JP4144647B1 - Vascular puncture device for medical dialysis - Google Patents

Abstract

【課題】静脈への刺入は一箇所で、静脈への刺入操作が容易で、迅速にできる単針型の透析用血管穿刺具２０を提供する。
【解決手段】単針型の透析用血管穿刺具２０において、先端部の外管穿刺針３０を分岐管４０と伸縮調節管５０からなる穿刺具本体２０１に対して着脱可能に構成する。
【選択図】図１A single needle type dialysis blood vessel puncture device 20 is provided which can be pierced into a vein at a single location and can be quickly and easily pierced into a vein.
In a single-needle type dialysis blood vessel puncture device 20, an outer tube puncture needle 30 at a distal end portion is configured to be detachable from a puncture device body 201 including a branch tube 40 and an expansion / contraction adjustment tube 50.
[Selection] Figure 1

Description

本発明は、血液透析装置の血液回路に関し、特に血液透析装置を透析者の血管へ接続するために使用する血管穿刺具に関する。The present invention relates to a blood circuit of a hemodialysis apparatus, and more particularly, to a blood vessel puncture device used to connect a hemodialysis apparatus to a blood vessel of a dialyzer.

血液透析は、急性あるいは慢性の腎不全症者の血液中の老廃物や余分な水分を、人工腎臓と呼ばれる血液透析装置を用いて除去する治療法を言う。
図１５は従来から行われている一般的な血液透析システムを示す概要図である。該図１５において、透析者１から体外に導出された血液は、血液取出回路２を経由し、透析器としてのダイアライザ３へ送流され、ここで浄化されて血液還流回路４を経由し透析者１の体内へ還流される。Hemodialysis is a treatment method that removes waste and excess water in the blood of patients with acute or chronic renal failure using a hemodialysis machine called an artificial kidney.
FIG. 15 is a schematic diagram showing a general hemodialysis system conventionally performed. In FIG. 15, the blood led out from the body from the dialyzer 1 is sent to the dialyzer 3 as a dialyzer via the blood extraction circuit 2, where it is purified and passed through the blood return circuit 4. 1 is returned to the body.

図１６は上記の従来法における透析者１と血液取出回路２および血液還流回路４との接続法を示す説明図である。該図１６において、９０は透析者１の腕部の動脈、９１は静脈、９２は透析者の手首にあらかじめ処置された動静脈シャントを示している。該シャント９２は動脈９０と静脈９１とを吻合して、該吻合部の血管を膨大させ、体外への血液取出しを容易とするための処置である。  FIG. 16 is an explanatory view showing a method of connecting the dialyzer 1 with the blood extraction circuit 2 and the blood reflux circuit 4 in the conventional method. In FIG. 16, 90 is an artery in the arm of the dialyzer 1, 91 is a vein, and 92 is an arteriovenous shunt pretreated on the dialer's wrist. The shunt 92 is a treatment for anastomosing the artery 90 and the vein 91 to enlarge the blood vessels in the anastomosis and facilitate blood removal outside the body.

この動静脈シャント９２により付近の静脈９１が膨大して太くなり、後述の血液取出用穿刺針５や血液還流用穿刺針６の静脈９１への刺入れが容易となる。血液取出用穿刺針５は血液取出回路２の端部に、血液還流用穿刺針６は血液還流回路４の端部に各々取り付けられている。  The arteriovenous shunt 92 enlarges the nearby vein 91 enormously and facilitates the insertion of the blood extraction puncture needle 5 and the blood reflux puncture needle 6 described later into the vein 91. The blood extraction puncture needle 5 is attached to the end of the blood extraction circuit 2, and the blood recirculation puncture needle 6 is attached to the end of the blood recirculation circuit 4.

血液透析回路を形成する際は、図１６に示すように、まず血液取出用穿刺針５をシャント９２近くの静脈９１に刺入れると共に、血液還流用穿刺針６を血液取用穿刺針５の刺入れ位置より若干下流側の静脈９１に刺入れる。なお、血液取出用穿刺針５の刺入れ方向は、静脈９１の血流方向と逆向きに、また、血液還流用穿刺針６の刺入れ方向は、静脈９１の血流方向と順方向に設定する。  When forming the hemodialysis circuit, as shown in FIG. 16, the blood extraction puncture needle 5 is first inserted into a vein 91 near the shunt 92 and the blood reflux puncture needle 6 is inserted into the blood extraction puncture needle 5. The vein 91 is inserted slightly downstream from the insertion position. The insertion direction of the blood extraction puncture needle 5 is set to be opposite to the blood flow direction of the vein 91, and the insertion direction of the blood return puncture needle 6 is set to the forward direction with respect to the blood flow direction of the vein 91. To do.

以上により、透析者１とダイアライザ３との間に血液透析回路が形成される。血液透析が開始されると、血液取用穿刺針５先端から透析者１の血液が穿刺針５に導入される。穿刺針５へ導入された血液は、該穿刺針５から血液取出回路２を経由し、ダイアライザ３の血液導入部７からダイアライザ３内へ連続的に導入される。ダイアライザ３では、導入された血液が浄化され、浄化された血液はダイアライザ３の血液導出部９から血液還流回路４を介して、穿刺針６から静脈９１へ還流される。  As described above, a hemodialysis circuit is formed between the dialyzer 1 and the dialyzer 3. When hemodialysis is started, the blood of the dialyzer 1 is introduced into the puncture needle 5 from the tip of the blood puncture needle 5. The blood introduced into the puncture needle 5 is continuously introduced from the blood introduction part 7 of the dialyzer 3 into the dialyzer 3 via the blood extraction circuit 2. In the dialyzer 3, the introduced blood is purified, and the purified blood is returned from the puncture needle 6 to the vein 91 via the blood return circuit 4 from the blood outlet 9 of the dialyzer 3.

上記の従来法の血液透析では、血液取出用と血液還流用の２本の穿刺針５，６を静脈９１へ刺入れるため、透析者１にとってはこれが大きな負担となっていた。これを解消するために、穿刺針を二重管構造に形成し、静脈への刺入を一箇所にして血液取出用と血液還流用の回路が形成できるようにした単針型の穿刺針が、特開昭５４−２８４９９号や国際公開ＷＯ２００６／０２２０２５で提供されている。図１７、図１８は、これらの穿刺針の主要部の概要を示している。  In the conventional hemodialysis described above, since two puncture needles 5 and 6 for blood extraction and blood recirculation are inserted into the vein 91, this is a heavy burden on the dialyzer 1. In order to solve this problem, a single needle type puncture needle is formed in which a puncture needle is formed in a double tube structure, and a circuit for blood extraction and blood circulation can be formed by inserting a vein into one place. , Japanese Patent Application Laid-Open No. 54-28499 and International Publication WO 2006/022025. 17 and 18 show an outline of the main part of these puncture needles.

