JP2016195678A - Puncture needle for subcutaneous tunnel - Google Patents

Puncture needle for subcutaneous tunnel Download PDF

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JP2016195678A
JP2016195678A JP2015076987A JP2015076987A JP2016195678A JP 2016195678 A JP2016195678 A JP 2016195678A JP 2015076987 A JP2015076987 A JP 2015076987A JP 2015076987 A JP2015076987 A JP 2015076987A JP 2016195678 A JP2016195678 A JP 2016195678A
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needle
subcutaneous tunnel
subcutaneous
tip
catheter
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JP6504446B2 (en
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能久 藤野
Yoshihisa Fujino
能久 藤野
来見　良誠
Yoshimasa Kurumi
良誠 来見
裕利 北川
Hirotoshi Kitagawa
裕利 北川
鈴木　賢
Masaru Suzuki
賢 鈴木
翔吾 森
Shogo Mori
翔吾 森
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Nipro Corp
Shiga University of Medical Science NUC
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Nipro Corp
Shiga University of Medical Science NUC
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Abstract

PROBLEM TO BE SOLVED: To provide a puncture needle for a subcutaneous tunnel capable of performing therapeutic simply.SOLUTION: A puncture needle 1 for a subcutaneous tunnel, which is a puncture needle for forming a subcutaneous tunnel 2 having both ends 2a, 2b opened to a skin, includes a bent inner needle 10 having a sharp needle tip on the distal end, an inner needle hub 20 provided on the base end side of the inner needle, and a hollow outer needle 30 through which the inner needle is inserted, and in which a needle tip is projected from the distal end. The outer diameter of a base end side part 30a of the outer needle is equal to or less than the maximum outer diameter of the outer needle.SELECTED DRAWING: Figure 1

Description

本発明は、皮下トンネル用穿刺針に関する。   The present invention relates to a puncture needle for a subcutaneous tunnel.

皮下組織を貫通して両端が皮膚に開口する皮下トンネルを形成するための穿刺針（皮下トンネル用穿刺針）として、たとえば、特許文献１〜３に示すカテーテル留置用穿刺具が知られている。このカテーテル留置用穿刺具は、所定角度に湾曲した針本体と、針本体の基端に取り付けられた操作部と、針本体が挿入されるカニューレとを備えている。   As a puncture needle (puncture needle for subcutaneous tunnel) for forming a subcutaneous tunnel penetrating through a subcutaneous tissue and having both ends opened to the skin, for example, catheter placement puncture devices shown in Patent Documents 1 to 3 are known. This catheter placement puncture tool includes a needle body curved at a predetermined angle, an operation unit attached to a proximal end of the needle body, and a cannula into which the needle body is inserted.

このカテーテル留置用穿刺具を用いて皮下トンネルを形成する際には、針本体をカニューレ内に挿入し、カニューレの基端側部分内に操作部を嵌める。そして、針本体を体内に穿刺し皮下部を通過させた後、針本体の先端を体外に露出させる。これに伴い、カニューレは皮下部を貫通し、カニューレの両端はそれぞれ皮膚上に現れる。このカニューレの基端から針本体を抜き出し、カテーテルをカニューレの先端側から挿入して基端側から引き出している。そして、カニューレを皮下部およびカテーテルから基端側に抜き出して、カテーテルを皮下部に留置してから、カテーテルを血管などに挿入している。   When forming a subcutaneous tunnel using the catheter placement puncture device, the needle body is inserted into the cannula, and the operating portion is fitted into the proximal end portion of the cannula. Then, after the needle body is punctured into the body and passed through the subcutaneous part, the tip of the needle body is exposed outside the body. Along with this, the cannula penetrates the subcutaneous part, and both ends of the cannula appear on the skin. The needle body is extracted from the proximal end of the cannula, and the catheter is inserted from the distal end side of the cannula and pulled out from the proximal end side. Then, the cannula is extracted from the subcutaneous part and the catheter to the proximal end side, and the catheter is placed in the subcutaneous part, and then the catheter is inserted into a blood vessel or the like.

意匠登録 第１１８５００１号公報Design Registration No. 1185001 意匠登録 第１１８５００２号公報Design Registration No. 1185002 意匠登録 第１１８５００３号公報Design Registration No. 1185003

特許文献１の皮下トンネル用留置具では、カニューレの基端側部分内に操作部を嵌めている。このため、このカニューレの基端側部分はその中に操作部が納まるように大径部になっており、基端側部分の径はカニューレの中で最も大きくなっている。よって、カニューレを皮下部およびカテーテルから抜き出す際には、カニューレをこの基端側から抜き出さなければならない。このように、カニューレの抜き出す方向が制限されていることにより、施術において不便になることがある。   In the indwelling device for a subcutaneous tunnel of Patent Document 1, an operation portion is fitted in the proximal end portion of the cannula. For this reason, the proximal end side portion of the cannula has a large diameter portion so that the operation portion is accommodated therein, and the diameter of the proximal end side portion is the largest in the cannula. Therefore, when extracting the cannula from the subcutaneous part and the catheter, the cannula must be extracted from the proximal side. As described above, the direction in which the cannula is extracted may be limited, which may be inconvenient in the treatment.

そこで本発明は、施術を簡単に行うことができる皮下トンネル用穿刺針を提供することを目的としている。   Therefore, an object of the present invention is to provide a puncture needle for a subcutaneous tunnel that can be easily treated.

