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CN119949912A - Myocardial perforation repair cover - Google Patents

Myocardial perforation repair cover Download PDF

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Publication number
CN119949912A
CN119949912A CN202411857192.8A CN202411857192A CN119949912A CN 119949912 A CN119949912 A CN 119949912A CN 202411857192 A CN202411857192 A CN 202411857192A CN 119949912 A CN119949912 A CN 119949912A
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CN
China
Prior art keywords
suture
ring
cover body
flushing
perforation
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Granted
Application number
CN202411857192.8A
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Chinese (zh)
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CN119949912B (en
Inventor
孙杰
兰宝石
黄祖超
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Wuxi Holy Noah Technology Co ltd
Zhongda Hospital of Southeast University
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Wuxi Holy Noah Technology Co ltd
Zhongda Hospital of Southeast University
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Application filed by Wuxi Holy Noah Technology Co ltd, Zhongda Hospital of Southeast University filed Critical Wuxi Holy Noah Technology Co ltd
Priority to CN202411857192.8A priority Critical patent/CN119949912B/en
Publication of CN119949912A publication Critical patent/CN119949912A/en
Application granted granted Critical
Publication of CN119949912B publication Critical patent/CN119949912B/en
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Abstract

The invention provides a myocardial perforation repair cover, which belongs to the field of medical appliances and comprises a cover body sealed at the outer side of a pericardium, wherein the cover body is communicated with the cover body and is provided with a liquid inlet pipe, a liquid outlet pipe and a plurality of operation valve ports, the edge of the cover body is sealed and sewed on the pericardium to form a sealed operation space, a video rod and a sewing appliance are arranged through the valve port pipe, the video rod obtains a clear view in the operation space through flushing of the liquid inlet pipe and the liquid outlet pipe at a sewed position, and myocardial perforation is sewed by the sewing appliance.

Description

Myocardial perforation repair cover
Technical Field
The invention mainly relates to the medical field, in particular to a myocardial perforation repair cover.
Background
Part of patients within 1 week after myocardial infarction return to myocardial perforation, and symptoms such as pericardial packing, myocardial compression, arrhythmia and heart failure are accompanied, so that the heart failure is caused, and symptoms such as dyspnea, edema and the like appear.
Once myocardial perforation occurs, surgical treatment is the only treatment. The only current surgical scheme is an external circulation lower open chest operation, and once the pericardium is opened during the operation, a large amount of blood is quickly lost, so that the external circulation and blood recovery are necessary. There are risks of major bleeding, re-perforation and complications of extracorporeal circulation, such as clotting dysfunction, infections (including pulmonary infections, blood infections), brain complications (cerebral embolism, cerebral hemorrhage, etc.).
The perforation is found timely, the perforation range is small, the physical condition of the patient is good, and the success rate of the operation of the medical team with abundant experience can reach about 60-80%. If the perforation area is large, serious complications occur (such as surgical rescue after cardiac arrest due to cardiac tamponade), the patient is older and has poor physical tolerance, the success rate may be reduced to below 40%.
In order to improve the success rate of the operation, a clinical urgent need is to provide an operation tool for repairing myocardial perforation without using extracorporeal circulation support, which reduces the operation bleeding, reduces the operation complications and improves the survival rate of patients.
Disclosure of Invention
Aiming at the defects in the prior art, the invention provides a myocardial perforation repair cover, which comprises a bowl-shaped flexible cover body 1 for forming a sealed operation space by stitching on a heart bag, wherein a sealing membrane ring 11 is arranged on the inner side of the bowl opening edge of the cover body 1, a liquid inlet 12 and a liquid outlet 13 are arranged near the bowl opening edge of the cover body 1 and penetrate through the cover body 1, at least two operation valve ports 14 are arranged on the bowl wall and the bowl bottom of the cover body 1 and penetrate through the cover body 1, and each operation valve port 14 comprises a video rod placement valve port and an operation instrument placement valve port.
Further, a pressure monitoring tube is arranged in the inner cavity of the communication cover body 1.
Further, the device also comprises a flushing pipe 4 used for sealing the liquid inlet 12, a liquid inlet connection ring 41 is movably arranged outside the flushing pipe 4 in a sealing manner, the tail of the flushing pipe 4 is connected with a flushing liquid bag, a flushing pressurizer 43 is arranged outside the flushing liquid bag, the flushing pressurizer 43 pressurizes the flushing liquid bag, and the liquid inlet connection ring 41 is in fit and sealing connection with the liquid inlet 12.
Further, the device also comprises a liquid discharge pipe 5 used for sealing the liquid discharge port 13, a liquid discharge connection ring 52 is movably arranged outside the liquid discharge pipe 5 in a sealing mode, a blood recovery bag 51 is arranged at the tail of the liquid discharge pipe 5, and the liquid discharge connection ring 52 is in fit and sealing connection with the liquid discharge port 13.