図１７において、１０は従来の単針型の穿刺針を示し、該穿刺針１０は一方部（図において左方部）が穿刺部１１に形成され他方部が二又で、二又の一方が血液取出管１２、他方が血液還流管１３でなり、全体がほぼＹ字形の中空管でなる外管穿刺針１４と、該外管穿刺針１４内に血液取出管１２の端部から挿入され、先端部が穿刺部１１から突出可能な内部穿刺針１５とからなる。血液還流管１３内には、血液還流用チューブ１６が挿入され、その先端１７が外管穿刺針１４の三叉部付近に待機状態にセットされている。なお、該血液還流用チューブ１６の他端は血液還流用回路と接続可能な接続部（図示せず）に形成されている。１８は穿刺部１１の先端部に形成した血液流入口である。  In FIG. 17, reference numeral 10 denotes a conventional single needle type puncture needle. The puncture needle 10 has one part (left side in the figure) formed in the puncture part 11 and the other part is bifurcated. An outer tube puncture needle 14 consisting of a blood extraction tube 12, the other being a blood reflux tube 13 and a substantially Y-shaped hollow tube as a whole, and being inserted into the outer tube puncture needle 14 from the end of the blood extraction tube 12 The tip portion is composed of an internal puncture needle 15 that can project from the puncture portion 11. A blood recirculation tube 16 is inserted into the blood recirculation tube 13, and its distal end 17 is set in a standby state near the trident portion of the outer tube puncture needle 14. The other end of the blood recirculation tube 16 is formed in a connection portion (not shown) that can be connected to the blood recirculation circuit. Reference numeral 18 denotes a blood inflow port formed at the tip of the puncture part 11.

上記の二又型穿刺針で血液透析回路を形成するには、まず図１７において外管穿刺針１４内にセットした内部穿刺針１５の先端部を動静脈シャント９２の静脈９１へ刺入れると共に外管穿刺針１４の先端を動静脈シャント９２の静脈９１への刺入れる。次に、内部穿刺針１５を外管穿刺針１４から抜き出し、血液取出管１２の端部に血液取出回路２を接続する。血液取出回路２の他端は図１６に示すように予めダイアライザ３の血液導入部７に接続されている。  In order to form a hemodialysis circuit with the above-mentioned two-pronged puncture needle, first, in FIG. 17, the distal end portion of the inner puncture needle 15 set in the outer tube puncture needle 14 is inserted into the vein 91 of the arteriovenous shunt 92 and externally. The tip of the tube puncture needle 14 is inserted into the vein 91 of the arteriovenous shunt 92. Next, the inner puncture needle 15 is extracted from the outer tube puncture needle 14, and the blood extraction circuit 2 is connected to the end of the blood extraction tube 12. The other end of the blood extraction circuit 2 is connected in advance to the blood introduction part 7 of the dialyzer 3 as shown in FIG.

次に、血液還流管１３内に挿入されていた血液還流用チューブ１６を図１８に示すように穿刺部１１の先端部方向へ押し込み、チューブ１６先端部を穿刺部１１の先端から突出させて、静脈９１へ刺入する。以上で透析の血液回路が形成される。  Next, the blood reflux tube 16 inserted into the blood reflux tube 13 is pushed toward the distal end portion of the puncture portion 11 as shown in FIG. 18, and the distal end portion of the tube 16 is protruded from the distal end of the puncture portion 11, The vein 91 is inserted. Thus, a blood circuit for dialysis is formed.

上記のようにセットされた血液透析回路において透析を開始すると、穿刺部１１の先端および血液流入口１８から透析者１の血液が穿刺部１１内に取出され、血液取出管１２から血液取出回路２へ送流される。
一方、浄化された血液は血液還流回路４（図１５参照）から血液還流用チューブ１６へ送流され、血液還流用チューブ１６の先端１７から透析者１の血管へ還流される。
特開昭５４−２８４９９号 特公表ＷＯ２００６／０２２０２５ When dialysis is started in the hemodialysis circuit set as described above, the blood of the dialyzer 1 is taken out from the tip of the puncture unit 11 and the blood inlet 18 into the puncture unit 11, and the blood extraction circuit 2 is extracted from the blood extraction tube 12. To be sent to.
On the other hand, the purified blood is sent from the blood recirculation circuit 4 (see FIG. 15) to the blood recirculation tube 16 and is recirculated from the distal end 17 of the blood recirculation tube 16 to the blood vessel of the dialyzer 1.
JP 54-28499 A Special Publication WO2006 / 022025

上記のように、従来の単針型構造の穿刺針１０は、血管への刺入れは一箇所で済むが、穿刺針１０は穿刺部１１と血液取出管１２と血液還流管１３との一体型構成で、全体としてＹ字形の二又管構造であるため、構成が通常の穿刺針に比較して複雑で、大きくなりやすく、特に穿刺針１０の静脈への刺入れ時に血液取出管１２や血液還流管１３が刺入操作の邪魔になり、刺入操作性が悪いという問題を有していた。また、血液還流用チューブ１６を血液還流管１３から穿刺部１１方向に押し込んで血液還流用チューブ１６の先端１７を血管に刺入れる際には、血液還流用チューブ１６が図１８に示すようにＡ部で折れ曲がるためその刺入操作が困難であるという問題をも有していた。
この発明の目的は、静脈への刺入は一箇所で、静脈への刺入操作が容易で、迅速にできる単針型の透析用血管穿刺具を提供することを目的とする。As described above, the puncture needle 10 having a conventional single needle structure needs only to be inserted into a blood vessel at one location, but the puncture needle 10 is an integrated type of a puncture portion 11, a blood extraction tube 12, and a blood reflux tube 13. Since the configuration is a Y-shaped bifurcated tube structure as a whole, the configuration is complicated and large compared to a normal puncture needle, and particularly when the puncture needle 10 is inserted into a vein, the blood extraction tube 12 and blood The reflux tube 13 obstructs the piercing operation and has a problem that the piercing operability is poor. Further, when the blood reflux tube 16 is pushed from the blood reflux tube 13 toward the puncture portion 11 and the tip 17 of the blood reflux tube 16 is inserted into the blood vessel, the blood reflux tube 16 becomes A as shown in FIG. It has a problem that the insertion operation is difficult because it is bent at the part.
An object of the present invention is to provide a single-needle type vascular puncture device for dialysis that can be pierced into a vein at one place, and the piercing operation into the vein is easy and quick.

