CN104921784A - Lateral ventricle frontal angle puncture guiding device - Google Patents
Lateral ventricle frontal angle puncture guiding device Download PDFInfo
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- CN104921784A CN104921784A CN201510330933.1A CN201510330933A CN104921784A CN 104921784 A CN104921784 A CN 104921784A CN 201510330933 A CN201510330933 A CN 201510330933A CN 104921784 A CN104921784 A CN 104921784A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
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Abstract
The invention provides a lateral ventricle frontal angle puncture guiding device. The lateral ventricle frontal angle puncture guiding device comprises a CT machine, a fixing support, a positioning device, an angle scale and a puncture catheter. The fixing support comprises a fixing rod, the axial direction of the fixing rod is the Y direction, and the direction perpendicular to the Y direction is the X direction. The angle scale is installed on the fixing support through the positioning device, and the angle scale can horizontally move in the X direction and the Y direction and can rotate in the X direction. The puncture catheter is installed on the angle scale, and the deviation angle of the puncture catheter can be adjusted along scale marks of the angle scale. By the adoption of the lateral ventricle frontal angle puncture guiding device, the accurate position of a puncture target point of a patient is extracted through the CT machine, the puncture position, the puncture angle and the puncture depth of the puncture catheter are determined by adjusting the deviation angels of the positioning device and the puncture catheter on the angle scale, the probability of improper puncture is decreased, and the safety level of an operation is increased.
Description
Technical field
The present invention relates to technical field of medical instruments, particularly relate to a kind of cornu frontale ventriculi lateralis guiding puncture device.
Background technology
Cornu frontale ventriculi lateralis puncture is the common operation that neurosurgery carries out Ventriculo peritoneal shunt and EVD operation.The parameter such as position, angle, the degree of depth of puncture of frontal angle is the key of Ventriculo peritoneal shunt and EVD operation success or failure.
The desirable position of puncture of frontal angle is that homonymy tricorn Men Shi hole (i.e. Monro hole) is front, away from Intraventricular choroid plexus and tricorn wall.Conventional method is free-hand puncture, and point of puncture is 2.5cm outside 2cm in hairline, head median line.During puncture procedure, puncture needle is pointed to offside endocanthion at oblique coronal plane, in sagittal plane by bilateral external auditory canal line, slow inserting needle is about about 4cm has cerebrospinal fluid to overflow, then puts into forward about about 1.5cm.Operator needs with oneself subjective sensation, holds the angle of puncture needle on coronalplane and sagittal plane in piercing process, even high age and service seniority doctor is also difficult to find desirable puncture position accurately, and feldsher still more.Therefore, occur that the situation of puncture angle deviation is of common occurrence, foreign literature is reported, the ratio of desirable puncture is only about 40%.
Certainly, in the hospital that equipment perfects, the instruments such as stereotactic apparatus, intraoperative ultrasound, navigator also can be used to assist to carry out puncture procedure, very high precision can be reached like this.But owing to there is high, the complex operation of cost, expending the factors such as duration, patient both domestic and external does not have condition to use above-mentioned armarium greatly, and simple and crude in condition, it is pressed for time, many operations also cannot be equipped with above-mentioned armarium in time.
For above problem, some doctors once designed, made the comparatively simple auxiliary device for cornu frontale ventriculi lateralis puncture.
Illustrate, Fig. 1 is the structural representation of the puncture direction finder of prior art, as shown in Figure 1, puncture direction finder determines the puncture direction of puncture conduit by the semicircle mainboard indicating angle index, and the puncture conduit on this semicircle mainboard points to the mid point of bilateral external auditory meatus all the time.But, desirable Monro hole not on the line of point of puncture and bilateral external auditory meatus mid point, so namely there is larger error in theory in puncture direction finder.