Further, a water filtering hole area is arranged through the side wall of the blood recovery bag 51, a water filtering film 54 is arranged in the sealed water filtering hole area, a water filtering opening 55 is arranged on the outer side of the recovery bag 51, the water filtering opening 55 seals the water filtering film 54 area, and a water accumulating bag 56 for storing filtered liquid is arranged in a communicating manner.
Further, the suture locking device also comprises an operation instrument and a suture locking ring, wherein the operation instrument comprises a video rod, an operation scissors, a compression ring, a suture forceps and a pushing ring forceps.
Furthermore, the flushing pipe 4 and the liquid discharge pipe 5 are communicated with each other outside the cover body 1 and are provided with a side-through one-way valve port 44, a matched guide core is arranged, the guide core is arranged in the front section of the flushing pipe 4 or the liquid discharge pipe 5 through the side-through one-way valve port 44, the guide core is a metal rod wrapping a flexible shell and can be shaped, and the tail part of the guide core is provided with a handle.
The suture confining ring comprises a metal ring, an inner cavity is matched with a double-strand suture, a clamp end and a clamp body end are sequentially arranged at the clamp head part of the push ring, a threading hole is formed through the clamp body end, the threading hole is smaller than the inner cavity of the suture confining ring, the suture confining ring is movably inlaid at the clamp end of the push ring, and the length of the clamp end is not greater than the height of the suture confining ring.
Further, the suture confining ring is an elliptic flexible ring, the two ends of the short shaft are provided with inserting grooves, the size of the clamp head of the pushing ring clamp is corresponding to the limit grooves of the suture confining ring, the clamp head of the pushing ring clamp is provided with magnetism, and the pressing ring comprises a probing ring and a handheld handle.
The using method of the myocardial perforation repair cover comprises the following steps:
S1, fixing a cover body 1, namely, cutting a precordial region, exposing pericardium, and sealing and sewing the bowl-shaped edge of the cover body 1 at a proper position of the pericardium;
S2, flushing is established, namely the front section of the flushing pipe 4 is hermetically placed into the cavity of the cover body 1 through the liquid inlet 12, and the tail part of the flushing pipe is connected with the flushing liquid bag 41;
s3, positioning and perforating, namely, embedding a video rod and a surgical scissors into the cover body 1 through the operation valve port 14, cutting open pericardium to expose myocardial surface perforation;
S4, establishing a visual field, namely placing a guide core 61 into the flushing pipe 4 and the liquid discharge pipe 5 through the side-through one-way valve port 6, adjusting the positions of the front end openings of the flushing pipe 4 and the liquid discharge pipe 5 close to myocardial perforation under video of a video rod, and continuously flushing and draining the myocardial perforation;
s5, fixing perforation, namely arranging a compression ring into the cover body 1 through the operation valve port 14, moderately compressing the perforation position, and limiting myocardial activity amplitude of the corresponding perforation position;
S6, suturing perforation, namely, suturing the needle thread by a pair of suture forceps, placing the suture forceps into a cavity of the cover body 1 through an operation valve port 14, leaving the tail part of the suture outside the cover body 1, suturing the myocardial perforation by using the suture forceps, pulling out the suture forceps, taking the head end of the needle thread out of the cover body 1, removing the surgical needle, moderately tightening the head end and the tail end of the suture thread, penetrating a suture confinement ring and a threading hole at the head end of the push ring forceps through the head end and the tail end of the suture thread, penetrating the push ring forceps laterally, pulling the head end and the tail end of the suture thread, pushing the suture confinement ring to the myocardial perforation position by using the push ring forceps, propping the suture thread to close the myocardial perforation by using the push ring forceps, deforming and closing the suture confinement ring by using the clamp, temporarily fastening the suture confinement ring at the suture outside the perforation, and pulling out the push ring forceps to retain the suture thread;
S7, repeatedly closing, namely if a plurality of perforations exist, repeating the above operation, and suturing and closing all myocardial perforations;
S8, reinforcing and closing, namely removing the cover body 1, exposing the myocardial surface under direct vision, removing the suture confinement ring, manually knotting the suture again, closing myocardial perforation, and cutting off redundant line bodies if a plurality of perforation are arranged;
S9, hemostatic suture, namely suturing pericardium, stopping bleeding and suturing the incision;
S10, blood recovery.
The invention has the beneficial effects that:
1. The invention avoids the risk of direct opening of the myocardial perforation and rapid loss of heart blood through the perforation, and can recycle the blood loss liquid at the same time, so that the risk of myocardial perforation repair operation is greatly reduced, thereby improving the treatment rate.
