CN105748132A - Bypass blood vessel guiding device for internal arteriovenous fistula of artificial blood vessel - Google Patents

Bypass blood vessel guiding device for internal arteriovenous fistula of artificial blood vessel Download PDF

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Publication number
CN105748132A
CN105748132A CN201610300138.2A CN201610300138A CN105748132A CN 105748132 A CN105748132 A CN 105748132A CN 201610300138 A CN201610300138 A CN 201610300138A CN 105748132 A CN105748132 A CN 105748132A
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CN
China
Prior art keywords
blood vessel
artificial blood
union joint
arteriovenous fistula
internal arteriovenous
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CN201610300138.2A
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Chinese (zh)
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CN105748132B (en
Inventor
张亚莉
蒋红利
李大庆
路万虹
黄惠梅
王文涛
李燕
张文静
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First Affiliated Hospital of Xian Jiaotong University
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First Affiliated Hospital of Xian Jiaotong University
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Priority to CN201610300138.2A priority Critical patent/CN105748132B/en
Publication of CN105748132A publication Critical patent/CN105748132A/en
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Publication of CN105748132B publication Critical patent/CN105748132B/en
Expired - Fee Related legal-status Critical Current
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3415Trocars; Puncturing needles for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3468Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3454Details of tips
    • A61B2017/3456Details of tips blunt

Abstract

The invention discloses a bypass blood vessel guiding device for internal arteriovenous fistula of an artificial blood vessel. The bypass blood vessel guiding device comprises a guiding syringe and a connector, wherein the rear end of the connector can be connected with the artificial blood vessel; the guiding syringe is fixedly mounted at the front end of the connector; a sleeve head is fixed outside the syringe needle of the guiding syringe; one end of the artificial blood vessel is arranged at the rear end of the connector in a sleeving manner, a fixing ring for fixing the artificial blood vessel on the connector tightly sleeves the artificial blood vessel, a barrier chip for spacing the fixing ring is fixed on the connector, and the end part of the artificial blood vessel and the end part of the fixing ring are separately jointed with the rear side of the barrier chip. The bypass blood vessel guiding device disclosed by the invention is quite simple in structure, reasonable in design and convenient to use and operate; the blood vessel guiding device can be used for forming a tunnel, so that the artificial blood vessel can be smoothly guided from the tunnel, the whole process has small damage to blood vessels and tissues of a patient, the process operation of a surgery is simple, the pain of the patient can be relieved, and the probability of infection of the patient is reduced.