For another example, Fig. 2 is the puncture gate apparatus structural representation of prior art, and as shown in Figure 2, puncture gate apparatus arranges crossbeam in two armstands, and trocar sleeve is vertically set on crossbeam, and lancet device punctures along the central through hole of trocar sleeve.But cornu frontale ventriculi lateralis puncture has an angle of inclination on oblique coronalplane, and such guarantee ventricles of the brain cannula tip does not contact with tricorn wall, and this puncture gate apparatus is a vertical puncturing, be difficult to ensure puncture ideal position.
Therefore, design and a kind ofly use simple, easy to operate, to have high puncture precision puncture auxiliary device to be those skilled in the art's technical problems urgently to be resolved hurrily.
Summary of the invention
The object of the present invention is to provide a kind of cornu frontale ventriculi lateralis guiding puncture device, to solve the guiding puncture appliance arrangement of prior art or too expensive or that steering error is large or guided puncture angle is undesirable problem.
To achieve these goals, the present invention is by the following technical solutions:
A kind of cornu frontale ventriculi lateralis guiding puncture device provided by the invention, comprises CT machine, fixed support, positioner, angle scale and puncture conduit; Described fixed support comprises fixed bar, and the axis of described fixed bar is Y-direction, is X-direction perpendicular to described Y-direction; Described angle scale is arranged on described fixed support by described positioner, and described angle scale respectively along described X-direction and described Y-direction translation, and can rotate around described X-direction; Described puncture conduit is arranged on described angle scale, and described puncture conduit can along the scale adjustment deflection angle of described angle scale.
Further, described cornu frontale ventriculi lateralis guiding puncture device also comprises the positioning sliding block that can rotate in a circumferential direction around described angle scale, described puncture conduit connects the center of circle of described positioning sliding block and described angle scale respectively, and described puncture conduit can be rotated around the described center of circle along with described positioning sliding block.The technique effect of this technical scheme is: puncture conduit is rotated around the center of circle of angle scale by positioning sliding block, namely determines the deviation angle of this puncture conduit by 2, strengthens precise angular positions, and improves the stationarity of puncture conduit.
Preferably, described angle scale is quadrant dish.The technique effect of this technical scheme is: due to point of puncture 1 cm on the left of sagittal suture or before right side and coronal suture, and the conduit that punctures departs from the angle of Y-direction and puncture angle is not more than 90 degree, therefore angle scale is the requirement that quadrant dish can meet puncture, does not also take unnecessary operative space simultaneously.
Further, described positioner comprises horizontal adjustment plate; One end of described horizontal adjustment plate is connected with described angle scale, the other end and cross bar hinged, make described horizontal adjustment plate can around the axial-rotation of described cross bar; Described cross bar is parallel with X-direction and hinged with described fixed bar.The technique effect of this technical scheme is: due in operation, patient faces upward and lies at operating-table, require that cornu frontale ventriculi lateralis guiding puncture device is positioned at the volume top of patient's head, and horizontal adjustment plate can rotate around the cross bar be connected on fixed bar, achieve the levelness of adjustment cornu frontale ventriculi lateralis guiding puncture device integral device.
Further, described positioner also comprises X guide runner, and Y guide runner, described X guide runner is arranged on described horizontal adjustment plate, described angle scale is connected with described horizontal adjustment plate by described X guide runner, makes described angle scale can relative to described horizontal adjustment plate along described X-direction translation; Described Y guide runner is arranged on described cross bar, make described cross bar by described Y guide runner relative to described fixed bar along described Y-direction translation.The technique effect of this technical scheme is: by arranging X guide runner and Y guide runner, angle scale can be adjusted respectively in the translation of X-direction and cross bar translation in the Y direction, achieve the adjustment of displacement of cornu frontale ventriculi lateralis guiding puncture device in both direction in length and breadth.
Further, also comprise correcting mechanism, described correcting mechanism is for calibrating the position of described puncture conduit relative to described fixed bar.The technique effect of this technical scheme is: by the adjustment of Level-adjusting, X-direction and Y-direction adjustment of displacement and the anglec of rotation, puncture conduit should meet the status requirement of puncture in theory, supplement and correcting mechanism is set, the guiding accuracy of cornu frontale ventriculi lateralis guiding puncture device can be ensured further.
