CN109963519B - 骨内进入装置 - Google Patents
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Abstract
一种进入装置，被配置成用于将骨内导管插入骨骼的内部。在一个实施方案中，公开了一种骨内进入装置，其包括装置主体、与该装置主体包括在一起的套管针、以及可移除地设置在该套管针上的骨内导管。该装置主体被配置成使得该进入装置的使用者能够手动地将该套管针的远侧尖端穿过患者身体的皮肤表面插入至该患者的骨骼的外表面。还公开了一种推进机构，并且该推进机构被配置成：在将该套管针的远侧尖端插入到骨骼的外表面之后，将该套管针和该骨内导管选择性地且向远侧推进到该患者骨骼内部中预定距离。
Description
相关申请的交叉引用
本申请要求2016年10月27日提交的题为“Intraosseous Access Device”的美国临时专利申请号62/413,879的权益，该临时专利申请的全部内容以引用的方式并入本文中。
发明内容
简而言之，本文的实施方案涉及一种被配置成用于将骨内导管插入骨骼内部的进入(access)装置。在某些情况下需要这种通路(access)以使药物能够快速注入骨骼的内部骨内部分，然后这些药物可以被快速吸收到体内。根据将要描述的实施方案，与已知的骨内装置相比，本文公开的进入装置能够将骨内导管插入骨骼内部预定距离，这使得装置的使用者能够将导管的远侧尖端准确地放置在骨内区域内的所需位置。
在一个实施方案中，公开了一种骨内进入装置，其包括：装置主体，与该装置主体包括在一起的套管针；和可移除地设置在该套管针上的骨内导管。该装置主体被配置成使得该进入装置的使用者能够手动地将该套管针的远侧尖端穿过患者身体的皮肤表面插入至该患者的骨骼的外表面。还公开了一种推进机构，并且该推进机构被配置成：在将该套管针的远侧尖端插入到该骨骼的外表面之后，将该套管针和该骨内导管选择性地且向远侧推进到该患者骨骼的内部中。
除了以上所述之外，还公开了其他进入装置和骨内导管构造。
本发明的这些和其他特征将从以下说明和所附权利要求中变得更清楚、或者可以通过实践如以下所列出的本发明的实施方案来了解。
附图说明
将参考附图中示出的本公开文本的具体实施方案来呈现对本公开文本的更具体的描述。应了解，这些附图只是描绘了本发明的典型实施方案，因此不应被认为是对本发明范围的限制。通过使用附图，将借助额外的特定性和细节来描述和解释本发明的示例实施方案，在附图中：
图1是根据一个实施方案的骨内进入装置的侧视图；
图2A至图2D描绘了如图1中所示的进入装置的多个使用阶段；
图3A至图3D描绘了根据一个实施方案的骨内导管的多个视图；
图4是根据一个实施方案的骨内导管的截面侧视图；
图5A至图5D描绘了根据一个实施方案的进入装置的多个使用阶段；
图6是根据一个实施方案的骨内导管的截面侧视图；
图7是示出了图6中导管的放置的截面侧视图；
图8是图6的导管的一部分的截面侧视图；
图9A和9B描绘了图6的导管的多个视图以及与其一起使用的进入装置；
图10是根据一个实施方案的骨内进入装置的截面侧视图；
图11是根据一个实施方案的骨内进入装置的截面侧视图；
图12是根据一个实施方案的骨内进入装置的截面侧视图；
图13是根据一个实施方案的骨内导管的截面侧视图；并且
图14是图13的导管的一部分的截面侧视图。
具体实施方式
现在将参考附图，其中相同的结构将具有相同的参考标记。应理解，附图是本公开文本的示例性实施方案的图解和示意性表示，并且既不是限制性的，也不一定按比例绘制。
为清楚起见，应理解，“近侧”一词是指离使用本文所述的装置的临床医生相对更近的方向，而“远侧”一词是指相对远离该临床医生的方向。例如，导管放置在患者体内的末端被认为是导管的远侧端，而留在体外的导管末端是导管的近侧端。此外，本文(包括权利要求书)中所使用的词语“包含”和“具有”应与“包括”一词具有相同的含义。