本発明に係る皮下トンネル用穿刺針は、両端が皮膚に開口する皮下トンネルを形成するための穿刺針であって、湾曲し、かつ、先端に鋭利な針先を有する内針と、前記内針の基端側に設けられている内針ハブと、前記内針が挿通され、かつ、先端から前記針先が突き出している中空の外針と、を備え、前記外針の基端側部分の外径が前記外針の最大外径以下である。   A puncture needle for a subcutaneous tunnel according to the present invention is a puncture needle for forming a subcutaneous tunnel whose both ends are open to the skin, and is curved and has an inner needle having a sharp needle tip at the tip, and the inner needle An inner needle hub provided on the proximal end of the outer needle, and a hollow outer needle through which the inner needle is inserted and the needle tip protrudes from the distal end. The outer diameter is not more than the maximum outer diameter of the outer needle.

本発明によれば、湾曲した内針が外針内に嵌められた皮下トンネル用穿刺針の針先を皮膚に穿刺し、皮下組織を貫通させて、皮膚から体外に突き出すと、両端が皮膚に開口する皮下トンネルが形成される。そして、外針から内針を抜いた後、外針内にカテーテルを挿入してから、外針を体外へ取り出す。この際、外針の基端側部分の外径は外針の最大外径以下であることにより、外針を基端側からも先端側からも引き抜くことができる。このように、外針を引き抜く方向が制限されないため、施術を簡単に行うことができる。   According to the present invention, when the needle tip of a puncture needle for a subcutaneous tunnel in which a curved inner needle is fitted in the outer needle is punctured into the skin, penetrates the subcutaneous tissue, and protrudes from the skin to the outside of the body, both ends are brought into contact with the skin. An open subcutaneous tunnel is formed. Then, after removing the inner needle from the outer needle, the catheter is inserted into the outer needle, and then the outer needle is taken out of the body. At this time, since the outer diameter of the proximal end portion of the outer needle is equal to or smaller than the maximum outer diameter of the outer needle, the outer needle can be pulled out from both the proximal end side and the distal end side. Thus, since the direction in which the outer needle is pulled out is not limited, the treatment can be performed easily.

本発明は、以上に説明した構成を有し、施術を簡単に行うことができる皮下トンネル用穿刺針を提供することができるという効果を奏する。   The present invention has the above-described configuration, and has an effect of providing a puncture needle for a subcutaneous tunnel that can be easily performed.

本発明の第１実施形態に係る皮下トンネル用穿刺針を示す斜視図である。It is a perspective view which shows the puncture needle for subcutaneous tunnels concerning 1st Embodiment of this invention. 図１の皮下トンネル用穿刺針を示す正面図である。It is a front view which shows the puncture needle for subcutaneous tunnels of FIG. 図２の皮下トンネル用穿刺針を先端側から視た図である。It is the figure which looked at the puncture needle for subcutaneous tunnels of FIG. 2 from the front end side. 皮下トンネル用穿刺針を体内に穿刺した状態を示す図である。It is a figure which shows the state which punctured the puncture needle for subcutaneous tunnels in the body. 図４の皮下トンネル用穿刺針の外針を留置した状態を示す図である。FIG. 5 is a diagram showing a state where an outer needle of the hypodermic tunnel puncture needle of FIG. 4 is indwelled. 図５の外針内にカテーテルを通した状態を示す図である。It is a figure which shows the state which passed the catheter through the outer needle of FIG. 図６のカテーテルから外針を抜き出した状態を示す図である。It is a figure which shows the state which extracted the outer needle from the catheter of FIG. 本発明の第２実施形態に係る皮下トンネル用穿刺針を示す斜視図である。It is a perspective view which shows the puncture needle for subcutaneous tunnels concerning 2nd Embodiment of this invention.

以下、本発明に係る実施形態の皮下トンネル用穿刺針について図面を参照して説明する。なお、以下では全ての図面を通じて同一または相当する要素には同一の参照符号を付して、その重複する説明を省略する。また、以下の説明で用いる方向の概念は、説明する上で便宜上使用するものであって、発明の構成の向き等をその方向に限定するものではない。さらに、以下に説明する皮下トンネル用穿刺針は、本発明の一実施形態に過ぎない。従って、本発明は実施形態に限定されず、発明の趣旨を逸脱しない範囲で追加、削除、変更が可能である。   Hereinafter, a puncture needle for a subcutaneous tunnel according to an embodiment of the present invention will be described with reference to the drawings. In the following description, the same or corresponding elements are denoted by the same reference symbols throughout the drawings, and redundant description thereof is omitted. In addition, the concept of the direction used in the following description is used for convenience in description, and does not limit the direction of the configuration of the invention in that direction. Further, the hypodermic tunnel puncture needle described below is only one embodiment of the present invention. Therefore, the present invention is not limited to the embodiments, and additions, deletions, and changes can be made without departing from the spirit of the invention.

（第１実施形態）
図１〜図３に示す皮下トンネル用穿刺針１は、皮下組織を貫通して両端が皮膚に開口する皮下トンネルを形成するために用いられる。なお、以下の説明では、皮下トンネル用穿刺針１によって患者への針の穿刺を行う施術者に対して遠位側の端を先端とし、施術者に対して近位側の端を基端と称している。 (First embodiment)
The puncture needle 1 for a subcutaneous tunnel shown in FIGS. 1 to 3 is used to form a subcutaneous tunnel that penetrates a subcutaneous tissue and has both ends opened to the skin. In the following description, the distal end of the practitioner who punctures the patient with the hypodermic tunnel puncture needle 1 is the distal end, and the proximal end is the proximal end of the practitioner. It is called.

