CN103330985B

CN103330985B - Two bronchus replaces shutoff sleeve pipe

Info

Publication number: CN103330985B
Application number: CN201310275927.1A
Authority: CN
Inventors: 李伟
Original assignee: Individual
Current assignee: Individual
Priority date: 2013-07-03
Filing date: 2013-07-03
Publication date: 2016-01-20
Anticipated expiration: 2033-07-03
Also published as: CN103330985A

Abstract

The invention belongs to medical instruments field.Be specifically related to a kind of two bronchus and replace shutoff sleeve pipe, be made up of two bronchus shutoff pipe, endotracheal tube and moulding seal wire.Two bronchus shutoff pipe end is provided with Y shape knuckle fork, straddles on trachea carina, two bifurcated is equipped with cuff after insertion, can quick position, fixing, strong Ipsilateral two lung of isolation, realizes one-lung ventilation.The conductor housing end opening of endotracheal tube and catheter body is suitable for reading is equipped with bayonet socket, fixing two bronchus shutoff pipe after docking.Structure of the present invention is simple, reasonable in design, and advantage the most outstanding is the double cuff structure on shutoff pipe bifurcated, for wet lung and pulmonary belb patient safe and reasonable more; Do not need branchofiberoscope to assist when secondly inserting and just easily can realize accurate location, the two lung of isolation fast; If moreover postoperatively need use respirator, only need pull out bronchus shutoff pipe, avoid in art the secondary intubate replace tubes after using double lumen endobronchial tube.

Description

Two bronchus replaces shutoff sleeve pipe

Technical field

The invention belongs to medical instruments field, be specifically related to a kind of two bronchus and replace shutoff sleeve pipe.

Background technology

One-lung ventilation is that open chest surgery is as management of respiratory method conventional in the operations such as Resection Esophagus Carcinoma, lobectomy of lungs, stripping of the pleura operation, thoracic spine surgery, thoracoscope.Can make art side lung static, wither, facilitate operation technique; Also play the effect of strong Ipsilateral lung isolation, prevent the secretions of Ipsilateral lung, blood, abscess etc. from flowing into strong side.One-lung ventilation device conventional clinically at present mainly contains double lumen endobronchial tube intubate, bronchial obstruction conduit and single lumen endobronchial tube, but there is certain technological deficiency separately.

Double lumen endobronchial tube intubate first location difficulty, often need debug repeatedly, even needs, by fibre bronchus mirror location, easily to cause airway mucus to damage; Secondly, ventilation complex management, higher to anesthetist's level requirement, otherwise easily there is the serious consequences such as hypoxemia; Again, double lumen endobronchial tube external diameter is comparatively large, and each lumen diameter is less, is not suitable for child, and during mechanical ventilation, airway pressure is higher, and long-time high airway pressure ventilation easily causes mechanicalness injury of lung; Further, if postoperative patient needs mechanical ventilation, secondary intubate of having to is replaced by single-lumen bronchial tube.

Conventional bronchial obstruction conduit have Univent conduit, Arndt conduit, Forgaty conduit etc. several, so all need to realize location by fibre bronchus mirror, the basic hospital not possessing fibre bronchus mirror at some cannot use.Cao Hui discloses a kind of branch type bronchial blocker assembly (application number 201120191745.2), trachea carina can be utilized directly to locate when not using fibre bronchus mirror, but it equally with bronchial obstruction conduit conventional on the market has following defect, first have for the patient of wet lung and face strong side lung by the risk of flooding, although bronchial obstruction conduit has suction function, if can in actual application its blocking cuff in the deflated condition its attract effect be very little, and once the cuff that comes loose attracts, secretions in Ipsilateral lung, blood or pus will certainly flow into strong side lung, lead to grave consequences, moreover when needing the lung inflation of withering to Ipsilateral to open again in art, offside Hyperinflation must be caused, if offside lung exists the pathological changes such as bulla, cause possibly and break, cause the consequences such as pneumothorax.

There is all deficiencies because of it in single lumen endobronchial tube, clinically seldom uses.

