CN104921784B - A kind of cornu frontale ventriculi lateralis guiding puncture device - Google Patents

A kind of cornu frontale ventriculi lateralis guiding puncture device Download PDF

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Publication number
CN104921784B
CN104921784B CN201510330933.1A CN201510330933A CN104921784B CN 104921784 B CN104921784 B CN 104921784B CN 201510330933 A CN201510330933 A CN 201510330933A CN 104921784 B CN104921784 B CN 104921784B
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puncture
angle scale
conduit
angle
scale
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CN104921784A (en
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张宝国
顾建文
王妮
程刚戈
黄永安
董连强
周岩
马宏伟
张晖
王宇博
舒成
赵明月
张嘉靖
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3403Needle locating or guiding means

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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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Abstract

The present invention provides a kind of cornu frontale ventriculi lateralis guiding puncture devices, including CT machines, fixing bracket, positioner, angle scale and puncture conduit;The fixing bracket includes fixed link, and the axial direction of the fixed link is Y-direction, is X-direction perpendicular to the Y-direction;The angle scale is mounted on by the positioner on the fixing bracket, and the angle scale can be translated and can rotated around the X-direction along the X-direction and the Y-direction respectively;The puncture conduit is mounted on the angle scale, and the puncture conduit can adjust deflection angle along the scale of the angle scale.The cornu frontale ventriculi lateralis guiding puncture device of the present invention extracts the elaborate position of patient's puncture target spot using CT machines, by adjusting positioner and puncture deflection angle of the conduit on angle scale, puncture position, angle and the depth for puncturing conduit is determined, puncture improperly probability is reduced, improves the security level of operation.

Description

A kind of cornu frontale ventriculi lateralis guiding puncture device
Technical field
The present invention relates to the field of medical instrument technology more particularly to a kind of cornu frontale ventriculi lateralis guiding puncture devices.
Background technology
Cornu frontale ventriculi lateralis puncture is that neurosurgery carries out Ventriculo peritoneal shunt and the common operation of extraventricular drainage operation.Volume The parameters such as position, angle, the depth that angle punctures are the key that Ventriculo peritoneal shunt and extraventricular drainage operation success or failure.
Before the preferable position of puncture of frontal angle is homonymy telocoele Men Shi holes (i.e. Monro holes), in the separate ventricles of the brain choroid plexus and Telocoele wall.Common method is single-handedly to puncture, and point of puncture is 2cm in hairline, 2.5cm on the outside of head median line.Puncture procedure When, puncture needle is directed toward offside endocanthion in oblique coronal plane, in sagittal plane by bilateral external auditory meatus line, slow inserting needle is about 4cm or so has cerebrospinal fluid spilling, is put into about 1.5cm or so further along.Operator is needed with oneself subjective sensation, and assurance punctures through Angle of the puncture needle on coronal-plane and sagittal plane in journey, even high seniority doctor is also difficult to find preferable puncture position accurately, Still more feldsher.Therefore, it is commonplace to there is the situation of puncture angle deviation, foreign literature report, the ratio that ideal punctures Example is only 40% or so.
Certainly, can also be come in the hospital perfected in equipment using instruments such as stereotactic apparatus, intraoperative ultrasound, navigators auxiliary Carry out puncture procedure is helped, can so reach very high precision.But due to exist spend high, cumbersome, consuming duration etc. because Element, greatly patient both domestic and external there is no condition using above-mentioned Medical Devices, and condition is simple and crude, situation it is pressed for time Under, many operations can not also be equipped with above-mentioned Medical Devices in time.
The problem of for more than, some doctors once designed, made it is relatively simple punctured for cornu frontale ventriculi lateralis it is auxiliary Help device.
For example, Fig. 1 be the prior art puncture direction finder structure diagram, as shown in Figure 1, puncture direction finder by The semicircle mainboard of angle index is indicated to determine to puncture the puncture direction of conduit, the puncture conduit on the semicircle mainboard is always It is directed toward the midpoint of bilateral external auditory meatus.However, preferably Monro holes not on the line at point of puncture Yu bilateral external auditory meatus midpoint, So theoretically i.e. there are larger errors for puncture direction finder.
