CN110192915B - Puncture positioning system for intracranial hematoma minimally invasive puncture and accurate three-dimensional positioner - Google Patents
Puncture positioning system for intracranial hematoma minimally invasive puncture and accurate three-dimensional positioner Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
- A61B2017/3405—Needle locating or guiding means using mechanical guide means
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Abstract
The invention provides an accurate three-dimensional positioner which is used for intracranial hematoma minimally invasive puncture and comprises a positioning device and a positioning belt, wherein the positioning device comprises a support frame, a sliding piece and a reference rod, the support frame comprises a top plate, a bottom plate and a connecting plate, the top plate and the connecting plate are oppositely arranged, and a sliding hole and an angle positioning scale mark are arranged on the top plate; three first reference rod positioning holes are formed in the bottom plate along the sliding holes; three first drainage tube positioning holes are formed in the bottom plate corresponding to the three first reference rod positioning holes; the sliding piece is arranged on the top plate through a bolt, and a second reference rod positioning hole and a second drainage tube positioning hole are formed in the sliding piece at intervals; one end of the reference rod is inserted into the first reference rod positioning hole, and the reference rod penetrates through the sliding hole and the second reference rod positioning hole; the locating belt is arranged on the supporting frame. The accurate three-dimensional positioner can improve the puncture accuracy of the intracranial hematoma minimally invasive puncture. The invention also provides a puncture positioning system for the intracranial hematoma minimally invasive puncture.
Description
Technical Field
The invention relates to a positioning device, in particular to a puncture positioning system for intracranial hematoma puncture minimally invasive puncture and an accurate three-dimensional positioner thereof.
Background
Cerebral apoplexy is the first cause of death of human beings at present, and is characterized by high morbidity, high mortality and high disability rate, wherein the incidence rate of cerebral hemorrhage is 60-80 people/10 ten thousand per year, and the incidence rate of acute phase disease death is up to 30-40% and survivors more than 30% leave over dysfunction in about 20-30% of the total cerebral apoplexy in China; adult cerebral hemorrhage in European and American countries accounts for 10-20% of all cerebral strokes, and the death rate is 23-52%.
Based on the limitation that the surgical craniotomy has great trauma, high risk and rapid reduction of local pressure-induced re-bleeding or edema aggravation on cerebral hemorrhage patients, minimally invasive hematoma drainage is increasingly important and applied to clinic. In the past, a minimally invasive hematoma drainage method generally adopts a line drawing method, an aiming method and the like to perform nearby principle puncture, the puncture direction is inaccurate, the depth of a drainage tube cannot be changed, the puncture drainage is mainly performed in a local small range, hematoma is not thoroughly removed, and moreover, a brain stem, a third ventricle and a fourth ventricle are not dared to puncture, and the puncture with a longer drainage tube is needed. Based on the above, the improved soft channel three-dimensional positioning technology is widely applied to a minimally invasive hematoma drainage method, the technology needs a soft channel drainage tube to enter the cranium for a long distance (the basal ganglia bleeding needs about 12 cm), accurate positioning is needed, particularly the third ventricle, the fourth ventricle and the brainstem drainage are more needed to be accurately positioned, multiple punctures are not allowed, otherwise, the damage is large, the effect is poor, particularly the brainstem puncture is not allowed to fail. However, many years of clinical experience have experienced less accurate penetration and have seen lower beginners. In the operation process, the puncture tube placement position is inaccurate, multiple punctures are needed, CT is repeated for multiple times, because no clear reference object exists, each tube placement is a new tube resetting process, multiple punctures lead to fatigue of operators, assistants and CT technicians, and the problems of increased risk of patient re-bleeding, distrust of family members and the like are caused.
Disclosure of Invention
Aiming at the problems of incomplete hematoma removal and difficult positioning in the soft channel technology of the nearby principle puncture of the traditional method, the accurate three-dimensional positioner capable of improving the puncture accuracy of the intracranial hematoma minimally invasive puncture is provided.
In order to achieve the above purpose, the technical scheme adopted by the invention is as follows:
The accurate three-dimensional positioner is used for intracranial hematoma minimally invasive puncture and comprises a positioning device and a positioning belt, wherein the positioning device comprises a support frame, a sliding piece and a reference rod, the support frame comprises a top plate, a bottom plate and a connecting plate, the top plate and the bottom plate are oppositely arranged, and the connecting plate is connected with the bottom plate and the top plate; the top plate is provided with a sliding hole in a penetrating way, and the top plate is also provided with angle positioning graduation marks extending along the length direction of the sliding hole; three first reference rod positioning holes are formed in the bottom plate at intervals along the length direction of the sliding hole, and the distance between two adjacent first reference rod positioning holes is 15mm; three first drainage tube positioning holes are correspondingly formed in the bottom plate in a penetrating mode through the three first reference rod positioning holes, and the connecting line of each first drainage tube positioning hole and the corresponding first reference rod positioning hole is perpendicular to the length direction of the sliding hole; the sliding part is arranged on the top plate through a bolt, the sliding part can be stressed to move along the sliding hole when the bolt is in a loosening state, a second reference rod positioning hole and a second drainage tube positioning hole are formed in the sliding part at intervals, the connecting line of the second reference rod positioning hole and the second drainage tube positioning hole is perpendicular to the length direction of the sliding hole, the second reference rod positioning hole and the three first reference rod positioning holes are all located in the same vertical plane and are communicated with the sliding hole, and the second drainage tube positioning hole and the three first drainage tube positioning holes are all located in the same vertical plane and are used for a drainage tube to pass through; one end of the reference rod is alternatively inserted into the first reference rod positioning hole, and the reference rod penetrates through the sliding hole and the second reference rod positioning hole; the positioning strap is coupled to at least one of the top plate, the bottom plate, and the connecting plate to position the positioning device on the patient's head.
Further, the slider includes sliding plate and flexible gasket, the sliding plate slidingly support in on the roof, flexible gasket is located the sliding plate is dorsad on the side of roof, the second is referenced the pole locating hole and is link up the sliding plate with flexible gasket, the bolt include the screw and with the nut that the screw cooperation was used, the screw wears to establish in proper order flexible gasket, sliding plate and the sliding hole, the nut with the screw connects soon.
Further, the top plate, the bottom plate, the connecting plate and the sliding plate are all made of transparent materials.
