction,
Two second sliding eyes symmetrical with two first sliding eyes are offered on second side plate, first side plate
The the first location graduation line extended along the length direction of two first sliding eyes, second side plate are additionally provided on lateral surface
Lateral surface on be additionally provided with the second location graduation line extended along the length direction of two second sliding eyes, described first is fixed
0 scale of position graduation mark and the second location graduation line is located in same level；The top of first side plate is equipped with the
One top plate, a side of first top plate is concordant with the medial surface of first side plate, and first top plate is equipped with along it
The third location graduation line that length direction extends, the top of second side plate are equipped with the second top plate, and the one of second top plate
Side is concordant with the medial surface of second side plate, and second top plate is equipped with the 4th positioning extended along its length and carves
Line is spent, first top plate and second top plate are parallel with the bottom plate, and the third location graduation line and described the
0 scale of four location graduation lines is located in same level；Two and two described first are equipped at intervals on first top plate
Corresponding first stud of sliding eye is equipped at intervals with two and two second sliding eyes corresponding second on second top plate
One end of stud, first stud and second stud connects with corresponding first top plate and second top plate respectively
It connects, freely hanging and port is at least concordant with the lower end of first sliding eye or second sliding eye for the other end, described
Matched first nut and the second nut are arranged on first stud and second stud；The supporting plate include head planker and
Planker is rested the head on, the head splint rear end and the pillow bracket front edge of board are mutually close to the head splint and the pillow bracket board width are equal
And the length of the head splint is greater than the length of the pillow bracket plate, the pillow planker is equipped with occipitalia through-hole；The head splint two
The middle part of long side is equipped with symmetrical the first connecting plate and the second connecting plate, and the middle part of two long side of pillow bracket plate is equipped with symmetrical
Third connecting plate and the 4th connecting plate, first connecting plate and second connecting plate and the third connecting plate and described
4th connecting plate is in mirror symmetry；First connecting plate and second connecting plate are each passed through described first positioned at rear end
Sliding eye and second sliding eye, the third connecting plate and the 4th connecting plate are each passed through to be slided positioned at described the first of front end
Dynamic hole and second sliding eye；First connecting plate, second connecting plate, the third connecting plate and the described 4th connect
Perforation offers third sliding eye on fishplate bar, is each passed through positioned at first stud of front end and second stud described
Third sliding eye on third connecting plate and the 4th connecting plate, first stud and second stud positioned at rear end
The third sliding eye being each passed through on first connecting plate and second connecting plate, first nut and second spiral shell
Female outer diameter is all larger than the aperture of the third sliding eye, and first nut and second nut are located at described the
Above and below three sliding eyes；The restraint strap includes subband and master tape, and the subband is set to first side plate or described
On first top plate, the master tape is symmetrically set on second side plate or second top plate；
It wherein, further include the first temples through-hole and the second temples through-hole, first temporo in the described first accurate eyelid retractor
Portion's through-hole is set to the middle and upper part of first side plate and is located between two first sliding eyes, and the second temples through-hole is set
In symmetrical on second side plate and in the first temples through-hole, and in the described first accurate eyelid retractor, first side
The height of plate is identical with the height of second side plate；In the described second accurate eyelid retractor, the first side plate height is less than
The height of second side plate.
Further, the described first accurate eyelid retractor further includes infrared locator, and the infrared locator includes successively connecting
First base folder, connecting rod, the first sliding cross bar, the second sliding cross bar, Universal-head and the cross hairs infrared lamp connect, described first
It is vertical with the connecting rod to slide cross bar, the second sliding cross bar is vertical with the first sliding cross bar；First sliding
Cross bar includes interior bar and outer bar, and one end of the interior bar is sheathed in the outer bar, the outer bar can interior bar sliding relatively,
The interior bar is connect with the connecting rod, and the outer bar is connect with the second sliding cross bar, is set on the second sliding cross bar
There is sliding part, the sliding part is connect with the Universal-head, and the sliding part is equipped with tightening knob, and the sliding part is described
Tightening knob when being in releasing orientation can stress along the second sliding cross bar move and then drive the cross hairs infrared lamp
Synchronizing moving, the infrared locator pass through first base folder and first top plate, second top plate or the bottom
Plate is detachably connected.
Further, the cross hairs infrared lamp is equipped at least one horizontal column.
Further, the described second accurate eyelid retractor further includes referring to bar, and the reference bar is two, two references
Bar includes second base folder and the stock with second base folder connection, and two reference bars pass through the second base
Folder is detachably connected with first top plate and second top plate respectively.
Further, at least one level is respectively equipped on first top plate, second top plate and the bottom plate
Column.
Further, horizontally disposed on the bottom plate to have several sliding grooves, first side plate and/or described
The bottom end of two side plates be equipped with sliding bar corresponding with the sliding groove, the sliding bar can stress moved along the sliding groove
It is dynamic.
