Disclosure of Invention
The invention aims to overcome the defects of the prior art and provide a visual stomach tube with an anesthetic function, a using method and a system, wherein the device can provide image guidance in the intubation process, the anesthetic can be controllably released outside the stomach tube, the operation difficulty of the intubation is reduced, the discomfort of a patient can be relieved, and the success rate of the intubation is improved.
The invention provides the following technical scheme:
the invention provides a visual stomach tube with an anesthetic function, which comprises:
the image acquisition structure comprises a first shooting structure, and the first shooting structure is connected with the front end of the stomach tube and is used for carrying out image acquisition operation when the stomach tube is inserted;
The anesthetic release structure is arranged on the wall of the stomach tube and can release anesthetic out of the stomach tube;
And the controller is used for controlling the anesthetic release structure to release the anesthetic.
The gastric tube is characterized in that at least one first cavity is arranged in the gastric tube, at least one part of the tube wall of the first cavity is in contact with the outside, at least one end of the first cavity, which faces the front end of the gastric tube, is closed, anesthetic circulates in the first cavity, a plurality of secretion ports capable of opening and closing are axially arranged on the tube wall of the first cavity, and the controller is used for controlling the opening and closing of the secretion ports.
Further, the device also comprises an interlayer cavity formed by the inner tube wall of the stomach tube and the outer tube wall of the stomach tube, wherein the interlayer cavity is provided with a containing space which can contain anesthetic;
the outer tube wall is provided with a micropore channel which penetrates through the outer tube wall and is communicated with the interlayer cavity and the outside of the stomach tube;
The microporous passageway is capable of remaining closed in response to pressure when the hydraulic or pneumatic pressure within the sandwich cavity is below a first threshold and conducting when the first threshold is exceeded.
Further, the device also comprises an esophagus monitoring structure, status data of the esophagus is collected through the esophagus monitoring structure, the controller is used for judging whether the user has vomiting reaction or not based on the status data of the esophagus, and if so, the anesthetic releasing structure is triggered to execute anesthetic releasing operation.
Further, the esophagus monitoring structure comprises a second shooting structure capable of extending into the stomach tube and used for collecting image data of the esophagus and a pressure sensor.
The pressure sensor is embedded in the wall of the stomach tube and is close to the surface of the stomach tube, a micro air bag is arranged below the pressure sensor, and the pressure sensor is protruded towards the direction close to the wall of the stomach tube by inflating and expanding the micro air bag, or is retracted by deflating and retracting the pressure sensor towards the direction far from the wall of the stomach tube.
Further, the pressure sensor comprises an annular structure integrally formed with the gastric tube.
The invention provides a use method realized by the visual stomach tube with anesthesia function, which comprises the following steps:
s1, performing image acquisition operation through an image acquisition structure;
S2, in the image acquisition process, the controller controls the anesthetic release structure to release the anesthetic out of the stomach tube.
Further, S2 further includes collecting esophageal status data of the user, determining whether a vomiting reaction exists in the user, and if so, performing an anesthetic release operation.
The invention provides a visual gastric tube system, which comprises the visual gastric tube with anesthetic function.
Compared with the prior art, the invention has the following advantages and positive effects by taking the technical scheme as an example:
according to the invention, the visual function is combined with the stomach tube, and the image acquisition structure is used for realizing real-time image guidance in the whole intubation process, so that the risk of misoperation caused by blind insertion operation is obviously reduced, the operation difficulty is reduced, the intubation time is shortened, and the intubation efficiency is improved.
Through setting up the anesthetic release structure on the stomach tube pipe wall, control through the controller, can release anesthetic outward to the stomach tube as required, can effectively alleviate the mucous membrane irritation symptom of persistence, reduce the physiology uncomfortable sense and the resistance of patient intubate in-process, improved the adaptability of stomach tube under difficult intubate scene, the operation degree of difficulty and success rate.
The anesthetic release structure is simple in overall design, small in influence on occupation of original space of the gastric tube, and the volume of the gastric tube cannot be additionally increased, so that adverse influence on tube insertion operation is avoided.
