Fold the needle
Acupuncture treatment , folding pin is one of the more common accidents, ancient physicians have long attached great importance to this , such as the famous physician Dou Hanqing Jin and Yuan Dynasties , in its relegated to the ” standard secluded Fu” , highlighted : ” and Cardiff shilling needle Yao , while taking into account the needle loss . ” Yuan and Ming Dynasties Some physicians also summed up the experience and methods of taking muscle breakage .
Modern reports about the needle off in our newspapers and magazines have seen much, and tend to stay only introduced in the surgical removal of broken needles or raised as a lesson for breakage and in vivo activity in vivo retention will cause any few studies kinds consequences . Japanese Acupuncture sector has the great importance , which may be more common in accidents related to breakage . In recent years, they are the reason for breakage , swimming in the body caused by circumstances and consequences , made a lot of experimental clinical observation and in-depth research, including guinea pigs , rabbits and dogs and other animals of different sizes as experimental subjects , using the needle has a lily and needles are also often used in clinical stainless steel needle , made a lot of valuable information , quite worth learning from.
[ Reason ] injury
First, the needle reasons
( A ) , needle poor quality : refers to the use of inferior materials or shoddy manufacturers of needles . In addition , Japan to produce a mercury- coated needle ( the purpose of the needle body is smooth, easy-to- needle ) , due to the corrosive effects of mercury , occur fairly frequently off the needle .
( Two ) , using the old needle : Needle applications too frequent or too long , there are inflected , scars , etc. ; excessive alcohol use or autoclaved long soak times , causing the needle body softened, injury, place too long , but also due to oxidation rust, stiff brittle.
( Three ) , the life of needles and needle thickness about: Cuzhen longer life . Needle you need to be constantly updated.
Second, the reason healer
( A ) , operating unskilled, violent action . After piercing a sense of resistance, still forced piercing ; lag occurs when the needle injection needle still forced to pull out . Unnecessarily deep puncture , causing severe muscle contraction may break the needle .
(B ) In the process of acupuncture , qi in order to seek a sense of satisfaction , way too Da , twisting angle is too big , too fast and so the frequency . In particular, some patients with difficult to get gas , such as paraplegia , which may be due to strong tactics breakage .
Third, the patient reasons
( A ) , first received acupuncture, intense fear ; often because acupuncture can not tolerate intense soreness , or because of pain, and can lead to reflex muscle spasms, severe muscle contraction occurs off the needle .
( Two ) , leaving the needle in the process, some uncontrollable movements of patients, such as severe cough , sneezing , or sudden significant change in position , etc., can cause the needle off .
Fourth, part of the reason
( A ) , the needle , the needle off the needle body often occurs in connection with the needle handle , there is that place from 3 ~ 5mm needle , but also easy to break . Energized, the needle corrosion parts, body and skin contact with the needle at the common, pitting can also occur in several places the needle body .
(B ) on the body , where a needle can occur off the abdomen, chest , waist , back, limbs and joints and other parts. Acupuncture needles at home and abroad have documented the occurrence of folding over , the degree of activity in the larger multi- site, but Juque , Xinyu, liver Yu, Gaohuangshu other points there have been reported off the needle . Head and facial acupuncture needles off the case , relatively rare .
Five reasons EA
Means in acupuncture therapy, needle breakage due to electrolytic corrosion , DC needle instrument relating to the major and connected to it. Currently, the use of electro-acupuncture device in China for a pulse electro-acupuncture , it ‘s rarely a DC component in the electrical stimulation process, less common electrolytic corrosion off the needle . But it should be noted that the current existing output pulse electro-acupuncture device is a pulse transformer isolation go through and only the DC component of the pulse current through the AC component , when electro-acupuncture device used for too long , or homemade EA instrument output transformer without strict examination , can cause waveform mixed with pulse output DC component . And there is a DC component , will make the connection of two needle electrodes in an , as electrolysis and corrosion , thinning, rusty , brittle hair as well as the body off the needle .
In addition to acupuncture needles off with the DC component of the outside, still affected by the following factors:
( A ) , frequency and waveform : low powered frangible pin to high frequency stimulation better. Waveform should choose non-corrosive , such as alternating rectangular waveform .