Further, the bottom plate, first side plate, second side plate, first top plate, second top plate
It is made with the supporting plate of transparent acrylic board.
Further, the bottom plate is equipped with support leg, and the support leg is respectively arranged on four angles of the lower surface of base plate
On.
Further, the front end of the pillow bracket plate and the front end of the bottom plate are located at same level, the pillow planker
Front end is in arc line shaped, rear concave end of the camber line to the pillow bracket plate；The bottom plate front end corresponds to the portion of the pillow bracket plate
Point be in and it is described pillow planker front end the consistent arc line shaped of arc line shaped.
Further, the quantity of the restraint strap is 2 pairs, the filial generation of one pair of them restraint strap be set to first side plate or
The front end of first top plate, master tape are symmetrically set in the front end of second side plate or second top plate, another pair restraint strap
Filial generation be set to the rear end of first side plate or first top plate, master tape is symmetrically set in second side plate or described second
The rear end of top plate.
The invention has the following advantages:
1. above-mentioned two accurate eyelid retractor, pass through bottom plate, the supporting plate of the side of being set on the bottom plate and opposite and be vertical at bottom plate
Support of the side plate combination of two sides for patients head is fixed, to keep the symmetrical level of patients head.Wherein, the first side plate
And/or second side plate can opposed bottom horizontally slip, conducive to by the slidable adjustment of side plate to adapt to different patients heads'
Size, to achieve the purpose that immobilized patients head to be allowed to arbitrarily to rotate；It is adjusted by using head splint and pillow bracket plate
The height of patient's occipitalia and pillow above section, so that patient's bilateral crystalline lens line and nasion intersection point, bilateral crystalline lens
It is located along the same line with bilateral external auditory canal and the plane at place is perpendicular to horizontal plane, and then precisely determine that the standard of CT scan is flat
Face promotes the consistency of multiple CT scan, further, by the adjusting of side plate and supporting plate, can make to puncture plane perpendicular to
It operates horizontal plane (bed surface), is conducive to operator and grasps puncture direction, improve the accuracy of puncture and intubation, puncture success rate
Height, avoids repeatedly puncturing and put that pipe position is bad causes multi damage, it is often more important that reduces bleeding risk again, improves trouble
The success rate of person's cerebral hemorrhage treatment.
2. the accurate Needle localization support system of above-mentioned intracranial hematoma Minimally invasive puncture includes two accurate eyelid retractors,
In, it is preoperative use that the first accurate eyelid retractor, which further includes temples through-hole and infrared locator, and temples through-hole and occipitalia are logical
Hole influences eyelid retractor two for placing the apparatus for determining puncture angle when patient's corresponding site bleeding, to avoid the apparatus protrusion
The fixation of side plate and the Level tune of supporting plate, infrared locator are used to provide line of reference then so that operator passes through supporting plate
Adjust so that each point in plane on the same line with determine CT scan standard flat and maximum hemotoncus plane and make
The two planes are obtained perpendicular to horizontal plane, while for reference setting-out, to promote the precision to draw lines.Second accurate eyelid retractor is
It is used in art, the height of the first side plate avoids grasping lower than the height of the second side plate on the basis of effective immobilized patients head
Author is limited when carrying out the positioning of patient's temporal approach or occipital approach is positioned by side plate, and the convenience of positioning operation is improved.
3. avoiding the influence of metal artifacts under CT without metal material in above-mentioned accurate eyelid retractor, further improving
The accuracy of positioning.
[Detailed description of the invention]
Fig. 1 is a kind of structural schematic diagram of the accurate Needle localization support system of intracranial hematoma Minimally invasive puncture of the present invention.
Fig. 2 is the partial structure diagram that first accurate eyelid retractor removes infrared locator in Fig. 1 of the present invention.
Fig. 3 is the partial structure diagram that second accurate eyelid retractor removes referring to bar in Fig. 1 of the present invention.
Fig. 4 is the right view that first accurate eyelid retractor removes infrared locator in Fig. 1 of the present invention.
Fig. 5 is the structural schematic diagram of the second side plate of the first accurate eyelid retractor in Fig. 1 of the present invention.
Fig. 6 and Fig. 7 is the front and back structural schematic diagram of Fig. 1 insole board of the present invention respectively.
Fig. 8 is the structural schematic diagram of pillow bracket plate in Fig. 1 of the present invention.
Fig. 9 is the structural schematic diagram of head splint in Fig. 1 of the present invention.
Figure 10 is the structural schematic diagram of infrared locator in Fig. 1 of the present invention.
Figure 11 is the structural schematic diagram in Fig. 1 of the present invention referring to bar.