皮下トンネル用穿刺針１は、内針１０、内針ハブ２０および外針３０によって構成されている。内針１０は、皮膚下にある皮下組織に外針３０を進入させるための硬質の針であって、たとえば、金属材料または硬質の合成樹脂から形成されている。内針１０は本体（内針本体）１１および針先１２を有しており、内針本体１１および針先１２は一体的に形成されている。   The hypodermic tunnel puncture needle 1 includes an inner needle 10, an inner needle hub 20, and an outer needle 30. The inner needle 10 is a hard needle for allowing the outer needle 30 to enter the subcutaneous tissue under the skin, and is made of, for example, a metal material or a hard synthetic resin. The inner needle 10 has a main body (inner needle main body) 11 and a needle tip 12, and the inner needle main body 11 and the needle tip 12 are integrally formed.

内針本体１１は、中実の円柱形状または中空の円筒形状であって、その外径は長さ方向に亘って一定またはほぼ一定である。内針本体１１は、その先端が針先１２に接続されており、基端が内針ハブ２０に接続されている。   The inner needle body 11 has a solid columnar shape or a hollow cylindrical shape, and its outer diameter is constant or substantially constant over the length direction. The inner needle body 11 has a distal end connected to the needle tip 12 and a proximal end connected to the inner needle hub 20.

内針本体１１は、Ｕ字状に湾曲しており、第１直線部１１ａ、第２直線部１１ｂおよび湾曲部１１ｃを有している。第１直線部１１ａは、内針本体１１の基端側の部分であって、その先端が湾曲部１１ｃの基端と接続し、基端が内針ハブ２０の先端と接続している。第１直線部１１ａは、その中心軸が内針ハブ２０の中心軸は一致しており、内針ハブ２０の先端から直線状に突き出している。第２直線部１１ｂは、内針本体１１の先端側の部分であって、その先端が針先１２に接続し、基端が湾曲部１１ｃの先端と接続している。湾曲部１１ｃは、第１直線部１１ａと第２直線部１１ｂとの間に設けられており、滑らかに湾曲している。   The inner needle body 11 is curved in a U shape, and has a first straight portion 11a, a second straight portion 11b, and a curved portion 11c. The first straight portion 11 a is a portion on the proximal end side of the inner needle main body 11, and has a distal end connected to the proximal end of the curved portion 11 c and a proximal end connected to the distal end of the inner needle hub 20. The first straight portion 11 a has a central axis that coincides with the central axis of the inner needle hub 20, and protrudes linearly from the tip of the inner needle hub 20. The second straight portion 11b is a portion on the distal end side of the inner needle main body 11, and has a distal end connected to the needle tip 12 and a proximal end connected to the distal end of the bending portion 11c. The curved portion 11c is provided between the first straight portion 11a and the second straight portion 11b and is smoothly curved.

内針本体１１は９０度以上に湾曲している。すなわち、第１直線部１１ａと第２直線部１１ｂとの成す角度は、たとえば、９０度以下になるように湾曲部１１ｃが湾曲している。これにより、針先１２および第２直線部１１ｂは、第１直線部１１ａに対して垂直に延びる、または、各先端に向かってこの垂直線より内針ハブ２０側に近づく方向に延びる。   The inner needle body 11 is curved at 90 degrees or more. That is, the bending portion 11c is bent so that the angle formed by the first straight portion 11a and the second straight portion 11b is, for example, 90 degrees or less. As a result, the needle tip 12 and the second straight portion 11b extend perpendicular to the first straight portion 11a, or extend in the direction closer to the inner needle hub 20 side than the vertical line toward each tip.

さらに、内針本体１１は１８０度以下に湾曲していることが好ましい。これにより、針先１２および第２直線部１１ｂは、第１直線部１１ａに対して平行に延びる、または、各先端に向かってこの平行線より内針ハブ２０側から離れる方向に延びる。   Furthermore, it is preferable that the inner needle body 11 bends to 180 degrees or less. Thereby, the needle tip 12 and the second straight portion 11b extend in parallel to the first straight portion 11a, or extend in a direction away from the inner needle hub 20 side from the parallel line toward each tip.

内針ハブ２０の中心軸に対して垂直な方向において、針先１２の位置は内針ハブ２０の先端またはその近傍に位置する。また、第２直線部１１ｂの長さは、たとえば、皮下トンネル２の長さに等しいなど、皮下トンネル２の長さに応じて設定される。   In the direction perpendicular to the central axis of the inner needle hub 20, the needle tip 12 is positioned at or near the tip of the inner needle hub 20. Further, the length of the second straight part 11b is set according to the length of the subcutaneous tunnel 2, for example, equal to the length of the subcutaneous tunnel 2.