Further, a drainage tube position avoiding hole is formed in one side of the top plate in a penetrating mode, and the drainage tube position avoiding hole is located below the second drainage tube positioning hole and is communicated with the second drainage tube positioning hole.
Further, the number of the connecting plates is two, the two connecting plates are oppositely arranged, and the opposite sides of each connecting plate are respectively connected with the top plate and the bottom plate; the sliding hole and the first reference rod positioning hole are positioned between the two connecting plates; each connecting plate is provided with a mounting hole in a penetrating way; the positioning belt penetrates through the mounting holes on the two connecting plates and is supported on the bottom plate; and reference rod avoidance holes are formed in the positioning belt at intervals along the direction of the sliding hole.
Further, the reference rod is made of bone material.
Further, a positioning line parallel to the length direction of the reference rod is arranged on the outer wall of the reference rod.
Further, the positioning device further comprises a protractor, the protractor and the first drainage tube positioning holes are respectively positioned on two opposite sides of the supporting frame, the protractor is fixedly connected with the top plate and the bottom plate, three groups of angle measurement scales are arranged on the protractor, and the centers of the three groups of angle measurement scales respectively correspond to the three first reference rod positioning holes so as to measure the inclination angles of the reference rods at the three first reference rod positioning holes respectively.
The invention also provides another accurate three-dimensional positioner which is used for the intracranial hematoma minimally invasive puncture and comprises a positioning device and a positioning belt, wherein the positioning device comprises a support frame, a sliding piece, a reference rod and an angle gauge, the support frame comprises a top plate, a bottom plate and a connecting plate, the top plate is arranged opposite to the bottom plate, and the connecting plate is connected with the bottom plate and the top plate; a sliding hole is formed in the top plate in a penetrating manner; three first reference rod positioning holes are formed in the bottom plate at intervals along the length direction of the sliding hole, and the distance between two adjacent first reference rod positioning holes is 15mm; three first drainage tube positioning holes are correspondingly formed in the bottom plate in a penetrating mode through the three first reference rod positioning holes, and the connecting line of each first drainage tube positioning hole and the corresponding first reference rod positioning hole is perpendicular to the length direction of the sliding hole; the sliding part is arranged on the top plate through a bolt, the sliding part can be stressed to move along the sliding hole when the bolt is in a loosening state, a second reference rod positioning hole and a second drainage tube positioning hole are formed in the sliding part at intervals, the connecting line of the second reference rod positioning hole and the second drainage tube positioning hole is perpendicular to the length direction of the sliding hole, the second reference rod positioning hole and the three first reference rod positioning holes are all located in the same vertical plane and are communicated with the sliding hole, and the second drainage tube positioning hole and the three first drainage tube positioning holes are all located in the same vertical plane and are used for a drainage tube to pass through; one end of the reference rod is alternatively inserted into the first reference rod positioning hole, and the reference rod penetrates through the sliding hole and the second reference rod positioning hole; the protractor is fixedly connected with at least one element of the top plate, the bottom plate and the connecting plate, three groups of angle measurement scales are arranged on the protractor, and the centers of the three groups of angle measurement scales respectively correspond to three first reference rod positioning holes so as to measure the inclination angles of the reference rods at the three first reference rod positioning holes respectively; the positioning strap is coupled to at least one of the top plate, the bottom plate, and the connecting plate to position the positioning device on the patient's head.
The invention also provides a puncture positioning system for intracranial hematoma minimally invasive puncture, which comprises the two accurate stereotactic devices, wherein the positioning belt of one accurate stereotactic device is of a nonmetallic girdle belt structure, and the positioning devices of the accurate stereotactic device are all made of nonmetallic materials; the positioning belt of the other accurate stereotactic device is a flexible metal belt, and the length is smaller than the length of the nonmetallic girdle belt.
By adopting the technical scheme, the invention has the following beneficial effects:
1. The accurate three-dimensional positioner is characterized in that the bottom plate is provided with three first reference rod positioning holes, when the accurate three-dimensional positioner is used, the first reference rod positioning holes positioned at the middle position are overlapped with the central mark point of the forehead, and at the moment, the positions of the first reference rod positioning holes corresponding to the intracranial hematoma positions are actual puncture points. One end of the reference rod is inserted into a first reference rod positioning hole corresponding to the intracranial hematoma position, and then the reference rod is rotated by taking the puncture point as the center, so that the included angle between the reference rod and the plumb line is consistent with the included angle determined on the CT plane, and the length direction of the reference rod is the puncture direction at the moment. Because the first drainage tube locating hole corresponds to the first reference rod locating hole, and the second drainage tube locating hole corresponds to the second reference rod locating hole, the connecting line of the first drainage tube locating hole and the second drainage tube locating hole is parallel to the reference rod, and the positioning device is translated in the operation, so that the first drainage tube locating hole is aligned to the actual puncture point, the drainage tube sequentially passes through the first drainage tube locating hole and the second drainage tube locating hole to enter the brain, the consistency of the drainage tube and the puncture direction can be ensured, the aim of improving the puncture accuracy of the intracranial hematoma minimally invasive puncture is achieved, the damage is greatly reduced, the re-bleeding risk is reduced, the number of times of re-checking CT is reduced, and the efficiency and the treatment effect are improved. The included angle between the reference rod and the plumb line during rotation can be calculated rapidly according to the angle positioning graduation line and/or the protractor, and the use is more convenient.
2. Above-mentioned puncture positioning system for intracranial hematoma minimal access surgery, including two accurate stereolocators, one of them accurate stereolocator adopts the nonmetal clitellum, for the preoperative use, utilizes the nonmetal clitellum can be fixed in patient's head with positioner better, avoids the patient to remove and leads to positioner to shift and reduce positioning accuracy. Another accurate stereotactic adopts shorter flexible strap, and its area occupied is little, does benefit to the disinfection in the art, avoids the overlength area body to lead to the patient to infect, reduces the possibility that the art infects, and flexible strap is difficult for the lateral bending deformation, can improve the accuracy of location.
3. According to the puncture positioning system for the intracranial hematoma minimally invasive puncture, the accurate three-dimensional positioner used before the operation is made of the bone material, and meanwhile, the positioning device and the endless belt are made of metal, so that the influence of metal artifacts under CT is avoided, and the positioning accuracy is further improved.