本公开文本的实施方案总体上涉及一种被配置成用于将骨内导管插入骨骼内部的进入装置。在某些情况下需要这种通路以使药物能够快速注入骨骼的内部骨内部分，然后这些药物可以被快速吸收到体内。根据将要描述的实施方案，与已知的骨内装置相比，本文公开的进入装置能够将骨内导管插入骨骼内部预定距离，这使得装置的使用者能够将导管的远侧尖端准确地放置在骨内区域内的所需位置。
图1描绘了根据一个实施方案的整体用10指代的骨内进入装置(“进入装置”)的多种细节。进入装置10被示为具有可移除地包括在其中的骨内导管(“导管”)20，也称为骨内插管。尽管下面将给出进一步的细节，但是在本实施方案中，导管20总体上包括毂42和在近侧端44A与远侧端44B之间延伸的附接插管44。插管44被可滑动地套在套管针(“套针”)38上，该套针从进入装置10向远侧延伸并在远侧尖端38B处终止。
如所示的，进入装置10包括在近侧端30A与远侧端30B之间延伸的主体30。在本实施方案中，主体30成形为限定适于由进入装置10的使用者抓握的手枪式握把，但主体的许多其他合适的形状也是可能的。
主体30容纳有推进机构，该推进机构被配置成在使用进入装置10期间沿远侧方向选择性地推进套针38和包括在一起的导管20。在本实施方案中，推进机构包括内部弹簧，该内部弹簧安装在主体30内并可操作地连接到套针38。可通过致动器(诸如释放触发器36)选择性地释放弹簧，以相对于主体30向远侧推进套针38。这使得套针38和包括在一起的导管20能够被驱动到患者的骨骼中，如下面将进一步描述的。如图1中所示，还包括安全开关34，并且该安全开关被配置成防止使用者无意中致动释放触发器36。在本实施方案中，安全开关34定位在释放触发器36附近并且必须从其初始位置移位(诸如通过滑动)，以便例如能够通过使用者的手指致动释放触发器。当然，可以采用其他安全开关和释放触发器构造。
图2A至图2D根据一个实施方案描绘了在将导管20插入患者的骨骼中时进入装置10的多个使用阶段。为清楚起见，图中省略了使用者的手。如图2A所示，使用者抓住进入装置的主体30并通过手动力引导套针38的远侧尖端38B穿过患者的皮肤表面50和皮下组织52，直到套针的远侧尖端碰到骨骼的壁(“骨壁”)54。此时，安全开关34被使用者脱开，并且释放触发器36被使用者的手指按下，这进而使内部弹簧(或其他合适的推进机构)向远侧驱动套针远侧尖端38B穿过骨壁54并进入骨骼内部(骨髓56)，如图2B中所见。这还使导管插管44的远侧尖端44B按照需要置于骨髓56中。注意，作为推进机构的内部弹簧用作对套针和导管进行推进的选择性器件的一个示例。应当理解，在其他实施方案中，可以采用其他结构和部件来提供相同的功能，包括钻机、化学品或其他炸药、受控炸药等。
注意，进入装置10和推进机构被配置成将插管远侧尖端44B推进到骨骼中预定距离。在一个实施方案中，预定距离可以从进入骨骼大约0.25英寸到大约1英寸变化，但各种其他可能的深度是可能的。在进入不同厚度的骨骼时，可能需要改变预定深度。在一个实施方案中，进入装置主体30上可以包括诸如深度刻度盘等深度选择器。利用这种深度刻度盘，使用者可以选择推进机构将推进插管44的远侧尖端44B的期望深度。这种实施方案中的深度刻度盘可以改变弹簧的预致动压缩，以便实现根据深度刻度盘设置对套针38和导管20进行相应推进。在其他实施方案中，可以采用其他控制件来根据预定的期望深度改变弹簧或其他推进机构的致动。在又一实施方案中，进入装置10可以被配置成将套针38和导管20插入一个预设深度。
