CN1309429C - 密封的回压呼吸装置 - Google Patents
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Abstract
由呼吸困难患者使用的手持呼吸装置,通过产生对呼气的阻力在患者的气道中产生密封的回压。呼气阀安装在空心体内,并且预设的压簧安装在所述阀与装置主体的可调节帽或凸轮之间。一对阀孔穿过主体的壁,一个孔起患者吸气的吸气口作用,而第二口用于呼出二氧化碳。吸气阀安装在所述主体的内部的装置常开端与呼气阀之间。在一个实施方式中,装置连接到喷雾器以促进建立正压并且向患者的肺发送药品。
Description
相关申请的交叉参引
本申请是本申请人于1999年12月23日提交的题目为“喷雾器的密封的回压连接装置”(Sealed Back Pressure Attachment Device forNebulizer)的471,533共同申请的后续部分,其内容全部引入本文作为参考。
技术领域
本发明涉及辅助患者肺功能的装置;它可以单独用于煅练有关呼吸的肌肉也可以与喷雾器结合用于向患者的气道发送药物。具体地,本发明涉及在使用者的气道内产生正回压以保持气道通畅和恢复正常呼吸的装置。
背景技术
喷雾器是辅助呼吸困难患者的最广泛使用的装置;在哮喘发作、肺气肿发作及类似病情时喷雾器帮助给药。喷雾器通常用在急诊室内,当常规计量的吸入剂(MDI)剂量不能够逆转气道狭窄时由患者和医务人员使用。喷雾器把液体药物破碎成雾状的微细液粒,然后把药物发送进肺和患者的气道。
常规地,喷雾器发送气道扩张剂,例如,把患者送进急诊室时,患者的血液中通常有高浓度的二氧化碳。喷雾器帮助把大量需要的扩张剂发送到患者的肺中以助于把二氧化碳从肺内排出。扩张剂含有与患者细支气管中的受体反应以通畅气道的化学药物。所述药物可能包括固醇、硫酸镁、以及支气管扩张剂。
然而,常规的喷雾器相对较慢,可能需要长达八个小时的治疗时间。当患者就诊时的急性病情要求立即处理时,往往使用带有面罩的安布氏呼吸袋。面罩密封患者的口和鼻;当挤压所述呼吸袋时正压把药物迫入患者的气道。这种操作难免并发症。空气可能被错送到患者的胃中从而引起胃扩张或者呕吐,呕吐转而又加重呼吸危象,因为有可能吸入呕吐物并且把呼吸物呛入肺内。
有些患者可能既不能受益于喷雾器也不能受益于安布呼吸袋;他们得用呼吸机,这是一种采用插入患者气管中的气管插管的人工呼吸机。这种正压远大于使用带安布呼吸袋的喷雾器时的正压。往往会把过量的空气迫入患者的肺中。患者使用呼吸机的时间越长,就越不容易让患者脱离呼吸机。长期地使用呼吸机易于引起患者呼吸肌群萎缩,这种萎缩可以成为不可逆的。
发明内容
本发明旨在消除与现有技术相关的缺点,并且提供既可由患者使用也可以由医务人员使用的手持装置用于进行呼吸肌煅练以及用于在喷雾器的辅助下发送药物。
因此,本发明的一个目的是提供一种密封的定标回压装置,所述装置可以让哮喘、肺气肿或者其它呼吸疾病患者的缩窄的气道中有一定的正压。
本发明的另一个目的是提供一种用于喷雾器的密封回压呼吸连接装置,所述的连接装置可以预设以产生所希望的压力量并且发送药物以恢复患者的呼吸。
本发明的另一个目的是提供一种可以辅助煅练患者的呼吸肌群的呼吸装置。
本发明的上述目的和其它目的通过一种手持的轻便装置达到,所述装置具有用于调节在患者的气道中产生的正压量的装置。所述的装置具有一个空心体,带有安装在空心体内部的支架上的呼气阀。所述的空心体设有两个通孔:吸入口和呼出口。一个可以如橡胶垫片那样简单的吸入阀安装在空心体内呼气阀与开口末端之间。
开口端可以载有口罩,或者做成适当的大小和形状通过岐管连接到喷雾器上。对置的空心体密闭末端载有用于调节正压的装置。在一个实施方式中,所述的调节装置是可以螺纹地与所述空心体接合的帽;在第二实施例方式中,所述调节装置是可调节的凸轮杆。在呼气阀与调节装置之间安装一个压簧。可以把标定设置到所希望的压力,优选地在5厘米水柱至29厘米水柱之间。
附图说明
下面参照附图进行说明,其中相同的部件用相同的标号标示,并且附图中
图1是根据本发明的第一实施方式的连接装置的透视图。
图2是图1所示装置的纵剖面图,示出可以与主体螺纹接合的可调节帽。