Drawings
FIG. 1 is a schematic diagram of a puncture positioning system for minimally invasive puncture of intracranial hematoma according to a preferred embodiment of the invention.
Fig. 2 is a schematic view of a portion of the accurate stereotactic apparatus of fig. 1 with the protractor removed.
FIG. 3 is a schematic view of the precision stereotactic apparatus of FIG. 2 with the positioning belt removed.
Fig. 4 is a front view of the positioning device of fig. 1.
Fig. 5 is a top view of the top plate of fig. 3.
Fig. 6 is a schematic structural view of the sliding plate in fig. 3.
Fig. 7 is a schematic view of the flexible gasket of fig. 3.
Fig. 8 is a reference view of the usage status of the accurate stereotactic apparatus according to the embodiment of the present invention.
Description of the main reference signs
A puncture positioning system for 100-intracranial hematoma minimally invasive puncture, a 2, 4-accurate three-dimensional positioner, a 5-positioning device, a 52-supporting frame, a 521-top plate, a 523-bottom plate, a 525-connecting plate, a 54-sliding piece, a 542-sliding plate, a 544-flexible gasket, a 56-reference rod, a 562-observation hole, a 58-bolt, a 582-screw, a 584-nut, a 6-positioning belt, a 62-positioning mark, a 64-limiting part, a 7-sliding hole, an 8-angle positioning scale line, a 10-first reference rod positioning hole, a 11-first drainage tube positioning hole, a 12-second reference rod positioning hole, a 13-second drainage tube positioning hole, a 14-mounting hole, a 15-reference rod avoidance hole, a 16-first connecting piece, a 17-second connecting piece, a 18-drainage tube avoidance hole, a 19-positioning line, a 20-through hole, a 21-perforation, a 23-protractor, a 232-angle measurement scale line, a 234-angle measuring plate and a 200-drainage tube.
Detailed Description
The following description of the embodiments of the present invention will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that the embodiments described are only some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
It will be understood that when an element is referred to as being "fixed to" another element, it can be directly on the other element or intervening elements may also be present. When a component is considered to be "connected" to another component, it can be directly connected to the other component or intervening components may also be present. When an element is referred to as being "disposed on" another element, it can be directly on the other element or intervening elements may also be present. The terms "vertical," "horizontal," "left," "right," and the like are used herein for illustrative purposes only.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The terminology used herein in the description of the invention is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. The term "and/or" as used herein includes any and all combinations of one or more of the associated listed items.
Referring to fig. 1, a preferred embodiment of the present invention provides a puncture positioning system 100 for minimally invasive puncture of intracranial hematoma, comprising two accurate stereotactics 2, 4. Of the two accurate stereotactics 2,4, one accurate stereotactic 2 is used before the operation for adjust the puncture angle before the operation, and the other accurate stereotactic 4 is used in the operation for provide the direction of guidance for the puncture in the operation. The accurate stereotactic apparatus 2 does not need to be sterilized, and the accurate stereotactic apparatus 4 needs to be sterilized before use.
Referring to fig. 2 and 3, the two accurate stereotactic apparatuses 2 and 4 each include a positioning device 5 and a positioning belt 6 connected to the positioning device 5. The positioning device 5 includes a support bracket 52, a slider 54, and a reference lever 56. The support frame 52 includes a top plate 521, a bottom plate 523, and a connection plate 525, the top plate 521 is disposed opposite to the bottom plate 523, and the connection plate 525 connects the bottom plate 523 and the top plate 521. In the present embodiment, the number of the connection plates 525 is two, the two connection plates 525 are disposed opposite to each other, and opposite sides of each connection plate 525 are respectively connected to the top plate 521 and the bottom plate 523. The top plate 521 is provided with a sliding hole 7, the top plate 521 is also provided with an angle positioning scale mark 8 extending along the length direction of the sliding hole 7, and the angle positioning scale mark 8 can be arranged on the top plate 5 by printing or the like. Three first reference rod positioning holes 10 are formed in the bottom plate 523 at intervals along the length direction of the sliding hole 7, and the distance between two adjacent first reference rod positioning holes 10 is 15mm, so that the positions of the first reference rod positioning holes 10 correspond to the puncture points. The first reference rod positioning hole 10 is used for positioning the reference rod 56, wherein the first reference rod positioning hole 10 in the middle position is also used for aligning with the forehead median mark point to position the positioning device 5. In the present embodiment, the first reference rod positioning hole 10 has a through hole shape, and it is understood that in other embodiments, the first reference rod positioning hole 10 may have a blind hole shape or the like. Three first drainage tube positioning holes 11 are correspondingly formed in the bottom plate 523 in a penetrating mode through the three first reference rod positioning holes 10, and the connecting line between the center of each drainage tube positioning hole 11 and the center of the corresponding first reference rod positioning hole 10 is perpendicular to the length direction of the sliding hole 7. In this embodiment, each first drainage tube positioning hole 11 penetrates through the top surface, the bottom surface and one of the side edges of the bottom plate 523. The sliding hole 7, the three first reference rod positioning holes 10 and the three first drainage tube positioning holes 11 are all positioned between the two connecting plates 525.
The slider 54 is mounted on the top plate 521 by a bolt 58 and is capable of being forced to move along the slide hole 7 when the bolt 58 is in a released state. The sliding piece 54 is provided with a second reference rod positioning hole 12 and a second drainage tube positioning hole 13 at intervals, a connecting line between the center of the second reference rod positioning hole 12 and the center of the second drainage tube positioning hole 13 is perpendicular to the length direction of the sliding hole 7, the second reference rod positioning hole 12 and the three first reference rod positioning holes 10 are all positioned in the same vertical plane and communicated with the sliding hole 7, and the second drainage tube positioning hole 13 and the three first drainage tube positioning holes 11 are all positioned in the same vertical plane and used for a drainage tube 200 to pass through. In the present embodiment, the slider 54 includes a sliding plate 542 and a flexible spacer 544, the sliding plate 542 is slidably supported on the top plate 521, the flexible spacer 544 is located on a side of the sliding plate 542 facing away from the top plate 521, and the second reference rod positioning hole 12 penetrates the sliding plate 542 and the flexible spacer 544. Referring to fig. 4,6 and 7, the bolt 58 includes a screw 582 and a nut 584 cooperating with the screw 582, and the screw 582 sequentially passes through the flexible pad 544, the sliding plate 542 and the sliding hole 7, specifically: the flexible gasket 544 is provided with a through hole 20, and the sliding plate 542 is provided with a through hole 21; the screw 582 is inserted through the through hole 20, the through hole 21, and the slide hole 7 in this order. A nut 584 is threaded with screw 582 and is positioned on the side of top plate 521 opposite flexible washer 544. Flexible pad 544 is preferably made of a rubber material.