Description

Artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide
Technical field
The invention belongs to technical field of medical instruments, be specifically related to a kind of artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide.
Background technology
Chronic renal failure is the Progressive symmetric erythrokeratodermia progress of various chronic renal disease, lose with causing nephron and renal function irreversibility, cause that the late period of chronic renal failure is uremia with metabolite retention, Water-Electrolyte and acid base imbalance and endocrine disturbance for distinctive clinical syndrome.
Development along with society, the appearance of population aging, chronic kidney disease and the chronic renal failure caused thereof increase year by year at global sickness rate, and the whole world there are about end stage renal failure 220~2,700,000 people every year, accepts the patient of dialysis treatment just with the speed increment of annual 10%~12%.China's chronic kidney disease prevalence is very high, account for the 10% of total crowd's sickness rate, the existing uremic patient sum of China has exceeded 2,000,000 people according to estimates, have nearly 1,000,000 patients to depend on dialysis to sustain life, and annual new discovery uremia case accounts for 1/1000000th of China's total population, uremia, because of high disability rate, high medical care expenses, endangers huge, is therefore one of common disease jeopardizing human health.
The essential therapeutic arsenals in chronic renal failure latter stage at end has peritoneal dialysis, hemodialysis and renal transplantation.Hemodialysis is the important way of renal replacement therapies, and the needs of patients for long-term dialysis sets up long-term dialysis path, certainly the most often selects Autogenous arteriovenous internal fistula.But causing that Autogenous arteriovenous internal fistula cannot be set up in practice for some reason, main cause has: patient's native blood vessel condition is poor, it is impossible to set up;There is obturation in the Autogenous arteriovenous internal fistula set up, it is impossible to re-establish.If still needing to continue hemodialysis for these patients, it is accomplished by the operation of pedestrian's work bypass, artificial blood vessel's turn of tidal stream operation process needs artificial blood vessel guided from subcutaneous tunnel of beating, when current artificial blood vessel guides from tunnel, without unified apparatus, useful mosquito forceps beats tunnel, also useful common iron wire beats tunnel, before beating tunnel, one end stitching thread of artificial blood vessel is tied up on mosquito forceps or common iron wire, or with, on hemostasis clamp, driving tractive to guide by mosquito forceps or common iron wire.Its shortcoming is: (1), as entering in human body, especially should have the medical apparatus and instruments of strict medical treatment qualification production of units with the object of blood samples of patients closing contact;(2) currently used all apparatuses are all likely to result in the damage of patient veins beneath the skin, tissue when beating tunnel, and with stitching thread ligation or tractive artificial blood vessel's end, are all likely to result in the damage of artificial blood vessel's pipe end, add the misery of patient;Because the size beating its tunnel, tunnel with mosquito forceps is difficult to control to, therefore it cannot be guaranteed that tunnel matches with the thickness of artificial blood vessel completely, too small blood vessel constriction, cross conference and leave gap;(3) operation process difficulty operation, extends operating time, increases infection chance.
Summary of the invention
It is an object of the invention to overcome above-mentioned deficiency of the prior art, artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide is provided, its structure is very simple, reasonable in design and uses easy to operate, blood vessel guide can be adopted to beat tunnel and artificial blood vessel guided from tunnel smoothly, patient vessel, tissue are caused damage minimum by whole process, operation process is simple to operate, can reduce patient suffering, reduces infection chance.
For achieving the above object, the technical solution used in the present invention is: a kind of artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide, it is characterized in that: include the union joint guiding pin and rear end can be connected with artificial blood vessel, described guiding pin is fixedly mounted on the front end of union joint, the syringe needle extenal fixation of described guiding pin has pullover, one end of described artificial blood vessel is set in the rear end of union joint, the retainer ring for being fixed on union joint by artificial blood vessel tightly it is cased with outside described artificial blood vessel, described union joint is fixed with the catch that retainer ring rises position-limiting action, all fit with the rear side of catch in the end of described artificial blood vessel and retainer ring.
Above-mentioned artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide, it is characterised in that: the shape of cross section of described union joint is circular, and the maximum gauge of described union joint rear end is more than the internal diameter 1mm~2mm of artificial blood vessel.
Above-mentioned artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide, it is characterised in that: described pullover outer surface is arc surface.
Above-mentioned artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide, it is characterised in that: the front end of described union joint is truncated cone-shaped structure, and the small end of described truncated cone-shaped structure is connected with guiding pin.
Above-mentioned artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide, it is characterised in that: described catch generally circular in shape, the diameter of described catch and the outside diameter of truncated cone-shaped structure are equal.
Above-mentioned artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide, it is characterised in that: the length of described truncated cone-shaped structure is 1cm~1.5cm, and the length being positioned at the union joint of described artificial blood vessel is 1.5cm~2cm.
Above-mentioned artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide, it is characterised in that: the shape of cross section of described guiding pin is circular, and the diameter of described guiding pin is 2mm~3mm.
Above-mentioned artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide, it is characterised in that: the length of described guiding pin is 20cm~25cm.
Above-mentioned artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide, it is characterised in that: described pullover pullover for medical duroplasts, described union joint is medical duroplasts union joint, and described catch is medical duroplasts catch.
Above-mentioned artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide, it is characterised in that: described retainer ring is medical grade rubber retainer ring, and described guiding pin is that medical steel wire guides pin.
The present invention compared with prior art has the advantage that
1, present configuration is very simple, reasonable in design and use easy to operate.