本発明は上記の目的を達成するために提供するもので、請求項１の発明は先端部を先細りの管状体で形成した外管穿刺針と、先端部を針状に形成した内部穿刺針と、側面に血液取出口を設けた分流管と、先端部を先細りのチューブ体で形成した血液還流用カニューレとからなり、上記外管穿刺針に上記分流管の一端部を着脱可能に連結し、上記分流管の適宜位置を柔軟部材で形成したペアン挟み部を設け、
請求項２の発明は、先端部を先細りの管状体で形成した外管穿刺針と、先端部を針状に形成した内部穿刺針と、側面に血液取出口を設けた分流管と、長手方向が伸縮可能に形成した伸縮調節管と、先端部を先細りのチューブ体で形成した血液還流用カニューレとからなり、上記内部穿刺針を上記外管穿刺針に装着して上記内部穿刺針の先端部を上記外管穿刺針の先端から突出可能とし、また上記外管穿刺針に上記分流管の一端部を着脱可能に連結し、かつ上記分流管の他端部に上記伸縮調節管の一端部を着脱可能に連結すると共に上記血液還流用カニューレを上記伸縮調節管の他端部から上記伸縮調節管内に挿入して上記伸縮調節管の他端部に上記血液還流用カニューレのコネクタ部を固定し、上記縮調節管を外管穿刺針の先端から突出可能に構成し、
請求項３の発明は、上記請求項１または請求項２記載の発明において、上記穿刺針が注射器に取り付けた注射針でなることを特徴とし、
請求項４の発明は、上記請求項２または３において、上記伸縮調節管の伸縮部を蛇腹で形成し、
請求項５の発明は、上記請求項２ないし４において、上記伸縮調節管に外側管と該外側管内にスライド可能に挿入可能に形成した内側管とを有することである。The present invention is provided to achieve the above object, and the invention of claim 1 is directed to an outer tube puncture needle having a tip portion formed of a tapered tubular body, and an inner puncture needle having a tip portion formed in a needle shape. , Consisting of a flow dividing tube provided with a blood outlet on the side surface and a blood reflux cannula formed with a tapered tube body at the tip, and detachably connecting one end of the flow dividing tube to the outer tube puncture needle, Provide a pair of pines formed by a flexible member at an appropriate position of the flow dividing pipe,
The invention according to claim 2 includes an outer tube puncture needle having a tip portion formed of a tapered tubular body, an inner puncture needle having a tip portion formed in a needle shape, a shunt tube having a blood outlet on a side surface, and a longitudinal direction. A telescopic adjustment tube formed to be extendable and a blood reflux cannula formed with a tapered tube body at the tip, and the inner puncture needle is attached to the outer tube puncture needle to attach the tip of the inner puncture needle Can be protruded from the distal end of the outer tube puncture needle, and one end portion of the diversion tube is detachably connected to the outer tube puncture needle, and one end portion of the telescopic adjustment tube is connected to the other end portion of the diversion tube. The blood circulation cannula is detachably connected and the blood circulation cannula is inserted into the expansion adjustment tube from the other end of the expansion adjustment tube, and the connector portion of the blood circulation cannula is fixed to the other end of the expansion adjustment tube. The above-mentioned contraction control tube can protrude from the tip of the outer tube puncture needle Configured,
The invention of claim 3 is characterized in that, in the invention of claim 1 or claim 2, the puncture needle is an injection needle attached to a syringe.
Invention of Claim 4 forms the expansion-contraction part of the said expansion-contraction adjustment pipe | tube in the said Claim 2 or 3 by a bellows,
According to a fifth aspect of the present invention, in the above-described second to fourth aspects, the expansion / contraction adjustment tube includes an outer tube and an inner tube formed to be slidably inserted into the outer tube.

本発明透析用血管穿刺具は単針型の血管穿刺具において、穿刺針部のみを分離して血管に刺入することができるので、その刺入操作が容易でかつ迅速に行うことが可能となり、透析前の装置の設定が効率的に行うことができる効果ある。また、請求項２ないし５の発明では、構成要素が複数に分離できるものであり、従来の単針型のような一体型と比較して製造が容易となる利点もある。さらに、血液還流用カニューレを血管へ刺入れる際には、血液還流用カニューレ全体を折曲部を発生させることなく、直線的形状を維持しつつ操作できるので操作性を向上させる効果もある。  The dialysis blood vessel puncture device according to the present invention is a single needle type blood vessel puncture device, and only the puncture needle portion can be separated and inserted into a blood vessel, so that the insertion operation can be performed easily and quickly. There is an effect that the setting of the apparatus before dialysis can be performed efficiently. Further, in the inventions of claims 2 to 5, the constituent elements can be separated into a plurality of parts, and there is an advantage that the manufacture is easy as compared with an integrated type such as a conventional single needle type. Furthermore, when the blood recirculation cannula is inserted into the blood vessel, the entire blood recirculation cannula can be operated while maintaining a linear shape without generating a bent portion, so that the operability can be improved.

図１は本発明の透析用血管穿刺具２０の主要部を示し、透析用血管穿刺具２０は、図１中の符号３０，４０，５０，７０で示す各構成要素と、図３の符号３５で示す構成要素とからなる。すなわち、３０は外管穿刺針、３５は内部穿刺針、４０は分流管、５０は伸縮調節管、７０は血液還流用カニューレである。図２ないし図６は上記透析用血管穿刺具２０を各構成要素に分離した状態を示し、図２は外管穿刺針３０、図４は分流管４０、図５は伸縮調節管５０、図６は血液還流用カニューレ７０をそれぞれ示している。以下に上記各構成要素を詳細に説明する。  FIG. 1 shows a main portion of a dialysis blood vessel puncture device 20 according to the present invention. The dialysis blood vessel puncture device 20 includes components shown by reference numerals 30, 40, 50 and 70 in FIG. 1, and reference numeral 35 in FIG. It consists of the component shown by. That is, 30 is an outer tube puncture needle, 35 is an inner puncture needle, 40 is a flow dividing tube, 50 is a telescopic adjustment tube, and 70 is a blood reflux cannula. 2 to 6 show a state in which the dialysis blood vessel puncture device 20 is separated into components, FIG. 2 shows an outer tube puncture needle 30, FIG. 4 shows a flow dividing tube 40, FIG. 5 shows a telescopic adjustment tube 50, FIG. Each show a blood reflux cannula 70. The above components will be described in detail below.

図２において外管穿刺針３０は管状体で、主要部は針状の穿刺部３１に、基端部（図において右端部）は連結部３２に形成し、該連結部３２の外周面にはネジ部３３を形成する。ネジ部３３の内径は穿刺部３１の内径より大きく、穿刺針部３１と連結部３２との境界付近において段差的に拡大させ、段部３２１を形成する。３４は穿刺部３１の先端付近に複数個穿孔して形成した血液流入口である。  In FIG. 2, the outer tube puncture needle 30 is a tubular body, a main part is formed in a needle-like puncture part 31, and a base end part (right end part in the figure) is formed in a connection part 32. The screw part 33 is formed. The inner diameter of the screw portion 33 is larger than the inner diameter of the puncture portion 31 and is enlarged stepwise in the vicinity of the boundary between the puncture needle portion 31 and the connecting portion 32 to form a step portion 321. Reference numeral 34 denotes a blood inflow port formed by punching a plurality of holes near the tip of the puncture portion 31.

