CN117797347A - Hemodialysis is with taking dacron cover to take tunnel card to Fu pipe - Google Patents

Abstract

The invention discloses a kav catheter with a terylene sleeve and a tunnel for hemodialysis, which belongs to the technical field of kav catheters and comprises a catheter body, wherein one end of the catheter body is provided with a connecting piece, one end of the connecting piece, which is far away from the catheter body, is communicated with two extension tubes, the extension tubes are communicated with the catheter body through the connecting piece, the two extension tubes are provided with stop clamps, one ends of the two extension tubes, which are far away from the connecting piece, are provided with connectors, the catheter body is sleeved with kav, the kav is elliptical, and the kav is close to the connecting piece; the connecting piece includes the fixed block, and the equal fixedly connected with fixed wing in fixed block both ends is close to body one end and is equipped with the decompression cover, and the fixed block is close to epitaxial tube one end and is equipped with the interface that corresponds with the epitaxial tube respectively. The elliptic kafu with the simple structure can be more adhered to the skin characteristics of a patient, so that the following firm growth in the skin of the patient is realized, and the stability of the catheter is improved.

Description

A Kraft catheter with a polyester sleeve and tunnel for hemodialysis

Technical field

The invention belongs to the technical field of Kraft catheters, and is specifically a Kraft catheter with a polyester sheath and a tunnel for hemodialysis.

Background technique

Maintenance hemodialysis is the main alternative treatment for patients with end-stage renal disease. In recent years, blood purification technology has made great progress and development, and the number of patients receiving dialysis treatment has also continued to grow. Long-term hemodialysis treatment requires reliable and durable vascular access. Vascular access refers to the blood flow channel established for blood purification. It is a bridge connecting the dialysis machine and the patient. It is also the basic guarantee for the patient to successfully undergo blood purification. It is the lifeline of long-term hemodialysis patients. In our country, with the continuous expansion and progress of hemodialysis work and the improvement of related medical insurance systems, more and more patients with end-stage renal disease have begun to enter the ranks of hemodialysis treatment. Among them, the elderly, those with diabetes, hypertension and those with peripheral The number of patients with vascular disease is also increasing day by day. These patients often lack suitable blood vessels to establish conventional arteriovenous fistulas, so tunneled catheters with Dacron sleeves have become a more suitable hemodialysis access.

The tunneled hemodialysis central venous catheter uses a septum to divide the catheter into two cavities that do not communicate with each other. The venous cavity opens in the front and the arterial cavity opens in the back. The arterial cavity and the venous cavity each have several side holes. Increase blood flow. Most of the existing Kraft catheters with polyester sleeves and tunneled Kraft catheters are standardized and are directly placed outside the tube. When the Kraft is inserted into the skin, the Kraft appears because it is placed outside the tube. It is rectangular in shape and does not fit well with the skin. When growing, the skin and Kraft need to gradually grow and fill the corners and gaps of Kraft.

Contents of the invention

In order to solve the above-mentioned problem of insufficient fit between Kraft and skin, the purpose of the present invention is to provide a Kraft catheter with a polyester sleeve and a tunnel for hemodialysis. The oval Kraft can better fit the patient's skin characteristics to achieve subsequent follow-up. Grows firmly in the patient's skin, increasing the stability of the catheter.

In order to achieve the above object, the technical solution of the present invention is as follows: a Kraft catheter with a polyester sheath and a tunnel for hemodialysis, including a tube body. One end of the tube body is provided with a connector, and the connector is connected to two extension tubes at one end away from the tube body. , the extension tube is connected to the pipe body through the connecting piece. Both extension tubes are equipped with cut-off clamps. The ends of the two extension tubes away from the connecting piece are equipped with joints. The tube body is also covered with Kraft, which is oval in shape. , and Kraft is close to the connector;

The connecting piece includes a fixed block, and fixed wings are fixedly connected to both ends of the fixed block. One end of the fixed block close to the pipe body is provided with a decompression sleeve. One end of the fixed block close to the epitaxial tube is respectively provided with interfaces corresponding to the epitaxial tube.