For another example, Fig. 2 is the puncture gate apparatus structure diagram of the prior art, as shown in Fig. 2, puncture gate apparatus is vertical at two Crossbeam is set on arm, and trocar sleeve is vertically set on crossbeam, and lancet device is punctured along the central through hole of trocar sleeve. However, cornu frontale ventriculi lateralis puncture on oblique coronal-plane be there are one angle of inclination, so just can guarantee ventricles of the brain cannula tip with Telocoele wall does not contact, this puncture gate apparatus is a vertical puncturing, it is difficult to ensure to puncture ideal position.
Therefore, it using being simple and convenient to operate, having the high puncture auxiliary device for puncturing precision is this field skill to design a kind of The technical issues of art personnel are urgently to be resolved hurrily.
The content of the invention
It is an object of the invention to provide a kind of cornu frontale ventriculi lateralis guiding puncture devices, are drawn with the puncture for solving the prior art It leads appliance arrangement or prohibitively expensive or steering error is big or the problem of guided puncture angle is undesirable.
To achieve these goals, the present invention uses following technical scheme:
A kind of cornu frontale ventriculi lateralis guiding puncture device provided by the invention, including CT machines, fixing bracket, positioner, angle Scale and puncture conduit;The fixing bracket includes fixed link, and the axial direction of the fixed link is Y-direction, perpendicular to the Y-direction For X-direction;The angle scale is mounted on by the positioner on the fixing bracket, and the angle scale being capable of edge respectively The X-direction and the Y-direction are translated and can rotated around the X-direction;The puncture conduit is mounted on the angle scale On, and the puncture conduit can adjust deflection angle along the scale of the angle scale.
Further, the cornu frontale ventriculi lateralis guiding puncture device further includes the positioning that can be rotated in a circumferential direction around the angle scale Sliding block, the conduit that punctures connect the center of circle of the positioning sliding block and the angle scale respectively, enable it is described puncture conduit with The positioning sliding block is rotated around the center of circle.The technical solution has technical effect that:Conduit is punctured by positioning sliding block around angle The center of circle rotation of scale, i.e., the deviation angle for determining the puncture conduit by 2 points strengthen precise angular positions, and improve and wear Pierce the stationarity of conduit.
Preferably, the angle scale is a quarter disk.The technical solution has technical effect that:Since point of puncture exists 1 centimetre or so before sagittal suture left or right side and coronal suture, and the angle i.e. puncture angle for puncturing conduit deviation Y-direction is not more than 90 degree, therefore angle scale can meet the requirement of puncture for a quarter disk, while also it is not take up extra operative space.
Further, the positioner includes horizontal adjustment plate;One end of the horizontal adjustment plate connects with the angle scale It connects, the other end is hinged with cross bar, makes the horizontal adjustment plate can be around the axial-rotation of the cross bar;The cross bar is put down with X-direction It goes and is hinged with the fixed link.The technical solution has technical effect that:Operating table is lain at since in operation, patient faces upward, It is required that cornu frontale ventriculi lateralis guiding puncture device is located at the top of the volume of patient's head, and horizontal adjustment plate can be around being connected in fixed link Cross bar rotates, and realizes the levelness of adjustment cornu frontale ventriculi lateralis guiding puncture device integral device.
Further, the positioner further includes X guide runners and Y guide runners, and the X guide runners are arranged at On the horizontal adjustment plate, the angle scale is connected by the X guide runners with the horizontal adjustment plate, makes the angle scale It can be translated compared with the horizontal adjustment plate along the X-direction;The Y guide runners are arranged on the cross bar, make the horizontal stroke Bar can be translated by the Y guide runners compared with the fixed link along the Y-direction.The technique effect of the technical solution exists In:By setting X guide runners and Y guide runners, adjusting angle scale can be distinguished in the translation of X-direction and cross bar in the Y direction Translation, realize adjustment of displacement of the cornu frontale ventriculi lateralis guiding puncture device in both direction in length and breadth.
