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WO2020067164A1 - Hemostatic instrument - Google Patents

Hemostatic instrument Download PDF

Info

Publication number
WO2020067164A1
WO2020067164A1 PCT/JP2019/037614 JP2019037614W WO2020067164A1 WO 2020067164 A1 WO2020067164 A1 WO 2020067164A1 JP 2019037614 W JP2019037614 W JP 2019037614W WO 2020067164 A1 WO2020067164 A1 WO 2020067164A1
Authority
WO
WIPO (PCT)
Prior art keywords
expansion member
region
expansion
hand
covering
Prior art date
Application number
PCT/JP2019/037614
Other languages
French (fr)
Japanese (ja)
Inventor
遼 岡村
和田　哲
Original Assignee
テルモ株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by テルモ株式会社 filed Critical テルモ株式会社
Publication of WO2020067164A1 publication Critical patent/WO2020067164A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/132—Tourniquets
    • A61B17/135—Tourniquets inflatable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/132—Tourniquets
    • A61B17/1322—Tourniquets comprising a flexible encircling member
    • A61B17/1325—Tourniquets comprising a flexible encircling member with means for applying local pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0042—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping
    • A61B2017/00455—Orientation indicators, e.g. recess on the handle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00902—Material properties transparent or translucent
    • A61B2017/00907—Material properties transparent or translucent for light