在图2C中，通过向近侧撤回进入装置主体30，将套针38从导管20的插管44中撤回，从而导致进入装置10与导管20分离。在撤回进入装置10之后，插管44留在原位，其远侧尖端44B置于骨髓56内，如所示的。注意，此时导管毂42与皮肤表面50间隔开。在图2D中，调节导管20使得毂42邻近皮肤表面50，如下面进一步详细说明的。而且，延伸器60被示出为可操作地附接到毂42，以便使药物或其他流体能够通过导管20注入并经由导管插管44进入骨髓56。
图3A至图3D根据一个实施方案描绘了导管20的各种细节，其中毂42限定了基部部分64和连接器部分66，该连接器部分被配置成使得延伸器60能够与导管可操作地连接。毂42包括内腔68，该内腔与插管44配合以限定流体路径从而允许流体通过导管。如所示的，插管44(其在本实施方案中包括足够刚性的材料，诸如不锈钢、PEEK、或其他合适的金属/热塑性塑料/材料)可相对于毂42滑动，从而使得可调整导管20的总长度——对于如图3B中所示的插管远侧尖端深放置而言是相对较长长度，并且对于如图3C中所示的插管远侧尖端浅放置而言是相对较短长度。这进而使得导管20的毂42能够靠在皮肤表面50上，如图2D所示，无论插管44的远侧尖端44B的深度如何。如果不可调节，则导管可能呈现毂42与皮肤表面50间隔开的情形，类似于图2C中所示。
更详细地，O形环70使得插管44从毂42的延伸可能变化，该O形环介于毂42的基部部分64与插管44的外表面之间的内腔68中，这进而使插管能够以流体密封的方式在毂内腔中纵向滑动。应当理解，O形环70可以位于毂42的内腔68中的其他位置，并且除了O形环之外可以利用其他流体密封模式。图3D示出，在本实施方案中，可以将插管44撤回到毂42中，使得它延伸经过毂的连接器部分66并进入延伸器60，从而能够进一步缩短导管20的整体纵向长度。
图4根据另一实施方案描绘了导管20，其中插管44包括第一插管部分44A和第二插管部分44B，它们伸缩地彼此配合，有两个O形环70介于其间并位于第一插管部分与毂基部部分64的内腔68之间，使得插管部分能够相对于彼此并相对于毂基部部分伸展和收缩。这种伸缩构造可以允许导管20的总纵向长度具有更大的变化。而且，如所示的，第一和第二插管部分的近侧端包括径向延伸的唇缘，当插管部分完全伸展时，这些述唇缘防止插管部分与彼此以及与毂分离。尽管其他规格尺寸是可能的，但在本实施方案中，第一插管部分44A是15规格尺寸，而配合在第一插管部分内部的第二插管部分44B是18规格尺寸。要理解的是，可以采用一个、两个、或更多个伸缩部分。
图5A描绘了根据一个实施方案的进入装置10的多种特征和操作，其中主体30包括伸缩部分，该伸缩部分在进入装置使用之前最初遮蔽套针38。在使用进入装置10期间，并且如图5A所示，使用者抓住进入装置的主体30并将其远侧端30B靠皮肤表面50放置。然后通过手动推动将套针38的远侧尖端38B穿过患者的皮肤表面50和皮下组织52插入，直到套针的远侧尖端碰到骨骼的壁(“骨壁”)54，如图5B中所示。注意，该动作使得进入装置主体30的伸缩部分74折叠到主体的更近侧部分中，使得套针38可以从主体延伸出。而且，应当理解，该动作使得围绕套针38设置的导管插管44最初至少部分地缩回到导管毂42内，然后随着套针向远侧朝向骨壁54延伸而向远侧延伸。图3A至图3D和图4中所示的导管20的构造是可用于图5A至图5D中所示进入装置实施方案的合适导管构造的示例，但其他导管构造也是可能的。如已经讨论的，最初由进入装置主体30的伸缩部分74遮蔽套针38防止了在套针从进入装置主体伸出之前使用者与套针无意中接触。在一个实施方案中，进入装置主体的伸缩部分仅在使用进入装置后才遮蔽套针。
此时，安全开关34被使用者脱开，并且释放触发器36被使用者的手指按下，这进而使内部弹簧(或其他合适的推进机构)向远侧驱动套针远侧尖端38B穿过骨壁54并进入骨骼(骨髓56)，如图5C中所见。这还使导管插管44的远侧尖端44B按照需要置于骨髓56中。注意，由于毂42的纵向可延伸性质，毂在导管插入程序的开始和整个过程中靠在皮肤表面50上，如图5A至图5D所见。