One end of the reference rod 56 is alternatively inserted into the three first reference rod positioning holes 10, and the reference rod 56 penetrates through the sliding hole 7 and the second reference rod positioning hole 12. In the present embodiment, the positioning belt 6 is mounted on the connection plate 525 to position the positioning device 5 on the head of the patient, specifically: each connecting plate 525 is provided with a mounting hole 14; the positioning belt 6 is penetrated through the mounting holes 14 on the two connecting plates 525 and is supported on the bottom plate 523; three reference rod avoidance holes 15 are formed in the positioning belt 6 at intervals along the direction of the sliding hole 7, the reference rod avoidance holes 15 are used for allowing the reference rods 56 to pass through, and the distance between two adjacent reference rod avoidance holes 15 is equal to the distance between two adjacent first reference rod positioning holes 10. Referring again to fig. 1, in the precision stereotactic apparatus 2 for preoperative use, the positioning belt 6 is a flexible belt made of a non-metallic material, such as rubber. One end of the flexible strap is provided with a first connector 16 and the other end of the flexible strap is provided with a second connector 17, the first connector 16 and the second connector 17 being detachably connectable together so that the flexible strap forms an endless belt structure around the head of the patient. The first connecting piece 16 and the second connecting piece 17 can be hook surface and rough surface of the magic tape, or sub-buckle and female buckle of the hidden buckle, etc. The positioning belt 6 of the accurate stereotactic apparatus 4 used in the operation is a flexible metal belt made of flexible metal material, and the length of the positioning belt 6 is smaller than that of the accurate stereotactic apparatus 2 used before the operation. The flexible metal strip is provided with a locating mark 62 for alignment with the midline on the greatest level of hematoma. In the present embodiment, the positioning belt 6 of the accurate stereotactic apparatus 4 used in the operation is preferably made of aluminum sheet, which has better elastic deformation capability, and can flexibly deform according to the radian of the brain of the patient so as to be better fitted with the head of the patient; at the same time, the aluminum sheet does not bend sideways as easily as the rubber tape, resulting in the positioning mark 62 being deviated from or not easily aligned with the midline on the maximum level of hematoma. In this embodiment, both free ends of the flexible metal strip are bent to form the stopper 64 to prevent the flexible metal strip from being separated from the mounting hole 14.
Referring to fig. 3, in the present embodiment, a drainage tube avoidance hole 18 is further formed on one side of the top plate 521 in a penetrating manner, and the drainage tube avoidance hole 18 is located below the second drainage tube positioning hole 13 and is communicated with the second drainage tube positioning hole 13. The drain clearance hole 18 is for the drain 200 to pass through.
Referring to fig. 2, in the present embodiment, a positioning line 19 parallel to the length direction of the reference rod 56 is provided on the outer wall of the reference rod 56, so as to facilitate the medical staff to position the reference rod 56.
In the present embodiment, the top plate 521, the bottom plate 523, the connection plate 525, and the slide plate 542 are made of a transparent material.
In this embodiment, the reference rod 56 is made of a bone material, and preferably has the same diameter as the drain tube 200. Preferably, the reference rod 56 is made of bovine bone, which has better strength, is not easy to break during processing, is not easy to bend and deform during use, and can further improve the positioning accuracy. The top plate 521, the bottom plate 523, the connecting plate 525, the sliding plate 542, the bolts 58, and the like of the positioning device 5 in the preoperatively used accurate stereotactic apparatus 2 are preferably made of non-metallic materials, such as plastics.
In the present embodiment, the positioning device 5 further includes a protractor 23, and the protractor 23 is fixedly connected to the top plate 521 and the bottom plate 523 by means of adhesion or the like. The protractor 23 is provided with three groups of angle measurement scales 232, and the centers of the three groups of angle measurement scales 232 respectively correspond to the three first reference rod positioning holes 10 and are used for measuring the inclination angles of the reference rod 56 at the three first reference rod positioning holes 10 respectively. In this embodiment, the protractor 23 is formed by splicing three angle measuring plates 234 in an adhesive manner, each angle measuring plate 234 is fixedly connected with the top plate 521 and the bottom plate 523 in an adhesive manner, etc., the plane of each angle measuring plate 234 is perpendicular to the connection line between the center of each drainage tube positioning hole 11 and the center of the corresponding first reference rod positioning hole 10, the center of each group of angle measurement scales 232 is on the same straight line with the center of the corresponding first reference rod positioning hole 10 and the center of the drainage tube positioning hole 11 corresponding to the first reference rod positioning hole 10, and the zero scale line of each group of angle measurement scales 232 is perpendicular to the connection line between the first drainage tube positioning hole 11 and the corresponding first reference rod positioning hole 10. Three sets of angle measurement scales 232 are provided on the sides of the three measuring angle plates 234 facing the reference bar 56, respectively. It will be appreciated that in other embodiments, the three sets of angle measurement indicia 232 may be provided on the same plate.
The inclination angle of the reference rod 56 can be secondarily measured through the protractor 23, and the measuring precision of the accurate three-dimensional positioners 2 and 4 can be further improved through the mutual matching of the reference rod and the angle positioning graduation marks 8. It will be appreciated that the protractor 23 may be fixedly connected to other portions of the support frame 52, for example, two opposite sides of the protractor 23 may be fixedly connected to two connecting plates 525, or connected to the top plate 521, the bottom plate 523 and the connecting plates 525, so long as the protractor 23 can be fixed to the support frame 52. In the present embodiment, the protractor 23 and the first drainage tube positioning hole 11 are respectively located at two opposite sides of the supporting frame 52, so as to observe the inclination angle of the reference rod 56, and the protractor 23 does not affect the puncturing operation of the drainage tube 200. Preferably, the protractor 23 is made of a non-metallic material, such as a transparent plastic plate.
