阅读说明：本技术 一种穿刺方法 (Puncture method ) 是由 王为民 王宏志 王恩君 夏莉 周玉琴 于 2019-10-10 设计创作，主要内容包括：本发明公开了一种穿刺方法,根据穿刺对象的医学影像资料确定病灶位置,将所述病灶位置所在的直线作为定位参考线；根据定位参考线规划入针路径。通过上述优化设计的穿刺方法,通过根据病灶位置在横断面上选择定位参考线,以定位参考线作为参考在定位参考线所在任一平面内选择入针路径,实现入针路径的快速准确的确定,入针路径的选择不受CT扫描横断面的限制,从而减少对医护人员穿刺经验的依赖,实现面向病灶的快速准确穿刺。(The invention discloses a puncture method, which is characterized in that the position of a focus is determined according to medical image data of a puncture object, and a straight line where the position of the focus is located is used as a positioning reference line; and planning the needle path according to the positioning reference line. According to the optimally designed puncture method, the positioning reference line is selected on the cross section according to the position of the focus, the needle insertion path is selected in any plane where the positioning reference line is located by taking the positioning reference line as a reference, the needle insertion path is determined quickly and accurately, the needle insertion path is not limited by the CT scanning cross section, the dependence on the puncture experience of medical staff is reduced, and the focus-oriented quick and accurate puncture is realized.)

1. A method of lancing, comprising the steps of:

determining the position of a focus according to the medical image data of the puncture object, and selecting a straight line passing through the position of the focus as a positioning reference line;

and planning the needle path according to the positioning reference line.

2. The puncture method according to claim 1, wherein a positioning reference line coincides with a point where a distance from the body surface of the puncture subject to the lesion position is the smallest and a straight line where the lesion position is located.

3. The puncture method according to claim 1 or 2, wherein the needle insertion path is planned on a conical surface around the positioning reference line with the focal position as a vertex.

4. A puncture method according to claim 3, wherein said planning of the path of the needle according to the positioning reference line comprises in particular: determining the needle inserting position, determining the needle inserting direction and determining the needle inserting depth.

5. The lancing method according to claim 4, wherein the determining the needle insertion position specifically comprises: and determining the needle inserting position on the body surface of the puncture object according to the medical image data of the focus.

6. The lancing method according to claim 5, wherein the determining the needle insertion direction specifically comprises: and taking a straight line of the needle inserting position and the lesion position as a needle inserting reference line, and determining the needle inserting direction according to the needle inserting reference line.

7. The lancing method of claim 6, wherein the determining the needle insertion depth specifically comprises: and selecting one point on the positioning reference line as a first reference point, wherein the first reference point is positioned outside the puncture object body, taking the focus position as a target point, taking the needle inserting position as a needle inserting point, and obtaining the needle inserting depth according to the first reference point, the target point and the needle inserting point.

8. The puncture method according to claim 7, wherein a straight line on which the first reference point and the needle insertion point are located is taken as an auxiliary line, and the needle insertion depth X is:

X＝(sinB/sinA)D；

wherein D is the distance between the first reference point and the needle insertion point, A is the included angle between the needle insertion reference line and the positioning reference line, and B is the included angle between the auxiliary line and the positioning reference line.

9. The lancing method of claim 7, wherein the determining the needle insertion depth specifically comprises: selecting one point on the needle insertion reference line as a second reference point, wherein the second reference point is positioned outside the puncture object body, and calculating the needle insertion depth according to the relative coordinates of the first reference point, the target point, the needle insertion point and the second reference point;

preferably, the needle insertion depth X is:

wherein L1 is the distance between the first reference point and the target point, L2 is the distance between the first reference point and the second reference point, and L3 is the distance between the second reference point and the target point.

10. The lancing method of claim 9, wherein the second reference point and the first reference point are located on a straight line perpendicular to a positioning reference line.

Technical Field

The invention relates to the technical field of clinical medical treatment, in particular to a puncture method.