Definitions

  • the present invention relates to a hemostatic device.
  • a blood vessel e.g., a radial artery
  • various medical elongate bodies are introduced into the blood vessel through a puncture site formed in the blood vessel of the patient's arm.
  • Techniques for performing treatment or treatment on a site are known (see Patent Document 1 below).
  • a catheter procedure utilizing the radial artery is called a transradial artery approach, and is considered as a useful technique for coronary artery access and lower limb artery access, for example.
  • the radial artery located on the arm of the human body is connected to the palm artery bypassing the hand side. Therefore, at present, as a new technique of the transradial artery approach, the palmar artery (including the distal radial artery) is accessed from the anatomical snuff box located on the back side of the hand or from a position around the snuff box, and the vascular access is performed.
  • a catheter procedure using dTRA (distal transradial approach) for performing treatment through a site has been attempted.
  • Blood vessels such as palmar arteries located in the hand are located in places where there are many movable parts such as fingers. Therefore, when the patient spreads his hand or grasps his hand, the shape around the puncture site of the hand changes due to the movement of the hand. Therefore, when stopping the puncture site of the hand, it is preferable that the pressing member arranged on the hand follows the movement of the hand and maintains an appropriate pressure on the puncture site. In other words, there is a need for a hemostatic device in which the pressing member follows the movement of the hand and can effectively perform pressure hemostasis on a puncture site of a blood vessel located in the hand.
  • An object of the present invention is to provide a hemostatic device capable of maintaining a compressive force on a site to be performed.
  • a hemostatic device includes a pressing member disposed at a site of a patient's hand where hemostasis is to be performed, and a covering member that covers at least a part of the pressing member in a state where the pressing member covers the site where the hemostasis is to be performed.
  • the covering member has a fixing member for fixing the pressing member to at least one of the arm and the hand in a state where the pressing member covers the site to stop bleeding, and the pressing member Is provided on the covering member at a position where the center line of the pressing member does not coincide with the center line of the covering member, and the first member overlaps the fixing member in the longitudinal direction of the covering member on the covering member.
  • the second region is formed by fixing the pressing member to at least one of the arm of the patient and the hand of the patient with the covering member fixed to the first region by the fixing force applied by the fixing member to the first region. Is also held against the hand with a small force.
  • the covering member has the pressing member fixed to at least one of the arm and the hand, and the second region of the pressing member is fixed by the fixing member via the covering member. Since it is not tightened against the patient's skin, it means that when the patient moves his hand, the second region follows the hand movement more easily than the first region of the pressing member and moves more easily.
  • the hemostatic device covers at least a part of the pressing member in a state where the pressing member is disposed at a site where the hemostasis of the patient's hand is to be performed and the pressing member covers the site where the hemostasis is to be performed.
  • a covering member wherein the covering member fixes the pressing member to at least one of the arm of the patient and the hand of the patient in a state where the pressing member covers the site to stop bleeding.
  • the pressing member is provided on the covering member at a position where the center line of the pressing member does not match the center line of the covering member, and on the covering member in the longitudinal direction of the covering member.
  • the first region of the pressing member is firmly fixed to at least one of the arm and the hand, and the second region of the pressing member is movable closer to the tip of the hand than the first region. Is held in the state of having. Therefore, when the patient moves his / her hand with the hemostatic device attached to the patient, the first region of the pressing member prevents displacement of the pressing member and the second region of the pressing member moves the hand. Deform to follow. Specifically, the first region of the pressing member is fastened to the patient's skin via the covering member by the fixing member. To prevent.
  • the hemostatic device is mounted on the patient. Is transmitted to the first region of the pressing member. Therefore, the hemostatic device can suitably prevent the first region of the pressing member from being displaced, and can maintain the pressing force of the pressing member on the portion where hemostasis is to be performed.
  • the second region of the pressing member is not fastened to the patient's hand by the fixing member in a state where the hemostatic device is mounted on the patient's hand. For this reason, the hemostatic device suppresses the movement of the hand on the fingertip side of the patient from being restricted by the fixing member when the device is mounted on the patient's hand. Therefore, the patient is not excessively restricted in hand movement even when the hemostatic device is worn.
  • FIG. 2 is a cross-sectional view of the hemostatic device, taken along arrows 2A-2A shown in FIG. 1, showing a state before an expansion member is expanded.
  • FIG. 2B is a cross-sectional view of the hemostatic device corresponding to FIG. 2A, showing a state where an expanding member is expanded.
  • FIG. 3 is a side view of the hemostatic device viewed from the direction of arrow 3A shown in FIG. 1. It is a perspective view for explaining the example of use of the hemostatic device concerning a 1st embodiment. It is a perspective view for explaining the example of use of the hemostatic device concerning a 1st embodiment.
  • FIG. 7 is a sectional view taken along arrows 7A-7A shown in FIG. 6, schematically showing a state in which a hemostatic device is attached to a patient. It is a figure showing the hemostatic device concerning a 2nd embodiment, and is the top view seen from the inner surface side of a covering member.
  • FIG. 9 is a cross-sectional view of the hemostasis device along an arrow 9A-9A shown in FIG. 8, showing a state before an expansion member is expanded.
  • FIG. 9B is a cross-sectional view of the hemostasis device corresponding to FIG. 9A, showing a state where an expansion member is expanded.
  • FIG. 11 is a cross-sectional view taken along the arrow 11A-11A shown in FIG. 10, schematically showing a state in which the hemostatic device is attached to a patient's hand. It is a figure showing the hemostatic device concerning a 3rd embodiment, and is a top view seen from the inner surface side of a covering member.
  • FIG. 13 is a cross-sectional view of the hemostatic device, taken along arrows 13A-13A shown in FIG. 12, showing a state before an expansion member is expanded.
  • FIG. 13B is a cross-sectional view of the hemostatic device corresponding to FIG. 13A, showing a state where an expanding member is expanded.
  • FIG. 15 is a cross-sectional view taken along arrows 15A-15A shown in FIG. 14, schematically showing a state in which a hemostatic device is attached to a patient's hand. It is a figure showing the hemostatic device concerning a 4th embodiment, and is a top view seen from the inner surface side of a covering member.
  • FIG. 17 is a sectional view of the hemostatic device, taken along arrows 17A-17A shown in FIG. 16, showing a state before the expansion member is expanded.
  • FIG. 17B is a cross-sectional view of the hemostasis device corresponding to FIG. 17A, showing a state where the expansion member is expanded.
  • FIGS. 1 to 4 are diagrams for explaining the hemostatic device 10 according to the first embodiment, and FIGS. 4 to 7 are diagrams for explaining an example of use of the hemostatic device 10.
  • the hemostatic device 10 travels on the instep Hb side of a hand (for example, left hand) H located closer to the finger than a forearm (corresponding to “arm”) A of the patient.
  • Puncture site t (“haemostasis”) formed on the radial artery side of palmar artery (deep palm artery) B1 (eg, an anatomical artery around the snuff box or a distal radial artery running on the fingertip side of the snuff box)
  • the anatomical snuff box is a cavity of the hand H located on the radial side of the forearm A when the thumb is spread.
  • the hemostatic device 10 includes a pressing member 100 disposed at the puncture site t, and a cover that covers at least a part of the pressing member 100 in a state where the pressing member 100 covers the puncture site t. And a member 200.
  • the covering member 200 is a fixing member that fixes the pressing member 100 to at least one of the forearm A and the hand H in a state where the pressing member 100 covers the puncture site t. 210.
  • the pressing member 100 is configured by an expanding member including a bag body 110 expandable by injecting a fluid, and an expansion space 115 surrounded by the bag body 110. doing. 2A and 2B, the bag body 110 is connected to a support member 300 described later. Note that the bag 110 may be connected to at least one of the covering member 200 and a support member 300 described below. In the following description, the pressing member 100 will be described as the expanding member 100.
  • the tip side of the patient's hand H means the side where the fingertip of the hand H is arranged (the left side in FIG. 1).
  • the “inner surface” in each part of the hemostatic device 10 is a surface that is arranged to face the patient's body surface when the hemostatic device 10 is attached to the patient, and the “outer surface” is the inner surface. The opposite surface (the surface that is not disposed facing the body surface).
  • FIG. 1 is a plan view of the hemostatic device 10 viewed from the inner surface 200a side of the covering member 200.
  • the extension member 100 is provided on the covering member 200 at a position where the center line c1 of the extension member 100 does not match the center line c2 of the covering member 200.
  • the center line c1 of the extension member 100 is offset from the center line c2 of the covering member 200 toward the support member 300 provided on the covering member 200 (left side in FIG. 1).
  • the extension member 100 is fixed on the covering member 200 (in a range where the covering member 200 is continuous in the longitudinal direction of the covering member 200) in the longitudinal direction of the covering member 200.
  • a second region 102 (see FIG. 6) that is located closer to the distal end of the hand H than the first region 101. That is, the first region 101 is a part of the extension member 100 that overlaps the fixing member 210 in the longitudinal direction of the covering member 200 in a range where the covering member 200 is continuous in the longitudinal direction of the covering member 200.
  • the longitudinal direction of the covering member 200 is a direction along the arrow X1-X2 shown in FIG.
  • a direction orthogonal to the longitudinal direction of the covering member 200 is defined as a width direction, and is indicated by arrows Y1-Y2.
  • the center line c2 of the covering member 200 is a linear virtual line passing through the center position of the covering member 200 in the width direction.
  • the center line c1 of the extension member 100 is a linear imaginary line passing through the center of the extension member 100 in the width direction (the left-right direction in FIG. 1) which is the same direction as the width direction of the covering member 200.
  • the center line c1 of the expansion member 100 extends substantially parallel to the center line c2 of the covering member 200.
  • the expansion member 100 has a substantially rectangular shape on the plan view shown in FIG. Therefore, the width of the expansion member 100 is substantially constant along the longitudinal direction of the covering member 200.
  • the expansion member 100 may have, for example, a shape such as a circle, an ellipse, and a polygon on the plan view shown in FIG. As described above, when the expansion member 100 is formed in a shape that does not have a substantially constant width along the longitudinal direction of the covering member 200, the center line c1 of the expansion member 100 is, for example, a plan view shown in FIG. At the center of the expansion member 100 in the width direction and extends substantially parallel to the center line c2 of the covering member 200.
  • the first region 101 of the expansion member 100 is formed at one end in the width direction of the expansion member 100 with reference to a boundary b1 between the first region 101 and the second region 102 of the expansion member 100. It is provided on the part 103 side.
  • the second region 102 of the expansion member 100 is provided on the other end 104 side of the expansion member 100 in the width direction with reference to the boundary portion b1.
  • the center line c1 of the expansion member 100 and the boundary b1 between the first area 101 and the second area 102 are arranged at overlapping positions on the plan view shown in FIG.
  • the hemostatic device 10 is mounted on the patient and the expansion member 100 is expanded, and the body surface of the patient (the body surface of the forearm A or the hand H) is expanded. (A body surface of the body).
  • the supporting member 300 is connected to the covering member 200 while covering the second region 102 of the expanding member 100.
  • the support member 300 is formed integrally with the covering member 200. As shown in FIG. 1, a portion where the covering member 200 extends so as to cover the second region 102 along the width direction of the expanding member 100 forms a supporting member 300. The support member 300 is disposed so as to cover the entire second region 102 along the width direction of the expansion member 100.
  • the support member 300 may be disposed so as to cover only a part of the second region 102. Further, the support member 300 can be configured as a member separate from the covering member 200 as described later (see FIG. 23).
  • the hemostatic device 10 is disposed between the support member 300 and the expansion member 100 (between the vertical direction shown in FIGS. 2A and 2B) and connected to the support member 300.
  • the auxiliary expansion member 400 is provided.
  • the auxiliary expansion member 400 has a space 415 communicating with the expansion space 115 of the expansion member 100, and a bag 410 that covers the space 415.
  • a communication hole 116 is formed in the bag 110 of the expansion member 100.
  • a communication hole 416 is formed in the bag 410 of the auxiliary expansion member 400.
  • the expansion space 115 of the expansion member 100 and the space 415 of the auxiliary expansion member 400 communicate with each other via the communication holes 116 and 416.
  • the length of the auxiliary expanding member 400 (the length along the longitudinal direction of the covering member 200) is substantially the same as the length of the expanding member 100 in the longitudinal direction.
  • the width of the auxiliary expansion member 400 (the width in a direction orthogonal to the longitudinal direction of the covering member 200) is shorter than the width of the expansion member 100. In the present embodiment, the width of the auxiliary expansion member 400 is approximately ⁇ of the width of the expansion member 100.
  • the auxiliary expansion member 400 is disposed so as to overlap the second region 102 of the expansion member 100 and the support member 300 along the longitudinal direction of the covering member 200.
  • the auxiliary expansion member 400 is arranged such that the longitudinal direction of the auxiliary expansion member 400 is substantially parallel to the longitudinal direction of the covering member 200.
  • the first region 101 and the covering member 200 overlap in the expansion direction of the expansion member 100.
  • the second region 102, the auxiliary expansion member 400, and the support member 300 overlap in the expansion direction of the expansion member 100.
  • the other end 104 in the width direction of the expansion member 100, the other end 404 in the width direction of the auxiliary expansion member 400, and the other end 304 in the width direction of the support member 300 are Connected to each other.
  • the other ends 104, 304, and 404 are ends located on the left side (ends on which the covering member 200 is not disposed) of the members 100, 400, and 300 in the plan view of FIG. is there.
  • the other end 104 in the width direction of the expansion member 100 and the other end 404 in the width direction of the auxiliary expansion member 400 are connected to the other end 304 in the width direction of the support member 300 at different positions close to each other. It may be.
  • the expansion member 100 and the auxiliary expansion member 400 are connected to each other also around the communication hole 116 of the expansion member 100 and around the communication hole 416 of the auxiliary expansion member 400.
  • the support member 300 is formed integrally with the covering member 200. Therefore, the expansion member 100 and the auxiliary expansion member 400 are connected to the support member 300, and thus are connected to the covering member 200 via the support member 300.
  • the bag 110 of the expansion member 100 is formed of two sheet-like members.
  • the bag body 110 can be formed, for example, by joining the outer peripheral edges of two sheet-shaped members in a state where an expansion space 115 is formed between two sheet-shaped members formed in a substantially rectangular shape. it can.
  • the bag 410 of the auxiliary expansion member 400 can be formed of two joined substantially rectangular sheet-like members.
  • the expansion member 100 and the auxiliary expansion member 400 have one side located on the outer periphery of the expansion member 100 (one side located on the other end portion 104 in the width direction shown in FIG. 2B) and one side located on the outer periphery of the auxiliary expansion member 400 (FIG. 2B). Are connected to the support member 300.
  • the bag 110 of the expansion member 100 is formed by joining the outer peripheral portions of the two sheet-shaped members as described above. Therefore, when the expansion member 100 expands, the vicinity of the center position (near the boundary part b1) of the expansion member 100 is higher than the one end 103 and the other end 104 of the expansion member 100 in the width direction. In the vertical direction (the vertical direction in FIG. 2B). Further, the bag body 410 of the auxiliary expansion member 400 is formed by joining the outer peripheral portions of the two sheet-shaped members as described above. Therefore, when the auxiliary expansion member 400 is expanded, the vicinity of the center position of the auxiliary expansion member 400 in the width direction (the left-right direction in FIG.
  • the expansion member 100 and the auxiliary expansion member 400 can be deformed so as to follow the shape of the patient's hand H, and a state in which a compressive force is applied to the puncture site t. It can be suitably maintained.
  • the joining method of the sheet-like members forming the extension member 100 and the joining method of the sheet-like members forming the auxiliary extension member 400 are not particularly limited. For example, fusion or adhesion can be adopted. Further, the method of connecting the expansion member 100, the auxiliary expansion member 400, and the support member 300 is not particularly limited. For example, fusion or adhesion can be adopted. Further, a method of connecting the periphery of the communication hole 116 of the expansion member 100 and the periphery of the communication hole 416 of the auxiliary expansion member 400 is not particularly limited. For example, fusion or adhesion can be adopted.
  • the expansion member 100 and the auxiliary expansion member 400 are not limited to a structure in which a plurality of sheet-like members are joined.
  • the expansion member 100 and the auxiliary expansion member 400 may be formed of, for example, one bag-shaped member in which a space into which a fluid can flow is formed.
  • one end 103 in the width direction of the expansion member 100, one end 403 in the width direction of the auxiliary expansion member 400, and one end 203 of the covering member 200 in the width direction are not connected.
  • the hemostatic device 10 has a marker portion 117 for positioning the expansion member 100 with respect to the puncture site t.
  • the marker portion 117 is disposed at a position corresponding to a boundary portion b1 between the first region 101 of the expansion member 100 and the second region 102 of the expansion member 100.
  • the marker portion 117 is disposed at a position corresponding to a substantially central position in the longitudinal direction and the width direction of the expanding member 100 (a central position in the vertical direction and the horizontal direction in FIG. 1).
  • the marker portion 117 can be arranged on, for example, the inner surface of the surface (inner surface) on the side arranged to face the body surface of the expansion member 100.
  • the marker portion 117 is, for example, an inner surface or an outer surface of a surface (outer surface) opposite to a surface of the expanding member 100 facing the body surface of the expanding member 100, and an inner surface of the supporting member 300. It is also possible to arrange it on the surface or the outer surface.
  • the marker portion 117 is attached to the one end portion of the auxiliary expansion member 400. 403 may be arranged on the outer surface.
  • the marker part 117 is composed of, for example, a transparent central part and a colored linear frame surrounding the central part.
  • the surgeon can place the marker portion 117 at the puncture site t while confirming the puncture site t via the transparent central portion of the marker portion 117. Therefore, the surgeon can easily arrange the boundary portion b1 between the first region 101 and the second region 102 at the puncture site t using the marker portion 117.
  • the marker portion 117 may be formed, for example, only with a colored central portion without a frame portion.
  • the specific shape and color of the marker portion 117, the method of forming the marker portion 117 on the expansion member 100, and the like are not particularly limited.
  • a portion of the expansion member 100, the covering member 200, the support member 300, and the auxiliary expansion member 400 that overlaps the marker portion 117 in a plan view and its surroundings are translucent or colored and transparent. Thereby, even in a state where the marker portion 117 is superimposed on the puncture site t, the surgeon can visually recognize the puncture site t from the outer surface side of the covering member 200 and the outer surface side of the support member 300 (FIG. 6). See).
  • the hemostatic device 10 operates to inject a fluid (for example, a gas such as air) into the expansion member 100 and the auxiliary expansion member 400 and to discharge the fluid from the expansion member 100 and the auxiliary expansion member 400.
  • a fluid for example, a gas such as air
  • the hemostatic device 10 operates to inject a fluid (for example, a gas such as air) into the expansion member 100 and the auxiliary expansion member 400 and to discharge the fluid from the expansion member 100 and the auxiliary expansion member 400.
  • a fluid for example, a gas such as air
  • the injection section 500 includes a flexible tube 501, a bag 503 disposed at one end of the tube 501 so as to communicate with the lumen of the tube 501, and a check valve connected to the bag 503 (see FIG. (Not shown).
  • the other end of the tube 501 opposite to the one end where the bag portion 503 is arranged is connected to the expansion member 100.
  • the other end of the tube 501 can be connected to the bag 110 with an adhesive or the like while being sandwiched between two sheet-like members forming the bag 110 of the expansion member 100, for example.
  • a convex portion that partially protrudes outward from the sheet-like member may be formed in a portion of the bag body 110 that sandwiches the tube 501. Good.
  • the lumen of the tube 501 communicates with the expansion space 115 of the expansion member 100.
  • the injection unit 500 is configured such that the tube 501 is connected to one end of the support member 300 in the longitudinal direction in a state where the other end of the tube 501 is connected to the expansion member 100 (the upper end in FIG. 1). Are drawn from.
  • the tube 501 is positioned on the side of the patient's hand H (in the direction in which the hand H extends) when the hemostatic device 10 is mounted on the patient, as described above. (See FIG. 5). Therefore, when the hemostatic device 10 is mounted on a patient, it is possible to prevent the tube 501 from interfering with the introducer 600.
  • the tube 501 may be disposed so as to be drawn out from the other end (the lower end in FIG. 1) of the support member 300 in the longitudinal direction, as shown in an embodiment (see FIG. 12) described later.
  • the surgeon or the like inserts the tip of the syringe (not shown) into the connector 505 of the injection part 500, opens the check valve, and pushes the pusher of the syringe. By pushing, the air in the syringe is injected into the expansion space 115 of the expansion member 100.
  • the expansion member 100 expands. Further, the air injected into the expansion space 115 of the expansion member 100 passes through the communication hole 116 formed in the expansion member 100 and the communication hole 416 formed in the auxiliary expansion member 400, and the space of the auxiliary expansion member 400. 415.
  • the auxiliary expansion member 400 When air flows into the space 415 of the auxiliary expansion member 400, the auxiliary expansion member 400 expands. When the expansion member 100 and the auxiliary expansion member 400 expand, the bag portion 503 of the injection part 500 that communicates with the expansion space 115 of the expansion member 100 via the tube 501 expands. By confirming the expansion of the bag portion 503, the surgeon or the like can easily visually confirm that the expansion member 100 and the auxiliary expansion member 400 can be pressurized without air leakage. When the expansion member 100 and the auxiliary expansion member 400 are to be contracted, the front cylinder portion of the syringe is inserted into the connector 505 of the injection section 500, and the pusher of the syringe is pulled to release the air inside the expansion member 100 and the auxiliary expansion. The air in the member 400 is discharged to the syringe.
  • the covering member 200 is formed of a flexible band-shaped member that can be wound substantially one round along the outer circumference near the wrist located on the tip side of the forearm portion A.
  • a first fixing portion 211 constituting the fixing member 210 is disposed on an inner surface 200 a of one end portion (upper end portion in FIG. 1) 201 of the covering member 200 in the longitudinal direction.
  • a second fixing portion 212 constituting the fixing member 210 is disposed on the outer surface 200b of the other end portion (lower end portion in FIG. 1) 202 of the covering member 200 in the longitudinal direction.
  • the first fixing portion 211 and the second fixing portion 212 are formed in a rectangular shape having long sides extending in the longitudinal direction of the covering member 200 on the plan view shown in FIG.
  • the first fixing portion 211 can be configured on the female side (or the male side) of the hook-and-loop fastener
  • the second fixing portion 212 can be configured on the male side (or the female side) of the hook-and-loop fastener, for example. it can.
  • the hook-and-loop fastener is a fastener that can be attached and detached from the surface, and is, for example, Magic @ Tape (registered trademark) or Velcro (registered trademark).
  • the specific structure of the fixing member 210 is not particularly limited as long as the fixing member 210 can fix the covering member 200 to at least one of the forearm portion A and the hand H of the patient.
  • a frame member or the like through which one longitudinal end 201 of the member 200 or the other longitudinal end 202 of the covering member 200 passes may be used.
  • the center line c2 of the covering member 200 is the center position of the fixing member 210 (the first fixing portion 211 and the second fixing portion 212) (the center position in the width direction of the fixing member 210). Center position in the left-right direction). Therefore, when the hemostatic device 10 is mounted on a patient, the fixing force of the fixing member 210 fixing the first region 101 of the expansion member 100 to the patient extends over substantially the entire first region 101 of the expansion member 100.
  • “the fixing force by which the fixing member 210 fixes the first region 101 of the expansion member 100 to the patient” means that the fixing member 210 moves the first region 101 of the expansion member 100 through the covering member 200 to the patient. A force that tightens against the skin.
  • the center line c2 of the covering member 200 is defined as a line passing through the center position in the width direction of the covering member 200 (the center position in the left-right direction in FIG. 1).
  • the center line c2 of the covering member 200 does not have to pass through the center of the fixing member 210 in the width direction. That is, the center line c2 of the covering member 200 is not affected by the shape of the fixing member 210 in the plan view illustrated in FIG.
  • the center line c2 of the covering member 200 is, for example, a portion where the extension member 100 of the covering member 200 is arranged.
  • the shape of the fixing member 210 is not limited to a rectangle as shown in FIG. 1 as described in a modified example (see FIGS. 22 and 23) described later.
  • the material used for the covering member 200 is not particularly limited, for example, polyvinyl chloride, polyethylene, polypropylene, polybutadiene, polyolefin such as ethylene-vinyl acetate copolymer (EVA), polyethylene terephthalate (PET), polybutylene terephthalate ( PBT), various thermoplastic elastomers such as polyvinylidene chloride, silicone, polyurethane, polyamide elastomer, polyurethane elastomer, polyester elastomer, nylon, nylon elastomer, or any combination thereof (blend resin, polymer alloy, Laminated body).
  • EVA ethylene-vinyl acetate copolymer
  • PET polyethylene terephthalate
  • PBT polybutylene terephthalate
  • various thermoplastic elastomers such as polyvinylidene chloride, silicone, polyurethane, polyamide elastomer, polyurethane elastomer, polyester elasto
  • the material used for the support member 300 is not particularly limited, but when the support member 300 is formed integrally with the covering member 200, the same material as the above-described covering member 200 can be exemplified.
  • the material used for the support member 300 is preferably harder than the material used for the covering member 200.
  • materials include, for example, acrylic resins, polyvinyl chloride (especially rigid polyvinyl chloride), polyethylene, polypropylene, polyolefins such as polybutadiene, polystyrene, poly- (4-methylpentene-1), polycarbonate, ABS resin, Polymethyl methacrylate (PMMA), polyacetal, polyacrylate, polyacrylonitrile, polyvinylidene fluoride, ionomer, acrylonitrile-butadiene-styrene copolymer, polyester such as polyethylene terephthalate (PET), polybutylene terephthalate (PBT), butadiene-styrene Examples thereof include copolymers, aromatic or aliphatic polyamides, and fluorine-based resins such as polytetrafluoroethylene.
  • the hemostatic device 10 can be provided with a bag (pocket) at a portion where the support member 300 is arranged.
  • the support member 300 is, for example, a curved plate-like member (for example, a plate-like member having an inner surface that is convexly curved along the shape of the body surface of the forearm portion A or the hand H) that can be inserted into the bag portion. Can be configured. Further, the support member 300 may be fixed to the covering member 200 by sticking it to the surface of the covering member 200 with an adhesive or the like as shown in an embodiment described later (see FIG. 21).
  • the same materials as those exemplified as the material of the covering member 200 can be exemplified.
  • the length of the expansion member 100 in the longitudinal direction (the length in the vertical direction in FIG. 1) and the width of the expansion member 100 (the length in the horizontal direction in FIG. 1) are determined when the hemostatic device 10 is attached to the patient. There is no particular limitation as long as a pressing force can be applied to t. Further, the length and width in the longitudinal direction of the first region 101 and the second region 102 of the expansion member 100 are not particularly limited. Further, the length and width of the auxiliary expansion member 400 in the longitudinal direction are not particularly limited. Further, the length and width of the support member 300 in the longitudinal direction are not particularly limited.
  • the length and width of the covering member 200 are not particularly limited as long as the covering member 200 can be fixed to at least one of the forearm A and the hand H of the patient in a state where the covering member 200 is attached.
  • the width of the covering member 200 is preferably shorter than the width of the expanding member 100 as shown in FIG.
  • the puncture site t of the hand H is formed at a position close to the stalk-like projection S of the ulna in the direction from the forearm A to the fingertip side (FIG. 5). See). Therefore, when the width of the covering member 200 is formed to be shorter than the width of the expanding member 100, when the hemostatic device 10 is attached to the patient as shown in FIGS. Can be arranged so as to be hooked on the stalk S of the ulna of the patient.
  • FIG. 4 shows a state where a part of the sheath tube 610 has been pulled out from the puncture site t after the above procedure has been completed.
  • the surgeon or the like arranges the boundary portion b1 between the first region 101 and the second region 102 of the expansion member 100 so as to overlap the puncture site t, as shown in FIGS.
  • the surgeon or the like can easily arrange the boundary portion b1 at the puncture site t by checking the positions of the marker portion 117 and the puncture site t.
  • the surgeon or the like can arrange the first region 101 on the forearm A side and the second region 102 on the tip side of the hand H with reference to the vicinity of the puncture site t.
  • the surgeon or the like winds the covering member 200 around the wrist located on the distal end side of the forearm portion A of the patient.
  • the surgeon or the like fixes the hemostatic device 10 to the forearm A and the hand H of the patient using the fixing member 210 provided on the covering member 200.
  • the surgeon When the surgeon or the like attaches the hemostatic device 10 to a patient, as shown in FIG. 5, the surgeon arranges the outer peripheral edge of one end portion 203 of the covering member 200 in the width direction so as to be hooked on the pedicle S of the ulna of the patient. be able to.
  • the covering member 200 By disposing the covering member 200 in this manner, when the hemostatic device 10 is mounted on a patient, it is possible to suitably prevent the covering member 200 from being displaced from the stalk-shaped projection S of the ulna toward the forearm A side. .
  • the surgeon or the like expands the expansion member 100 and the auxiliary expansion member 400 using the injection section 500 (see FIG. 1) and a syringe (not shown).
  • the expansion member 100 and the auxiliary expansion member 400 expand, the expansion member 100 applies a pressing force to the puncture site t.
  • the surgeon or the like removes the sheath tube 610 of the introducer 600 from the puncture site t while maintaining a state in which the expanding member 100 applies a compressive force to the puncture site t. .
  • the surgeon or the like may further inject air into the expansion member 100 to increase the pressing force applied to the puncture site t.
  • the expansion member 100 keeps applying a compressive force to the puncture site t by maintaining the expanded member 100 in the expanded state.
  • the hemostatic device 10 attached to the patient has a circumferential direction near the wrist where the first region 101 of the expanding member 100 is located on the tip side of the forearm portion A together with the covering member 200 (indicated by arrows r1 and r2 in FIGS. 6 and 7).
  • Direction (the direction connecting the back of the hand Hb side and the palm side of the hand). Therefore, the first region 101 of the expansion member 100 is fastened to the vicinity of the forearm A and the vicinity of the forearm A of the hand H (near the wrist) by the fixing member 210 provided on the covering member 200.
  • the position at which the expansion member 100 is fixed to the patient's limb is not particularly limited.
  • the expansion member 100 may be fixed to one of the forearm A and the hand H, or the expansion member 100 may be fixed to both the forearm A and the hand H.
  • the hemostatic device 10 Before the hemostatic device 10 is attached to the patient, the hemostatic device 10 is configured such that the second region 102 of the expansion member and the fixing member 210 provided on the covering member 200 do not overlap in the longitudinal direction. ing. Therefore, in a state in which the hemostatic device 10 is mounted on the patient, the second region 102 of the expansion member 100 is disposed closer to the distal end of the hand H than the fixing member 210 in the longitudinal direction of the covering member 200. Thus, the force applied by the fixing member 210 provided on the covering member 200 to the second region 102 of the expansion member 100 is smaller than the fixing force applied by the fixing member 210 to the first region 101 of the expansion member 100.
  • the second region 102 of the expansion member 100 is movable to follow the movement of the finger of the hand H of the patient. Therefore, when the patient moves the finger, the movement of the finger becomes difficult to be transmitted from the second area 102 to the first area 101.
  • the expansion member 100 can suppress the entire expansion member 100 from moving along with the movement of the finger.
  • the expansion member 100 can suitably maintain the state where the first region 101 of the expansion member 100 is fixed to the forearm A of the patient. Therefore, the hemostatic device 10 can stably maintain a state in which the compressive force is effectively applied from the expansion member 100 to the puncture site t.
  • the auxiliary expansion member 400 is disposed between the expansion member 100 and the support member 300 (see FIG. 2B). Therefore, when the expanding member 100 expands, the auxiliary expanding member 400 suppresses the floating of the expanding member 100 from the body surface of the patient. Therefore, the expanding member 100 can effectively apply a compressive force to the puncture site t in a state where the expanding member 100 is expanded.
  • the auxiliary expansion member 400 is disposed so as to overlap the second region 102 of the expansion member 100 and the support member 300 along the longitudinal direction of the covering member 200 (see FIG. 1). Therefore, as shown in FIG. 7, when the hemostatic device 10 is attached to a patient, the auxiliary expansion member 400 is arranged over a wide range in the circumferential direction of the hand H.
  • the distal radial artery side of the palm artery B located on the patient's hand H is meandering along the circumferential direction of the patient's hand H depending on the patient. Since the auxiliary expansion member 400 is arranged over a wide range in the circumferential direction of the hand H as described above, the auxiliary expansion member 400 can press the expansion member 100 over a wide range in the circumferential direction of the hand H.
  • the hemostatic device 10 is effective for the expansion member 100 on the distal radial artery side of the palm artery B. It becomes possible to apply a compressive force.
  • the other end 404 in the width direction of the auxiliary extension member 400 is connected to the support member 300, and one end 403 in the width direction of the auxiliary extension member 400 is connected to the support member 300. No (see FIG. 2B). Therefore, in a state where the hemostatic device 10 is mounted on the hand H of the patient and the auxiliary expansion member 400 is expanded, one end 403 of the auxiliary expansion member 400 in the width direction is the other end of the auxiliary expansion member 400 in the width direction.
  • the end portion 404 is used as a fulcrum, and is easily deformed following the movement of the hand H of the patient.
  • the auxiliary expansion member 400 can effectively prevent the expansion member 100 from rising from the body surface of the patient.
  • the support member 300 presses the second region 102 of the expansion member 100 from the outer surface side of the auxiliary expansion member 400. Accordingly, the support member 300 allows the second region 102 of the expansion member 100 to be deformed along the longitudinal direction of the covering member 200 while the second region 102 of the expansion member 100 Suppress expansion in the direction away from. Therefore, the expansion member 100 can effectively apply a compressive force to the vicinity of the puncture site t even when the patient performs an operation such as gripping the hand H in a state where the expansion member 100 is expanded. .
  • the expansion member 100 is connected to the support member 300 (see FIG. 2B). Therefore, when the expansion member 100 expands, the expansion member 100 can be prevented from being displaced from the support member 300.
  • the auxiliary expansion member 400 is connected to the support member 300. Therefore, when the auxiliary expansion member 400 expands, the auxiliary expansion member 400 can be prevented from being displaced from the support member 300.
  • the second region 102 of the expansion member 100 is fastened to the patient's skin by the covering member 200. Absent.
  • the expansion member 100 since the expansion member 100 is connected to the support member 300, it is possible to prevent the second region 102 of the expansion member 100 from being displaced with respect to the support member 300.
  • the hemostatic device 10 includes the expansion member (pressing member) 100 disposed at the puncture site t of the patient's hand H and the expansion member 100 with the expansion member 100 covering the puncture site t. And a covering member 200 that covers at least a part thereof, wherein the covering member 200 fixes the expansion member 100 to at least one of the forearm portion A and the hand H in a state where the extension member 100 covers the puncture site t.
  • the fixing member 210 is provided.
  • the extension member 100 is provided on the covering member 200 at a position where the center line c1 of the extension member 100 does not coincide with the center line c2 of the covering member 200, and the fixing member is disposed on the covering member 200 in the longitudinal direction of the covering member 200.
  • the first region 101 includes a first region 101 overlapping with the second region 210 and a second region 102 disposed closer to the distal end of the hand H than the first region 101 is.
  • the second region 102 of the expanding member 100 is smaller than the fixing force applied by the fixing member 210 to the first region 101 when the covering member 200 fixes the expanding member 100 to at least one of the forearm A and the hand H. It is held against the hand H with a small force.
  • the hemostatic device 10 includes an expansion member (pressing member) 100 disposed at the puncture site t of the patient's hand H, and the expansion member 100 with the expansion member 100 covering the puncture site t. And a covering member 200 that covers at least a part thereof, wherein the covering member 200 fixes the expansion member 100 to at least one of the forearm portion A and the hand H in a state where the extension member 100 covers the puncture site t.
  • the fixing member 210 is provided.
  • the extension member 100 is provided on the covering member 200 at a position where the center line c1 of the extension member 100 does not coincide with the center line c2 of the covering member 200, and the fixing member is disposed on the covering member 200 in the longitudinal direction of the covering member 200.
  • the first region 101 includes a first region 101 overlapping with the second region 210 and a second region 102 disposed closer to the distal end of the hand H than the first region 101 is.
  • the covering member 200 does not have the fixing member 210 for fixing the expansion member 100 to the hand H in a region extending to the second region 102 side.
  • the first region 101 of the expanding member 100 is firmly fixed to at least one of the forearm A and the hand H, and the second region 102 of the expanding member 100 is It is held in a state having mobility on the tip side of the hand H with respect to the area 101. Therefore, when the patient moves the hand H with the hemostatic device 10 attached to the patient, the first region 101 of the expanding member 100 prevents the expansion member 100 from being displaced and Since the second region 102 is not tightened to the surface of the hand H by the fixing member 210 than the first region 101 of the expansion member 100, the second region 102 is deformed so as to follow the movement of the patient's hand H.
  • the hemostatic device 10 When the hemostatic device 10 is attached to the patient, the second region 102 of the expansion member 100 is deformed so as to follow the movement of the patient's hand H as described above. Is transmitted to the first region 101 of the expansion member 100. Therefore, the hemostatic device 10 can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force of the expansion member 100 on the puncture site t. In the hemostatic device 10, the second region 102 of the expansion member 100 is not fastened to the patient's hand H by the fixing member 210 in a state where the hemostatic device 10 is mounted on the patient's hand H.
  • the hemostatic device 10 suppresses the movement of the hand H on the fingertip side of the patient from being restricted by the fixing member 210 in a state of being mounted on the patient's hand H. Therefore, the movement of the hand H is not excessively restricted even when the patient wears the hemostatic device 10.
  • the pressing member 100 is an expansion member 100 including a bag body 110 expandable by injecting a fluid, and an expansion space 115 surrounded by the bag body 110. Therefore, the surgeon or the like operates the injection of the fluid into the expansion space 115 of the expansion member 100 and the discharge of the fluid from the expansion space 115 of the expansion member 100 so that the expansion member 100 applies the expansion member 100 to the puncture site t.
  • the pressing force to be applied can be easily adjusted.
  • the hemostatic device 10 includes a support member 300 that suppresses expansion of the expanding member 100 in a direction away from the patient's body surface. Is more preferred.
  • the support member 300 prevents the second region 102 of the expansion member 100 from expanding in a direction away from the patient's body surface. Compression force can be effectively applied to this.
  • the support member 300 presses the surface of the bag 110 toward the patient's skin when the expansion member 100 expands, so that the support member 300 has an effect on the puncture site t. Compression force can be given to the user.
  • the hemostatic device 10 has the support member 300 which suppresses expansion of the expansion member 100 in the direction away from the patient's body surface.
  • the support member 300 is connected to the covering member 200 while covering the second region 102 of the expansion member 100, and the bag 110 of the expansion member 100 is connected to the support member 300. Therefore, when the expansion member 100 expands, the expansion member 100 is suppressed from expanding in the direction away from the patient's body surface when the expansion member 100 expands, so that the puncture site t is effectively prevented. Compression force can be applied.
  • the support member 300 since the support member 300 is connected to the covering member 200, the support member 300 can be prevented from being displaced from the covering member 200 in a state where the hemostatic device 10 is attached to the patient. Further, since the expansion member 100 is connected to the support member 300, when the expansion member 100 expands, the second region 102 of the expansion member 100 can be prevented from being displaced from the support member 300.
  • the hemostatic device 10 is provided between the support member 300 and the expansion member 100 and has an auxiliary expansion member 400 connected to the support member 300.
  • the auxiliary expansion member 400 includes a space 415 that communicates with the expansion space 115 of the expansion member 100, and a bag 410 that covers the space 415.
  • the auxiliary expansion member 400 suppresses the floating of the expansion member 100 from the body surface of the patient between the expansion member 100 and the support member 300. Therefore, the expansion member 100 is effective for the puncture site t while allowing the second region 102 of the expansion member 100 to deform along the longitudinal direction of the covering member 200 in a state where the expansion member 100 is expanded. Compression force can be applied to the body.
  • the auxiliary expansion member 400 since the auxiliary expansion member 400 is connected to the support member 300, when the auxiliary expansion member 400 expands, the auxiliary expansion member 400 can be prevented from being displaced from the support member 300.
  • the auxiliary expansion member 400 is arranged so as to overlap the second region 102 of the expansion member 100 and the support member 300 along the longitudinal direction of the covering member 200. Therefore, the auxiliary expansion member 400 is arranged over a wide range in the circumferential direction of the hand H when the hemostatic device 10 is mounted on the patient. Therefore, even when the distal radial artery side of the palm artery B located in the hand H of the patient is meandering along the circumferential direction of the hand H, the hemostatic device 10 allows the auxiliary expansion member 400 to move to the palm artery B. It can be arranged to overlap the distal radial artery side. Therefore, the expansion member 100 pressed by the auxiliary expansion member 400 when the auxiliary expansion member 400 expands can effectively apply a compressive force to the distal radial artery side of the palmar artery B.
  • hemostatic device 10 has marker portion 117 for positioning expansion member 100 with respect to puncture site t.
  • the marker portion 117 is disposed at a position corresponding to a boundary portion b1 between the first region 101 of the expansion member 100 and the second region 102 of the expansion member 100. Therefore, when the operator or the like places the expansion member 100 at the puncture site t, the operator confirms the position of the marker portion 117, and thereby the boundary portion b1 between the first region 101 and the second region 102 of the expansion member 100 punctures the puncture site. t can be easily aligned.
  • the surgeon or the like can arrange the first region 101 of the expansion member 100 on the forearm A side when viewed from the puncture site t.
  • the region 102 can be arranged on the tip side of the hand H when viewed from the puncture site t. Therefore, the surgeon or the like can easily arrange the hemostatic device 10 on the patient by the marker portion, and can effectively apply the pressing force of the expansion member 100 to the puncture site t.
  • FIGS. 8, 9A, and 9B are diagrams for explaining the hemostatic device 10A according to the second embodiment
  • FIGS. 10 and 11 are diagrams for explaining a usage example of the hemostatic device 10A.
  • the hemostatic device 10A according to the second embodiment is different from the hemostatic device 10 according to the first embodiment in the arrangement of the auxiliary expansion member 400A.
  • the auxiliary expansion member 400A extends along a direction intersecting with the longitudinal direction of the covering member 200 (the width direction of the covering member 200 and the direction of arrow Y1-Y2 in the drawing).
  • the first region 101 of the expansion member 100, the second region 102 of the expansion member 100, and the support member 300 are disposed so as to overlap.
  • the length of the auxiliary extension member 400A along the longitudinal direction of the covering member 200 is approximately 2 of the length of the extension member 100 along the longitudinal direction of the covering member 200.
  • the auxiliary expansion member 400 ⁇ / b> A is arranged closer to the end 105 of the expansion member 100 located on the one end 201 side of the covering member 200 in the longitudinal direction.
  • the auxiliary expansion member 400A is arranged such that the extension direction (the left-right direction in FIG. 8) of the auxiliary expansion member 400A is orthogonal to the longitudinal direction of the covering member 200 on the plan view shown in FIG.
  • the other end 104 in the width direction of the expansion member 100, the other end 404 of the auxiliary expansion member 400A, and the other end 304 in the width direction of the support member 300 are connected to each other. ing.
  • the other end 104 in the width direction of the expansion member 100 and the other end 404 in the width direction of the auxiliary expansion member 400A are connected to the other end 304 in the width direction of the support member 300 at different positions close to each other. It may be.
  • the expansion member 100 and the auxiliary expansion member 400A are also connected to each other also around the communication hole 116 of the expansion member 100 and around the communication hole 416 of the auxiliary expansion member 400A.
  • the expansion member 100 and the auxiliary expansion member 400A are connected to the cover member 200 via the support member 300 by being connected to the support member 300.
  • One end 103 in the width direction of the expansion member 100, one end 403 of the auxiliary expansion member 400A, and one end 203 of the covering member 200 in the width direction are not connected.
  • the surgeon or the like positions the marker portion 117 disposed at a position corresponding to the boundary portion b1 between the first region 101 of the expansion member 100 and the second region 102 of the expansion member 100 at the puncture site t.
  • the expansion member 100 is placed on the forearm A and the hand H of the patient.
  • the surgeon or the like uses the fixing member 210 to fix the expansion member 100 to the patient.
  • the auxiliary expansion member 400A is arranged such that the auxiliary expansion member 400A is positioned closer to the end portion 105 of the expansion member 100 located on the one end portion 201 side of the covering member 200 in the longitudinal direction (see FIG. 8). . Therefore, in a state where the expansion member 100 is fixed to the patient, the auxiliary expansion member 400A is positioned on the outer side in the circumferential direction of the hand H (the side indicated by the arrow r2 in FIGS. When the upper Hb side of the hand H is set to the upper surface side of the hand H, the hand H is disposed on the side where the torso of the patient is disposed).
  • the palm artery B and the vein (cephalic vein) V located on the hand H are running in parallel depending on the site of the hand H of the patient to be subjected to hemostasis.
  • the vein V is located on the inner side in the circumferential direction of the hand H than the palmar artery B (the side indicated by the arrow r1 in FIGS. 10 and 11). (The side opposite to the side where the fuselage is located).
  • the expansion member 100 when performing the hemostasis, if the auxiliary expansion member 400A is arranged outside the hand H in the circumferential direction, the direction in which the expansion member 100 applies the compression force is the palm artery B Since the expansion member 100 is directed to the side, the expansion member 100 can intensively apply a compressive force to the palmar artery B. Therefore, the expansion member 100 and the auxiliary expansion member 400B can effectively apply a compression force to the palmar artery B while suppressing applying an excessive compression force to the vein V.
  • the hemostatic device 10A similarly to the hemostatic device 10 according to the first embodiment, when the hemostatic device 10A is attached to a patient, the first region 101 of the expansion member 100 is attached to the covering member 200.
  • the second region 102 of the expansion member 100 can be deformed so as to follow the movement of the patient's hand H while being firmly fixed to the patient by the provided fixing member 210. Therefore, the hemostatic device 10A can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force of the expansion member 100 on the puncture site t.
  • FIGS. 12, 13A, and 13B are diagrams for explaining the hemostatic device 10B according to the third embodiment
  • FIGS. 14 and 15 are diagrams for explaining a usage example of the hemostatic device 10B.
  • the hemostatic device 10B according to the third embodiment is different from the hemostatic device 10A according to the second embodiment in the arrangement of the auxiliary expansion member 400B.
  • the auxiliary expansion member 400A extends along a direction intersecting with the longitudinal direction of the covering member 200 (the width direction of the covering member 200, the direction of arrow Y1-Y2 in the figure).
  • the first region 101 of the expansion member 100, the second region 102 of the expansion member 100, and the support member 300 are disposed so as to overlap.
  • the length of the auxiliary extension member 400B along the longitudinal direction of the covering member 200 is approximately ⁇ of the length of the extension member 100 along the longitudinal direction of the covering member 200.
  • the auxiliary expansion member 400B is arranged closer to the end 106 of the expansion member 100 located on the other end 202 side of the covering member 200 in the longitudinal direction.
  • the auxiliary extension member 400B is arranged such that the extension direction (the left-right direction in FIG. 12) of the auxiliary extension member 400B is orthogonal to the longitudinal direction of the covering member 200 on the plan view shown in FIG.
  • the other end 104 in the width direction of the expansion member 100, the other end 404 of the auxiliary expansion member 400B, and the other end 304 in the width direction of the support member 300 are connected to each other. ing.
  • the other end 104 in the width direction of the expansion member 100 and the other end 404 in the width direction of the auxiliary expansion member 400B are connected to the other end 304 in the width direction of the support member 300 at different positions close to each other. It may be.
  • the expansion member 100 and the auxiliary expansion member 400B are also connected to each other around the communication hole 116 of the expansion member 100 and the communication hole 416 of the auxiliary expansion member 400B.
  • the expansion member 100 and the auxiliary expansion member 400B are connected to the cover member 200 via the support member 300 by being connected to the support member 300.
  • One end 103 in the width direction of the expansion member 100, one end 403 of the auxiliary expansion member 400B, and one end 203 of the covering member 200 in the width direction are not connected.
  • the surgeon or the like aligns the marker portion 117 disposed at the boundary b1 between the first region 101 of the expansion member 100 and the second region 102 of the expansion member 100 with the puncture site t,
  • the expansion member 100 is placed on the forearm A and the hand H of the patient.
  • the surgeon or the like uses the fixing member 210 to fix the expansion member 100 to the patient.
  • the auxiliary expansion member 400B is disposed such that the auxiliary expansion member 400B is positioned close to the end 106 of the expansion member 100 located on the other end 202 side of the covering member 200 in the longitudinal direction (see FIG. 12). ). Therefore, in a state where the expansion member 100 is fixed to the patient, the auxiliary expansion member 400B is positioned inside the hand H in the circumferential direction (the side indicated by the arrow r1 in FIGS. 14 and 15) as shown in FIGS. Placed in
  • the palmar artery B located on the hand H and the nerve (shallow radial nerve) N run in parallel. Further, the nerve N travels outside the palm artery B in the circumferential direction of the hand H (on the side indicated by the arrow r2 in FIGS. 14 and 15).
  • the expansion member 100 when performing the hemostasis, if the auxiliary expansion member 400B is disposed inside the hand H in the circumferential direction, the direction in which the expansion member 100 applies the pressing force is the palm artery B Since the expansion member 100 is directed to the side, the expansion member 100 can intensively apply a compressive force to the palmar artery B. Therefore, the expansion member 100 and the auxiliary expansion member 400B can effectively apply a compression force to the palmar artery B while suppressing applying an excessive compression force to the nerve N.
  • the hemostatic device 10B when the hemostatic device 10B is attached to a patient, the first region 101 of the expansion member 100 is attached to the covering member 200.
  • the second region 102 of the expansion member 100 can be deformed so as to follow the movement of the patient's hand H while being firmly fixed to the patient by the provided fixing member 210. Therefore, the hemostatic device 10B can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force of the expansion member 100 on the puncture site t.
  • FIGS. 16, 17A, and 17B are views showing a hemostatic device 10C according to the fourth embodiment.
  • the hemostatic device 10C according to the fourth embodiment does not include an auxiliary expanding member. In such a point, it differs from the hemostatic device 10 according to the first embodiment.
  • the other end 104 in the width direction of the expansion member 100 and the other end 304 in the width direction of the support member 300 are connected to each other.
  • the expansion member 100 is connected to the covering member 200 via the support member 300 by being connected to the support member 300.
  • One end 103 in the width direction of the expansion member 100 and one end 203 in the width direction of the covering member 200 are not connected.
  • the tube 501 provided in the injection section 500 is connected to the expansion member 100.
  • a method for connecting the tube 501 to the expansion member 100 a method similar to the method for connecting the tube 501 to the auxiliary expansion member 400 described in the first embodiment can be adopted.
  • the first region 101 of the expansion member 100 is provided on the covering member 200 in a state where the hemostatic device 10C is mounted on a patient.
  • the second region 102 of the expansion member 100 can be deformed so as to follow the movement of the patient's hand H while being firmly fixed to the patient by the fixing member 210. Therefore, the hemostatic device 10C can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force of the expansion member 100 on the puncture site t.
  • the hemostatic device 10C since the hemostatic device 10C includes the support member 300 that suppresses expansion of the expansion member 100 in a direction away from the patient's body surface, when the expansion member 100 expands, the second region 102 of the expansion member 100 Can be suppressed from expanding in the direction away from the patient's body surface, and a compression force can be effectively applied to the puncture site t. Further, since the support member 300 is connected to the covering member 200, it is possible to prevent the support member 300 from being displaced from the covering member 200 when the hemostatic device 10C is attached to the patient. Further, since the expansion member 100 is connected to the support member 300, when the expansion member 100 expands, the second region 102 of the expansion member 100 can be prevented from being displaced from the support member 300.
  • FIG. 18 is a diagram showing a hemostatic device 10D according to the fifth embodiment.
  • the hemostatic device 10D according to the fifth embodiment does not include the auxiliary expansion member and the support member. In such a point, it differs from the hemostatic device 10 according to the first embodiment.
  • the tube 501 provided in the injection section 500 is connected to the expansion member 100.
  • the expansion member 100 is connected to the covering member 200.
  • the expansion member 100 can be connected to the covering member 200 at an arbitrary position in the first region 101 of the expansion member 100, for example.
  • the first region 101 of the expansion member 100 is provided on the covering member 200 in a state where the hemostatic device 10D is mounted on a patient.
  • the second region 102 of the expansion member 100 can be deformed so as to follow the movement of the patient's hand H while being firmly fixed to the patient by the fixing member 210. Therefore, the hemostatic device 10D can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force of the expansion member 100 on the puncture site t.
  • FIG. 19 is a diagram showing a hemostatic device 10E according to the sixth embodiment.
  • the hemostatic device 10E is at a position where the center line c1 of the expansion member 100 and the boundary b1 between the first area 101 and the second area 102 are shifted.
  • the expansion member 100 is disposed at a position where the center line c1 of the expansion member 100 is shifted from the one end 203 in the width direction of the covering member 200 toward the other end 204 in the width direction (left side in FIG. 19).
  • the marker section 117 is disposed at a position corresponding to the second area 102 located between the center line c1 of the expansion member 100 along the longitudinal direction of the covering member 200 and the first area 101.
  • the marker portion 117 is arranged at the center position of the expansion member 100 (the center position in the longitudinal direction and the width direction in the plan view of FIG. 19).
  • the expansion member 100 may be arranged at a position where the center line c1 of the expansion member 100 is shifted from the boundary b1 between the first region 101 and the second region 102. Even in the case of such a configuration, the hemostatic device 10E can prevent the first region 101 of the expansion member 100 from being displaced in a state where the hemostatic device 10E is worn on the patient, and can prevent the first member 101 from moving to the puncture site t of the expansion member 100. Can maintain pressure.
  • the marker portion 117 is used. Is arranged at a position corresponding to the second region 102 located between the center line c1 of the expansion member 100 along the longitudinal direction of the covering member 200 and the first region 101, so that the hemostatic device 10E is attached to the patient.
  • the vicinity of the center position of the expansion member 100 can be easily arranged with respect to the puncture site t.
  • the expansion member 100 can effectively apply a compressive force to the puncture site t arranged at the center position of the expansion member 100.
  • the arrangement of the expansion member 100 and the arrangement of the marker portion 117 shown in the sixth embodiment can be adopted in any of the hemostatic devices described in the first to fifth embodiments.
  • FIG. 20 is a diagram showing a hemostatic device 10F according to the seventh embodiment.
  • a concave portion 201F that is concavely curved in the width direction of the covering member 200 is formed at one end portion 203 of the covering member 200F in the width direction.
  • the expansion member (pressing member) 100 overlaps the fixing member 210 on the covering member 200F in the longitudinal direction of the covering member 200F.
  • FIG. 21 is a diagram showing a hemostatic device 10G according to the eighth embodiment.
  • the support member 300G is formed separately from the covering member 200.
  • the support member 300G can be connected to the covering member 200 by an adhesive or the like, for example. Even when the supporting member 300G is formed separately from the covering member 200 and is attached to the covering member 200, the supporting member 300G supports the second region 102 of the expanding member 100 from the outer surface side of the expanding member 100. Thereby, expansion of the expansion member 100 in a direction away from the patient's body surface can be suppressed.
  • the fixing member 210 described in each of the above-described embodiments has a substantially rectangular shape having a long side along the longitudinal direction of the covering member 200. However, as long as the shape of the fixing member 210 can be provided on the covering member 200 and a desired fixing force for fixing the first region 101 of the expanding member (pressing member) 100 to the patient's limb can be applied. Is not particularly limited.
  • the fixing member 210 may have an arch shape as shown in FIG. Further, as shown in FIG. 23, the fixing member 210 may have a shape in which a notch is formed in a part of a circle. 22 and 23 illustrate only the first fixing portion 211 of the fixing member 210, the second fixing portion 212 can also be formed in the shape illustrated in FIGS. The fixing member 210 only needs to be able to connect the first fixing portion 211 and the second fixing portion 212. For example, the shape of the first fixing portion 211 and the shape of the second fixing portion 212 may be different.
  • the hemostatic device according to the present invention has been described through the embodiments.
  • the present invention is not limited to the contents described in the specification, and can be appropriately changed based on the description in the claims. is there.
  • a hemostatic device for stopping a puncture site formed on the back of the left hand is exemplified. It can also be used to stop the puncture site or the like formed on the palm.
  • the hemostatic device is used for a part other than the back of the left hand, the position of the auxiliary expansion member shown in the second or third embodiment is appropriately changed to a position where the auxiliary expansion member can exhibit a desired effect. be able to.
  • the pressing member is not limited to the expansion member described in each embodiment.
  • the pressing member is formed of, for example, a mechanical member capable of changing the amount of pressing against the hand by an external operation such as rotation, a resin material such as plastic or the like, which is pressed against the hand to apply a surface pressure, or a gel.
  • Member a member containing a gel whose water content decreases with time to gradually reduce the compression force, an elastic material such as a sponge-like substance, an aggregate of fibers such as cotton (cotton), a metal,
  • a member having a predetermined three-dimensional shape (such as a sphere, an ellipsoid, or a triangular pyramid) or a combination of these members may be used.
  • expansion member pressing member
  • 101 first area 101 first area
  • 102 second area 103 one end in the width direction of the expansion member
  • 104 the other end in the width direction of the expansion member
  • 110 bags 115 expansion space, 117 marker part, 200, 200F covering member, 200a inner surface of the covering member, 200b outer surface of the covering member, 201 one end in the longitudinal direction of the covering member, 202 the other end in the longitudinal direction of the covering member, 203 one end in the width direction of the covering member;
  • 204 the other end in the width direction of the covering member 210 fixing member, 211 first fixed part, 212 second fixing part, 300, 300G support member, 304