Summary of the invention: the present invention has the plurality of advantages of existing one-lung ventilation device and overcomes above-mentioned all technological deficiencies.It is simple to operate, and do not use fibre bronchus mirror just can easily realize quick and precisely locating, two lung isolation effect is definite; When attracting Ipsilateral secretions, blood or pus, first to strong collateral shutoff sleeve bag gas-filling, then make Ipsilateral prop up shutoff cuff deflation, more fully attract through shutoff pipe or endotracheal tube, thoroughly remove Ipsilateral secretions, available protecting is good for side lung and is flooded, safe and reliable; At strong collateral shutoff sleeve bag gas-filling, Ipsilateral props up multiple of the state descending Ipsilateral lung inflation of shutoff cuff deflation, effectively can avoid strong side Hyperinflation, particularly applicable to bulla patient; In the present invention, shutoff pipe external diameter is much smaller than endotracheal tube internal diameter, and without the conductor housing (conductor housing end opening is the most narrow positions of endotracheal tube) of endotracheal tube when inserting, at utmost reduce aeration resistance, reduce mechanical ventilation airway pressure, greatly reduce injury of lung probability, more outstanding for child's effect; This sleeve pipe, regardless of left right model, avoids the trouble selecting left and right pipe; Postoperatively can conveniently pull out shutoff pipe, retain trachea tubes connection respirator, avoid intubate again.

Technical scheme of the present invention realizes in the following manner: a kind of two bronchus replaces shutoff sleeve pipe, comprises endotracheal tube, two bronchus shutoff pipe and moulding seal wire.It is characterized in that: described endotracheal tube comprises catheter adapter, catheter body, conduit capsule, conduit capsule charge valve, conduit capsule gas tube, conduit end opening.The described pair of bronchus shutoff pipe comprises that tube chamber is suitable for reading, tube chamber upper flap, shutoff pipe body, knuckle fork, shutoff pipe are good for collateral, that shutoff pipe Ipsilateral props up, strong collateral and Ipsilateral props up bronchus Plugging brusa, Plugging brusa charge valve, Plugging brusa gas tube.Described moulding seal wire is flexible arc tinsel.

The connection respirator suitable for reading of described conductor housing or the loop of anesthetic machine, end opening connecting duct body.Described catheter slipjoint end opening has a n shape bayonet socket, and in the middle part of joint, there is flank both sides, and one of them flank is provided with small structure.Described endotracheal tube body is suitable for reading is provided with U-shaped bayonet socket, and U-shaped bayonet socket surrounding conduit wall is embedded with C shape elastic ring, can be metal, closely fixing effect is played when conductor housing inserts, cyclic spring filament can be embedded with in the tube wall of U-shaped bayonet socket bottom, support tube wall, prevent body discounting occludes lumen.Below U-shaped bayonet socket, tube wall is fixed with connecting line, and the connecting line other end is fixed on the aperture of conductor housing flank, prevents conductor housing from losing.Described conduit capsule charge valve connecting duct capsule gas tube, the traveling in endotracheal tube wall of a gas tube part is opened on conduit capsule; Described conduit capsule is positioned at above conduit end opening, the space after inflation between airtight conduit outer wall and inner surface of trachea; Described endotracheal tube end opening is oblique concave surface, facilitates endotracheal tube to enter glottis, and concave structure avoids the adherent blocking of conduit end opening.

The described pair of removably insertable endotracheal tube of bronchus shutoff pipe.Described pair of suitable for reading being used for of bronchus shutoff pipe tube chamber attracts and inserts moulding seal wire; Described tube chamber upper flap line is fixed on shutoff pipe upper end, and the fastening when Ipsilateral lung or two pulmonary ventilation, for airtight tube chamber; The described shutoff pipe tube chamber other end is opened on Ipsilateral and props up; Described two Plugging brusa charge valves connect Plugging brusa gas tube, and two Plugging brusa gas tube respective travelings in two bronchus shutoff tube wall are opened on the strong collateral Plugging brusa propped up with Ipsilateral respectively; Describedly prop up the charge valve that Plugging brusa is connected with Ipsilateral and be marked with " trouble " word or relevant letter, the charge valve that described and strong collateral Plugging brusa is connected is marked with " being good for " word or is correlated with alphabetical, or two charge valve colors are distinguished; Knuckle fork in described shutoff pipe body lower end is Y-shaped structure, is propped up formed by shutoff pipe body lower end, strong collateral and Ipsilateral; Described strong collateral propping up with Ipsilateral is separated by shutoff pipe body end, the tube chamber of shutoff pipe only with Ipsilateral Zhi Xiangtong, two are branched off into nature angle, for elastomeric material, during use, two branches are closed up rear insertion endotracheal tube body suitable for reading, across descending in two guide recess, pass rear angle from conduit end opening automatically to separate, paste inner surface of trachea to continue to insert, strong collaterally enter strong side main bronchus, Ipsilateral inserts after propping up and entering Ipsilateral main bronchus again, until meet obstructions, now knuckle fork straddles in knuckle, completes location; Ipsilateral isolates Ipsilateral lung after propping up shutoff sleeve bag gas-filling, realizes strong side lung one-lung ventilation.