Further, described correcting mechanism comprises cross laser line connector, and described cross laser line connector is arranged on described angle scale.The technique effect of this technical scheme is: on angle scale, arrange cross laser line connector, and aims at so that horizontal adjustment plate is auxiliary, can realize the calibration of the parameter in three directions and deflection angle, levelness and X, Y-direction shift value.
Preferably, the laser generator of described cross laser line connector is level of security laser generator.The technique effect of this technical scheme is: cornu frontale ventriculi lateralis guiding puncture device is positioned at the volume top of patient's head, and the medical personnel that punctures needs to operate around cross laser line connector.So, in order to ensure the healthy of patient and operation carry out smoothly, level of security laser generator selected by laser generator.
Further, between described positioning sliding block and described angle scale, between described cross laser line connector and described angle scale, between described X guide runner and described angle scale, between described Y guide runner and described fixed bar, securing member is provided with.The technique effect of this technical scheme is: be can the connecting portion of relative motion, in order to keep stable, so be provided with securing member between parts at interconnective position everywhere for this.
Preferably, described securing member is trip bolt.The technique effect of this technical scheme is: trip bolt selected by securing member, is because trip bolt is conventional effective securing member, and is beneficial to observation and adjustment.
The invention has the beneficial effects as follows: cornu frontale ventriculi lateralis guiding puncture device of the present invention utilizes CT machine to extract the elaborate position of patient's puncture target spot, the deflection angle on angle scale by adjustment positioner and puncture conduit, determine the puncture position of puncture conduit, angle and the degree of depth, reduce the probability improperly that punctures, improve the security level of operation.
Accompanying drawing explanation
In order to be illustrated more clearly in the technical scheme of the specific embodiment of the invention, below the accompanying drawing used required in describing detailed description of the invention is briefly described.As a comparison, further comprises the drawing of prior art in accompanying drawing.Apparently, the accompanying drawing in the following describes is some embodiments of the present invention, for those of ordinary skill in the art, under the prerequisite not paying creative work, can also obtain other accompanying drawing according to these accompanying drawings.
Fig. 1 is the structural representation of the puncture direction finder of prior art;
Fig. 2 is the puncture gate apparatus structural representation of prior art;
Fig. 3 is the structural representation of cornu frontale ventriculi lateralis guiding puncture device provided by the invention;
Fig. 4 is puncture needle track side surface body table projection;
Fig. 5 is head point of puncture view;
Fig. 6 is the oblique coronalplane CT image schematic diagram of puncture.
Reference numeral:
1-punctures conduit; 2-angle scale; 3-positioning sliding block;
The 4-center of circle; 5-horizontal adjustment plate; 6-cross bar;
7-X guide runner; 8-Y guide runner; 9-cross laser line connector;
10-fixed bar; A-Monro hole; B-body puncture point;
D-median sagittal plane and the oblique coronalplane body surface projection line intersection point of puncture;
E-median sagittal line; F-geisoma mid point; G-tragus gauge point.
Detailed description of the invention
Be clearly and completely described technical scheme of the present invention below in conjunction with accompanying drawing, obviously, described embodiment is the present invention's part embodiment, instead of whole embodiments.Based on the embodiment in the present invention, those of ordinary skill in the art, not making the every other embodiment obtained under creative work prerequisite, belong to the scope of protection of the invention.
In describing the invention, it should be noted that, orientation or the position relationship of the instruction such as term " " center ", " on ", D score, "left", "right", " vertically ", " level ", " interior ", " outward " they be based on orientation shown in the drawings or position relationship; be only the present invention for convenience of description and simplified characterization; instead of instruction or imply the device of indication or element must have specific orientation, with specific azimuth configuration and operation, therefore can not be interpreted as limitation of the present invention.In addition, term " first ", " second ", " the 3rd " only for describing object, and can not be interpreted as instruction or hint relative importance.