The beneficial effects of the basic plan are: 1. During hemodialysis, the catheter is inserted into the appropriate position. The Kraft catheter with a polyester sleeve and a tunnel can better avoid the occurrence of thrombosis and catheter infection during use. , which significantly improves the safety during dialysis. The use of Kraft catheter with polyester sheath and tunnel can meet the patient's flow rate during dialysis, eliminate excessive water and elements in the patient's body, and ensure the adequacy of dialysis.

2. Compared with temporary catheters, the most notable feature of this catheter and the temporary central venous catheter is that there is a Kraft, or polyester sleeve, at the distal end of the catheter for the connective tissue to grow into, which plays a role in fixing the catheter and preventing pathogenic bacteria from entering the body from the insertion port. As a result, the Kraft grows together with the subcutaneous tissue to make the catheter more firmly fixed and reduce the chance of infection. Therefore, the service life of the tunneled catheter is longer than that of the temporary central venous catheter.

3. From the material point of view, temporary central venous catheters are mostly made of polyurethane or polyethylene materials, which are relatively hard; while tunneled hemodialysis central venous catheters are mostly made of silicone or optimized polyurethane materials, which are softer and can increase the patient's comfort.

4. Since the catheter is set to an oval shape, when the catheter is inserted, the catheter will be smooth in shape, which will reduce the discomfort of the patient to the catheter. At the same time, because the patient's subcutaneous tissue is soft, the oval-shaped catheter can better fit the patient's skin characteristics, so as to achieve a more firm growth in the patient's skin and increase the stability of the catheter.

Furthermore, the Kraft is provided with a number of grooves, the grooves are circular, and the grooves are filled with disinfectant.

The beneficial effects of the basic solution are: through the design of the groove, the contact area between Kraft and the patient's subcutaneous tissue can be increased, thereby allowing Kraft to grow more firmly with the patient and increasing the fixation of the catheter; at the same time, the design of the disinfectant can It can disinfect the skin incision to a certain extent when inserting the catheter, thereby reducing certain damage and contamination to the patient's skin incision during the insertion process.

Furthermore, the tube body is also covered with an auxiliary Kraft. The auxiliary Kraft is located on the side of the Kraft away from the fixed block, and the length of the auxiliary Kraft is smaller than the length of the Kraft. The auxiliary Kraft is oval.

The beneficial effects of the basic solution are: the design of the auxiliary Kraft can increase the fixed points when the catheter is fixed to the skin, thereby increasing the stability of the catheter. At the same time, because the length of the auxiliary Kraft is smaller than that of the Kraft, it will It is easy to peel off, thereby reducing the difficulty of removing the catheter.

Furthermore, the method of using this catheter is also included. The steps are as follows:

Step 1: Disinfection and preparation: The patient's head is tilted to the left, the top of the sternocleidomastoid triangle is used as the puncture point, routine disinfection and draping are performed, and 2% lidocaine is infiltrated for local anesthesia;

Step 2, preparation for insertion: After anesthesia takes effect, insert the 18G puncture needle with the needle tip and the skin coronal surface pointing to the right nipple. Puncture the right internal jugular vein under B-ultrasound positioning, draw back while inserting the needle, and see dark red venous blood flowing out. Insert a long hydrophilic guide wire along the puncture needle. After the guide wire is placed smoothly, pull out the puncture needle, insert the Fr.5 vascular sheath along the guide wire, pull out the guide wire, open the three-way valve, draw back the dark red blood, and close the three-way valve.