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Abstract

[Problem] To provide a hemostatic instrument capable of, even in when movement or the like of a hand occurs while hemostasis is performed, having a portion of a pressing member to follow the motion of the hand so as to enable the pressing member to maintain a compressive force exerted on a site subject to hemostasis. [Solution] This hemostatic instrument 10 is equipped with an expansion member 100 that is provided to a covering member 200 at a position where the center line c1 of an expansion member is not aligned with the center line c2 of the covering member, and that has, on the covering member, a first region 101 overlapping a fixing member 210 in the longitudinal direction of the covering member, and a second region 102 disposed closer to a distal-end side of the hand H than the first region. The second region of the expansion member is retained on the hand with a force smaller than a fixing force imparted to the first region by the fixing member, while the covering member is keeping the expansion member fixed to the forearm part and/or the hand.

Description

止血器具Hemostatic device
　本発明は、止血器具に関する。 The present invention relates to a hemostatic device.
　カテーテル手技の１つとして、患者の腕の血管（例えば、橈骨動脈）を穿刺し、患者の腕の血管に形成した穿刺部位を介して各種の医療用長尺体を血管内に導入し、病変部位に対する処置や治療を行う手技が知られている（下記特許文献１を参照）。橈骨動脈を利用するカテーテル手技は、経橈骨動脈アプローチと呼ばれており、例えば、冠動脈アクセスや下肢動脈アクセスのための有用な技術として考えられている。 As one of the catheter procedures, a blood vessel (e.g., a radial artery) of a patient's arm is punctured, and various medical elongate bodies are introduced into the blood vessel through a puncture site formed in the blood vessel of the patient's arm. Techniques for performing treatment or treatment on a site are known (see Patent Document 1 below). A catheter procedure utilizing the radial artery is called a transradial artery approach, and is considered as a useful technique for coronary artery access and lower limb artery access, for example.
　人体の腕に位置する橈骨動脈は、手側を迂回する手掌動脈とつながっている。そのため、現在、経橈骨動脈アプローチの新しい手法として、手の甲側に位置する解剖学上のスナッフボックス、又は、スナッフボックス周辺の位置から手掌動脈（遠位橈骨動脈を含む）にアクセスし、その血管アクセス部位を介して治療を行うｄＴＲＡ（ｄｉｓｔａｌ　ｔｒａｎｓｒａｄｉａｌ　ａｐｐｒｏａｃｈ）によるカテーテル手技が試みられている。 橈 The radial artery located on the arm of the human body is connected to the palm artery bypassing the hand side. Therefore, at present, as a new technique of the transradial artery approach, the palmar artery (including the distal radial artery) is accessed from the anatomical snuff box located on the back side of the hand or from a position around the snuff box, and the vascular access is performed. A catheter procedure using dTRA (distal transradial approach) for performing treatment through a site has been attempted.
特開２００８－１１９５１７号公報JP 2008-119517 A
　手に位置する手掌動脈等の血管は、指等の可動部位が多い箇所に位置する。そのため、患者が手を広げたり、手を握ったりすると、手の穿刺部位の周囲の形状は、手の動きにより変化する。従って、手の穿刺部位を止血する際、手に配置される押圧部材は、手の動きに追従し、穿刺部位への適切な圧迫を維持することが好ましい。すなわち、押圧部材が手の動きに追従し、手に位置する血管の穿刺部位に対して効果的な圧迫止血を行える止血器具が求められている。 血管 Blood vessels such as palmar arteries located in the hand are located in places where there are many movable parts such as fingers. Therefore, when the patient spreads his hand or grasps his hand, the shape around the puncture site of the hand changes due to the movement of the hand. Therefore, when stopping the puncture site of the hand, it is preferable that the pressing member arranged on the hand follows the movement of the hand and maintains an appropriate pressure on the puncture site. In other words, there is a need for a hemostatic device in which the pressing member follows the movement of the hand and can effectively perform pressure hemostasis on a puncture site of a blood vessel located in the hand.
　本発明は、上記のような課題を鑑み、止血を行っている最中に手の動き等が生じた場合であっても、押圧部材の一部が手の動きに追従し、押圧部材の止血すべき部位への圧迫力を維持できる止血器具を提供することを目的とする。 The present invention has been made in view of the above-described problems, and even when a hand movement or the like occurs during hemostasis, a part of the pressing member follows the hand movement and the hemostasis of the pressing member. An object of the present invention is to provide a hemostatic device capable of maintaining a compressive force on a site to be performed.
　本発明に係る止血器具は、患者の手の止血すべき部位に配置される押圧部材と、前記押圧部材が前記止血すべき部位を覆った状態で、前記押圧部材の少なくとも一部を覆う被覆部材と、を備え、前記被覆部材は、前記押圧部材が前記止血すべき部位を覆った状態で、前記押圧部材を腕および前記手の少なくとも一方に対して固定する固定部材を有し、前記押圧部材は、前記押圧部材の中央線と前記被覆部材の中央線とが一致しない位置で前記被覆部材に設けられているとともに、前記被覆部材上で前記被覆部材の長手方向において前記固定部材と重なる第１領域と、前記第１領域よりも前記手の先端側に配置される第２領域と、を有し、前記第２領域は、前記被覆部材が前記腕および前記手の少なくとも一方に前記押圧部材を固定した状態で、前記固定部材が前記第１領域に付与する固定力よりも小さな力で前記手に対して保持される。ここで、「前記第２領域は、前記被覆部材が前記患者の腕および前記患者の手の少なくとも一方に前記押圧部材を固定した状態で、前記固定部材が前記第１領域に付与する固定力よりも小さな力で前記手に対して保持される。」とは、被覆部材が腕および手の少なくとも一方に押圧部材を固定した状態で、押圧部材の第２領域が固定部材により被覆部材を介して患者の皮膚に対して締め付けられないため、患者が手を動かした際、第２領域が押圧部材の第１領域よりも手の動きに対して追従して動きやすいことを意味する。 A hemostatic device according to the present invention includes a pressing member disposed at a site of a patient's hand where hemostasis is to be performed, and a covering member that covers at least a part of the pressing member in a state where the pressing member covers the site where the hemostasis is to be performed. Wherein the covering member has a fixing member for fixing the pressing member to at least one of the arm and the hand in a state where the pressing member covers the site to stop bleeding, and the pressing member Is provided on the covering member at a position where the center line of the pressing member does not coincide with the center line of the covering member, and the first member overlaps the fixing member in the longitudinal direction of the covering member on the covering member. Region, and a second region disposed closer to the distal end of the hand than the first region, wherein the second region is configured such that the covering member applies the pressing member to at least one of the arm and the hand. Fixed state The fixing member is held against the hand with a small force than the fixed force applied to the first region. Here, "the second region is formed by fixing the pressing member to at least one of the arm of the patient and the hand of the patient with the covering member fixed to the first region by the fixing force applied by the fixing member to the first region. Is also held against the hand with a small force. "Means that the covering member has the pressing member fixed to at least one of the arm and the hand, and the second region of the pressing member is fixed by the fixing member via the covering member. Since it is not tightened against the patient's skin, it means that when the patient moves his hand, the second region follows the hand movement more easily than the first region of the pressing member and moves more easily.
　また、本発明に係る止血器具は、患者の手の止血すべき部位に配置される押圧部材と、前記押圧部材が前記止血すべき部位を覆った状態で、前記押圧部材の少なくとも一部を覆う被覆部材と、を備え、前記被覆部材は、前記押圧部材が前記止血すべき部位を覆った状態で、前記押圧部材を前記患者の腕および前記患者の手の少なくとも一方に対して固定する固定部材を有し、前記押圧部材は、前記押圧部材の中央線と前記被覆部材の中央線とが一致しない位置で前記被覆部材に設けられているとともに、前記被覆部材上で前記被覆部材の長手方向において前記固定部材と重なる第１領域と、前記第１領域よりも前記手の先端側に配置される第２領域と、を有し、前記被覆部材は、前記第２領域側に延在する領域に、前記押圧部材を前記手に対して固定する前記固定部材を有していない。 In addition, the hemostatic device according to the present invention covers at least a part of the pressing member in a state where the pressing member is disposed at a site where the hemostasis of the patient's hand is to be performed and the pressing member covers the site where the hemostasis is to be performed. A covering member, wherein the covering member fixes the pressing member to at least one of the arm of the patient and the hand of the patient in a state where the pressing member covers the site to stop bleeding. And the pressing member is provided on the covering member at a position where the center line of the pressing member does not match the center line of the covering member, and on the covering member in the longitudinal direction of the covering member. A first region overlapping the fixing member, and a second region disposed closer to the distal end of the hand than the first region, wherein the covering member extends in a region extending toward the second region. , The pressing member in the hand Not having the fixing member for fixing to.
　本発明に係る止血器具は、押圧部材の第１領域が腕および手の少なくとも一方に対してしっかりと固定されるとともに、押圧部材の第２領域が第１領域よりも手の先端側で可動性を持った状態で保持される。そのため、止血器具は、止血器具を患者に装着した状態で患者が手を動かした際、押圧部材の第１領域が押圧部材の位置ずれを防止するとともに、押圧部材の第２領域が手の動きに追従するように変形する。具体的には、押圧部材の第１領域は、固定部材により被覆部材を介して患者の皮膚に対して締め付けられるため、患者が手を動かした場合、止血すべき部位に対する押圧部材の位置ずれを防止する。また、押圧部材の第２領域は、固定部材により被覆部材を介して患者の皮膚に対して締め付けられていないため、患者が手を動かした際、手の動きに追従するように変形する。従って、止血器具は、止血器具が患者に装着された状態で、上記のように押圧部材の第２領域が患者の手の動きに追従するように変形することにより、患者が手を動かした際に生じる力が押圧部材の第１領域へ伝わることを抑制できる。そのため、止血器具は、押圧部材の第１領域が位置ずれすることを好適に防止でき、押圧部材の止血すべき部位への圧迫力を維持できる。また、本発明に係る止血器具は、患者の手に止血器具を装着した状態で、固定部材により、患者の手に対して押圧部材の第２領域を締め付けていない。そのため、止血器具は、患者の手に装着された状態で、患者の指先側において、手の動きが固定部材により制限されることを抑制する。従って、患者は、止血器具を装着した状態でも、過剰に手の動きが制限されることがない。 In the hemostatic device according to the present invention, the first region of the pressing member is firmly fixed to at least one of the arm and the hand, and the second region of the pressing member is movable closer to the tip of the hand than the first region. Is held in the state of having. Therefore, when the patient moves his / her hand with the hemostatic device attached to the patient, the first region of the pressing member prevents displacement of the pressing member and the second region of the pressing member moves the hand. Deform to follow. Specifically, the first region of the pressing member is fastened to the patient's skin via the covering member by the fixing member. To prevent. Further, since the second region of the pressing member is not fastened to the patient's skin via the covering member by the fixing member, the second region deforms so as to follow the hand movement when the patient moves the hand. Therefore, when the patient moves his or her hand by deforming the second region of the pressing member to follow the movement of the patient's hand as described above, the hemostatic device is mounted on the patient. Is transmitted to the first region of the pressing member. Therefore, the hemostatic device can suitably prevent the first region of the pressing member from being displaced, and can maintain the pressing force of the pressing member on the portion where hemostasis is to be performed. In the hemostatic device according to the present invention, the second region of the pressing member is not fastened to the patient's hand by the fixing member in a state where the hemostatic device is mounted on the patient's hand. For this reason, the hemostatic device suppresses the movement of the hand on the fingertip side of the patient from being restricted by the fixing member when the device is mounted on the patient's hand. Therefore, the patient is not excessively restricted in hand movement even when the hemostatic device is worn.
第１実施形態に係る止血器具を示す図であって、被覆部材の内面側から見た平面図である。It is a figure showing the hemostatic device concerning a 1st embodiment, and is the top view seen from the inner surface side of a covering member. 図１に示す矢印２Ａ－２Ａに沿う止血器具の断面図であって、拡張部材が拡張する前の状態を示す図である。FIG. 2 is a cross-sectional view of the hemostatic device, taken along arrows 2A-2A shown in FIG. 1, showing a state before an expansion member is expanded. 図２Ａに対応する止血器具の断面図であって、拡張部材が拡張した状態を示す図である。FIG. 2B is a cross-sectional view of the hemostatic device corresponding to FIG. 2A, showing a state where an expanding member is expanded. 図１に示す矢印３Ａ方向から見た止血器具の側面図である。FIG. 3 is a side view of the hemostatic device viewed from the direction of arrow 3A shown in FIG. 1. 第１実施形態に係る止血器具の使用例を説明するための斜視図である。It is a perspective view for explaining the example of use of the hemostatic device concerning a 1st embodiment. 第１実施形態に係る止血器具の使用例を説明するための斜視図である。It is a perspective view for explaining the example of use of the hemostatic device concerning a 1st embodiment. 第１実施形態に係る止血器具の使用例を説明するための斜視図である。It is a perspective view for explaining the example of use of the hemostatic device concerning a 1st embodiment. 図６に示す矢印７Ａ－７Ａに沿う断面図であって、患者に止血器具を装着した状態を模式的に示す図である。FIG. 7 is a sectional view taken along arrows 7A-7A shown in FIG. 6, schematically showing a state in which a hemostatic device is attached to a patient. 第２実施形態に係る止血器具を示す図であって、被覆部材の内面側から見た平面図である。It is a figure showing the hemostatic device concerning a 2nd embodiment, and is the top view seen from the inner surface side of a covering member. 図８に示す矢印９Ａ－９Ａに沿う止血器具の断面図であって、拡張部材が拡張する前の状態を示す図である。FIG. 9 is a cross-sectional view of the hemostasis device along an arrow 9A-9A shown in FIG. 8, showing a state before an expansion member is expanded. 図９Ａに対応する止血器具の断面図であって、拡張部材が拡張した状態を示す図である。FIG. 9B is a cross-sectional view of the hemostasis device corresponding to FIG. 9A, showing a state where an expansion member is expanded. 第２実施形態に係る止血器具の使用例を説明するための斜視図である。It is a perspective view for explaining the example of use of the hemostatic device concerning a 2nd embodiment. 図１０に示す矢印１１Ａ－１１Ａに沿う断面図であって、患者の手に止血器具を装着した状態を模式的に示す図である。FIG. 11 is a cross-sectional view taken along the arrow 11A-11A shown in FIG. 10, schematically showing a state in which the hemostatic device is attached to a patient's hand. 第３実施形態に係る止血器具を示す図であって、被覆部材の内面側から見た平面図である。It is a figure showing the hemostatic device concerning a 3rd embodiment, and is a top view seen from the inner surface side of a covering member. 図１２に示す矢印１３Ａ－１３Ａに沿う止血器具の断面図であって、拡張部材が拡張する前の状態を示す図である。FIG. 13 is a cross-sectional view of the hemostatic device, taken along arrows 13A-13A shown in FIG. 12, showing a state before an expansion member is expanded. 図１３Ａに対応する止血器具の断面図であって、拡張部材が拡張した状態を示す図である。FIG. 13B is a cross-sectional view of the hemostatic device corresponding to FIG. 13A, showing a state where an expanding member is expanded. 第３実施形態に係る止血器具の使用例を説明するための斜視図である。It is a perspective view for explaining the example of use of the hemostatic device concerning a 3rd embodiment. 図１４に示す矢印１５Ａ－１５Ａに沿う断面図であって、患者の手に止血器具を装着した状態を模式的に示す図である。FIG. 15 is a cross-sectional view taken along arrows 15A-15A shown in FIG. 14, schematically showing a state in which a hemostatic device is attached to a patient's hand. 第４実施形態に係る止血器具を示す図であって、被覆部材の内面側から見た平面図である。It is a figure showing the hemostatic device concerning a 4th embodiment, and is a top view seen from the inner surface side of a covering member. 図１６に示す矢印１７Ａ－１７Ａに沿う止血器具の断面図であって、拡張部材が拡張する前の状態を示す図である。FIG. 17 is a sectional view of the hemostatic device, taken along arrows 17A-17A shown in FIG. 16, showing a state before the expansion member is expanded. 図１７Ａに対応する止血器具の断面図であって、拡張部材が拡張した状態を示す図である。FIG. 17B is a cross-sectional view of the hemostasis device corresponding to FIG. 17A, showing a state where the expansion member is expanded. 第５実施形態に係る止血器具を示す図であって、被覆部材の内面側から見た平面図である。It is a figure showing the hemostatic instrument concerning a 5th embodiment, and is a top view seen from the inside surface side of a covering member. 第６実施形態に係る止血器具を示す図であって、被覆部材の内面側から見た平面図である。It is a figure showing the hemostatic device concerning a 6th embodiment, and is a top view seen from the inside surface side of a covering member. 第７実施形態に係る止血器具を示す図であって、被覆部材の内面側から見た平面図である。It is a figure showing the hemostatic device concerning a 7th embodiment, and is a top view seen from the inner surface side of a covering member. 第８実施形態に係る止血器具を示す図であって、被覆部材の内面側から見た平面図である。It is a figure showing the hemostatic device concerning an 8th embodiment, and is a top view seen from the inner surface side of a covering member. 固定部材の形状例を示す図である。It is a figure which shows the example of a shape of a fixing member. 固定部材の形状例を示す図である。It is a figure which shows the example of a shape of a fixing member.
　以下、添付した図面を参照しながら、本発明の実施形態を説明する。なお、以下の記載は特許請求の範囲に記載される技術的範囲や用語の意義を限定するものではない。また、図面の寸法比率は説明の都合上誇張されており、実際の比率とは異なる場合がある。 Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. The following description does not limit the technical scope and the meaning of the terms described in the claims. In addition, the dimensional ratios in the drawings are exaggerated for convenience of description, and may be different from the actual ratios.
　（第１実施形態）
　図１～図４は、第１実施形態に係る止血器具１０を説明するための図、図４～図７は、止血器具１０の使用例を説明するための図である。 (1st Embodiment)
FIGS. 1 to 4 are diagrams for explaining the hemostatic device 10 according to the first embodiment, and FIGS. 4 to 7 are diagrams for explaining an example of use of the hemostatic device 10.
　止血器具１０は、例えば、図６および図７に示すように、患者の前腕部（「腕」に相当する）Ａよりも手指側に位置する手（例えば、左手）Ｈの甲Ｈｂ側を走行する手掌動脈（深掌動脈）Ｂ１の橈骨動脈側（例えば、解剖学上のスナッフボックス周辺の動脈又はスナッフボックスよりも指先側を走行する遠位橈骨動脈）に形成された穿刺部位ｔ（「止血すべき部位」に相当する）に留置していた医療用長尺体（例えば、イントロデューサー６００のシースチューブ）６１０を抜去する際、その穿刺部位ｔを止血するために使用することができる。なお、解剖学上のスナッフボックスは、親指を広げた際に前腕部Ａの橈骨側に位置する手Ｈの空洞である。 For example, as shown in FIGS. 6 and 7, the hemostatic device 10 travels on the instep Hb side of a hand (for example, left hand) H located closer to the finger than a forearm (corresponding to “arm”) A of the patient. Puncture site t (“haemostasis”) formed on the radial artery side of palmar artery (deep palm artery) B1 (eg, an anatomical artery around the snuff box or a distal radial artery running on the fingertip side of the snuff box) When removing the long medical body (for example, the sheath tube of the introducer 600) 610 that has been indwelled in the "site to be", it can be used to stop the puncture site t. The anatomical snuff box is a cavity of the hand H located on the radial side of the forearm A when the thumb is spread.
　止血器具１０は、図１、図６に示すように、穿刺部位ｔに配置される押圧部材１００と、押圧部材１００が穿刺部位ｔを覆った状態で、押圧部材１００の少なくとも一部を覆う被覆部材２００と、を備えている。また、図１、図４に示すように、被覆部材２００は、押圧部材１００が穿刺部位ｔを覆った状態で、押圧部材１００を前腕部Ａおよび手Ｈの少なくとも一方に対して固定する固定部材２１０を有している。 As shown in FIGS. 1 and 6, the hemostatic device 10 includes a pressing member 100 disposed at the puncture site t, and a cover that covers at least a part of the pressing member 100 in a state where the pressing member 100 covers the puncture site t. And a member 200. Further, as shown in FIGS. 1 and 4, the covering member 200 is a fixing member that fixes the pressing member 100 to at least one of the forearm A and the hand H in a state where the pressing member 100 covers the puncture site t. 210.
　本実施形態では、押圧部材１００は、図２Ａ、図２Ｂに示すように、流体の注入により拡張可能な袋体１１０と、袋体１１０に囲われた拡張空間１１５と、を備える拡張部材により構成している。また、袋体１１０は、図２Ａ、図２Ｂに示すように、後述する支持部材３００と接続している。なお、袋体１１０は、被覆部材２００および後述する支持部材３００の少なくとも一方と接続していればよい。以下の説明では、押圧部材１００は拡張部材１００として説明する。 In the present embodiment, as shown in FIGS. 2A and 2B, the pressing member 100 is configured by an expanding member including a bag body 110 expandable by injecting a fluid, and an expansion space 115 surrounded by the bag body 110. doing. 2A and 2B, the bag body 110 is connected to a support member 300 described later. Note that the bag 110 may be connected to at least one of the covering member 200 and a support member 300 described below. In the following description, the pressing member 100 will be described as the expanding member 100.
　本明細書の説明では、患者の手Ｈの先端側は、手Ｈの指先が配置される側（図１の左側）を意味する。また、止血器具１０の各部における「内面」とは、止血器具１０を患者に装着した際に、患者の体表面に向い合うように配置される側の面であり、「外面」は、内面の反対側の面（体表面に向い合せて配置されない側の面）である。なお、図１は、被覆部材２００の内面２００ａ側から見た止血器具１０の平面図である。 で は In the description of this specification, the tip side of the patient's hand H means the side where the fingertip of the hand H is arranged (the left side in FIG. 1). In addition, the “inner surface” in each part of the hemostatic device 10 is a surface that is arranged to face the patient's body surface when the hemostatic device 10 is attached to the patient, and the “outer surface” is the inner surface. The opposite surface (the surface that is not disposed facing the body surface). FIG. 1 is a plan view of the hemostatic device 10 viewed from the inner surface 200a side of the covering member 200.
　拡張部材１００は、図１、図２Ａ、図２Ｂに示すように、拡張部材１００の中央線ｃ１と被覆部材２００の中央線ｃ２とが一致しない位置で被覆部材２００に設けられている。拡張部材１００の中央線ｃ１は、被覆部材２００の中央線ｃ２に対して、被覆部材２００に設けられた支持部材３００側（図１の左側）にオフセットしている。 As shown in FIGS. 1, 2A, and 2B, the extension member 100 is provided on the covering member 200 at a position where the center line c1 of the extension member 100 does not match the center line c2 of the covering member 200. The center line c1 of the extension member 100 is offset from the center line c2 of the covering member 200 toward the support member 300 provided on the covering member 200 (left side in FIG. 1).
　拡張部材１００は、図１、図６に示すように、被覆部材２００上で（被覆部材２００が被覆部材２００の長手方向において連続している範囲で）、被覆部材２００の長手方向において固定部材２１０と重なる第１領域１０１と、第１領域１０１よりも手Ｈの先端側に配置される第２領域１０２（図６を参照）と、を有している。すなわち、第１領域１０１は、被覆部材２００が被覆部材２００の長方向において連続している範囲で、被覆部材２００の長手方向において固定部材２１０と重なる拡張部材１００の一部の領域である。 As shown in FIGS. 1 and 6, the extension member 100 is fixed on the covering member 200 (in a range where the covering member 200 is continuous in the longitudinal direction of the covering member 200) in the longitudinal direction of the covering member 200. And a second region 102 (see FIG. 6) that is located closer to the distal end of the hand H than the first region 101. That is, the first region 101 is a part of the extension member 100 that overlaps the fixing member 210 in the longitudinal direction of the covering member 200 in a range where the covering member 200 is continuous in the longitudinal direction of the covering member 200.
　被覆部材２００の長手方向は、図１に示す矢印Ｘ１－Ｘ２に沿う方向である。また、図１に示す平面図上において、被覆部材２００の長手方向と直交する方向を幅方向とし、矢印Ｙ１－Ｙ２で示す。 長 手 The longitudinal direction of the covering member 200 is a direction along the arrow X1-X2 shown in FIG. In the plan view shown in FIG. 1, a direction orthogonal to the longitudinal direction of the covering member 200 is defined as a width direction, and is indicated by arrows Y1-Y2.
　被覆部材２００の中央線ｃ２は、被覆部材２００の幅方向の中心位置を通る直線状の仮想線である。 中央 The center line c2 of the covering member 200 is a linear virtual line passing through the center position of the covering member 200 in the width direction.
　拡張部材１００の中央線ｃ１は、被覆部材２００の幅方向と同一方向である拡張部材１００の幅方向（図１の左右方向）の中心位置を通る直線状の仮想線である。拡張部材１００の中央線ｃ１は、被覆部材２００の中央線ｃ２と略平行に延びている。 The center line c1 of the extension member 100 is a linear imaginary line passing through the center of the extension member 100 in the width direction (the left-right direction in FIG. 1) which is the same direction as the width direction of the covering member 200. The center line c1 of the expansion member 100 extends substantially parallel to the center line c2 of the covering member 200.
　拡張部材１００は、図１に示す平面図上において、略矩形形状を有している。そのため、拡張部材１００の幅は、被覆部材２００の長手方向に沿って略一定である。 The expansion member 100 has a substantially rectangular shape on the plan view shown in FIG. Therefore, the width of the expansion member 100 is substantially constant along the longitudinal direction of the covering member 200.
　なお、拡張部材１００は、図１に示す平面図上において、例えば、丸、楕円、多角形等の形状であってもよい。上記のように拡張部材１００が被覆部材２００の長手方向に沿って略一定の幅を有さない形状で形成される場合、拡張部材１００の中央線ｃ１は、例えば、図１に示す平面図上において拡張部材１００の幅方向の中心位置を通り、かつ、被覆部材２００の中央線ｃ２と略平行に延びる直線で定義することができる。 The expansion member 100 may have, for example, a shape such as a circle, an ellipse, and a polygon on the plan view shown in FIG. As described above, when the expansion member 100 is formed in a shape that does not have a substantially constant width along the longitudinal direction of the covering member 200, the center line c1 of the expansion member 100 is, for example, a plan view shown in FIG. At the center of the expansion member 100 in the width direction and extends substantially parallel to the center line c2 of the covering member 200.
　図２Ａおよび図２Ｂに示すように、拡張部材１００の第１領域１０１は、拡張部材１００の第１領域１０１と第２領域１０２の境界部ｂ１を基準にして、拡張部材１００の幅方向の一端部１０３側に設けられている。また、拡張部材１００の第２領域１０２は、境界部ｂ１を基準にして、拡張部材１００の幅方向の他端部１０４側に設けられている。 As shown in FIGS. 2A and 2B, the first region 101 of the expansion member 100 is formed at one end in the width direction of the expansion member 100 with reference to a boundary b1 between the first region 101 and the second region 102 of the expansion member 100. It is provided on the part 103 side. The second region 102 of the expansion member 100 is provided on the other end 104 side of the expansion member 100 in the width direction with reference to the boundary portion b1.
　本実施形態では、拡張部材１００の中央線ｃ１と、第１領域１０１と第２領域１０２の境界部ｂ１は、図１に示す平面図上において、重なる位置に配置されている。 In the present embodiment, the center line c1 of the expansion member 100 and the boundary b1 between the first area 101 and the second area 102 are arranged at overlapping positions on the plan view shown in FIG.