Described endotracheal tube body and shutoff pipe body and strong, Ipsilateral prop up long axis direction and are equipped with X-ray position line and scale;

Accompanying drawing explanation

Fig. 1 is overall structure schematic diagram

Fig. 2 is conductor housing and catheter body epimere structural representation

Fig. 3 is the planar structure schematic diagram of conductor housing flank and aperture

Fig. 4 is endotracheal tube and shutoff pipe cross sectional representation

In accompanying drawing: 1. endotracheal tube; 1-1. conductor housing; 1-2. conductor housing is suitable for reading; 1-3. flank; 1-4. aperture; 1-5 conductor housing end opening; 1-6.n shape bayonet socket; 1-7. catheter body; 1-8. catheter body is suitable for reading; 1-9.U type bayonet socket; 1-10.C type elastic ring; 1-11. connecting line; 1-12. conduit capsule charge valve; 1-13. conduit capsule gas tube; 1-14. conduit capsule; 1-15. conduit end opening; 1-16. guide recess 2. bronchus shutoff pipe; 2-1. tube chamber is suitable for reading; 2-2. tube chamber upper flap; 2-3. shutoff body; 2-4. Plugging brusa charge valve; 2-5. Plugging brusa gas tube; 2-6. Plugging brusa; 2-7. knuckle is pitched; 2-8. is good for collateral; 2-9. Ipsilateral props up; 3. moulding seal wire.

Detailed description of the invention:

See Fig. 1, the two bronchus of the present invention replaces shutoff sleeve pipe and is made up of endotracheal tube (1), two bronchus shutoff pipes (2) and moulding seal wire (3).The described pair of bronchus shutoff pipe (2) through the catheter body (1-7) of endotracheal tube (1), fixing two bronchus shutoff pipe (2) that the conductor housing (1-1) of endotracheal tube (1) is detachable.

Described endotracheal tube (1) comprises detachable catheter adapter (1-1), catheter body (1-7), the connecting line (1-11) be connected to a fixed with conductor housing (1-1) and catheter body (1-7), the N-shaped bayonet socket (1-6) of conductor housing (1-1) lower end, the U-shaped bayonet socket (1-9) of catheter body (1-7) upper end, U-shaped bayonet socket (1-9) C type elastic ring (1-10) around, the conduit capsule (1-14) of catheter body (1-7) lower end, conduit capsule charge valve (1-12), conduit capsule gas tube (1-13), described conduit capsule charge valve (1-14) is through conduit capsule gas tube (1-13) and conduit capsule (1-14) UNICOM, thus can inflate it, on catheter body (1-7) medial wall with tube chamber centrage for axis of symmetry is provided with two guide recess (1-16).

The described pair of bronchus shutoff pipe (2) comprises tube chamber (2-1) suitable for reading, tube chamber upper flap (2-2), shutoff body (2-3), two Plugging brusa charge valves (2-4) of shutoff body upper end and two the Plugging brusa gas tubes (2-5) be attached thereto, strong collateral (2-8) of shutoff body (2-3) end and Ipsilateral and props up (2-9), strong collateral (2-8) and Ipsilateral and prop up two Plugging brusas (2-6) on (2-9).Two Plugging brusa charge valves (2-4) are communicated with through Plugging brusa gas tube (2-5) one to one with two Plugging brusas (2-6), can inflate it.

