Tus nqi tseem ceeb ntawm Dual -Technology Echogenic koob nyob rau hauv niaj hnub Peripheral Nerve Block

https://www.nature.com/articles/s41598-024-72620-8

1. Cov Ntsiab Lus Kho Mob

Peripheral hlab ntsha thaiv yog lub ntsiab tseem ceeb thev naus laus zis ntawm niaj hnub tshuaj loog hauv cheeb tsam, dav siv nyob rau hauv ntau yam kev phais thiab kev cuam tshuam qhov mob. Txawm li cas los xij, kev ua haujlwm ntawm cov hlab ntsha ib txwm siv los ntawm cov koob txhaj tshuaj zoo tib yam thiab ib qho kev taw qhia thev naus laus zis tau ntev -kev kho mob tsis txaus. Pa qhov muag tsis pom kev puncture heev nyob ntawm cov kws kho mob cov kev paub txog tus kheej thiab kev nco qab anatomical, nrog rau qhov tsis paub tseeb ntawm qhov kev tso ntawm rab koob. Txawm tias muaj kev taw qhia yooj yim ultrasound, cov koob zoo tib yam tam sim no tsis muaj zog thiab fuzzy ultrasonic teeb liab, ua rau nws nyuaj rau kev paub qhov txawv ntawm lub cev ntawm fascia thiab cov ntaub so ntswg hauv lub sijhawm. Qhov no yooj yim ua rau rab koob sib txawv, ua rau cov hlab ntsha tsis tiav, ncua kev siv tshuaj loog, lossis ua tsis tiav. Tsis tas li ntawd, qhov chaw tsis raug feem ntau ua rau muaj kev sib tsoo vascular puncture, hematoma hauv zos, thiab cov paj hlwb raug mob. Rau cov neeg mob uas muaj kev hloov pauv hauv anatomical, qhov ua yuam kev ntawm cov kev ua haujlwm ib txwm muaj nce zuj zus, ua rau tsis muaj tshuaj loog zoo, muaj kev mob tshwm sim ntau dua, thiab qhov tshwm sim ntau dua ntawm cov teeb meem tom qab kev phais, uas cuam tshuam rau kev txhim kho tus qauv ntawm cov tshuaj loog hauv cheeb tsam.

2. Txoj Cai Ua Haujlwm ntawm cov khoom

Echogenic koob rau Nerve Blockdaws kev lag luam mob cov ntsiab lus ntawm cov paj hlwb ib txwm siv los ntawm kev sib koom ua ke ntawm ob lub thev naus laus zis: hluav taws xob paj hlwb stimulation thiab kev taw qhia ultrasound. Sib txawv ntawm cov koob zoo tib yam, cov khoom no txais kev kos duab laser thiab electropolishing machining tshuab ntawm stainless hlau koob nto. Lub micro- txheej txheem nto tsim cov ntsiab lus ruaj khov ultrasonic reflection cov ntsiab lus, uas tuaj yeem ua kom pom tseeb thiab siab -brightness ncha dluab nyob rau hauv ultrasound scanning, realizing tag nrho cov tiag tiag - lub sij hawm visualization ntawm rab koob lub cev thiab koob tip trajectory. Lub caij no, rab koob txhawb nqa hluav taws xob cov paj hlwb ua haujlwm: qis- zaus micro- tam sim no kis tau los ntawm cov kab mob tsis huv stainless hlau rab koob. Thaum lub koob taub mus ze rau lub hom phiaj peripheral paj hlwb, nws tuaj yeem ua rau cov hlab ntsha tshwj xeeb reflex thiab cov leeg nqaij sib txuas lus. Cov kws kho mob tau txais cov lus qhia qhov tseeb los ntawm cov hlab ntsha hluav taws xob teb, thiab txheeb xyuas qhov sib thooj ntawm rab koob mus rau lub hom phiaj paj. Qhov sib ntxiv dual - hom kev txheeb xyuas qhov tseeb - lub sij hawm ultrasound pom thiab cov paj hlwb hluav taws xob stimulation tawm tswv yim kiag li tshem tawm qhov kev ua yuam kev ntawm ib qho kev taw qhia thev naus laus zis, paub txog qhov tseeb qhov kev tso ntawm rab koob.

