JP4593186B2 - Catheter housing - Google Patents

Description

The present invention relates to catheters container.

  For diagnosis and treatment of intestinal obstruction, the obstruction release method is often used by inserting a catheter nasally from the esophagus through the large intestine into the intestine and draining the intestinal contents or depressurizing the intestinal tract to reduce the internal load. Has been.

  The conventional catheter structure used for such applications has a guiding portion in which a plurality of metal balls, rings, and other weights that facilitate insertion of the catheter are embedded in a flexible resin in a bead shape at the distal end portion. The body tube is provided with a plurality of suction holes and a balloon that is inflated by liquid injection. A branch tube connected to each lumen is connected to the end of the body tube, and a connector is connected to the end of the branch tube. It has an attached structure.

  The main body tube usually has two to three lumens, and basically a main lumen serving as a passage for discharging contents in the intestine to the outside of the body, and a sub for injecting an inflation fluid into the balloon. It is composed of lumens. Further, another sub-lumen serving as an air introduction passage for improving suction efficiency and preventing excessive suction to the intestinal wall may be attached.

  When inserting the catheter into the intestinal tract, the guide wire is inserted into the catheter in advance outside the body, and the insertion into the body is aimed while adjusting the tip position of the guide wire and adjusting the rigidity of the catheter. The intestinal contents after indwelling are sucked and discharged from the suction hole of the main body tube and discharged from the connector through the branch tube communicating with the main lumen. (Patent Document 1). The balloon passes through the pyloric ring, passes through the next bend, the Tritz ligament, and then advances the catheter to the intestinal obstruction by the peristaltic movement of the intestine.

  The use of such a catheter is common, but the catheter used for this purpose is a long tube of 2 to 3 m, and the guide wire to be used is longer, so the insertion operation into the catheter is performed alone. It was difficult to do, and the cleaning operation was performed with great care.

  In addition, since the catheter is long, resistance to insertion and withdrawal of the guide wire is large, and it is necessary to use a lubricant. A hydrogel-coated guide wire is used to improve the operability and the handling of the lubricant. Since the guide wire is injected with water in the protective case to give lubricity, there is a problem that it is very slippery and difficult to grip when grasping by hand, and this is a guiding operation into the body after insertion into the catheter Even in the adjustment operation of the inner guide wire tip position, it is slippery and necessitated complicated operation. In addition, this product is often used in cases of sudden intestinal obstruction, but the above-mentioned preoperative operation and complexity have hindered emergency treatment.

JP 2001-299927 A

  An object of the present invention is to provide a medical catheter that can be operated by a single person, without the operation of inserting a guide wire into the catheter before insertion into a patient, and a container for the medical catheter.

According to the present invention, which incorporates a lumen, and ileus treatment catheter inside the guide wire is inserted in the lumen, see containing and a container for containing the catheter ileus treatment is withdrawn from the container Also provided is a catheter housing body that is used by injecting a lubricant into the lumen of the intestinal obstruction treatment catheter .

  This container accommodates the catheter with the guide wire inserted in advance. For this reason, it is possible to take out the catheter from the container and to use it immediately without inserting the guide wire. Therefore, it is possible to perform a single operation even in an emergency.

  In this container, the medical catheter is bundled in a state of being wound with a predetermined diameter, and the distal end portion and the proximal end portion of the catheter are arranged so as not to contact the bundled portion of the medical catheter. It is good also as the structure currently made. Alternatively, the guide portion and the balloon provided on the catheter may be arranged so as not to contact the bundled portion of the medical catheter. By doing so, damage to the distal end side of the catheter, particularly the guiding portion and the balloon can be effectively suppressed.

  In the present invention, a guiding portion provided at the distal end of the catheter, a visual recognition portion provided on the catheter proximal side of the guiding portion and configured to visually recognize the inside of the catheter, and a catheter proximal side of the visual recognition portion And a balloon provided, and a distal end portion of the guide wire may be positioned at the visual recognition portion. In this way, the tip position of the guide wire can be visually confirmed before the catheter is inserted into the body, and when the catheter is inserted into the body, the guide wire can be operated while confirming the tip position with X-rays. It becomes possible.