針先１２は、皮膚および皮下組織を穿刺可能に鋭利な形状を有している。たとえば、針先１２は、その先端面が内針ハブ２０または第１直線部１１ａ側を向くように斜めにカットされている。針先１２は、その中心軸と第２直線部１１ｂの中心軸とは一致しており、内針本体１１の先端から直線状に突き出している。   The needle tip 12 has a sharp shape that can puncture the skin and subcutaneous tissue. For example, the needle tip 12 is cut obliquely so that the distal end surface thereof faces the inner needle hub 20 or the first linear portion 11a side. The needle tip 12 coincides with the central axis of the second linear portion 11 b and projects linearly from the tip of the inner needle main body 11.

内針ハブ２０は、たとえば、合成樹脂から形成されており、略円柱形状または略円筒形状を有している。内針ハブ２０には、医師や看護師などの施術者が把持し易いように略直方体形状の把持部２１が設けられていている。なお、内針ハブ２０の形状や材料は、施術者が手で把持可能であって、皮下トンネルを形成できる強度を有していれば、特に限定されない。   The inner needle hub 20 is made of, for example, a synthetic resin and has a substantially columnar shape or a substantially cylindrical shape. The inner needle hub 20 is provided with a gripping portion 21 having a substantially rectangular parallelepiped shape so that a practitioner such as a doctor or a nurse can easily grip. In addition, the shape and material of the inner needle hub 20 are not particularly limited as long as the practitioner can grasp by hand and has a strength capable of forming a subcutaneous tunnel.

外針３０は、可撓性を有する合成樹脂により形成され、中空の円筒形状の細管である。外針３０の先端側部分３０ｂは先端に近くなるほど細くなるようなテーパ形状を有しており、先端側部分３０ｂ以外の部分が一定である。このため、外針３０の外径は、先端側部分３０ｂが外針３０の最大外径より小さく、基端側部分３０ａが外針３０の最大外径と同径である。なお、ここでは、基端側部分３０ａが外針３０の最大外径と同径としたが、外針３０の基端側部分３０ａの外径は、外針３０の最大外径以下であればよい。たとえば、外針３０の基端側部分３０ａの外径が外針３０の最大外径未満であってもよい。   The outer needle 30 is a hollow cylindrical thin tube formed of a synthetic resin having flexibility. The distal end portion 30b of the outer needle 30 has a taper shape that becomes thinner as it approaches the distal end, and the portions other than the distal end portion 30b are constant. Therefore, the outer diameter of the outer needle 30 is such that the distal end portion 30 b is smaller than the maximum outer diameter of the outer needle 30, and the proximal end portion 30 a is the same diameter as the maximum outer diameter of the outer needle 30. Here, the proximal end portion 30 a has the same diameter as the maximum outer diameter of the outer needle 30, but the outer diameter of the proximal end portion 30 a of the outer needle 30 is less than or equal to the maximum outer diameter of the outer needle 30. Good. For example, the outer diameter of the proximal end portion 30 a of the outer needle 30 may be less than the maximum outer diameter of the outer needle 30.

外針３０の先端側部分３０ｂの内径は他の部分に比べて小さく、この先端側部分３０ｂを除く外針３０の内径は一定である。外針３０の内径は内針本体１１の外径より大きく、この差は外針３０の先端側部分３０ｂが他の部分より小さくなっている。   The inner diameter of the distal end portion 30b of the outer needle 30 is smaller than that of the other portions, and the inner diameter of the outer needle 30 excluding the distal end portion 30b is constant. The inner diameter of the outer needle 30 is larger than the outer diameter of the inner needle body 11, and this difference is such that the distal end portion 30b of the outer needle 30 is smaller than the other portions.

外針３０の長さは内針１０の長さより短く設定されている。外針３０内に内針１０を挿入した際、外針３０の基端が内針ハブ２０の先端に当たり、外針３０の先端から内針１０の針先１２が突出する。   The length of the outer needle 30 is set shorter than the length of the inner needle 10. When the inner needle 10 is inserted into the outer needle 30, the proximal end of the outer needle 30 hits the distal end of the inner needle hub 20, and the needle tip 12 of the inner needle 10 protrudes from the distal end of the outer needle 30.

次に、図４〜図７を参照しながら、皮下トンネル用穿刺針１を用いて皮下トンネル２を形成し、皮下トンネル２にカテーテル５を通す施術方法について説明する。なお、この施術方法では、患者の体内にある検査や治療などの対象部分（たとえば、硬膜外腔）にカテーテル５の先端側部分が既に挿入されており、このカテーテル５の基端側部分を皮下トンネル２に通すための施術方法である。ただし、皮下トンネル用穿刺針１を用いた施術はこの施術方法に限定されない。   Next, with reference to FIG. 4 to FIG. 7, a treatment method in which the subcutaneous tunnel 2 is formed using the subcutaneous tunnel puncture needle 1 and the catheter 5 is passed through the subcutaneous tunnel 2 will be described. In this treatment method, the distal end portion of the catheter 5 has already been inserted into a target portion (for example, epidural space) in the patient's body for examination and treatment, and the proximal end portion of the catheter 5 is This is a treatment method for passing through the subcutaneous tunnel 2. However, the treatment using the subcutaneous tunnel puncture needle 1 is not limited to this treatment method.