Drawings
FIG. 1 is a schematic view of a cover structure of the present invention;
FIG. 2 is a diagram showing the construction of the present invention in use;
FIG. 3 is a cross-sectional view of the present invention in use;
FIG. 4 is a schematic view of the internal structure of the operating valve port of the present invention;
FIG. 5 is a schematic view of the structure of the flushing pressurizer of the present invention;
FIG. 6 is a schematic view showing the internal structure of the flushing pressurizer of the present invention;
FIG. 7 is a schematic view of the structure of the blood collection bag of the present invention;
FIG. 8 is a schematic view showing the internal structure of the blood collection bag of the present invention;
FIG. 9 is a schematic view of the suture confinement ring structure of the present invention;
FIG. 10 is a schematic view of the structure of the push ring pliers of the present invention;
in the drawing the view of the figure,
1. Cover body, 11 sealing film ring, 12 liquid inlet, 13 liquid outlet, 14 operating valve port
4. A flushing pipe; 41, a liquid inlet adapter ring, 43, a flushing pressurizer, 44, a side-through one-way valve port;
5. The device comprises a liquid discharge pipe, a blood recovery bag, a liquid discharge connection ring, a water filtering film, a water filtering hole, a water accumulating bag and a water accumulating bag.
Detailed Description
The present invention will be further described with reference to the following examples in order to better understand the technical solutions of the present invention and to make the above features, objects and advantages of the present invention more clearly understood. The examples are only for illustrating the present invention and are not intended to limit the scope of the present invention.
Referring to fig. 1,2 and 3, the myocardial perforation repair cover comprises a bowl-shaped flexible cover body 1 for forming a sealed operation space by stitching on a pericardium, wherein a sealing membrane ring 11 is arranged on the inner side of the bowl opening edge of the cover body 1, a liquid inlet 12 and a liquid outlet 13 are arranged adjacent to the bowl opening edge of the cover body 1 and penetrate through the cover body 1, and the cover body 1 is used for constructing a semi-closed space for operation outside the pericardium, wherein the semi-closed space can achieve the capability of maintaining dynamic balance of pressure in the operation. Wherein the sealing membrane ring 11 of the cover body 1 is used for sealing after being sutured and fixed with the pericardium.
At least two operation valve ports 14 are arranged on the bowl wall and bowl bottom of the cover body 1 and penetrate through the cover body 1, wherein the operation valve ports 14 comprise video rod placing valve ports and operation instrument placing valve ports, and are used for placing video rods and operation instruments for operation. In order to facilitate the operation of the attending physician, two operating valve ports 14 are distributed at both sides of the housing 1.
Referring to fig. 3, in order to facilitate the position adjustment of the instrument during the operation, especially in the case where a plurality of positions are required for suturing, the cover 1 is provided in two upper and lower parts, and is hermetically connected by a fitting manner, and in a special case, the positions of the two operation valve ports 14 can be adjusted by rotating the upper and lower sides in a small range.
Referring to fig. 4, in this embodiment, the operation valve port 14 is provided as an operation tube, and a sealing valve membrane including a duckbill valve membrane and a cone valve membrane is provided at a nozzle portion of one end of the operation tube, the duckbill valve membrane being closely adjacent to the cone valve membrane. The duckbill valve membrane is normally closed, the cover body 1 is sealed through the duckbill valve membrane, the duckbill valve membrane can be also opened after the operation instrument is arranged in the conical valve membrane, and the cover body 1 is sealed through the conical valve membrane and the sealing of the operation instrument.
In order to intuitively observe the cover body 1 during operation, a pressure monitoring pipe is arranged in the inner cavity of the communicated cover body 1, the hydraulic pressure in the pressure monitoring pipe is equal to the pressure in the cover body 1, and the pressure intensity of the cover body 1 can be indirectly monitored through a pressure measuring instrument at the other end.
Referring to fig. 2 and 3, in order to further maintain the stability of the pressure in the housing 1, a flushing pipe 4 for sealing the inlet 12 and a drain pipe 5 for sealing the outlet 13 are further included:
the outer seal of the flushing pipe 4 is movably provided with a liquid inlet connection ring 41, the tail part of the flushing pipe 4 is connected with a flushing liquid bag, and a flushing pressurizer 43 is arranged outside the flushing liquid bag, and the flushing pressurizer 43 pressurizes the flushing liquid bag;
after the flushing pipe 4 is inserted into the cover body 1, adjustment is needed, and after the flushing pipe reaches a designated position or flushing position, the liquid inlet 12 is in sealing engagement with the flushing pipe 4 by screwing the liquid inlet engagement ring 41, so that overflow of liquid in the flushing process is reduced. And in order to fit the entering angle of the flushing pipe 4, a section of corrugated pipe for adjusting the entering angle is arranged at the liquid inlet 12.