正如图2A至2D中所示和联系其讨论的实施方案，进入装置10和推进机构被配置成将插管远侧尖端44B推进到骨骼中预定距离。在此实施方案和其他实施方案中，应当理解，可以根据如本文所讨论的使用者偏好来改变预定距离，并且进入装置可以被配置成使得其能够将导管推进到骨骼中在使用进入装置之前未预先确定的距离。
在图5D中，通过向近侧撤回进入装置主体30，将套针38从导管20的插管44撤回，从而导致进入装置10与导管20分离。当进入装置主体30向近侧撤回时，伸缩部分74向远侧延伸以在套针从导管20移除时完全覆盖并遮蔽套针38，从而防止针无意中刺到使用者。在一个实施方案中，在伸缩部分74和导管20上都可以包括干涉表面，以帮助伸缩部分向远侧延伸，如图5D所见。在另一实施方案中，可由使用者手动伸展伸缩部分74。
在撤回进入装置10之后，插管44留在原位，其远侧尖端44B置于骨髓56内，如所示的。注意，导管毂42根据需要靠着皮肤表面50保持就位。导管20可以被修整(dressed)，连接到延伸器60，并且以其他方式准备好用于经由导管插管44将流体注入骨髓56。
图6至图8根据一个实施方案描绘了可以与进入装置10一起使用的导管120的示例的细节。如所示的，导管120在近侧端包括毂122，该毂被配置成可操作地与延伸器连接，并且该导管在远侧端包括刚性插管部分124，该刚性插管部分在近侧端124A与远侧端124B之间延伸。在本实施方案中，柔性导管部分126可操作地连接在毂122和插管部分124之间，并且与插管部分的近侧端124A重叠。用作流体路径的内腔128由毂122、插管部分124、和导管部分126限定。插管部分124包括足够刚性的材料以穿透骨骼而不会弯曲或折叠，诸如不锈钢、PEEK、或包括其他金属和热塑性塑料的其他合适材料。在一个实施方案中，毂122和导管部分126包括合适的热塑性塑料或其他材料。
图7描绘了采用导管120的方式，其中插管部分被示为穿过骨壁54插入，使得其近侧端124A位于骨壁外部并且其远侧端124B置于骨髓56中。导管部分126的远侧段在骨壁54和皮肤表面50之间延伸，而导管的其余部分留在患者体外。在本实施方案中，可滑动的弯管件150被示为套在导管管子126上。在使用期间，弯管件可沿着导管管子126滑动并定位成帮助导管管子在退出患者身体时顺应皮肤表面50。弯管件可以包括90度的其他角度弯曲，以辅助导管管子126的这种顺应性。
还要注意，虽然图7示出了插管部分124通过皮肤表面50伸出，但是一个实施方案中，该插管部分可以完全置于患者体内，使得导管管子126的远侧部分也置于皮肤表面之下。
图8示出了，在本实施方案中，附接到插管部分124的近侧端124A的固定线130通过导管部分126的内腔128向近侧延伸到毂122，它们在毂处被固定。固定线130提供必要的强度以使插管部分124能够从骨壁54拉出而不与导管120的其余部分分离。注意，在一个实施方案中，固定线130可以集成到导管部分126的壁中。在另一实施方案中，可以包括一根、两根、或更多根固定线130。在又一实施方案中，固定线130越过毂122的近侧端伸出。在另一实施方案中，固定线可以采用其他形式，比如像固定带。因此可以设想这些和其他变化。
图9A示出了导管120装载在进入装置10的套针38上的方式。图9B示出了在一个实施方案中套针38可包括肩部134，当导管120安置于套针上时，近侧端124A抵靠该肩部。这为套针38提供了一个表面，在使用进入装置30期间推挤该表面以推进导管124穿过骨壁54并进入骨髓56，同时在导管放置完成后仍然能够使套针轻易地从导管中撤回。注意，肩部的特定位置、尺寸、和其他构造可以与本文所示和所述的不同。