図４に示すように、体内に既に留置されているカテーテル５によって皮膚３に穿孔６が形成されている。施術者は、内針ハブ２０の把持部２１を手に持って穿刺する。この際、患者の負担や治療上の便宜などを考慮し、穿孔６に皮下トンネル用穿刺針１の針先１２を挿入することが望ましい。また、針先１２がカテーテル５を傷つけないように、針先１２をカテーテル５に沿わせるようにする。なお、針先１２の穿刺の位置は、穿孔６の近傍であってもよい。   As shown in FIG. 4, a perforation 6 is formed in the skin 3 by a catheter 5 already placed in the body. The practitioner punctures the hand holding part 21 of the inner needle hub 20 in his / her hand. At this time, it is desirable to insert the needle tip 12 of the puncture needle 1 for the subcutaneous tunnel into the perforation 6 in consideration of the burden on the patient and the convenience of treatment. Further, the needle tip 12 is made to follow the catheter 5 so that the needle tip 12 does not damage the catheter 5. Note that the puncture position of the needle tip 12 may be in the vicinity of the perforation 6.

そして、施術者は、針先１２を斜め下方に向かって突き刺して皮下組織４内に挿入してから、針先１２を斜め上方に向きを変えて施術者側に引き上げる。これにより、内針１０および外針３０が、皮下組織４を曲線状に貫通して、これらの両端側部分は皮膚３から体外に突き出す。   Then, the practitioner stabs the needle tip 12 obliquely downward and inserts it into the subcutaneous tissue 4, and then turns the needle tip 12 obliquely upward and pulls it up to the practitioner side. As a result, the inner needle 10 and the outer needle 30 penetrate the subcutaneous tissue 4 in a curved shape, and both end portions thereof protrude from the skin 3 to the outside of the body.

施術者は、内針１０を基端側から外針３０内から取り出して、図５に示すように、外針３０を体内に留置する。この外針３０によって、湾曲した皮下トンネル２が皮下組織４内に形成される。皮下トンネル２の両端が皮膚３上に開口し、この皮下トンネル２の両端開口２ａ、２ｂの間の長さは、たとえば、数十ｍｍである。なお、皮下トンネル２の両端開口２ａ、２ｂの一方開口２ａはカテーテル５の挿入口として利用され、他方開口２ｂはカテーテル５の取出口として利用される。ここでは、挿入口は、カテーテル５の穿孔６またはその近傍に形成された開口２ａである。   The practitioner takes the inner needle 10 out of the outer needle 30 from the proximal end side, and places the outer needle 30 in the body as shown in FIG. A curved subcutaneous tunnel 2 is formed in the subcutaneous tissue 4 by the outer needle 30. Both ends of the subcutaneous tunnel 2 are opened on the skin 3, and the length between the both ends openings 2a and 2b of the subcutaneous tunnel 2 is, for example, several tens of mm. In addition, one opening 2a of both-end openings 2a and 2b of the subcutaneous tunnel 2 is used as an insertion port of the catheter 5, and the other opening 2b is used as an outlet of the catheter 5. Here, the insertion port is the opening 2a formed in the perforation 6 of the catheter 5 or in the vicinity thereof.

図６に示すように、カテーテル５の基端を外針３０の基端および皮下トンネル２の挿入口２ａから挿入して、外針３０および皮下トンネル２を通過させて、外針３０の先端および皮下トンネル２の取出口２ｂから引き出す。これにより、カテーテル５は外針３０および皮下トンネル２を通過し、カテーテル５の基端側部分が外針３０の先端および取出口２ｂから突き出す。   As shown in FIG. 6, the proximal end of the catheter 5 is inserted from the proximal end of the outer needle 30 and the insertion port 2a of the subcutaneous tunnel 2, and is passed through the outer needle 30 and the subcutaneous tunnel 2, and the distal end of the outer needle 30 and Pull out from the outlet 2b of the subcutaneous tunnel 2. Thus, the catheter 5 passes through the outer needle 30 and the subcutaneous tunnel 2, and the proximal end portion of the catheter 5 protrudes from the distal end of the outer needle 30 and the outlet 2b.

最後に、図７に示すように、外針３０をその先端側から引き出すと、外針３０は皮下トンネル２およびカテーテル５から取り出される。これにより、カテーテル５は、湾曲する皮下トンネル２内を通過して体外へ出る。ここで、皮下トンネル２の挿入口２ａおよび取出口２ｂを覆うように保護テープ（図示せず）を皮膚３に貼る。   Finally, as shown in FIG. 7, when the outer needle 30 is pulled out from the distal end side, the outer needle 30 is taken out from the hypodermic tunnel 2 and the catheter 5. Thereby, the catheter 5 passes through the curved subcutaneous tunnel 2 and goes out of the body. Here, a protective tape (not shown) is applied to the skin 3 so as to cover the insertion port 2a and the outlet 2b of the subcutaneous tunnel 2.

上記構成によれば、外針３０の基端側部分３０ａの外径が外針３０の最大外径以下に形成されているため、外針３０の基端側部分３０ａに大径部が設けられていない。また、外針３０の先端側部分３０ｂには、通常、外針３０を体内に挿入し易いように大径部が設けられない。このため、外針３０の両端側部分には大径部がないため、外針３０を抜く方向が大径部によって制限されることはなく、施術を簡単に行うことができる。また、埋設されているカテーテル５を通すための皮下トンネル２を形成するような場合には、安全に施術を行うことができる。   According to the above configuration, since the outer diameter of the proximal end portion 30a of the outer needle 30 is formed to be equal to or smaller than the maximum outer diameter of the outer needle 30, the large diameter portion is provided in the proximal end portion 30a of the outer needle 30. Not. The distal end portion 30b of the outer needle 30 is usually not provided with a large diameter portion so that the outer needle 30 can be easily inserted into the body. For this reason, since there is no large diameter part in the both-ends side part of the outer needle 30, the direction which pulls out the outer needle 30 is not restrict | limited by the large diameter part, and operation can be performed easily. Further, when the subcutaneous tunnel 2 for passing the embedded catheter 5 is formed, the treatment can be performed safely.