In this embodiment, the reference rod 56 is further provided with an observation hole 562, so that a medical staff can conveniently view the position of the positioning line 19 on the reference rod 56 on the angle measurement scale 232 through the observation hole 562, and the accuracy of angle positioning is improved.
The following briefly describes the method of using the puncture positioning system 100 for intracranial hematoma puncture:
Step S1: determination of a standard plane: taking the bilateral lens and the external auricular portal, namely the canthus line (namely the OM line) as standard planes, and performing skull CT scanning at an interlayer spacing of 5mm to obtain CT flat sheets;
Step S2: determination of the maximum level of hematoma: marking the maximum hematoma layer on the CT flat plate, calculating the distance from the standard plane (namely the skull base layer surface) to the maximum hematoma layer, drawing a front midline along the nose tip, the nose root and the skull top, measuring the corresponding arc-shaped distance from the nose root (lens position) to the maximum hematoma layer of the forehead along the front midline, and making a forehead mark; in the same way, corresponding mark points of the maximum hematoma layer are marked above the external auditory meatus at two sides, and are connected into a plane along the three mark points (the right midpoint of the forehead and the upper points of the external auditory meatus at two sides), and the plane is a puncture plane which is matched with the maximum hematoma layer on the CT plane. When the three marking points are respectively stuck with 3 electrode plates for rechecking CT to determine the puncture direction, etc.;
Step S3: determination of the direction of the drainage tube in the puncture plane: marking a midline on the maximum hematoma layer surface of the CT flat plate, marking a position (an actual puncture point position, a puncture point position of the forehead is relatively fixed, a drainage tube is easily fixed at a flat position, the frontal sinus and an upper sagittal sinus are avoided) at a position which is 15mm away from the midline of the maximum hematoma layer surface by utilizing a ruler, marking a position (5-10 mm away from the edge of the hematoma) which is required to reach the distal end of the maximum hematoma layer surface, intersecting a connecting line of the two points with the midline to obtain an included angle, and measuring the degree of the included angle by using an angle meter. The steps S1-S3 are part of the prior art and are not described in detail herein for the sake of brevity.
Step S4: the puncture direction is regulated and determined by adopting a precise stereotactic device 2 used before operation: the accurate stereotactic device 2 used before the operation is fixed on the head of a patient through the locating belt 6, and the first reference rod locating hole 10 positioned at the middle position of the accurate stereotactic device 2 used before the operation is coincided with the central mark point of the forehead, at the moment, the position of the first reference rod locating hole 10 corresponding to the intracranial hematoma position is the actual puncture point. One end of the reference rod 56 is inserted into one of the first reference rod positioning holes 10 according to the intracranial hematoma position (15 mm from the anterior median hole and corresponding to 15mm lateral to the anterior median line of the forehead of the CT flat plate), for example, if the intracranial hematoma position is positioned at the left side of the cerebral median line, one end of the reference rod 56 sequentially passes through the sliding hole 7 and the corresponding reference rod avoidance hole 15 on the positioning belt 6 and then is inserted into the first reference rod positioning hole 10 at the left side of the forehead median marking point, and if the intracranial hematoma position is positioned at the right side of the cerebral median line, one end of the reference rod 56 sequentially passes through the sliding hole 7 and the corresponding reference rod avoidance hole 15 on the positioning belt 6 and then is inserted into the first reference rod positioning hole 10 at the right side of the forehead median marking point; if the intracranial hematoma position deviates to the central line of the brain, one end of the reference rod 56 sequentially passes through the sliding hole 7 and the corresponding reference rod avoidance hole 15 on the positioning belt 6 and then is inserted into the first reference rod positioning hole 10 aligned with the central mark point of the forehead, namely positioned at the middle position. The other end of the reference rod 56 is movable to adjust the inclination angle of the reference rod 56 so that the angle between the reference rod 56 and the plumb line coincides with the angle determined in step S3, i.e., the needle insertion direction of the drainage tube. The method comprises the following steps: in this embodiment, the surfaces of the top plates 521 in the two puncture positioners are provided with angle positioning graduation marks 8, the arrangement of the angle positioning graduation marks 8 is shown in fig. 5, three origin points are arranged at intervals between the angle positioning graduation marks 8, the three origin points respectively correspond to the three first reference rod positioning holes 10, and the distance between two adjacent graduations in the angle positioning graduation marks 8 is 1mm. One end of the reference rod 56 is inserted into the first reference rod positioning hole 10, the free end of the reference rod 56 is moved along the direction of the sliding hole 7, and the reference rod 56 drives the sliding piece 54 to move along the sliding hole 7. Each time the reference rod 56 moves by 1mm, i.e. a scale, corresponds to an inclination angle of 2.5 ° of the reference rod 56, the reference rod 56 is moved along the sliding hole 7 by a predetermined scale position after the angle is measured on the CT plane, and in this process, the inclination angle of the reference rod 56 can be determined with the aid of the protractor 23. After the reference rod 56 moves to the preset scale position, the nut 584 is screwed to fix the sliding member 54 on the supporting frame 52, so that the positioning accuracy is prevented from being reduced due to accidental movement of the sliding member 54 and the reference rod 56. It will be appreciated that the arrangement of the angular positioning graduations 8 is not limited to this embodiment, as long as it assists the healthcare worker in positioning the reference rod 56 to the desired angle.
Step S5: and (3) carrying out standard plane CT review to determine whether the marking point is correct and whether the extension line of the direction of the reference rod 56 in the accurate three-dimensional positioner 2 used before operation is consistent with the route and the reached position required by the actual operation of the drainage tube, if the extension line is inconsistent, the accurate three-dimensional positioner can be actually operated until the extension line is consistent, and most of the accurate three-dimensional positioner can be practically successful once through multiple cases of operation. The tilt angle of the reference rod 56 in the preoperatively used precision stereotactic device 2 is finally determined after the review. The inclination angle of the reference bar 56 in the stereotactic apparatus 4 used in the operation is adjusted to coincide with the inclination angle of the reference bar 56 finally determined by the stereotactic apparatus 2 used in the operation.