图3是第一实施方式的纵剖面图,示出与主体分开的可调节帽。
图4是根据本发明装置的第二实施方式的透视图,安装在把所述装置连接到喷雾器的岐管上。
图5是图4所示带有调节凸轮杆的装置的纵剖面图。
图6是第二实施方式的纵剖面图,示出吸入和呼出的气流运动。
图7是正视详图示出呼气阀上的进气开口。
图9是详图,示出进气阀。
具体实施方式
下面详细参照附图,标号10标示出根据本发明第一实施方式的装置。装置10包括细长的空心主体12,所述细长的空心主体12具有第一圆柱部分14、整体连接的中间圆锥部分16、和口罩18,所述口罩18整体地连接中间部分16。中心孔20形成在主体12中,从口罩开口22起,经口罩18、圆锥部分16和主体14延伸。
可调节的螺纹帽24封闭主体部分14的常闭末端26。帽24在帽的内壁上设有螺纹28。在帽中形成中心塞32,所述塞32从帽24的内端34向外伸出。图3中看得较清楚,端34形成环形肩台,所述肩台提供第一对接表面,如下文所详述,压簧40顶在第一对接表面上。
经过空心体12的壁切割出吸气口42,而在主体部分14内于与吸气口42分开的位置处形成呼气口44。呼气阀50处在口42和44之间,该阀以开放的进气位详示于图7中。在本发明的第一和第二实施方式中使用的是相同的阀50,因此在下文说明第二实施方式时将忽略对它的说明。
呼气阀50安装在装配在主体部分14内的支架,或者说框架52上。支架52设有与主部分14磨擦配合的环形凸缘54。凸缘54的内角提供压簧40的第二对接表面。
邻接于主部分14和圆锥部分16间的连接区在主部分14的内壁上形成向内伸的肩台56。在把支架52和呼气阀50一起压在肩台56上时,所述的肩台形成止档。
进气阀60(图9)安装在主部分14中的开口端22与支架52之间。进气阀60可以简单得是桡性的橡胶垫片,所述的桡性橡胶垫片形成在吸气时开放的单向阀门。圆形进气阀60的直径小于主体14中的孔20的内径,让一些空气可以绕进气阀60流动。进气阀,或者说活门60用桡性的材料例如乳胶制造。当压力对着活塞并且对着弹簧40时活门在活塞、支架50的口上,但是活门通过支架中的孔开放让新鲜空气流入。
组装了装置10后,弹簧40在其一端围绕塞32顶在肩台34上。弹簧40的第二端顶在安装在支架52中的阀52上,常态下把呼气阀迫在图2所示的关闭位。如图8所示,进空气时所述阀开放,但是在呼气时对气流提供预设的阻力。
当使用者需要煅练肌肉或者简单地扩张气道时,它把其唇部封闭在口罩18的开口端周围。在吸气过程中,空气从吸气口42,流经阀50,绕阀60然后流进口罩18的开口端22,呼气时气流相反,从开口端22流出绕过阀60,并且对抗压簧40的阻力沿排气口44的方向流动。为了把气体排出主体12,使用者必须在弹簧上施加足够的压力把支架52移动进离开出气口44的位置让气体能够排出。
由于弹簧40向打开呼气阀施加阻力,在患者的气道产生正回压,迫使患者呼气时加以较多的力,从而加强涉及呼吸的肌肉。与把帽24与弹簧40接触时可以把帽24或多或少紧紧地螺纹地拧在主体12上,使之能够调节以产生5厘米水柱到20厘米水柱范围的珔压。我们发现这个正压范围对于多数患者是充分的,尽管如果希望,可以方便地进行其它的压力调节。
现在转向图4至6所示的第二实施例,示出了喷雾器连接装置70。所述装置70包含细长的总体上圆柱主体72,该圆柱主体72具有常开端74和常闭端76。可调节的凸轮杆78固定在连接到在端76内的活塞94的轴上,以能够调节开放和关闭安装在主体72中的呼气阀所需要的压力。所述压力可以调节到所希望的值,例如在5厘米水柱至10厘米水柱的范围,这取决于使用者的状态。
所述的调节可以通过控制杆的位置达到。例如,第一位置指示10厘米水柱的压力。通过沿相反的方向摆动所述杆,使用者可以调节弹簧的压缩以产生约5厘米水柱的压力。当然可以把凸轮杆的移动定标到所希望的范围内的任何压力,在主体72上设定不同的位置,并且通过适当的标记指示该设定。
主体72设有直接吸气口80和直接排出口82。开口端74用于与岐管84磨擦接合所述岐管84载有口罩86和常规的喷雾器88.岐管84、口罩86和喷雾器88不是本发明的部分;它们在图4中用虚线示出。