　止血器具１０は、図１および図２Ｂに示すように、止血器具１０を患者に装着し、かつ、拡張部材１００を拡張させた状態において、患者の体表面（前腕部Ａの体表面や手Ｈの体表面）から離れる方向への拡張部材１００の拡張を抑制する支持部材３００を有している。 As shown in FIG. 1 and FIG. 2B, the hemostatic device 10 is mounted on the patient and the expansion member 100 is expanded, and the body surface of the patient (the body surface of the forearm A or the hand H) is expanded. (A body surface of the body).
　支持部材３００は、拡張部材１００の第２領域１０２を覆いつつ、被覆部材２００に接続されている。 The supporting member 300 is connected to the covering member 200 while covering the second region 102 of the expanding member 100.
　本実施形態では、支持部材３００は、被覆部材２００と一体的に形成している。図１に示すように、拡張部材１００の幅方向に沿って第２領域１０２を覆うように被覆部材２００が延びた部分は、支持部材３００を形成している。支持部材３００は、第２領域１０２全体を拡張部材１００の幅方向に沿って覆うように配置している。 In the present embodiment, the support member 300 is formed integrally with the covering member 200. As shown in FIG. 1, a portion where the covering member 200 extends so as to cover the second region 102 along the width direction of the expanding member 100 forms a supporting member 300. The support member 300 is disposed so as to cover the entire second region 102 along the width direction of the expansion member 100.
　なお、支持部材３００は、第２領域１０２の一部のみを覆うように配置してもよい。また、支持部材３００は、後述するように被覆部材２００と別部材で構成することも可能である（図２３を参照）。 The support member 300 may be disposed so as to cover only a part of the second region 102. Further, the support member 300 can be configured as a member separate from the covering member 200 as described later (see FIG. 23).
　止血器具１０は、図２Ａおよび図２Ｂに示すように、支持部材３００と拡張部材１００との間（図２Ａおよび図２Ｂに示す上下方向の間）に配置されるとともに、支持部材３００に接続された補助拡張部材４００を有している。 2A and 2B, the hemostatic device 10 is disposed between the support member 300 and the expansion member 100 (between the vertical direction shown in FIGS. 2A and 2B) and connected to the support member 300. The auxiliary expansion member 400 is provided.
　補助拡張部材４００は、図２Ｂに示すように、拡張部材１００の拡張空間１１５と連通する空間部４１５と、空間部４１５を覆う袋体４１０と、を有している。 As shown in FIG. 2B, the auxiliary expansion member 400 has a space 415 communicating with the expansion space 115 of the expansion member 100, and a bag 410 that covers the space 415.
　拡張部材１００の袋体１１０には連通孔１１６が形成されている。また、補助拡張部材４００の袋体４１０には連通孔４１６が形成されている。拡張部材１００の拡張空間１１５と補助拡張部材４００の空間部４１５は、各連通孔１１６、４１６を介して互いに連通している。 袋 A communication hole 116 is formed in the bag 110 of the expansion member 100. A communication hole 416 is formed in the bag 410 of the auxiliary expansion member 400. The expansion space 115 of the expansion member 100 and the space 415 of the auxiliary expansion member 400 communicate with each other via the communication holes 116 and 416.
　図１に示すように、本実施形態では、補助拡張部材４００の長さ（被覆部材２００の長手方向に沿う長さ）は、拡張部材１００の長手方向の長さと略同一である。また、補助拡張部材４００の幅（被覆部材２００の長手方向と直交する方向の幅）は、拡張部材１００の幅よりも短い。本実施形態では、補助拡張部材４００の幅は、拡張部材１００の幅の略１／２である。 As shown in FIG. 1, in this embodiment, the length of the auxiliary expanding member 400 (the length along the longitudinal direction of the covering member 200) is substantially the same as the length of the expanding member 100 in the longitudinal direction. The width of the auxiliary expansion member 400 (the width in a direction orthogonal to the longitudinal direction of the covering member 200) is shorter than the width of the expansion member 100. In the present embodiment, the width of the auxiliary expansion member 400 is approximately の of the width of the expansion member 100.
　図１に示すように、補助拡張部材４００は、被覆部材２００の長手方向に沿って拡張部材１００の第２領域１０２および支持部材３００と重なるように配置されている。また、補助拡張部材４００は、補助拡張部材４００の長手方向が被覆部材２００の長手方向と略平行になるように配置している。 As shown in FIG. 1, the auxiliary expansion member 400 is disposed so as to overlap the second region 102 of the expansion member 100 and the support member 300 along the longitudinal direction of the covering member 200. The auxiliary expansion member 400 is arranged such that the longitudinal direction of the auxiliary expansion member 400 is substantially parallel to the longitudinal direction of the covering member 200.
　止血器具１０全体で各部材の配置関係を見ると、図２Ｂに示すように、拡張部材１００は、第１領域１０１と被覆部材２００が拡張部材１００の拡張方向に沿って重なっている。また、拡張部材１００は、第２領域１０２と補助拡張部材４００と支持部材３００が拡張部材１００の拡張方向に沿って重なっている。 配置 Looking at the arrangement relationship of each member in the entire hemostatic device 10, as shown in FIG. 2B, in the expansion member 100, the first region 101 and the covering member 200 overlap in the expansion direction of the expansion member 100. Further, in the expansion member 100, the second region 102, the auxiliary expansion member 400, and the support member 300 overlap in the expansion direction of the expansion member 100.
　図２Ａ、図２Ｂに示すように、拡張部材１００の幅方向の他端部１０４と、補助拡張部材４００の幅方向の他端部４０４と、支持部材３００の幅方向の他端部３０４は、互いに接続されている。上記の各他端部１０４、３０４、４０４は、図１の平面図上において、各部材１００、４００、３００の左側に位置する端部（被覆部材２００が配置されていない側の端部）である。なお、拡張部材１００の幅方向の他端部１０４、及び、補助拡張部材４００の幅方向の他端部４０４は、互いに近接する異なる位置で、支持部材３００の幅方向の他端部３０４に接続されていてもよい。また、本実施形態では、拡張部材１００と補助拡張部材４００は、拡張部材１００の連通孔１１６の周囲および補助拡張部材４００の連通孔４１６の周囲でも互いに接続されている。 As shown in FIGS. 2A and 2B, the other end 104 in the width direction of the expansion member 100, the other end 404 in the width direction of the auxiliary expansion member 400, and the other end 304 in the width direction of the support member 300 are Connected to each other. The other ends 104, 304, and 404 are ends located on the left side (ends on which the covering member 200 is not disposed) of the members 100, 400, and 300 in the plan view of FIG. is there. The other end 104 in the width direction of the expansion member 100 and the other end 404 in the width direction of the auxiliary expansion member 400 are connected to the other end 304 in the width direction of the support member 300 at different positions close to each other. It may be. In the present embodiment, the expansion member 100 and the auxiliary expansion member 400 are connected to each other also around the communication hole 116 of the expansion member 100 and around the communication hole 416 of the auxiliary expansion member 400.
　前述したように支持部材３００は被覆部材２００と一体的に形成されている。そのため、拡張部材１００および補助拡張部材４００は、支持部材３００と接続されることにより、支持部材３００を介して被覆部材２００と接続されている。 支持 As described above, the support member 300 is formed integrally with the covering member 200. Therefore, the expansion member 100 and the auxiliary expansion member 400 are connected to the support member 300, and thus are connected to the covering member 200 via the support member 300.
　本実施形態では、拡張部材１００の袋体１１０は、二つのシート状の部材で形成している。袋体１１０は、例えば、略矩形形状に形成された二つのシート状の部材の間に拡張空間１１５を形成した状態で、二つのシート状の部材の外周縁を接合することにより形成することができる。補助拡張部材４００の袋体４１０も拡張部材１００の袋体１１０と同様に、接合された略矩形形状の二つのシート状の部材で形成することができる。拡張部材１００および補助拡張部材４００は、拡張部材１００の外周に位置する一辺（図２Ｂに示す幅方向の他端部１０４に位置する一辺）および補助拡張部材４００の外周に位置する一辺（図２Ｂに示す幅方向の他端部４０４に位置する一辺）が支持部材３００と接続されている。 で は In the present embodiment, the bag 110 of the expansion member 100 is formed of two sheet-like members. The bag body 110 can be formed, for example, by joining the outer peripheral edges of two sheet-shaped members in a state where an expansion space 115 is formed between two sheet-shaped members formed in a substantially rectangular shape. it can. Similarly to the bag 110 of the expansion member 100, the bag 410 of the auxiliary expansion member 400 can be formed of two joined substantially rectangular sheet-like members. The expansion member 100 and the auxiliary expansion member 400 have one side located on the outer periphery of the expansion member 100 (one side located on the other end portion 104 in the width direction shown in FIG. 2B) and one side located on the outer periphery of the auxiliary expansion member 400 (FIG. 2B). Are connected to the support member 300.
　拡張部材１００の袋体１１０は、上記のように二つのシート状の部材の外周部分を接合して形成している。そのため、拡張部材１００は、拡張部材１００が拡張した際、拡張部材１００の中心位置付近（境界部ｂ１付近）が拡張部材１００の幅方向の一端部１０３および他端部１０４と比較して、高さ方向（図２Ｂの上下方向）に大きく拡張する。また、補助拡張部材４００の袋体４１０は、上記のように二つのシート状の部材の外周部分を接合して形成している。そのため、補助拡張部材４００は、補助拡張部材４００が拡張した際、補助拡張部材４００の幅方向（図２Ｂの左右方向）の中心位置付近が補助拡張部材４００の幅方向の一端部４０３および他端部４０４と比較して、高さ方向に大きく拡張する。そのため、拡張部材１００および補助拡張部材４００が拡張した際、図２Ｂに示すように、拡張部材１００の幅方向の他端部１０４付近と補助拡張部材４００の幅方向の他端部４０４付近との間には、隙間ｇが形成される。止血器具１０が患者に装着されて拡張部材１００と補助拡張部材４００が拡張した際、拡張部材１００と補助拡張部材４００は、穿刺部位ｔへ圧迫力を付与した状態を維持しつつ、上記の隙間ｇを介して可動することができる。そのため、拡張部材１００および補助拡張部材４００は、患者が手Ｈなどを動かした際、患者の手Ｈの形状に追従するように変形することができ、穿刺部位ｔへ圧迫力を付与した状態を好適に維持することができる。 袋 The bag 110 of the expansion member 100 is formed by joining the outer peripheral portions of the two sheet-shaped members as described above. Therefore, when the expansion member 100 expands, the vicinity of the center position (near the boundary part b1) of the expansion member 100 is higher than the one end 103 and the other end 104 of the expansion member 100 in the width direction. In the vertical direction (the vertical direction in FIG. 2B). Further, the bag body 410 of the auxiliary expansion member 400 is formed by joining the outer peripheral portions of the two sheet-shaped members as described above. Therefore, when the auxiliary expansion member 400 is expanded, the vicinity of the center position of the auxiliary expansion member 400 in the width direction (the left-right direction in FIG. 2B) is one end portion 403 and the other end of the auxiliary expansion member 400 in the width direction. As compared with the portion 404, the portion expands greatly in the height direction. Therefore, when the expansion member 100 and the auxiliary expansion member 400 expand, as shown in FIG. 2B, the vicinity of the other end portion 104 in the width direction of the expansion member 100 and the vicinity of the other end portion 404 in the width direction of the auxiliary expansion member 400 are changed. A gap g is formed between them. When the hemostatic device 10 is attached to a patient and the expansion member 100 and the auxiliary expansion member 400 expand, the expansion member 100 and the auxiliary expansion member 400 maintain the state where a compressive force is applied to the puncture site t while maintaining the above-described gap. It can move through g. Therefore, when the patient moves the hand H or the like, the expansion member 100 and the auxiliary expansion member 400 can be deformed so as to follow the shape of the patient's hand H, and a state in which a compressive force is applied to the puncture site t. It can be suitably maintained.
　拡張部材１００を形成するシート状の部材の接合方法や補助拡張部材４００を形成するシート状の部材の接合方法は特に限定されないが、例えば、融着や接着を採用することができる。また、拡張部材１００、補助拡張部材４００、支持部材３００を接続する方法も特に限定されないが、例えば、融着や接着を採用することができる。また、拡張部材１００の連通孔１１６の周囲と補助拡張部材４００の連通孔４１６の周囲を接続する方法も特に限定されないが、例えば、融着や接着を採用することができる。 接合 The joining method of the sheet-like members forming the extension member 100 and the joining method of the sheet-like members forming the auxiliary extension member 400 are not particularly limited. For example, fusion or adhesion can be adopted. Further, the method of connecting the expansion member 100, the auxiliary expansion member 400, and the support member 300 is not particularly limited. For example, fusion or adhesion can be adopted. Further, a method of connecting the periphery of the communication hole 116 of the expansion member 100 and the periphery of the communication hole 416 of the auxiliary expansion member 400 is not particularly limited. For example, fusion or adhesion can be adopted.
　なお、拡張部材１００および補助拡張部材４００は、複数のシート状の部材を接合した構造に限定されることはない。拡張部材１００および補助拡張部材４００は、例えば、流体が流入可能な空間が内部に形成された一つの袋状の部材で形成してもよい。 The expansion member 100 and the auxiliary expansion member 400 are not limited to a structure in which a plurality of sheet-like members are joined. The expansion member 100 and the auxiliary expansion member 400 may be formed of, for example, one bag-shaped member in which a space into which a fluid can flow is formed.
　図２Ｂに示すように、拡張部材１００の幅方向の一端部１０３と、補助拡張部材４００の幅方向の一端部４０３と、被覆部材２００の幅方向の一端部２０３は、接続されていない。 2B, one end 103 in the width direction of the expansion member 100, one end 403 in the width direction of the auxiliary expansion member 400, and one end 203 of the covering member 200 in the width direction are not connected.
　止血器具１０は、図１および図２Ｂに示すように、拡張部材１００を穿刺部位ｔに対して位置合わせするためのマーカー部１１７を有している。マーカー部１１７は、拡張部材１００の第１領域１０１と拡張部材１００の第２領域１０２の境界部ｂ１に対応する位置に配置している。また、マーカー部１１７は、拡張部材１００の長手方向および幅方向の略中心位置（図１の上下方向および左右方向の中心位置）に対応した位置に配置している。 1) As shown in FIGS. 1 and 2B, the hemostatic device 10 has a marker portion 117 for positioning the expansion member 100 with respect to the puncture site t. The marker portion 117 is disposed at a position corresponding to a boundary portion b1 between the first region 101 of the expansion member 100 and the second region 102 of the expansion member 100. The marker portion 117 is disposed at a position corresponding to a substantially central position in the longitudinal direction and the width direction of the expanding member 100 (a central position in the vertical direction and the horizontal direction in FIG. 1).
　図２Ｂに示すように、マーカー部１１７は、例えば、拡張部材１００の体表面に向い合せて配置される側の面（内面）の内表面に配置することができる。ただし、マーカー部１１７は、例えば、拡張部材１００の拡張部材１００の体表面に向い合せて配置される側の面と反対側の面（外面）の内表面やその外表面、支持部材３００の内表面や外表面等に配置することも可能である。また、図２Ａ、図２Ｂに示す断面図上において拡張部材１００の中心位置と補助拡張部材４００の一端部４０３とが重なるように配置される場合、マーカー部１１７は、補助拡張部材４００の一端部４０３の外表面に配置してもよい。 マ ー カ ー As shown in FIG. 2B, the marker portion 117 can be arranged on, for example, the inner surface of the surface (inner surface) on the side arranged to face the body surface of the expansion member 100. However, the marker portion 117 is, for example, an inner surface or an outer surface of a surface (outer surface) opposite to a surface of the expanding member 100 facing the body surface of the expanding member 100, and an inner surface of the supporting member 300. It is also possible to arrange it on the surface or the outer surface. When the center position of the expansion member 100 and the one end portion 403 of the auxiliary expansion member 400 overlap each other on the cross-sectional views shown in FIGS. 2A and 2B, the marker portion 117 is attached to the one end portion of the auxiliary expansion member 400. 403 may be arranged on the outer surface.
　マーカー部１１７は、例えば、透明な中心部と、その中心部を囲む有色の線状の枠部と、から構成されることが好ましい。これにより、術者は、マーカー部１１７の透明な中心部を介して穿刺部位ｔを確認しつつ、穿刺部位ｔにマーカー部１１７を配置することができる。そのため、術者は、マーカー部１１７を利用し、穿刺部位ｔに第１領域１０１と第２領域１０２の境界部ｂ１を簡単に配置することができる。なお、マーカー部１１７は、例えば、枠部を有さず、有色な中心部のみで形成してもよい。また、マーカー部１１７の具体的な形状、色、拡張部材１００への形成方法等は特に限定されない。 It is preferable that the marker part 117 is composed of, for example, a transparent central part and a colored linear frame surrounding the central part. Thus, the surgeon can place the marker portion 117 at the puncture site t while confirming the puncture site t via the transparent central portion of the marker portion 117. Therefore, the surgeon can easily arrange the boundary portion b1 between the first region 101 and the second region 102 at the puncture site t using the marker portion 117. Note that the marker portion 117 may be formed, for example, only with a colored central portion without a frame portion. The specific shape and color of the marker portion 117, the method of forming the marker portion 117 on the expansion member 100, and the like are not particularly limited.
　なお、拡張部材１００、被覆部材２００、支持部材３００、補助拡張部材４００においてマーカー部１１７と平面視上において重なる部分およびその周囲は、半透明または有色透明であることが好ましい。それにより、術者は、マーカー部１１７を穿刺部位ｔに重ね合わせた状態においても、被覆部材２００の外面側や支持部材３００の外面側から穿刺部位ｔを視認することが可能になる（図６を参照）。 In addition, it is preferable that a portion of the expansion member 100, the covering member 200, the support member 300, and the auxiliary expansion member 400 that overlaps the marker portion 117 in a plan view and its surroundings are translucent or colored and transparent. Thereby, even in a state where the marker portion 117 is superimposed on the puncture site t, the surgeon can visually recognize the puncture site t from the outer surface side of the covering member 200 and the outer surface side of the support member 300 (FIG. 6). See).
　図１に示すように、止血器具１０は、拡張部材１００および補助拡張部材４００への流体（例えば、空気等の気体）の注入と、拡張部材１００および補助拡張部材４００からの流体の排出を操作するための注入部５００を有している。 As shown in FIG. 1, the hemostatic device 10 operates to inject a fluid (for example, a gas such as air) into the expansion member 100 and the auxiliary expansion member 400 and to discharge the fluid from the expansion member 100 and the auxiliary expansion member 400. To perform the injection.
　注入部５００は、可撓性を有するチューブ５０１と、チューブ５０１の内腔と連通するようにチューブ５０１の一端部に配置された袋部５０３と、袋部５０３に接続された逆止弁（図示せず）を内蔵する管状のコネクタ５０５と、を有している。 The injection section 500 includes a flexible tube 501, a bag 503 disposed at one end of the tube 501 so as to communicate with the lumen of the tube 501, and a check valve connected to the bag 503 (see FIG. (Not shown).
　チューブ５０１は、図１に示すように、袋部５０３が配置された一端部と反対側の他端部が拡張部材１００に接続されている。チューブ５０１の他端部は、例えば、拡張部材１００の袋体１１０を形成する二つのシート状の部材の間に挟み込まれた状態で接着材等により袋体１１０に接続することができる。なお、拡張部材１００を形成するシート状の部材には、例えば、袋体１１０のチューブ５０１を挟み込む部分に、シート状の部材の外方側へ部分的に突出する凸部が形成されていてもよい。 As shown in FIG. 1, the other end of the tube 501 opposite to the one end where the bag portion 503 is arranged is connected to the expansion member 100. The other end of the tube 501 can be connected to the bag 110 with an adhesive or the like while being sandwiched between two sheet-like members forming the bag 110 of the expansion member 100, for example. In the sheet-like member forming the expansion member 100, for example, a convex portion that partially protrudes outward from the sheet-like member may be formed in a portion of the bag body 110 that sandwiches the tube 501. Good.
　注入部５００は、チューブ５０１が拡張部材１００と接続されることにより、チューブ５０１の内腔が拡張部材１００の拡張空間１１５と連通する。 In the injection section 500, when the tube 501 is connected to the expansion member 100, the lumen of the tube 501 communicates with the expansion space 115 of the expansion member 100.
　注入部５００は、図１に示すように、チューブ５０１は、チューブ５０１の他端部が拡張部材１００と接続された状態で支持部材３００の長手方向の一端部側（図１の上端部側）から引き出されている。止血器具１０は、上記のように注入部５００のチューブ５０１が配置されることにより、止血器具１０を患者に装着した際、チューブ５０１が患者の手Ｈの側部側（手Ｈが延びる方向と交差する側）に配置される（図５を参照）。そのため、止血器具１０を患者に装着した際、チューブ５０１がイントロデューサー６００と干渉することを防止できる。なお、チューブ５０１は、後述する実施形態（図１２を参照）において示すように、支持部材３００の長手方向の他端部側（図１の下端部側）から引き出すように配置してもよい。 As shown in FIG. 1, the injection unit 500 is configured such that the tube 501 is connected to one end of the support member 300 in the longitudinal direction in a state where the other end of the tube 501 is connected to the expansion member 100 (the upper end in FIG. 1). Are drawn from. When the hemostatic device 10 is mounted on a patient, the tube 501 is positioned on the side of the patient's hand H (in the direction in which the hand H extends) when the hemostatic device 10 is mounted on the patient, as described above. (See FIG. 5). Therefore, when the hemostatic device 10 is mounted on a patient, it is possible to prevent the tube 501 from interfering with the introducer 600. The tube 501 may be disposed so as to be drawn out from the other end (the lower end in FIG. 1) of the support member 300 in the longitudinal direction, as shown in an embodiment (see FIG. 12) described later.
　術者等は、拡張部材１００および補助拡張部材４００を拡張させる際、注入部５００のコネクタ５０５にシリンジ（図示せず）の先筒部を挿入して逆止弁を開き、シリンジの押し子を押して、シリンジ内の空気を拡張部材１００の拡張空間１１５に注入する。拡張部材１００の拡張空間１１５内に空気が注入されると、拡張部材１００が拡張する。また、拡張部材１００の拡張空間１１５内に注入された空気は、拡張部材１００に形成された連通孔１１６および補助拡張部材４００に形成された連通孔４１６を介して、補助拡張部材４００の空間部４１５に流入する。補助拡張部材４００の空間部４１５内に空気が流入すると、補助拡張部材４００が拡張する。拡張部材１００および補助拡張部材４００が拡張すると、チューブ５０１を介して拡張部材１００の拡張空間１１５と連通している注入部５００の袋部５０３が膨張する。術者等は、袋部５０３の膨張を確認することにより、空気が漏れずに、拡張部材１００および補助拡張部材４００を加圧できていることを目視で容易に確認できる。なお、拡張部材１００および補助拡張部材４００を収縮させる際は、注入部５００のコネクタ５０５にシリンジの先筒部を挿入して、シリンジの押し子を引いて、拡張部材１００内の空気および補助拡張部材４００内の空気をシリンジへ排出させる。 When expanding the expansion member 100 and the auxiliary expansion member 400, the surgeon or the like inserts the tip of the syringe (not shown) into the connector 505 of the injection part 500, opens the check valve, and pushes the pusher of the syringe. By pushing, the air in the syringe is injected into the expansion space 115 of the expansion member 100. When air is injected into the expansion space 115 of the expansion member 100, the expansion member 100 expands. Further, the air injected into the expansion space 115 of the expansion member 100 passes through the communication hole 116 formed in the expansion member 100 and the communication hole 416 formed in the auxiliary expansion member 400, and the space of the auxiliary expansion member 400. 415. When air flows into the space 415 of the auxiliary expansion member 400, the auxiliary expansion member 400 expands. When the expansion member 100 and the auxiliary expansion member 400 expand, the bag portion 503 of the injection part 500 that communicates with the expansion space 115 of the expansion member 100 via the tube 501 expands. By confirming the expansion of the bag portion 503, the surgeon or the like can easily visually confirm that the expansion member 100 and the auxiliary expansion member 400 can be pressurized without air leakage. When the expansion member 100 and the auxiliary expansion member 400 are to be contracted, the front cylinder portion of the syringe is inserted into the connector 505 of the injection section 500, and the pusher of the syringe is pulled to release the air inside the expansion member 100 and the auxiliary expansion. The air in the member 400 is discharged to the syringe.
　被覆部材２００は、図６に示すように、前腕部Ａの先端側に位置する手首付近の外周に沿って略一周巻き付けることが可能な可撓性を備える帯状の部材で形成している。図３に示すように、被覆部材２００の長手方向の一端部（図１の上側の端部）２０１の内面２００ａには、固定部材２１０を構成する第１固定部２１１が配置されている。また、被覆部材２００の長手方向の他端部（図１の下側の端部）２０２の外面２００ｂには、固定部材２１０を構成する第２固定部２１２が配置されている。 As shown in FIG. 6, the covering member 200 is formed of a flexible band-shaped member that can be wound substantially one round along the outer circumference near the wrist located on the tip side of the forearm portion A. As shown in FIG. 3, a first fixing portion 211 constituting the fixing member 210 is disposed on an inner surface 200 a of one end portion (upper end portion in FIG. 1) 201 of the covering member 200 in the longitudinal direction. Further, a second fixing portion 212 constituting the fixing member 210 is disposed on the outer surface 200b of the other end portion (lower end portion in FIG. 1) 202 of the covering member 200 in the longitudinal direction.
　第１固定部２１１および第２固定部２１２は、図１に示す平面図上において、被覆部材２００の長手方向に延びた長辺を備える長方形に形成している。 The first fixing portion 211 and the second fixing portion 212 are formed in a rectangular shape having long sides extending in the longitudinal direction of the covering member 200 on the plan view shown in FIG.
　第１固定部２１１は、例えば、面ファスナーの雌側（または雄側）で構成することができ、第２固定部２１２は、例えば、面ファスナーの雄側（または雌側）で構成することができる。面ファスナーは、面的に着脱可能なファスナーであり、例えば、Ｍａｇｉｃ　Ｔａｐｅ（登録商標）やＶｅｌｃｒｏ（登録商標）である。なお、固定部材２１０は、被覆部材２００を患者の前腕部Ａおよび手Ｈの少なくとも一方に固定することが可能であれば具体的な構造は特に限定されず、例えば、スナップ、ボタン、クリップ、被覆部材２００の長手方向の一端部２０１または被覆部材２００の長手方向の他端部２０２を通す枠部材等であってもよい。 For example, the first fixing portion 211 can be configured on the female side (or the male side) of the hook-and-loop fastener, and the second fixing portion 212 can be configured on the male side (or the female side) of the hook-and-loop fastener, for example. it can. The hook-and-loop fastener is a fastener that can be attached and detached from the surface, and is, for example, Magic @ Tape (registered trademark) or Velcro (registered trademark). The specific structure of the fixing member 210 is not particularly limited as long as the fixing member 210 can fix the covering member 200 to at least one of the forearm portion A and the hand H of the patient. A frame member or the like through which one longitudinal end 201 of the member 200 or the other longitudinal end 202 of the covering member 200 passes may be used.
　図１に示すように、被覆部材２００の中央線ｃ２は、固定部材２１０（第１固定部２１１、第２固定部２１２）の中心位置（固定部材２１０の幅方向の中心位置であり、図１の左右方向の中心位置）と重ねて配置されている。そのため、止血器具１０を患者に装着した際、固定部材２１０が拡張部材１００の第１領域１０１を患者に対して固定する固定力は、拡張部材１００の第１領域１０１の略全体に及ぶ。ここで、「固定部材２１０が拡張部材１００の第１領域１０１を患者に対して固定する固定力」とは、固定部材２１０が被覆部材２００を介して拡張部材１００の第１領域１０１を患者の皮膚に対して締め付ける力である。 As shown in FIG. 1, the center line c2 of the covering member 200 is the center position of the fixing member 210 (the first fixing portion 211 and the second fixing portion 212) (the center position in the width direction of the fixing member 210). Center position in the left-right direction). Therefore, when the hemostatic device 10 is mounted on a patient, the fixing force of the fixing member 210 fixing the first region 101 of the expansion member 100 to the patient extends over substantially the entire first region 101 of the expansion member 100. Here, “the fixing force by which the fixing member 210 fixes the first region 101 of the expansion member 100 to the patient” means that the fixing member 210 moves the first region 101 of the expansion member 100 through the covering member 200 to the patient. A force that tightens against the skin.