図３において、内部穿刺針３５は実線で示し、仮想線は通常の注射器の本体部分３６を示している。すなわち、内部穿刺針３５は通常の注射器の金属製注射針３７が利用可能で、必ずしも注射器の本体部分３６を必要としないが、金属製注射針３７が内部穿刺針３５として利用できる。３８は内部穿刺針３５の基部である。内部穿刺針３５は上記外管穿刺針３０内に挿入可能で、外管穿刺針３０の連結部３２側から挿入し、基部３８を外管穿刺針３０内の段部３２１に突き当てたとき、先端部３９が外管穿刺針３０の先端３１１から所定長さ突出するように構成する。  In FIG. 3, the internal puncture needle 35 is indicated by a solid line, and the phantom line indicates a main body portion 36 of a normal syringe. That is, as the internal puncture needle 35, a metal injection needle 37 of a normal syringe can be used, and the main body portion 36 of the syringe is not necessarily required, but the metal injection needle 37 can be used as the internal puncture needle 35. Reference numeral 38 denotes a base portion of the internal puncture needle 35. When the inner puncture needle 35 can be inserted into the outer tube puncture needle 30 and is inserted from the connecting portion 32 side of the outer tube puncture needle 30, and the base 38 is abutted against the step 321 in the outer tube puncture needle 30, The distal end portion 39 is configured to protrude from the distal end 311 of the outer tube puncture needle 30 by a predetermined length.

図４において、分流管４０は全体を管体で形成し、その長手方向の略中央に血液取出口４１を形成し、該血液取出口４１の縁部に接続用ネジ部４１１を形成する。分流管４０の一方端部（図において左端部）は上記外管穿刺針３０の連結部３２と液密に連結するための連結部４３に形成する。該連結部４３は上記外管穿刺針３０の連結部３２の内側に密接に挿入できるようにすると共に、リング状のカプラ４４を回転可能に嵌合する。該カプラ４４の内周面には上記外管穿刺針３０のネジ部３３とネジ結合可能なネジ部４５に形成する。４６はカプラ４４の端部に形成した突起で連結部４３に形成したストッパ４７に引っ掛かるように構成し、カプラ４４が分流管４０において所定位置から端部方向（図の左方向）の移動を規制する。４２は分流管４０の適宜位置を柔軟部材で形成したペアン挟み部、４８は血液取出口４１の近くで後述の連結部４９側に設けた血液流出防止弁である。該血液流出防止弁４８の中心部には血液還流用カニューレ７０が密接して挿通可能なカニューレ挿通孔４８１を形成する。一方、分流管４０の他端部（図の右側端部）の外周面には連結部４９を形成し、該連結部４９の外周面にネジ部４９１を形成する。  In FIG. 4, the diversion tube 40 is entirely formed of a tubular body, a blood outlet 41 is formed at the approximate center in the longitudinal direction, and a connecting screw portion 411 is formed at the edge of the blood outlet 41. One end portion (left end portion in the figure) of the flow dividing tube 40 is formed in a connection portion 43 for fluidly connecting to the connection portion 32 of the outer tube puncture needle 30. The connecting portion 43 allows the ring-shaped coupler 44 to be rotatably fitted while allowing the connecting portion 43 to be closely inserted inside the connecting portion 32 of the outer tube puncture needle 30. On the inner peripheral surface of the coupler 44, a screw portion 45 that can be screw-coupled with the screw portion 33 of the outer tube puncture needle 30 is formed. 46 is a projection formed at the end of the coupler 44 so as to be caught by a stopper 47 formed at the connecting portion 43, and the coupler 44 restricts movement of the shunt pipe 40 from a predetermined position toward the end (left direction in the figure). To do. Reference numeral 42 denotes a paired pinch portion formed by a flexible member at an appropriate position of the flow dividing tube 40, and reference numeral 48 denotes a blood outflow prevention valve provided near the blood outlet 41 on the connecting portion 49 side described later. At the center of the blood outflow prevention valve 48, a cannula insertion hole 481 is formed through which the blood reflux cannula 70 can be closely inserted. On the other hand, a connecting portion 49 is formed on the outer peripheral surface of the other end portion (right end portion in the figure) of the flow dividing tube 40, and a screw portion 491 is formed on the outer peripheral surface of the connecting portion 49.

図５において、伸縮調節管５０は一部を伸縮自在の蛇腹式の伸縮部５１に形成し、長さが調節できるようにする。５２は伸縮部５１の伸縮を固定するための伸縮固定枠で、伸縮部５１を囲むように伸縮部５１に装着する。該伸縮固定枠５２は左右に配置した基板５３，５４と該基板５３，５４間に架渡すように取り付けた引掛受片５５，５５とで形成する。  In FIG. 5, a part of the expansion / contraction adjustment tube 50 is formed in an expandable / contractible bellows type expansion / contraction part 51 so that the length can be adjusted. Reference numeral 52 denotes an expansion / contraction fixing frame for fixing expansion / contraction of the expansion / contraction part 51, and is attached to the expansion / contraction part 51 so as to surround the expansion / contraction part 51. The telescopic fixing frame 52 is formed by substrates 53 and 54 arranged on the left and right and hook receiving pieces 55 and 55 attached so as to be bridged between the substrates 53 and 54.

伸縮部５１の引掛受片５５，５５は、その長さすなわち基板５３，５４間は伸長状態の伸縮部５１の長さとほぼ同じにし、全体に亘って多数の引掛凹凸部を形成する。なお、引掛受片５２，５２の個数は特定するものではないが、本例では１８０度の位置に２本配置した例を示している。また、図では表わしてはいないが、本例の基板５３，５４は円盤状で中心部に通孔を形成し、該通孔に伸縮部５１の両側の位置の伸縮調節管５０を挿通した状態に配置する。そして一方の基板５３は伸縮調節管５０に対し回転可能であるが、伸縮調節管５０の長手方向には摺動不可に固定し、他方の基板５４は，伸縮調節管５０の非蛇腹部に対し、回転可能、かつスライド可能に構成する。The lengths of the hook receiving pieces 55, 55 of the stretchable portion 51, that is, the length between the substrates 53, 54 are substantially the same as the length of the stretchable stretchable portion 51, and a large number of catching uneven portions are formed throughout. In addition, although the number of the catch receiving pieces 52 and 52 is not specified, the example which has arrange | positioned two in the position of 180 degree | times is shown in this example. Although not shown in the drawing, the substrates 53 and 54 of the present example are disk-shaped and have a through hole formed in the center, and the expansion / contraction adjustment pipes 50 at positions on both sides of the expansion / contraction part 51 are inserted through the through hole. To place. One substrate 53 is rotatable with respect to the expansion / contraction adjustment tube 50, but is fixed in a non-slidable manner in the longitudinal direction of the expansion / contraction adjustment tube 50, and the other substrate 54 is against the non-bellows portion of the expansion / contraction adjustment tube 50. It is configured to be rotatable and slidable.

