CN1859939B - 具有纤维光学组件的喉罩通气道装置 - Google Patents
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- A—HUMAN NECESSITIES
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- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
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Abstract
本发明提供了一种喉罩通气道装置(200),包括:气道管(210),从近端延伸至远端(214),所述气道管(210)限定能够在其中容纳气管内管(195)的内通道(215);罩部分(230),包括可充气套囊(234),并限定与内通道(215)流体连通的开口,所述罩部分(230)可通过患者的嘴插到患者内的插入位置,所述套囊(234)适于在充气时和罩部分(230)处于所插入的位置时围绕患者的声门开口;以及纤维光学观察装置(300),具有远端(314)和近端(312),所述纤维光学观察装置(300)的远端(314)设置在气道管(210)的远端(214)的附近,以向用户提供远程观察。
Description
技术领域
本发明涉及具有纤维光学组件的喉罩通气道装置。更具体地,本发明涉及具有纤维光学组件的插管式(intubating)喉罩通气道装置。
背景技术
喉罩通气道装置是对在不清醒的患者内建立气道有用的广为公知的装置。美国专利No.4,509,514是描述喉罩通气道装置的多种应用之一。这样的装置已经使用了许多年,并且提供了对较老的、甚至广为公知的气管内管的替代器具。在至少近七十年中,包括长细管的气管内管一直用于在不清醒的患者体内建立气道,其中所述长细管具有设置在管远端的可充气球囊。操作中,气管内管的远端插入通过患者的嘴,经过患者的喉入口(或声门开口),进入患者气管内。一旦被这样定位,则球囊(balloon)被充气,以便形成与气管的内衬(interior lining)的密封。在所述密封被建立后,可将正压施加给管近端,以使患者的肺换气。并且,球囊和气管的内衬之间的密封保护肺防止吸气(例如,密封防止从胃部反流的物质被吸入患者的肺)。
尽管它们已经是非常成功,但是气管内管具有几个主要缺点。气管内管的首要缺点涉及难于适当插入管。将气管内管插入患者内是要求高熟练度的过程。并且,甚至对于熟练的医师,插气管内管有时也是困难的,或是不可能的。在许多实例中,插气管内管的困难性已经悲剧性地导致患者死亡,因为不可能相当快地在患者内建立气道。并且,插气管内管通常要求操纵患者的头和颈,并进一步要求患者的颌(jaw)被迫张开很大。这些必要的操作使得将气管内管插入可能遭受脖部受伤的患者体内变得困难,或不理想。
与气管内管相比,将喉罩通气道装置插入患者体内从而建立气道相对较易。并且,喉罩通气道装置是“仁慈的”装置,因为即使它被不当插入,也仍趋向于建立气道。因此,喉罩通气道装置常常被认为是“救生”装置。并且,可仅对患者头、颈、颌进行较小操作而将喉罩通气道装置插入。进而,喉罩通气道装置提供了对患者的肺的换气,而不要求接触气管的敏感内衬,且所建立的气道的尺寸典型地显著大于用气管内管建立的气道的尺寸。并且,喉罩通气道装置不妨碍咳嗽的程度与气管内管相同。主要由于这些优点,喉罩通气道装置近年来已经逐渐地普及。
美国专利No.5,303,697和6,079,409描述了可被称为“插管式喉罩通气道装置”的现有技术装置类型的实例。所述插管式装置对方便气管内管的插入是有用的。在所述插管式喉罩通气道装置已安置在患者体内时,所述装置可充当用于随后插入的气管内管的引导件。以此方式使用喉罩通气道装置便于通常称为气管内管的“盲插”的方式。仅需患者的头、颈、和颌的较小运动就可插所述插管式喉罩通气道装置,并且一将所述装置定位在所述患者内,就可几乎不需要患者的额外的运动而插气管内管。这与如果不用插管式喉罩通气道装置的协助插气管内管时要求患者的头、颈、和颌的较大运动形成鲜明的对比。
插管式喉罩通气道装置的一种通用形式已经商业市场化多年,如Cyprus的Laryngeal Mask Company制造的“Fastrach”。图1A示出现有技术Fastrach装置100的前侧的示图。图1B示出在如图1A中所示的箭头1B-1B的方向上所取的装置100的截面图。