In this embodiment, the rinse liquid bag is fixed to the outside by external means or the like, and is communicated with the rinse pipe 4, and after the rinse liquid bag is pressurized by the rinse pressurizer 43, the liquid in the rinse liquid bag is discharged into the rinse pipe 4, and finally enters the hood 1.
Among them, the flushing pressurizer 43 may be a medical pressurizer.
Referring to fig. 5 and 6, in the present embodiment, the flushing pressurizer 43 is specifically configured by a base, a "concave" type blocking plate fixed to the base for placing a flushing fluid bag, a squeeze plate adapted to the "concave" type blocking plate, a pushing worm on one side of the squeeze plate away from the blocking plate, a small-sized bi-directional motor connected to and driven by a turbine through a side wall of the pushing worm, and a gear shift switch for controlling the power of the small-sized bi-directional motor. The small-sized bidirectional motor is communicated with an external power supply through the distribution box, and after the external power supply is connected, the gear-shifting switch is started, the small-sized bidirectional motor rotates and is driven to the pushing worm through the turbine, and the worm is pushed to push or pull the extrusion plate forwards or backwards.
In order to prevent the pushing worm and the extrusion plate from falling off, the side wall of the extrusion plate is provided with an imbedding groove which is in limit connection with the round imbedding plate at one end of the pushing worm. Similarly, in order to prevent the squeeze plate and the blocking plate from separating, the squeeze plate side wall is provided with a moving protrusion embedded in a groove of the blocking plate side wall.
Referring to figures 2 and 3, a liquid discharge connection ring 52 is movably arranged on the outer seal of the liquid discharge pipe 5, a blood recovery bag 51 is arranged at the tail part of the liquid discharge pipe 5, and the liquid discharge connection ring 52 is in fit and closed connection with the liquid discharge port 13. In order to fit the entering angle of the liquid discharge pipe 5, a section of corrugated pipe for adjusting the entering angle is arranged at the liquid discharge port 13.
After the liquid discharge pipe 5 is detected into the cover body 1, adjustment is needed, and after the liquid discharge pipe reaches a designated position or a liquid discharge position, the liquid discharge port 13 is in sealing connection with the liquid discharge pipe 5 by screwing the liquid discharge connection ring 52, so that overflow of liquid in the liquid discharge process is reduced. In the present embodiment, the blood collection bag 51 is externally fixed to the outside and communicates with the drain pipe 5.
Referring to fig. 7 and 8, the blood collection bag 51 has a structure in which a water filtering hole area is formed through the side wall of the blood collection bag 51, a water filtering film 54 is formed by sealing the water filtering hole area, a water filtering hole 55 is formed on the outer side of the blood collection bag 51, the water filtering hole 55 seals the water filtering film 54 area, and a water accumulation bag 56 for storing filtered liquid is formed in communication.
The blood of the patient enters the blood recovery bag 51 from the liquid discharge pipe 5, and the residual water in the blood recovery bag 51 is discharged to the water accumulation bag 56 through the water filtering film 54 due to the continuous flushing of the continuous flushing pipe 4 and the continuous drainage of the liquid discharge pipe 5, so that the preliminary filtration is finished. The residual blood can be used as spare blood and selectively returned to the patient.
Especially in the case of a plurality of perforations in the heart muscle, the blood is lost more due to the overlong operation process. Meanwhile, in order to ensure the clear view of the video stick, continuous flushing of the perforation is required, and the blood concentration in the blood collection bag 51 is low. Based on this, the blood in the blood collection bag 51 must be used to the full, i.e., filtered and returned to the patient for life monitoring. In particular, when anticoagulants are used in a large amount, ACT testing is required and protamine is infused. ACT test refers to a test that activates clotting time of whole blood, protamine is used to treat bleeding caused by excessive injection of heparin, a commonly used anticoagulant.
In order to ensure suturing at the myocardial perforation, the device also comprises an operation device and a suture confinement ring, wherein the operation device comprises a video rod, an operation scissors, a compression ring, a suture forceps and a ring pushing forceps.
In order to prevent any one of the flushing pipe 4 and the liquid discharge pipe 5 from reversing and causing accidents in operation, the flushing pipe 4 and the liquid discharge pipe 5 are communicated with each other outside the cover body 1 and provided with side-through one-way valve ports 44, and likewise, the flushing pipe 4 and the liquid discharge pipe 5 are soft in texture and provided with handles for ensuring movement of the flushing pipe 4 and the liquid discharge pipe 5 in the cover body 1 and reducing collision damage, the flushing pipe 4 and the liquid discharge pipe 5 are respectively provided with matched guide cores, the guide cores are arranged in the front section of the flushing pipe 4 or the liquid discharge pipe 5 through the side-through one-way valve ports 44, the guide cores are metal rods wrapping flexible shells and can be shaped, and the tail parts of the guide cores are provided with handles. The flushing pipe 4 and the liquid discharge pipe 5 are indirectly controlled by the tail handle.