  Moreover, it is good also as a structure provided with a liquid injection | pouring part in the base end side of a catheter. Examples of the liquid herein include a liquid for eluting or dispersing the lubricant applied to the guide wire.

  A branch injection connector having a guide wire fixing portion on the catheter proximal side, a connector connection portion on the catheter distal end side, and an infusion liquid port in the center is connected in advance to the end of the lumen into which the guide wire is inserted. It is good also as a structure.

  The guide wire may be lubricated.

  The guide wire may extend from the proximal end of the catheter, and the extended portion of the guide wire may be covered with a protective member.

  As described above, the catheter for insertion into the intestinal tract according to the present invention eliminates the need for a complicated operation of inserting a guide wire into the catheter as a preparation for the insertion into the body after opening the sterilization bag. , Single operation is possible.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. In all the drawings, the same reference numerals are given to the same components, and the description will be omitted as appropriate.

First Embodiment This embodiment is an example in which the present invention is applied to an intestinal catheter. FIG. 1 is a diagram showing a schematic structure of a catheter 1 according to this embodiment. In the figure, the left side is the distal end and the right side is the proximal end.

  As shown in FIG. 1, the catheter 1 includes a main body tube 2 having a plurality of lumens provided therein, and a guide portion 4 that guides the catheter into the body is provided at a distal end portion thereof. A branch tube 7 is connected to the base end side of the main body tube 2. The branch tube 7 includes a tube provided with a connector A, a tube provided with a connector B, and a tube provided with a one-way valve 10. A liquid injection connector 11 is connected to the connector B, and a guide wire fixing portion 13 is provided on the base end side. The guide wire 20 is provided so as to pass through the body tube 2 from the proximal end side guide wire fixing portion 13 to the visual recognition portion 16 of the catheter.

  Hereinafter, the configuration of each unit will be described.

  The main body tube 2 has a main lumen that leads to the suction hole 6 for discharging the intestinal contents, a fluid injection subroutine that inflates the balloon 3 provided in the vicinity of the distal end, and an improvement in the suction effect by the suction hole 6 Each is equipped with air introduction sub-lumens for preventing the suction pressure from being applied (not shown). A connector A, a connector B, or a one-way valve 10 is connected to each lumen at the rear end of the main body tube 2 through a branch tube 7 in a gas-liquid manner. Various materials can be used as the material of the main tube 2, and for example, vinyl chloride resin, polyurethane resin, silicone rubber, or a composite material thereof can be used.

  It is desirable to apply a lubricity treatment to the outer periphery or lumen of the main body tube 2. Examples of such treatment include coating with fluororesin and kneading of silicone oil into the resin of the catheter. In addition, various hydrogel coatings are practically used. Considering the toxicity to the human body, collagen, polyvinyl pyrrolidone, polyacrylamide, etc. are preferable for the hydrogel. For fixing to the catheter, these hydrogels previously made into a solution are coated on the catheter and then crosslinked with glutaraldehyde. Use a method, a method of coating these hydrogel monomers with a polymerization initiator after coating, a method of coating a catheter with a hydrogel solution modified with a photoreactive crosslinking agent, and fixing it to the catheter by light irradiation, etc. Can do.

  The injection connector 11 is mainly used for a catheter that is placed in the body while using a guide wire together. It can be connected to the rear end of the catheter to integrally fix the guide wire to the catheter. At the same time, it is possible to inject lubricant, contrast medium, and the like. The structure is composed of a main body 12 connected to the rear end of the catheter and a guide wire fixing portion 13 for fixing the guide wire 20 in a liquid-tight manner by compressing an elastic body 15 built in the main body 12. The main body 12 is provided with a liquid injection port 14 (liquid injection portion) that forms a connector that can be connected to a syringe 30 for injecting a lubricant and the like, and has a tip formed as a bamboo shoot-like connection portion. For example, 13 is provided with a rib on the outer periphery so as to be easily rotated, and is screwed to the main body 12. The material of this product is not particularly limited, and in order to achieve the function, the main body 12 and the guide wire fixing portion 13 are made of hard resin, and the elastic body 15 is made of soft resin, rubber or the like.

