CN101212997B - 呼吸辅助设备 - Google Patents

呼吸辅助设备 Download PDF

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CN101212997B
CN101212997B CN2006800238672A CN200680023867A CN101212997B CN 101212997 B CN101212997 B CN 101212997B CN 2006800238672 A CN2006800238672 A CN 2006800238672A CN 200680023867 A CN200680023867 A CN 200680023867A CN 101212997 B CN101212997 B CN 101212997B
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manifold
oxygen
assistance apparatus
supply device
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M·P·F·克拉默
K·P·奥唐奈
C·S·J·奎尔
M·J·佩顿
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Fisher and Paykel Appliances Ltd
Fisher and Paykel Healthcare Ltd
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Abstract

本发明的呼吸辅助设备包括复式接头,其设置于或可被改装至气体供应和加湿装置。复式接头允许来自氧气浓缩器的气体与流经气体供应和加湿装置的气流(最通常为空气)相混合。氧气和其它呼吸气体(空气)的混合输出物随后被加湿。本发明的呼吸辅助设备和复式接头提供了一种安全方法,用于向气体供应和加湿装置的输入空气流添加氧气,并且降低气体供应装置内聚集的氧气量,以减小装置内出现火花时着火的危险。

Description

呼吸辅助设备
技术领域
本发明涉及一种气体供应和气体加湿设备,其包括复式接头,用于向气体供应装置添加氧气。 
背景技术
本领域中已知多种方法用于辅助患者的呼吸。连续正呼吸道压力(CPAP)涉及在压力下向患者施予空气,通常利用鼻面罩。其用于治疗打鼾和以吸气过程中的上呼吸道重复性塌陷为特征的阻塞性睡眠呼吸暂停(OSA)。正压力将上呼吸道撑开,以防止其塌陷。利用鼻CPAP治疗OSA已被证明既有效又安全,但是CPAP难以使用,并且大多数患者会出现明显的副作用,特别是在治疗的早期阶段。 
上呼吸道症状负面影响利用CPAP的治疗。粘膜干燥不舒服,并且可能在夜间弄醒患者。反跳式鼻淤血通常在后续日子里出现,类似于病毒感染。如果不加处理,上呼吸道症状会负面影响CPAP的使用率。 
鼻阻力的增加可能会影响作用于咽的CPAP治疗级别,并且降低治疗的效力。要为每个使用CPAP的患者确定各自的压力,并且该压力在患者界面被设置。鼻阻力的变化会影响传送到咽的压力,并且如果变化的幅度足够大,则可能复发打鼾或呼吸道塌陷,或减小施加到肺的压力级别。 
CPAP还常被用于治疗患者的各式各样的呼吸不适或疾病,包括慢性阻塞性肺疾病(COPD)。 
氧气是给呼吸或其它不适的住院患者的最常开处方的药剂。通过鼻插管或面罩传送氧气对遭受呼吸暂停的患者是有益的。通过增加吸入氧气含量(比例),氧气治疗可减小呼吸所需的力量,并且可以纠正所导致的缺氧症(组织中氧气级别低)。 
治疗的持续时间取决于潜在疾病。例如,手术后患者可以只在从手术复原的同时接收氧气,而COPD患者要求每天16至18小时氧气。 