装置100包括刚性钢气道管110、硅罩(silicone mask)部分130、刚性钢柄180、和充气线路(inflation line)190。柄180在管的近端112附近连接至气道管110。罩部分130在管的远端114连接至气道管110。罩部分130包括圆顶状背板132和可充气套囊(cuff)134。罩部分130也包括会厌提升棒(elevator bar)150。棒150的一端152连接至背板132。所述棒150的另一端154是“自由浮动的”,或不连接至所述装置的任何其它部分。棒150有效地铰接至所述罩部分的其余部分。图1A和1B示出处于其歇置位置(即,在无外力作用于棒150上时由棒150占据的位置)的棒150。
在操作中,套囊134被放气,接着罩部分通过患者的嘴插入患者的咽,同时所述气道管的近端112和柄180保留在患者的嘴外面。柄180可用于操纵所述装置。套囊134接着被充气,以围绕患者的声门开口形成密封。在装置100被这样安置之后,所述装置(图1A中所示)的远端开口117与患者的声门开口对准,且所述装置提供了从气道管110的近端112延伸到患者的气管的密封的气道。在会厌提升棒150处于图1A和1B中所示的歇置位置中时,棒150防止患者的会厌落入由充气的套囊和背板限定的碗形形状中,从而防止会厌堵塞所述装置提供的气道通道。图1C示出插入通过装置100的气管内管195。气管内管195的远端196插入气道管的近端112,接着气管内管195前进,直到远端196到达罩部分130,然后通过罩部分130。如图所示,当气管内管195的远端196通过所述罩部分时,它将棒150的远端(或“自由”端)154从歇置位置移出。
如图1B中所示,气道管110限定从近射线116延伸到远射线118的弧形区域,所述射线116、118在曲率中心C相遇。如图1B和1C中所示,背板132限定斜面(ramp)140。气道110和斜面140的弯曲使得气管内管的盲插成为可能。即,当装置100被插在患者体内时,气道管和斜面的弯曲确保随后插入的气管内管在其经过装置100的远端开口时将与气管对准。由射线116、118限定的角度θ约为一百二十度。斜面140对此弯曲额外增加约十七度,使得插入通过所述装置的气管内管弯曲通过约一百三十七度。
Fastrach是可再用装置,并且可在变得太旧从而不能再用之前可多次消毒(和再用)。尽管Fastrach一直工作地非常好,但是仍需要改进的插管式喉罩通气道装置。本发明的一个目的是提供这样的装置。
发明内容
根据本发明,提供了一种喉罩通气道装置,包括:气道管,从近端延伸至远端,所述气道管用于限定能够在其中接收气管内管的内通道;罩部分,连接至所述气道管的远端,所述罩部分包括可充气套囊,并限定与所述内通道流体连通的开口,所述罩部分可通过患者的嘴插到患者体内的插入位置,所述套囊适于在充气时和所述罩部分处于所插入的位置时围绕患者的声门开口;以及纤维光学观察装置,具有近端和远端,所述纤维光学观察装置的远端被设置在所述气道管的远端的附近,以向用户提供远程观察。
因此,所述装置包括使得医生能确保在使气管内管插入通过所述装置之前所述装置的远端与患者的气管适当对准的光学系统。
所述气道管可由例如塑料等不昂贵的材料(代替钢)制造,从而所述装置可被用作一次性(disposable)装置。
所述罩部分可包括会厌提升棒,所述棒限定一孔口,并且可被设置在歇置位置和打开位置中,所述纤维光学观察装置提供对延伸穿过由所述棒限定的孔口的区域的观察。
所述纤维光学观察装置优选包括位于其远端的透镜,所述透镜与所述内通道隔开,以避免所述透镜和插在所述通道中的气管内管之间的接触。这有助于避免插入或取出所述管时所述透镜对管的损坏。
所述罩部分可包括背板,所述背板限定一斜面,所述斜面限定用于支承插在所述通道中的气管内管的支承面。这有助于方便所述管的插入。所述斜面可包括通道,所述或每条光纤延伸通过所述通道。
所述装置可包括用于防止所述通道中的气管内管中的松散材料接触所述透镜的装置,且所述防止装置可适于防止在将所述管插入通过所述通道时从气管内管擦落的材料接触所述透镜。可选地或另外地,所述防止装置可适于防止在从所述通道取出所述气管内管时从所述气管内管刮掉(scraped)的松散材料接触所述透镜。所述防止装置可包括设置在所述透镜和所述通道之间的一个或多个凹口。所述或每个槽可与所述背板一体形成。
可选地,所述或每个凹口可由设置在所述背板上的环限定,所述纤维光学装置的透镜通过所述环的孔口。
附图说明
在本领域的技术人员阅读以下详细描述和附图后本发明的另外的目的和优点将变得显而易见,其中仅借助于本发明的最佳模式的例示示出和描述了几个实施例。
图1A示出现有技术喉罩通气道装置的前视图。
图1B示出沿如图1A中所示的线1B-1B的截面图。
图1C示出插入通过图1A中所示的装置的气管内管。
图2A示出根据本发明构造的插管式喉罩通气道装置的前视图。
图2B示出沿如图2A中所示的线2B-2B的截面图。
图2C示出沿如图2B中所示的线2C-2C的截面图。
图2D示出由如图2B中所示的标以2D的虚圆围住的装置的部分的放大图。
