一种胸腔穿刺针定位固定器的设计及应用

The invention relates to the design and application of a thoracic puncture needle positioning fixator

气胸及胸腔积液需要进行胸腔穿刺,是临床工作中经常遇到的情况,这也是临床中最常用的有创操作之一,虽然操作步骤简单,但如果操作不当、经验不足或配合不佳,会出现相应的并发症,如血胸、胸膜反应、肋间血管神经损伤、复张性肺水肿等.王店人民医院医护人员在现有胸腔穿刺针装置基础上进行改良,设计出一种胸腔穿刺针定位固定器,并获得了国家实用新型专利(专利号:ZL 202121369771.X).胸腔穿刺针定位固定器包括:圆柱体透明底座、自带胶带、圆形固定孔、4块挡板、连接件.临床上使用定位固定器前,首先要在彩色超声的协助下做好胸腔穿刺的标识,然后将固定器通过底座的3条透明胶带固定在患者胸部标识处,固定器固定稳妥后胸腔穿刺针通过圆形固定孔垂直进针,穿刺针顺利进入患者胸腔内.因圆形固定孔有一定的厚度,所以在穿刺过程中可以控制进针速度及深度,从而防止进针过快和过深造成医源性损伤,在完成该项操作后将圆形固定孔上方的4块挡板转起,通过连接件使4块挡板保持竖直状态,这样可以更好地阻止胸透针发生倾斜及脱落.该装置操作简单、方便、易掌握,有很强的实用性,能大大提高医务工作者对胸腔穿刺术的信心,值得在临床推广使用.

Thoracopuncture is frequently performed in clinical practice to treat conditions like pneumothorax and pleural effusion,making it one of the most common invasive procedures.Although the procedure is simple,it may lead to corresponding complications such as hemothorax,pleural reaction,intercostal vascular and nerve injury,and revascularization pulmonary edema if the operation is improper,inexperienced or not well cooperated.Medical staff in Wangdian People's Hospital of Jiaxing improved the existing thoracic puncture needle device and designed a positioning fixator for thoracic puncture needle,and obtained the National Utility Model Patent of China(ZL 202121369771.X).The rib cage puncture needle positioning fixator consists of a cylindrical transparent base,self-adhesive tape,circular fixing holes,4 baffles,and connecting pieces.Before the clinical use of the positioning fixator,it is necessary to make the mark of thoracic puncture with the assistance of color ultrasound,and then fix the fixator at the mark of the patient's chest through 3 strips of transparent tape on the base.After the fixator is firmly fixed,the thoracic puncture needle is vertically inserted through the circular fixing hole,and the puncture needle enters the patient's chest smoothly.The thickness of the circular fixed hole allows for precise control of injection speed and depth,minimizing the risk of iatrogenic injury from overly rapid or deep insertion.After the completion of this operation,the 4 baffles above the circular fixed hole are turned up,and the 4 baffles are kept upright through the connecting piece,which can better prevent the tilt and fall off of the chest X-ray needle.The device is easy to operate,convenient,user-friendly,significantly boosting the confidence of medical staff during thoracentesis,making it highly suitable for widespread clinical use.