By means of the controller, the release of anesthetic can be effectively controlled. And by matching with an esophagus monitoring structure, acquiring state data of the esophagus in real time. If the patient is monitored to have vomiting response, the controller automatically triggers the anesthetic release structure to release the anesthetic, and timely responds to the physiological change of the patient to intervene, so that discomfort of the patient is relieved, and the failure probability of intubation is reduced.
Detailed Description
The drug concentration-adjustable labor analgesia device disclosed by the invention is further described in detail below with reference to the accompanying drawings and specific examples. It should be noted that the technical features or combinations of technical features described in the following embodiments should not be regarded as being isolated, and they may be combined with each other to achieve a better technical effect. In the drawings of the embodiments described below, like reference numerals appearing in the various drawings represent like features or components and are applicable to the various embodiments. Thus, once an item is defined in one drawing, no further discussion thereof is required in subsequent drawings.
It should be noted that the structures, proportions, sizes, etc. shown in the drawings are merely used in conjunction with the disclosure of the present specification, and are not intended to limit the applicable scope of the present invention, but rather to limit the scope of the present invention. The scope of the preferred embodiments of the present invention includes additional implementations in which functions may be performed out of the order described or discussed, including in a substantially simultaneous manner or in an order that is reverse, depending on the function involved, as would be understood by those of skill in the art to which embodiments of the present invention pertain.
Techniques, methods, and apparatus known to one of ordinary skill in the relevant art may not be discussed in detail, but are intended to be part of the specification where appropriate. In all examples shown and discussed herein, any specific values should be construed as merely illustrative, and not a limitation. Thus, other examples of the exemplary embodiments may have different values.
The present invention provides a visual gastric tube 100 with anesthetic function, as shown in fig. 1, the gastric tube 200 comprising:
the image acquisition structure comprises a first camera structure 300, wherein the first camera structure 300 is arranged at the front end of the stomach tube 200 and is used for performing image acquisition operation when the stomach tube 200 is inserted.
In one embodiment, the first camera structure 300 includes a first camera and a strut 310 for supporting the first camera, where the strut 310 drives the first camera to move by pulling the strut 310, and can enter the gastric tube 200, move back and forth in the gastric tube 200, or leave the gastric tube 200.
Optionally, the first camera structure 300 is removably attached to the front end of the gastric tube 200, including but not limited to a snap-in, adhesive, friction connection. Specifically, for example, a latch is provided on the first camera, a slot is correspondingly provided at the front end of the stomach tube 200, and the latch is inserted through the latch
The anesthetic release structure is arranged on the wall of the stomach tube 200 and can release anesthetic out of the stomach tube 200.
And the controller is used for controlling the anesthetic release structure to release the anesthetic.
As shown in fig. 2, at least one first channel 210 is disposed in the gastric tube 200, the first channel 210 is disposed in the gastric tube 200, has a lumen independent of the gastric tube 200, and has at least a portion of the wall contacting the outside, and anesthetic flows into the first channel 210.
The first lumen 210 may be provided on the wall of the single-sided gastric tube 200, or the first lumen 210 may be provided on both walls of the double-sided gastric tube 200.
The first channel 210 is closed at one end facing the front end of the gastric tube 200, and is open at the other end, or is selectively opened by providing a cover capable of opening and closing at the end.
The anesthetic agent may be introduced into the first channel 210 through an open end, and may be pre-injected a predetermined amount prior to insertion, or may be injected into the first channel 210 as desired during insertion.
The anesthetic agent may be in gel or liquid form.
The wall of the first cavity 210 is provided with a plurality of openable secretion ports 220 along the axial direction, and as a typical implementation manner, the secretion ports 220 are provided with gates 230, and the controller controls the opening and closing of the gates 230, so as to control the opening and closing of the secretion ports 220.
When the stoma 220 is open, anesthetic agent enters the space outside the gastric tube 200 through the stoma 220. When the secretion port 220 is closed, the anesthetic stops flowing out.
In another embodiment, as shown in fig. 3, the device further comprises a interlayer cavity 260 formed by the inner tube wall 240 of the gastric tube 200 and the outer tube wall 250 of the gastric tube 200, wherein the interlayer cavity 260 has a containing space and can contain anesthetic agent.