图9A进一步描绘了调节部件的细节，该调节部件被配置成调节推进机构使套针38的远侧尖端38B和导管120推进的深度(注意，当前关于调节部件的讨论可以应用于本文中的其他实施方案)。如所示的，弹簧140包括在进入装置主体30内并且被配置成推进机构，以通过套针的近侧端38A向套针38提供向远侧的推进力(如本文中的其他实施方案一样)。这里被实施为旋转调节刻度盘142的调节部件设置在进入装置主体30的表面上，并且可由进入装置的使用者移动，以选择套针38的远侧尖端38B以及相应地导管120的远侧尖端124B将被弹簧140推进的预定深度。在本实施方案中，调节刻度盘142可操作地连接到一个或多个控制臂144，该控制臂被配置成改变弹簧140的预致动长度。这进而减少或增加了致动之前储存在弹簧140中的势能，从而提供套针38和导管120向骨骼中相对更浅或更深的推进。除此之外，在其他实施方案中，可以采用其他调节部件和推进机构。
鉴于上述情况，要理解的是，弹簧140用作推进套针和导管的选择性器件的一个示例。注意，弹簧140被认为是选择性的，因为它由使用者通过触发器或其他合适的部件选择性地致动。应当理解，在其他实施方案中，可以采用其他结构和部件来提供相同的功能。
图10描绘了根据一个实施方案的骨内进入装置(“进入装置”)210的细节，包括细长主体230，该细长主体内部设置有骨内导管(“导管”)220，也称为骨内插管。如前所述，导管220包括毂242，从毂向远侧延伸出插管244。如所示的，本实施方案中的导管220可滑动地套在套管针(“套针”)248上并且容纳在套筒246内，该套筒本身设置在进入装置主体230内。
进入装置210进一步包括推进机构，该推进机构被配置成在使用进入装置210期间沿远侧方向选择性地推进套针248和包括在一起的导管220。在本实施方案中，推进机构包括第一致动器和第二致动器，第一致动器在此实现为被配置成选择性地激活第一弹簧252的第一触发器250，第二致动器在此实现为被配置成选择性地致动第二弹簧262的第二触发器260。第一弹簧252是相对低力的弹簧，其被配置成在由第一触发器250致动时(例如，通过在远侧方向上手动按下第一触发器)提供力以将含导管的套筒246向远侧推出进入装置主体230的远侧端一个预定距离。在使用进入装置210期间采取该动作以推进套针248和导管220穿过患者的皮肤表面和组织到达骨壁。注意，在本实施方案中，在致动第一触发器250以使导管220向远侧推进之后，套筒246的远侧端靠在皮肤表面上。
相比之下，第二弹簧262是相对高力的弹簧，其被配置成在由第二触发器260致动时(例如，通过在近侧方向上手动拉动第二触发器)提供力以将导管220从套筒246的开放性远侧端向远侧推进进一步的预定距离。在使用进入装置210期间采取该动作以推进套针248和导管220的远侧端穿过骨壁并进入患者的骨髓。使用相对高力的弹簧262是必要的，以使套针248和导管220能够穿透相对坚硬且刚性的骨壁。一旦导管220的远侧端在患者的骨髓中就位，就可以通过由使用者向近侧撤回进入装置主体230来从患者身体撤回套针。
应当理解，第二弹簧262用作用于推进套针248和导管220的选择性器件的示例，并且因此被配置为施加必要大小的力以如上所述对患者骨壁进行穿透。第二弹簧262被认为是选择性的，因为它由使用者通过触发器或其他合适的部件致动。应当理解，在其他实施方案中，可以采用其他结构和部件来提供相同的功能。注意，第一和第二弹簧252、262可以被配置成使套针248/导管220穿透到骨骼中不同的预定距离。在一个实施方案中，进入装置被配置成使得第一和第二弹簧导致针对每个弹簧穿透单一预定深度。在另一实施方案中，进入装置包括调节该弹簧中的一个或多个弹簧的力以改变套针/导管穿透量的能力。因此可以设想这些和其他修改。