  A liquid such as sterile physiological saline is injected from the liquid injection port 14 of the liquid injection connector 11. This liquid is introduced into the lumen to elute or disperse the lubricant applied to the guide wire. The liquid injection port 14 is preferably covered with a cap. Covering the main tube 2 main lumen with the cap ensures that a lubricating solution such as sterile physiological saline is always secured, and the guide wire 20 is always under fluid lubrication and is resistant to operation and removal. Can be reduced.

  A conventionally known guide wire 20 can be used. The shape, size, material, and physical properties are not particularly limited, and are determined in consideration of slipperiness, rigidity, and cost according to the catheter material or lumen lubrication treatment.

  The guide wire 20 can be inserted into the lumen of the catheter through the guide wire fixing portion 13 and the catheter can be performed substantially linearly. By extending the catheter 1 substantially linearly, the surface of the guide wire 20 can be prevented from being damaged, and the operation of the guide wire 20 during use and the removal resistance are not affected.

  Here, at least one of the outer periphery of the catheter and each lumen of the catheter may be lubricated, or the guide wire 20 may be lubricated.

  The guiding portion 4 is at the distal end of the catheter and plays a role of guiding the catheter into the body. A metal ball 5 is embedded in the guiding portion 4 in a bead shape in the extending direction of the catheter. The metal sphere 5 functions as a weight, and in addition, a ring, a coil, or the like can be used.

  The balloon 3 has a function of prompting insertion of the catheter by peristaltic movement. Specifically, after passing through the pyloric ring and passing through the next bending part, the tritium ligament, it works to advance the catheter to the intestinal obstruction part by peristaltic movement of the intestine.

  FIG. 2 is a diagram schematically showing a cross-sectional structure of the catheter 1. Here, the cross-sectional structure at the base end side of the balloon installation portion 21 is shown as an example.

  The main body tube 2 has an elliptical cross section. A first lumen 23 is provided in the main body tube 2, and a second lumen 24 and a third lumen 25 are disposed on both sides thereof. Each lumen is provided so as to penetrate from the proximal end side of the main body tube 2 to the distal end side, and is open at the proximal end side. The first lumen 23 becomes a passage for discharging the contents in the intestine to the outside of the body. The second lumen 24 serves to inject inflation fluid into the balloon. The third lumen 25 serves as an air introduction passage for improving suction efficiency and preventing excessive suction on the intestinal wall. The guide wire 20 is provided so as to pass through the inside of the first lumen 23. A lubricant layer 22 is provided on the outer surface of the main body tube 2, the inner surface of the first lumen 23, and the outer surface of the guide wire 20. The main body tube 2 is provided with an X-ray opaque line 26 on a part of its side surface, but the other part is made of a material that transmits X-rays.

  FIG. 3 is a view showing a detailed cross-sectional structure of the distal end portion of the catheter 1. From the front end side, the guide part 4, the visual recognition part 16, and the balloon installation part 21 are provided in this order. The visual recognition unit 16 has a configuration in which a state inside the main body tube 2 can be confirmed by visual observation and observation using X-rays. In the present embodiment, the length of the visual recognition part 16 is about 15 mm.