Main element symbol description:
In figure, the accurate Needle localization support system of 100- intracranial hematoma Minimally invasive puncture, the accurate eyelid retractor of 1- first, 2-
Second accurate eyelid retractor, 11- bottom plate, 111- sliding groove, 112- support leg, the first side plate of 12-, the first sliding eye of 121-, 122-
First temples through-hole, 123- the second temples through-hole, 124- the first location graduation line, the second side plate of 13-, the second sliding eye of 131-,
132- the second location graduation line, 14- supporting plate, 141- head splint, 142- pillow bracket plate, 143- occipitalia through-hole, the first connecting plate of 144-,
The second connecting plate of 145-, 146- third connecting plate, the 4th connecting plate of 147-, 148- third sliding eye, the first top plate of 15-, 151-
Third location graduation line, the first stud of 152-, the second top plate of 16-, the 4th location graduation line of 161-, the second stud of 162-, 17-
One nut, the second nut of 18-, 19- sliding bar, 3- support device, 4- restraint strap, 41- subband, the first connector of 411-, 42- are female
Band, the second connector of 421-, 5- infrared locator, 51- first base folder, 52- connecting rod, 53- first slide cross bar, 54- the
Two sliding cross bars, 55- Universal-head, 56- cross hairs infrared lamp, 57- sliding part, 58- tightening knob, 6- is referring to bar, 7- horizontal column.
The present invention that the following detailed description will be further explained with reference to the above drawings.
[specific embodiment]
Following will be combined with the drawings in the embodiments of the present invention, and technical solution in the embodiment of the present invention carries out clear, complete
Site preparation description, it is clear that described embodiments are only a part of the embodiments of the present invention, instead of all the embodiments.It is based on
Embodiment in the present invention, it is obtained by those of ordinary skill in the art without making creative efforts every other
Embodiment shall fall within the protection scope of the present invention.
It should be noted that it can be directly on another component when component is referred to as " being fixed on " another component
Or there may also be components placed in the middle.When a component is considered as " connection " another component, it, which can be, is directly connected to
To another component or it may be simultaneously present component placed in the middle.When a component is considered as " being set to " another component, it
It can be and be set up directly on another component or may be simultaneously present component placed in the middle.Term as used herein is " vertical
", " horizontal ", "left", "right" and similar statement for illustrative purposes only.
Unless otherwise defined, all technical and scientific terms used herein and belong to technical field of the invention
The normally understood meaning of technical staff is identical.Term as used herein in the specification of the present invention is intended merely to description tool
The purpose of the embodiment of body, it is not intended that in the limitation present invention.Term " and or " used herein includes one or more phases
Any and all combinations of the listed item of pass.
Referring to Figure 1, a preferred mode of the invention provides a kind of intracranial hematoma Minimally invasive puncture accurate Needle localization branch
Support system, including the first accurate eyelid retractor 1 and the second accurate eyelid retractor 2 are used wherein the first accurate eyelid retractor 1 uses in the preoperative
In the determination of CT scan standard aspect and maximum hemotoncus level, the second accurate eyelid retractor 2 uses in art, for making maximum blood
Swollen level (puncturing level) and horizontal plane.
Please also refer to Fig. 1-6 and Fig. 8-9, the first accurate eyelid retractor 1 and the second accurate eyelid retractor 2 are wrapped
Including support device 3 and restraint strap 4, the support device 3 includes bottom plate 11, the first side plate 12, the second side plate 13 and supporting plate 14,
First side plate 12 and second side plate 13 are relatively arranged on the bottom plate 11 and vertical and described with the bottom plate 11
Second side plate 13 can the relatively described bottom plate 11 horizontally slip, specifically: on the bottom plate 11 in the horizontal direction one in front and one in back
There are two sliding groove 111, the bottom end of second side plate 13 is equipped with two cunnings corresponding with two sliding grooves 111 for setting
Lever 19, the sliding bar 19 can stress moved left and right along the sliding groove 111, so that second side plate 13 be driven to move
It is dynamic, for carrying out slidable adjustment so that the head of patient is well fixed between two side plates according to the head size of patient；
It being spaced apart and is set there are two the first sliding eye 121 on first side plate 12, first sliding eye 121 is arranged along the vertical direction,
Two second sliding eyes 131 symmetrical with two first sliding eyes 121 are offered on second side plate 12；Described
The the first location graduation line extended along the length direction of two first sliding eyes 121 is additionally provided on the lateral surface of side plate 12
124, the length direction along two second sliding eyes 131 extends second is additionally provided on the lateral surface of second side plate 13
0 scale of location graduation line 132, the first location graduation line 124 and the second location graduation line 132 is located at same level
On face；The top of first side plate 12 is equipped with the first top plate 15, a side of first top plate 15 and first side plate
12 medial surface is concordant, and first top plate 15 is equipped with the third location graduation line 151 that extends along its length, and described the
The top of two side plates 13 is equipped with the second top plate 16, and a side of second top plate 16 and the medial surface of second side plate 13 are flat
Together, second top plate 16 is equipped with the 4th location graduation line 161 extended along its length, first top plate 15 and institute
It is parallel with the bottom plate 11 to state the second top plate 16, and the third location graduation line 151 and the 4th location graduation line 161
0 scale be located in same level；Be equipped at intervals on first top plate 15 two it is right with two first sliding eyes 121
The first stud 152 answered is equipped at intervals with two and two second sliding eyes 131 corresponding second on second top plate 16
One end of stud 162, first stud 152 and second stud 162 respectively with corresponding first top plate 15 and institute
The connection of the second top plate 16 is stated, the other end freely at least slide with first sliding eye 121 or described second by hanging and port
The lower end in hole 131 is concordant, and matched first nut, 17 He is arranged on first stud 152 and second stud 162
Second nut 18.