　被覆部材２００の中央線ｃ２は、被覆部材２００の幅方向の中心位置（図１の左右方向の中心位置）を通る線で定義される。被覆部材２００の中央線ｃ２は、固定部材２１０の幅方向の中心位置を通らなくてもよい。つまり、被覆部材２００の中央線ｃ２は、図１に示す平面図上における固定部材２１０の形状や固定部材２１０の中心位置の配置等には左右されない。また、被覆部材２００の中央線ｃ２は、被覆部材２００が長手方向に沿って略同一の幅を備える長方形状を有していない場合、例えば、被覆部材２００の拡張部材１００が配置された部分において、被覆部材２００の幅方向の中心位置を通る線で定義することができる。 The center line c2 of the covering member 200 is defined as a line passing through the center position in the width direction of the covering member 200 (the center position in the left-right direction in FIG. 1). The center line c2 of the covering member 200 does not have to pass through the center of the fixing member 210 in the width direction. That is, the center line c2 of the covering member 200 is not affected by the shape of the fixing member 210 in the plan view illustrated in FIG. In addition, when the covering member 200 does not have a rectangular shape having substantially the same width along the longitudinal direction, the center line c2 of the covering member 200 is, for example, a portion where the extension member 100 of the covering member 200 is arranged. , Can be defined by a line passing through the center position of the covering member 200 in the width direction.
　なお、固定部材２１０の形状は、後述する変形例（図２２、図２３を参照）でも説明するように、図１に示すような長方形のみに限定されることはない。 Note that the shape of the fixing member 210 is not limited to a rectangle as shown in FIG. 1 as described in a modified example (see FIGS. 22 and 23) described later.
　被覆部材２００に用いる材料は、特に限定されないが、例えば、ポリ塩化ビニル、ポリエチレン、ポリプロピレン、ポリブタジエン、エチレン－酢酸ビニル共重合体（ＥＶＡ）のようなポリオレフィン、ポリエチレンテレフタレート（ＰＥＴ）、ポリブチレンテレフタレート（ＰＢＴ）のようなポリエステル、ポリ塩化ビニリデン、シリコーン、ポリウレタン、ポリアミドエラストマー、ポリウレタンエラストマー、ポリエステルエラストマー等の各種熱可塑性エラストマー、ナイロン、ナイロンエラストマー、あるいはこれらを任意に組み合わせたもの（ブレンド樹脂、ポリマーアロイ、積層体等）が挙げられる。 Although the material used for the covering member 200 is not particularly limited, for example, polyvinyl chloride, polyethylene, polypropylene, polybutadiene, polyolefin such as ethylene-vinyl acetate copolymer (EVA), polyethylene terephthalate (PET), polybutylene terephthalate ( PBT), various thermoplastic elastomers such as polyvinylidene chloride, silicone, polyurethane, polyamide elastomer, polyurethane elastomer, polyester elastomer, nylon, nylon elastomer, or any combination thereof (blend resin, polymer alloy, Laminated body).
　支持部材３００に用いる材料は、特に限定されないが、支持部材３００が被覆部材２００と一体的に形成される場合、上記の被覆部材２００と同一の材料を例示することができる。 材料 The material used for the support member 300 is not particularly limited, but when the support member 300 is formed integrally with the covering member 200, the same material as the above-described covering member 200 can be exemplified.
　なお、支持部材３００が被覆部材２００と別部材で構成される場合、支持部材３００に用いられる材料は、被覆部材２００に用いられる材料よりも硬質なものであることが好ましい。そのような材料として、例えば、アクリル樹脂、ポリ塩化ビニル（特に硬質ポリ塩化ビニル）、ポリエチレン、ポリプロピレン、ポリブタジエンのようなポリオレフィン、ポリスチレン、ポリ－（４－メチルペンテン－１）、ポリカーボネート、ＡＢＳ樹脂、ポリメチルメタクリレート（ＰＭＭＡ）、ポリアセタール、ポリアクリレート、ポリアクリロニトリル、ポリフッ化ビニリデン、アイオノマー、アクリロニトリル－ブタジエン－スチレン共重合体、ポリエチレンテレフタレート（ＰＥＴ）、ポリブチレンテレフタレート（ＰＢＴ）のようなポリエステル、ブタジエン－スチレン共重合体、芳香族または脂肪族ポリアミド、ポリテトラフルオロエチレン等のフッ素系樹脂等を挙げることができる。上記のような硬質な材料で支持部材３００を構成する場合、止血器具１０には、支持部材３００を配置する部分に袋部（ポケット）を設けることができる。支持部材３００は、例えば、上記の袋部に挿入可能な湾曲した板状の部材（前腕部Ａや手Ｈの体表面の形状に沿って凸状に湾曲した内面を備える板状の部材等）で構成することができる。また、支持部材３００は、後述する実施形態で示すように、接着剤等で被覆部材２００の表面に貼り付けることにより、被覆部材２００に固定してもよい（図２１を参照）。 When the support member 300 is formed separately from the covering member 200, the material used for the support member 300 is preferably harder than the material used for the covering member 200. Such materials include, for example, acrylic resins, polyvinyl chloride (especially rigid polyvinyl chloride), polyethylene, polypropylene, polyolefins such as polybutadiene, polystyrene, poly- (4-methylpentene-1), polycarbonate, ABS resin, Polymethyl methacrylate (PMMA), polyacetal, polyacrylate, polyacrylonitrile, polyvinylidene fluoride, ionomer, acrylonitrile-butadiene-styrene copolymer, polyester such as polyethylene terephthalate (PET), polybutylene terephthalate (PBT), butadiene-styrene Examples thereof include copolymers, aromatic or aliphatic polyamides, and fluorine-based resins such as polytetrafluoroethylene. When the support member 300 is made of a hard material as described above, the hemostatic device 10 can be provided with a bag (pocket) at a portion where the support member 300 is arranged. The support member 300 is, for example, a curved plate-like member (for example, a plate-like member having an inner surface that is convexly curved along the shape of the body surface of the forearm portion A or the hand H) that can be inserted into the bag portion. Can be configured. Further, the support member 300 may be fixed to the covering member 200 by sticking it to the surface of the covering member 200 with an adhesive or the like as shown in an embodiment described later (see FIG. 21).
　拡張部材１００および補助拡張部材４００に用いられる材料は、例えば、被覆部材２００の材料として例示したものと同様のものを例示することができる。 材料 As the material used for the expansion member 100 and the auxiliary expansion member 400, for example, the same materials as those exemplified as the material of the covering member 200 can be exemplified.
　拡張部材１００の長手方向の長さ（図１の上下方向の長さ）および拡張部材１００の幅（図１の左右方向の長さ）は、止血器具１０を患者に装着した状態において、穿刺部位ｔに対して圧迫力を付与可能な限り、特に限定されない。また、拡張部材１００の第１領域１０１および第２領域１０２の長手方向の長さや幅も特に限定されない。また、補助拡張部材４００の長手方向の長さや幅も特に限定されない。また、支持部材３００の長手方向の長さや幅も特に限定されない。 The length of the expansion member 100 in the longitudinal direction (the length in the vertical direction in FIG. 1) and the width of the expansion member 100 (the length in the horizontal direction in FIG. 1) are determined when the hemostatic device 10 is attached to the patient. There is no particular limitation as long as a pressing force can be applied to t. Further, the length and width in the longitudinal direction of the first region 101 and the second region 102 of the expansion member 100 are not particularly limited. Further, the length and width of the auxiliary expansion member 400 in the longitudinal direction are not particularly limited. Further, the length and width of the support member 300 in the longitudinal direction are not particularly limited.
　また、被覆部材２００の長さや幅も、患者の前腕部Ａおよび手Ｈの少なくとも一方に被覆部材２００を装着した状態で固定することが可能な限り、特に限定されない。ただし、被覆部材２００の幅は、図１に示すように、拡張部材１００の幅よりも短い方が好ましい。患者の前腕部Ａよりも手指側に位置する手Ｈの甲Ｈｂ側を走行する手掌動脈（深掌動脈）Ｂの橈骨動脈側（例えば、解剖学上のスナッフボックス周辺の動脈又はスナッフボックスよりも指先側を走行する遠位橈骨動脈）を穿刺する際、手Ｈの穿刺部位ｔは、前腕部Ａから指先側に向かう方向において、尺骨の茎状突起Ｓに近い位置に形成される（図５を参照）。そのため、被覆部材２００の幅が拡張部材１００の幅よりも短く形成される場合、図５、図６に示すように患者に止血器具１０を装着した際、術者は、被覆部材２００の幅方向の一端部２０３を患者の尺骨の茎状突起Ｓに引っ掛けるように配置することが可能になる。止血器具１０を患者に装着した際に上記のように被覆部材２００を配置することにより、止血器具１０が位置ずれすることを好適に防止することができる。 The length and width of the covering member 200 are not particularly limited as long as the covering member 200 can be fixed to at least one of the forearm A and the hand H of the patient in a state where the covering member 200 is attached. However, the width of the covering member 200 is preferably shorter than the width of the expanding member 100 as shown in FIG. The radial artery side of the palm artery (deep palm artery) B that runs on the instep Hb side of the hand H located on the finger side of the patient's forearm A (for example, compared to the artery around the anatomical snuff box or the snuff box) When puncturing the distal radial artery running on the fingertip side), the puncture site t of the hand H is formed at a position close to the stalk-like projection S of the ulna in the direction from the forearm A to the fingertip side (FIG. 5). See). Therefore, when the width of the covering member 200 is formed to be shorter than the width of the expanding member 100, when the hemostatic device 10 is attached to the patient as shown in FIGS. Can be arranged so as to be hooked on the stalk S of the ulna of the patient. By disposing the covering member 200 as described above when the hemostatic device 10 is mounted on a patient, it is possible to preferably prevent the hemostatic device 10 from being displaced.
　次に、図４～図７を参照して、止血器具１０の使用例を説明する。 Next, an example of use of the hemostatic device 10 will be described with reference to FIGS.
　図４には、患者の手（左手）Ｈの甲Ｈｂに形成した穿刺部位ｔを介して手掌動脈Ｂの遠位橈骨動脈側にイントロデューサー６００のシースチューブ６１０を挿入して各種の手技を実施し終えた状態を示している。また、図４では、上記の手技を終えた後、穿刺部位ｔからシースチューブ６１０の一部を引き抜いた状態を示している。 In FIG. 4, various procedures are performed by inserting the sheath tube 610 of the introducer 600 into the distal radial artery side of the palmar artery B via the puncture site t formed on the back Hb of the patient's hand (left hand) H. FIG. FIG. 4 shows a state where a part of the sheath tube 610 has been pulled out from the puncture site t after the above procedure has been completed.
　術者等は、止血を開始するに際し、図４、図５に示すように、拡張部材１００の第１領域１０１と第２領域１０２の境界部ｂ１を穿刺部位ｔに重ねるように配置する。この際、術者等は、マーカー部１１７と穿刺部位ｔの位置を確認することにより、境界部ｂ１を穿刺部位ｔに容易に配置することができる。これにより、術者等は、穿刺部位ｔ付近を基準にして、第１領域１０１を前腕部Ａ側に配置することができ、第２領域１０２を手Ｈの先端側に配置することができる。 When starting the hemostasis, the surgeon or the like arranges the boundary portion b1 between the first region 101 and the second region 102 of the expansion member 100 so as to overlap the puncture site t, as shown in FIGS. At this time, the surgeon or the like can easily arrange the boundary portion b1 at the puncture site t by checking the positions of the marker portion 117 and the puncture site t. Thus, the surgeon or the like can arrange the first region 101 on the forearm A side and the second region 102 on the tip side of the hand H with reference to the vicinity of the puncture site t.
　次に、術者等は、図５に示すように、被覆部材２００を患者の前腕部Ａの先端側に位置する手首付近に巻き付ける。術者等は、被覆部材２００に設けられた固定部材２１０を使用して、止血器具１０を患者の前腕部Ａおよび手Ｈに固定する。 Next, as shown in FIG. 5, the surgeon or the like winds the covering member 200 around the wrist located on the distal end side of the forearm portion A of the patient. The surgeon or the like fixes the hemostatic device 10 to the forearm A and the hand H of the patient using the fixing member 210 provided on the covering member 200.
　術者等は、止血器具１０を患者に装着する際、図５に示すように、被覆部材２００の幅方向の一端部２０３の外周縁を患者の尺骨の茎状突起Ｓに引っ掛けるように配置することができる。このように被覆部材２００を配置することにより、止血器具１０を患者に装着した際、被覆部材２００が尺骨の茎状突起Ｓから前腕部Ａ側に位置ずれすることを好適に防止することができる。 When the surgeon or the like attaches the hemostatic device 10 to a patient, as shown in FIG. 5, the surgeon arranges the outer peripheral edge of one end portion 203 of the covering member 200 in the width direction so as to be hooked on the pedicle S of the ulna of the patient. be able to. By disposing the covering member 200 in this manner, when the hemostatic device 10 is mounted on a patient, it is possible to suitably prevent the covering member 200 from being displaced from the stalk-shaped projection S of the ulna toward the forearm A side. .
　次に、術者等は、注入部５００（図１を参照）およびシリンジ（図示省略）を使用して、拡張部材１００および補助拡張部材４００を拡張させる。拡張部材１００および補助拡張部材４００が拡張すると、拡張部材１００が穿刺部位ｔに対して圧迫力を付与する。 Next, the surgeon or the like expands the expansion member 100 and the auxiliary expansion member 400 using the injection section 500 (see FIG. 1) and a syringe (not shown). When the expansion member 100 and the auxiliary expansion member 400 expand, the expansion member 100 applies a pressing force to the puncture site t.
　次に、術者等は、図６に示すように、穿刺部位ｔに対して拡張部材１００が圧迫力を付与した状態を維持しながら、イントロデューサー６００のシースチューブ６１０を穿刺部位ｔから抜去する。なお、術者等は、穿刺部位ｔからイントロデューサー６００のシースチューブ６１０を抜去した後、拡張部材１００にさらに空気を注入して穿刺部位ｔに対して付与する圧迫力を増加させてもよい。拡張部材１００は、穿刺部位ｔからシースチューブ６１０が抜去された後も、拡張部材１００が拡張状態を維持することにより、穿刺部位ｔに対して圧迫力を付与し続ける。 Next, as shown in FIG. 6, the surgeon or the like removes the sheath tube 610 of the introducer 600 from the puncture site t while maintaining a state in which the expanding member 100 applies a compressive force to the puncture site t. . After removing the sheath tube 610 of the introducer 600 from the puncture site t, the surgeon or the like may further inject air into the expansion member 100 to increase the pressing force applied to the puncture site t. Even after the sheath tube 610 is removed from the puncture site t, the expansion member 100 keeps applying a compressive force to the puncture site t by maintaining the expanded member 100 in the expanded state.
　患者に装着された止血器具１０は、被覆部材２００とともに拡張部材１００の第１領域１０１が前腕部Ａの先端側に位置する手首付近の周方向（図６および図７の矢印ｒ１、ｒ２で示す方向であり、手の甲Ｈｂ側と手の掌側とを結ぶ方向）に沿って巻き付けられた状態で固定される。そのため、拡張部材１００の第１領域１０１は、被覆部材２００に設けられた固定部材２１０により、前腕部Ａおよび手Ｈの前腕部Ａ付近（手首付近）に対して締め付けられる。 The hemostatic device 10 attached to the patient has a circumferential direction near the wrist where the first region 101 of the expanding member 100 is located on the tip side of the forearm portion A together with the covering member 200 (indicated by arrows r1 and r2 in FIGS. 6 and 7). Direction (the direction connecting the back of the hand Hb side and the palm side of the hand). Therefore, the first region 101 of the expansion member 100 is fastened to the vicinity of the forearm A and the vicinity of the forearm A of the hand H (near the wrist) by the fixing member 210 provided on the covering member 200.
　なお、止血器具１０を使用した止血を行う際、拡張部材１００を患者の肢体に対して固定する位置は特に限定されない。例えば、前腕部Ａおよび手Ｈの一方に対して拡張部材１００を固定してもよいし、前腕部Ａおよび手Ｈの両方に対して拡張部材１００を固定してもよい。 When performing hemostasis using the hemostatic device 10, the position at which the expansion member 100 is fixed to the patient's limb is not particularly limited. For example, the expansion member 100 may be fixed to one of the forearm A and the hand H, or the expansion member 100 may be fixed to both the forearm A and the hand H.
　また、止血器具１０が患者に装着される前の状態において、止血器具１０は、拡張部材の第２領域１０２と被覆部材２００に設けられた固定部材２１０とが長手方向で重ならないように構成されている。そのため、止血器具１０が患者に装着された状態において、拡張部材１００の第２領域１０２は、被覆部材２００の長手方向において、固定部材２１０よりも手Ｈの先端側に配置される。それにより、被覆部材２００に設けられた固定部材２１０が拡張部材１００の第２領域１０２に及ぼす力は、固定部材２１０が拡張部材１００の第１領域１０１に付与する固定力よりも小さい。従って、止血器具１０が患者に装着された状態で、拡張部材１００の第２領域１０２は、患者の手Ｈの指の動きに追従するように可動できる。そのため、患者が指を動かした際に、指の動きが第２領域１０２側から第１領域１０１側へ伝わり難くなる。それにより、拡張部材１００は、止血器具１０が患者に装着された状態で患者が手Ｈを動かした際に、拡張部材１００全体が指の動きに同伴して動くことを抑制できる。それにより、拡張部材１００は、拡張部材１００の第１領域１０１が患者の前腕部Ａに対して固定された状態を好適に維持できる。従って、止血器具１０は、拡張部材１００から穿刺部位ｔに対して圧迫力を効果的に付与した状態を安定的に維持することができる。 Before the hemostatic device 10 is attached to the patient, the hemostatic device 10 is configured such that the second region 102 of the expansion member and the fixing member 210 provided on the covering member 200 do not overlap in the longitudinal direction. ing. Therefore, in a state in which the hemostatic device 10 is mounted on the patient, the second region 102 of the expansion member 100 is disposed closer to the distal end of the hand H than the fixing member 210 in the longitudinal direction of the covering member 200. Thus, the force applied by the fixing member 210 provided on the covering member 200 to the second region 102 of the expansion member 100 is smaller than the fixing force applied by the fixing member 210 to the first region 101 of the expansion member 100. Therefore, with the hemostatic device 10 attached to the patient, the second region 102 of the expansion member 100 is movable to follow the movement of the finger of the hand H of the patient. Therefore, when the patient moves the finger, the movement of the finger becomes difficult to be transmitted from the second area 102 to the first area 101. Thereby, when the patient moves the hand H with the hemostatic device 10 attached to the patient, the expansion member 100 can suppress the entire expansion member 100 from moving along with the movement of the finger. Thereby, the expansion member 100 can suitably maintain the state where the first region 101 of the expansion member 100 is fixed to the forearm A of the patient. Therefore, the hemostatic device 10 can stably maintain a state in which the compressive force is effectively applied from the expansion member 100 to the puncture site t.
　また、補助拡張部材４００は、拡張部材１００と支持部材３００との間に配置されている（図２Ｂを参照）。そのため、補助拡張部材４００は、拡張部材１００が拡張した際、拡張部材１００が患者の体表面から浮き上がるのを抑制する。従って、拡張部材１００は、拡張部材１００が拡張した状態で、穿刺部位ｔに対して効果的に圧迫力を付与することができる。 補助 The auxiliary expansion member 400 is disposed between the expansion member 100 and the support member 300 (see FIG. 2B). Therefore, when the expanding member 100 expands, the auxiliary expanding member 400 suppresses the floating of the expanding member 100 from the body surface of the patient. Therefore, the expanding member 100 can effectively apply a compressive force to the puncture site t in a state where the expanding member 100 is expanded.
　また、補助拡張部材４００は、被覆部材２００の長手方向に沿って拡張部材１００の第２領域１０２および支持部材３００と重なるように配置されている（図１を参照）。そのため、図７に示すように、止血器具１０を患者に装着した状態において、補助拡張部材４００は、手Ｈの周方向の広い範囲に亘って配置される。患者の手Ｈに位置する手掌動脈Ｂの遠位橈骨動脈側は、患者によっては、患者の手Ｈの周方向に沿って蛇行している。補助拡張部材４００が上記のように手Ｈの周方向の広い範囲に亘って配置されるため、補助拡張部材４００は、手Ｈの周方向の広い範囲に亘って拡張部材１００を押圧することができる。そのため、止血器具１０は、患者の手Ｈに位置する手掌動脈Ｂの遠位橈骨動脈側が蛇行しているような場合においても、拡張部材１００が手掌動脈Ｂの遠位橈骨動脈側に対して効果的に圧迫力を付与することが可能になる。 The auxiliary expansion member 400 is disposed so as to overlap the second region 102 of the expansion member 100 and the support member 300 along the longitudinal direction of the covering member 200 (see FIG. 1). Therefore, as shown in FIG. 7, when the hemostatic device 10 is attached to a patient, the auxiliary expansion member 400 is arranged over a wide range in the circumferential direction of the hand H. The distal radial artery side of the palm artery B located on the patient's hand H is meandering along the circumferential direction of the patient's hand H depending on the patient. Since the auxiliary expansion member 400 is arranged over a wide range in the circumferential direction of the hand H as described above, the auxiliary expansion member 400 can press the expansion member 100 over a wide range in the circumferential direction of the hand H. it can. Therefore, even when the distal radial artery side of the palm artery B located in the patient's hand H is meandering, the hemostatic device 10 is effective for the expansion member 100 on the distal radial artery side of the palm artery B. It becomes possible to apply a compressive force.
　また、補助拡張部材４００は、補助拡張部材４００の幅方向の他端部４０４が支持部材３００と接続されており、補助拡張部材４００の幅方向の一端部４０３が支持部材３００とは接続されていない（図２Ｂを参照）。そのため、止血器具１０が患者の手Ｈに装着されて、かつ、補助拡張部材４００が拡張した状態において、補助拡張部材４００の幅方向の一端部４０３側は、補助拡張部材４００の幅方向の他端部４０４側を支点とし、患者の手Ｈの動きに追従して変形しやすくなる。従って、止血器具１０は、止血器具１０を装着した患者が手Ｈを握り込む等の動作をして手Ｈが曲げられる際に、補助拡張部材４００の幅方向の一端部４０３側が手Ｈの形状に追従するように湾曲する。それにより、補助拡張部材４００は、患者が手Ｈを握り込む等の動作をした場合においても、拡張部材１００が患者の体表面から浮き上がるのを効果的に抑制することができる。 In the auxiliary extension member 400, the other end 404 in the width direction of the auxiliary extension member 400 is connected to the support member 300, and one end 403 in the width direction of the auxiliary extension member 400 is connected to the support member 300. No (see FIG. 2B). Therefore, in a state where the hemostatic device 10 is mounted on the hand H of the patient and the auxiliary expansion member 400 is expanded, one end 403 of the auxiliary expansion member 400 in the width direction is the other end of the auxiliary expansion member 400 in the width direction. The end portion 404 is used as a fulcrum, and is easily deformed following the movement of the hand H of the patient. Accordingly, when the patient wearing the hemostatic device 10 bends the hand H by performing an operation such as grasping the hand H, the one end 403 side of the auxiliary expanding member 400 in the width direction of the auxiliary expanding member 400 has the shape of the hand H. To follow. Accordingly, even when the patient performs an operation such as gripping the hand H, the auxiliary expansion member 400 can effectively prevent the expansion member 100 from rising from the body surface of the patient.
　また、支持部材３００は、拡張部材１００および補助拡張部材４００が拡張した際、補助拡張部材４００の外面側から拡張部材１００の第２領域１０２を押さえる。それにより、支持部材３００は、拡張部材１００の第２領域１０２が被覆部材２００の長手方向に沿って変形することを許容しつつ、拡張部材１００の第２領域１０２が患者の手Ｈの体表面から離れる方向に拡張するのを抑制する。従って、拡張部材１００は、拡張部材１００が拡張した状態において、患者が手Ｈを握り込む等の動作をした場合においても、穿刺部位ｔ周辺に対して効果的に圧迫力を付与することができる。 支持 Also, when the expansion member 100 and the auxiliary expansion member 400 expand, the support member 300 presses the second region 102 of the expansion member 100 from the outer surface side of the auxiliary expansion member 400. Accordingly, the support member 300 allows the second region 102 of the expansion member 100 to be deformed along the longitudinal direction of the covering member 200 while the second region 102 of the expansion member 100 Suppress expansion in the direction away from. Therefore, the expansion member 100 can effectively apply a compressive force to the vicinity of the puncture site t even when the patient performs an operation such as gripping the hand H in a state where the expansion member 100 is expanded. .
　また、本実施形態では、拡張部材１００は支持部材３００と接続されている（図２Ｂを参照）。そのため、拡張部材１００が拡張した際、拡張部材１００が支持部材３００から位置ずれすることを防止できる。同様に、補助拡張部材４００は支持部材３００と接続されている。そのため、補助拡張部材４００が拡張した際、補助拡張部材４００が支持部材３００から位置ずれすることを防止できる。また、止血器具１０が患者の手Ｈに装着されて、かつ、補助拡張部材４００が拡張した状態において、拡張部材１００の第２領域１０２は、被覆部材２００により患者の皮膚に対して締め付けられていない。本実施形態では、拡張部材１００が支持部材３００と接続されているため、拡張部材１００の第２領域１０２が支持部材３００に対して位置ずれすることを防止できる。 In addition, in this embodiment, the expansion member 100 is connected to the support member 300 (see FIG. 2B). Therefore, when the expansion member 100 expands, the expansion member 100 can be prevented from being displaced from the support member 300. Similarly, the auxiliary expansion member 400 is connected to the support member 300. Therefore, when the auxiliary expansion member 400 expands, the auxiliary expansion member 400 can be prevented from being displaced from the support member 300. In a state where the hemostatic device 10 is attached to the patient's hand H and the auxiliary expansion member 400 is expanded, the second region 102 of the expansion member 100 is fastened to the patient's skin by the covering member 200. Absent. In the present embodiment, since the expansion member 100 is connected to the support member 300, it is possible to prevent the second region 102 of the expansion member 100 from being displaced with respect to the support member 300.
　以上、本実施形態に係る止血器具１０は、患者の手Ｈの穿刺部位ｔに配置される拡張部材（押圧部材）１００と、拡張部材１００が穿刺部位ｔを覆った状態で、拡張部材１００の少なくとも一部を覆う被覆部材２００と、を備えており、被覆部材２００は、拡張部材１００が穿刺部位ｔを覆った状態で、拡張部材１００を前腕部Ａおよび手Ｈの少なくとも一方に対して固定する固定部材２１０を有している。拡張部材１００は、拡張部材１００の中央線ｃ１と被覆部材２００の中央線ｃ２とが一致しない位置で被覆部材２００に設けられているとともに、被覆部材２００上で被覆部材２００の長手方向において固定部材２１０と重なる第１領域１０１と、第１領域１０１よりも手Ｈの先端側に配置される第２領域１０２と、を有している。そして、拡張部材１００の第２領域１０２は、被覆部材２００が前腕部Ａおよび手Ｈの少なくとも一方に拡張部材１００を固定した状態で、固定部材２１０が第１領域１０１に付与する固定力よりも小さな力で手Ｈに対して保持される。 As described above, the hemostatic device 10 according to the present embodiment includes the expansion member (pressing member) 100 disposed at the puncture site t of the patient's hand H and the expansion member 100 with the expansion member 100 covering the puncture site t. And a covering member 200 that covers at least a part thereof, wherein the covering member 200 fixes the expansion member 100 to at least one of the forearm portion A and the hand H in a state where the extension member 100 covers the puncture site t. The fixing member 210 is provided. The extension member 100 is provided on the covering member 200 at a position where the center line c1 of the extension member 100 does not coincide with the center line c2 of the covering member 200, and the fixing member is disposed on the covering member 200 in the longitudinal direction of the covering member 200. The first region 101 includes a first region 101 overlapping with the second region 210 and a second region 102 disposed closer to the distal end of the hand H than the first region 101 is. The second region 102 of the expanding member 100 is smaller than the fixing force applied by the fixing member 210 to the first region 101 when the covering member 200 fixes the expanding member 100 to at least one of the forearm A and the hand H. It is held against the hand H with a small force.