2, blood vessel guide of the present invention can be adopted to beat tunnel and artificial blood vessel guided from tunnel smoothly, patient vessel, tissue are caused damage minimum by whole process, and operation process is simple to operate, decreases operation time, patient suffering can be reduced, reduce infection chance.
3, the present invention can effectively solve to adopt mosquito forceps, common iron wire, when beating tunnel, patient veins beneath the skin, tissue are caused damage, it is prevented that artificial blood vessel is caused damage;And adopt blood vessel guide of the present invention to solve to adopt mosquito forceps to beat the size in its tunnel, tunnel to be difficult to control to it cannot be guaranteed that the problem that matches with artificial blood vessel's thickness completely of tunnel, it can be ensured that patient vessel's pressurized uniformly, will not leave behind excessive gap.
4, material therefor of the present invention is medical material, for medical device product, it is desirable to the regular medical apparatus and instruments production unit having qualification produces, and patient will not cause damage, and can greatly reduce infection chance.
Below by drawings and Examples, the present invention is described in further detail.
Accompanying drawing explanation
Fig. 1 is the structural representation of the present invention.
Description of reference numerals:
1 guides pin;2 is pullover;3 union joints;
4 catch;5 artificial blood vessels;6 retainer ring.
Detailed description of the invention
As shown in Figure 1, the present invention includes the union joint 3 guiding pin 1 and rear end can be connected with artificial blood vessel 5, described guiding pin 1 is fixedly mounted on the front end of union joint 3, the syringe needle extenal fixation of described guiding pin 1 has pullover 2, one end of described artificial blood vessel 5 is set in the rear end of union joint 3, described artificial blood vessel 5 is outer is tightly cased with the retainer ring 6 for artificial blood vessel 5 being fixed on union joint 3, being fixed with the catch 4 to 6 position-limiting actions of retainer ring on described union joint 3, all fits with the rear side of catch 4 in the end of described artificial blood vessel 5 and retainer ring 6.
In the present embodiment, the shape of cross section of described union joint 3 is circular, and the maximum gauge of described union joint 3 rear end is more than the internal diameter 1mm~2mm of artificial blood vessel 5, and one end of such artificial blood vessel 5 is enclosed within union joint 3 and firmly, can could effectively prevent artificial blood vessel 5 from coming off.
In the present embodiment, the described outer surface of pullover 2 is arc surface, can greatly reduce the damage to patient veins beneath the skin, tissue.
In the present embodiment, the front end of described union joint 3 is truncated cone-shaped structure, and the small end of described truncated cone-shaped structure is connected with guiding pin 1, in order to union joint 3 can beat tunnel from patient is subcutaneous smoothly, reduces as far as possible patient subcutaneous tissue injury.
In the present embodiment, described catch 4 generally circular in shape, the diameter of described catch 4 and the outside diameter of truncated cone-shaped structure are equal, to prevent injured patient veins beneath the skin, tissue.
In the present embodiment, the length of described truncated cone-shaped structure is 1cm~1.5cm, the length being positioned at the union joint of described artificial blood vessel 5 is 1.5cm~2cm, the length being positioned at the union joint of artificial blood vessel 5 is longer than the length of the union joint being positioned at outside artificial blood vessel 5, namely the length of truncated cone-shaped structure it is longer than, can ensure that artificial blood vessel 5 is firmly on union joint 3, effectively prevents artificial blood vessel 5 from coming off.
In the present embodiment, the shape of cross section of described guiding pin 1 is circular, and the diameter of described guiding pin 1 is 2mm~3mm, so as to beats tunnel from subcutaneous smoothly, reduces as far as possible patient subcutaneous tissue injury.
In the present embodiment, the length of described guiding pin 1 is 20cm~25cm, it is simple to beat tunnel from patient is subcutaneous.
In the present embodiment, described pullover 2 is that medical duroplasts is pullover, and described union joint 3 is medical duroplasts union joint, and described catch 4 is medical duroplasts catch.
In the present embodiment, described retainer ring 6 is medical grade rubber retainer ring, and medical grade rubber has elasticity, can artificial blood vessel 5 be well fixed on union joint 3;Described guiding pin 1 guides pin for medical steel wire, has certain degree of hardness, it is simple to beat tunnel from patient is subcutaneous.
Common artifical internal arteriovenous fistula maintenance shunt, such as brachial artery-cephalic vein artificial blood vessel's internal fistula, brachial artery-median cubital vein artificial blood vessel's internal fistula, axillary artery-axillary vein artificial blood vessel's internal fistula, brachial artery-axillary vein artificial blood vessel's internal fistula, femoral artery-great saphenous vein artificial blood vessel's internal fistula, femoral artery-femoral vein artificial blood vessel's internal fistula, still most commonly seen with brachial artery-median cubital vein artificial blood vessel's internal fistula clinically at present.The operation principle of artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide is illustrated below for brachial artery-median cubital vein artificial blood vessel's internal fistula.
Before using, one end of artificial blood vessel 5 is enclosed within the rear end of union joint 3, and by retainer ring 6, artificial blood vessel 5 is fixed on union joint 3, so that artificial blood vessel 5 and blood vessel guide are connected as a whole.After patient's local anaesthesia or brachial plexus anesthesial and routine disinfection, before patient's left or right, above carpal joint song side, walking crosswise or curved incision of 2cm~4cm is cut at 2cm~3cm place;Then the stringer otch respectively of the interior outside below patient's elbow joint is about 3cm, dissects, separates brachial artery and median cubital vein, and blocks brachial artery and venous blood flow;Tunnel is beaten again through blood vessel guide, beat tunnel from patient's ancon incision and artificial blood vessel 5 is guided to the otch above patient's carpal joint, then tunnel is beaten from this incision again, artificial blood vessel 5 is guided to another incision of patient's ancon, after placing, the two ends of artificial blood vessel 5 are carried out with the brachial artery of patient and median cubital vein respectively end-to-side anastomosis, check without hemorrhage, blood flow is unobstructed, without narrow rear skin suture, aseptic adjuvant is wrapped up.Owing to having smooth pullover 2 at the syringe needle extenal fixation guiding pin 1, therefore that patient veins beneath the skin, tissue injury is minimum.
The above; it it is only presently preferred embodiments of the present invention; not the present invention is imposed any restrictions, every any simple modification, change and equivalent structure transformation above example made according to the technology of the present invention essence, all still fall within the protection domain of technical solution of the present invention.