Step 3: Insert the catheter: Make a skin incision at the exit of the vascular sheath and the right subclavian edge. Use a tunnel guide needle to guide the catheter from the skin incision at the right subclavian edge to the vascular sheath exit, and then insert it into the vascular sheath. A guide wire is inserted inside, and the dilator is used to fully expand the skin and subcutaneous tissue along the guide wire. The avulsion sheath is inserted into the right internal jugular vein along the guide wire. The guide wire and inner core are removed, and the catheter is inserted into the right neck along the avulsion sheath. Internal vein, simultaneously tear the avulsion sheath to both sides until the catheter completely enters the right internal jugular vein and positions Kraft close to the interface;

Step 4: Catheter adjustment: Adjust the position of the proximal end of the catheter under fluoroscopy to ensure that there is no distortion or deformation of the catheter neck. After the position is determined, suture the puncture point incision and subcutaneous tunnel opening, and suture the end of the catheter to the skin to fix it;

Step 5: Disinfect after insertion: Use heparin saline to repeatedly flush both lumens of the catheter to confirm patency, and seal the tube with heparin; cover the suture wound and the end of the catheter with sterile dressing.

The beneficial effects of the basic solution are: Step 1 ensures a sterile environment in the operating area and reduces the risk of infection. At the same time, the use of local anesthesia can reduce the patient's pain; the second step establishes the vascular access for hemodialysis, providing necessary conditions for subsequent dialysis treatment; the third step is to insert the dialysis catheter into the right internal jugular vein to provide the necessary conditions for hemodialysis. Direct vascular access is achieved; step four ensures the correct position and stability of the dialysis catheter, preventing the catheter from shifting or twisting; step five reduces the risk of infection and maintains patency of the catheter.

Furthermore, in step two, the long hydrophilic guidewire inserted along the puncture needle is 45cm, and the inserted length is 20cm.

The beneficial effects of the basic solution are: the long hydrophilic guidewire inserted along the puncture needle in the insertion preparation step is 45cm and the insertion length is 20cm, which can provide better operational guidance, stability and safety, and at the same time improve Operational efficiency and accuracy.

Furthermore, in step three, the skin incisions made at the exit of the vascular sheath and the lower edge of the right clavicle are located 1 cm between the exit of the vascular sheath and the lower edge of the right clavicle.

The beneficial effects of the basic plan are: the incision position is closer to the vascular sheath outlet and the lower edge of the right clavicle, which can reduce the traction and damage to surrounding tissues during the operation, thereby reducing the patient's pain; at the same time, the incision position is close to the vascular sheath outlet It is close to the lower edge of the right clavicle, the scar tissue formed is relatively small, and the impact on the aesthetics is relatively small.

Furthermore, in step three, the size of the skin incisions made at the exit of the vascular sheath and at the lower edge of the right clavicle is 0.8 cm.

The beneficial effects of the basic plan are: the incision size of 0.8cm can reduce the damage to surrounding tissues during the operation, reduce the patient's pain and postoperative recovery time; the smaller incision can provide a more precise surgical operating space, allowing the doctor to be more precise. Accurate execution of surgical steps improves the accuracy and success rate of the operation; smaller incisions can reduce the risk of infection after surgery because the surface area in contact with the outside world is reduced.

Furthermore, in step three, the position of Kraft is placed at the subcutaneous tissue, and the position of the auxiliary Kraft is positioned at the muscle close to the subcutaneous tissue.

The beneficial effect of the basic solution is that placing Kraft in the subcutaneous tissue can provide better stability and prevent it from moving or twisting during operation. At the same time, the auxiliary Kraft is located close to the muscles of the subcutaneous tissue, which can also increase the stability of the entire catheter; placing the Kraft in the subcutaneous tissue can reduce damage to surrounding tissues and improve the safety of the operation. At the same time, the auxiliary Kraft is located close to the muscles and subcutaneous tissue, which can also avoid damage to important blood vessels and nerves.

Description of drawings

FIG. 1 is an axonometric view of a Kraft catheter with a polyester sleeve and a tunnel for hemodialysis according to an embodiment of the present invention.

Figure 2 is a front view of a Kraft catheter with a polyester sheath and a tunnel for hemodialysis in an embodiment of the present invention.

Figure 3 is a schematic diagram of the insertion of a Kraft catheter with a polyester sheath and a tunnel for hemodialysis in an embodiment of the present invention.