现在参阅图5和6,较详细地示出装置70的内部。从图5可以看出,主体72设有从开口端74延伸到封闭端76的封闭壁92的中心孔90。凸轮杆78可旋转地安装在轴77上(图6),所述的轴77固定地连接在封闭端76的壁92上。活塞94在中心孔90中只为调节弹簧96的压缩移动小的距离。
压簧96安装在构件94和呼气阀98之间。阀98在各方面都与阀50相似,所以在此略不详述。用呼气阀98可以通过迫使患者对抗压簧的弹力呼气而产生回压。类似于阀60的进气阀在主体72内处于开口端74和阀98之间。
在进空气进气时,空气经口80,经阀98和进气阀60沿箭头100方向流动。在排气或者说呼气过程中,空气对抗常闭活塞/支架部分的橡胶垫片或者活门阀流动。在连续呼气时,患者能够对抗压簧96的阻力从出气口82移开支架,让空气经呼气阀98和经呼气口82沿箭头102的方向流动,如图6所示。
一把可调节的凸轮杆78设定为对空气流动具有所希望的阻力后,附着件70就安装在岐管84上并且连接到喷雾器88。置于喷雾器88中的一定量的药物104与经岐管84流到口罩86的空气混合然后发送到患者的气道。由气雾剂形成件106分布的微细药滴与流流导管72的气流相交。形成的气雾与呼入的气流混合然后发送进使用者的气道中,扩展气道并且缓解患者的哮喘发作或者其它呼吸困难。
优选地,在呼气或者吸气的过程中,患者保持其嘴紧紧地绕口罩18和86封闭住,从而密封装置10和70的开口端并且使得能够有效地发送药物和呼出气体。当患者呼气时,呼气阀倾向于扩张患者的气道并且通过产生回压阻止肺泡约缩小。
当迫使空气仅经用罩或者用凸轮78预设以提供阻力的呼气阀呼出时,呼出的气流不能够经吸气口呼出而是必须经呼气口44或82流动。通过在装置10和70中保持密封的正回压,保持患者的气道开通恢复正常呼吸。当充气囊中的压力与气管中的气压平衡时,药物有更好的机会深入气道引起气道扩张。
装置10和70让捕获的二氧化碳能够经呼气口44或82逸出,从而降低进入使用者血流的二氧化碳浓度。当捕获的气体从肺排出时,患者用较少的努力肺就可以产生较大吸气压力。
当气道扩展后,锥形(pyramid)效应自行建立从而增加了极需要的含氧流量。由于使压力能够均衡并且能够增加全肺范围容量,使用者经历长的呼出期。当扩展了气道后,显著地改善了空气流入和流出肺。肺不是高度缩小的;新鲜空气较易于进入肺。
另外,如果用于附着件70,从喷雾器88喷入药物104更加有效地达到肺的受影响区域并且进一步扩张气道。因此,患者原塌缩和阻塞的气道保持开通并且可以达到准确地药物投送。用较少的药量治疗却较有效。
本发明可以用于哮喘或肺气肿患者。许多哮喘患者有意外发作并且难于得到药物。得到药物前患者就会窒息的焦虑可加重发作。通过提供便于使用的小型便携装置,患者可以至少恢复一些呼吸并且减少焦虑的因素。
在肺气肿发作时,终末细小支气管衰弱并且处于永久性扩大的状态。肺泡壁往往损坏。由于肺泡空间丢失,气体交换的表面积减少肺,组织反弹作用消失。
正是由于缺乏弹性引起肺反弹作用不足并且使呼吸肌疲劳。肺不能够适当的松驰和恢复其常位。在这种状态,常建议患者用“吹苗样”呼气法。通过使用密封的回压装置10或者70肺气肿患者可以增加送入肺的空气并且从血流中排出二氧化碳。
装置10和70防止细支气管、肺泡塌缩。减少总合的高度塌缩让患者能够更加充分地吸气和呼气,从而把药物发送到较大的受损组织表面。此外,密封的回压有助于保持肺泡和气道开通,让二氧化碳能够从肺放出进入大气。从肺和血流有效地排出气体改善了患者的生理功能,并且可以让更多的氧气送入肺内。
我们设想可以把阀10和70预设到比以上所述值较大的值,尤其是患者有气道塌缩方面的显著问题时,尽管优选的设定范围是5厘米水柱到20厘米水柱。
我们设想本发明的装置可以用于煅练患者并恢复其正常呼吸能力。对于第一实施方式的装置10尤其如此。我们还设想结合口罩使用鼻卡和/或模制加垫口罩以保证更好地把患者的唇密封在口罩周围。
本发明的装置可以廉价地用现有材料,譬如塑料和轻金属制造。弹簧40当然要用强度足以经受装置使用过程中的多次压缩和膨胀的材料制造。我们设想,如果希望的话,口罩18可以制造成可拆卸地与主体部分14接合。在这种情况下,可以用窄小的空间,譬如患者的衣袋,携带具有独立口罩18的的装置10,而在需要的时候把口罩与装置的其余部分接合。