Further, correcting mechanism is further included, the correcting mechanism is used to calibrate the puncture conduit compared with the fixation The position of bar.The technical solution has technical effect that:Pass through Level-adjusting, X-direction and Y-direction adjustment of displacement and the anglec of rotation The adjustment of degree, the status requirement of puncture should be met in theory by puncturing conduit, and supplement sets correcting mechanism, can further protect Hinder the guiding accuracy of cornu frontale ventriculi lateralis guiding puncture device.
Further, the correcting mechanism includes cross laser line connector, and the cross laser line connector is arranged at the angle On scale.The technical solution has technical effect that:Cross laser line connector is set on angle scale, and with horizontal adjustment plate Auxiliary alignment, can realize the calibration of parameter i.e. deflection angle, levelness and the X, Y-direction shift value in three directions.
Preferably, the laser generator of the cross laser line connector is security level laser generator.The technical solution Have technical effect that:Cornu frontale ventriculi lateralis guiding puncture device is located at the top of the volume of patient's head, and punctures medical personnel's need It to be operated around cross laser line connector.So in order to ensure being smoothed out for the health of patient and operation, laser Generator selects security level laser generator.
Further, between the positioning sliding block and the angle scale, the cross laser line connector and the angle scale it Between, between the X guide runners and the angle scale, between the Y guide runners and the fixed link, be both provided with fastening Part.The technical solution has technical effect that:The position being connected with each other everywhere is that can be with the connecting portion of relative motion It keeps stablizing, so being provided with fastener between component.
Preferably, the fastener is trip bolt.The technical solution has technical effect that:Fastener selects fastening spiral shell Nail is because trip bolt is conventional effective fastener, and is beneficial to observation and adjustment.
The beneficial effects of the invention are as follows:The cornu frontale ventriculi lateralis guiding puncture device of the present invention is punctured using CT machines extraction patient The elaborate position of target spot by adjusting positioner and punctures deflection angle of the conduit on angle scale, it is determined that puncture conduit Puncture position, angle and depth, reduce puncture improperly probability, improve the security level of operation.
Description of the drawings
In order to illustrate more clearly of the technical solution of the specific embodiment of the invention, specific embodiment will be described below Needed in attached drawing be briefly described.As a comparison, the drawing of the prior art is further comprised in attached drawing.Obviously Ground, the accompanying drawings in the following description are some embodiments of the present invention, for those of ordinary skill in the art, are not being paid On the premise of creative work, other attached drawings are can also be obtained according to these attached drawings.
Fig. 1 is the structure diagram of the puncture direction finder of the prior art;
Fig. 2 is the puncture gate apparatus structure diagram of the prior art;
Fig. 3 is the structure diagram of cornu frontale ventriculi lateralis guiding puncture device provided by the invention;
Fig. 4 is puncture needle track side surface body table perspective view;
Fig. 5 is overhead point of puncture view;
Fig. 6 is the oblique coronal-plane CT images schematic diagram of puncture.
Reference numeral:
1- punctures conduit;2- angle scales;3- positioning sliding blocks;
The 4- centers of circle;5- horizontal adjustment plates;6- cross bars;
7-X guide runners;8-Y guide runners;9- cross laser line connectors;
10- fixed links;A-Monro holes;B- body punctures point;
D- median sagittal planes are with puncturing oblique coronal-plane body surface projection line intersection point;
E- median sagittal lines;F- geisomas midpoint;G- tragus mark points.
Specific embodiment
Technical scheme is clearly and completely described below in conjunction with attached drawing, it is clear that described implementation Example is part of the embodiment of the present invention, instead of all the embodiments.Based on the embodiments of the present invention, ordinary skill Personnel's all other embodiments obtained without making creative work, belong to the scope of protection of the invention.
In the description of the present invention, it is necessary to explanation, term " " center ", " on ", " under ", "left", "right", " vertical ", The orientation or position relationship of the instructions such as " level ", " interior ", " outer " be based on orientation shown in the drawings or position relationship, merely to Convenient for the description present invention and simplify description rather than instruction or imply signified device or element must have specific orientation, With specific azimuth configuration and operation, therefore it is not considered as limiting the invention.In addition, term " first ", " second ", " the 3rd " is only used for description purpose, and it is not intended that instruction or hint relative importance.