５７は伸縮部５１の端部（図では右端）に取付けた引掛片で、上記引掛受片５１の引掛凹凸部に接触させ、伸縮部５１の伸縮と共に移動し、上記引掛受片５１に対しラチェット機能を有する。すなわち、伸縮調節管５０を縮小方向に押圧するとそれに伴って引掛片５７は移動し、伸縮部５１は縮小される。縮小方向の押圧を停止すると、伸縮部５１は元の長さに戻ろうとするが、引掛片５７が引掛受片５１の引掛凹凸部に引っ掛かり、元の長さに戻ることはできず、縮小状態が維持される。ラチェット機能を解除するには、伸縮調節管５０の長手方向を軸とする方向に伸縮調節管５０を回転させ、引掛片５７を引掛受片５２から外せばよい。Reference numeral 57 denotes a hook piece attached to an end portion (the right end in the figure) of the expansion / contraction portion 51, which is brought into contact with the hook uneven portion of the hook receiving piece 51, moves along with the expansion / contraction of the expansion / contraction portion 51, and is ratchet with respect to the hook receiving piece 51. It has a function. That is, when the expansion / contraction adjustment tube 50 is pressed in the reduction direction, the hooking piece 57 moves accordingly, and the expansion / contraction part 51 is reduced. When the pressing in the reduction direction is stopped, the expansion / contraction part 51 tries to return to the original length, but the hooking piece 57 is caught by the hooking uneven part of the hook receiving piece 51 and cannot return to the original length, and is in a reduced state. Is maintained. To release the ratchet function, the expansion / contraction adjustment tube 50 may be rotated in a direction about the longitudinal direction of the expansion / contraction adjustment tube 50, and the hook piece 57 may be removed from the hook receiving piece 52.

図５において、伸縮調節管５０の一方の端部（図５において左側端部）は分流管４０の連結部４３と同様の連結部５８に形成してカプラ６０を嵌合する。すなわち、上記突起４７と同様のストッパ５８１を形成する。そして該連結部５８は上記分流管４０の連結部４３と上記外管穿刺針３０の連結部３２との連結と同様に上記分流管４０の連結部４９１へ連結可能に形成する。また、伸縮調節管５０の他方の端部は連結部５９に形成し、その外周面にネジ部５９１を形成すると共に、内面をテーパ５９２に形成する。  In FIG. 5, one end portion (left end portion in FIG. 5) of the expansion / contraction adjustment tube 50 is formed in a connection portion 58 similar to the connection portion 43 of the flow dividing tube 40 to fit the coupler 60. That is, a stopper 581 similar to the protrusion 47 is formed. The connecting portion 58 is formed to be connectable to the connecting portion 491 of the flow dividing tube 40 in the same manner as the connection of the connecting portion 43 of the flow dividing tube 40 and the connecting portion 32 of the outer tube puncture needle 30. Further, the other end of the expansion / contraction adjustment tube 50 is formed in the connecting portion 59, the screw portion 591 is formed on the outer peripheral surface thereof, and the inner surface is formed in the taper 592.

図６において、血液還流用カニューレ７０は先端部７１１がテーパに形成したカニューレ本体７１と該カニューレ本体７１の基端部に設けたコネクタ部７２とでなる。なお、先端部７１１はきわめて柔軟な例えばシリコンゴム等の材質で形成し、先端部７１１を除くカニューレ本体７１は柔軟な塩化ビニル等の材質で形成する。コネクタ部７２は内部がカニューレ本体と７１と内通した管体部７３と、該管体部７３に嵌合したカプラ７４とでなる。管体部７３の一方端部はカニューレ本体７１の端部と接続している連結部７５でなり、該連結部７５の外周面は伸縮調節管５０の連結部５９の内面と密接するテーパ７５１に形成する。管体部７３の他端部は連結部７６で、該連結部７６の外周面にはネジ部７７を形成する。７８は管体部７３の一部を柔軟部材で形成したペアン挟み部である。
なお、請求項１でいう穿刺具本体とは、図１において符号２０１で示す部分をいう。すなわち、分流管４０と伸縮調節管５０と血液還流用カニューレ７０とで構成される部分が穿刺具本体に相当する。In FIG. 6, the blood recirculation cannula 70 includes a cannula body 71 having a tapered tip 711 and a connector 72 provided at the proximal end of the cannula body 71. The tip 711 is made of a very flexible material such as silicon rubber, and the cannula body 71 excluding the tip 711 is made of a flexible material such as vinyl chloride. The connector portion 72 is composed of a tube body portion 73 having an inside communicated with the cannula main body 71 and a coupler 74 fitted to the tube body portion 73. One end of the tube portion 73 is a connecting portion 75 connected to the end of the cannula body 71, and the outer peripheral surface of the connecting portion 75 is a taper 751 that is in close contact with the inner surface of the connecting portion 59 of the telescopic adjustment tube 50. Form. The other end of the tube part 73 is a connecting part 76, and a screw part 77 is formed on the outer peripheral surface of the connecting part 76. Reference numeral 78 denotes a paired pinch portion in which a part of the tube portion 73 is formed of a flexible member.
In addition, the puncture device main body referred to in claim 1 refers to a portion denoted by reference numeral 201 in FIG. That is, the part constituted by the diversion tube 40, the expansion / contraction adjustment tube 50, and the blood reflux cannula 70 corresponds to the puncture device body.

次に本発明の血管穿刺具２０の使用方法について説明する。
まず、図３に示す注射器本体３６に取付けられている状態の内部穿刺針３５を図２に示す外管穿刺針３０の連結部３２側から外管穿刺針３０内に挿入し、図７に示すように内部穿刺針３５の先端３９を外管穿刺針３０先端３１１から突出させると共に、図３に示す内部穿刺針３５の基端３８を外管穿刺針３０の連結部３２の段部３２１に突き当てて内部穿刺針３５を外管穿刺針３０内にセットする。Next, the usage method of the blood vessel puncture device 20 of this invention is demonstrated.
First, the inner puncture needle 35 attached to the syringe main body 36 shown in FIG. 3 is inserted into the outer tube puncture needle 30 from the connecting portion 32 side of the outer tube puncture needle 30 shown in FIG. 2, and shown in FIG. In this manner, the distal end 39 of the inner puncture needle 35 protrudes from the distal end 311 of the outer tube puncture needle 30 and the proximal end 38 of the inner puncture needle 35 shown in FIG. 3 projects into the step 321 of the connecting portion 32 of the outer tube puncture needle 30. The inner puncture needle 35 is set in the outer tube puncture needle 30 by applying.