Figure 4 is a schematic diagram of a method of using a Kraft catheter with a polyester sheath and a tunnel for hemodialysis in an embodiment of the present invention.

Detailed ways

The following is further detailed through specific implementation methods:

The reference numbers in the drawings of the description include: pipe body 1, connector 2, pressure reducing sleeve 201, fixed block 202, fixed wing 203, interface 204, cut-off clamp 3, extension tube 4, joint 5, Kraft 6, auxiliary Kraft7.

Example 1

Basically as shown in Figures 1 to 4 of the accompanying drawings: a Kraft catheter with a polyester sheath and a tunnel for hemodialysis, including a tube body 1. One end of the tube body 1 is provided with a connector 2, and the connector 2 is connected to an end away from the tube body 1. Two extension tubes 4. The extension tube 4 is connected to the tube body 1 through the connector 2. The two extension tubes 4 are equipped with cut-off clamps 3. The ends of the two extension tubes 4 away from the connector 2 are equipped with joints 5. The tube body 1 is also covered with a Kraft 6, the Kraft 6 is oval, and the Kraft 6 is close to the connecting piece 2;

The connector 2 includes a fixed block 202. Both ends of the fixed block 202 are fixedly connected with fixed wings 203. The fixed block 202 is provided with a decompression sleeve 201 at one end close to the tube body 1. The fixed block 202 is provided with a decompression sleeve 201 at one end close to the epitaxial tube 4. 4 corresponding interface 204. This catheter is made of silicone or optimized polyurethane material.

The specific implementation process is as follows: When actually inserting the catheter, use a tunnel guide needle to guide the catheter from the 1cm skin incision at the lower edge of the right clavicle to the exit of the vascular sheath. Then insert a guide wire into the vascular sheath, use a dilator to fully expand the skin and subcutaneous tissue along the guide wire, insert the avulsion sheath into the right internal jugular vein along the guide wire, remove the guide wire and inner core, and move the catheter along the avulsion sheath Insert into the right internal jugular vein, and tear the avulsion sheath to both sides at the same time until the catheter completely enters the right internal jugular vein; after the catheter is inserted into the appropriate position, the Kraft 6 catheter with a polyester sheath and tunnel can be used during use. It can better avoid the occurrence of thrombosis and catheter infection, which significantly improves the safety during dialysis. The use of Kraft catheter with polyester sleeve and tunnel can meet the patient's flow rate during dialysis and eliminate excessive water and element in the patient's body. Ensure the adequacy of dialysis.

Example 2

The difference from the above embodiment is that the Kraft 6 is provided with several grooves, the grooves are circular, and the grooves are filled with disinfectant.

The specific implementation process is as follows: through the design of the groove, the contact area between Kraft 6 and the patient's subcutaneous tissue can be increased, so that Kraft 6 can grow more firmly with the patient and increase the fixation of the catheter; at the same time, the design of the disinfectant, It can disinfect the skin incision to a certain extent when inserting the catheter, thereby reducing certain damage and contamination to the patient's skin incision during the insertion process.

Example 3

The difference from the above embodiment is that the tube body 1 is also covered with an auxiliary clamp 7. The auxiliary clamp 7 is located on the side of the clamp 6 away from the fixed block 202, and the length of the auxiliary clamp 7 is smaller than the length of the clamp 6. The auxiliary Kraft 7 is oval in shape.

The specific implementation process is as follows: The design of auxiliary Kraft 7 can increase the fixing points when the catheter is fixed to the skin, thereby increasing the stability of the catheter. At the same time, because the length of auxiliary Kraft 7 is shorter than Kraft 6, it will be easier to peel off compared to Kraft 6, thereby reducing the difficulty of removing the catheter.