  Although not shown in FIG. 3, the first lumen 23 shown in FIG. 5 is provided from the proximal end side of the catheter 1 to the viewing portion 16, and the guide wire 20 is inserted in advance inside the lumen. The distal end position of the guide wire 20 is located in the visual recognition part 16 having a length of about 15 mm provided between the rear end part of the guide part 4 and the balloon installation part 21. With such an arrangement, the tip position of the guide wire 20 can be visually confirmed outside the body, and can be used immediately without adjusting the position of the guide wire 20 before use. It is also possible to confirm the tip position in the body. If the tip position of the guide wire is outside the visual recognition part 16, it is difficult to confirm the tip position. This is because the guiding part 4, the balloon 3 and the balloon setting part 21 contain a contrast agent, and if there is a tip of the guide wire 20 in these regions, it will be assimilated at the time of contrasting, It is difficult to confirm.

As described above, in the catheter 1 of the present embodiment, the guide wire 20 for in-vivo guidance is inserted in advance into the lumen of the catheter. Conventionally, in order to improve the rigidity of the catheter 1 before the treatment, it has been necessary to insert and integrate the guide wire 20 into the catheter 1 by a plurality of people. However, the guide wire 20 is inserted into the lumen of the catheter in advance. Therefore, there is no complicated operation before the treatment, and the surgeon can immediately perform the operation alone in the treatment of intestinal obstruction requiring urgent.
In addition, since the catheter 1 of the present embodiment is configured to introduce saline from the liquid injection port 14, good operability can be obtained. Conventionally, the structure is such that saline is poured into the guide wire protecting case from the proximal side of the catheter, so that the gripping portion on the proximal side of the catheter often gets wet. However, since the outer wall of the catheter is coated with a lubricant, it may become slippery when touched with saline, and the operability may be significantly reduced. In this embodiment, such a decrease in operability can be prevented.

Second Embodiment In this embodiment, a configuration example of a catheter container that accommodates a catheter will be described. The structure of the catheter is the same as that described in the first embodiment. The catheter 1 is provided with a guide portion 4, a visual recognition portion 16, and a balloon installation portion 21 in this order from the distal end side. The visual recognition unit 16 is configured to be able to confirm the state inside the main body tube 2 by visual observation and observation using X-rays. A guide wire 20 is inserted in advance into a lumen provided from the proximal end side of the catheter 1 to the visual recognition portion 16. The distal end of the guide wire 20 is located in the visual recognition part 16.

  FIG. 4 is a view showing a container 45 that houses the catheter 1. The container 45 includes a sterilization bag 40 in which the catheter 1 is accommodated and a syringe accommodating portion in which the syringe 30 is accommodated. The syringe 30 is used for balloon expansion or for contrast medium injection. The syringe 30 is made of a material that does not transmit ethylene oxide gas.

  The guide wire 20 is inserted in advance into a lumen (not shown) in the catheter 1. The guide wire 20 extends from the liquid injection connector 11 provided on the proximal side of the catheter.

  The catheter 1 is housed in a state of being wound with a predetermined winding diameter. On the other hand, the extended portion of the guide wire 20 is fixed by a tape (not shown) and accommodated in a state of being wound with a winding diameter smaller than the predetermined winding diameter. By doing so, the extended portion of the guide wire 20 is prevented from coming into contact with other portions of the catheter 1 and causing damage.

  The syringe 30 can be filled with sterilized distilled water in advance and can be used immediately for balloon expansion. Moreover, it is good also as a form which inject | pours a contrast agent in the syringe 30 and can utilize immediately for contrast agent injection | pouring. By doing so, it can be used as an emergency kit that can be used immediately.

  The arrangement of these components in the packaged state is arranged so as not to protrude from the distal end of the catheter in order to prevent damage to the distal flexible portion of the guide wire 20, and the rear end portion of the guide wire 20 that is necessarily held by the operator is Then, it is projected from the rear end of the injection connector 11 at the end of the catheter. The packaging material is not particularly limited, and may be directly disposed in a sterilization bag as shown in FIG. 3 or a tray or the like may be used.