(B ) , the current strength and power-on time : the greater the current strength , power the longer , the more prone fold needle. An experiment proved to 3 ~ 8mA current electricity 30 ~ 60min, located in the anode needle tip easily broken ; 15mA or 30mA powered electricity 1h 30min, needle roots appear broken. It is proposed that acupuncture should be below 10V output voltage , power-on time of no more than 30min.
( Three ) , needle electrodes connected : the anode frangible pin , energized approach taken three experimental observations in humans and found that no matter anode energized law , law and bipolar cathode powered electricity law , both anode eclipse obviously less cathodic corrosion .
Six other reasons: the last three decades , with a variety of stimulation of acupuncture points are emerging , making off needle tends to complicate the situation . Injection, improper operation , needles breaking into the cavity . Scalp therapy due to long needle into the scalp , coupled with excessive twisting frequency , breakage can occur . Especially catgut implantation ligation , the body can easily cause the needle to break .
Clinical manifestations
Clinical manifestations include activities off the needle and the needle body after in vivo .
First, there are clinical manifestations of the needle after discount
Some Japanese scholars clinical and experimental data show that the most dangerous move breakage is on the organ and nervous system damage. Its complications include septic arthritis , peritoneal and organ damage, nerve palsy, intractable neuralgia.
( A ) non- vital organs or joints . More generally do not have serious consequences. The common features are: After folding needle breakage locally tenderness , and gradually reduced. Sometimes the weight off the needle has a sense of place , activity can occur even when pain, but often without dyskinesia .
( Two ) , intra-articular fold needle. Regardless of the size of the joints in the fold needles, will be presented with severe movement disorders and pain , such as intercostal joint fold needle , there may be multiple difficulty breathing, chest pain ; spinal joints off the needle , long after the event there is severe pain and movement disorders .
( Three ) , folding organ inside the needle , the situation is often more serious. Vary , and different parts of the organs off the needle , can cause varying degrees of pain and dysfunction , pulmonary off pin, the frequency of cough , dyspnea and intercostal neuralgia pain episodes like . Heart break needles, severe angina -like pain , difficulty breathing , and can quickly enter a state of shock ; bladder needle, urine can cause a short number , discharge difficulties , or hematuria.
Fold the organ needles , can be manifested as chronic symptoms , folding pin mostly in retroperitoneal organs and hollow organs. Tend to be small perforation , symptoms often very subtle , and longer duration of time . If the rectum needle, can cause chronic perforation, can be expressed as only intermittent abdominal pain , diarrhea, mild abdominal tenderness , no signs of peritonitis . Pelvis broken needles , there may be recurrent hematuria , severe hydronephrosis , the course often those who , within the pelvis to breakage as the core has formed stones.
In addition, as breakage involving peripheral nerves, local pain, which did not shoot at the numbness , sensory loss, such as the needle off into the blood vessels, it is possible with the blood flow from arteries into smaller vessels, pain or danger of embolism occurs . Also observed that the full three years off the needle , in addition to causing difficulty walking , it can also affect the function of the urinary system , and urinate frequently , a significant increase in urine output and so on .
Second, the needle body in vivo activity
Animal experiments showed that the dogs ‘ hand three years ” mobile point of breakage less parallel to the muscle fibers within a week after the necropsy was found in the muscle fascia between the radius and ulna . Mobile ” shoulder Yu ” point , the broadest and most complex , rising and falling repeatedly moved about 60cm. Necropsy was found in the right ear when the roots of the skin. Fewer moving limb breakage ” in the ditch ” points in the first 28 days , “Zusanli ” Point the first 22 days in parallel with the muscle fibers , both of which are found in the fascia. ” Air Sea Yu ,” the broken needle moves at least , it did not change the angle , necropsy found to have entered the bone marrow. Breakage of the neck , ” wind pool ” point of the needle, move up and down along the back of the neck by about 6cm, but the first 28 days after the X line is difficult to confirm , autopsy did not find . May have been naturally excreted. Before and after the ” Tianzhu ” point of breakage along the neck moves about 10cm, while the Ministry of necropsy found in the ears bent obvious breakage . There mesenteric and hepatic invasion waist breakage reports . In general, the activity of large parts of the broken needle moves a big margin ; activity of smaller magnitude smaller moving parts sometimes relatively static . Hard, thick needle stump is easy movement , while the soft, curved needle is not easy to move [ 1 ] .