Referring to fig. 9 and 10, the suture confinement ring comprises a metal ring, an inner cavity is matched with a double-strand suture, a clamp end and a clamp body end are sequentially arranged at the clamp head part of the push ring, a threading hole is formed through the clamp body end, the threading hole is smaller than the inner cavity of the suture confinement ring, the suture confinement ring is movably inlaid at the clamp end of the push ring, and the length of the clamp end is not greater than the height of the suture confinement ring.
The suture confinement ring is an elliptic flexible ring, the two ends of the short shaft are provided with insertion grooves, the size of the clamp head of the pushing ring clamp is corresponding to the limit grooves of the suture confinement ring, the clamp head of the pushing ring clamp is provided with magnetism, and the compression ring comprises a penetration ring and a hand-held handle.
The heart activity can affect the suturing of the operation, and limited inhibition is needed, so that the consistent effect can be achieved by pressing the pressing ring, namely pressing the penetrating ring, and the conventional suturing operation is carried out subsequently, so that details are omitted.
After the primary threading is finished, the tail end of the surgical suture is extremely threaded and penetrates through the suture confining ring, the suture confining ring is pushed to a suture position through the surgical suture by the ring pushing pliers, and the suture confining ring is extruded and deformed in a clamping mode, so that the primary fixing is finished. Finally, after knotting and fixing, the suture fastening ring is taken down by the ring pushing pliers, and all fixing is completed.
In order to prevent the suture confinement ring from falling off from the push ring clamp, the top end of the push ring clamp is provided with a magnet, and the suture confinement ring is prevented from falling off in a magnetic adsorption mode. The side wall of the inner cavity of the suture fastening ring is also provided with an anti-rebound bulge and an imbedding groove with matched size, and after the suture fastening ring is pressed, the anti-rebound bulge is matched with the imbedding groove, so that the suture line can be further pressed and rebound can be prevented.
The using method of the myocardial perforation repair cover comprises the following steps:
s1, fixing the cover body 1, namely, cutting the precordial region, exposing the pericardium, sealing and sewing the bowl-shaped edge of the cover body 1 at a proper position of the pericardium, and completely covering the perforation position during sewing.
S2, flushing is established, wherein the front section of a flushing pipe 4 is hermetically placed into a cavity of the cover body 1 through a liquid inlet 12, the tail part of the flushing pipe is connected with a flushing liquid bag 41, the front section of a liquid discharge pipe 5 is hermetically placed into the cavity of the cover body 1 through a liquid discharge port 13, the tail part of the liquid discharge pipe is connected with the flushing liquid bag 41, gas of the cover body 1 is emptied, flushing pressure and flow velocity are regulated, and flushing drainage is continuously carried out in the cover body 1, in this step, the flushing drainage needs to maintain dynamic balance, and the pressure in the cover body 1 is ensured to be maintained at a constant value, and the value corresponds to the internal pressure of a perforation position, for example, a value of 0.5-1.2 Kpa can be adopted at a right atrium for maintaining internal and external pressure balance at the perforation position.
S3, positioning perforation, namely, embedding a video rod and a surgical scissors into the cover body 1 through the operation valve port 14, cutting off the pericardium, exposing myocardial surface perforation, pulling out the surgical scissors, adjusting the video rod to find the myocardial perforation position, and determining the pressure in the cover body 1 again before cutting off the pericardium.
S4, establishing a visual field, namely placing a guide core 61 into the flushing pipe 4 and the liquid discharge pipe 5 through the side-through one-way valve port 6, regulating the positions of the front end openings of the flushing pipe 4 and the liquid discharge pipe 5 close to myocardial perforation positions under the video of a video rod, and continuously flushing and draining the myocardial perforation positions, wherein the flushing pipe 4 and the liquid discharge pipe 5 are as close to the perforation positions as possible, but cannot influence the visual field of operation, restoring the red blood staining area to a visual state in a flushing mode, and taking out the guide core 61 after the positions of the flushing pipe 4 and the liquid discharge pipe 5 are debugged, and placing the guide core 61 into the visual state if more perforation positions.
S5, fixing perforation, namely arranging a compression ring into the cover body 1 through the operation valve port 14, moderately compressing the perforation position and limiting the myocardial activity amplitude of the corresponding part of perforation, and because of heart fluctuation, for better suturing, a certain inhibition on the activity is required, and limited limitation can be carried out through the compression ring, thereby assisting the completion of the suturing.