  Next, a method for using the catheter 1 will be described. First, the sterilization bag 40 is opened and the catheter 1, the injection connector 11, and the guide wire 20 are taken out, and a lubricant is injected from the injection port 14 of the injection connector 11 with a syringe 30 as a preparation. In general, olive oil is often used as the lubricant, but when the surface of the catheter lumen or the guide wire 20 is coated with hydrogel, sterilized physiological saline or the like is used. .

  The subsequent insertion operation from the nasal cavity is performed while adjusting the distal end position of the guide wire 20 and the distal end position of the catheter as usual, and reaches the target intestinal obstruction site. Thereafter, the injection connector 11 and the guide wire 20 are removed, The indwelling is completed by connecting to the aspirator and drainage storage container.

Third Embodiment In this embodiment, a configuration example of a catheter container that accommodates a catheter will be described. The structure of the catheter is the same as that described in the first embodiment. The catheter 1 is provided with a guide portion 4, a visual recognition portion 16, and a balloon installation portion 21 in this order from the distal end side. The visual recognition unit 16 is configured to be able to confirm the state inside the main body tube 2 by visual observation and observation using X-rays. A guide wire 20 is inserted in advance into a lumen provided from the proximal end side of the catheter 1 to the visual recognition portion 16. The distal end of the guide wire 20 is located in the visual recognition part 16.

  FIG. 5 is a diagram showing a schematic structure of a storage body 55 in which the catheter 1 is stored in the product tray 50. A storage chamber 56 having a circular shape in plan view is provided inside the product tray 50, and the catheter 1 is stored in the storage chamber 56.

  A tube retainer 51 is provided in the accommodation chamber 56. The tube retainer 51 is fixed in a state where the tubes 2 are bundled.

  In addition, a rib 52 is provided in the storage chamber 56, so that the distal end portion of the catheter including the balloon 3 and the guide portion 4 is fixed at a position away from other portions of the catheter. ing.

  This container accommodates the catheter 1 in a wound state, but in this case, the balloon 3 and the tube tip guide 4 may be damaged by contacting and rubbing with the tube during transportation. . Therefore, in this embodiment, the catheter 1 is wound with a predetermined winding diameter, and the catheter tip including the balloon 3 and the tube tip guide 4 is wound with a winding diameter smaller than the predetermined winding diameter. And That is, the radius of curvature of the bundled portion of the catheter and the radius of curvature of the distal end portion of the catheter are arranged to be different, and the distal end portion and the proximal end portion of the catheter do not coincide with each other and the catheter bundles are bundled. It is arranged so that it does not come into contact with any part. Specifically, a rib 52 is provided on the inner side of the product tray 50, so that the distal end portion of the catheter is arranged on the inner side so that it does not come into contact with other portions of the catheter. By adopting such a configuration, damage prevention of the balloon 3 and the tube tip guiding portion 4 is achieved.

  The wound diameter of the catheter 1 is set within a range in which the guide wire 20 and the internal structure of the catheter 1 are not deformed and the surface resin layer is not damaged. When the guide wire 20 is wound in the state where the guide wire 20 is inserted into the catheter 1, the inner wall of the lumen of the catheter 1 is deformed due to the stress applied from the guide wire 20 to the inner wall surface of the catheter 1, and the inner lumen of the first to third lumens. There is a concern that the cavity collapses. For this reason, the outer diameter 53 is preferably 200 to 350 mm, and the inner diameter 54 is preferably wound and stored at 100 to 200 mm. Within this range, it is difficult for an abnormal force to be applied to the guide wire, and the surface is rubbed and the lubricating treatment layer is rarely damaged.

  In addition, the liquid injection connector 11 in the product tray 50 may be connected to the suction lumen connector of the catheter 1, but may be arranged in a separated position if it can be immediately connected. In any case, it is preferable that the guide wire 20 is passed. Since the connector may be deformed when the suction lumen connector of the catheter 1 is fitted with a thermoplastic resin such as vinyl chloride resin or polyurethane resin, it is not connected to the suction lumen connector of the catheter 1 and separated. It is preferred to place it on the product tray. Even if it is fitted with a thermosetting resin such as silicone rubber, the deformation does not proceed.