The outer tube wall 250 is provided with a micro-porous channel 261 which penetrates the outer tube wall 250 and communicates the interlayer cavity 260 with the outside of the gastric tube 200.
The micro-porous channel 261 has a pressure response characteristic that remains closed when the hydraulic or pneumatic pressure within the sandwich chamber 260 is below a first threshold value and is conductive when the first threshold value is exceeded.
The microporous passageway 261 remaining closed is primarily accomplished by at least one of the following:
Specifically, the pore size of the microporous passageway 261 is small, and the anesthetic cannot leak out because the surface tension of the end of the microporous passageway remains closed to form a physical barrier.
Or the liquid forms a gas-liquid interface in the micropore channel 261, the liquid forms a concave meniscus at the micropore outlet, and the capillary pressure generated by the surface tension is balanced with the external pressure, which is equivalent to forming a natural seal by utilizing the surface tension of the liquid.
Alternatively, the micro-porous channel 261 is made of, for example, an elastic material such as a medical silicone rubber material, and is closed by elastic shrinkage of the material in a natural state.
Further, the microporous channel 261 employs a tapered channel with a wide inlet and a narrow outlet.
When the micro-porous channel 261 is subjected to hydraulic or pneumatic pressure exceeding a first threshold, the conducting process mainly comprises at least one of the following steps:
In the case where the pore diameter of the microporous passageway 261 is extremely small and self-structural tension causes closure, when the internal pressure of the interlayer exceeds the capillary pressure, the fluid starts to infiltrate outward from the center of the pore channel, disrupting the gas-liquid interface balance, and forming a continuous liquid flow. The external pressure overcomes the intermolecular forces, causing the liquid to wet the walls of the pores and flow outwardly.
Similarly, in the case of a dominant closure of the liquid surface tension, as the internal pressure of the interlayer of the tube wall increases, the liquid moves towards the micropores under pressure drive, and the radius of curvature of the meniscus gradually decreases. When the internal pressure of the interlayer exceeds the capillary pressure, the kinetic energy of liquid molecules overcomes the potential energy of surface tension, the meniscus is destroyed, the liquid begins to wet the wall of the hole, the interface energy of the gas phase and the liquid phase is unbalanced, and the anesthetic is oozed outwards through the micropore channel 261 under the driving of pressure.
In the case that the interlayer of the pipe wall is made of an elastic material, when the hydraulic pressure or the air pressure in the interlayer of the pipe wall exceeds a first threshold value, the hole wall material of the micropore channel 261 is elastically deformed to be expanded and deformed, the inner diameter is increased, and the anesthetic agent is allowed to seep outwards through the micropore channel 261.
The device also comprises an esophagus monitoring structure, status data of the esophagus is acquired through the esophagus monitoring structure, the controller is used for judging whether the user has vomiting reaction or not based on the status data of the esophagus, and if so, the anesthetic releasing structure is triggered to execute anesthetic releasing operation.
As shown in fig. 4, the esophageal monitoring structure includes a second camera structure 400 that can extend into the stomach tube 200 to collect image data of the esophagus as one of status data of the esophagus.
As one of the typical embodiments, the second camera structure 400 is similar to the first camera structure 300, and includes a second camera and a support rod 310 for supporting the second camera, and the second camera is driven by the support rod 310 to move into the gastric tube 200 or to leave the gastric tube 200.
The connecting piece 320 is arranged on the wall of the stomach tube 200 and can be detachably connected with the second camera, so that the second camera is fixed on the wall of the stomach tube 200, and the images in the body of a user outside the stomach tube 200 can be acquired through the wall of the transparent stomach tube 200, and can be static or dynamic.
Processing and analyzing the image data, extracting key visual information capable of reflecting the state of esophagus, and comparing the extracted information with a preset judgment standard, wherein the processing and analyzing method mainly comprises the following steps of:
Monitoring the change in shape of the esophagus, identifying the outline morphology of the esophagus, and normally, slightly contracting and expanding the esophagus when swallowing food. In the vomiting reaction, obvious over-dilatation or irregular contraction may occur in the esophagus. Tracking the morphological change of the inner wall of the esophagus, and judging whether an abnormal peristaltic mode appears. If the esophageal contractions are more frequent and stronger than those of normal swallowing, and of longer duration, this may indicate the onset of an vomiting response.