Claims (10)

1. an artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide, it is characterized in that: include the union joint (3) guiding pin (1) and rear end can be connected with artificial blood vessel (5), described guiding pin (1) is fixedly mounted on the front end of union joint (3), the syringe needle extenal fixation of described guiding pin (1) has pullover (2), one end of described artificial blood vessel (5) is set in the rear end of union joint (3), described artificial blood vessel (5) is tightly cased with outward the retainer ring (6) for artificial blood vessel (5) being fixed on union joint (3), described union joint (3) is fixed with the catch (4) that retainer ring (6) rises position-limiting action, all fit with the rear side of catch (4) in the end of described artificial blood vessel (5) and retainer ring (6).
2. the artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide described in claim 1, it is characterized in that: the shape of cross section of described union joint (3) is circle, and the maximum gauge of described union joint (3) rear end is more than the internal diameter 1mm~2mm of artificial blood vessel (5).
3. the artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide described in claim 1, it is characterised in that: the outer surface of described pullover (2) is arc surface.
4. the artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide described in claim 1, it is characterised in that: the front end of described union joint (3) is truncated cone-shaped structure, and the small end of described truncated cone-shaped structure is connected with guiding pin (1).
5. the artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide described in claim 4, it is characterised in that: described catch (4) generally circular in shape, the diameter of described catch (4) and the outside diameter of truncated cone-shaped structure are equal.
6. the artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide described in claim 4, it is characterised in that: the length of described truncated cone-shaped structure is 1cm~1.5cm, and the length being positioned at the union joint of described artificial blood vessel (5) is 1.5cm~2cm.
7. the artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide described in claim 1, it is characterised in that: the shape of cross section of described guiding pin (1) is circular, and the diameter of described guiding pin (1) is 2mm~3mm.
8. the artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide described in claim 1, it is characterised in that: the length of described guiding pin (1) is 20cm~25cm.
9. the artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide described in claim 1, it is characterized in that: described pullover (2) are pullover for medical duroplasts, described union joint (3) is medical duroplasts union joint, and described catch (4) is medical duroplasts catch.
10. the artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide described in claim 1, it is characterised in that: described retainer ring (6) is medical grade rubber retainer ring, and described guiding pin (1) guides pin for medical steel wire.
CN201610300138.2A 2016-05-06 2016-05-06 Artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide device Expired - Fee Related CN105748132B (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110353782A (en) * 2019-08-02 2019-10-22 武汉市第一医院 Artifical internal arteriovenous fistula maintenance hypodermic tunnel device
CN110353782B (en) * 2019-08-02 2024-05-03 武汉市第一医院 Subcutaneous tunnel device for artificial blood vessel arteriovenous internal fistula

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4955899A (en) * 1989-05-26 1990-09-11 Impra, Inc. Longitudinally compliant vascular graft
US5192310A (en) * 1991-09-16 1993-03-09 Atrium Medical Corporation Self-sealing implantable vascular graft
CN101607108A (en) * 2009-07-27 2009-12-23 温州医学院 A kind of novel blood vessel transplantation device
CN201782845U (en) * 2009-12-22 2011-04-06 孙立忠 Stent type artificial vessel conveying device for aortic surgery
CN206007333U (en) * 2016-05-06 2017-03-15 西安交通大学第一附属医院 Artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4955899A (en) * 1989-05-26 1990-09-11 Impra, Inc. Longitudinally compliant vascular graft
US5192310A (en) * 1991-09-16 1993-03-09 Atrium Medical Corporation Self-sealing implantable vascular graft
CN101607108A (en) * 2009-07-27 2009-12-23 温州医学院 A kind of novel blood vessel transplantation device
CN201782845U (en) * 2009-12-22 2011-04-06 孙立忠 Stent type artificial vessel conveying device for aortic surgery
CN206007333U (en) * 2016-05-06 2017-03-15 西安交通大学第一附属医院 Artifical internal arteriovenous fistula maintenance turn of tidal stream blood vessel guide

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110353782A (en) * 2019-08-02 2019-10-22 武汉市第一医院 Artifical internal arteriovenous fistula maintenance hypodermic tunnel device
CN110353782B (en) * 2019-08-02 2024-05-03 武汉市第一医院 Subcutaneous tunnel device for artificial blood vessel arteriovenous internal fistula

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