In the description of the present invention, it is necessary to illustrate, unless otherwise clearly defined and limited, term " installation ", " phase Even ", " connection " should be interpreted broadly, for example, it may be being fixedly connected or being detachably connected or be integrally connected;It can To be mechanical connection or be electrically connected;It can be directly connected, can also be indirectly connected by intermediary, Ke Yishi Connection inside two elements.For the ordinary skill in the art, with concrete condition above-mentioned term can be understood at this Concrete meaning in invention.
Fig. 3 is the structure diagram of cornu frontale ventriculi lateralis guiding puncture device provided by the invention.As shown in figure 3, telocoele Puncture of frontal angle guide device includes CT machines (not marking), fixing bracket, positioner, angle scale for being fixed on operating bed 2 and puncture conduit 1.Fixing bracket is a fixed link 10, the axial direction of fixed link 10 is set as Y-direction, perpendicular to Y-direction For X-direction.Wherein, angle scale 2 is mounted on by positioner in fixed link 10, and by adjusting positioner, angle scale 2 can It translates, and can rotate around X-direction with Y-direction in X direction respectively.A puncture conduit 1 is also set up on angle scale 2, is punctured Conduit 1 can adjust itself deflection angle compared with angle scale 2 along the scale on angle scale 2.
Further, on the basis of above-described embodiment, as shown in figure 3, being provided with positioning sliding block 3 on angle scale 2, position Sliding block 3 can rotate in a circumferential direction around angle scale 2.Conduit 1 is punctured to be connected with positioning sliding block 3, and it is hinged with the center of circle 4 of angle scale 2. By controlling positioning sliding block 3 that puncture conduit 1 can be made to be rotated around the center of circle 4, and change puncture along the circumferential rotation of angle scale 2 Conduit 1 compared with angle scale 2 deflection angle.
Preferably, on the basis of above-described embodiment, as shown in figure 3, angle scale 2 uses a quarter disk.Wherein, angle Scale 2 can also use angle scale 2 semicircle or that other are fan-shaped, and the present embodiment uses a quarter disk, was both not take up Redundant space position also meets the guiding requirement for puncturing conduit 1.
Preferably, on the basis of above-described embodiment, as shown in figure 3, positioner includes a horizontal adjustment plate 5, water One end connection angle scale 2 of Heibei provincial opera whole plate 5, connecting portion can be that a quarter disk crosses out one section come;Level is adjusted The other end of whole plate 5 is hinged with cross bar 6, and cross bar 6 is connected with fixed link.The connection structure allows horizontal adjustment plate 5 around X Direction rotates, and then angle scale 2 is fixed on horizontal plane.Wherein, horizontal adjustment plate 5 can also be directly connected to angle scale 2 or Person is hinged with support bracket fastened fixed link 10, and but, adjustment effect is not so good as the mounting means of the present embodiment.
Further, on the basis of above-described embodiment, as shown in figure 3, positioner further includes X guide runners 7, Y is led To sliding block 8, wherein X guide runners 7 are fixed on horizontal adjustment plate 5, and one section that angle scale 2 crosses out is with translatable Mode be connected on X guide runners 7 so that angle scale 2 can in X direction be translated compared with horizontal adjustment plate 5;Y is oriented to Sliding block 8 is fixed on cross bar 6 and is socketed with fixed link 10, so as to cross bar 6 can by Y guide runners 8 compared with fixed link 10 along Y Direction translates.The effect of 8 two components of X guide runners 7 and Y guide runners is, angle scale 2 can be made particularly to puncture conduit 1 It can be translated along the X direction with Y-direction.Wherein, two sliding blocks can also be arranged between the component of other relative motions, such as water X guide runners 7 between Heibei provincial opera whole plate 5 and cross bar 6 are set, Y guide runners 8 are set between fixed link 10 and operating table.This implementation Set-up mode in example is a mode of more convenient operation.