3. Kev faib khoom thiab Scenario Matching

Raws li kev tshawb fawb ywj pheej thiab kev tsim kho tshwj xeeb thiab cov kev xav tau ntawm kev kho mob, echogenic paj hlwb thaiv cov koob tsim ua tiav qhov loj me uas npog 8G txog 26G, thiab txhawb nqa tag nrho - qhov loj me kev pabcuam. Nyob rau hauv cov nqe lus ntawm cov khoom configuration, tag nrho cov khoom txais siab -zoo kho mob stainless hlau raws li cov ntaub ntawv raw, nrog zoo rigidity, toughness thiab biocompatibility, ua tau raws li nruj me ntsis raws li cov kev cai ntawm kev kho mob puncture thiab txhaj tshuaj. Nyob rau hauv cov nqe lus ntawm machining thev naus laus zis, tag nrho cov koob tau txais kev kho laser marking echo li kev kho mob, cov electropolishing smoothing, thiab kev ua haujlwm siab -kub sterilization kev kho kom muaj kev ruaj ntseg echo kev ua tau zoo thiab xoom kab mob. Hauv kev soj ntsuam kev sib piv, 22G-26G zoo- ntsuas koob yog tsim rau cov hlab ntsha peripheral uas muaj qhov tob tob tob thiab cov nqaij mos; 8G-21G nruab nrab thiab tuab-gauge koob hloov mus rau qhov sib sib zog nqus hlab ntsha thaiv cov xwm txheej uas yuav tsum tau muaj kev ruaj ntseg zoo. Cov khoom siv cov txheej txheem ntim cov thawv, thiab tuaj yeem kho cov ntim tshwj xeeb raws li cov neeg siv khoom xav tau, ntsib kev kho mob thiab batch kev yuav khoom.

4. Cov Txheej Txheem Kev Ua Haujlwm

Cov txheej txheem kev ua haujlwm ntawm echogenic paj hlwb thaiv koob tau muab faib ua plaub theem tseem ceeb. Ua ntej, kev npaj ua ntej: xaiv qhov sib thooj koob ntsuas raws li qhov chaw phais, qhov tob ntawm cov hlab ntsha thiab cov neeg mob lub cev, xyuas cov khoom kom tsis muaj menyuam thiab kev ntim khoom, thiab debug cov cuab yeej ultrasound thiab cov khoom siv paj hlwb. Qhov thib ob, kev soj ntsuam qhov chaw: muab tus neeg mob tso rau hauv qhov chaw ua haujlwm, siv ultrasound sojntsuam txhawm rau txheeb xyuas lub hom phiaj paj hlwb thiab ib puag ncig cov hlab ntsha thiab cov nqaij mos, thiab qhia meej txog kev sib raug zoo ntawm lub cev. Thib peb, dual-mode puncture: txais yuav nyob rau hauv- dav hlau lossis tawm- ntawm- txoj kev dav hlau puncture, ua ntej lub koob echogenic maj mam, soj ntsuam qhov tiag -lub sij hawm koob trajectory los ntawm ultrasound dluab, thiab tig lub paj hlwb stimulation ntaus ntawv kom tso zis tsawg- siv tam sim no. Zoo- kho lub koob txoj hauj lwm kom txog rau thaum lub hom phiaj paj hlwb yog induced kom paub meej tias qhov tseeb koob qhov chaw. Plaub, kev xa tshuaj thiab tshuaj xyuas: ua qhov kev xav tsis zoo kom tsis suav nrog vascular puncture txaus ntshai, txhaj tshuaj loog hauv zos maj mam, saib xyuas cov tshuaj sib txawv nyob ib puag ncig ntawm cov paj hlwb hauv kev saib xyuas ultrasound, thiab ua tiav cov haujlwm thaiv tom qab lees tias tsis muaj cov tshuaj tiv thaiv txawv txav.