图3示出插入通过根据本发明构造的插管式喉罩通气道装置的气管内管。
具体实施方式
图2A示出根据本发明构造的一次性插管式喉罩通气道装置200的前视图。图2B示出沿如图2A中所示的线2B-2B的方向的装置200的截面图。图2C示出沿如图2B中所示的线2C-2C的方向的装置200的截面图。图2D示出由图2B中所示的虚圆2D围住的装置200的部分的放大图。
装置200包括刚性气道管210、硅罩部分230、刚性柄280、和充气线路290。柄280在气道管210的近端212附近连接至气道管210。罩部分230在气道管210的远端214连接至气道管210。罩部分230包括圆顶状硅背板232和可充气套囊234。罩部分230也包括会厌提升棒250。棒250的一端252连接至背板232。所述棒250的另一端254是“自由浮动的”,或不连接至所述装置的任何其它部分。如图2B中所示,气道管210限定从近射线216延伸到远射线218的弧形区域,所述射线216、218在曲率中心C相遇。如图2B和2C中所示,背板232限定斜面240。与现有技术装置100相同,由射线216、218限定的角度θ约为一百二十度,且斜面240对此弯曲增加约十七度。不同尺寸的罩部分可连接至气道管,以使所述装置适合较大或较小的患者,且在其它罩部分中的斜面可稍大于或小于十七度弯曲。
如图2C中最佳所示,气道管210限定中心气道通道215。中心气道通道215从所述管的近端212延伸到远端214。在装置200插在患者体内且套囊234被充气时,套囊234围绕患者的声门开口形成密封,且气道通道215与患者的肺连通。当装置200被插在患者内时,柄280和气道管的近端212留在患者嘴外面,且所述装置提供从气道管的近端212通过通道215延伸到患者的声门开口的密封的气道通道。
将图1A-1B和2A-2B比较,将理解,装置200具有与装置100相同的许多特性。这两个装置都包括硅罩部分、刚性气道管、和刚性柄。然而,尽管可再用装置100包括钢气道管和钢柄,但装置200是一次性的,且包括塑料(例如,聚碳酸酯)气道管210和塑料(例如,聚碳酸酯)的柄280。装置200的气道管210和柄280优选由例如聚碳酸酯等刚性材料制成。由于它由刚性塑料代替钢制成,所以气道管210的壁比气道管110的壁厚。如图2C中所示,气道管210的壁的厚度T大致等于1.9毫米。如图2C中所示,由管210限定的气道通道215的直径D大致等于12.2毫米。
装置100和200之间的另一重要区别是,装置200包括纤维光学系统300。纤维光学系统300包括从近端312延伸到远端的光纤束310,且透镜314在光纤的远端安装至所述光纤。当装置200被插在患者内时,束310的近端312留在患者嘴外面,并且可连接至标准观察装置(例如,屏幕或目镜)。透镜314设置在斜面240附近。
尽管气道管的弯曲和斜面的形状通常便于气管内管的盲插,但是纤维光学系统300有利地提供了对与装置200的远端对准的患者组织(anatomy)的观察。这使得能在尝试将气管内管插入通过装置200之前调整所述装置的远端和患者的声门开口之间的对准。如果装置的远端没有与患者的声门开口完全对准,则如所得到的光纤视图所示,柄280可用于对装置200的位置进行微小调整,从而便于气管内管的随后插入。这与现有技术形成鲜明的对比,在所述现有技术中,声门开口通过昂贵的机构寻找和识别,所述机构内置至允许其远尖端在单个平面上弯曲的光纤电缆自身内。
如图2C中最佳所示,除了中心气道通道215外,气道管210也限定凹口(notch)219。凹口219被限定在管210的壁中,并且在气道通道215外面,与气道通道215不连通。凹口219容纳光纤束310的部分。如图2B中所示,凹口219从气道管上的位置330延伸到斜面240。位置330在柄280和管210的连接点(junction)附近,并且位于所述连接点和管的远端之间。如上所指出,光纤束310从近端312延伸到透镜314。束310的自由部分从近端312通过限定在柄280内的孔282延伸到点330。束310的“被容纳的”或“被保护的”部分从点330延伸到透镜314。
如图2A和2D中最佳所示,会厌提升棒250为“桨形”,且远端254限定孔口256。当棒250位于其歇置位置中时(即,当套囊234被充气,且没有外力作用于棒250上时),纤维光学系统300的透镜314与孔口256对准,从而棒250不会阻碍透镜提供的观察。
在图2C中,气道管210的顶点用340表示。顶点340是在装置插在患者体内时由患者的上牙齿接触的管的点。如图2C中所示,凹口219在位置330附近的气道管的区域中从顶点340偏移,以确保患者的牙齿不会接触和损坏光纤束310。尽管凹口219从点330附近的顶点偏移,但随着凹口219沿着管向下向罩部分前进,凹口219占用更大的中央的位置,使得在远端,透镜314与如图2A和2D中所示的会厌提升棒250中的孔口256中心对准。