たとえば、図４〜図７に示すような、埋設されているカテーテル５を通す皮下トンネル２を形成する場合について説明する。患者の負担や治療上の便宜などを考慮して、カテーテル５の穿孔６またはその近傍から皮下トンネル２にカテーテル５を挿入する必要があるため、皮下トンネル２の挿入口２ａを穿孔６またはその近傍に形成しなければならない。また、カテーテル５の先端は体内に埋設されているため、カテーテル５を外針３０内に挿入した後は、カテーテル５の基端側（皮下トンネル２の取出口２ｂ）から外針３０を抜き出す必要がある。   For example, the case where the subcutaneous tunnel 2 through which the embedded catheter 5 is passed as shown in FIGS. 4 to 7 will be described. Considering the burden on the patient and the convenience of treatment, it is necessary to insert the catheter 5 into the subcutaneous tunnel 2 from or near the perforation 6 of the catheter 5, so that the insertion port 2a of the subcutaneous tunnel 2 is perforated at or near the perforation 6 Must be formed. Further, since the distal end of the catheter 5 is embedded in the body, it is necessary to extract the outer needle 30 from the proximal end side (the outlet 2b of the subcutaneous tunnel 2) of the catheter 5 after the catheter 5 is inserted into the outer needle 30. There is.

ここで、大径部が設けられている外針３０を用いた場合、カテーテル５から外針３０を取り出す方向は大径部によって制限されている。よって、カテーテル５の穿孔６から離れた位置に穿刺して、穿孔６の位置から針先１２を体外に出す。これにより、挿入口２ａを穿孔６に設け、カテーテル５を穿孔６から皮下トンネル２に挿入することができる。また、外針３０の大径部を取出口２ｂ側に設け、皮下トンネル２の取出口２ｂから外針３０を抜き出すことができる。しかしながら、体内にある針先１２の位置を目視できないため、穿孔６の位置で体外に針先１２を出すことは難しいうえ、針先１２がカテーテル５に当たりカテーテル５を傷つける恐れがある。   Here, when the outer needle 30 provided with the large diameter portion is used, the direction in which the outer needle 30 is extracted from the catheter 5 is limited by the large diameter portion. Therefore, the catheter 5 is punctured at a position away from the perforation 6 and the needle tip 12 is moved out of the body from the position of the perforation 6. Thereby, the insertion port 2 a is provided in the perforation 6, and the catheter 5 can be inserted into the subcutaneous tunnel 2 from the perforation 6. In addition, a large diameter portion of the outer needle 30 can be provided on the outlet 2b side, and the outer needle 30 can be extracted from the outlet 2b of the subcutaneous tunnel 2. However, since the position of the needle tip 12 in the body cannot be visually confirmed, it is difficult to bring the needle tip 12 out of the body at the position of the perforation 6, and the needle tip 12 may hit the catheter 5 and damage the catheter 5.

これに対し、皮下トンネル用穿刺針１では、外針３０の基端側部分３０ａに大径部が設けられていない。これにより、カテーテル５から外針３０を取り出す方向が制限されていないため、カテーテル５の穿孔６に穿刺しても、皮下トンネル２の取出口２ｂから外針３０を抜き出すことができる。よって、カテーテル５の穿孔６の位置およびカテーテル５の位置を確認しながら、針先１２を穿刺して施術することができる。よって、カテーテル５を傷つけることなく安全に、穿孔６またはその近傍に穿刺して挿入口を簡単に形成することができる。   On the other hand, in the hypodermic tunnel puncture needle 1, the large-diameter portion is not provided in the proximal end portion 30 a of the outer needle 30. Thereby, since the direction in which the outer needle 30 is extracted from the catheter 5 is not limited, the outer needle 30 can be extracted from the outlet 2b of the subcutaneous tunnel 2 even if the puncture 6 of the catheter 5 is punctured. Therefore, the needle tip 12 can be punctured while performing the operation while confirming the position of the perforation 6 of the catheter 5 and the position of the catheter 5. Therefore, it is possible to easily form the insertion port by puncturing at or near the perforation 6 without damaging the catheter 5.

さらに、外針３０の基端側部分３０ａの外径を外針３０の最大外径未満にすると、外針３０がさらに抜き易くなる。   Furthermore, when the outer diameter of the proximal end portion 30 a of the outer needle 30 is less than the maximum outer diameter of the outer needle 30, the outer needle 30 is further easily pulled out.

また、内針本体１１が湾曲しているため、湾曲した皮下トンネル２を容易に形成することができる。湾曲した皮下トンネル２からカテーテル５が抜けにくいため、カテーテル５をより確実に固定することができる。さらに、皮下トンネル２内で出血している場合、湾曲した皮下トンネル２の底に血液が溜まるので、体外への出血を防止することができる。また、内針本体１１が湾曲していることにより、外針３０が内針１０から外れにくいため、施術し易い。   Further, since the inner needle main body 11 is curved, the curved subcutaneous tunnel 2 can be easily formed. Since the catheter 5 is difficult to be removed from the curved subcutaneous tunnel 2, the catheter 5 can be more reliably fixed. Furthermore, when bleeding in the subcutaneous tunnel 2, blood accumulates at the bottom of the curved subcutaneous tunnel 2, so that bleeding outside the body can be prevented. Further, since the inner needle body 11 is curved, the outer needle 30 is unlikely to be detached from the inner needle 10, so that the treatment is easy.