S6, suturing perforation, namely, suturing the needle thread by a pair of suture forceps, placing the suture forceps into a cavity of the cover body 1 through an operation valve port 14, leaving the tail part of the suture outside the cover body 1, suturing the myocardial perforation by using the suture forceps, pulling out the suture forceps, taking the head end of the needle thread out of the cover body 1, removing the surgical needle, moderately tightening the head end and the tail end of the suture thread, penetrating a suture confinement ring and a threading hole at the head end of the push ring forceps through the head end and the tail end of the suture thread, penetrating the push ring forceps laterally, pulling the head end and the tail end of the suture thread, pushing the suture confinement ring to the myocardial perforation position by using the push ring forceps, propping the suture thread to close the myocardial perforation by using the push ring forceps, deforming and closing the suture confinement ring by using the clamp, temporarily fastening the suture confinement ring at the suture outside the perforation, and pulling out the push ring forceps to retain the suture thread;
S7, repeatedly closing, namely if a plurality of perforations exist, repeating the above operation, and suturing and closing all myocardial perforations;
S8, reinforcing and closing, namely removing the cover body 1, exposing the myocardial surface under direct vision, removing the suture confinement ring, manually knotting the suture again, closing myocardial perforation, and cutting off redundant line bodies if a plurality of perforation are arranged;
S9, hemostatic suture, namely suturing pericardium, stopping bleeding and suturing the incision;
s10, blood recovery. In the case of too long a procedure, the patient's blood needs to be returned, and the blood recovery bag 51 can be directly returned after most of the water is filtered out, so as to assist the recovery of the patient's life state. ACT testing is subsequently performed depending on the patient's condition, and protamine is selectively used, due to the use of anticoagulants during surgery.
The above-described embodiments are merely illustrative of the principles of the present application and their effectiveness, and are not intended to limit the present application. Modifications and variations may be made to the above-described embodiments by those skilled in the art without departing from the spirit and scope of the present application. Accordingly, it is intended that all equivalent modifications and variations which a person having ordinary skill in the art would accomplish without departing from the spirit and technical spirit disclosed in the present patent application shall be covered by the claims of the present patent application.

Claims (10)

1.心肌穿孔修补罩,其特征在于:包括用于缝合在心包上形成密封操作空间的碗形柔质的罩体(1),所述罩体(1)碗口边缘内侧设置密封膜圈(11);临近罩体(1)碗口边缘贯穿连通罩体(1)设置进液口(12)和排液口(13);在罩体(1)碗壁及碗底贯穿连通罩体(1)设置至少两个操作阀口(14);所述操作阀口(14)包括视频杆置入阀口和操作器械置入阀口。1. A myocardial perforation repair cover, characterized in that it comprises a bowl-shaped soft cover body (1) for suturing on the pericardium to form a sealed operating space, a sealing membrane ring (11) is arranged on the inner side of the edge of the cover body (1); a liquid inlet (12) and a liquid outlet (13) are arranged adjacent to the edge of the cover body (1) and penetrate through the cover body (1) to connect with the cover body; at least two operating valve ports (14) are arranged on the cover body (1) bowl wall and bowl bottom to penetrate through the cover body (1); the operating valve ports (14) include a video rod insertion valve port and an operating instrument insertion valve port. 2.根据权利要求1所述的心肌穿孔修补罩,其特征在于:连通罩体(1)内腔设置压强监测管。2. The myocardial perforation repair cover according to claim 1 is characterized in that a pressure monitoring tube is arranged in the inner cavity of the cover body (1). 3.根据权利要求1所述的心肌穿孔修补罩,其特征在于:还包括用于密封置入进液口(12)的冲洗管(4),冲洗管(4)外密封活动设置进液衔接环(41),冲洗管(4)尾部连接冲洗液袋,冲洗液袋外设置冲洗加压器(43),冲洗加压器(43)对冲洗液袋加压;进液衔接环(41)与进液口(12)适配封闭衔接。