技术领域technical field
本发明涉及医疗器械技术领域，特别涉及一种医用的气管导管。 The invention relates to the technical field of medical devices, in particular to a medical endotracheal tube.
背景技术Background technique
单侧肺通气是开胸手术如食管癌切除、肺叶切除、胸膜剥脱手术、胸椎前路手术、胸腔镜等手术中常用的呼吸道管理方法。可以使术侧肺静止、萎陷，方便手术操作；还起到健患侧肺隔离的作用，防止患侧肺的分泌物、血液、脓肿等流入健侧。目前临床上常用的单肺通气装置主要有双腔支气管内导管（DLTs）、单腔支气管导管、单腔气管导管结合支气管封堵器，气管导管与支气管封堵管联合管（如Univent导管）等，然而各自都存在一定的缺陷。Unilateral lung ventilation is a commonly used airway management method in thoracotomy operations such as esophagectomy, lobectomy, pleurectomy, anterior thoracic spine surgery, and thoracoscopic surgery. It can make the lung on the operated side static and collapsed, which is convenient for operation; it also plays the role of isolating the lung on the affected side, preventing the secretions, blood, abscess, etc. of the affected lung from flowing into the healthy side. Currently, clinically used one-lung ventilation devices mainly include double-lumen endobronchial tubes (DLTs), single-lumen bronchial tubes, single-lumen endotracheal tubes combined with bronchial occluders, combined tubes of tracheal tubes and bronchial occlusion tubes (such as Univent catheters), etc. , however, each has certain drawbacks.
采用双腔支气管内导管（DLTs）进行肺隔离，常有如下缺点或并发症：（1）双腔气管导管外径较粗，行插管时常常会损伤到呼吸道；（2）双肺分隔定位较难，尤其是右上肺主支气管开口处易被套囊阻塞；（3）导管内径过细，术中易气道高压；（4）支气管套囊过度充气可引起支气管破裂；（5）可供选择的型号较少，临床受一定的限制。The use of double-lumen endobronchial tubes (DLTs) for lung isolation often has the following disadvantages or complications: (1) The outer diameter of the double-lumen endotracheal tube is relatively large, and the airway is often damaged during intubation; (2) The positioning of the lungs is separated Difficult, especially the opening of the main bronchus of the right upper lung is easily blocked by the cuff; (3) The inner diameter of the catheter is too small, and the airway is prone to high pressure during the operation; (4) Excessive inflation of the bronchial cuff can cause bronchial rupture; (5) Alternative There are fewer models, and the clinical practice is subject to certain restrictions.
采用单腔支气管导管则不能进行双肺和单肺通气的转换。一种单腔三囊支气管导管需要纤维支气管镜定位，本身不能解决困难插管问题，术毕需机械通气者需重新换。Switching between double-lung and single-lung ventilation is not possible with a single-lumen bronchial tube. A single-lumen three-bag bronchial catheter requires fiberoptic bronchoscope positioning, which cannot solve the problem of difficult intubation by itself. Those who need mechanical ventilation after the operation need to be replaced again.
采用可视导管联合支气管封堵管效果较好，但是单独的封堵管成本较高，且封堵管过长，置入时较繁琐。Using a visual catheter combined with a bronchial occlusion tube has a better effect, but the cost of a separate occlusion tube is high, and the occlusion tube is too long, making it cumbersome to insert.
采用Univent导管需要纤维支气管镜定位，其管壁有一容纳封堵管的隧道，但隧道直径过大会影响插管，直径过细会影响封堵管的活动，且封堵管过细不利于吸引血痰分泌物，有文献证实其定位时间长于双腔管，且体位变动后封堵管移位有一定发生率，需纤维支气管镜随时定位调整。不能实时动态监测封堵管移位情况，且导管本身不能引导困难插管。Using the Univent catheter requires fiberoptic bronchoscopy for positioning. There is a tunnel on the wall of the tube to accommodate the occlusion tube. However, if the diameter of the tunnel is too large, it will affect the intubation. , literature has confirmed that its positioning time is longer than that of the double-lumen tube, and there is a certain incidence of displacement of the occlusion tube after body position changes, and fiberoptic bronchoscopic positioning and adjustment are required at any time. The displacement of the occlusion tube cannot be monitored dynamically in real time, and the catheter itself cannot guide difficult intubation.