In describing the invention, it should be noted that, unless otherwise clearly defined and limited, term " installation ", " being connected ", " connection " should be interpreted broadly, and such as, can be fixedly connected with, also can be removably connect, or connect integratedly; Can be mechanical connection, also can be electrical connection; Can be directly be connected, also indirectly can be connected by intermediary, can be the connection of two element internals.For the ordinary skill in the art, concrete condition above-mentioned term concrete meaning in the present invention can be understood.
Fig. 3 is the structural representation of cornu frontale ventriculi lateralis guiding puncture device provided by the invention.As shown in Figure 3, cornu frontale ventriculi lateralis guiding puncture device comprises CT machine (mark), for being fixed on fixed support, positioner, angle scale 2 and the puncture conduit 1 on operation table.Fixed support is a fixed bar 10, and the axis of setting fixed bar 10 is Y-direction, and perpendicular to Y-direction is X-direction.Wherein, angle scale 2 is arranged on fixed bar 10 by positioner, by adjustment positioner, angle scale 2 can distinguish in X direction with Y-direction translation, and can to rotate around X-direction.Angle scale 2 is also arranged a puncture conduit 1, puncture conduit 1 can along the deflection angle of the scale adjustment on angle scale 2 self relative to angle scale 2.
Further, on the basis of above-described embodiment, as shown in Figure 3, angle scale 2 is provided with positioning sliding block 3, positioning sliding block 3 can rotate in a circumferential direction around angle scale 2.Puncture conduit 1 is connected with positioning sliding block 3, and hinged with the center of circle 4 of angle scale 2.By controlling positioning sliding block 3 along the rotation of angle scale 2 circumference, puncture conduit 1 can be made to rotate around the center of circle 4, and change the deflection angle of puncture conduit 1 relative to angle scale 2.
Preferably, on the basis of above-described embodiment, as shown in Figure 3, angle scale 2 uses quadrant dish.Wherein, that angle scale 2 can also use semicircle or that other are fan-shaped angle scale 2, the present embodiment uses quadrant dish, neither takies redundant space position, also meets the guiding requirement of puncture conduit 1.
Preferably, on the basis of above-described embodiment, as shown in Figure 3, positioner comprises a horizontal adjustment plate 5, one end joint angle scale 2 of horizontal adjustment plate 5, and connecting portion can be quadrant dish lateral extensometer out one section; The other end and the cross bar 6 of horizontal adjustment plate 5 are hinged, and cross bar 6 is connected with fixed bar.This syndeton makes horizontal adjustment plate 5 can rotate around X-direction, and then is fixed on horizontal plane by angle scale 2.Wherein, all right directly joint angle scale 2 of horizontal adjustment plate 5, or hinged with support bracket fastened fixed bar 10, but, Adjustment effect is all not as the mounting means of the present embodiment.
Further, on the basis of above-described embodiment, as shown in Figure 3, positioner also comprises X guide runner 7, Y guide runner 8, wherein X guide runner 7 is fixedly installed on horizontal adjustment plate 5, and one section that angle scale 2 crosses out can the mode of translation be connected on X guide runner 7, thus make angle scale 2 can relative to horizontal adjustment plate 5 translation in X direction; Y guide runner 8 to be fixed on cross bar 6 and to be socketed with fixed bar 10, thus cross bar 6 by Y guide runner 8 relative to fixed bar 10 along Y-direction translation.The effect of X guide runner 7 and Y guide runner 8 two parts is, can make angle scale 2 particularly puncture conduit 1 can along the X direction with Y-direction translation.Wherein, two slide blocks can also be arranged between the parts of other relative motion, as arranged X guide runner 7 between horizontal adjustment plate 5 and cross bar 6, arrange Y guide runner 8 between fixed bar 10 and operating-table.Set-up mode in the present embodiment is a mode of comparatively handled easily.