Further, on the basis of above-described embodiment, as shown in figure 3, cornu frontale ventriculi lateralis guiding puncture device is also set up There is correcting mechanism.By the adjustment of Level-adjusting, X-direction and Y-direction adjustment of displacement and rotational angle, theoretically meet The position location requirement of conduit 1 is punctured, and supplements the correcting mechanism set, can further ensure cornu frontale ventriculi lateralis guiding puncture The guiding accuracy of device.
Further, on the basis of above-described embodiment, the correcting mechanism of the present embodiment selects cross laser line connector 9, Cross laser line connector 9 is in being arranged on angle scale 2.Using two orthogonal laser beams of cross laser line connector 9, with And horizontal adjustment plate 5 existing for script, you can to calibrate the position in three directions exactly:Conduit 1 is punctured compared with angle scale 2 The deflection angle in the center of circle 4, the levelness for puncturing conduit 1 and puncture position of the conduit 1 compared with support bracket fastened X-direction and Y-direction Shifting parameter.
Preferably, on the basis of above-described embodiment, the laser generator of cross laser line connector 9 selects security level to swash Optical generator.According to the energy rank of laser generator and laser occurring principle, different types of laser generator transmitting swashs Light is different to the harm of human body.Consider that the present embodiment makes from the health of protection patient and protection operator Cross laser line connector 9, laser generator are security level laser generator.
Further, on the basis of above-described embodiment, as shown in figure 3, between each component mutually moved, particularly It is related between the moving component that adjustment punctures 1 position of conduit, has been mounted with the fastener of fixation.Such as in positioning sliding block It is led between 3 and angle scale 2, between cross laser line connector 9 and angle scale 2, between X guide runners 7 and angle scale 2, in Y Between sliding block 8 and fixed link 10, fastener is both provided with.
Preferably, on the basis of above-described embodiment, fastener is trip bolt.Wherein fastener can also select spiral shell Bolt, pin etc..The present embodiment uses trip bolt easy to use, without additionally setting pin hole or attaching nut, can adjust Arbitrary position is fixed in stroke.
In Ventriculo peritoneal shunt and extraventricular drainage operation, the cornu frontale ventriculi lateralis guiding puncture device of the present embodiment is utilized When guiding positioning, operating process is as follows:
1st, determine to puncture distance AB and puncture angle β:
Fig. 4 is punctures needle track side surface body table perspective view, and Fig. 5 is overhead point of puncture view, and Fig. 6 is the oblique coronal-plane CT of puncture Image schematic diagram.As shown in Figure 4,5, 6, CT display labels are placed in tragus mark point G and geisoma midpoint F first and carries out CT It scans and rebuilds, obtain the oblique coronal-plane of the puncture through bilateral tragus mark point G and Monro hole A.Setting-out is carried out on CT machines such as Shown in Fig. 6, measurement punctures distance AB and puncture angle β.
2nd, determine body puncture point B and puncture horizontal plane:
As shown in Figure 4,5, 6, median sagittal line E is marked in patients head, it can be deduced that median sagittal plane is with puncturing tiltedly hat Shape face body surface projection line intersection point D.Median sagittal plane in Fig. 6 is measured to hand on D and horizontal plane with puncturing oblique coronal-plane body surface projection line The distance of body puncture point B, you can draw patient body-surface point of puncture B.Horizontal plane where BD lines are skull point of puncture, is suffering from Person's head surface extends BD lines to tragus mark point G.
3rd, adjustment is punctured 1 position of conduit and is calibrated using cross laser line connector 9:
Patient is in dorsal position, and the plane where making median sagittal line E is vertical;Setting punctures wearing for conduit 1 on angle scale 2 Pierce angle beta;Horizontal adjustment plate 5, X guide runners 7 and Y guide runners 8 are adjusted, the end of puncture conduit 1 is made to be worn positioned at body surface Pierce point B;Cross laser line connector 9 is opened, horizontal adjustment plate 5, X guide runners 7 and Y guide runners 8 is readjusted, makes cross The ordinate of laser rays is Chong Die with median sagittal line E, horizontal line and the BD line overlaps of cross laser line, while punctures the end of conduit 1 Positioned at body puncture point B, whole trip bolts are tightened.It is finally calibrated so as to puncture conduit 1.