5. Kev paub txog kev siv tshuaj kho mob

Ntau cov ntaub ntawv siv tshuaj kho mob tau txheeb xyuas tias dual- cov koob tshuaj echogenic muaj qhov zoo dua li cov koob tshuaj ib txwm muaj. Lub laser ncha txhim kho cov qauv zoo heev txhim kho qhov kev paub txog ultrasound ntawm lub koob taub, txo qhov muag tsis pom kev thiab rov kho lub sijhawm ntau dua 60%. Qhov kev txheeb xyuas dual ntawm kev pom kev pom ntawm ultrasound thiab cov paj hlwb ua haujlwm tau zoo kom tsis txhob muaj qhov sib txawv ntawm qhov tshwm sim los ntawm kev hloov pauv ntawm lub cev, ua rau ib qho - lub sijhawm ua tiav ntawm cov hlab ntsha peripheral los ntawm 75% mus rau ntau dua 98%. Kev xyaum kho mob qhia tau hais tias qhov koob txhaj tshuaj yog qhov ua rau txo qis lub sijhawm pib ntawm kev hnov ​​​​mob thiab lub cev muaj zog, txo cov tshuaj loog hauv zos li ntawm 20%, thiab txo cov kev pheej hmoo ntawm cov tshuaj phiv thiab vascular infiltration. Meanwhile, lub cev electropolishing koob lub cev yuav txo tau cov ntaub so ntswg kev sib txhuam thiab kev raug mob, zoo txo ​​qhov tshwm sim ntawm postoperative zos o, hematoma thiab paj hlwb teeb meem, thiab zoo heev txhim kho cov neeg mob intraoperative kev nplij siab thiab postoperative rov qab nyhuv.

6. Cov ntsiab lus thiab sublimation

Qhov tseeb ntawm lub hom phiaj paj hlwb hauv zos yog qhov tseem ceeb hauv kev txiav txim siab qhov ua tiav ntawm peripheral hlab ntsha thaiv tshuaj loog. Cov cuab yeej siv tshuaj tua kab thiab ib qho kev taw qhia thev naus laus zis raug txwv los ntawm kev pom tsis zoo thiab tsis muaj kev tawm tswv yim txog paj hlwb, uas tsis tuaj yeem ua tau raws li qhov siab - qhov tseeb thiab siab - kev nyab xeeb ntawm kev kho mob niaj hnub hauv cheeb tsam tshuaj loog. Echogenic Needle for Nerve Block integrates hluav taws xob paj hlwb stimulation thiab ultrasound dual kev taw qhia technologies, thiab yog nruab nrog siab - precision machining thiab sterile kho txheej txheem. Nws pab daws qhov mob ntawm qhov chaw kho mob ntawm qhov tsis raug, qhov ua tau zoo tsawg thiab cov teeb meem siab ntawm cov paj hlwb ib txwm muaj. Raws li kev ua haujlwm siab -kev ua tau zoo thiab muaj kev nyab xeeb hauv kev txhaj tshuaj thiab puncture ntsuas, nws ua kom zoo rau tag nrho cov txheej txheem ntawm kev ua haujlwm tshuaj loog hauv cheeb tsam, paub meej, ua haujlwm tau zoo thiab tsis tshua muaj kev cuam tshuam cov hlab ntsha, thiab dhau los ua cov cuab yeej tseem ceeb rau kev kho tshuaj loog.

7. Cov lus qhia txog kev txhim kho yav tom ntej thiab kev thov

With the continuous promotion of precision medicine and enhanced recovery after surgery (ERAS) concept, clinical requirements for nerve block accuracy, safety and minimally invasive performance are increasingly strict. In the future, medical institutions should comprehensively promote the replacement of ordinary needles with dual-technology echogenic needles in routine peripheral nerve block operations. It is suggested to carry out hierarchical training for clinicians, standardize the dual-mode coordination operation of ultrasound visualization and nerve stimulation, and improve the proficiency of precise puncture. Manufacturers need to further optimize laser marking technology to enhance the echo stability of fine-gauge needles, and enrich customized size specifications to adapt to more refined surgical scenarios. Meanwhile, formulate unified clinical application specifications to promote the standardized and popularized development of echogenic nerve block needle technology in the field of regional anesthesia.