而且，目前神经外科脑功能区手术，既要准确完全切除病变组织，又不能损伤正常的运动、语言、听觉等功能，需要用到全麻术中唤醒技术。传统的方法是全麻诱导后放喉罩，术中减浅麻醉清醒后拔出喉罩，根据病人自主应答反应来行功能区肿瘤切除，切除完后加深麻醉重新置入喉罩。传统方法需插拔喉罩，病人体位固定，术中如发生癫痫或其它意外，不能及时处理，麻醉风险较大。现有一种食管鼻咽通气管，可以经鼻插入食管，堵塞食管及鼻咽口咽行声门上通气作全麻，术中唤醒时咽部气囊放气即可说话，不用插拔导管，通气及唤醒转换快，减少了风险。但是食管鼻咽通气管无可视功能，不能第一时间准确放入食道；该管通气孔位于侧孔，不利于吸痰，一旦术中血痰堵塞侧孔易发生气道高压低氧血症，术中体位变化不易监测导管移位。Moreover, the current neurosurgical brain functional area surgery requires accurate and complete resection of diseased tissue without damaging normal motor, language, hearing and other functions, and requires the use of wake-up techniques during general anesthesia. The traditional method is to place the laryngeal mask after induction of general anesthesia, remove the laryngeal mask after light anesthesia wakes up during the operation, perform tumor resection in the functional area according to the patient's own response, and reinsert the laryngeal mask after deepening the anesthesia. The traditional method needs to insert and remove the laryngeal mask, and the patient's position is fixed. If epilepsy or other accidents occur during the operation, they cannot be treated in time, and the risk of anesthesia is relatively high. There is an esophageal nasopharyngeal ventilation tube, which can be inserted into the esophagus through the nose to block the esophagus and nasopharynx oropharynx and perform supraglottic ventilation for general anesthesia. When awakened during the operation, the pharyngeal air bag can be deflated to speak, without inserting or pulling out the catheter, ventilation And the wake-up transition is fast, reducing the risk. However, the esophageal nasopharyngeal ventilation tube has no visual function, so it cannot be accurately inserted into the esophagus at the first time; the ventilation hole of the tube is located in the side hole, which is not conducive to sputum suction. Intraoperative body position changes are not easy to monitor catheter displacement.
发明内容Contents of the invention
本发明所要解决的技术问题是提供一种使用方便、可动态视频监控的可视气管导管与支气管封堵管联合管。The technical problem to be solved by the present invention is to provide an easy-to-use visual tracheal tube combined with a bronchial occlusion tube capable of dynamic video monitoring.