Step S6: the accurate stereotactic device 2 used before the operation is taken down from the head of the patient, disinfection and anesthesia are carried out on the patient, the accurate stereotactic device 4 used during the operation is placed on the head of the patient, the first reference rod locating hole 10 in the middle position of the accurate stereotactic device 4 used during the operation is enabled to coincide with the central marking point of the forehead, the locating mark 62 of the locating strap 6 is aligned with the central line on the maximum layer of hematoma, the locating device 5 is translated, the first drainage tube locating hole 11 corresponding to the reference rod 56 is enabled to be located at the actual puncture point, the assistant presses the locating strap 6 of the accurate stereotactic device used during the operation to prevent the movement of the accurate stereotactic device, then the drainage tube 200 sequentially passes through the second drainage tube locating hole 13 and the first drainage tube locating hole 11 to enter the brain, and the puncture direction of the drainage tube 200 can be ensured to be consistent with the inclination angle of the reference rod 56 (fig. 8). Preferably, the puncture positioning system 100 for intracranial hematoma minimally invasive puncture according to the embodiment of the invention is used for positioning, and the other parts of the head of a patient can be partially covered with a sterile towel during operation, so that only the part to be punctured can be leaked (the whole head of the patient needs to be exposed by the traditional line drawing method, the aiming method and the improved soft channel stereotactic method, so that the infection chance in the operation of the patient is increased, the patient is more sanitary, and the bacterial infection is reduced.
The frontal approach is positioned in such a way that the thalamus bleeding, cerebellum bleeding puncture points, fourth ventricle, brain stem position are relatively fixed in practice, and the brain lobe bleeding puncture points are changeable (change depending on hematoma position, morphological change), for example: for cerebellum, brain stem hemorrhage, fourth ventricle puncture site: forming two opposite angles of continuous midpoints of a quadrangle on the occipital tuberosity horizontal line, the hairline, the mastoid lateral margin and the posterior midline, and fixing relatively; the thalamus puncture point is 10-20mm above the ear tip, depending on hematoma; other cerebral hemorrhage puncture points have larger change, but all the important blood vessels and important functional areas need to be avoided, and the direction of the drainage tube can be according to the frontal approach included angle method as long as the puncture point positions are well fixed.
In the above-mentioned accurate stereotactic device 2,4, offer three first reference pole locating hole 10 on the bottom plate 523, when using, will be located the first reference pole locating hole 10 and the mark point coincidence in the middle position in the middle of the forehead, at this moment, the position of first reference pole locating hole 10 corresponding to intracranial hematoma position is the actual puncture point. One end of the reference rod 56 is inserted into the first reference rod positioning hole 10 corresponding to the intracranial hematoma position, and then the reference rod 56 is rotated about the puncture point, so that the included angle between the reference rod 56 and the plumb line is consistent with the included angle determined on the CT plane, and at this time, the length direction of the reference rod 56 is the puncture direction. Because the first drainage tube positioning hole 11 corresponds to the first reference rod positioning hole 10 and the second drainage tube positioning hole 13 corresponds to the second reference rod positioning hole 12, the connecting line of the first drainage tube positioning hole 11 and the second drainage tube positioning hole 13 is parallel to the reference rod 56, and the drainage tube 200 sequentially passes through the first drainage tube positioning hole 11 and the second drainage tube positioning hole 13 to enter the brain, so that the consistency of the drainage tube 200 and the puncture direction can be ensured, the aim of improving the puncture accuracy of the minimally invasive puncture of intracranial hematoma is achieved, the damage is greatly reduced, the re-bleeding risk is reduced, the recheck CT times are reduced, and the efficiency and the treatment effect are improved. The included angle between the reference rod 56 and the plumb line during rotation can be calculated quickly according to the angle positioning graduation marks 8 on the top plate 521, so that the use is more convenient.
The accurate stereotactic device 2, 4 has simple structure and smaller volume, and is convenient for application in intracranial hematoma puncture.
The accurate stereotactic device 2,4 comprises three first reference rod positioning holes 10, so that the positioning device 5 can puncture and position intracranial hematoma positions at different positions, thereby achieving the aim of multiple purposes and being more convenient to use.
The puncture positioning system 100 for intracranial hematoma minimally invasive puncture adopts two accurate stereotactics 2 and 4 aiming at the situation that the equipment before operation is not required to be disinfected and the equipment in operation is required to be disinfected, wherein one accurate stereotactic 2 adopts an annular belt structure made of nonmetallic materials, and for preoperation use, the positioning device 5 can be better fixed on the head of a patient by utilizing the positioning belt 6 of the nonmetallic annular belt structure, so that the displacement of the positioning device 5 caused by the movement of the patient is avoided, and the positioning precision is reduced; and the ring belt structure made of nonmetallic materials can avoid the influence of metal artifacts under CT, so that CT review is facilitated. The other accurate stereotactic device 4 adopts a shorter flexible metal belt, the occupied area is small, the disinfection in operation is facilitated, and the positioning belt 6 is made of flexible metal material, and the deformation is not easy to occur like rubber material in the disinfection process.
The puncture positioning system 100 for the intracranial hematoma minimally invasive puncture is characterized in that the reference rods 56 in the accurate three-dimensional positioners 2 and 4 are made of bone materials, and meanwhile, the positioning device 5 and the positioning belt 6 in the accurate three-dimensional positioner 2 are made of metal-free materials before operation, so that the influence of metal artifacts under CT is avoided, CT review is facilitated, and the positioning accuracy is further improved.
In the puncture positioning system 100 for intracranial hematoma minimally invasive puncture, the reference rod 56 is provided with the positioning line 19 parallel to the length direction of the reference rod 56, and the positioning line 19 is used for facilitating the medical staff to judge the moving distance of the reference rod 56 along the sliding hole 7. The accurate stereotactic device 4 used in the operation is provided with a positioning mark 62 on the positioning belt 6, and is used for aligning with the median line on the maximum hematoma layer during the operation so as to further improve the positioning accuracy of the positioning device 5.
The above-described puncture positioning system 100 for intracranial hematoma minimally invasive puncture, the slider 54 further comprises a flexible pad 544, by which the friction between the flexible pad 544 and the reference rod 56 can be increased to better fix the reference rod 56. The puncture positioning system 100 for intracranial hematoma minimally invasive puncture can change the angle of the reference rod 56 to adapt to different puncture parts, so as to achieve the most satisfactory effect; both the support frame 52 and the sliding plate 542 are made of transparent materials, so that the position and the direction of the puncture point and the condition of the reference rod 56 can be seen, and the puncture point can be adjusted in time.