  As mentioned above, although embodiment of this invention was described with reference to drawings, these are the illustrations of this invention, Various structures other than the above are also employable.

  For example, the extending portion of the guide wire 20 may be covered with a protective member such as a resin protective tube. A lubricant coating layer is provided on the surface of the guide wire 20. By providing the protective member, the coating layer is suitably protected.

It is a figure which shows the state which connected the injection connector to the catheter for intestine insertion as an Example of the medical catheter which concerns on embodiment, and inserted the guide wire. It is a figure which shows typically the cross-section of a catheter. It is a figure which shows the sectional view detailed structure of the front-end | tip part of the catheter for insertion in the intestine which is one Example of the medical catheter which concerns on embodiment, and is a figure which shows the state which connected the injection connector and inserted the guide wire. . It is a figure which shows the structure of the medical catheter accommodating body which concerns on embodiment. It is a figure which shows the structure of the medical catheter accommodating body which concerns on embodiment.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Medical catheter 2 Main body tube 3 Balloon 4 Guide part 5 Metal ball 6 Suction hole 7 Branch tube 8 Connector A
9 Connector B
DESCRIPTION OF SYMBOLS 10 One-way valve 11 Injection connector 12 Main body 13 Guide wire fixing | fixed part 14 Injection port 15 Elastic body 16 Visualization part 20 Guide wire 21 Balloon installation part 22 Lubricity treatment part 23 1st lumen 24 2nd lumen 25 3rd lumen 26 X Wire impermeable line 30 Syringe 40 Sterilization bag 50 Product tray 51 Tube holding wing 52 Rib 53 Outer diameter 54 Inner diameter

Claims (11)

An intestinal obstruction treatment catheter having a lumen inside, and a guide wire inserted into the lumen;
A container for housing the intestinal obstruction treatment catheter;
Only including,
A catheter housing body that is used by injecting a lubricant into the lumen of the intestinal obstruction treatment catheter taken out of the container . The catheter housing according to claim 1,
A catheter housing body in which the intestinal obstruction treatment catheter is bundled in a wound state with a predetermined diameter. The catheter housing according to claim 2,
The intestinal obstruction treatment catheter is;
A visual recognition unit configured to visually recognize the inside of the catheter by visual observation and observation using X-rays; and
A balloon provided on the catheter proximal side of the visual recognition unit;
Further comprising
A catheter housing body in which a distal end portion of the guide wire is located in the visual recognition portion. The catheter housing according to claim 3,
A catheter housing body further comprising a guide portion provided on the distal end side of the visual recognition portion and configured to guide the catheter into the body. The catheter housing according to claim 4,
A catheter housing body in which the guiding portion and the balloon are arranged so as not to contact a bundled portion of the catheter for intestinal obstruction treatment. The catheter housing body according to any one of claims 1 to 5,
A catheter housing body in which the guide wire extends from the proximal end portion of the catheter. The catheter housing according to claim 6,
A catheter housing body in which an extended portion of the guide wire is covered with a protective member. The catheter housing according to claim 2,
A catheter housing body arranged such that a distal end portion and a proximal end portion of the catheter do not come into contact with a bundled portion of the catheter for intestinal obstruction treatment. A catheter housing body according to any one of claims 1 to 8,
The catheter housing body in which the catheter for intestinal obstruction treatment further includes a liquid injection part. The catheter housing body according to any one of claims 1 to 9,
In the intestinal obstruction treatment catheter, a branch injection connector having a guide wire fixing part on the proximal side of the catheter, a connector connection part on the distal end side of the catheter, and an infusion solution port is provided in advance at the end of the lumen into which the guide wire is inserted Connected catheter housing. A catheter housing body according to any one of claims 1 to 10,
A catheter housing body in which the guide wire is lubricated.

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