The flow of the internal liquid or substance is monitored. During vomiting, the stomach contents often reflux into the esophagus, forming a fluid or solid material flow characteristic. If the presence of foreign or irregular matter appears in the image, it can be determined that this is a precursor to vomiting.
The esophageal monitoring structure also includes a pressure sensor 500.
When the vomiting reflex is initiated, the esophagus undergoes a strong contraction in the opposite direction to normal peristalsis, which creates unique pressure fluctuations in different sections of the esophagus, and pressure data is collected by pressure sensor 500, tracking the direction of propagation, intensity gradient, and duration of the pressure fluctuations. The orderly progressive pressure change generated by normal swallowing is obviously different from the abnormal multimodal oscillation waveform during vomit, and whether the vomit reaction exists or not is judged by comparing the preset standard pressure waveform of normal swallowing with all aspects of the acquired pressure waveform.
When the pressure waveform is abnormal, the linkage camera unit verifies whether synchronous liquid level rising or mucous membrane cramping exists, and the interference factors such as cough, hiccup and the like are eliminated through multi-mode data cross verification, so that the accuracy of vomiting reaction is improved.
As a typical embodiment, the pressure sensor 500 is embedded in the wall of the gastric tube 200 and the pressure sensor 500 is located near the surface of the gastric tube 200, collecting the relative pressure data between the gastric tube 200 and the esophagus of the user.
Further, a micro-balloon 520 is disposed below the pressure sensor 500, and the pressure sensor 500 is protruded in a direction approaching the wall of the food tube by inflating the micro-balloon 520. The outer tube wall 250 of the stomach tube 200 above the pressure sensor 500 can be made of a material with higher flexibility, when the micro air bag 520 jacks the pressure sensor 500, the pressure surface of the outer tube wall 250 is partially deformed to form contact bumps, so that the pressure sensor 500 is relatively closer to the food tube wall of a user, the pressure sensor 500 is more convenient to collect pressure data, and the overall shape of the stomach tube 200 is not influenced, so that the disadvantage of intubation is caused.
The inner tube wall 240 of the gastric tube 200 below the pressure sensor 500 may be made of a material having a higher hardness than the outer tube wall 250, thereby maintaining the structural strength of the gastric tube 200 as a whole to prevent collapse during insertion.
When the micro balloon 520 is deflated, the pressure sensor 500 is retracted relatively away from the wall of the food tube.
In particular, the micro balloon 520 may be inflated during the process of collecting pressure data, and deflated when the gastric tube 200 needs to be withdrawn.
In another embodiment, as shown in fig. 5, the pressure sensor 500 includes an annular structure 510 integrally formed with the gastric tube 200.
The integrated into one piece design eliminates the risk of droing of external part, and the surface is smooth seamless, reduces mucous membrane fish tail probability to can not cause the increase of stomach tube 200 external diameter, avoid influencing the intubate operation.
When peristaltic movement or spasm occurs in the esophagus, muscle contraction force is transmitted to the annular structure contacted with the esophagus through the esophagus wall, and pressure data of different positions of the esophagus wall can be acquired simultaneously through the pressure sensitive element above.
And triggering the anesthetic release structure to release anesthetic when the controller judges that the user has vomiting reaction according to the acquired esophageal state data.
As one embodiment, the controller determines whether the user has a vomiting response according to the following formula.
For example, Desoph(t) = Drest + (ΔR(t) * Kr) + (ΔP(t) * Kp
Wherein Desoph(t) represents the esophageal diameter estimated at time t.
Drest represents the intrinsic internal diameter of the esophagus in a relaxed state, without swallowing, retching, coughing, etc., and without external stimuli, where the intrinsic internal diameter is usually preset, and different preset values are set according to different patients, such as adult males, adult females, elderly males, elderly females, children.
No external stimulus "refers to no pathological level stimulus (such as intubation friction, vomiting reflex), excluding microstimulation that may be applied during diagnosis.
Δr (t) represents the radial deformation amount of the annular sensor at time t due to pressure, and the contraction is negative and the expansion is positive.