为解决上述技术问题所采用的技术方案：一种可视气管导管与支气管封堵管联合管，包括气管导管和支气管封堵管，在所述气管导管前端具有微型摄像头及LED灯，所述气管导管的末端伸出有与微型摄像头及LED灯相连的电线束，所述电线束具有一USB接口，所述电线束通过USB接口与一显示器相连，所述支气管封堵管穿过气管导管并从气管导管的前端伸出，所述支气管封堵管的前端具有一封堵囊和与封堵囊相连的封堵囊充气管，所述封堵囊充气管穿过气管导管从气管导管的末端伸出，所述封堵囊充气管的末端还设有一封堵囊充气阀，所述支气管封堵管的末端从气管导管的末端穿出并设有一盖帽，在所述气管导管中部还设有气管导管囊，所述气管导管囊连接有一气管导管囊充气管并从气管导管末端伸出，所述气管导管囊充气管的末端设有气管导管囊充气阀。The technical solution adopted to solve the above technical problems: a combined tube of a visual tracheal tube and a bronchial occlusion tube, including a tracheal tube and a bronchial occlusion tube, with a micro camera and an LED light at the front end of the tracheal tube, the tracheal tube The end of the catheter stretches out a bundle of wires connected to the miniature camera and LED lights, the wire bundle has a USB interface, the wire bundle is connected to a display through the USB interface, and the bronchial occlusion tube passes through the endotracheal tube and passes through the endotracheal tube The front end of the endotracheal tube stretches out, and the front end of the bronchial occlusion tube has a blockage bag and a blockage bag inflation tube connected with the blockage bag, and the blockage bag inflation tube passes through the endotracheal tube and extends from the end of the endotracheal tube. The end of the occlusion bag inflation tube is also provided with an occlusion bag inflation valve, the end of the bronchial occlusion tube passes through the end of the endotracheal tube and is provided with a cap, and a trachea is also provided in the middle of the endotracheal tube The endotracheal catheter bag is connected with an endotracheal catheter bag inflation tube and protrudes from the end of the endotracheal catheter, and the end of the endotracheal catheter bag inflation tube is provided with an endotracheal catheter bag inflation valve.
进一步，所述微型摄像头及LED灯与支气管封堵管分别相对立固定在气管导管前端两侧。Further, the micro-camera and the LED light are respectively fixed on both sides of the front end of the tracheal tube opposite to the bronchial occlusion tube.
进一步，所述支气管封堵管从气管导管的前端伸出4~5cm。Further, the bronchial occlusion tube protrudes 4-5 cm from the front end of the endotracheal tube.
进一步，所述气管导管的管壁上标识有刻度线。Further, the tube wall of the endotracheal tube is marked with scale marks.
进一步，所述气管导管和支气管封堵管采用塑料材质。Further, the tracheal tube and the bronchial blocking tube are made of plastic.
进一步，所述气管导管囊的容量为10-100ml。Further, the volume of the endotracheal tube bag is 10-100ml.
有益效果：此气管导管与支气管封堵管联合管进行插管时，通过前端设置的微型摄像头及LED灯，在可视下便于操作者进行气管插管，当气管导管经过声门后，气管导管前端左或右旋转90度，使支气管封堵管对准需要封堵的一侧支气管，封堵囊位于隆突下约0.5cm，而气管导管位于隆突上2~3cm处，气管导管囊充气以固定气管导管，术中根据需要对封堵囊充放气以便单肺或双肺通气，其中支气管封堵管还可吸引血痰或肺内空气。其中通过微型摄像头及LED灯与显示器配合全程视频监控特别是体位变动后的封堵囊移位，可随时调整气管导管深度及方向。Beneficial effects: when the endotracheal tube and bronchial occlusion tube are combined for intubation, the micro camera and LED lights arranged at the front end facilitate the operator to perform endotracheal intubation. When the endotracheal tube passes through the glottis, the endotracheal tube The front end is rotated 90 degrees left or right, so that the bronchial occlusion tube is aligned with the bronchus on the side to be occluded. The occlusion bag is located about 0.5 cm below the carina, and the endotracheal tube is located 2 to 3 cm above the carina. The endotracheal tube bag is inflated To fix the endotracheal tube, inflate and deflate the occlusion bag as needed during the operation for one-lung or double-lung ventilation, and the bronchial occlusion tube can also attract bloody sputum or air in the lung. The depth and direction of the endotracheal tube can be adjusted at any time through micro-camera, LED lights and monitors in conjunction with the whole process of video monitoring, especially the displacement of the occlusion bag after body position changes.