3. The myocardial perforation repair cover according to claim 1 is characterized in that it also includes a flushing tube (4) for sealingly inserting into the liquid inlet (12), a liquid inlet connecting ring (41) is movably provided on the outside of the flushing tube (4) for sealing, the tail of the flushing tube (4) is connected to a flushing liquid bag, a flushing pressurizer (43) is provided outside the flushing liquid bag, and the flushing pressurizer (43) pressurizes the flushing liquid bag; the liquid inlet connecting ring (41) is adapted to be sealed and connected with the liquid inlet (12). 4.根据权利要求1所述的心肌穿孔修补罩,其特征在于:还包括用于密封置入排液口(13)的排液管(5),排液管(5)外密封活动设置排液衔接环(52),排液管(5)尾部设置血液回收袋(51);排液衔接环(52)与排液口(13)适配封闭衔接。4. The myocardial perforation repair cover according to claim 1 is characterized in that it also includes a drainage tube (5) for sealingly inserting the drainage port (13), a drainage connection ring (52) is movably provided on the outside of the drainage tube (5) for sealing, and a blood recovery bag (51) is provided at the tail of the drainage tube (5); the drainage connection ring (52) is adapted to be sealed and connected with the drainage port (13). 5.根据权利要求4所述的心肌穿孔修补罩,其特征在于:贯穿血液回收袋(51)侧壁设置滤水孔区,密封滤水孔区设置滤水膜(54);在回收袋(51)外侧设置滤水口(55),滤水口(55)密封滤水膜(54)区,连通设置用于保存滤出液体的积水袋(56)。5. The myocardial perforation repair cover according to claim 4 is characterized in that: a water filter hole area is set through the side wall of the blood recovery bag (51), and a water filter membrane (54) is set to seal the water filter hole area; a water filter port (55) is set on the outside of the recovery bag (51), and the water filter port (55) seals the water filter membrane (54) area and is connected to a water accumulation bag (56) for storing filtered liquid. 6.根据权利要求1所述的心肌穿孔修补罩,其特征在于:还包括操作器械和缝线禁锢环,操作器械包括视频杆、手术剪、压迫环、缝合钳和推环钳。6. The myocardial perforation repair cover according to claim 1 is characterized in that it also includes operating instruments and suture locking rings, and the operating instruments include video rods, surgical scissors, compression rings, suture forceps and push ring forceps. 7.根据权利要求3或4所述的心肌穿孔修补罩,其特征在于:所述冲洗管(4)和排液管(5)在罩体(1)外连通设置侧通单向阀口(44),并设置匹配的引导芯,引导芯经侧通单向阀口(44)置入冲洗管(4)或排液管(5)前段;引导芯为包裹柔性外壳的金属杆,可塑形,尾部设置手柄。7. The myocardial perforation repair cover according to claim 3 or 4 is characterized in that: the flushing tube (4) and the drainage tube (5) are connected to each other outside the cover body (1) by a side one-way valve port (44), and a matching guide core is provided, and the guide core is inserted into the front section of the flushing tube (4) or the drainage tube (5) through the side one-way valve port (44); the guide core is a metal rod wrapped in a flexible shell, which can be shaped, and a handle is provided at the tail. 8.根据权利要求6所述的心肌穿孔修补罩,其特征在于:所述缝线禁锢环包括金属环,内腔与双股缝线适配;所述推环钳头部依次设置钳夹端、钳身端,贯穿钳身端设置穿线孔;穿线孔小于缝线禁锢环内腔;缝线禁锢环活动镶嵌设置在推环钳钳夹端,钳夹端长度不大于缝线禁锢环高度。8. The myocardial perforation repair cover according to claim 6 is characterized in that: the suture restraining ring includes a metal ring, and the inner cavity is adapted to the double-strand suture; the head of the push-ring pliers is sequentially provided with a clamp end and a clamp body end, and a threading hole is provided through the clamp body end; the threading hole is smaller than the inner cavity of the suture restraining ring; the suture restraining ring is movably embedded in the clamp end of the push-ring pliers, and the length of the clamp end is not greater than the height of the suture restraining ring. 9.根据权利要求8所述的心肌穿孔修补罩,其特征在于:所述缝线禁锢环为椭圆形的柔性环,短轴两端设置插入槽,所述推环钳的钳头处的尺寸设置与缝线禁锢环的限位槽相对应,推环钳的钳头处带有磁性,所述压迫环包括探入环和手持柄。9. The myocardial perforation repair cover according to claim 8 is characterized in that: the suture restraining ring is an elliptical flexible ring, insertion grooves are set at both ends of the short axis, the size setting of the clamp head of the push-ring pliers corresponds to the limiting groove of the suture restraining ring, the clamp head of the push-ring pliers is magnetic, and the compression ring includes a probe ring and a hand-held handle. 10.