Background

In recent years, minimally invasive techniques have rapidly developed and become widespread, with a considerable part of the work being to perform deep tissue target punctures under CT. Ct (computed tomography), that is, electronic computed tomography, uses precisely collimated X-ray beams, gamma rays, ultrasonic waves, etc. to scan the cross section of a human body one by one together with a detector with extremely high sensitivity, has the characteristics of fast scanning time, clear image, etc., and can be used for the examination of various diseases. The CT scanning requires that a human body lies down and enters the CT machine to scan the cross section of the human body layer by layer. Therefore, unlike the puncture under B-ultrasound or DSA (Digital subtraction angiography), the puncture under CT cannot be performed under real-time dynamic observation, and needs to be performed step by step in the CT scanning plane, and often needs to be adjusted many times during the puncture process, which is time-consuming and long-lasting, and has a large error.

Disclosure of Invention

In order to solve the technical problems in the background technology, the invention provides a puncture method.

The invention provides a puncture method, which comprises the following steps:

determining the position of a focus according to the medical image data of the puncture object, and selecting a straight line passing through the position of the focus as a positioning reference line;

and planning the needle path according to the positioning reference line.

Preferably, the positioning reference line is coincident with a point where the distance from the body surface of the puncture object to the lesion position is the minimum and the lesion position is located on a straight line.

Preferably, the needle insertion path is planned on a conical surface around the positioning reference line with the focus position as a vertex.

Preferably, the step of planning the needle inserting path according to the positioning reference line specifically comprises: determining the needle inserting position, determining the needle inserting direction and determining the needle inserting depth.

Preferably, the determining the needle insertion position specifically includes: and determining the needle inserting position on the body surface of the puncture object according to the medical image data of the focus.

Preferably, the determining the needle insertion direction specifically includes: and taking a straight line of the needle inserting position and the lesion position as a needle inserting reference line, and determining the needle inserting direction according to the needle inserting reference line.

Preferably, the determining the needle insertion depth specifically includes: and selecting one point on the positioning reference line as a first reference point, wherein the first reference point is positioned outside the puncture object body, taking the focus position as a target point, taking the needle inserting position as a needle inserting point, and obtaining the needle inserting depth according to the first reference point, the target point and the needle inserting point.

Preferably, a straight line where the first reference point and the needle inserting point are located is taken as an auxiliary line, and the needle inserting depth X is:

X＝(sinB/sinA)D；

wherein D is the distance between the first reference point and the needle insertion point, A is the included angle between the needle insertion reference line and the positioning reference line, and B is the included angle between the auxiliary line and the positioning reference line.

Preferably, the determining the needle insertion depth specifically includes: and selecting one point on the needle insertion reference line as a second reference point, wherein the second reference point is positioned outside the puncture object body, and calculating the needle insertion depth according to the relative coordinates of the first reference point, the target point, the needle insertion point and the second reference point.

Preferably, the needle insertion depth X is:

wherein L1 is the distance between the first reference point and the target point, L2 is the distance between the first reference point and the second reference point, and L3 is the distance between the second reference point and the target point.

Preferably, the second reference point and the first reference point are located on a straight line perpendicular to a positioning reference line.

According to the puncture method, the focus position is determined according to the medical image data of a puncture object, and a straight line where the focus position is located is used as a positioning reference line; and planning the needle path according to the positioning reference line. According to the optimally designed puncture method, the positioning reference line is selected on the cross section according to the position of the focus, the needle insertion path is selected in any plane where the positioning reference line is located by taking the positioning reference line as a reference, the needle insertion path is determined quickly and accurately, the needle insertion path is not limited by the CT scanning cross section, the dependence on the puncture experience of medical staff is reduced, and the focus-oriented quick and accurate puncture is realized.

Drawings

Fig. 1 is a schematic structural diagram of a puncture assisting device for implementing a puncture method according to the present invention in a simulation process.

Fig. 2 is a schematic structural diagram of a puncture assisting device for implementing a puncture method according to the present invention during a puncture process.

Detailed Description

Fig. 1 and 2 show a schematic structural diagram of a puncture assisting device for implementing a puncture method according to the present invention in a simulation process, and fig. 2 shows a schematic structural diagram of a puncture assisting device for implementing a puncture method according to the present invention in a puncture process.