このようにセットした状態で内部穿刺針３５の先端３９を、図８に示すように透析者１のシャント９２近くの静脈９１へ刺入れる。この刺入れと共に外管穿刺針３０の穿刺針部３１の先端３１１も静脈９１へ刺入れられる。その後、図９に示すように、外管穿刺針３０の刺入状態を維持したまま、内部穿刺針３５を注射器本体３６と共に外管穿刺針３０から抜きとる。この際、該部からの出血を防止するための止血処理をする。  In this state, the distal end 39 of the internal puncture needle 35 is inserted into a vein 91 near the shunt 92 of the dialyzer 1 as shown in FIG. Along with this insertion, the distal end 311 of the puncture needle portion 31 of the outer tube puncture needle 30 is also inserted into the vein 91. Thereafter, as shown in FIG. 9, the inner puncture needle 35 is removed from the outer tube puncture needle 30 together with the syringe main body 36 while maintaining the inserted state of the outer tube puncture needle 30. At this time, hemostasis processing is performed to prevent bleeding from the portion.

次に図９に示す静脈９１に残された外管穿刺針３０の連結部３２に分流管４０の連結部４３を図１０に示すように連結する。すなわち、分流管４０の連結部４３を外管穿刺針３０の連結部３２の内側に挿入し、カプラ４４を外管穿刺針３０のネジ部３３にネジ留めする。これにより、図４に示すカプラ４４の突起４６がストッパ４７に引っ掛かり、連結部４３を外管穿刺針３０の連結部３２内に押し込まれ、該部の連結状態が固定される。なお、該連結の前または後にペアン挟み部４２にペアンを留めて血路を閉塞し、血液の外部への流出を防止ための処置をする。  Next, the connecting portion 43 of the flow dividing tube 40 is connected to the connecting portion 32 of the outer tube puncture needle 30 remaining in the vein 91 shown in FIG. 9 as shown in FIG. That is, the connecting portion 43 of the branch pipe 40 is inserted inside the connecting portion 32 of the outer tube puncture needle 30, and the coupler 44 is screwed to the screw portion 33 of the outer tube puncture needle 30. As a result, the protrusion 46 of the coupler 44 shown in FIG. 4 is caught by the stopper 47, and the connecting portion 43 is pushed into the connecting portion 32 of the outer tube puncture needle 30, so that the connected state of the portion is fixed. In addition, before or after the connection, a treatment is performed to prevent the blood from flowing out by closing the blood passage by closing the paired pines in the paired pin portion 42.

次に、図１１に示すように上記分流管４０の連結部４９に伸縮調節管５０の連結部５８を連結して分流管４０と伸縮調節管５０とを連通に接続する。この場合の連結は上記分流管４０の連結部４３と上記外管穿刺針３０の連結部３２との連結方法と同様に行う。また、分流管４０と伸縮調節管５０とを接続する前または後に、図１２に示すように血液還流用カニューレ７０を伸縮調節管５０の連結部５９側から伸縮調節管５０内に挿入し、図６に示すコネクタ部７２の連結部７５を伸縮調節管５０の連結部５９内に装着する。そしてカプラ７４を、図５に示す連結部５９のネジ部５９１にネジ留めする。  Next, as shown in FIG. 11, the connecting portion 58 of the expansion / contraction adjustment pipe 50 is connected to the connecting portion 49 of the distribution pipe 40 to connect the distribution pipe 40 and the expansion / contraction adjustment pipe 50 in communication. The connection in this case is performed in the same manner as the connection method between the connection portion 43 of the flow dividing tube 40 and the connection portion 32 of the outer tube puncture needle 30. Before or after connecting the diversion tube 40 and the expansion / contraction adjustment tube 50, as shown in FIG. 12, the blood reflux cannula 70 is inserted into the expansion / contraction adjustment tube 50 from the connecting portion 59 side of the expansion / contraction adjustment tube 50. The connecting portion 75 of the connector portion 72 shown in FIG. Then, the coupler 74 is screwed to the screw portion 591 of the connecting portion 59 shown in FIG.

次に、図１３に示すように血液還流用カニューレ７０が装着された伸縮調節管５０の伸縮部５１の、長さが縮小する方向に伸縮調節管５０を押圧して縮小させると、血液還流用カニューレ７０は伸縮調節管５０および分流管４０内を外管穿刺針３０方向へ移動し、先端部７１１が外管穿刺針３０の先端３１１から突出し静脈９１へ刺入れできる。伸縮調節管５０への押圧を停止すると、伸縮部５１は元の長さに復元しようとするが、引掛片５７が引掛受片５５に引掛っているためラチェット効果により、伸縮部５１の復元は押さえられ、血液還流用カニューレ７０はその位置で固定された状態となる。したがって、引掛受片５２の位置のメモリを読めば血液還流用カニューレ７０の移動距離を知ることができ、血液還流用カニューレ７０の先端部７１１の外管穿刺針３０の先端３１１からの突出長さも目測できる。よって、その突出長さを所定値に調節する場合には、引掛片５７のメモリの位置を見ながら行えばよい。なお、この操作時は血液還流用カニューレのペアン挟み部７８にペアンを留めて血流路を閉塞しておく。以上のようにして本発明の血管穿刺具２０を透析者１の静脈９１へ接続する。  Next, as shown in FIG. 13, when the expansion / contraction adjustment tube 50 is pressed and reduced in the direction in which the length of the expansion / contraction portion 51 of the expansion / contraction adjustment tube 50 to which the blood recirculation cannula 70 is attached is reduced, The cannula 70 moves in the telescopic adjustment tube 50 and the diversion tube 40 toward the outer tube puncture needle 30, and the distal end portion 711 protrudes from the distal end 311 of the outer tube puncture needle 30 and can be inserted into the vein 91. When the pressing on the expansion / contraction adjustment tube 50 is stopped, the expansion / contraction part 51 tries to restore to the original length, but since the hook piece 57 is hooked on the hook receiving piece 55, the expansion / contraction part 51 is restored by the ratchet effect. The blood reflux cannula 70 is fixed at that position. Accordingly, the movement distance of the blood recirculation cannula 70 can be known by reading the memory at the position of the hook receiving piece 52, and the protruding length of the distal end portion 711 of the blood recirculation cannula 70 from the distal end 311 of the outer tube puncture needle 30 is also determined. I can measure it. Therefore, when adjusting the protrusion length to a predetermined value, it is only necessary to observe the memory position of the hook piece 57. During this operation, the blood flow channel is closed by holding a pair of pins in the pair of pinned portions 78 of the blood reflux cannula. As described above, the blood vessel puncture device 20 of the present invention is connected to the vein 91 of the dialyzer 1.