附图说明Description of drawings
下面结合附图和实施例对本发明做进一步的说明；Below in conjunction with accompanying drawing and embodiment the present invention will be further described;
图1为本发明实施例的结构示意图；Fig. 1 is the structural representation of the embodiment of the present invention;
图2为本发明用于单侧肺通气的示意图；Fig. 2 is the schematic diagram that the present invention is used for unilateral lung ventilation;
图3为本发明用于另一单侧肺通气的示意图；Fig. 3 is the schematic diagram that the present invention is used for another unilateral lung ventilation;
图4为本发明用于全麻术中唤醒的示意图。Fig. 4 is a schematic diagram of the present invention for awakening in general anesthesia.
具体实施方式Detailed ways
如图1所示，本发明一种可视气管导管与支气管封堵管联合管，包括气管导管1和支气管封堵管2，在气管导管1前端具有微型摄像头及LED灯11，气管导管1的末端伸出有与微型摄像头及LED灯11相连的电线束12，电线束12具有一USB接口13，电线束12通过USB接口13与一显示器3相连，支气管封堵管2穿过气管导管1并从气管导管1的前端伸出，支气管封堵管2的前端具有一封堵囊21和与封堵囊21相连的封堵囊充气管22，封堵囊充气管22穿过气管导管1从气管导管1的末端伸出，封堵囊充气管22的末端还设有一封堵囊充气阀23，支气管封堵管2的末端从气管导管1的末端穿出并设有一盖帽24，在气管导管1中部还设有气管导管囊14，气管导管囊14连接有一气管导管囊充气管15并从气管导管1末端伸出，气管导管囊充气管15的末端设有气管导管囊充气阀16。As shown in Figure 1, a combined tube of a visual tracheal tube and bronchial occlusion tube according to the present invention comprises a tracheal tube 1 and a bronchial occlusion tube 2, a micro camera and an LED light 11 are provided at the front end of the tracheal tube 1, and the end of the tracheal tube 1 The end stretches out a wire bundle 12 connected to the miniature camera and LED lamp 11, the wire bundle 12 has a USB interface 13, the wire bundle 12 is connected to a display 3 through the USB interface 13, and the bronchial blocking tube 2 passes through the endotracheal tube 1 and Stretch out from the front end of the endotracheal tube 1, the front end of the bronchial occlusion tube 2 has a blockage bag 21 and a blockage bag inflation tube 22 connected with the blockage bag 21, the blockage bag inflation tube 22 passes through the endotracheal tube 1 from the trachea The end of the catheter 1 protrudes, the end of the occlusion bag inflation tube 22 is also provided with a blockage bag inflation valve 23, and the end of the bronchial occlusion tube 2 passes through the end of the endotracheal tube 1 and is provided with a cap 24. The middle part is also provided with an endotracheal catheter bag 14, which is connected with an endotracheal catheter bag inflation tube 15 and stretches out from the end of the endotracheal tube 1, and the end of the endotracheal catheter bag inflation tube 15 is provided with an endotracheal catheter bag inflation valve 16.
在本实施例中，气管导管1的长度为30cm，在其管壁上标识有刻度线，支气管封堵管2从气管导管1的前端伸出约4~5cm，方向基本与气管导管1相平行，其中，支气管封堵管2前端的封堵囊21为蓝色的低压高容封堵囊，注气约8-15ml，借助封堵囊充气管22和封堵囊充气阀23实现对封堵囊21的充气放气，而气管导管囊14则为白色，当气管导管囊14的容量选为10-30ml时，可用于肺隔离和单肺通气；当气管导管囊14的容量选为70-100ml时，可用于神经外科术中唤醒。借助气管导管囊充气管15和气管导管囊充气阀16实现对气管导管囊14的充气放气。In this embodiment, the length of the tracheal tube 1 is 30 cm, and there are scale marks marked on the tube wall. The bronchial occlusion tube 2 protrudes from the front end of the tracheal tube 1 by about 4 to 5 cm, and the direction is basically parallel to the endotracheal tube 1. , wherein the occlusion capsule 21 at the front end of the bronchial occlusion tube 2 is a blue low-pressure high-capacity occlusion sac, about 8-15ml of gas is injected, and the occlusion is realized by means of the occlusion sac inflation tube 22 and the occlusion sac inflation valve 23. The inflation and deflation of the bag 21, while the endotracheal catheter bag 14 is white, when the capacity of the endotracheal catheter bag 14 is selected as 10-30ml, it can be used for lung isolation and single-lung ventilation; when the capacity of the endotracheal catheter bag 14 is selected as 70- When 100ml, it can be used for awakening during neurosurgery. Inflation and deflation of the endotracheal catheter bag 14 is realized by means of the endotracheal catheter bag inflation tube 15 and the endotracheal catheter bag inflation valve 16 .