　また、本実施形態に係る止血器具１０は、患者の手Ｈの穿刺部位ｔに配置される拡張部材（押圧部材）１００と、拡張部材１００が穿刺部位ｔを覆った状態で、拡張部材１００の少なくとも一部を覆う被覆部材２００と、を備えており、被覆部材２００は、拡張部材１００が穿刺部位ｔを覆った状態で、拡張部材１００を前腕部Ａおよび手Ｈの少なくとも一方に対して固定する固定部材２１０を有している。拡張部材１００は、拡張部材１００の中央線ｃ１と被覆部材２００の中央線ｃ２とが一致しない位置で被覆部材２００に設けられているとともに、被覆部材２００上で被覆部材２００の長手方向において固定部材２１０と重なる第１領域１０１と、第１領域１０１よりも手Ｈの先端側に配置される第２領域１０２と、を有している。被覆部材２００は、第２領域１０２側に延在する領域に、拡張部材１００を手Ｈに対して固定する固定部材２１０を有していない。 In addition, the hemostatic device 10 according to the present embodiment includes an expansion member (pressing member) 100 disposed at the puncture site t of the patient's hand H, and the expansion member 100 with the expansion member 100 covering the puncture site t. And a covering member 200 that covers at least a part thereof, wherein the covering member 200 fixes the expansion member 100 to at least one of the forearm portion A and the hand H in a state where the extension member 100 covers the puncture site t. The fixing member 210 is provided. The extension member 100 is provided on the covering member 200 at a position where the center line c1 of the extension member 100 does not coincide with the center line c2 of the covering member 200, and the fixing member is disposed on the covering member 200 in the longitudinal direction of the covering member 200. The first region 101 includes a first region 101 overlapping with the second region 210 and a second region 102 disposed closer to the distal end of the hand H than the first region 101 is. The covering member 200 does not have the fixing member 210 for fixing the expansion member 100 to the hand H in a region extending to the second region 102 side.
　上記のように構成した止血器具１０は、拡張部材１００の第１領域１０１が前腕部Ａおよび手Ｈの少なくとも一方に対してしっかりと固定されるとともに、拡張部材１００の第２領域１０２が第１領域１０１よりも手Ｈの先端側で可動性を持った状態で保持される。そのため、止血器具１０は、止血器具１０を患者に装着した状態で患者が手Ｈを動かした際、拡張部材１００の第１領域１０１が拡張部材１００の位置ずれを防止するとともに、拡張部材１００の第２領域１０２が拡張部材１００の第１領域１０１よりも固定部材２１０により手Ｈの表面に対して締め付けられていないため、患者の手Ｈの動きに追従するように変形する。止血器具１０は、止血器具１０が患者に装着された状態で、上記のように拡張部材１００の第２領域１０２が患者の手Ｈの動きに追従するように変形することにより、患者が手Ｈを動かした際に生じる力が拡張部材１００の第１領域１０１へ伝わることを抑制できる。そのため、止血器具１０は、拡張部材１００の第１領域１０１が位置ずれすることを防止でき、拡張部材１００の穿刺部位ｔへの圧迫力を維持できる。また、止血器具１０は、患者の手Ｈに止血器具１０を装着した状態で、固定部材２１０により、患者の手Ｈに対して拡張部材１００の第２領域１０２を締め付けていない。そのため、止血器具１０は、患者の手Ｈに装着された状態で、患者の指先側において、手Ｈの動きが固定部材２１０により制限されることを抑制する。従って、患者は、止血器具１０を装着した状態でも、過剰に手Ｈの動きが制限されることがない。 In the hemostatic device 10 configured as described above, the first region 101 of the expanding member 100 is firmly fixed to at least one of the forearm A and the hand H, and the second region 102 of the expanding member 100 is It is held in a state having mobility on the tip side of the hand H with respect to the area 101. Therefore, when the patient moves the hand H with the hemostatic device 10 attached to the patient, the first region 101 of the expanding member 100 prevents the expansion member 100 from being displaced and Since the second region 102 is not tightened to the surface of the hand H by the fixing member 210 than the first region 101 of the expansion member 100, the second region 102 is deformed so as to follow the movement of the patient's hand H. When the hemostatic device 10 is attached to the patient, the second region 102 of the expansion member 100 is deformed so as to follow the movement of the patient's hand H as described above. Is transmitted to the first region 101 of the expansion member 100. Therefore, the hemostatic device 10 can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force of the expansion member 100 on the puncture site t. In the hemostatic device 10, the second region 102 of the expansion member 100 is not fastened to the patient's hand H by the fixing member 210 in a state where the hemostatic device 10 is mounted on the patient's hand H. Therefore, the hemostatic device 10 suppresses the movement of the hand H on the fingertip side of the patient from being restricted by the fixing member 210 in a state of being mounted on the patient's hand H. Therefore, the movement of the hand H is not excessively restricted even when the patient wears the hemostatic device 10.
　また、押圧部材１００は、流体の注入により拡張可能な袋体１１０と、袋体１１０に囲われた拡張空間１１５と、を備える拡張部材１００である。そのため、術者等は、拡張部材１００の拡張空間１１５への流体の注入と、拡張部材１００の拡張空間１１５からの流体の排出を操作することにより、拡張部材１００が穿刺部位ｔに対して付与する圧迫力を容易に調整することができる。 押 圧 The pressing member 100 is an expansion member 100 including a bag body 110 expandable by injecting a fluid, and an expansion space 115 surrounded by the bag body 110. Therefore, the surgeon or the like operates the injection of the fluid into the expansion space 115 of the expansion member 100 and the discharge of the fluid from the expansion space 115 of the expansion member 100 so that the expansion member 100 applies the expansion member 100 to the puncture site t. The pressing force to be applied can be easily adjusted.
　また、押圧部材１００が拡張可能な袋体１１０を有する拡張部材１００の場合、止血器具１０は、患者の体表面から離れる方向への拡張部材１００の拡張を抑制する支持部材３００を有している方が好ましい。このような構成の場合、支持部材３００は、拡張部材１００が拡張した際、拡張部材１００の第２領域１０２が患者の体表面から離れる方向へ拡張することが抑制されるため、穿刺部位ｔに対して効果的に圧迫力を付与することができる。また、拡張部材１００が袋体１１０であるため、支持部材３００は、拡張部材１００が拡張した際、患者の皮膚側に向って袋体１１０の表面を押圧するため、穿刺部位ｔに対して効果的に圧迫力を付与することができる。 In the case where the pressing member 100 is the expanding member 100 having the expandable bag body 110, the hemostatic device 10 includes a support member 300 that suppresses expansion of the expanding member 100 in a direction away from the patient's body surface. Is more preferred. In the case of such a configuration, when the expansion member 100 expands, the support member 300 prevents the second region 102 of the expansion member 100 from expanding in a direction away from the patient's body surface. Compression force can be effectively applied to this. Further, since the expansion member 100 is the bag 110, the support member 300 presses the surface of the bag 110 toward the patient's skin when the expansion member 100 expands, so that the support member 300 has an effect on the puncture site t. Compression force can be given to the user.
　また、止血器具１０は、患者の体表面から離れる方向への拡張部材１００の拡張を抑制する支持部材３００を有している。支持部材３００は、拡張部材１００の第２領域１０２を覆いつつ被覆部材２００に接続されており、拡張部材１００の袋体１１０は、支持部材３００に接続されている。そのため、拡張部材１００は、拡張部材１００が拡張した際、拡張部材１００の第２領域１０２が患者の体表面から離れる方向へ拡張することが抑制されるため、穿刺部位ｔに対して効果的に圧迫力を付与することができる。また、支持部材３００は、被覆部材２００に接続されているため、止血器具１０を患者に装着した状態において、支持部材３００が被覆部材２００から位置ずれすることを防止できる。また、拡張部材１００は、支持部材３００に接続されているため、拡張部材１００が拡張した際、拡張部材１００の第２領域１０２が支持部材３００から位置ずれすることを抑制できる。 血 Moreover, the hemostatic device 10 has the support member 300 which suppresses expansion of the expansion member 100 in the direction away from the patient's body surface. The support member 300 is connected to the covering member 200 while covering the second region 102 of the expansion member 100, and the bag 110 of the expansion member 100 is connected to the support member 300. Therefore, when the expansion member 100 expands, the expansion member 100 is suppressed from expanding in the direction away from the patient's body surface when the expansion member 100 expands, so that the puncture site t is effectively prevented. Compression force can be applied. In addition, since the support member 300 is connected to the covering member 200, the support member 300 can be prevented from being displaced from the covering member 200 in a state where the hemostatic device 10 is attached to the patient. Further, since the expansion member 100 is connected to the support member 300, when the expansion member 100 expands, the second region 102 of the expansion member 100 can be prevented from being displaced from the support member 300.
　また、止血器具１０は、支持部材３００と拡張部材１００との間に配置されるとともに、支持部材３００に接続された補助拡張部材４００を有している。補助拡張部材４００は、拡張部材１００の拡張空間１１５と連通する空間部４１５と、空間部４１５を覆う袋体４１０と、を有している。補助拡張部材４００は、補助拡張部材４００が拡張した際、拡張部材１００と支持部材３００との間で拡張部材１００が患者の体表面から浮き上がるのを抑制する。従って、拡張部材１００は、拡張部材１００が拡張した状態で、拡張部材１００の第２領域１０２が被覆部材２００の長手方向に沿って変形することを許容しつつ、穿刺部位ｔに対して効果的に圧迫力を付与することができる。また、補助拡張部材４００は、支持部材３００に接続されているため、補助拡張部材４００が拡張した際、補助拡張部材４００が支持部材３００から位置ずれすることを抑制できる。 血 Furthermore, the hemostatic device 10 is provided between the support member 300 and the expansion member 100 and has an auxiliary expansion member 400 connected to the support member 300. The auxiliary expansion member 400 includes a space 415 that communicates with the expansion space 115 of the expansion member 100, and a bag 410 that covers the space 415. When the auxiliary expansion member 400 expands, the auxiliary expansion member 400 suppresses the floating of the expansion member 100 from the body surface of the patient between the expansion member 100 and the support member 300. Therefore, the expansion member 100 is effective for the puncture site t while allowing the second region 102 of the expansion member 100 to deform along the longitudinal direction of the covering member 200 in a state where the expansion member 100 is expanded. Compression force can be applied to the body. In addition, since the auxiliary expansion member 400 is connected to the support member 300, when the auxiliary expansion member 400 expands, the auxiliary expansion member 400 can be prevented from being displaced from the support member 300.
　また、補助拡張部材４００は、被覆部材２００の長手方向に沿って拡張部材１００の第２領域１０２および支持部材３００と重なるように配置されている。そのため、補助拡張部材４００は、止血器具１０を患者に装着した状態において、補助拡張部材４００が手Ｈの周方向の広い範囲に亘って配置される。従って、止血器具１０は、患者の手Ｈに位置する手掌動脈Ｂの遠位橈骨動脈側が手Ｈの周方向に沿って蛇行しているような場合においても、補助拡張部材４００を手掌動脈Ｂの遠位橈骨動脈側に重なるように配置することができる。そのため、補助拡張部材４００が拡張した際に補助拡張部材４００により押圧される拡張部材１００は、手掌動脈Ｂの遠位橈骨動脈側に対して効果的に圧迫力を付与することが可能になる。 The auxiliary expansion member 400 is arranged so as to overlap the second region 102 of the expansion member 100 and the support member 300 along the longitudinal direction of the covering member 200. Therefore, the auxiliary expansion member 400 is arranged over a wide range in the circumferential direction of the hand H when the hemostatic device 10 is mounted on the patient. Therefore, even when the distal radial artery side of the palm artery B located in the hand H of the patient is meandering along the circumferential direction of the hand H, the hemostatic device 10 allows the auxiliary expansion member 400 to move to the palm artery B. It can be arranged to overlap the distal radial artery side. Therefore, the expansion member 100 pressed by the auxiliary expansion member 400 when the auxiliary expansion member 400 expands can effectively apply a compressive force to the distal radial artery side of the palmar artery B.
　また、止血器具１０は、拡張部材１００を穿刺部位ｔに対して位置合わせするためのマーカー部１１７を有している。マーカー部１１７は、拡張部材１００の第１領域１０１と拡張部材１００の第２領域１０２の境界部ｂ１に対応する位置に配置している。そのため、術者等は、穿刺部位ｔに拡張部材１００を配置する際、マーカー部１１７の位置を確認することにより、拡張部材１００の第１領域１０１と第２領域１０２の境界部ｂ１を穿刺部位ｔに容易に位置合わせすることができる。それにより、術者等は、止血器具１０を患者に装着した際、拡張部材１００の第１領域１０１を穿刺部位ｔから見て前腕部Ａ側に配置することができ、拡張部材１００の第２領域１０２を穿刺部位ｔから見て手Ｈの先端側に配置することができる。従って、術者等は、マーカー部により、止血器具１０を患者に簡便に配置することができ、穿刺部位ｔに対して拡張部材１００の圧迫力を効果的に付与することができる。 血 Furthermore, hemostatic device 10 has marker portion 117 for positioning expansion member 100 with respect to puncture site t. The marker portion 117 is disposed at a position corresponding to a boundary portion b1 between the first region 101 of the expansion member 100 and the second region 102 of the expansion member 100. Therefore, when the operator or the like places the expansion member 100 at the puncture site t, the operator confirms the position of the marker portion 117, and thereby the boundary portion b1 between the first region 101 and the second region 102 of the expansion member 100 punctures the puncture site. t can be easily aligned. Thereby, when the operator or the like attaches the hemostatic device 10 to the patient, the surgeon or the like can arrange the first region 101 of the expansion member 100 on the forearm A side when viewed from the puncture site t. The region 102 can be arranged on the tip side of the hand H when viewed from the puncture site t. Therefore, the surgeon or the like can easily arrange the hemostatic device 10 on the patient by the marker portion, and can effectively apply the pressing force of the expansion member 100 to the puncture site t.
　（第２実施形態）
　次に、本発明の第２実施形態に係る止血器具１０Ａを説明する。第２実施形態の説明では、第１実施形態で既に説明した構成等についての詳細な説明は省略する。また、第２実施形態の説明で特に説明がない内容については、第１実施形態と同一のものとすることができる。 (2nd Embodiment)
Next, a hemostatic device 10A according to a second embodiment of the present invention will be described. In the description of the second embodiment, a detailed description of the configuration and the like already described in the first embodiment will be omitted. In the description of the second embodiment, contents that are not particularly described can be the same as those in the first embodiment.
　図８、図９Ａ、図９Ｂは、第２実施形態に係る止血器具１０Ａを説明するための図、図１０、図１１は、止血器具１０Ａの使用例を説明するための図である。 FIGS. 8, 9A, and 9B are diagrams for explaining the hemostatic device 10A according to the second embodiment, and FIGS. 10 and 11 are diagrams for explaining a usage example of the hemostatic device 10A.
　第２実施形態に係る止血器具１０Ａは、第１実施形態に係る止血器具１０と補助拡張部材４００Ａの配置が相違する。 血 The hemostatic device 10A according to the second embodiment is different from the hemostatic device 10 according to the first embodiment in the arrangement of the auxiliary expansion member 400A.
　止血器具１０Ａは、図８に示すように、補助拡張部材４００Ａが、被覆部材２００の長手方向と交差する方向（被覆部材２００の幅方向であり、図中の矢印Ｙ１－Ｙ２方向）に沿って拡張部材１００の第１領域１０１、拡張部材１００の第２領域１０２、および支持部材３００と重なるように配置されている。 In the hemostatic device 10A, as shown in FIG. 8, the auxiliary expansion member 400A extends along a direction intersecting with the longitudinal direction of the covering member 200 (the width direction of the covering member 200 and the direction of arrow Y1-Y2 in the drawing). The first region 101 of the expansion member 100, the second region 102 of the expansion member 100, and the support member 300 are disposed so as to overlap.
　補助拡張部材４００Ａの被覆部材２００の長手方向に沿う長さは、拡張部材１００の被覆部材２００の長手方向に沿う長さの略１／２である。また、補助拡張部材４００Ａは、被覆部材２００の長手方向の一端部２０１側に位置する拡張部材１００の端部１０５側に寄せて配置している。補助拡張部材４００Ａは、図８に示す平面図上で、補助拡張部材４００Ａの延在方向（図８の左右方向）が被覆部材２００の長手方向と直交するように配置されている。 長 The length of the auxiliary extension member 400A along the longitudinal direction of the covering member 200 is approximately ２ of the length of the extension member 100 along the longitudinal direction of the covering member 200. The auxiliary expansion member 400 </ b> A is arranged closer to the end 105 of the expansion member 100 located on the one end 201 side of the covering member 200 in the longitudinal direction. The auxiliary expansion member 400A is arranged such that the extension direction (the left-right direction in FIG. 8) of the auxiliary expansion member 400A is orthogonal to the longitudinal direction of the covering member 200 on the plan view shown in FIG.
　図９Ａ、図９Ｂに示すように、拡張部材１００の幅方向の他端部１０４と、補助拡張部材４００Ａの他端部４０４と、支持部材３００の幅方向の他端部３０４は、互いに接続されている。なお、拡張部材１００の幅方向の他端部１０４、及び、補助拡張部材４００Ａの幅方向の他端部４０４は、互いに近接する異なる位置で、支持部材３００の幅方向の他端部３０４に接続されていてもよい。また、拡張部材１００と補助拡張部材４００Ａは、拡張部材１００の連通孔１１６の周囲および補助拡張部材４００Ａの連通孔４１６の周囲でも互いに接続されている。 As shown in FIGS. 9A and 9B, the other end 104 in the width direction of the expansion member 100, the other end 404 of the auxiliary expansion member 400A, and the other end 304 in the width direction of the support member 300 are connected to each other. ing. The other end 104 in the width direction of the expansion member 100 and the other end 404 in the width direction of the auxiliary expansion member 400A are connected to the other end 304 in the width direction of the support member 300 at different positions close to each other. It may be. The expansion member 100 and the auxiliary expansion member 400A are also connected to each other also around the communication hole 116 of the expansion member 100 and around the communication hole 416 of the auxiliary expansion member 400A.
　拡張部材１００および補助拡張部材４００Ａは、支持部材３００と接続されることにより、支持部材３００を介して被覆部材２００と接続されている。拡張部材１００の幅方向の一端部１０３と、補助拡張部材４００Ａの一端部４０３と、被覆部材２００の幅方向の一端部２０３は、接続されていない。 The expansion member 100 and the auxiliary expansion member 400A are connected to the cover member 200 via the support member 300 by being connected to the support member 300. One end 103 in the width direction of the expansion member 100, one end 403 of the auxiliary expansion member 400A, and one end 203 of the covering member 200 in the width direction are not connected.
　図９Ｂに示すように、拡張部材１００および補助拡張部材４００Ａが拡張した際、拡張部材１００の幅方向の他端部１０４付近と補助拡張部材４００Ａの他端部４０４付近との間には、隙間ｇが形成される。 As shown in FIG. 9B, when the expansion member 100 and the auxiliary expansion member 400A expand, a gap is provided between the vicinity of the other end portion 104 of the expansion member 100 in the width direction and the vicinity of the other end portion 404 of the auxiliary expansion member 400A. g is formed.
　次に、図１０、図１１を参照して、止血器具１０Ａの使用例を説明する。 Next, an example of use of the hemostatic device 10A will be described with reference to FIGS.
　術者等は、図１０に示すように、拡張部材１００の第１領域１０１と拡張部材１００の第２領域１０２の境界部ｂ１に対応する位置に配置されたマーカー部１１７を穿刺部位ｔに位置合わせして、拡張部材１００を患者の前腕部Ａおよび手Ｈに配置する。術者等は、固定部材２１０を使用して、拡張部材１００を患者に対して固定する。 As shown in FIG. 10, the surgeon or the like positions the marker portion 117 disposed at a position corresponding to the boundary portion b1 between the first region 101 of the expansion member 100 and the second region 102 of the expansion member 100 at the puncture site t. In combination, the expansion member 100 is placed on the forearm A and the hand H of the patient. The surgeon or the like uses the fixing member 210 to fix the expansion member 100 to the patient.
　前述したように補助拡張部材４００Ａは、補助拡張部材４００Ａが被覆部材２００の長手方向の一端部２０１側に位置する拡張部材１００の端部１０５側に寄せて配置されている（図８を参照）。そのため、補助拡張部材４００Ａは、拡張部材１００を患者に対して固定した状態において、図１０、図１１に示すように、手Ｈの周方向の外側（図１０、図１１の矢印ｒ２で示す側であり、手Ｈの甲Ｈｂ側を手Ｈの上面側とした場合に患者の胴体が配置される側）に配置される。 As described above, the auxiliary expansion member 400A is arranged such that the auxiliary expansion member 400A is positioned closer to the end portion 105 of the expansion member 100 located on the one end portion 201 side of the covering member 200 in the longitudinal direction (see FIG. 8). . Therefore, in a state where the expansion member 100 is fixed to the patient, the auxiliary expansion member 400A is positioned on the outer side in the circumferential direction of the hand H (the side indicated by the arrow r2 in FIGS. When the upper Hb side of the hand H is set to the upper surface side of the hand H, the hand H is disposed on the side where the torso of the patient is disposed).
　図１１に示すように、止血対象となる患者の手Ｈの部位によっては、手Ｈに位置する手掌動脈Ｂと静脈（橈側皮静脈）Ｖが並走している。また、静脈Ｖは手掌動脈Ｂよりも手Ｈの周方向の内側（図１０、図１１の矢印ｒ１で示す側であり、手Ｈの甲Ｈｂ側を手Ｈの上面側とした場合に患者の胴体が配置される側と反対側）を走行している。本実施形態に係る止血器具１０Ａのように、止血を行う際に、補助拡張部材４００Ａが手Ｈの周方向の外側に配置されると、拡張部材１００が圧迫力を付与する方向が手掌動脈Ｂ側に向けられるため、拡張部材１００が手掌動脈Ｂに対して集中的に圧迫力を付与することができる。そのため、拡張部材１００および補助拡張部材４００Ｂは、静脈Ｖに対して過剰な圧迫力を付与することを抑制しつつ、手掌動脈Ｂに対して効果的に圧迫力を付与することができる。 As shown in FIG. 11, the palm artery B and the vein (cephalic vein) V located on the hand H are running in parallel depending on the site of the hand H of the patient to be subjected to hemostasis. The vein V is located on the inner side in the circumferential direction of the hand H than the palmar artery B (the side indicated by the arrow r1 in FIGS. 10 and 11). (The side opposite to the side where the fuselage is located). As in the hemostatic device 10A according to the present embodiment, when performing the hemostasis, if the auxiliary expansion member 400A is arranged outside the hand H in the circumferential direction, the direction in which the expansion member 100 applies the compression force is the palm artery B Since the expansion member 100 is directed to the side, the expansion member 100 can intensively apply a compressive force to the palmar artery B. Therefore, the expansion member 100 and the auxiliary expansion member 400B can effectively apply a compression force to the palmar artery B while suppressing applying an excessive compression force to the vein V.
　また、第２実施形態に係る止血器具１０Ａは、第１実施形態に係る止血器具１０と同様に、止血器具１０Ａを患者に装着した状態において、拡張部材１００の第１領域１０１が被覆部材２００に設けられた固定部材２１０により患者に対してしっかりと固定された状態で、拡張部材１００の第２領域１０２が患者の手Ｈの動きに追従するように変形することができる。そのため、止血器具１０Ａは、拡張部材１００の第１領域１０１が位置ずれすることを防止でき、拡張部材１００の穿刺部位ｔへの圧迫力を維持できる。 Further, in the hemostatic device 10A according to the second embodiment, similarly to the hemostatic device 10 according to the first embodiment, when the hemostatic device 10A is attached to a patient, the first region 101 of the expansion member 100 is attached to the covering member 200. The second region 102 of the expansion member 100 can be deformed so as to follow the movement of the patient's hand H while being firmly fixed to the patient by the provided fixing member 210. Therefore, the hemostatic device 10A can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force of the expansion member 100 on the puncture site t.
　（第３実施形態）
　次に、本発明の第３実施形態に係る止血器具１０Ｂを説明する。第３実施形態の説明では前述した各実施形態で既に説明した構成についての詳細な説明は省略する。また、第３実施形態の説明で特に説明がない内容については、前述した各実施形態と同一のものとすることができる。 (Third embodiment)
Next, a hemostatic device 10B according to a third embodiment of the present invention will be described. In the description of the third embodiment, a detailed description of the configuration already described in each embodiment described above will be omitted. In the description of the third embodiment, contents that are not particularly described can be the same as those in the above-described embodiments.
　図１２、図１３Ａ、図１３Ｂは、第３実施形態に係る止血器具１０Ｂを説明するための図、図１４、図１５は、止血器具１０Ｂの使用例を説明するための図である。 FIGS. 12, 13A, and 13B are diagrams for explaining the hemostatic device 10B according to the third embodiment, and FIGS. 14 and 15 are diagrams for explaining a usage example of the hemostatic device 10B.
　第３実施形態に係る止血器具１０Ｂは、第２実施形態に係る止血器具１０Ａと補助拡張部材４００Ｂの配置が相違する。 血 The hemostatic device 10B according to the third embodiment is different from the hemostatic device 10A according to the second embodiment in the arrangement of the auxiliary expansion member 400B.
　止血器具１０Ｂは、図１２に示すように、補助拡張部材４００Ａが、被覆部材２００の長手方向と交差する方向（被覆部材２００の幅方向であり、図中の矢印Ｙ１－Ｙ２方向）に沿って拡張部材１００の第１領域１０１、拡張部材１００の第２領域１０２、および支持部材３００と重なるように配置されている。 As shown in FIG. 12, in the hemostatic device 10B, as shown in FIG. 12, the auxiliary expansion member 400A extends along a direction intersecting with the longitudinal direction of the covering member 200 (the width direction of the covering member 200, the direction of arrow Y1-Y2 in the figure). The first region 101 of the expansion member 100, the second region 102 of the expansion member 100, and the support member 300 are disposed so as to overlap.
　補助拡張部材４００Ｂの被覆部材２００の長手方向に沿う長さは、拡張部材１００の被覆部材２００の長手方向に沿う長さの略１／２である。また、補助拡張部材４００Ｂは、被覆部材２００の長手方向の他端部２０２側に位置する拡張部材１００の端部１０６側に寄せて配置している。補助拡張部材４００Ｂは、図１２に示す平面図上で、補助拡張部材４００Ｂの延在方向（図１２の左右方向）が被覆部材２００の長手方向と直交するように配置されている。 The length of the auxiliary extension member 400B along the longitudinal direction of the covering member 200 is approximately の of the length of the extension member 100 along the longitudinal direction of the covering member 200. In addition, the auxiliary expansion member 400B is arranged closer to the end 106 of the expansion member 100 located on the other end 202 side of the covering member 200 in the longitudinal direction. The auxiliary extension member 400B is arranged such that the extension direction (the left-right direction in FIG. 12) of the auxiliary extension member 400B is orthogonal to the longitudinal direction of the covering member 200 on the plan view shown in FIG.
　図１３Ａ、図１３Ｂに示すように、拡張部材１００の幅方向の他端部１０４と、補助拡張部材４００Ｂの他端部４０４と、支持部材３００の幅方向の他端部３０４は、互いに接続されている。なお、拡張部材１００の幅方向の他端部１０４、及び、補助拡張部材４００Ｂの幅方向の他端部４０４は、互いに近接する異なる位置で、支持部材３００の幅方向の他端部３０４に接続されていてもよい。また、拡張部材１００と補助拡張部材４００Ｂは、拡張部材１００の連通孔１１６の周囲および補助拡張部材４００Ｂの連通孔４１６の周囲でも互いに接続されている。 As shown in FIGS. 13A and 13B, the other end 104 in the width direction of the expansion member 100, the other end 404 of the auxiliary expansion member 400B, and the other end 304 in the width direction of the support member 300 are connected to each other. ing. The other end 104 in the width direction of the expansion member 100 and the other end 404 in the width direction of the auxiliary expansion member 400B are connected to the other end 304 in the width direction of the support member 300 at different positions close to each other. It may be. The expansion member 100 and the auxiliary expansion member 400B are also connected to each other around the communication hole 116 of the expansion member 100 and the communication hole 416 of the auxiliary expansion member 400B.
　拡張部材１００および補助拡張部材４００Ｂは、支持部材３００と接続されることにより、支持部材３００を介して被覆部材２００と接続されている。拡張部材１００の幅方向の一端部１０３と、補助拡張部材４００Ｂの一端部４０３と、被覆部材２００の幅方向の一端部２０３は、接続されていない。 The expansion member 100 and the auxiliary expansion member 400B are connected to the cover member 200 via the support member 300 by being connected to the support member 300. One end 103 in the width direction of the expansion member 100, one end 403 of the auxiliary expansion member 400B, and one end 203 of the covering member 200 in the width direction are not connected.