透析を行うには、まず分流管４０の血液取出口４１へ血液取出回路２を接続すると共に、血液還流用カニューレ７０のコネクタ部７２へ血液還流回路４を接続して透析回路を構成し、分流管４０のペアン挟み部４２および血液還流用カニューレ７０のペアン挟み部７８のペアン留めを解除して、９１からの血液を血液還流カニューレ７０内のエアーをコネクタ部７２まで抜いた後、ペアン挟み部７８のペアン留めを解除して血液回路を開通させて透析を開始する。透析中は外管穿刺針３０の先端３１１および血液流入口３４から静脈９１に流通している血液が外管穿刺針３０へ連続に取込まれる。外管穿刺針３０内に取込まれた血液は外管穿刺針３０から分流管４０へ送流され、血液取出口４１から血液取出回路２へ送流される。血液取出回路２へ送流された血液はダイアライザ３で浄化され、還流側血液回路４を経由して、血液還流用カニューレ７０のコネクタ部７２から血液還流用カニューレ本体７１を流通して先端部７１１からシャント９２の静脈９１へ還流される。なお、静脈９１への還流位置すなわち血液還流用カニューレ７０の先端部７１１は、図１３に示すように外管穿刺針３０の先端３１１や血液流入口３４等の位置より必然的に血流の下流となり、還流した血液が外管穿刺針３０の先端３１１や血液流入口３４等から再度外管穿刺針３０へ取込れることはない。  In order to perform dialysis, first, the blood extraction circuit 2 is connected to the blood extraction port 41 of the distribution pipe 40, and the blood circulation circuit 4 is connected to the connector part 72 of the blood circulation cannula 70 to form a dialysis circuit. After the pairing of the paired pin 42 of the tube 40 and the paired pinion 78 of the blood reflux cannula 70 is released, the blood from the blood 91 is drawn out to the connector 72 and then the paired pin The 78 Peaning is released and the blood circuit is opened to start dialysis. During dialysis, blood flowing from the distal end 311 of the outer tube puncture needle 30 and the blood inlet 34 to the vein 91 is continuously taken into the outer tube puncture needle 30. The blood taken into the outer tube puncture needle 30 is sent from the outer tube puncture needle 30 to the diversion tube 40 and is sent from the blood outlet 41 to the blood extraction circuit 2. The blood sent to the blood extraction circuit 2 is purified by the dialyzer 3, passes through the blood circulation cannula body 71 from the connector part 72 of the blood circulation cannula 70 via the circulation side blood circuit 4, and the distal end 711. To the vein 91 of the shunt 92. It should be noted that the return position to the vein 91, that is, the distal end portion 711 of the blood return cannula 70 is inevitably downstream of the blood flow from the position of the distal end 311 of the outer tube puncture needle 30, the blood inlet 34, etc., as shown in FIG. Thus, the recirculated blood is not taken into the outer tube puncture needle 30 again from the distal end 311 of the outer tube puncture needle 30, the blood inlet 34, or the like.

図１４は他の実施例の伸縮調節管８０を示し、上記伸縮調節管５０と共通する部分は同じ符号を用いた。伸縮調節管８０の主要部は外側管８１と内側管８２とで形成し、内側管８２は外側管８１の内側に挿入可能で内側管８２の外面が外側管８１の内面に密接状態でスライド可能に構成する。８３は外側管８１の端部に嵌合させて設けた締付バンドで例えば市販のインシュロック（トーマスアンドベッツ社の商標）が利用できる。  FIG. 14 shows an expansion / contraction adjustment tube 80 according to another embodiment, and the same reference numerals are used for portions common to the expansion / contraction adjustment tube 50. The main part of the expansion / contraction adjustment tube 80 is formed by an outer tube 81 and an inner tube 82, and the inner tube 82 can be inserted inside the outer tube 81, and the outer surface of the inner tube 82 can slide in close contact with the inner surface of the outer tube 81. Configure. 83 is a fastening band provided by being fitted to the end of the outer tube 81, and for example, commercially available Insulok (trademark of Thomas and Bets) can be used.

外側管８１の一方の端部（図１３において左側端部）は伸縮調節管５０と同様の連結部５８に形成する。すなわち、連結部５８の外周にストッパ５８１を形成すると共にカプラ６０を嵌合する。そして該連結部５８も上記分流管４０のネジ部４７へ連結可能に形成する。また、内側管８２の一方の端部（図１３において右側端部）は伸縮調節管５０と同様の連結部５９を形成し、その外周面にネジ部５９１を形成する。以上により構成した伸縮調節管８０は内側管８２と外側管８１とを相互にスライドさせることにより長さが伸縮し調節することができる。そして締付バンド８３を締め付ければ、締付バンド８３部の外側管８２と内側管８１とが締付けられ、両者のスライドが困難となり、伸縮調節管８０の長さが固定される。従って、内側管８１と外側管８２との相互スライド機能と締付バンド８３の固定機能とを利用すれば、上記伸縮調節管５０と同様に長さを伸縮させ所定または任意に長さに調節することができる。以上から該伸縮調節管８０を上記血管穿刺具２０の伸縮調節管５０に換えて適用することは可能であり、その接続方法等は伸縮調節管５０の場合と全く同様にできるのでその詳細は省略する。One end portion (the left end portion in FIG. 13) of the outer tube 81 is formed in the connection portion 58 similar to the expansion / contraction adjustment tube 50. That is, the stopper 581 is formed on the outer periphery of the connecting portion 58 and the coupler 60 is fitted. The connecting portion 58 is also formed so as to be connectable to the screw portion 47 of the flow dividing tube 40. Further, one end portion (the right end portion in FIG. 13) of the inner tube 82 forms a connecting portion 59 similar to the expansion / contraction adjustment tube 50, and a screw portion 591 is formed on the outer peripheral surface thereof. The expansion / contraction adjustment tube 80 configured as described above can be adjusted by adjusting its length by sliding the inner tube 82 and the outer tube 81 relative to each other. If the tightening band 83 is tightened, the outer tube 82 and the inner tube 81 of the tightening band 83 are tightened, making it difficult to slide both of them, and the length of the expansion / contraction adjustment tube 80 is fixed. Therefore, if the mutual slide function of the inner tube 81 and the outer tube 82 and the fixing function of the fastening band 83 are utilized, the length is expanded and contracted in the same manner as the expansion / contraction adjustment tube 50, and the length is adjusted to a predetermined or arbitrary length. be able to. From the above, it is possible to apply the expansion / contraction adjustment tube 80 in place of the expansion / contraction adjustment tube 50 of the blood vessel puncture instrument 20, and the connection method and the like can be exactly the same as those of the expansion / contraction adjustment tube 50, and the details thereof are omitted. To do.