目前,一千六百万以上的成人受到COPD的折磨,一种描述一组肺疾病的涵盖性术语为不可逆气流限制,其主要涉及肺气肿和慢性支气管炎,最通常由几十年吸烟引起。当呼吸道限制平缓地发展时,其演化为永久性呼吸暂停,而身体机能无法发挥。诸如气管支气管感染、心力衰竭以及环境风险等情况可能激起COPD恶化,这就需要住院,直至剧烈的呼吸暂停受到控制。在COPD剧烈恶化过程中,患者通常经受加重的难以呼吸(呼吸困难症),缺氧症,痰量和脓增多,并且咳嗽加重。 
氧气治疗可以向COPD剧烈恶化的缺氧患者提供巨大的益处,可降低致命的组织衰竭的危险,并且减轻呼吸困难。氧气治疗相关的主要并发症是分解代谢过度(血液中二氧化碳级别升高)以及随后的呼吸衰竭。因此,施予的氧气剂量非常重要。 
为了精确地控制给予患者的氧气剂量,富氧气体必须超过患者的峰值吸气流,以防止夹带室内空气并稀释氧气。为实现这一点,大于20L/min的流量是常用的。如果通过鼻插管传送,这样的干燥气体流量会导致脱水和鼻通道和呼吸道发炎。为了避免这种情况出现,加热型加湿器可被使用。 
用于氧气治疗或仅仅向患者传输气体的大部分系统包括气体供应装置、加湿器和导管。界面包括面罩、嘴用器具、气管切开术入口元件和鼻插管,同面罩相比,鼻插管的优点是患者更舒服和更容易接受。 
气体供应装置通常可提供恒定的、预先规定级别的气流至加湿器。加湿器和导管然后可以在气体传输至患者之前将气体加热和加湿至设定温度和湿度。许多使用吹风机或连续正压力装置治疗COPD的患者要经历长期氧气治疗。这样的患者通常需要超过每天15小时的氧气治疗,这样,唯一可行的方法是为那些承受每天若干小时的加湿治疗和氧气治疗的患者组合氧气治疗和加湿治疗。由于都知道氧气治疗会使呼吸道干燥,因此组合治疗容易带来益处。 
目前CPAP系统通常结合氧气流动系统,以提供增大的氧气含量用于治疗呼吸疾病。这些系统通常在吹风机的高压力(气流出口)侧组合氧气源。这会导致三项主要缺点。首先,通过将氧气组合在高压力侧,需要使用带密封盖的连接端口在氧气流源未被连接时密封氧气引入端口,并且避免高压力气体泄露。第二,在吹风机接通呼吸回路之前氧气源已被接通的情况下,加湿腔和吹风机被充满100%氧气。这在已被接通的吹风机或加热的呼吸管中出现火花的情况下,容易发生着火的危险。第三,如果氧气气源添加在加湿腔出口,氧气在与传送至患者的其它气体混合时,会降低被传输的气体的整体湿度。 
发明内容
本发明的目的是提供一种呼吸辅助设备,其在一定程度上客服前面描述的缺点,或者至少向公众或行业提供一种实用的选择。 
为此,本发明的第一方面包括一种适于向患者传送加湿气体的呼吸辅助设备,其包括: 
气体供应装置,其具有入口,气体通过该入口被抽取, 
加湿装置,其包括具有出口的加湿腔,所述气体从所述入口流动通过所述加湿腔并且从所述出口流出,以及 
设在所述入口上或周围的复式接头,其用于将氧气或其它气体添加到所述气体中。 
优选地,所述复式接头包括氧气引入端口,其能够连接至氧气供应装置。 
优选地,所述复式接头基本上是矩形的。 
优选地,所述复式接头包括至少一个开口,以允许将其它气体抽入所述复式接头中。 
优选地,所述气体供应装置包括内部传感器,其能够检测流经所述呼吸辅助设备的氧气含量。 
优选地,所述气体供应装置包括控制器,其连接着所述内部传感器。 
优选地,所述气体供应装置包括显示器,其被所述控制器控制,并且所述控制器引起所述氧气含量在所述显示器上被显示和更新。 
对于本发明所涉及的技术领域中的技术人员而言,可以构想出许多结构变化以及本发明的不同实施和应用方式,而不脱离权利要求中限定的本发明范围。这里公开和描述的内容仅仅是解释性的,没有任何限制的意义。 
在本说明书中,对专利文献、其它外界文件或其它信息源的 引用主要是便于讨论本发明的特征。除非专门指出,否则对外界文件的引用绝不能认为是承认这些文件或信息源在任何法律意义上是本发明的现有技术或构成本领域公知常识的一部分。 