4th, puncture procedure:
The puncture tube punctured in conduit 1 is promoted to carry out cornu frontale ventriculi lateralis puncture, paracentesis depth is the distance of AB;It is fixed to puncture Pipe, removes this lateral cerebral ventricle puncture guide device.Cornu frontale ventriculi lateralis is completed to puncture.
It should be noted that cornu frontale ventriculi lateralis guiding puncture device can be used for the surgical procedure of two lateral cerebral ventricle punctures, use When only need rotate 180 degree.
Finally it should be noted that:The above embodiments are only used to illustrate the technical solution of the present invention., rather than its limitations;To the greatest extent Pipe is described in detail the present invention with reference to foregoing embodiments, it will be understood by those of ordinary skill in the art that:Its according to Can so modify to the technical solution recorded in foregoing embodiments either to which part or all technical characteristic into Row equivalent substitution;And these modifications or replacement, the essence of appropriate technical solution is not made to depart from various embodiments of the present invention technology The scope of scheme.

Claims (6)

1. a kind of cornu frontale ventriculi lateralis guiding puncture device, which is characterized in that including CT machines, fixing bracket, positioner, angle scale With puncture conduit;
The fixing bracket includes fixed link, and the axial direction of the fixed link is Y-direction, is X-direction perpendicular to the Y-direction;
The angle scale is mounted on by the positioner on the fixing bracket, and the angle scale can be respectively along described X-direction and the Y-direction are translated and can rotated around the X-direction;
The puncture conduit is mounted on the angle scale, and the puncture conduit can adjust partially along the scale of the angle scale Gyration;
The positioner includes horizontal adjustment plate;One end of the horizontal adjustment plate is connected with the angle scale, the other end with Cross bar is hinged, and makes the horizontal adjustment plate can be around the axial-rotation of the cross bar;The cross bar it is parallel with X-direction and with it is described Fixed link is hinged;
The positioner further includes X guide runners and Y guide runners;
The X guide runners are arranged on the horizontal adjustment plate, and the angle scale passes through the X guide runners and the level Adjustment plate connects, and makes the angle scale that can be translated compared with the horizontal adjustment plate along the X-direction;
The Y guide runners are arranged on the cross bar, make the cross bar can be by the Y guide runners compared with described solid Fixed pole is translated along the Y-direction;
Correcting mechanism is further included, the correcting mechanism is used to calibrate position of the puncture conduit compared with the fixed link;
The correcting mechanism includes cross laser line connector, and the cross laser line connector is arranged on the angle scale.
2. cornu frontale ventriculi lateralis guiding puncture device according to claim 1, which is characterized in that further including can be around the angle The positioning sliding block that scale rotates in a circumferential direction, the center of circle for puncturing conduit and connecting the positioning sliding block and the angle scale respectively, makes The puncture conduit can be rotated with the positioning sliding block around the center of circle.
3. cornu frontale ventriculi lateralis guiding puncture device according to claim 2, which is characterized in that the angle scale for four/ One disk.
4. cornu frontale ventriculi lateralis guiding puncture device according to claim 2, which is characterized in that the cross laser line connector Laser generator be security level laser generator.
5. cornu frontale ventriculi lateralis guiding puncture device according to claim 4, which is characterized in that the positioning sliding block with it is described Between angle scale, between the cross laser line connector and the angle scale, between the X guide runners and the angle scale, Between the Y guide runners and the fixed link, fastener is both provided with.
6. cornu frontale ventriculi lateralis guiding puncture device according to claim 5, which is characterized in that the fastener is fastening spiral shell Nail.
CN201510330933.1A 2015-06-15 2015-06-15 A kind of cornu frontale ventriculi lateralis guiding puncture device Expired - Fee Related CN104921784B (en)

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