さらに、内針本体１１が９０度以上に湾曲していることにより、短い皮下トンネル２を容易に形成することができる。このため、皮下トンネル２により損傷する皮下組織４の範囲を狭くすることができ、皮下トンネル２の形成による患者の負担を抑えることができる。また、皮下トンネル２の両端開口２ａ、２ｂ間の長さが短いため、１枚の保護テープで両端開口２ａ、２ｂの両方を覆うことができ、皮下トンネル２を通過するカテーテル５を簡単かつより確実に固定することができる。   Furthermore, since the inner needle body 11 is curved at 90 degrees or more, the short subcutaneous tunnel 2 can be easily formed. For this reason, the range of the subcutaneous tissue 4 damaged by the subcutaneous tunnel 2 can be narrowed, and the burden on the patient due to the formation of the subcutaneous tunnel 2 can be suppressed. In addition, since the length between the both end openings 2a and 2b of the subcutaneous tunnel 2 is short, both the end openings 2a and 2b can be covered with a single protective tape, and the catheter 5 passing through the subcutaneous tunnel 2 can be easily and more easily It can be fixed securely.

また、内針本体１１の先端側部分に第２直線部１１ｂが設けられている。これにより、施術者は、第２直線部１１ｂおよびその先端側に設けられている針先１２の進む方向を調整し易いため、施術を簡単に行うことができる。   Further, a second straight portion 11 b is provided at the tip side portion of the inner needle main body 11. Accordingly, the practitioner can easily adjust the direction in which the second straight portion 11b and the needle tip 12 provided on the distal end side thereof are advanced, and thus can perform the treatment easily.

さらに、外針３０の先端側部分３０ｂの外径が小さくなっているため、穿刺し易い。また、外針３０の先端側部分３０ｂの内径が小さくなっていることにより、外針３０と内針１０との間隔が狭く、外針３０が内心から外れにくいため、皮下トンネル用穿刺針１を取扱い易い。   Furthermore, since the outer diameter of the distal end portion 30b of the outer needle 30 is small, it is easy to puncture. Further, since the inner diameter of the distal end portion 30b of the outer needle 30 is reduced, the distance between the outer needle 30 and the inner needle 10 is narrow, and the outer needle 30 is difficult to come off from the inner center. Easy to handle.

（第２実施形態）
第２実施形態に係る皮下トンネル用穿刺針１では、内針本体１３の形状が第１実施形態に係る内針本体１１とは異なるが、それ以外は同様である。内針本体１３は、図８に示すように、湾曲せずに、その全長に亘って直線状に形成されている。内針本体１３は、その基端が内針ハブ２０の先端に接続し、その中心軸が内針ハブ２０の中心軸と一致して、内針ハブ２０の先端から真っ直ぐに延びている。内針本体１３は、その先端が針先１２の基端に接続し、その中心軸が針先１２の中心軸と一致して、針先１２は内針本体１３の先端から真っ直ぐに延びている。 (Second Embodiment)
In the puncture needle 1 for the subcutaneous tunnel according to the second embodiment, the shape of the inner needle main body 13 is different from that of the inner needle main body 11 according to the first embodiment, but the other points are the same. As shown in FIG. 8, the inner needle main body 13 is formed in a straight line over its entire length without being curved. The inner needle main body 13 has a proximal end connected to the distal end of the inner needle hub 20, and a central axis thereof coincides with the central axis of the inner needle hub 20 and extends straight from the distal end of the inner needle hub 20. The inner needle body 13 has a distal end connected to the proximal end of the needle tip 12, a central axis thereof coincides with the central axis of the needle tip 12, and the needle tip 12 extends straight from the distal end of the inner needle main body 13. .

この内針本体１３に、基端側部分３０ａの外径が外針３０の最大外径以下の外針３０を嵌めて、施術する。この場合、施術者は、皮膚３および皮下組織４の一部を指で挟んで、挟んだ部分に針先１２を穿刺する。そして、挟んだ部分に内針１０および外針３０を貫通させてから、内針１０を外針３０から抜き、指を離すと、図５に示すように湾曲した外針３０が皮下組織４内に埋設される。図６に示すように外針３０内にカテーテル５を通した後、図７に示すように外針３０を皮下トンネル２から抜き取れば、カテーテル５が皮下トンネル２内に埋設されることになる。   An operation is performed by fitting the outer needle 30 having an outer diameter of the proximal end portion 30 a equal to or smaller than the maximum outer diameter of the outer needle 30 to the inner needle body 13. In this case, the practitioner pinches part of the skin 3 and the subcutaneous tissue 4 with a finger and punctures the needle tip 12 in the pinched part. Then, after the inner needle 10 and the outer needle 30 are passed through the sandwiched portion, the inner needle 10 is removed from the outer needle 30 and the finger is released. As a result, as shown in FIG. Buried in After passing the catheter 5 through the outer needle 30 as shown in FIG. 6 and then withdrawing the outer needle 30 from the subcutaneous tunnel 2 as shown in FIG. 7, the catheter 5 is embedded in the subcutaneous tunnel 2. .