如图2和图3所示，通过此气管导管与支气管封堵管联合管进行插管时，气管导管1中可放入普通管芯，距气管导管1前端约5-7cm处包括支气管封堵管2在内向上折弯30至50度角，通过电线束12与显示器3相连，在可视下进行气管插管，当气管导管1过声门后，拔出管芯，气管导管1左或右旋转90度，使支气管封堵管2对准需要封堵的一侧支气管，封堵囊21位于隆突下约0.5cm，而气管导管1位于隆突上2~3cm处，气管导管囊14充气以固定气管导管1，通过微型摄像头及LED灯11与显示器3配合全程视频监控特别是体位变动后的封堵囊21移位，可随时调整气管导管1深度及方向。术中根据需要对封堵囊21充放气以便单肺或双肺通气，其中支气管封堵管2还可吸引血痰或肺内空气，当双肺通气时需在支气管封堵管2末端盖上盖帽24，单肺通气时打开。术毕将抽尽气的联合管退至总气管中进行复苏，危重病人可不必换管送至重症监护室ICU。As shown in Figure 2 and Figure 3, when intubating through the combined tube of the endotracheal tube and the bronchial occlusion tube, a common stylet can be placed in the endotracheal tube 1, and the distance from the front end of the endotracheal tube 1 is about 5-7cm including the bronchial occlusion The tube 2 is bent upward at an angle of 30 to 50 degrees, connected to the monitor 3 through the wire bundle 12, and the endotracheal intubation is performed under visibility. Rotate to the right by 90 degrees, so that the bronchial occlusion tube 2 is aligned with the bronchus on the side to be occluded. The occlusion bag 21 is located about 0.5 cm below the carina, while the endotracheal tube 1 is located 2-3 cm above the carina. The endotracheal tube bag 14 Inflate to fix the endotracheal tube 1, through the micro camera and LED light 11 and the display 3 to cooperate with the whole video monitoring, especially the displacement of the blocking bag 21 after the body position changes, the depth and direction of the endotracheal tube 1 can be adjusted at any time. During the operation, inflate and deflate the blocking bag 21 according to the need for one-lung or double-lung ventilation. The bronchial blocking tube 2 can also attract bloody sputum or air in the lungs. When ventilating both lungs, the end of the bronchial blocking tube 2 should be covered. Cap 24, open during one-lung ventilation. At the end of the operation, the exhausted combined tube is returned to the common trachea for resuscitation, and critically ill patients can be sent to the ICU without having to change the tube.
如图4所示，本气管导管与支气管封堵管联合管也可用于术中唤醒。方法：气管导管囊14的容量增加到70-100ml即可。全麻后（尽量不用肌松剂），经鼻可视下放本联合管至鼻咽部，再可视下将支气管封堵管2置入食道下2-3cm，将封堵囊21与气管导管囊14充气，以堵塞食道及鼻咽、口咽部实现声门上通气，术中清醒时气管导管囊14放气即可说话，与食管鼻咽管相比，优势有4点：1、可视化操作，2、术中吸痰方便；3、必要时可以术毕在可视下将导管插入气管带管回脑外科重症监护室；4、主要用于胸科的肺隔离及单肺通气。As shown in Figure 4, the combination tube of the endotracheal tube and bronchial occlusion tube can also be used for intraoperative wake-up. Method: The volume of the endotracheal tube bag 14 can be increased to 70-100ml. After general anesthesia (must not use muscle relaxants as much as possible), lower the combined tube to the nasopharynx through the nose, and then place the bronchial occlusion tube 2 into the lower esophagus 2-3cm, and connect the occlusion bag 21 with the endotracheal tube The balloon 14 is inflated to block the esophagus, nasopharynx, and oropharynx to realize supraglottic ventilation. When the endotracheal tube is awake during the operation, the balloon 14 can be deflated to speak. Compared with the esophageal nasopharyngeal tube, it has four advantages: 1. Visualization Operation, 2. It is convenient to suck sputum during the operation; 3. If necessary, after the operation, the catheter can be inserted into the trachea and brought back to the intensive care unit of brain surgery under visualization; 4. It is mainly used for lung isolation and single-lung ventilation in thoracic department.