光纤束310通常包含两组纤维。一组承载从远端312到透镜的光,以便照亮患者组织。另一组承载由透镜314接收的回到近端的光,以便提供对患者组织的观察。在所示出的实施例中,两组纤维延伸通过单个凹口219。然而,将理解,气道管可限定两个凹口,且每组纤维都可容纳在其自身的凹口中。在这样的实施例中,所述凹口可在斜面240相遇,从而两组纤维和透镜容纳在延伸通过斜面240的单个孔口中。
如图2D中最佳所示,装置300也包括环(collar)360。环360靠着斜面240的远端设置,并且容纳束310的最远部分和透镜314。环360可作为背板部分232的组成部分制造。包括圆顶状硅背板232、斜面240、环360、和套囊234的罩部分230举例来说可通过注塑成形形成为单个整体式(monolithic)部分。
图3示出插入通过装置200的气管内管195。环360执行的一个有用的功能是,它确保气管内管195一直保持与透镜314隔开。透镜314通常限定尖锐直角(sharp right angle)表面,因此理想的是将透镜314远离气管内管195隔开,以确保透镜314不会接触气管内管195的套囊,从而不可能撕裂气管内管195的套囊。再次参看图2D,环360确保透镜314与从支承面242延伸的线隔开距离D。距离D可等于约两毫米。
除了限定容纳束310的远端和透镜314的中央孔口外,环360也限定第一凹口370和第二凹口380。凹口370和380有助于保护透镜314。在管插入通过如图3中所示的插管式装置之前滑润剂常常被施加给气管内管195的套囊。理想的是防止所述润滑剂落到透镜314上,从而阻挡透镜314提供的观察。当气管内管195插入通过装置200时,凹口370收集可能从管195刮掉的任何润滑剂,从而防止所述润滑剂落到透镜314上。类似地,当通过装置200取回气管内管195时,凹口380收集可能从管195刮掉的任何润滑剂,从而再次防止所述润滑剂落到透镜314上。由于有时有必要取出一个气管内管,然后插入另一个,所以理想的是在取回气管内管时保护透镜314使得免于从所述气管内管刮掉的润滑剂。
凹口380的正上边缘可与环360的远端隔开约2.5毫米。限定凹口370的近端的正上边缘可与环360的远端隔开约五毫米。凹口370和380可为约1.5毫米深。
Claims (11)
1.一种喉罩通气道装置,包括:气道管,所述气道管从近端延伸至远端,所述气道管限定能够在其中容纳气管内管的内通道;罩部分,所述罩部分连接至所述气道管的远端,所述罩部分包括可充气套囊,并限定与所述内通道流体连通的开口,所述罩部分可通过患者的嘴插入患者内的插入位置,在充气时和所述罩部分处于所插入的位置时所述套囊适于围绕患者的声门开口;以及纤维光学观察装置,所述纤维光学观察装置具有远端和近端,所述纤维光学观察装置的远端被设置在所述气道管的远端的附近,以向用户提供远程观察。
2.根据权利要求1所述的装置,所述罩部分包括会厌提升棒,所述棒限定一孔口,并可被设置在歇置位置和打开位置中,所述纤维光学观察装置提供对延伸通过由所述棒限定的孔口的区域的观察。
3.根据权利要求1或2所述的装置,所述纤维光学观察装置包括位于其远端的透镜,所述透镜与所述内通道分开,以避免所述透镜和插在所述通道中的气管内管之间的接触。
4.根据权利要求1所述的装置,所述罩部分包括背板,所述背板限定斜面,所述斜面限定用于支承插在所述通道中的气管内管的支承面。
5.根据权利要求4所述的装置,还包含纤维光学系统,所述纤维光学系统包括从所述近端延伸到所述远端的光纤束,所述斜面包括通道,所述光纤束延伸通过所述通道。
6.根据权利要求5所述的装置,包括用于防止来自所述通道中的气管内管的松散材料接触所述透镜的装置。
7.根据权利要求6所述的装置,所述防止装置适于防止在将所述气管内管插入通过所述通道时从所述气管内管刮掉的材料接触所述透镜。
8.根据权利要求6所述的装置,所述防止装置适于防止在从所述通道取出所述气管内管时从所述气管内管刮掉的松散材料接触所述透镜。
9.根据权利要求6所述的装置,所述防止装置包括设置在所述透镜和所述通道之间的一个或多个凹口。
10.根据权利要求9所述的装置,所述凹口与所述背板一体形成。
11.根据权利要求9所述的装置,所述凹口由设置在所述背板上的环限定,所述纤维光学观察装置的透镜通过所述环的孔口。
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- 2004-08-18 WO PCT/EP2004/009259 patent/WO2005023350A1/en active Application Filing