Further, on the basis of above-described embodiment, as shown in Figure 3, cornu frontale ventriculi lateralis guiding puncture device is also provided with correcting mechanism.By the adjustment of Level-adjusting, X-direction and Y-direction adjustment of displacement and rotational angle, meet the position location requirement of puncture conduit 1 in theory, and supplement the correcting mechanism arranged, the guiding accuracy of cornu frontale ventriculi lateralis guiding puncture device can be ensured further.
Further, on the basis of above-described embodiment, the correcting mechanism of the present embodiment selects cross laser line connector 9, and cross laser line connector 9 is in being arranged on angle scale 2.Utilize two of cross laser line connector 9 orthogonal laser beams, and the horizontal adjustment plate 5 originally existed, namely can calibrate the position in three directions exactly: puncture conduit 1 is relative to the deflection angle in angle scale 2 center of circle 4, the levelness of puncture conduit 1 and puncture conduit 1 displacement parameter relative to support bracket fastened X-direction and Y-direction.
Preferably, on the basis of above-described embodiment, level of security laser generator selected by the laser generator of cross laser line connector 9.According to energy rank and the laser occurring principle of laser generator, the harm of laser to human body that dissimilar laser generator is launched is different.Consider from the healthy of protection patient and protection operator, the cross laser line connector 9 that the present embodiment uses, its laser generator is level of security laser generator.
Further, on the basis of above-described embodiment, as shown in Figure 3, between each parts mutually moved, particularly relate to adjustment puncture conduit 1 position moving component between, the securing member of a fixation has been installed.Such as between positioning sliding block 3 and angle scale 2, between cross laser line connector 9 and angle scale 2, between X guide runner 7 and angle scale 2, between Y guide runner 8 and fixed bar 10, be provided with securing member.
Preferably, on the basis of above-described embodiment, securing member is trip bolt.Wherein securing member can also select bolt, pin etc.The present embodiment uses the trip bolt be simple and easy to, and without the need to additionally arranging pin-and-hole or attaching nut, can fix arbitrary position in adjustment stroke.
In Ventriculo peritoneal shunt and EVD operation, when utilizing the cornu frontale ventriculi lateralis guiding puncture device of the present embodiment to guide location, operating process is as follows:
1, the distance AB and puncture angle β that punctures is determined:
Fig. 4 is puncture needle track side surface body table projection, and Fig. 5 is head point of puncture view, and Fig. 6 is the oblique coronalplane CT image schematic diagram of puncture.As shown in Figure 4,5, 6, first place CT show tags thing at tragus gauge point G and geisoma mid point F and carry out CT scan and rebuild, obtaining the oblique coronalplane of puncture through bilateral tragus gauge point G and Monro hole A.CT machine carries out setting-out as shown in Figure 6, measures puncture distance AB and puncture angle β.
2, body puncture point B and puncture horizontal plane is determined:
As shown in Figure 4,5, 6, mark median sagittal line E patients head, median sagittal plane and the oblique coronalplane body surface projection line intersection point D of puncture can be drawn.In survey map 6, the distance of body surface point of puncture B on D and horizontal plane handed over by median sagittal plane and the oblique coronalplane body surface projection line of puncture, can draw patient body-surface point of puncture B.BD line is skull point of puncture place horizontal plane, extends BD line to tragus gauge point G on patients head surface.
3, adjust puncture conduit 1 position and use cross laser line connector 9 to calibrate:
Patient is dorsal position, makes the plane at median sagittal line E place vertical; The puncture angle β of setting puncture conduit 1 on angle scale 2; Adjustment horizontal adjustment plate 5, X guide runner 7 and Y guide runner 8, make the end of puncture conduit 1 be positioned at body puncture point B; Open cross laser line connector 9, readjust horizontal adjustment plate 5, X guide runner 7 and Y guide runner 8, make the ordinate of cross laser line overlapping with median sagittal line E, the horizontal line of cross laser line and BD line overlap, the end of puncture conduit 1 is positioned at body puncture point B simultaneously, tightens whole trip bolt.Thus puncture conduit 1 is finally calibrated.