上面结合附图对本发明的实施方式作了详细说明，但是本发明不限于上述实施方式，在所述技术领域普通技术人员所具备的知识范围内，还可以在不脱离本发明宗旨的前提下作出各种变化。The embodiments of the present invention have been described in detail above in conjunction with the accompanying drawings, but the present invention is not limited to the above embodiments, and can also be made without departing from the gist of the present invention within the scope of knowledge of those of ordinary skill in the art. Variations.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201410834368.8ACN104491976A (en) | 2014-09-05 | 2014-12-26 | Visible tracheal catheter and bronchus blocking tube connecting tube |
| Application Number | Priority Date | Filing Date | Title |
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| CN201420513285 | 2014-09-05 | ||
| CN2014205132854 | 2014-09-05 | ||
| CN201410834368.8ACN104491976A (en) | 2014-09-05 | 2014-12-26 | Visible tracheal catheter and bronchus blocking tube connecting tube |
| Publication Number | Publication Date |
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| CN104491976Atrue CN104491976A (en) | 2015-04-08 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201410834368.8APendingCN104491976A (en) | 2014-09-05 | 2014-12-26 | Visible tracheal catheter and bronchus blocking tube connecting tube |
| Country | Link |
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| CN (1) | CN104491976A (en) |
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| US20030051733A1 (en)* | 2001-09-10 | 2003-03-20 | Pulmonx | Method and apparatus for endobronchial diagnosis |
| CN201235136Y (en)* | 2008-06-04 | 2009-05-13 | 贺定辉 | Bronchus block pipe guide |
| CN201404561Y (en)* | 2009-05-14 | 2010-02-17 | 王令平 | Invisible tracheal catheter |
| CN201735038U (en)* | 2010-08-09 | 2011-02-09 | 高宏 | Visible trachea cannula core |
| CN103330985A (en)* | 2013-07-03 | 2013-10-02 | 李伟 | Blocking sleeve tube with double bronchi alternated |
| CN204428601U (en)* | 2014-12-26 | 2015-07-01 | 广州中医药大学第一附属医院 | A kind of invisible tracheal catheter combines pipe with bronchus shutoff pipe |
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| CN106139350A (en)* | 2016-07-06 | 2016-11-23 | 河南驼人医疗器械集团有限公司 | A kind of integrated shooting visual trachea cannula |
| CN109009309A (en)* | 2018-09-06 | 2018-12-18 | 上海中医药大学附属曙光医院 | A kind of visual bronchial occlusive device |
| CN110124172A (en)* | 2019-06-21 | 2019-08-16 | 上海中医药大学附属曙光医院 | Visual side guiding tracheal catheter external member |
| CN114159663A (en)* | 2021-02-22 | 2022-03-11 | 上海交通大学医学院附属第九人民医院 | Trachea cannula device |
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| Date | Code | Title | Description |
|---|---|---|---|
| C06 | Publication | ||
| PB01 | Publication | ||
| C10 | Entry into substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| RJ01 | Rejection of invention patent application after publication | ||
| RJ01 | Rejection of invention patent application after publication | Application publication date:20150408 |