In the present embodiment, it is respectively equipped on first top plate 15, second top plate 16 and the bottom plate 11
At least one horizontal column 7, for judging first top plate 15, second top plate 16 and the bottom plate 11 whether in level
State, with the level of the producing means 3.
Please with further reference to Fig. 7, in the present embodiment, the bottom plate 11 is equipped with support leg 112, the support leg 112
It is respectively arranged on four angles of 11 lower surface of bottom plate.
The supporting plate 14 includes head planker 141 and pillow planker 142, and the pillow bracket plate 142 is used to hold the pillow of patient's head
Portion, the head splint 141 are used to hold the part of patient's head occipitalia or more, 141 rear end of head splint and the pillow bracket plate
142 front ends are mutually close to the length of the head splint 141 head splint 141 equal and described with 142 width of pillow bracket plate is greater than
The length of the pillow bracket plate 142, the pillow planker 142 are equipped with occipitalia through-hole 143, and the pillow through-hole is 2, for placing
The apparatus that puncture angle is determined when corresponding site bleeding avoids apparatus protrusion from influencing the Level tune of patients head；The head
The middle part of 141 liang of long sides of supporting plate is equipped with symmetrical the first connecting plate 144 and the second connecting plate 145, and the pillow bracket plate is 142 liang long
The middle part on side is equipped with symmetrical third connecting plate 146 and the 4th connecting plate 147, first connecting plate 144 and described second
Connecting plate 145 and the third connecting plate 146 and the 4th connecting plate 147 are in mirror symmetry；First connecting plate, 144 He
Second connecting plate 145 is each passed through first sliding eye 121 and second sliding eye 131 positioned at rear end, described
Third connecting plate 146 and the 4th connecting plate 147 are each passed through first sliding eye 121 and second sliding positioned at front end
Hole 131；First connecting plate 144, second connecting plate 145, the third connecting plate 146 and the 4th connecting plate
Perforation offers third sliding eye 148 on 147, distinguishes positioned at first stud 152 of front end and second stud 162
Third sliding eye 148 on the third connecting plate 146 and the 4th connecting plate 147, positioned at described the first of rear end
Stud 152 and second stud 162 are each passed through the third on first connecting plate 144 and second connecting plate 145
The outer diameter of sliding eye 148, first nut 17 and second nut 18 is all larger than the aperture of the third sliding eye 148,
And first nut 17 and second nut 18 are located above and below the third sliding eye 148.
When first nut 17 and 18 stress of the second nut reverse upward or downward simultaneously, corresponding connection
Plate can relatively corresponding sliding eye move up or down therewith, thus drive the head splint 141 or the pillow bracket plate 142 to
It above or moves down, and then has the function that the height for adjusting the head splint 141 or the pillow bracket plate 142, so that CT
The standard flat of scanning and maximum hemotoncus plane perpendicular to horizontal plane, meanwhile, can by corresponding location graduation line referring to adjusting
So that corresponding connecting plate opposite end is in sustained height, to ensure the level of corresponding supporting plate；And it is same being located at the second side plate 13
First nut 17, corresponding connecting plate on side and between the second nut 18 be in releasing orientation when, described second side
Plate 13 can the sliding to the left or to the right of the bottom plate 11 relatively, with the spacing between the big minor adjustment both side plate according to patients head
To the head of effective immobilized patients.
In the present embodiment, the front end of the pillow bracket plate 142 and the front end of the bottom plate 11 are located at same level, institute
The front end of pillow planker 142 is stated in arc line shaped, rear concave end of the camber line to the pillow bracket plate 142；11 front end pair of bottom plate
The part of pillow bracket plate 142 described in Ying Yu is in the consistent arc line shaped of arc line shaped with pillow 142 front end of planker, arc line shaped setting benefit
In the comfort that promotion patient uses.