　図１３Ｂに示すように、拡張部材１００および補助拡張部材４００Ｂが拡張した際、拡張部材１００の幅方向の他端部１０４付近と補助拡張部材４００Ｂの他端部４０４付近との間には、隙間ｇが形成される。 As shown in FIG. 13B, when the expansion member 100 and the auxiliary expansion member 400B expand, a gap is provided between the vicinity of the other end portion 104 of the expansion member 100 in the width direction and the vicinity of the other end portion 404 of the auxiliary expansion member 400B. g is formed.
　次に、図１４、図１５を参照して、止血器具１０Ｂの使用例を説明する。 Next, an example of use of the hemostatic device 10B will be described with reference to FIGS.
　術者等は、図１４に示すように、拡張部材１００の第１領域１０１と拡張部材１００の第２領域１０２の境界部ｂ１に配置されたマーカー部１１７を穿刺部位ｔに位置合わせして、拡張部材１００を患者の前腕部Ａおよび手Ｈに配置する。術者等は、固定部材２１０を使用して、拡張部材１００を患者に対して固定する。 As shown in FIG. 14, the surgeon or the like aligns the marker portion 117 disposed at the boundary b1 between the first region 101 of the expansion member 100 and the second region 102 of the expansion member 100 with the puncture site t, The expansion member 100 is placed on the forearm A and the hand H of the patient. The surgeon or the like uses the fixing member 210 to fix the expansion member 100 to the patient.
　前述したように補助拡張部材４００Ｂは、補助拡張部材４００Ｂが被覆部材２００の長手方向の他端部２０２側に位置する拡張部材１００の端部１０６側に寄せて配置されている（図１２を参照）。そのため、補助拡張部材４００Ｂは、拡張部材１００を患者に対して固定した状態において、図１４、図１５に示すように、手Ｈの周方向の内側（図１４、１５の矢印ｒ１で示す側）に配置される。 As described above, the auxiliary expansion member 400B is disposed such that the auxiliary expansion member 400B is positioned close to the end 106 of the expansion member 100 located on the other end 202 side of the covering member 200 in the longitudinal direction (see FIG. 12). ). Therefore, in a state where the expansion member 100 is fixed to the patient, the auxiliary expansion member 400B is positioned inside the hand H in the circumferential direction (the side indicated by the arrow r1 in FIGS. 14 and 15) as shown in FIGS. Placed in
　図１５に示すように、止血対象となる患者の手Ｈの部位によっては、手Ｈに位置する手掌動脈Ｂと神経（橈骨神経浅枝）Ｎが並走している。また、神経Ｎは手掌動脈Ｂよりも手Ｈの周方向の外側（図１４、図１５の矢印ｒ２で示す側）を走行している。本実施形態に係る止血器具１０Ｂのように、止血を行う際に、補助拡張部材４００Ｂが手Ｈの周方向の内側に配置されると、拡張部材１００が圧迫力を付与する方向が手掌動脈Ｂ側に向けられるため、拡張部材１００が手掌動脈Ｂに対して集中的に圧迫力を付与することができる。そのため、拡張部材１００および補助拡張部材４００Ｂは、神経Ｎに対して過剰な圧迫力を付与することを抑制しつつ、手掌動脈Ｂに対して効果的に圧迫力を付与することができる。 As shown in FIG. 15, depending on the part of the hand H of the patient to be subjected to hemostasis, the palmar artery B located on the hand H and the nerve (shallow radial nerve) N run in parallel. Further, the nerve N travels outside the palm artery B in the circumferential direction of the hand H (on the side indicated by the arrow r2 in FIGS. 14 and 15). As in the hemostatic device 10B according to the present embodiment, when performing the hemostasis, if the auxiliary expansion member 400B is disposed inside the hand H in the circumferential direction, the direction in which the expansion member 100 applies the pressing force is the palm artery B Since the expansion member 100 is directed to the side, the expansion member 100 can intensively apply a compressive force to the palmar artery B. Therefore, the expansion member 100 and the auxiliary expansion member 400B can effectively apply a compression force to the palmar artery B while suppressing applying an excessive compression force to the nerve N.
　また、第３実施形態に係る止血器具１０Ｂは、第１実施形態に係る止血器具１０と同様に、止血器具１０Ｂを患者に装着した状態において、拡張部材１００の第１領域１０１が被覆部材２００に設けられた固定部材２１０により患者に対してしっかりと固定された状態で、拡張部材１００の第２領域１０２が患者の手Ｈの動きに追従するように変形することができる。そのため、止血器具１０Ｂは、拡張部材１００の第１領域１０１が位置ずれすることを防止でき、拡張部材１００の穿刺部位ｔへの圧迫力を維持できる。 Further, in the hemostatic device 10B according to the third embodiment, as in the hemostatic device 10 according to the first embodiment, when the hemostatic device 10B is attached to a patient, the first region 101 of the expansion member 100 is attached to the covering member 200. The second region 102 of the expansion member 100 can be deformed so as to follow the movement of the patient's hand H while being firmly fixed to the patient by the provided fixing member 210. Therefore, the hemostatic device 10B can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force of the expansion member 100 on the puncture site t.
　（第４実施形態）
　次に、本発明の第４実施形態に係る止血器具１０Ｃを説明する。第４実施形態の説明では前述した各実施形態で既に説明した構成についての詳細な説明は省略する。また、第４実施形態の説明で特に説明がない内容については、前述した各実施形態と同一のものとすることができる。 (Fourth embodiment)
Next, a hemostatic device 10C according to a fourth embodiment of the present invention will be described. In the description of the fourth embodiment, a detailed description of the configuration already described in each embodiment described above will be omitted. In the description of the fourth embodiment, contents that are not particularly described can be the same as those in the above-described embodiments.
　図１６、図１７Ａ、図１７Ｂは、第４実施形態に係る止血器具１０Ｃを示す図である。 FIGS. 16, 17A, and 17B are views showing a hemostatic device 10C according to the fourth embodiment.
　図１６に示すように、第４実施形態に係る止血器具１０Ｃは、補助拡張部材を備えていない。そのような点において第１実施形態に係る止血器具１０と相違する。 よ う As shown in FIG. 16, the hemostatic device 10C according to the fourth embodiment does not include an auxiliary expanding member. In such a point, it differs from the hemostatic device 10 according to the first embodiment.
　図１７Ａ、図１７Ｂに示すように、拡張部材１００の幅方向の他端部１０４と支持部材３００の幅方向の他端部３０４は、互いに接続されている。拡張部材１００は、支持部材３００と接続されることにより、支持部材３００を介して被覆部材２００と接続されている。 17A and 17B, the other end 104 in the width direction of the expansion member 100 and the other end 304 in the width direction of the support member 300 are connected to each other. The expansion member 100 is connected to the covering member 200 via the support member 300 by being connected to the support member 300.
　拡張部材１００の幅方向の一端部１０３と被覆部材２００幅方向の一端部２０３は、接続されていない。 一端 One end 103 in the width direction of the expansion member 100 and one end 203 in the width direction of the covering member 200 are not connected.
　注入部５００が備えるチューブ５０１は、拡張部材１００に接続している。拡張部材１００にチューブ５０１を接続する方法は、第１実施形態で説明した補助拡張部材４００にチューブ５０１を接続する方法と同様の方法を採用することができる。 チ ュ ー ブ The tube 501 provided in the injection section 500 is connected to the expansion member 100. As a method for connecting the tube 501 to the expansion member 100, a method similar to the method for connecting the tube 501 to the auxiliary expansion member 400 described in the first embodiment can be adopted.
　第４実施形態に係る止血器具１０Ｃは、第１実施形態に係る止血器具１０と同様に、止血器具１０Ｃを患者に装着した状態において、拡張部材１００の第１領域１０１が被覆部材２００に設けられた固定部材２１０により患者に対してしっかりと固定された状態で、拡張部材１００の第２領域１０２が患者の手Ｈの動きに追従するように変形することができる。そのため、止血器具１０Ｃは、拡張部材１００の第１領域１０１が位置ずれすることを防止でき、拡張部材１００の穿刺部位ｔへの圧迫力を維持できる。 In the hemostatic device 10C according to the fourth embodiment, as in the hemostatic device 10 according to the first embodiment, the first region 101 of the expansion member 100 is provided on the covering member 200 in a state where the hemostatic device 10C is mounted on a patient. The second region 102 of the expansion member 100 can be deformed so as to follow the movement of the patient's hand H while being firmly fixed to the patient by the fixing member 210. Therefore, the hemostatic device 10C can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force of the expansion member 100 on the puncture site t.
　また、止血器具１０Ｃは、患者の体表面から離れる方向への拡張部材１００の拡張を抑制する支持部材３００を有しているため、拡張部材１００が拡張した際、拡張部材１００の第２領域１０２が患者の体表面から離れる方向へ拡張することを抑制でき、穿刺部位ｔに対して効果的に圧迫力を付与することができる。また、支持部材３００は、被覆部材２００に接続されているため、止血器具１０Ｃを患者に装着した状態において、支持部材３００が被覆部材２００から位置ずれすることを防止できる。また、拡張部材１００は、支持部材３００に接続されているため、拡張部材１００が拡張した際、拡張部材１００の第２領域１０２が支持部材３００から位置ずれすることを抑制できる。 In addition, since the hemostatic device 10C includes the support member 300 that suppresses expansion of the expansion member 100 in a direction away from the patient's body surface, when the expansion member 100 expands, the second region 102 of the expansion member 100 Can be suppressed from expanding in the direction away from the patient's body surface, and a compression force can be effectively applied to the puncture site t. Further, since the support member 300 is connected to the covering member 200, it is possible to prevent the support member 300 from being displaced from the covering member 200 when the hemostatic device 10C is attached to the patient. Further, since the expansion member 100 is connected to the support member 300, when the expansion member 100 expands, the second region 102 of the expansion member 100 can be prevented from being displaced from the support member 300.
　（第５実施形態）
　次に、本発明の第５実施形態に係る止血器具１０Ｄを説明する。第５実施形態の説明では前述した各実施形態で既に説明した構成についての詳細な説明は省略する。また、第５実施形態の説明で特に説明がない内容については、前述した各実施形態と同一のものとすることができる。 (Fifth embodiment)
Next, a hemostatic device 10D according to a fifth embodiment of the present invention will be described. In the description of the fifth embodiment, a detailed description of the configuration already described in each of the above-described embodiments will be omitted. In the description of the fifth embodiment, contents that are not particularly described can be the same as those in the above-described embodiments.
　図１８は、第５実施形態に係る止血器具１０Ｄを示す図である。 FIG. 18 is a diagram showing a hemostatic device 10D according to the fifth embodiment.
　図１８に示すように、第５実施形態に係る止血器具１０Ｄは、補助拡張部材および支持部材を備えていない。そのような点において第１実施形態に係る止血器具１０と相違する。 血 As shown in FIG. 18, the hemostatic device 10D according to the fifth embodiment does not include the auxiliary expansion member and the support member. In such a point, it differs from the hemostatic device 10 according to the first embodiment.
　注入部５００が備えるチューブ５０１は、拡張部材１００に接続している。また、拡張部材１００は、被覆部材２００に接続している。拡張部材１００は、例えば、拡張部材１００の第１領域１０１の任意の位置で被覆部材２００に接続することができる。 チ ュ ー ブ The tube 501 provided in the injection section 500 is connected to the expansion member 100. The expansion member 100 is connected to the covering member 200. The expansion member 100 can be connected to the covering member 200 at an arbitrary position in the first region 101 of the expansion member 100, for example.
　第５実施形態に係る止血器具１０Ｄは、第１実施形態に係る止血器具１０と同様に、止血器具１０Ｄを患者に装着した状態において、拡張部材１００の第１領域１０１が被覆部材２００に設けられた固定部材２１０により患者に対してしっかりと固定された状態で、拡張部材１００の第２領域１０２が患者の手Ｈの動きに追従するように変形することができる。そのため、止血器具１０Ｄは、拡張部材１００の第１領域１０１が位置ずれすることを防止でき、拡張部材１００の穿刺部位ｔへの圧迫力を維持できる。 In the hemostatic device 10D according to the fifth embodiment, as in the hemostatic device 10 according to the first embodiment, the first region 101 of the expansion member 100 is provided on the covering member 200 in a state where the hemostatic device 10D is mounted on a patient. The second region 102 of the expansion member 100 can be deformed so as to follow the movement of the patient's hand H while being firmly fixed to the patient by the fixing member 210. Therefore, the hemostatic device 10D can prevent the first region 101 of the expansion member 100 from being displaced, and can maintain the pressing force of the expansion member 100 on the puncture site t.
　（第６実施形態）
　次に、本発明の第６実施形態に係る止血器具１０Ｅを説明する。第６実施形態の説明では前述した各実施形態で既に説明した構成についての詳細な説明は省略する。また、第６実施形態の説明で特に説明がない内容については、前述した各実施形態と同一のものとすることができる。 (Sixth embodiment)
Next, a hemostatic device 10E according to a sixth embodiment of the present invention will be described. In the description of the sixth embodiment, a detailed description of the configuration already described in each embodiment described above will be omitted. In the description of the sixth embodiment, contents that are not particularly described can be the same as those in the above-described embodiments.
　図１９は、第６実施形態に係る止血器具１０Ｅを示す図である。 FIG. 19 is a diagram showing a hemostatic device 10E according to the sixth embodiment.
　止血器具１０Ｅは、拡張部材１００の中央線ｃ１と、第１領域１０１と第２領域１０２の境界部ｂ１がずれた位置にある。拡張部材１００は、拡張部材１００の中央線ｃ１が被覆部材２００幅方向の一端部２０３よりも幅方向の他端部２０４側（図１９の左側）にずれた位置に配置されている。 血 The hemostatic device 10E is at a position where the center line c1 of the expansion member 100 and the boundary b1 between the first area 101 and the second area 102 are shifted. The expansion member 100 is disposed at a position where the center line c1 of the expansion member 100 is shifted from the one end 203 in the width direction of the covering member 200 toward the other end 204 in the width direction (left side in FIG. 19).
　マーカー部１１７は、被覆部材２００の長手方向に沿う拡張部材１００の中央線ｃ１と第１領域１０１との間に位置する第２領域１０２に対応する位置に配置している。本実施形態では、マーカー部１１７は、拡張部材１００の中心位置（図１９の平面図上における長手方向および幅方向の中心位置）に配置している。 The marker section 117 is disposed at a position corresponding to the second area 102 located between the center line c1 of the expansion member 100 along the longitudinal direction of the covering member 200 and the first area 101. In the present embodiment, the marker portion 117 is arranged at the center position of the expansion member 100 (the center position in the longitudinal direction and the width direction in the plan view of FIG. 19).
　本実施形態に係る止血器具１０Ｅのように、拡張部材１００は、拡張部材１００の中央線ｃ１が第１領域１０１と第２領域１０２の境界部ｂ１からずれた位置に配置されていてもよい。このように構成されている場合においても、止血器具１０Ｅは、患者に装着された状態において、拡張部材１００の第１領域１０１が位置ずれすることを防止でき、拡張部材１００の穿刺部位ｔへの圧迫力を維持できる。 拡 張 Like the hemostatic device 10E according to the present embodiment, the expansion member 100 may be arranged at a position where the center line c1 of the expansion member 100 is shifted from the boundary b1 between the first region 101 and the second region 102. Even in the case of such a configuration, the hemostatic device 10E can prevent the first region 101 of the expansion member 100 from being displaced in a state where the hemostatic device 10E is worn on the patient, and can prevent the first member 101 from moving to the puncture site t of the expansion member 100. Can maintain pressure.
　また、本実施形態に係る止血器具１０Ｅのように、拡張部材１００の中央線ｃ１が被覆部材２００の幅方向の他端部２０４側にずれた位置に配置されているような場合、マーカー部１１７を被覆部材２００の長手方向に沿う拡張部材１００の中央線ｃ１と第１領域１０１との間に位置する第２領域１０２に対応する位置に配置することにより、止血器具１０Ｅを患者に装着する際、拡張部材１００の中心位置付近を穿刺部位ｔに対して容易に配置することが可能になる。それにより、拡張部材１００は、拡張部材１００の中心位置に配置された穿刺部位ｔに対して効果的に圧迫力を付与することが可能になる。 Further, as in the hemostatic device 10E according to the present embodiment, when the center line c1 of the expansion member 100 is arranged at a position shifted toward the other end portion 204 in the width direction of the covering member 200, the marker portion 117 is used. Is arranged at a position corresponding to the second region 102 located between the center line c1 of the expansion member 100 along the longitudinal direction of the covering member 200 and the first region 101, so that the hemostatic device 10E is attached to the patient. Thus, the vicinity of the center position of the expansion member 100 can be easily arranged with respect to the puncture site t. Thereby, the expansion member 100 can effectively apply a compressive force to the puncture site t arranged at the center position of the expansion member 100.
　なお、第６実施形態で示した拡張部材１００の配置やマーカー部１１７の配置は、第１～第５実施形態で説明したいずれの止血器具でも採用することができる。 The arrangement of the expansion member 100 and the arrangement of the marker portion 117 shown in the sixth embodiment can be adopted in any of the hemostatic devices described in the first to fifth embodiments.
　（第７実施形態）
　次に、本発明の第７実施形態に係る止血器具１０Ｆを説明する。第７実施形態の説明では前述した各実施形態で既に説明した構成についての詳細な説明は省略する。また、第７実施形態の説明で特に説明がない内容については、前述した各実施形態と同一のものとすることができる。 (Seventh embodiment)
Next, a hemostatic device 10F according to a seventh embodiment of the present invention will be described. In the description of the seventh embodiment, a detailed description of the configuration already described in each embodiment described above will be omitted. In the description of the seventh embodiment, contents which are not particularly described can be the same as those of the above-described embodiments.
　図２０は、第７実施形態に係る止血器具１０Ｆを示す図である。 FIG. 20 is a diagram showing a hemostatic device 10F according to the seventh embodiment.
　図２０に示すように、第７実施形態に係る止血器具１０Ｆは、被覆部材２００Ｆの幅方向の一端部２０３に被覆部材２００の幅方向に凹状に湾曲した凹部２０１Ｆが形成されている。止血器具１０Ｆは、被覆部材２００に上記のような凹部２０１Ｆが形成されている場合においても、拡張部材（押圧部材）１００が被覆部材２００Ｆ上で被覆部材２００Ｆの長手方向において固定部材２１０と重なる第１領域１０１と、第１領域１０１よりも手Ｈの先端側に配置される第２領域１０２とを有する限り、前述した各実施形態と同様に、止血器具１０Ｆを使用した圧迫止血を行っている最中に患者の指の可動性を第２領域１０２により高めつつ、第１領域１０１が位置ずれすることを防止できる効果を発揮することができる。 示 す As shown in FIG. 20, in the hemostatic device 10F according to the seventh embodiment, a concave portion 201F that is concavely curved in the width direction of the covering member 200 is formed at one end portion 203 of the covering member 200F in the width direction. In the hemostatic device 10F, even when the above-described concave portion 201F is formed in the covering member 200, the expansion member (pressing member) 100 overlaps the fixing member 210 on the covering member 200F in the longitudinal direction of the covering member 200F. As long as it has the 1st area 101 and the 2nd area 102 arrange | positioned at the front-end | tip side of the hand H rather than the 1st area | region 101, compression hemostasis using the hemostatic device 10F is performed similarly to each embodiment mentioned above. The effect that the first region 101 can be prevented from being displaced while the mobility of the patient's finger is enhanced by the second region 102 during the operation can be exhibited.
　（第８実施形態）
　次に、本発明の第８実施形態に係る止血器具１０Ｇを説明する。第８実施形態の説明では前述した各実施形態で既に説明した構成についての詳細な説明は省略する。また、第７実施形態の説明で特に説明がない内容については、前述した各実施形態と同一のものとすることができる。 (Eighth embodiment)
Next, a hemostatic device 10G according to an eighth embodiment of the present invention will be described. In the description of the eighth embodiment, a detailed description of the configuration already described in each embodiment described above will be omitted. In the description of the seventh embodiment, contents which are not particularly described can be the same as those of the above-described embodiments.
　図２１は、第８実施形態に係る止血器具１０Ｇを示す図である。 FIG. 21 is a diagram showing a hemostatic device 10G according to the eighth embodiment.
　図２１に示すように、第８実施形態に係る止血器具１０Ｇは、支持部材３００Ｇが被覆部材２００と別体で形成されている。支持部材３００Ｇは、例えば、被覆部材２００に対して接着材等により接続することができる。支持部材３００Ｇが被覆部材２００と別体で形成され、被覆部材２００に後付けされている場合においても、支持部材３００Ｇは、拡張部材１００の第２領域１０２を拡張部材１００の外表面側から支持することにより、患者の体表面から離れる方向への拡張部材１００の拡張を抑制することができる。 血 As shown in FIG. 21, in the hemostatic device 10G according to the eighth embodiment, the support member 300G is formed separately from the covering member 200. The support member 300G can be connected to the covering member 200 by an adhesive or the like, for example. Even when the supporting member 300G is formed separately from the covering member 200 and is attached to the covering member 200, the supporting member 300G supports the second region 102 of the expanding member 100 from the outer surface side of the expanding member 100. Thereby, expansion of the expansion member 100 in a direction away from the patient's body surface can be suppressed.
　（固定部材の形状例）
　前述した各実施形態で説明した固定部材２１０は、被覆部材２００の長手方向に沿う長辺を備える略長方形状を有していた。ただし、固定部材２１０の形状は、被覆部材２００に設けることができ、かつ、拡張部材（押圧部材）１００の第１領域１０１を患者の肢体に対して固定する所望の固定力を付与し得る限り、特に限定されない。 (Example of shape of fixing member)
The fixing member 210 described in each of the above-described embodiments has a substantially rectangular shape having a long side along the longitudinal direction of the covering member 200. However, as long as the shape of the fixing member 210 can be provided on the covering member 200 and a desired fixing force for fixing the first region 101 of the expanding member (pressing member) 100 to the patient's limb can be applied. Is not particularly limited.
　固定部材２１０は、図２２に示すように、アーチ形状を有していてもよい。また、固定部材２１０は、図２３に示すように、円形の一部に切欠きが形成されたような形状であってもよい。図２２および図２３では、固定部材２１０の第１固定部２１１のみを例示しているが、第２固定部２１２も図２２、図２３で示した形状で形成することが可能である。また、固定部材２１０は、第１固定部２１１と第２固定部２１２が接続可能であればよく、例えば、第１固定部２１１の形状と第２固定部２１２の形状が異なっていてもよい。 The fixing member 210 may have an arch shape as shown in FIG. Further, as shown in FIG. 23, the fixing member 210 may have a shape in which a notch is formed in a part of a circle. 22 and 23 illustrate only the first fixing portion 211 of the fixing member 210, the second fixing portion 212 can also be formed in the shape illustrated in FIGS. The fixing member 210 only needs to be able to connect the first fixing portion 211 and the second fixing portion 212. For example, the shape of the first fixing portion 211 and the shape of the second fixing portion 212 may be different.
　以上、実施形態を通じて本発明に係る止血器具を説明したが、本発明は明細書において説明した内容のみに限定されるものでなく、特許請求の範囲の記載に基づいて適宜変更することが可能である。 As described above, the hemostatic device according to the present invention has been described through the embodiments. However, the present invention is not limited to the contents described in the specification, and can be appropriately changed based on the description in the claims. is there.
　実施形態の説明では、左手の甲に形成した穿刺部位を止血するための止血器具を例示したが、止血器具は、右手の甲に形成された穿刺部位、右手の掌に形成された穿刺部位、左手の掌に形成された穿刺部位等を止血するために使用することも可能である。なお、止血器具は、左手の甲以外に使用される場合、第２実施形態や第３実施形態に示した補助拡張部材の位置は、補助拡張部材が所望の効果を発揮し得る位置に適宜変更することができる。 In the description of the embodiment, a hemostatic device for stopping a puncture site formed on the back of the left hand is exemplified. It can also be used to stop the puncture site or the like formed on the palm. When the hemostatic device is used for a part other than the back of the left hand, the position of the auxiliary expansion member shown in the second or third embodiment is appropriately changed to a position where the auxiliary expansion member can exhibit a desired effect. be able to.
　また、押圧部材は、各実施形態において説明した拡張部材に限定されることはない。押圧部材は、例えば、回転等の外部からの操作により手に対する押し込み量を可変自在な機械式の部材、面圧を付与するように手に対して押し込まれるプラスチック等の樹脂材料やゲル等で構成された部材、時間経過に応じて含水率が低下して圧迫力を徐々に減少させるゲルを含む部材、スポンジ状の物質等の弾性材料、綿（わた）のような繊維の集合体、金属、所定の立体形状を備える部材（球状、楕円体、三角錐等）、これらを適宜組み合わせたもの等で構成することも可能である。 The pressing member is not limited to the expansion member described in each embodiment. The pressing member is formed of, for example, a mechanical member capable of changing the amount of pressing against the hand by an external operation such as rotation, a resin material such as plastic or the like, which is pressed against the hand to apply a surface pressure, or a gel. Member, a member containing a gel whose water content decreases with time to gradually reduce the compression force, an elastic material such as a sponge-like substance, an aggregate of fibers such as cotton (cotton), a metal, A member having a predetermined three-dimensional shape (such as a sphere, an ellipsoid, or a triangular pyramid) or a combination of these members may be used.
　本出願は、２０１８年９月２６日に出願された日本国特許出願第２０１８－１８０２１０号に基づいており、その開示内容は、参照により全体として引用されている。 This application is based on Japanese Patent Application No. 2018-180210 filed on September 26, 2018, the disclosure of which is incorporated by reference in its entirety.
１０、１０Ａ、１０Ｂ、１０Ｃ、１０Ｄ、１０Ｅ、１０Ｆ、１０Ｇ　止血器具、
１００　拡張部材（押圧部材）、
１０１　第１領域、
１０２　第２領域、
１０３　拡張部材の幅方向の一端部、
１０４　拡張部材の幅方向の他端部、
１１０　袋体、
１１５　拡張空間、
１１７　マーカー部、
２００、２００Ｆ　被覆部材、
２００ａ　被覆部材の内面、
２００ｂ　被覆部材の外面、
２０１　被覆部材の長手方向の一端部、
２０２　被覆部材の長手方向の他端部、
２０３　被覆部材の幅方向の一端部、
２０４　被覆部材の幅方向の他端部、
２１０　固定部材、
２１１　第１固定部、
２１２　第２固定部、
３００、３００Ｇ　支持部材、
３０４　支持部材の幅方向の他端部、
４００、４００Ａ、４００Ｂ　補助拡張部材、
４０３　補助拡張部材の一端部、
４０４　補助拡張部材の他端部、
４１０　袋体、
４１５　空間部、
５００　注入部、
６００　イントロデューサー、
６１０　シースチューブ、
ｂ１　第１領域と第２領域の境界部、
ｃ１　拡張部材の中央線、
ｃ２　被覆部材の中央線、
ｇ　隙間、
Ａ　前腕部（腕）、
Ｂ　手掌動脈、
Ｈ　手、
Ｈｂ　手の甲、
Ｓ　茎状突起、
Ｎ　神経、
Ｖ　静脈、
ｔ　穿刺部位（止血すべき部位）。 10, 10A, 10B, 10C, 10D, 10E, 10F, 10G hemostatic device,
100 expansion member (pressing member),
101 first area,
102 second area,
103 one end in the width direction of the expansion member,
104 the other end in the width direction of the expansion member,
110 bags,
115 expansion space,
117 marker part,
200, 200F covering member,
200a inner surface of the covering member,
200b outer surface of the covering member,
201 one end in the longitudinal direction of the covering member,
202 the other end in the longitudinal direction of the covering member,
203 one end in the width direction of the covering member;
204 the other end in the width direction of the covering member,
210 fixing member,
211 first fixed part,
212 second fixing part,
300, 300G support member,
304 The other end in the width direction of the support member,
400, 400A, 400B auxiliary expansion member,
403 one end of the auxiliary expansion member,
404 the other end of the auxiliary expansion member,
410 bags,
415 space part,
500 injection section,
600 introducer,
610 sheath tube,
b1 a boundary between the first region and the second region;
c1 the center line of the expansion member,
c2 the center line of the covering member,
g gap,
A Forearm (arm),
B palmar artery,
H hand,
Hb back of hand,
S stalk,
N nerves,
V vein,
t Puncture site (site to stop bleeding).