如果需要,装置70可以附着在定剂量吸入器(MDI)上而不是在喷雾器上。在这种情况下可以用小垫片代替岐管84。小垫片常规地具有一个口,用于以细雾的形式发送药物,例如消炎药物。
本发明的设计中可以进行许多改变和修改而不偏离其精神。因此本发明的范围仅受所附权利要求书的限制。
Claims (14)
1.一种密封的回压装置,用于辅助患者的呼吸功能,包含:
细长空心体,所述细长空心体具有第一常开端、第二常闭端、吸入口和呼出口;
单向呼气阀,安装在空心体内,用于让排出的气体能够经呼出口呼出;
压簧,安装在呼气阀和第二常闭端之间,用于调节被患者呼出的气体的阻力;
安装在空心体的第二常闭端上用于调节压簧的压缩的装置;和
进气阀,安装在所述的第一常开端和所述的呼气阀之间,所述进气阀允许吸气气体和呼气气体在进气阀主体周围移动,
其特征在于,所述的调节装置含有可以在所述的空心体中滑动的活塞,所述的活塞提供所述压簧的对接表面,并且可调节的凸轮杆安装在所述的活塞上,用于调节对呼出气流的阻力。
2.如权利要求1所述的装置,其特征在于,所述的呼气阀由安装在空心体上的框架支承,所述的框架提供所述压簧的第二对接表面。
3.如权利要求2所述的装置,其特征在于,所述的空心体设有伸入由空心体形成的中心孔的环形的肩台,并且其中所述的框架与所述的肩台接触,从而阻止框架向所述的第一常开端滑动。
4.如权利要求1所述的装置,其特征在于,所述的第一常开端设有口罩,用于由患者的唇接合。
5.如权利要求1所述的装置,其特征在于,所述的空心体用于连接到喷雾器上以建立所述空心体与喷雾器之间的流体连通,用于向患者的气道发送药物。
6.如权利要求5所述的装置,其特征在于,所述空心体的第一常开端可拆卸地固定到喷雾器上。
7.如权利要求1所述的装置,其特征在于,所述的进气阀含有橡胶垫。
8.如权利要求1所述的装置,其特征在于,所述的凸轮杆可调节用于保持5厘米水柱至10厘米水柱之间的正回压。
9.如权利要求1所述的装置,其特征在于,所述呼气阀由支承架承载,所述支承架提供了所述压簧的第二对接表面。
10.如权利要求9所述的装置,其特征在于,所述的凸轮杆可以调节,以保持5厘米水柱至10厘米水柱之间的正回压。
11.如权利要求9所述的装置,其特征在于,所述的空心体用于连接到喷雾器上以建立所述空心体与喷雾器之间的流体连通,用于向患者的气道发送药物。
12.如权利要求11所述的装置,其特征在于,所述空心体的第一常开端可拆卸地固定到喷雾器上。
13.如权利要求1所述的装置,其特征在于,
所述压簧适于在所述空心体内保持正回压。
14.如权利要求13所述的装置,其特征在于,所述的凸轮杆可以调节,以保持5厘米水柱至10厘米水柱之间的正回压。
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Also Published As
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---|---|
EA200300511A1 (ru) | 2004-04-29 |
EP1328311A2 (en) | 2003-07-23 |
NZ525239A (en) | 2004-05-28 |
AU2002220068B2 (en) | 2006-12-14 |
US6510846B1 (en) | 2003-01-28 |
EA005171B1 (ru) | 2004-12-30 |
CN1482934A (zh) | 2004-03-17 |
WO2002034322A3 (en) | 2003-01-03 |
AU2006802A (en) | 2002-05-06 |
CA2425291A1 (en) | 2002-05-02 |
WO2002034322A2 (en) | 2002-05-02 |
WO2002034322B1 (en) | 2003-04-24 |
MXPA03003553A (es) | 2004-09-10 |
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