Use time image to insert common single-lumen bronchial tube to insert endotracheal tube (1) like that (endotracheal tube end opening 1-15 is approximately positioned in the middle part of trachea to correct position, the two clear symmetry of pulmonary respiration sound of auscultation), fixing endotracheal tube (1) after conduit capsule charge valve (1-12) conductive pipe capsule (1-14) inflation, moulding seal wire is inserted two bronchus shutoff pipe (2) to crotch, its radian is consistent with inserted endotracheal tube radian, the strong main bronchus direction, side of strong collateral (2-8) correspondence, Ipsilateral props up (2-9) corresponding Ipsilateral main bronchus, strong collateral (2-8) and Ipsilateral (2-9) close up, insert through catheter body (1-8) suitable for reading, keep same direction through catheter body (1-7), strong collateral (2-8) and Ipsilateral prop up (2-9) and automatically separate afterwards to pass conduit end opening (1-15), paste inner surface of trachea to continue to insert, strong collateral (2-8) enters strong side main bronchus, Ipsilateral props up (2-9) enter Ipsilateral main bronchus after run into obvious resistance, illustrate that knuckle fork (2-7) has straddled in knuckle, pull out moulding seal wire, location completes.Also can moulding seal wire and the guiding that utilizes guide recess (1-16) to complete two bronchus shutoff pipe (2) is inserted, endotracheal tube (1) is arc, consistent with the radian of oral cavity-larynx-trachea axis after inserting, guide recess (1-16) symmetry is positioned at its left and right sides, collateral (2-8) will be good for and Ipsilateral props up (2-9) across descending insertion in two guide recess (1-16), and straddle in knuckle complete location until run into obvious resistance.Then the shutoff body (2-3) exposed is snapped in U-shaped bayonet socket (1-9), conductor housing (1-1) tightly inserts catheter body (1-8) suitable for reading, it is airtight fixing to it that its N-shaped bayonet socket (1-6) blocks shutoff body (2-3), and conductor housing (1-1) is closely fixed by the C type elastic ring (1-10) in U-shaped bayonet socket (1-9) peripheral airways catheter wall.Conductor housing (1-2) suitable for reading connects respirator or anaesthesia machine loop mechanical ventilation.When needing one-lung ventilation, to Plugging brusa charge valve (2-4) inflation that the Plugging brusa propped up with Ipsilateral on (2-9) (2-6) is connected, realize two lung isolation, strong side pulmonary ventilation.Time in art as attracted Ipsilateral secretions, blood or pus; first will be good for shutoff cuff (2-6) inflation on collateral (2-8); again Ipsilateral is propped up shutoff cuff (2-6) venting on (2-9); through shutoff pipe tube chamber (2-1) suitable for reading or fully attract with sputum aspirator tube transtracheal catheters (1); thorough removing Ipsilateral secretions; available protecting is good for side lung and is avoided being flooded, safe and reliable.In art or when art finishes the lung recruitment withered to Ipsilateral, Plugging brusa (2-6) inflation on collateral (2-8) will be good for, Plugging brusa (2-6) venting on Ipsilateral props up (2-9), tube chamber upper flap (2-2) is closed after clearing pneogaster, transtracheal catheters (1) pressure-vent gradually, fully multiple of Ipsilateral lung can not only be made, effectively can also avoid the excessive expansion that strong side lung is unnecessary.Postoperative as needed Ventilators, first Plugging brusa (2-6) is exitted, extract endotracheal tube head (1-1) again, now just can easily by two bronchus shutoff pipe (2) removal, then reinsert endotracheal tube head (1-1) and rotate to the position that N-shaped bayonet socket (1-6) and U-shaped bayonet socket (1-9) fully stagger, be seated fixing, connect respirator loop.

Claims

1. a two bronchus replaces shutoff sleeve pipe, it is characterized in that: by endotracheal tube (1), two bronchus shutoff pipes (2) and moulding seal wire (3) composition, two bronchus shutoff pipe (2) combinationally uses through endotracheal tube (1), both are detachable, described endotracheal tube (1) comprises conductor housing (1-1) and the catheter body (1-7) be connected by connecting line (1-11) with it, both can closely insert, extract, described catheter body (1-7) lower end is provided with conduit capsule (1-14), described conduit capsule (1-14) is connected with conduit capsule charge valve (1-12) by conduit capsule gas tube (1-13), the tube chamber upper flap (2-2) that described pair of bronchus shutoff pipe (2) comprises tube chamber (2-1) suitable for reading and be attached thereto, shutoff pipe body (2-3), knuckle fork (2-7) of shutoff pipe body (2-3) lower end, the shutoff pipe that knuckle fork (2-7) separates is good for collateral (2-8), shutoff pipe Ipsilateral props up (2-9), strong collateral and Ipsilateral props up set bronchus Plugging brusa (2-6), described bronchus Plugging brusa (2-6) is connected with Plugging brusa charge valve (2-4) by Plugging brusa gas tube (2-5),