Example 4

The difference from the above embodiment is that the method of using the catheter is also included. The steps are as follows:

Step 1, disinfection preparation: tilt the patient's head to the left, take the top of the sternocleidomastoid muscle triangle as the puncture point, apply routine disinfection and draping, and use 2% lidocaine for local infiltration anesthesia;

Step 2: Preparation for insertion: After the anesthesia takes effect, insert the needle with an 18G puncture needle. The needle tip and the coronal surface of the skin point toward the right nipple. Puncture the right internal jugular vein under B-ultrasound positioning. Pull back while inserting the needle. You will see dark red spots. When the venous blood flows out, insert a long hydrophilic guidewire along the puncture needle. After placing the guidewire smoothly, pull out the puncture needle, insert the Fr.5 vascular sheath along the guidewire, pull out the guidewire, open the tee, and withdraw the aspiration site. Dark red blood, close the three-way; the long hydrophilic guidewire inserted along the puncture needle is 45cm, and the inserted length is 20cm;

Step 3: Insert the catheter: Make a 0.8cm skin incision at the exit of the vascular sheath and 1cm below the right subclavian edge. Use a tunnel guide needle to guide the catheter from the skin incision at the right subclavian edge to the exit of the vascular sheath, and then Insert a guide wire into the vascular sheath, use a dilator to fully expand the skin and subcutaneous tissue along the guide wire, insert the avulsion sheath into the right internal jugular vein along the guide wire, remove the guide wire and inner core, and place the catheter along the avulsion sheath Enter the right internal jugular vein, and tear the avulsion sheath to both sides at the same time until the catheter completely enters the right internal jugular vein, so that the position of Kraft 6 is placed in the subcutaneous tissue, and the position of auxiliary Kraft 7 is located close to the subcutaneous tissue. of muscles;

Step 4: Catheter adjustment: Adjust the position of the proximal end of the catheter under fluoroscopy to ensure that there is no distortion or deformation of the catheter neck. After the position is determined, suture the puncture point incision and subcutaneous tunnel opening, and suture the end of the catheter to the skin to fix it;

Step 5: Disinfection after insertion: Use heparinized saline to repeatedly flush the double lumens of the catheter to confirm that it is unobstructed, and seal the catheter with heparin; cover the suture wound and the end of the catheter with a sterile dressing.

It should be noted that in this article, relational terms such as first and second are only used to distinguish one entity or operation from another entity or operation, and do not necessarily require or imply that these entities or operations are mutually exclusive. any such actual relationship or sequence exists between them. Furthermore, the terms "comprises," "comprises," or any other variations thereof are intended to cover a non-exclusive inclusion such that a process, method, article, or apparatus that includes a list of elements includes not only those elements, but also those not expressly listed other elements, or elements inherent to the process, method, article or equipment.

The above are only embodiments of the present invention. Common knowledge such as the specific structures and characteristics of the solutions are not described in detail here. Those of ordinary skill in the art are aware of all common knowledge in the technical field to which the invention belongs before the filing date or priority date. Technical knowledge, being able to know all the existing technologies in the field, and having the ability to apply conventional experimental methods before that date. Persons of ordinary skill in the field can, under the inspiration given by this application, combine their own abilities to perfect and implement this plan, Some typical well-known structures or well-known methods should not be an obstacle for those of ordinary skill in the art to implement the present application. It should be pointed out that for those skilled in the art, several modifications and improvements can be made without departing from the structure of the present invention. These should also be regarded as the protection scope of the present invention and will not affect the implementation of the present invention. effectiveness and patented practicality. The scope of protection claimed in this application shall be based on the content of the claims, and the specific implementation modes and other records in the description may be used to interpret the content of the claims.

Claims (9)

1. The utility model provides a take dacron cover to take tunnel card to carry out hemodialysis pipe which characterized in that: the connecting piece is arranged at one end of the pipe body, two extension pipes are communicated with one end of the connecting piece, which is far away from the pipe body, and are communicated with the pipe body through the connecting piece, a stop clamp is arranged on each of the two extension pipes, a joint is arranged at one end of each of the two extension pipes, which is far away from the connecting piece, and a clamp is sleeved on the pipe body and is oval, and the clamp is close to the connecting piece;

the connecting piece includes the fixed block, and the equal fixedly connected with fixed wing in fixed block both ends is close to body one end and is equipped with the decompression cover, and the fixed block is close to epitaxial tube one end and is equipped with the interface that corresponds with the epitaxial tube respectively.