上記構成によれば、基端側部分３０ａの外径が外針３０の最大外径以下に形成された外針３０を用いることにより、第１実施形態の皮下トンネル用穿刺針１と同様に、簡単かつ安全に施術を行うことができる。また、外針３０の先端側部分３０ｂの内径が小さくなっていることにより、皮下トンネル用穿刺針１を取扱い易い。   According to the above configuration, by using the outer needle 30 formed so that the outer diameter of the proximal end side portion 30a is equal to or smaller than the maximum outer diameter of the outer needle 30, similarly to the hypodermic tunnel puncture needle 1 of the first embodiment, The treatment can be performed easily and safely. Further, since the inner diameter of the distal end portion 30b of the outer needle 30 is small, the subcutaneous tunnel puncture needle 1 is easy to handle.

（その他の実施形態）
上記全実施形態の皮下トンネル用穿刺針１では、外針３０の先端側部分３０ｂの内径および外径を他の部分より小さく形成した。これに対し、先端側部分３０ｂの内径および外径の少なくともいずれか一方が他の部分と同じであってもよい。 (Other embodiments)
In the puncture needle 1 for the subcutaneous tunnel of all the embodiments described above, the inner diameter and the outer diameter of the distal end side portion 30b of the outer needle 30 are formed smaller than other portions. On the other hand, at least one of the inner diameter and the outer diameter of the tip end portion 30b may be the same as the other portions.

また、第１実施形態の皮下トンネル用穿刺針１では、内針本体１１の一部が湾曲していたが、内針本体１１が全長に亘って湾曲していてもよい。また、内針本体１１において湾曲部１１ｃの両端に第１直線部１１ａおよび第２直線部１１ｂを設けたが、第１直線部１１ａおよび第２直線部１１ｂのいずれか一方のみを設けてもよい。このように、内針本体１１の先端側部分３０ｂが湾曲している場合、湾曲する針先１２を用いることもできる。   Further, in the hypodermic tunnel puncture needle 1 of the first embodiment, a part of the inner needle main body 11 is curved, but the inner needle main body 11 may be curved over the entire length. Moreover, although the 1st linear part 11a and the 2nd linear part 11b were provided in the both ends of the curved part 11c in the inner needle main body 11, you may provide only any one of the 1st linear part 11a and the 2nd linear part 11b. . As described above, when the distal end portion 30b of the inner needle main body 11 is curved, the curved needle tip 12 can be used.

１ ：皮下トンネル用穿刺針
２ ：皮下トンネル
２ａ ：開口
２ｂ ：開口
３ ：皮膚
１０ ：内針
１１ ：内針本体
１１ｂ ：第２直線部
１１ｃ ：湾曲部
１２ ：針先
１３ ：内針本体
２０ ：内針ハブ
３０ ：外針
３０ａ ：基端側部分 1: Piercing needle for subcutaneous tunnel 2: Subcutaneous tunnel 2a: Opening 2b: Opening 3: Skin 10: Inner needle 11: Inner needle main body 11b: Second straight part 11c: Curved part 12: Needle tip 13: Inner needle main body 20: Inner needle hub 30: Outer needle 30a: Base end side portion

Claims (4)

両端が皮膚に開口する皮下トンネルを形成するための穿刺針であって、
湾曲し、かつ、先端に鋭利な針先を有する内針と、
前記内針の基端側に設けられている内針ハブと、
前記内針が挿通され、かつ、先端から前記針先が突き出している中空の外針と、を備え、
前記外針の基端側部分の外径が前記外針の最大外径以下である、皮下トンネル用穿刺針。 A puncture needle for forming a subcutaneous tunnel whose both ends open to the skin,
An inner needle that is curved and has a sharp needle tip at the tip;
An inner needle hub provided on the proximal end side of the inner needle;
A hollow outer needle through which the inner needle is inserted and the needle tip protrudes from the tip;
A puncture needle for a subcutaneous tunnel, wherein an outer diameter of a proximal end portion of the outer needle is equal to or smaller than a maximum outer diameter of the outer needle. 前記内針は、９０度より大きく湾曲している、請求項１に記載の皮下トンネル用穿刺針。   The puncture needle for a subcutaneous tunnel according to claim 1, wherein the inner needle is curved larger than 90 degrees. 前記内針は、湾曲部、および、前記湾曲部より先端側に設けられている直線部を有している、請求項１または２に記載の皮下トンネル用穿刺針。   The puncture needle for a subcutaneous tunnel according to claim 1 or 2, wherein the inner needle has a curved portion and a straight portion provided on a distal end side with respect to the curved portion. 前記外針の接続された外針ハブが備えられていない、請求項１〜３のいずれか一項に記載の皮下トンネル用穿刺針。   The puncture needle for a subcutaneous tunnel according to any one of claims 1 to 3, wherein an outer needle hub to which the outer needle is connected is not provided.
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CN110292419A (en) * 2018-03-22 2019-10-01 深圳市擎源医疗器械有限公司 Hypodermic tunnel constructing apparatus

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Publication number Priority date Publication date Assignee Title
CN110292419A (en) * 2018-03-22 2019-10-01 深圳市擎源医疗器械有限公司 Hypodermic tunnel constructing apparatus

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