- 2004-08-18 AU AU2004269871A patent/AU2004269871B2/en not_active Ceased
- 2004-08-18 PL PL380066A patent/PL380066A1/pl not_active Application Discontinuation
- 2004-08-18 JP JP2006525673A patent/JP4653746B2/ja not_active Expired - Fee Related
- 2004-08-18 BR BRPI0414325-6A patent/BRPI0414325A/pt not_active IP Right Cessation
- 2004-08-18 ES ES04764245.9T patent/ES2599843T3/es active Active
- 2004-08-18 CA CA002537956A patent/CA2537956A1/en not_active Abandoned
- 2004-08-18 EP EP16175105.2A patent/EP3088029A1/en not_active Withdrawn
- 2004-08-18 RU RU2006110571/14A patent/RU2341300C2/ru not_active IP Right Cessation
- 2004-08-18 EP EP04764245.9A patent/EP1663363B1/en not_active Not-in-force
- 2004-08-20 TW TW093125102A patent/TW200514589A/zh unknown
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2006
- 2006-03-02 IL IL174079A patent/IL174079A0/en unknown
- 2006-04-04 ZA ZA200602749A patent/ZA200602749B/en unknown
- 2006-10-27 US US11/588,831 patent/US7896007B2/en not_active Expired - Fee Related
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Cited By (1)
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WO2020156031A1 (zh) | 2019-02-02 | 2020-08-06 | 长沙迈吉尔医疗科技有限公司 | 喉罩 |
Also Published As
Publication number | Publication date |
---|---|
RU2341300C2 (ru) | 2008-12-20 |
US7896007B2 (en) | 2011-03-01 |
US20070119460A1 (en) | 2007-05-31 |
JP4653746B2 (ja) | 2011-03-16 |
TW200514589A (en) | 2005-05-01 |
AU2004269871A1 (en) | 2005-03-17 |
ZA200602749B (en) | 2007-04-25 |
BRPI0414325A (pt) | 2006-11-07 |
US7128071B2 (en) | 2006-10-31 |
RU2006110571A (ru) | 2007-10-20 |
EP3088029A1 (en) | 2016-11-02 |
CA2537956A1 (en) | 2005-03-17 |
CN1859939A (zh) | 2006-11-08 |
JP2007521100A (ja) | 2007-08-02 |
IL174079A0 (en) | 2006-08-01 |
EP1663363A1 (en) | 2006-06-07 |
PL380066A1 (pl) | 2006-12-27 |
AU2004269871B2 (en) | 2010-11-11 |
EP1663363B1 (en) | 2016-07-27 |
US20050051175A1 (en) | 2005-03-10 |
ES2599843T3 (es) | 2017-02-03 |
WO2005023350A1 (en) | 2005-03-17 |
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