Compared with the positioning mode that the repeated puncture is needed and the tube placing position is not good, so that repeated damage is caused, the bleeding risk is increased, the clearing effect of hematoma is affected, the accurate three-dimensional positioners 2 and 4 are improved, the puncture success rate is improved, the working efficiency is improved, more importantly, the re-bleeding risk is reduced, the key one step of hematoma clearing and drainage is ensured, the possibility is provided for better saving the life, the time and energy of operators are saved, the cost of repeated CT review is saved, and the like.
Because basal ganglia hemorrhage is most common, and accounts for 50% -60% of cerebral hemorrhage, thalamus hemorrhage accounts for 10% -15%, and the basal ganglia hemorrhage accounts for about 70% of cerebral hemorrhage, the accurate stereotactics device 2 and 4 is most good at locating the two positions, and other parts are not problematic, so that the puncture problem of most cerebral hemorrhage patients is solved.
It will be appreciated that the positioning strap 6 may be connected to other portions of the support frame 52, such as to the connection plate 525 and/or the bottom plate 523 and/or the top plate 521, as long as the positioning strap 6 is capable of being connected to the support frame 52 and the positioning device 5 is capable of being positioned on the patient's head using the positioning strap 6.
It is to be understood that the number of the connection plates 525 is not limited to two in the present embodiment, and may be one or two or more, as long as the top plate 521 and the bottom plate 523 can be connected.
It will be appreciated that in other embodiments, the angular positioning graduation marks 8 may be omitted and that the inclination angle of the reference lever 56 may be measured using only the protractor 23.
The foregoing description is directed to the preferred embodiments of the present invention, but the embodiments are not intended to limit the scope of the invention, and all equivalent changes or modifications made under the technical spirit of the present invention should be construed to fall within the scope of the present invention.
Claims (7)
1. A accurate stereotactic ware for intracranial hematoma wicresoft puncture, its characterized in that: the positioning device comprises a support frame, a sliding piece and a reference rod, wherein the support frame comprises a top plate, a bottom plate and a connecting plate, the top plate and the bottom plate are oppositely arranged, and the connecting plate is connected with the bottom plate and the top plate; the top plate is provided with a sliding hole in a penetrating way, and the top plate is also provided with angle positioning graduation marks extending along the length direction of the sliding hole; three first reference rod positioning holes are formed in the bottom plate at intervals along the length direction of the sliding hole, and the distance between two adjacent first reference rod positioning holes is 15mm; three first drainage tube positioning holes are correspondingly formed in the bottom plate in a penetrating mode through the three first reference rod positioning holes, and the connecting line of each first drainage tube positioning hole and the corresponding first reference rod positioning hole is perpendicular to the length direction of the sliding hole; the sliding part is arranged on the top plate through a bolt, the sliding part can be stressed to move along the sliding hole when the bolt is in a loosening state, a second reference rod positioning hole and a second drainage tube positioning hole are formed in the sliding part at intervals, the connecting line of the second reference rod positioning hole and the second drainage tube positioning hole is perpendicular to the length direction of the sliding hole, the second reference rod positioning hole and the three first reference rod positioning holes are all located in the same vertical plane and are communicated with the sliding hole, and the second drainage tube positioning hole and the three first drainage tube positioning holes are all located in the same vertical plane and are used for a drainage tube to pass through; one end of the reference rod is alternatively inserted into the first reference rod positioning hole, and the reference rod penetrates through the sliding hole and the second reference rod positioning hole; the positioning belt is connected with at least one element of the top plate, the bottom plate and the connecting plate so as to position the positioning device on the head of a patient; the positioning device further comprises a protractor, the protractor and the first drainage tube positioning hole are respectively positioned at two opposite sides of the supporting frame, the protractor is fixedly connected with the top plate and the bottom plate, three groups of angle measurement scales are arranged on the protractor, and the centers of the three groups of angle measurement scales respectively correspond to the three first reference rod positioning holes so as to measure the inclination angles of the reference rods at the three first reference rod positioning holes respectively; the drainage tube keeps away a position hole has still been link up on one side of roof, drainage tube keeps away a position hole and is located the below of second drainage tube locating hole, and with second drainage tube locating hole is linked together.
2. The precision stereotactic apparatus of claim 1, wherein: the sliding part comprises a sliding plate and a flexible gasket, the sliding plate is slidably supported on the top plate, the flexible gasket is located on the side face, opposite to the top plate, of the sliding plate, the second reference rod positioning hole penetrates through the sliding plate and the flexible gasket, the bolt comprises a screw and a nut matched with the screw, the screw sequentially penetrates through the flexible gasket, the sliding plate and the sliding hole, and the nut is screwed with the screw.
3. The precision stereotactic apparatus of claim 1, wherein: the top plate, the bottom plate, the connecting plate and the sliding plate are all made of transparent materials.
4. The precision stereotactic apparatus of claim 1, wherein: the number of the connecting plates is two, the two connecting plates are oppositely arranged, and the opposite sides of each connecting plate are respectively connected with the top plate and the bottom plate; the sliding hole and the first reference rod positioning hole are positioned between the two connecting plates; each connecting plate is provided with a mounting hole in a penetrating way; the positioning belt penetrates through the mounting holes on the two connecting plates and is supported on the bottom plate; and reference rod avoidance holes are formed in the positioning belt at intervals along the direction of the sliding hole.
5. The precision stereotactic apparatus of claim 1, wherein: the reference rod is made of bone material.
6. The precision stereotactic apparatus of claim 1, wherein: and a positioning line parallel to the length direction of the reference rod is arranged on the outer wall of the reference rod.