根据权利要求1-9任一项所述的心肌穿孔修补罩,其特征在于,使用方法为:10. The myocardial perforation repair cover according to any one of claims 1 to 9, characterized in that the method of use is: S1:固定罩体(1):心前区切口,暴露心包,将罩体(1)碗口状边缘密封缝合在心包合适位置;S1: Fixing the mask (1): Make an incision in the precordial area to expose the pericardium, and seal and suture the bowl-shaped edge of the mask (1) to a suitable position in the pericardium; S2:建立冲洗:冲洗管(4)前段经进液口(12)密封置入罩体(1)腔,尾部连接冲洗液袋(41);排液管(5)前段经排液口(13)密封置入罩体(1)腔,尾部连接冲洗液袋(41);排空罩体(1)气体,调节冲洗压力及流速,对罩体(1)内持续冲洗引流;S2: Establish flushing: the front section of the flushing tube (4) is sealed and placed into the cavity of the cover body (1) through the liquid inlet (12), and the rear section is connected to the flushing liquid bag (41); the front section of the drainage tube (5) is sealed and placed into the cavity of the cover body (1) through the liquid drainage port (13), and the rear section is connected to the flushing liquid bag (41); the gas in the cover body (1) is emptied, and the flushing pressure and flow rate are adjusted to continuously flush and drain the inside of the cover body (1); S3:定位穿孔:经操作阀口(14)向罩体(1)内置入视频杆和手术剪,剪开心包,暴露心肌表面穿孔;拔出手术剪,调节视频杆找到心肌穿孔位置;S3: Positioning the perforation: inserting a video rod and surgical scissors into the cover body (1) through the operating valve port (14), cutting the pericardium, exposing the myocardial surface for perforation; pulling out the surgical scissors, and adjusting the video rod to find the position of the myocardial perforation; S4:建立视野:经侧通单向阀口(6)向冲洗管(4)和排液管(5)置入引导芯(61),视频杆视频下调节冲洗管(4)和排液管(5)前端开口临近心肌穿孔位置,对心肌穿孔位置持续冲洗引流;S4: Establishing the visual field: inserting the guide core (61) into the flushing tube (4) and the drainage tube (5) through the side one-way valve port (6), adjusting the front end openings of the flushing tube (4) and the drainage tube (5) close to the myocardial perforation position under the video rod video, and continuously flushing and draining the myocardial perforation position; S5:固定穿孔:经操作阀口(14)向罩体(1)内置入压迫环,适度压迫穿孔位置,限制穿孔对应部位心肌活动幅度;S5: Fixing the perforation: inserting a compression ring into the cover body (1) through the operating valve port (14), appropriately compressing the perforation position, and limiting the amplitude of myocardial activity at the perforation corresponding position; S6:缝闭穿孔:缝合钳钳夹缝合针线,经操作阀口(14)置入罩体(1)腔,缝合线尾部留在罩体(1)外;使用缝合钳对心肌穿孔缝合,缝合完成,拔出缝合钳,将针线头端带出罩体(1)外,去掉手术针;适度拉紧缝合线头尾两端,S6: Suturing the perforation: Clamp the suture needle and thread with a suture clamp, insert it into the cavity of the cover body (1) through the operating valve port (14), and leave the tail of the suture thread outside the cover body (1); use the suture clamp to suture the myocardial perforation, and after the suture is completed, pull out the suture clamp, bring the needle and thread head out of the cover body (1), and remove the surgical needle; appropriately tighten the head and tail of the suture thread, 经缝合线头尾两端穿入推环钳头端的缝线禁锢环及穿线孔,经推环钳侧方穿出;Insert the suture ends into the suture locking ring and threading hole at the head end of the push ring clamp, and then pass it out from the side of the push ring clamp; 拉持缝合线头尾两端,使用推环钳将缝线禁锢环沿缝合线推至心肌穿孔位置;推环钳顶持收紧缝合线闭合心肌穿孔,钳夹缝线禁锢环,使缝线禁锢环变形闭合,临时紧固定在穿孔外缝合线处;拔出推环钳,保留缝合线;Pull and hold both ends of the suture, and use the push ring forceps to push the suture locking ring along the suture to the position of the myocardial perforation; push the ring forceps to hold and tighten the suture to close the myocardial perforation, clamp the suture locking ring to deform and close it, and temporarily fix it tightly at the suture outside the perforation; pull out the push ring forceps to retain the suture; S7:重复闭合:若有多个穿孔,重复以上操作,缝线并闭合所有心肌穿孔;S7: Repeat closure: If there are multiple perforations, repeat the above steps, suture and close all myocardial perforations; S8:加固闭合:拆除罩体(1),直视下暴露心肌表面,拆除缝线禁锢环,S8: Reinforced closure: Remove the cover (1), expose the myocardial surface under direct vision, remove the suture locking ring, 重新手工打结缝合线,闭合心肌穿孔,剪除多余线体;若有多个穿孔,逐个完成;Re-tie the suture manually to close the myocardial perforation and cut off the excess suture; if there are multiple perforations, complete them one by one; S9:止血缝合:缝合心包,止血,缝合切口;S9: Hemostasis and suture: suture the pericardium, stop bleeding, and suture the incision; S10:血液回收:对血液回收袋(51)加压滤出水分,回输给患者。S10: Blood recovery: pressurize the blood recovery bag (51) to filter out water and return it to the patient.
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