图11描绘了根据另一实施方案的进入装置210，其中第一触发器250和第二触发器260均被配置为有待在近侧方向上被手动拉动以分别致动第一弹簧252和第二弹簧262的触发器。注意，图11示出了在通过手动向近侧拉动第一触发器250来致动第一弹簧252(其中导管220部分地从进入装置主体230的开放性远侧端延伸)之后，但是在通过手动向近侧拉动第二触发器260来致动第二弹簧262(这导致导管进一步向远侧弹出)之前进入装置210的构造。在一个实施方案中，应当理解，进入装置可以被配置成使得可以自动执行第一弹簧、第二弹簧、或两个弹簧的致动。而且，在一个实施方案中，相对较强的第二弹簧的尺寸可以设计成配合在相对较弱的第一弹簧内(比如像同心地)。在另一实施方案中，第一弹簧的尺寸被设计成容纳在第二弹簧内。
图12根据另一实施方案描绘了推进机构的细节，其中进入装置主体230在其内表面上限定多个棘齿270，这些棘齿被配置成与包括在保持导管220的套筒246的近侧部分上的两个径向延伸的接合臂272接合。这种刻度盘使得套筒246和所包括的导管220能够以步进的方式向远侧推进，而没有撤回到进入装置主体230中的能力。注意，棘齿部件的形状、尺寸、位置、和其他构造可以与本文所示和所述的不同。
图13和图14根据一个实施方案描绘了骨内导管320的细节，包括毂342和从其向远侧延伸的细长插管344。导管320在图13中示为在患者体内就位，其中插管344的远侧尖端延伸到骨髓56。内腔350由导管320限定，以使药物或其他流体能够注入到骨髓56。
图14示出了导管320的总长度可调节。鉴于此，在本实施方案中，毂342包括滑管，该滑管限定腔354和通向该腔的开口356。相应地，插管344通过开口356被接收并且在其近侧端包括径向延伸的边缘358，该边缘被配置成在腔354内向近侧/向远侧滑动，从而使得总纵向长度能够根据边缘在腔内的位置而变化。密封件360围绕开口356放置，以确保插管和开口之间的流体密封。以这种方式，导管320可以根据骨骼深度和使用者偏好而在期望的长度上变化。如果需要，在调节导管320以使毂能够靠在皮肤表面上之后，可以将毂342粘附到皮肤表面50上。
在不脱离本公开文本的精神的情况下，本发明的实施方案可以以其他特定形式实施。所描述的实施方案在所有方面都应被视为说明性的而非限制性的。因此，实施方案的范围是由所附权利要求书而不是由以上描述来指明。权利要求书的等效含义和范围内的所有变化都被包涵在权利要求书的范围内。
Claims (19)
1.一种骨内进入装置，其包括：
装置主体；
与所述装置主体连接的套管针，所述套管针包括设计用于插入骨骼的远侧尖端；
可移除地设置在所述套管针上的骨内导管，所述骨内导管包括：
毂，其具有近侧连接器部分和远侧基部部分；
内腔，其从所述近侧连接器部分的近侧端至所述远侧基部部分的远侧端延伸穿过所述毂；
插管，其独立于所述套管针可滑动地设置在所述内腔中，以提供从所述远侧基部部分延伸的可调节插管长度；
O形环，其在所述内腔中环绕所述插管；和
推进机构，所述推进机构被配置成将所述套管针和所述插管选择性地且向远侧推进入所述骨骼。
2.如权利要求1所述的骨内进入装置，其中所述装置主体包括手枪式握把形状。
3.如权利要求1所述的骨内进入装置，其中所述推进机构提供向远侧的推进力以向远侧推进所述套管针和所述插管。
4.如权利要求3所述的骨内进入装置，其中所述推进机构包括弹簧，所述弹簧提供所述向远侧的推进力。
5.如权利要求3所述的骨内进入装置，其中所述向远侧的推进力的大小能够由所述骨内进入装置的使用者改变。
6.如权利要求5所述的骨内进入装置，其中所述向远侧的推进力能够由使用者通过调节部件来改变。
7.如权利要求6所述的骨内进入装置，其中所述调节部件包括安装在所述骨内进入装置的主体上的调节刻度盘。
8.如权利要求7所述的骨内进入装置，其中所述推进机构包括弹簧，并且其中所述调节部件被配置成在向远侧推进所述套管针和所述插管之前改变所述弹簧的可操作长度。