7. A puncture positioning system for intracranial hematoma minimally invasive puncture, which is characterized in that: the positioning device comprises a support frame, a sliding piece and a reference rod, wherein the support frame comprises a top plate, a bottom plate and a connecting plate, the top plate and the bottom plate are oppositely arranged, and the connecting plate is connected with the bottom plate and the top plate; the top plate is provided with a sliding hole in a penetrating way, and the top plate is also provided with angle positioning graduation marks extending along the length direction of the sliding hole; three first reference rod positioning holes are formed in the bottom plate at intervals along the length direction of the sliding hole, and the distance between two adjacent first reference rod positioning holes is 15mm; three first drainage tube positioning holes are correspondingly formed in the bottom plate in a penetrating mode through the three first reference rod positioning holes, and the connecting lines of the first drainage tube positioning holes and the corresponding first reference rod positioning holes are perpendicular to the length direction of the sliding holes; the sliding part is arranged on the top plate through a bolt, the sliding part can be stressed to move along the sliding hole when the bolt is in a loosening state, a second reference rod positioning hole and a second drainage tube positioning hole are formed in the sliding part at intervals, the connecting line of the second reference rod positioning hole and the second drainage tube positioning hole is perpendicular to the length direction of the sliding hole, the second reference rod positioning hole and the three first reference rod positioning holes are all located in the same vertical plane and are communicated with the sliding hole, and the second drainage tube positioning hole and the three first drainage tube positioning holes are all located in the same vertical plane and are used for a drainage tube to pass through; one end of the reference rod is positioned at the first reference rod positioning hole, and the reference rod penetrates through the sliding hole and the second reference rod positioning hole; the positioning belt is connected with at least one element of the top plate, the bottom plate and the connecting plate so as to position the positioning device on the head of a patient; the positioning belt of one accurate three-dimensional positioner is of a nonmetallic ring belt structure, and the supporting frame, the sliding piece, the reference rod and the bolt of the accurate three-dimensional positioner are all made of nonmetallic materials; the positioning belt of the other accurate three-dimensional positioner is a flexible metal belt, and the length of the positioning belt is smaller than that of the nonmetallic endless belt; the positioning device further comprises a protractor, the protractor and the first drainage tube positioning hole are respectively positioned at two opposite sides of the supporting frame, the protractor is fixedly connected with the top plate and the bottom plate, three groups of angle measurement scales are arranged on the protractor, and the centers of the three groups of angle measurement scales respectively correspond to the three first reference rod positioning holes so as to measure the inclination angles of the reference rods at the three first reference rod positioning holes respectively; the drainage tube keeps away a position hole has still been link up on one side of roof, drainage tube keeps away a position hole and is located the below of second drainage tube locating hole, and with second drainage tube locating hole is linked together.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811145107X | 2018-09-29 | ||
| CN201811145107.XA CN109091214A (en) | 2018-09-29 | 2018-09-29 | Intracranial hematoma Minimally invasive puncture Needle localization system and accurate stereotaxic apparatus |
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| CN110192915A CN110192915A (en) | 2019-09-03 |
| CN110192915B true CN110192915B (en) | 2024-06-21 |
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| CN201811145107.XA Withdrawn CN109091214A (en) | 2018-09-29 | 2018-09-29 | Intracranial hematoma Minimally invasive puncture Needle localization system and accurate stereotaxic apparatus |
| CN201921139149.2U Expired - Fee Related CN211094531U (en) | 2018-09-29 | 2019-07-19 | Puncture positioning system and accurate stereotaxic apparatus for intracranial hematoma minimally invasive puncture |
| CN201910652968.5A Active CN110192915B (en) | 2018-09-29 | 2019-07-19 | Puncture positioning system for intracranial hematoma minimally invasive puncture and accurate three-dimensional positioner |
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| CN201811145107.XA Withdrawn CN109091214A (en) | 2018-09-29 | 2018-09-29 | Intracranial hematoma Minimally invasive puncture Needle localization system and accurate stereotaxic apparatus |
| CN201921139149.2U Expired - Fee Related CN211094531U (en) | 2018-09-29 | 2019-07-19 | Puncture positioning system and accurate stereotaxic apparatus for intracranial hematoma minimally invasive puncture |
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| CN109091214A (en) * | 2018-09-29 | 2018-12-28 | 刘国军 | Intracranial hematoma Minimally invasive puncture Needle localization system and accurate stereotaxic apparatus |
| CN113226212B (en) * | 2019-04-24 | 2024-03-19 | 阿布德韶重组基金会 | Guide and support for craniofacial compressions |
| CN110575238B (en) * | 2019-09-30 | 2024-06-18 | 右江民族医学院附属医院 | Three-dimensional accurate positioner for intracranial hematoma minimally invasive puncture |
| CN111166436B (en) * | 2020-02-12 | 2022-12-06 | 刘增辉 | Orienter for craniocerebral puncture |
| CN112006756B (en) * | 2020-08-12 | 2022-05-31 | 云南省中医医院(云南中医药大学第一附属医院) | Intervertebral foramen mirror channel guide module and using method thereof |
| CN112022501A (en) * | 2020-09-23 | 2020-12-04 | 中国人民解放军32298部队 | Mark appearance convenient to ophthalmic surgery uses |
| CN113729942B (en) * | 2021-10-08 | 2023-03-24 | 重庆市急救医疗中心 | Hematoma removing equipment intelligent positioning device and navigation system based on mixed reality technology |
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| CN211094531U (en) * | 2018-09-29 | 2020-07-28 | 刘国军 | Puncture positioning system and accurate stereotaxic apparatus for intracranial hematoma minimally invasive puncture |
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| KR101489440B1 (en) * | 2013-12-20 | 2015-02-03 | 경북대학교 산학협력단 | Guiding protractor system using leveler for accurate ventriculostomy |
| CN204410966U (en) * | 2014-07-21 | 2015-06-24 | 何承彪 | The three-dimensional guider of intracranial hematoma Wicresoft |
| CN204092126U (en) * | 2014-09-30 | 2015-01-14 | 舞阳县中心医院 | A kind of intracerebral hematoma soft passage microtrauma puncture position finder |
| KR101638055B1 (en) * | 2014-12-31 | 2016-07-08 | 주식회사 아모그린텍 | Guide apparatus for puncturing a injection needle |
| US10682156B2 (en) * | 2015-05-28 | 2020-06-16 | Akm A. Rahman | Angle-guidance device and method for CT guided drainage and biopsy procedures |
| CN105832427B (en) * | 2016-03-18 | 2019-01-18 | 南京鼓楼医院 | The external laser alignment guidance system of intracranial hematoma microscopic wound dissection and localization method |
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2018
- 2018-09-29 CN CN201811145107.XA patent/CN109091214A/en not_active Withdrawn
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| CN211094531U (en) * | 2018-09-29 | 2020-07-28 | 刘国军 | Puncture positioning system and accurate stereotaxic apparatus for intracranial hematoma minimally invasive puncture |
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| CN110192915A (en) | 2019-09-03 |
| CN109091214A (en) | 2018-12-28 |
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