Can be obtained by sensor internal strain measurements, such as:
the annular sensor comprises a flexible contact layer, a strain sensing array and a temperature compensation module, wherein the strain sensing array is composed of at least one group of symmetrically distributed metal strain gauges.
ΔR(t) = R0× (Δε(t) / εmax)
ΔR (t) is the amount of radial deformation of the sensor at time t, in millimeters, relative to the amount of initial radial change.
R0, the initial radius (factory calibration or calibration value before intubation) of the sensor in an unstressed state, and the unit millimeter.
And delta epsilon(t), namely the resistance change rate of the strain gauge at the time t, and reflecting the expansion degree of the material.
Epsilonmax maximum measurable strain of the strain gage (determined by material properties and manufacturing process).
Kr represents a deformation-diameter conversion coefficient determined by the physical structure and material characteristics of the annular sensor, and is usually a preset fixed value.
Δp (t) represents the amount of change in pressure Psensor(t） measured by the loop sensor at time t from baseline Prest.
ΔP(t)=Psensor(t)-Prest
Prest is intra-cavity pressure of the esophagus in a state of no autonomous contraction, no external stimulus and complete relaxation of the muscle, represents physiological equilibrium pressure of the esophagus smooth muscle under zero tension, and is a reference zero point of dynamic pressure change. The method can be obtained by the following steps:
Through set up the gasbag that can expand on the pipeline of intubate, be provided with pressure sensor in the gasbag, can gather pressure.
A) Inserting the pipeline into the esophagus of the patient, suspending the intubation operation for 60 seconds, and recovering the esophagus of the patient from mechanical stimulation, wherein the esophagus of the patient can be regarded as being in a relaxed state;
b) The balloon is inflated so that the balloon is inflated to contact the patient's esophagus, applying pressure to the esophageal wall, which is severely limited to a small value, such as 5.0±0.2mmHg, and strictly controlling the application time, such as 0.1 seconds.
The duration is short, the pressure value is small, and the stimulation belongs to the microstimulation applied in diagnosis and does not belong to external stimulation caused to esophagus.
C) After the pressure of the air bag is stable, the pressure sensor collects pressure data.
D) Summarizing the pressure data, taking the median of the pressure data as Prest.
Kp represents the pressure-diameter conversion coefficient determined by the biomechanical properties of the esophageal wall and the sensor structure, and can be calibrated or preset.
Desoph(t) is compared to a telescoping depth threshold Dthreshold and the duration T is compared to a preset threshold Tthreshold.
When Desoph(t)≤Dthreshold and T is more than or equal to Tthreshold, the user is judged to have vomiting reaction.
By way of example, such as:
Suppose that Kr is-0.85, Kp is-0.15, and Tthreshold (time threshold) is 0.3.3 seconds.
At the initial time, measured by image data, t=0, Desoph(t) =20 mm, Dthreshold=Desoph(t) ×w, assuming W is 30%, when the esophageal diameter is contracted to 30% of the resting diameter, this means a 70% diameter reduction, i.e. a contraction of 70%.
Dthreshold =20×0.3 =6 mm.
The W coefficient can be a fixed preset value, different values can be preset according to different conditions of patients, such as adults, old people and children, and clinical data can be collected for calibration at a later period on the basis of the preset values. 30% is merely an example, and is not a specific limitation in actual implementation.
Also, Kr,Kp is only an example, and is not a specific limitation in practical implementation. Different values are preset in specific implementation, clinical data are collected in later period for calibration,
For example, at time t1, ΔR (t) is-11.8 mm, ΔP (t) is 160mmHg, Desoph(t) is 6.03 mm, > Dthreshold.
At some point t2, ΔR (t) is-12.6 mm, ΔP (t) is 165mmHg, Desoph(t) is 4.55 mm, < Dthreshold.
At time t3, ΔR (t) is-13.0 mm, ΔP (t) is 170mmHg, Desoph(t) is 5.0 mm, < Dthreshold.
Between T1 and T2, the duration t=t1-t2 is 1 second.
Desoph(t)＞Dthreshold, and T is greater than Tthreshold, whereby the user is determined to be not present with vomiting response.
Between T2 and T3, the duration t=t2-t3 is 1 second.
Desoph(t)≤Dthreshold, and T≥Tthreshold, based on which it is determined that the user has a vomiting response.