The invention provides a puncture method, which comprises the following steps: determining the position of a focus according to the medical image data of the puncture object, and selecting a straight line passing through the position of the focus as a positioning reference line; and planning the needle path according to the positioning reference line.

In this embodiment, the proposed puncturing method determines a focal position according to medical image data of a puncturing object, and uses a straight line where the focal position is located as a positioning reference line; and planning the needle path according to the positioning reference line. According to the optimally designed puncture method, the positioning reference line is selected on the cross section according to the position of the focus, the needle insertion path is selected in any plane where the positioning reference line is located by taking the positioning reference line as a reference, the needle insertion path is determined quickly and accurately, the needle insertion path is not limited by the CT scanning cross section, the dependence on the puncture experience of medical staff is reduced, and the focus-oriented quick and accurate puncture is realized.

In a specific selection of the needle insertion path, the needle insertion path is planned on a conical surface surrounding the positioning reference line with the focus position as a vertex.

In a specific embodiment, the planning of the needle insertion path according to the positioning reference line specifically includes: determining the needle inserting position, the needle inserting direction and the needle inserting depth;

wherein, the determining the needle inserting position specifically comprises: determining the needle inserting position on the body surface of the puncture object according to the medical image data of the focus;

the determining the needle inserting direction specifically comprises: taking a straight line where the needle inserting position and the focus position are as a needle inserting reference line, and determining the needle inserting direction according to the needle inserting reference line;

the determining the needle insertion depth specifically comprises: and selecting one point on the positioning reference line as a first reference point, wherein the first reference point is positioned outside the puncture object body, taking the focus position as a target point, taking the needle inserting position as a needle inserting point, and obtaining the needle inserting depth according to the first reference point, the target point and the needle inserting point.

In order to clearly explain the puncturing method of the present embodiment, the present embodiment further provides a puncturing assistance device, which includes, with reference to fig. 1 and 2: a bracket 1 and a guide 2;

be equipped with the location indication pole on the support 1, be equipped with on the support 1 to keeping away from slide rail 4 that 3 directions of location indication pole extend, but be equipped with slidable mounting's slide 6 on the slide rail 4, be equipped with first pivot on the guide 2, first pivot perpendicular to pjncture needle direction passageway and location indication pole place plane set up, and guide 2 is rotatable through first pivot and installs on slide 6, is equipped with pjncture needle direction passageway in the guide 2, pjncture needle direction passageway is located location indication pole place plane.

In the puncture process of the embodiment, a needle inserting path is planned, a lesion position is determined in advance through CT scanning, a needle inserting position is selected, the support 1 is placed above a puncture object to be punctured, the positioning indication rod points to the lesion, then the extending direction of the sliding rail is rotated around the positioning indication rod according to the needle inserting position, the guide piece slides along the sliding rail along the sliding seat, the position of the puncture needle guide channel on the guide piece is adjusted, the lesion is located on the straight line of the puncture needle guide channel, and finally the needle inserting depth is determined according to the lesion position.

In the specific process of determining the needle insertion depth, selecting a point on a positioning indication rod as a first reference point, using a focus position as a target point, using the needle insertion position as a needle insertion point, obtaining the needle insertion depth according to the first reference point, the target point and the needle insertion point, and using a straight line where the first reference point and the needle insertion point are located as an auxiliary line in the specific calculation of the needle insertion depth.

Specifically, according to the law of sine and cosine of triangle, the needle insertion depth X is:

X＝(sinB/sinA)D； (1)

wherein D is the distance between the first reference point and the needle insertion point, A is the included angle between the needle insertion reference line and the positioning reference line, and B is the included angle between the auxiliary line and the positioning reference line.

When the device of the embodiment is used for calculating the depth of the needle insertion, the positioning indication rod is used as a positioning reference line, the upper end of the positioning indication rod is used as a first reference point, and D is the distance from the upper end of the positioning indication rod to the lesion position.

Then, the medical staff performs puncture according to the planned needle inserting path. Specifically, medical personnel can insert the puncture needle into the puncture needle guide channel and puncture the puncture depth along the puncture needle guide channel towards the focus direction, so that rapid and accurate puncture can be realized.