また、上記分流管４０と伸縮調節管５０と一体に形成することもできる。すなわち、上記の例では上記分流管４０と伸縮調節管５０とをネジ結合手段を用いて着脱可能に連結しているが、このネジ結合手段を形成しないで、該部を一体に連続する管体に形成することもできる。この場合、外管穿刺針３０が本体（一体に形成した分流管４０と伸縮調節管５０）に対し、ネジ結合手段により着脱可能に連結する構成となる。  Further, the branch pipe 40 and the expansion / contraction adjustment pipe 50 can be formed integrally. In other words, in the above example, the flow dividing pipe 40 and the expansion / contraction adjustment pipe 50 are detachably connected by using the screw connecting means, but the threaded pipe connecting means is not formed, and the tube is a continuous continuous body. It can also be formed. In this case, the outer tube puncture needle 30 is configured to be detachably connected to the main body (an integrally formed flow dividing tube 40 and expansion / contraction adjustment tube 50) by a screw coupling means.

本発明血管穿刺具を組立てた状態を示す正面図。  The front view which shows the state which assembled this invention blood vessel puncture device. 本発明血管穿刺具の外管穿刺針の正面図。  The front view of the outer tube puncture needle of the blood vessel puncture device of the present invention. 本発明血管穿刺具の内部穿刺針３５の正面図。  The front view of the internal puncture needle 35 of the blood vessel puncture device of the present invention. 本発明血管穿刺具の分流管の正面図。  The front view of the shunt tube of the blood vessel puncture device of the present invention. 本発明血管穿刺具の伸縮調節管の正面図。  The front view of the expansion-contraction adjustment tube of the blood vessel puncture device of the present invention. 本発明血管穿刺具の血液還流用カニューレの正面図。  The front view of the cannula for blood circulation of the blood vessel puncture device of the present invention. 本発明血管穿刺具の使用方法を示す説明図。  Explanatory drawing which shows the usage method of the blood vessel puncture device of this invention. 図７と同じ  Same as FIG. 図７と同じ  Same as FIG. 図７と同じ  Same as FIG. 図７と同じ  Same as FIG. 図７と同じ  Same as FIG. 図７と同じ  Same as FIG. 本発明血管穿刺具の伸縮調節管の他の実施例を示す正面図。  The front view which shows the other Example of the expansion-contraction adjustment pipe | tube of this invention vascular puncture device. 透析の概要を示す説明図。  Explanatory drawing which shows the outline | summary of dialysis. 従来の透析の概要を示す説明図。  Explanatory drawing which shows the outline | summary of the conventional dialysis. 従来の血管穿刺具の概要を示す説明図。  Explanatory drawing which shows the outline | summary of the conventional blood vessel puncture device. 図１７と同じ  Same as FIG.

符号の説明Explanation of symbols

２０……外管穿刺針、２０１……穿刺針具本体、３０……外管穿刺針、３５……内部穿刺針、３６……注射器本体、４０……分流管、５０……伸縮調節管、５１……伸縮部５１、７０……血液還流用カニューレ20 ... outer tube puncture needle, 201 ... puncture needle body, 30 ... outer tube puncture needle, 35 ... inner puncture needle, 36 ... syringe body, 40 ... shunt tube, 50 ... telescopic adjustment tube, 51 …… Expandable part 51, 70 …… Blood return cannula

Claims (5)

先端部を先細りの管状体で形成した外管穿刺針と、先端部を針状に形成した内部穿刺針と、側面に血液取出口を設けた分流管と、先端部を先細りのチューブ体で形成した血液還流用カニューレとからなり、上記外管穿刺針に上記分流管の一端部を着脱可能に連結し、上記分流管の適宜位置を柔軟部材で形成したペアン挟み部を設けたことを特徴とする透析用血管穿刺具。An outer tube puncture needle formed with a tapered tubular body at the tip, an inner puncture needle formed with a needle shaped tip, a flow dividing tube with a blood outlet on the side surface, and a tube formed with a tapered tube A blood flow cannula, wherein one end of the branch pipe is detachably connected to the outer tube puncture needle, and a pair of pinches formed by a flexible member at an appropriate position of the branch pipe are provided. Blood vessel puncture device for dialysis. 先端部を先細りの管状体で形成した外管穿刺針と、先端部を針状に形成した内部穿刺針と、側面に血液取出口を設けた分流管と、長手方向が伸縮可能に形成した伸縮調節管と、先端部を先細りのチューブ体で形成した血液還流用カニューレとからなり、上記内部穿刺針を上記外管穿刺針に装着して上記内部穿刺針の先端部を上記外管穿刺針の先端から突出可能とし、また上記外管穿刺針に上記分流管の一端部を着脱可能に連結し、かつ上記分流管の他端部に上記伸縮調節管の一端部を着脱可能に連結すると共に上記血液還流用カニューレを上記伸縮調節管の他端部から上記伸縮調節管内に挿入して上記伸縮調節管の他端部に上記血液還流用カニューレのコネクタ部を固定し、上記縮調節管を外管穿刺針の先端から突出可能に構成したしたことを特徴とする透析用血管穿刺具。An outer tube puncture needle formed with a tapered tubular tip, an inner puncture needle formed with a needle-like tip, a flow dividing tube provided with a blood outlet on the side, and a telescopic extension formed in the longitudinal direction A control tube and a blood reflux cannula formed with a tapered tube body at the tip. The inner puncture needle is attached to the outer tube puncture needle, and the tip of the inner puncture needle is attached to the outer tube puncture needle. It is possible to project from the tip, detachably connect one end portion of the diverter tube to the outer tube puncture needle, and detachably connect one end portion of the telescopic adjustment tube to the other end portion of the diverter tube and A blood recirculation cannula is inserted into the expansion / contraction adjustment tube from the other end of the expansion / contraction adjustment tube, and a connector portion of the blood recirculation cannula is fixed to the other end of the expansion / contraction adjustment tube. It was configured to be able to protrude from the tip of the puncture needle Dialysis vascular puncture device according to claim. 上記穿刺針は、注射器に取り付けた注射針でなることを特徴とする請求項１または請求項２記載の透析用血管穿刺具。The vascular puncture device for dialysis according to claim 1 or 2, wherein the puncture needle is an injection needle attached to a syringe. 上記伸縮調節管の伸縮部は蛇腹でなることを特徴とする請求項２または３記載の医療透析用血管穿刺器具。4. The medical dialysis blood vessel puncture device according to claim 2, wherein the expansion / contraction portion of the expansion / contraction adjustment tube is a bellows. 上記伸縮調節管は外側管と該外側管内にスライド可能に挿入可能に形成した内側管とを有することを特徴とする請求項２ないし４記載の医療透析用血管穿刺器具。5. The blood puncture device for medical dialysis according to claim 2, wherein the expansion / contraction adjustment tube has an outer tube and an inner tube formed to be slidably inserted into the outer tube.

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