4, puncture procedure:
The puncture tube promoted in puncture conduit 1 carries out cornu frontale ventriculi lateralis puncture, and paracentesis depth is the distance of AB; Fixing puncture tube, takes off this lateral cerebral ventricle puncture guiding device.Complete cornu frontale ventriculi lateralis puncture.
It should be noted that, cornu frontale ventriculi lateralis guiding puncture device can be used for the operation technique of two lateral cerebral ventricle punctures, only needs to revolve turnback during use.
Last it is noted that above each embodiment is only in order to illustrate technical scheme of the present invention, be not intended to limit; Although with reference to foregoing embodiments to invention has been detailed description, those of ordinary skill in the art is to be understood that: it still can be modified to the technical scheme described in foregoing embodiments, or carries out equivalent replacement to wherein some or all of technical characteristic; And these amendments or replacement, do not make the essence of appropriate technical solution depart from the scope of various embodiments of the present invention technical scheme.
Claims (10)
1. a cornu frontale ventriculi lateralis guiding puncture device, is characterized in that, comprises CT machine, fixed support, positioner, angle scale and puncture conduit;
Described fixed support comprises fixed bar, and the axis of described fixed bar is Y-direction, is X-direction perpendicular to described Y-direction;
Described angle scale is arranged on described fixed support by described positioner, and described angle scale respectively along described X-direction and described Y-direction translation, and can rotate around described X-direction;
Described puncture conduit is arranged on described angle scale, and described puncture conduit can along the scale adjustment deflection angle of described angle scale.
2. cornu frontale ventriculi lateralis guiding puncture device according to claim 1, it is characterized in that, also comprise the positioning sliding block that can rotate in a circumferential direction around described angle scale, described puncture conduit connects the center of circle of described positioning sliding block and described angle scale respectively, and described puncture conduit can be rotated around the described center of circle along with described positioning sliding block.
3. cornu frontale ventriculi lateralis guiding puncture device according to claim 2, is characterized in that, described angle scale is quadrant dish.
4. the cornu frontale ventriculi lateralis guiding puncture device according to Claims 2 or 3, it is characterized in that, described positioner comprises horizontal adjustment plate; One end of described horizontal adjustment plate is connected with described angle scale, the other end and cross bar hinged, make described horizontal adjustment plate can around the axial-rotation of described cross bar; Described cross bar is parallel with X-direction and hinged with described fixed bar.
5. cornu frontale ventriculi lateralis guiding puncture device according to claim 4, it is characterized in that, described positioner also comprises X guide runner, and Y guide runner;
Described X guide runner is arranged on described horizontal adjustment plate, and described angle scale is connected with described horizontal adjustment plate by described X guide runner, makes described angle scale can relative to described horizontal adjustment plate along described X-direction translation;
Described Y guide runner is arranged on described cross bar, make described cross bar by described Y guide runner relative to described fixed bar along described Y-direction translation.
6. cornu frontale ventriculi lateralis guiding puncture device according to claim 5, is characterized in that, also comprise correcting mechanism, and described correcting mechanism is for calibrating the position of described puncture conduit relative to described fixed bar.
7. cornu frontale ventriculi lateralis guiding puncture device according to claim 6, it is characterized in that, described correcting mechanism comprises cross laser line connector, and described cross laser line connector is arranged on described angle scale.
8. cornu frontale ventriculi lateralis guiding puncture device according to claim 7, is characterized in that, the laser generator of described cross laser line connector is level of security laser generator.
9. cornu frontale ventriculi lateralis guiding puncture device according to claim 8, it is characterized in that, between described positioning sliding block and described angle scale, between described cross laser line connector and described angle scale, between described X guide runner and described angle scale, between described Y guide runner and described fixed bar, be provided with securing member.
10. cornu frontale ventriculi lateralis guiding puncture device according to claim 9, is characterized in that, described securing member is trip bolt.
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