9.如权利要求1所述的骨内进入装置，其中所述推进机构被配置成向远侧推进所述套管针和所述插管进入所述骨骼内部的预定深度。
10.如权利要求9所述的骨内进入装置，其中所述预定深度能够通过调节部件来调节。
11.如权利要求1所述的骨内进入装置，其中所述推进机构被配置成由释放触发器来致动。
12.如权利要求11所述的骨内进入装置，其中所述骨内进入装置还包括安全开关，所述安全开关被配置成防止所述释放触发器的无意致动。
13.如权利要求1所述的骨内进入装置，其中所述推进机构被配置成将所述插管的远侧尖端向远侧推进到所述骨骼的骨内部分中。
14.如权利要求1所述的骨内进入装置，其中所述骨内进入装置被配置成将所述插管置于胫骨、胸骨和肱骨中的至少一者内。
15.如权利要求1所述的骨内进入装置，其中在使用所述骨内进入装置之前，所述套管针从所述装置主体向远侧延伸。
16.如权利要求1所述的骨内进入装置，其中所述推进机构包括以下各项中的至少一项：钻机、基于化学品的炸药、和弹簧。
17.如权利要求1所述的骨内进入装置，其中所述推进机构被设置在所述骨内装置主体内。
18.如权利要求1所述的骨内进入装置，其中所述骨内装置主体包括伸缩部分，所述伸缩部分被配置成在使用所述骨内进入装置之前覆盖所述套管针。
19.如权利要求18所述的骨内进入装置，其中所述伸缩部分被配置成在已将所述插管插入所述骨骼并且已从所述骨骼移除所述套管针之后覆盖所述套管针。
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| US62/413,879 | 2016-10-27 | ||
| PCT/US2017/058863 WO2018081632A1 (en) | 2016-10-27 | 2017-10-27 | Intraosseous access device |
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| CN109963519B true CN109963519B (zh) | 2022-06-21 |
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| JP2019531832A (ja) | 2019-11-07 |
| EP3528723C0 (en) | 2023-08-16 |
| BR112019008330A2 (pt) | 2019-07-16 |
| CN109963519A (zh) | 2019-07-02 |
| EP3528723A4 (en) | 2020-06-17 |
| EP4245352A3 (en) | 2023-11-15 |
| EP3528723A1 (en) | 2019-08-28 |
| ES2955558T3 (es) | 2023-12-04 |
| JP7065846B2 (ja) | 2022-05-12 |
| US20240050126A1 (en) | 2024-02-15 |
| EP3528723B1 (en) | 2023-08-16 |
| US20180116693A1 (en) | 2018-05-03 |
| US11883071B2 (en) | 2024-01-30 |
| AU2017350937B2 (en) | 2021-12-23 |
| US10893887B2 (en) | 2021-01-19 |
| EP4245352A2 (en) | 2023-09-20 |
| US20210137558A1 (en) | 2021-05-13 |
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