In animal experiments, the breakage in vivo activity around the following situations.
( A ) , after moving breakage , relevant organs and tissues causing pain or dysfunction , ultimately, surgical removal : or breakage after use in surgery, or other non- surgical methods to remove .
(B ) automatically discharged to the body. Breakage of the skin and connective tissue , many from the surface on their own , or discharge from the intestines and feces together .
(C ) In vivo effects of various physical and chemical factors , the gradual dissolution occurs , it generally requires quite a long time .
( Four ) , located in a relatively static breakage body parts , or surrounding tissue infections occur due to stimulation , was wrapped in fibrous connective tissue , long-term stay in the body .
[ Prevention ]
First, strengthen the needle ready before
( A ) , checking and selecting needles . Frequently updated needles, do not use bent , rusted or otherwise damaged needles are often difficult to find a small injury to the naked eye , but also to double check. The application of electro-acupuncture , electro-acupuncture device should be made to choose , do not use direct current meter and create their own needles or long pulse electro-acupuncture device . On the current intensity , frequency and wave pattern , should pay attention to regulation.
(B ) Before acupuncture , fully Rouan point area to relieve local spasm of newly diagnosed patients or mental stress , should first be psychological comfort . Pediatric patients , parents must make with a fixed position.
Second, pay attention to the operation surgery
( A ) , the needle required , to use his hands into the needle . To the left ( charge hand ) thumb and index finger pulp fixed needle , the needle into rapidly , then slowly release the charge hand , slowly send the needle . When the patient coughs or change position , they should stop pulling the needle or the needle upwards , piercing or needle injection in the process, when you encounter resistance, do not force or pull out the needle , can change the direction of piercing needle injection , or wait a moment acupuncture to the desired depth , the needle should be more than 0.5cm exposed skin not all piercing .
(B ) , the needle request. For patients with poor sense of qi , the needle should be stopped using the method of gas , not to blindly seek to strengthen air and tactics .
[ Approach ]
I. Needle : Needle accurate treatment can avoid or reduce the accident off the needle . When Needle , as caused by postural changes , you can make it return to the original position, and then pull out the pilot . Caused as a result of muscle tension , should stay a while, or around acupressure to relaxation after the needle . If there are many curved needle , the needle body oppression trial , so that the needle piercing the skin from another , cut pintail , tweezers and pull it out .
Second, folding pin: folding occurs after the needle , the doctor should be calm and do not panic the patient should be possible to maintain the original position without moving further processing . I have encountered secondary breakage , once made the point ligation for patients with gastric ulcer is located , breakage occurs in the abdominal, was the author and a nurse are more beside sedation , the patient is also unknown needle, results BP ended pliers with smooth stump removal ; while another , is also a polio patient in the ligation point line , breakage occurs in Huantiao , another nurse exclaimed fold in the side pin , children with a nervous, got up , transform body is located , resulting in an X-ray of a few hours before removing the stump . Breakage remained mostly straight down and subcutaneous fascia can be used as a reference when removed .
( A ) , shallow fold needle. ” Acupuncture Dacheng ” has referred to ” those who breakage , and then resume the original pin hole edge next needle , fill out of that .” At present , in general, pressing points around to make ends exposed tweezers to go.
( Two ) , deep break. In principle, should be surgically removed. Deep breakage of enucleation are generally more difficult , even though it is extremely skilled surgeon difficult . Some people think that ultimately can not be removed abroad accounted for 25 percent breakage . Acupuncturist shall assist the surgeon during surgery to determine the needle off the site , the X -ray ( beat , lateral film ) , and specifically calculated with a scalpel found . If conditions are available from two different angles of X -ray photographs , CT scans and other techniques to determine the three-dimensional needle position . If the needle is not long off , located in the limbs , but also in the X-ray , surgery to remove direct .