Claims (7)

  1. 　患者の手の止血すべき部位に配置される押圧部材と、
    　前記押圧部材が前記止血すべき部位を覆った状態で、前記押圧部材の少なくとも一部を覆う被覆部材と、を備え、
    　前記被覆部材は、前記押圧部材が前記止血すべき部位を覆った状態で、前記押圧部材を前記患者の腕および前記患者の手の少なくとも一方に対して固定する固定部材を有し、
    　前記押圧部材は、前記押圧部材の中央線と前記被覆部材の中央線とが一致しない位置で前記被覆部材に設けられているとともに、前記被覆部材上で前記被覆部材の長手方向において前記固定部材と重なる第１領域と、前記第１領域よりも前記手の先端側に配置される第２領域と、を有し、
    　前記第２領域は、前記被覆部材が前記腕および前記手の少なくとも一方に前記押圧部材を固定した状態で、前記固定部材が前記第１領域に付与する固定力よりも小さな力で前記手に対して保持される、止血器具。     A pressing member disposed at a site where hemostasis is to be performed on a patient's hand,
    In a state where the pressing member covers the site to stop bleeding, a covering member that covers at least a part of the pressing member,
    The covering member has a fixing member that fixes the pressing member to at least one of the patient's arm and the patient's hand in a state where the pressing member covers the site to stop bleeding,
    The pressing member is provided on the covering member at a position where the center line of the pressing member does not coincide with the center line of the covering member, and the fixing member is provided on the covering member in the longitudinal direction of the covering member. A first region that overlaps, and a second region that is located closer to the distal end of the hand than the first region,
    In the second region, in a state where the covering member fixes the pressing member to at least one of the arm and the hand, the fixing member applies a smaller force to the hand than a fixing force applied to the first region. Hemostatic device that is held.
  2. 　前記押圧部材は、流体の注入により拡張可能な袋体と、前記袋体に囲われた拡張空間と、を備える拡張部材である、請求項１に記載の止血器具。 2. The hemostatic device according to claim 1, wherein the pressing member is an expansion member including a bag body that can be expanded by injecting a fluid, and an expansion space surrounded by the bag body. 3.
  3. 　前記患者の体表面から離れる方向への前記拡張部材の拡張を抑制する支持部材をさらに有し、
    　前記支持部材は、前記第２領域を覆いつつ、前記被覆部材に接続されており、
    　前記拡張部材の前記袋体は、前記支持部材に接続されている、請求項２に記載の止血器具。     A support member that suppresses expansion of the expansion member in a direction away from the patient's body surface,
    The support member is connected to the covering member while covering the second region,
    The hemostatic device according to claim 2, wherein the bag body of the expansion member is connected to the support member.
  4. 　前記支持部材と前記拡張部材との間に配置されるとともに、前記支持部材に接続された補助拡張部材を有し、
    　前記補助拡張部材は、前記拡張部材の前記拡張空間と連通する空間部と、前記空間部を覆う袋体と、を有する請求項３に記載の止血器具。     While being disposed between the support member and the expansion member, having an auxiliary expansion member connected to the support member,
    The hemostatic device according to claim 3, wherein the auxiliary expansion member includes a space that communicates with the expansion space of the expansion member, and a bag that covers the space.
  5. 　前記補助拡張部材は、前記被覆部材の長手方向に沿って前記第２領域および前記支持部材と重なるように配置されている、請求項４に記載の止血器具。 The hemostatic device according to claim 4, wherein the auxiliary expansion member is disposed so as to overlap the second region and the support member along a longitudinal direction of the covering member.
  6. 　前記補助拡張部材は、前記被覆部材の長手方向と交差する方向に沿って前記第１領域、前記第２領域、および前記支持部材と重なるように配置されている、請求項４に記載の止血器具。 The hemostatic device according to claim 4, wherein the auxiliary expansion member is arranged so as to overlap the first region, the second region, and the support member along a direction intersecting with a longitudinal direction of the covering member. .
  7. 　前記押圧部材を前記止血すべき部位に対して位置合わせするためのマーカー部をさらに有し、
    　前記マーカー部は、前記第１領域と前記第２領域の境界部、または、前記被覆部材の長手方向に沿う前記押圧部材の中央線と前記第１領域との間に位置する前記第２領域に対応する位置に配置されている、請求項１～６のいずれか１項に記載の止血器具。     Further comprising a marker portion for positioning the pressing member to the site to stop the hemostasis,
    The marker portion is located at a boundary between the first region and the second region, or at a second region located between a center line of the pressing member and a first region along a longitudinal direction of the covering member. The hemostatic device according to any one of claims 1 to 6, which is arranged at a corresponding position.
PCT/JP2019/037614 2018-09-26 2019-09-25 Hemostatic instrument WO2020067164A1 (en)

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JP2018180210A JP2022036331A (en) 2018-09-26 2018-09-26 Hemostatic device
JP2018-180210 2018-09-26

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Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5968072A (en) * 1993-12-20 1999-10-19 Medical Wraps, Inc. Method and apparatus for cold compression treatment of wounds
US20170224357A1 (en) * 2016-02-10 2017-08-10 Robert Tremaine Whalen Barrel Inflatable Belt

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5968072A (en) * 1993-12-20 1999-10-19 Medical Wraps, Inc. Method and apparatus for cold compression treatment of wounds
US20170224357A1 (en) * 2016-02-10 2017-08-10 Robert Tremaine Whalen Barrel Inflatable Belt

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