The restraint strap 4 is 2 pairs, and each pair of restraint strap includes subband 41 and master tape 42, the end of 41 free end of filial generation
Portion of portion is equipped with the first connector 411, and the end of 42 free end of master tape is equipped with the second connector 421, first connector
411 and second connector 421 can be removably joined together so that the restraint strap 4 and support device 3 are constituted
One ring structure around patients head further improves accurate branch for preventing second side plate 13 from sliding to the right
Support the stationarity of device, the first connector 411 and the second connector 421 may respectively be the hook surface and hair side or hidden discount of velcro
Sub-buckle and female thread etc..The filial generation 41 of one pair of them restraint strap 4 is set to the front end of first side plate 12, and master tape 42 is symmetrically set in
The front end of second side plate 13, for constraining the forehead of patient；The filial generation 41 of another pair restraint strap 4 is set to first side plate
12 rear end, master tape 42 is symmetrically set in the rear end of second side plate 13, for constraining the chin portion of patient.
It further include the first temples through-hole 122 and the second temples through-hole 123 in the first accurate eyelid retractor 1, described first
Temples through-hole 122 is set to the middle and upper part of first side plate 12 and is located between two first sliding eyes 121, described second
Temples through-hole 123 is on second side plate 13 and symmetrical in the first temples through-hole 122, goes out for placing corresponding site
The apparatus of puncture angle is determined when blood, in case the head that apparatus protrusion influences patient is fixed；And in the described first precisely support
In device 1, the height of first side plate 12 is identical with the height of second side plate 13.
Continuing with referring to Figure 10, the first accurate eyelid retractor further includes infrared positioning 5, for assist determine plane and
Setting-out.The infrared locator 5, which slides cross bar 53, second including sequentially connected first base folder 51, connecting rod 52, first, to be slided
Dynamic cross bar 54, Universal-head 55 and cross hairs infrared lamp 56, the first sliding cross bar 53 is vertical with the connecting rod 52, and described the
Two sliding cross bars 54 are vertical with the first sliding cross bar 53；The first sliding cross bar 53 includes interior bar 531 and outer bar 532,
One end of the interior bar 531 is sheathed in the outer bar 532, and the outer bar 532 interior bar 531 can be slided relatively, it is described in
Bar 531 is connect with the connecting rod 52, and the outer bar 532 is connect with the second sliding cross bar 54, the second sliding cross bar
54 are equipped with sliding part 57, and the sliding part 57 is connect with the Universal-head 55, and the sliding part 57 is equipped with tightening knob 58,
The sliding part 57 when the tightening knob 58 is in releasing orientation can stress along it is described second sliding cross bar 54 move into
And 56 synchronizing moving of cross hairs infrared lamp is driven, the infrared locator 5 passes through first base folder 51 and described the
One top plate 15 is detachably connected.When determining CT scan standard flat or puncturing plane, opens the cross hairs infrared lamp 56 and exist
Patients head gets in front cross infrared ray, and by adjusting the interior bar 531, the outer bar 532 and the sliding part
58 are overlapped the intersection point of infrared ray with nasion intersection point or hemotoncus maximum level with nasion intersection point with patient's bilateral crystalline lens line,
Then by adjusting the head planker 141 and pillow bracket plate 142 and determining referring to the third location graduation line 151 and the described 4th
Position graduation mark 161 is overlapped remaining index point of patient with the horizontal line of cross infrared ray, that is, can determine required plane.Into one
Step, the cross hairs infrared lamp 56 is equipped at least one horizontal column 7, for judging whether the cross hairs infrared lamp 56 is located
In horizontality, to ensure the accuracy of reference.
In the described second accurate eyelid retractor 2,12 height of the first side plate is less than the height of second side plate 13,
On the basis of effective immobilized patients head, avoid operator when carrying out the positioning of patient's temporal approach or occipital approach is positioned by side
Plate limitation, improves the convenience of positioning operation.
Please continue to refer to Figure 11, the described second accurate support 2 further includes referring to bar 6, and the reference bar 6 is two, every
Include referring to bar second base folder 61 and with 61 stocks 62 that connect of second base folder, two described to pass through institute referring to bar
It states second base folder to be detachably connected with first top plate and second top plate respectively, in surgical procedure, by two institutes
It states and is clipped on first top plate 15 and second top plate 16 respectively referring to bar 6, and make two reference pipe 6 and the entry points
On the same line, for observing be pierced into hose during inserting needle sets pipe whether forward partially or to retrodeviating, to ensure hose
It is inserted perpendicularly into patient to intracranial hemorrhage place, to promote the precision for setting pipe, it is preferred that described fix position referring to pipe 6 at two
It postpones, it is described referring to exceptionally straight a connecting line or connecting rod is connected between bar 6 at two, it then will during inserting needle sets pipe
Hose is slowly inserted into close to the connecting line or connecting rod, that is, be can ensure that and described set pipe accuracy.