Specifically, the controller triggers the opening of the secretion port 220, and the amount of anesthetic agent released is monitored by the flow sensor, creating an intervention mechanism for the vomiting reflex.
When the release amount reaches a preset threshold, the secretion port 220 is closed again, stopping the release of anesthetic. And then monitoring the state of the esophagus again through the esophagus monitoring structure, judging whether the vomiting reaction of the user is eliminated after the anesthetic is released, and triggering the release operation of the anesthetic again if the vomiting reaction still exists, and repeating the processes until the vomiting reaction of the user is eliminated.
The amount of the single-release anesthetic is preset to ensure the safety of the anesthetic operation, and the upper limit of the total amount of the released anesthetic is preset under the condition that the repeated release is needed, and when the upper limit is reached, the controller can forcibly terminate the anesthetic release operation no matter whether the user still has vomiting reaction or not.
Still further, when the controller releases the anesthetic, the amount or rate of release is precisely controlled based on the actual physical pressure conditions within the esophagus to prevent over-release or under-effects.
The controller adjusts the release rate of the anesthetic agent according to the following formula:
Q(t) = K * max(Pesoph(t) - Pthreshold,0)
wherein Q (t) is the rate of anesthetic release at time t in units of volume/time or mass/time.
K is a scaling factor that is a constant determined based on the physical characteristics of the catheter and the nature of the anesthetic agent.
Pesoph(t) is the esophageal pressure measured by the pressure sensor at time t.
Pthreshold is a pressure threshold for triggering anesthesia release, and can be a fixed preset value, and can be respectively preset with different values according to different conditions of patients, such as adults, old people and children, and can also be calibrated by collecting clinical data in later period based on the preset value.
Max (Pesoph(t) - Pthreshold, θ) is a condition for controlling the release rate of anesthetic agent by the control center.
If Pesoph(t) - Pthreshold <0, taking a larger value of 0, if the esophageal pressure Pesoph(t) is less than the threshold Pthreshold, then the release rate Q (t) =Kx0=0.
Only when the esophageal pressure Pesoph(t) exceeds the threshold Pthreshold, Pesoph(t) - Pthreshold >0, taking this positive value, the release rate Q (t) =k× (Pesoph(t) - Pthreshold), the release rate Q (t) is positive.
The control center can correspondingly open the secretion port only when the esophageal pressure exceeds a preset threshold value, or the micropore channel can be opened automatically, the anesthetic can be released, otherwise, the release rate is zero, and the release rate of the anesthetic is proportional to the pressure value exceeding the threshold value.
The present invention provides a method of use by a visualised gastric tube 100 with anaesthetic function as described in any one of the above, as shown in fig. 6, the method comprising the steps of:
s1, performing image acquisition operation through an image acquisition structure.
S2, in the image acquisition process, the controller controls the anesthetic release structure to release the anesthetic out of the stomach tube 200.
Further, S2 further includes collecting esophageal status data of the user, determining whether a vomiting reaction exists in the user, and if so, performing an anesthetic release operation.
The present invention also provides a visual gastric tube system comprising a visual gastric tube 100 with anaesthetic function as described in any one of the above.
The components may be selectively and operatively combined in any number within the scope of the present disclosure. In addition, terms like "comprising," "having," and the like should be construed by default as inclusive or open-ended, rather than exclusive or closed-ended, unless expressly defined to the contrary. All technical, scientific, or other terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Common terms found in dictionaries should not be too idealized or too unrealistically interpreted in the context of the relevant technical document unless the present disclosure explicitly defines them as such.
It will be evident to those skilled in the art that the invention is not limited to the details of the foregoing illustrative embodiments, and that the present invention may be embodied in other specific forms without departing from the spirit or essential characteristics thereof. The present embodiments are, therefore, to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein. Any reference sign in a claim should not be construed as limiting the claim concerned.
Furthermore, it should be understood that although the present disclosure describes embodiments, not every embodiment is provided with a separate embodiment, and that this description is provided for clarity only, and that the disclosure is not limited to the embodiments described in detail below, and that the embodiments described in the examples may be combined as appropriate to form other embodiments that will be apparent to those skilled in the art.