Catheter body (1-7) internal diameter of described endotracheal tube (1) is significantly greater than the external diameter sum that strong collateral (2-8) of two bronchus shutoff pipe (2) and Ipsilateral prop up (2-9), thus makes pair bronchus shutoff pipe (2) can pass catheter body (1-7) smoothly;

There is flank (1-3) described both sides, conductor housing (1-1) middle part, one of them flank (1-3) is provided with aperture (1-4) structure, aperture (1-4) is fixed in connecting line (1-11) one end, the other end is fixed on the lateral wall of catheter body (1-7) epimere, conductor housing end opening (1-5) is provided with n shape bayonet socket (1-6), and its bore equals shutoff pipe body (2-3) external diameter;

The lower ending opening of described endotracheal tube (1) and conduit end opening (1-15) are oblique concave structure;

Described catheter body (1-7) is arc, its inwall left and right sides is arranged with guide recess (1-16), guide recess (1-16) arises from conduit (1-8) suitable for reading below, be piercing in conduit end opening (1-15), strong collateral (2-8) and Ipsilateral for guiding two bronchus shutoff pipe prop up (2-9) and insert along correct direction, conduit (1-8) suitable for reading is provided with U-shaped bayonet socket (1-9), its bore equals shutoff pipe body (2-3) external diameter, U-shaped bayonet socket (1-9) surrounding conduit wall is embedded with C shape elastic ring (1-10), for metal material, fixing airtight effect is played to the conductor housing (1-1) inserted, catheter body (1-7) wall of U-shaped bayonet socket (1-9) below is embedded with helical form elastic metallic filament supporting tube, prevent catheter body (1-7) to be converted into dead angle and block ventilation.

2. the two bronchus of one according to claim 1 replaces shutoff sleeve pipe, it is characterized in that: described shutoff pipe body (2-3) lower end is provided with knuckle fork (2-7) structure, knuckle fork (2-7) is Y-shaped, straddle on trachea carina after insertion, thus complete the location to two bronchus shutoff pipe (2) accurately fast.

3. the two bronchus of one according to claim 1 replaces shutoff sleeve pipe, it is characterized in that: described knuckle fork (2-7) separates shutoff pipe and is good for collateral (2-8) and shutoff pipe Ipsilateral props up (2-9), the tube chamber of two bronchus shutoff pipe (2) only props up (2-9) and communicates with Ipsilateral, two are branched off into nature angle, angle is between 60 ° to 85 °, for elastomeric material, can smoothly by catheter body (1-7) after closing up, pass conduit end opening (1-15) Self-bouncing afterwards, strong collateral (2-8) and Ipsilateral prop up on (2-9) and are equipped with bronchus Plugging brusa (2-6), shutoff pipe is good for the color of collateral (2-8) and the Plugging brusa on it (2-6) and Plugging brusa charge valve (2-4) solid colour inflated it, different with Ipsilateral plugging system.

4. the two bronchus of one according to claim 1 replaces shutoff sleeve pipe, it is characterized in that: described prop up the Plugging brusa charge valve (2-4) that the Plugging brusa (2-6) on (2-9) is connected to Ipsilateral and be marked with " trouble " word or relevant letter, another Plugging brusa charge valve (2-4) is marked with " being good for " word or relevant letter, or two charge valve colors are distinguished.

5. the two bronchus of one according to claim 1 replaces shutoff sleeve pipe, it is characterized in that: described catheter body (1-7), shutoff pipe body (2-3), shutoff pipe are good for the long axis direction that collateral (2-8) and Ipsilateral prop up (2-9) and are equipped with radiopaque strip-like developing pipe and length scale.

6. the two bronchus of one according to claim 1 replaces shutoff sleeve pipe, it is characterized in that: described moulding seal wire (3) is flexible arc tinsel, can insert two bronchus shutoff pipe to crotch.