In the present embodiment, the bottom plate 11, first side plate 12, second side plate 13, first top plate
15, second top plate 16 and the supporting plate 14 are made of acrylic board transparent, with high hardness.
It following is a brief introduction of the above-mentioned intracranial hematoma Minimally invasive puncture application method of accurate Needle localization support system:
The determination of step S1:CT scanning standard plane: first outside patient's bilateral crystalline lens line and nasion point of intersection, bilateral
(tragus) does index point respectively at the outer body surface projection of the corner of the eyes, bilateral external auditory canal；The first accurate eyelid retractor 1 of the present invention is placed on hospital bed
And after adjusting and being in horizontality to the bottom plate 11, first top plate 15 and second top plate 16, patients head is set
It in the support device 3 and ajusts, slides second side plate 13 and be stuck between both side plate and cannot arbitrarily turn to patients head
It is dynamic；The infrared ray positioning lamp 56 is opened, by adjusting the intersection point and patient's bilateral crystalline lens line for making " cross " infrared ray
It is overlapped with nasion point of intersection, and the horizontal line of " cross " infrared ray is made to pass through other above-mentioned four index points respectively, if four
A index point is not entirely located in the horizontal line of " cross " infrared ray, then to the head splint 141 and the pillow bracket plate 142 into
Row adjustment, until five index points are on the horizontal line of " cross " infrared ray and the plane of its formation is perpendicular to horizontal plane
(bed surface) can determine the standard flat of CT scan, then connect the filial generation 41 and master tape 42 of two pairs of restraint straps 4, fixed
It is good；Finally, removing the infrared locator 5, patient's push-in CT Room is checked, is carried out suitably according still further to the infrared ray of CT machine
Fine tuning；
Step S2: hemotoncus maximum level is to puncture the determination of plane: going out hemotoncus maximum in the CT plain film subscript that scanning obtains
Level is calculated from standard flat (i.e. CT scan standard flat) to the distance of hemotoncus maximum level；Then along nose, the nasion,
Calvarium portion hits exactly one anterior median line of picture, measures along anterior median line to forehead maximum hemotoncus layer since nasion portion (lens position)
The corresponding arc distance in face, carries out forehead index point；It is corresponding to mark maximum hemotoncus level above the external auditory canal of two sides for same method
Two sides external auditory canals above index point, it is to puncture in plane, with CT plane most that three above index point, which connects the plane to be formed,
Big hemotoncus level matches；3 microxeas or 3 small steel balls are pasted respectively in these three index points, are fixed and are punctured early period
The apparatus of angle positioning, the check for carrying out CT scan standard flat, which further determines that, to be punctured plane and punctures direction etc.；
Step S3: it punctures the setting-out of plane: after check determines, utilizing the infrared locator 5 again, open described infrared
Line positioning lamp 56 by adjusting the intersection point of " cross " infrared ray is overlapped with patient's forehead index point, and keeps " cross " red
The horizontal line of outside line passes through index point above above-mentioned two two sides external auditory canal respectively, and ensures the plane that three index points are formed
Perpendicular to horizontal plane (bed surface), then drawn lines using self-control ink fountain according to the horizontal line of " cross " infrared ray；
Step S4: plane is punctured in puncture process perpendicular to the determination of bed surface: will be by patients head according to the method for step 1
It is placed in the support system 3 of horizontal positioned the second accurate eyelid retractor 2 on one's sick bed, by adjusting the head splint 141 and institute
It states pillow bracket plate 142 and to puncture plane perpendicular to the horizontal plane (bed surface), then described be separately adjusted to angularly two referring to pipe 6
It is located at the position of same horizontal line with entry point, conduction hose is placed in entry point and keeps described being located at referring to pipe 6 with two
The encephalic of patient is slowly inserted into conplane position.
It needs repeatedly to puncture and put that pipe position is bad causes multi damage relative to the past, increases bleeding risk, influence
The method for supporting (by padding solid fiberboard etc. in patient's brain) of the elimination effect of hemotoncus, above-mentioned accurate Needle localization support system
The scanning effect that ensure that CT standard flat keeps the scanning result for checking CT every time very nearly the same, maximum hemotoncus has precisely been determined
It punctures plane and precisely draws lines, meanwhile, to puncture plane in art perpendicular to bed surface, be conducive to operator and grasp puncture direction,
Improve puncture success rate, it is often more important that reduce the risk of bleeding again, preferably saved the life of patients with cerebral hemorrhage；And
Time, the energy for saving behaviour patient save the cost etc. of repeatedly check CT.