2. The dacron-sheathed tunneled kafu catheter for hemodialysis according to claim 1, wherein: the card is provided with a plurality of grooves which are round, and disinfectant is filled in the grooves.

3. The dacron-sheathed tunneled kafu catheter for hemodialysis according to claim 2, wherein: the pipe body is further sleeved with an auxiliary clamping device, the auxiliary clamping device is located on one side, far away from the fixed block, of the clamping device, the length of the auxiliary clamping device is smaller than that of the clamping device, and the auxiliary clamping device is elliptical.

4. A dacron jacketed tunneled kafu catheter for hemodialysis according to claim 3, wherein: the catheter is prepared from silica gel or optimized polyurethane materials.

5. The dacron-sheathed tunneled kafu catheter for hemodialysis according to claim 4, wherein: the method for using the catheter also comprises the following steps:

step one, disinfection preparation: the head of the patient is deviated to the left, the top end of the triangle of the sternocleidomastoid muscle is taken as a puncture point, and the normal disinfection towel is used for local infiltration anesthesia of 2 percent lidocaine;

step two, preparing for placement: after anesthesia is effective, an 18G puncture needle is held to enter the needle, the needle tip and the skin crown face point to the direction of a right nipple, the right internal jugular vein is punctured under the positioning of B ultrasonic, dark red venous blood flows out while entering the needle, a long hydrophilic guide wire is arranged along the puncture needle, after the guide wire is placed smoothly, the puncture needle is pulled out, a Fr.5 vascular sheath is arranged along the guide wire, the guide wire is pulled out, a tee joint is opened, dark red blood at the back suction position is sucked back, and the tee joint is closed;

step three, placing a catheter: respectively making skin incisions at the outlet of a vascular sheath and the lower edge of a right collarbone, guiding a catheter from the skin incision at the lower edge of the right collarbone to the outlet of the vascular sheath by using a tunnel guide needle, then placing a guide wire into the vascular sheath, fully expanding skin and subcutaneous tissues along the guide wire by using a dilator, placing a avulsion sheath along the guide wire into a right internal jugular vein, removing the guide wire and an inner core, placing the catheter along the avulsion sheath into the right internal jugular vein, and simultaneously tearing the avulsion sheath to two sides until the catheter completely enters the right internal jugular vein, and positioning the kafu close to an interface;

step four, adjusting the guide pipe: adjusting the proximal end position of the catheter under perspective to ensure no distortion and deformation of the neck of the catheter, and suturing the incision of the puncture point and the opening of the subcutaneous tunnel after the position is determined, so as to suture and fix the tail end of the catheter and the skin;

step five, disinfection after implantation: repeatedly flushing the catheter with heparin saline, confirming smoothness, and sealing the catheter with heparin; a sterile dressing covers the suture wound and the catheter tip.

6. The dacron-sheathed tunneled kafu catheter for hemodialysis according to claim 5, wherein: in the second step, the long hydrophilic guide wire placed along the puncture needle is 45cm, and the placed length is 20cm.

7. The dacron jacketed tunneled kafu catheter for hemodialysis according to claim 6, wherein: in the third step, the skin incision made at the outlet of the vascular sheath and at the lower edge of the right collarbone is 1cm away from the outlet of the vascular sheath and at the lower edge of the right collarbone.

8. The dacron jacketed tunneled kafu catheter for hemodialysis according to claim 7, wherein: in the third step, the size of the skin incision at the outlet of the vascular sheath and at the lower edge of the right collarbone is 0.8cm.

9. The dacron jacketed tunneled kafu catheter for hemodialysis according to claim 8, wherein: in the third step, the position of the Carff is placed at the subcutaneous tissue, and the auxiliary Carff is positioned at the muscle close to the subcutaneous tissue.