Through the puncture auxiliary device and the puncture method of the embodiment, the positioning indication rod is used as the positioning reference line for copying and positioning, medical staff can puncture quickly and accurately, the puncture direction is accurate in the puncture process, CT scanning confirmation is not needed to be carried out repeatedly, the puncture speed and the puncture precision are greatly improved, and the pain of a puncture object is relieved.

In order to facilitate calculation of the needle insertion depth, the determining of the needle insertion depth specifically includes: and selecting one point on the needle insertion reference line as a second reference point, wherein the second reference point is positioned outside the puncture object body, and calculating the needle insertion depth according to the relative coordinates of the first reference point, the target point, the needle insertion point and the second reference point.

In particular, according to the Pythagorean theorem, L₁ ²+L₂ ²＝(X+L₃)²， (2)

Namely, the needle insertion depth X is:

wherein L1 is the distance between the first reference point and the target point, L2 is the distance between the first reference point and the second reference point, and L3 is the distance between the second reference point and the target point.

In a specific design manner of the puncture assisting device of the embodiment, the slide rail is arranged perpendicular to the direction of the positioning indication rod, the first size scale is arranged on the slide rail, a position where a straight line where the slide rail is located intersects with the positioning indication rod is used as a first reference point, the position is used as a zero point of the first size scale, and the guide piece is used as a second reference point. Therefore, when calculating the needle insertion depth, L1 is the distance from the zero point of the slide rail to the focal position, L2 is the corresponding first dimension scale of the guide on the slide rail, and L3 is the distance from the guide to the needle insertion position.

To further simplify the calculation of the needle penetration depth, the distance between the second reference point and the lesion position is taken as the reference needle penetration depth, i.e., X + L3. Meanwhile, in a specific design mode of the positioning indication rod, the positioning indication rod comprises an indication sleeve 31 and a positioning reference needle 32, a reference needle channel extending along a straight line where the second rotating shaft is located is arranged in the middle of the indication sleeve 31, the positioning indication rod 3 further comprises a positioning reference needle 32 located in the indication sleeve 31, and a target reference part 33 is arranged at the lower end of the positioning reference needle 32; when in use, the direction of the focus can be positioned through the indicating sleeve in advance, the positioning reference needle extends out along the indicating sleeve, the lower end target reference part simulates the focus position, a second size scale is arranged on the positioning reference needle, the 0 point of the second size scale corresponds to the target reference part 33, the corresponding scale value of the first reference point on the second size scale is L1, and therefore the reference needle inserting depth from the second reference point to the focus position can be directly obtained according to equation (2)

Furthermore, the calculation of the reference needle insertion depth can also be simplified by simulating the puncture procedure. In the simulation process, the direction of a focus is positioned in advance through an indicating sleeve, a positioning reference needle extends out along the indicating sleeve, a target reference part at the lower end simulates the position of the focus, a simulation needle 9 with third-dimension scales penetrates into a puncture needle guide channel, the tail end of the simulation needle 9 is used as a zero point of the third-dimension scales, the tail end of the simulation needle 9 extends to the target reference part, the angle of the puncture needle guide channel is adjusted through the simulation needle 9 according to the position of the inserted needle, a third edge is determined according to two side edges of a triangle and an included angle of the triangle, and finally the scale value of a second reference point on the third-dimension scales is the depth of the inserted; by the method, the determination of the needle inserting depth in the puncture process is improved, so that the puncture accuracy and the puncture speed are further improved.

In order to relieve the pain of a patient in the puncture process, in the actual operation, the positioning reference line is selected to coincide with the straight line where the point with the minimum distance from the puncture object body surface to the focus position is located, so that the puncture depth is shortened as much as possible in the puncture process.

In this embodiment, the focal position and the point with the minimum distance from the body surface of the puncture object to the focal position are determined according to the medical image data of the puncture object, and the straight line where the focal position and the point are located is selected as the positioning reference line, i.e., the positioning indication rod is arranged toward the focal position along the point on the body surface of the puncture object.

The above description is only for the preferred embodiment of the present invention, but the scope of the present invention is not limited thereto, and any person skilled in the art should be considered to be within the technical scope of the present invention, and the technical solutions and the inventive concepts thereof according to the present invention should be equivalent or changed within the scope of the present invention.