It is appreciated that in another embodiment, second side plate 13 is fixedly connected with the bottom plate, and described the
Side plate 12 also can the relatively described bottom plate 11 horizontally slip or first side plate 12 and second side plate 13 being capable of phases
It horizontally slips to the bottom plate 11, concrete mode is equal are as follows: in the horizontal direction corresponding to slidably side plate on the bottom plate 11
Sliding groove 111 is arranged in position, while sliding bar 19 corresponding with the sliding groove 111 being arranged on corresponding side plate；It is sliding simultaneously
The quantity of dynamic slot and corresponding sliding bar is not limited to one in present embodiment, or one or more, as long as energy
Enough adjust the spacing between first side plate 12 and second side plate 13.
It is appreciated that in another embodiment, the pillow through-hole 143 can be one, as long as its space size
Puncture angle jig for positioning used when carrying out cerebellum and brain stem Needle localization can be positioned with occipital approach by patient.
It is appreciated that in another embodiment, the quantity of the restraint strap 4 is not limited to two in present embodiment
It is right, or a pair or two pairs or more, as long as first side plate 12 and second side plate 13 can be connected and fixed
?；Meanwhile the master tape 42 can also be connect with other positions of the support device 3, such as with first top plate 15
Or the bottom plate 11 connects, the subband 41 can also be connect with other positions of the support device 3, such as with second
Top plate 16 or bottom plate 11 connect, as long as the subband 41 and the master tape 42 can form one with the support device 3
Annular lives patient's ring fixed.
It is appreciated that in another embodiment, the infrared locator 5 can be pressed from both sides by the first base 51 with
Other positions of the support device 3 connect, for example, with first top plate 15, the bottom plate 11, first side plate 12 and
Second side plate 13 connects, as long as the infrared locator 5 can be fixed in the support device 3 and is adjusted
The position that " cross " infrared ray that the cross infrared lamp is emitted extremely needs.
Claims (10)
1. a kind of accurate Needle localization support system of intracranial hematoma Minimally invasive puncture, it is characterised in that: precisely propped up including first
Device and the second accurate eyelid retractor are supportted, the first accurate eyelid retractor and the second accurate eyelid retractor include support device peace treaty
Band, the support device include bottom plate, the first side plate, the second side plate and supporting plate, first side plate and described second side
Plate is relatively arranged on the bottom plate and vertical with the bottom plate, and first side plate and/or second side plate being capable of phases
It horizontally slips to the bottom plate；It is spaced apart and is set there are two the first sliding eye on first side plate, the first sliding eye edge is perpendicular
Histogram offers two second sliding eyes symmetrical with two first sliding eyes, institute on second side plate to setting
The the first location graduation line for being additionally provided on the lateral surface of the first side plate and extending along the length direction of two first sliding eyes is stated,
The second location graduation extended along the length direction of two second sliding eyes is additionally provided on the lateral surface of second side plate
0 scale of line, the first location graduation line and the second location graduation line is located in same level；First side plate
Top be equipped with the first top plate, a side of first top plate is concordant with the medial surface of first side plate, it is described first push up
Plate is equipped with the third location graduation line extended along its length, and the top of second side plate is equipped with the second top plate, described
A side of second top plate is concordant with the medial surface of second side plate, and second top plate is equipped with to be extended along its length
The 4th location graduation line, first top plate and second top plate are parallel with the bottom plate, and the third positioning carve
0 scale of degree line and the 4th location graduation line is located in same level；Be equipped at intervals on first top plate two with
Corresponding first stud of two first sliding eyes is equipped at intervals with two and two second slidings on second top plate
One end of corresponding second stud in hole, first stud and second stud respectively with corresponding first top plate and institute
The connection of the second top plate is stated, the free hanging and port of the other end is at least and under first sliding eye or second sliding eye
Hold level with both hands together, is arranged with matched first nut and the second nut on first stud and second stud；The supporting plate
Including head planker and pillow planker, the head splint rear end and the pillow bracket front edge of board are mutually close to the head splint and the pillow
Supporting plate width is equal and the length of the head splint is greater than the length of the pillow bracket plate, and the pillow planker is equipped with occipitalia through-hole；
The middle part of two long side of head splint is equipped with symmetrical the first connecting plate and the second connecting plate, in two long side of pillow bracket plate
Portion is equipped with symmetrical third connecting plate and the 4th connecting plate, first connecting plate and second connecting plate and the third
Connecting plate and the 4th connecting plate are in mirror symmetry；First connecting plate and second connecting plate are each passed through after being located at
First sliding eye and second sliding eye at end, the third connecting plate and the 4th connecting plate are each passed through positioned at front end
First sliding eye and second sliding eye；First connecting plate, second connecting plate, the third connecting plate
Third sliding eye is offered with penetrating through on the 4th connecting plate, first stud and second stud positioned at front end
The third sliding eye being each passed through on the third connecting plate and the 4th connecting plate, positioned at rear end first stud and
Second stud is each passed through the third sliding eye on first connecting plate and second connecting plate, first nut
The aperture of the third sliding eye, and first nut and second nut point are all larger than with the outer diameter of second nut
It Wei Yu not be above and below the third sliding eye；The restraint strap includes subband and master tape, and the subband is set to described the
On side plate or first top plate, the master tape is symmetrically set on second side plate or second top plate；
It wherein, further include the first temples through-hole and the second temples through-hole in the described first accurate eyelid retractor, first temples is logical
Hole is set to the middle and upper part of first side plate and is located between two first sliding eyes, and the second temples through-hole is set to institute
State it is on the second side plate and symmetrical in the first temples through-hole, and in the described first accurate eyelid retractor, first side plate
Height is identical with the height of second side plate；In the described second accurate eyelid retractor, the first side plate height is less than described
The height of second side plate.
2. positioning support system as described in claim 1, it is characterised in that: the first accurate eyelid retractor further includes infrared positioning
Device, the infrared locator include sequentially connected first base folder, connecting rod, the first sliding cross bar, the second sliding cross bar, ten thousand
To head and cross hairs infrared lamp, the first sliding cross bar is vertical with the connecting rod, the second sliding cross bar and described the
One sliding cross bar is vertical；The first sliding cross bar includes interior bar and outer bar, and one end of the interior bar is sheathed in the outer bar,
The outer bar can interior bar sliding relatively, the interior bar connect with the connecting rod, and the outer bar and described second slides cross
Bar connection, the second sliding cross bar are equipped with sliding part, and the sliding part connect with the Universal-head, sets on the sliding part
Have a tightening knob, the sliding part when the tightening knob is in releasing orientation can stress moved along the second sliding cross bar
Dynamic to drive the cross hairs infrared lamp synchronizing moving in turn, the infrared locator passes through first base folder and described first
Top plate, second top plate or the bottom plate are detachably connected.
3. positioning support system as claimed in claim 2, it is characterised in that: the cross hairs infrared lamp is equipped at least one water
Flat column 7.
4. positioning support system as described in claim 1, it is characterised in that: the second accurate eyelid retractor further includes reference bar,
The reference bar is two, two stocks for including second base folder referring to bar and connecting with second base folder,
Two described pressed from both sides referring to bar by the second base are detachably connected with first top plate and second top plate respectively.
5. positioning support system as described in claim 1, it is characterised in that: first top plate, second top plate and described
At least one horizontal column 7 is respectively equipped on bottom plate.
6. positioning support system as described in claim 1, it is characterised in that: horizontally disposed on the bottom plate to have several cunnings
The bottom end of dynamic slot, first side plate and/or second side plate is equipped with sliding bar corresponding with the sliding groove, the cunning
Lever can stress moved along the sliding groove.
7. positioning support system as described in claim 1, it is characterised in that: the bottom plate, first side plate, described second side
Plate, first top plate, second top plate and the supporting plate are made of transparent acrylic board.
8. positioning support system as described in claim 1, the bottom plate is equipped with support leg, and the support leg is respectively arranged on described
On four angles of lower surface of base plate.
9. positioning support system as described in claim 1, it is characterised in that: the front end of the pillow bracket plate and the front end of the bottom plate
Positioned at same level, the front end of the pillow planker is in arc line shaped, rear concave end of the camber line to the pillow bracket plate；The bottom
The part that front edge of board corresponds to the pillow bracket plate is in and the consistent arc line shaped of arc line shaped for resting the head on planker front end.
10. positioning support system as described in claim 1, it is characterised in that: the quantity of the restraint strap is 2 pairs, one pair of them
The filial generation of restraint strap is set to the front end of first side plate or first top plate, and master tape is symmetrically set in second side plate or institute
The front end of the second top plate is stated, the filial generation of another pair restraint strap is set to the rear end of first side plate or first top plate, master tape
It is symmetrically set in the rear end of second side plate or second top plate.
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| CN201811532577.1A CN109350197B (en) | 2018-12-14 | 2018-12-14 | Accurate puncture positioning and supporting system for intracranial hematoma minimally invasive puncture |
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| CN110575238A (en) * | 2019-09-30 | 2019-12-17 | 右江民族医学院附属医院 | Three-dimensional accurate positioner for intracranial hematoma minimally invasive puncture |
| CN112043535A (en) * | 2020-09-30 | 2020-12-08 | 首都医科大学附属北京天坛医院 | Intracranial hematoma suction punching positioning device |
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| WO2017000538A1 (en) * | 2015-07-02 | 2017-01-05 | 贺石生 | Arc-shaped precise positioning device capable of being assembled and disassembled |
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| CN109350197B (en) | 2024-05-17 |
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