附图说明
下面将参照附图描述本发明的优选实施方式。 
图1示出了呼吸辅助设备,其可以使用本发明的复式接头。 
图2是带有本发明的复式接头的吹风和加湿装置的后视图。 
图3是本发明的复式接头的后视图。 
图4是图3中的复式接头的第一透视图。 
图5是图3中的复式接头的第二透视图。 
具体实施方式
本发明的呼吸辅助设备包括复式接头(manifold),其优选设至于或可被改装于气体供应和加湿装置上。复式接头允许气体从氧气浓缩器与流经气体供应和加湿装置的气流(最通常空气)相混合。氧气和其它呼吸气体(空气)的混合输出物随后被加湿。 
本发明的呼吸辅助设备和复式接头提供了一种安全方法,以添加氧气至气体供应和加湿装置的输入空气流,并且减小氧气在气体供应装置中的聚集量,降低装置中出现火花时着火的危险。 
本发明提供了一种呼吸辅助设备,其中气体流依次流经气体供应装置或气流驱动器(例如吹风机,风扇或压缩机),加湿腔,加热的传输回路,然后流向患者界面,例如图1所示的情况。 
气体借助于患者界面2输送到患者1。本发明的设备所用的患者界面可以是全罩式面罩、鼻面罩、鼻插管、嘴用器具或气管切 开术连接件,但在下面的描述以及图示中仅讨论使用鼻插管时的情况。 
参照图1,本发明的加湿装置被显示为患者1通过鼻插管2接收加湿和加压气体。插管2连接着气体输送路径或吸气导管3,后者又连接至组合式气体供应和加湿装置4(包括加湿腔5)。在吹风加湿装置4的优选实施方式中,气体供应装置或吹风机组合于一个带有加湿器和加湿腔的壳体中。 
在优选实施方式中,加湿腔5从壳体10延伸出来,并且在使用中能够被患者或其它使用者拆下和更换(通过滑动运动)。此外,通向加湿腔5的引入端口(未示出)位于壳体10内。需要理解,前面描述的涉及壳体的实施例以及图1仅仅示出了组合式气体供应和加湿装置的壳体的一种形式。在其它形式中,气体供应装置或吹风机和加湿器可以位于单独的壳体中。 
吸气导管3连接至加湿腔5的出口8,加湿腔容纳着一定体积的水6。吸气导管3包含加热器具或加热丝7,用于加热导管的壁,以减少加湿气体在导管和患者界面(鼻插管2)内的凝结。加湿腔5优选由塑料制成,并且可以具有高导热性基座(例如铝基座),其直接接触加热板(未示出,但位于腔5的基部,在吹风机壳体内)。气体供应和加湿装置4设有控制装置或电子控制器,其可以包括基于微处理器的控制器,以执行存储在相关存储器中的计算机软件指令。控制器从输入源例如使用者输入装置或键盘(未示出)接收输入,这样,装置4的使用者可以,例如,设置供应至患者1的气体的湿度或温度的预订要求值(预设值)。 
响应于使用者通过键盘(或按钮)设定的湿度或温度值,以及其它可行的输入例如检测气流或温度的内部传感器的输入,或通过控制器中计算出的参数,控制器确定何时(或到什么级别) 向加热板供电以加热加湿腔5中的水6。随着加湿腔5中的一定体积的水6被加热,水蒸气开始充入腔中位于水面上方的容积,并且与装置的吹风机部分供应的气体(例如空气)流一起排出加湿腔出口8,所述气体流是通过气体供应和加湿装置4后部的入口9进入装置4的。 
装置4中的气体供应装置优选为变速泵或风扇,其通过吹风机入口9抽取空气或其它气体。变速泵或风扇的速度优选由前面描述的控制装置或电子控制器响应于使用者输入到装置4中的输入信号来控制。 
如前面所讨论,有益的是,向遭受COPD和其它呼吸疾病的患者提供带有加湿治疗的氧气治疗。本发明的呼吸辅助设备通过使用复式接头提供了这一点,该复式接头可连接至现有的气体供应和加湿装置,例如,Fisher & Paykel Healthcare Limited的SleepStyleTM 600系列CPAP装置。应当指出,用于提供高气流量和潜在气体加湿的任何CPAP、自动PAP、双级或其它气流产生装置可以使用复式接头,如后文所述。复式接头允许来自氧气浓缩器的输出与来自气体供应和加湿装置的气流相组合,并且氧气和其它呼吸气体的混合输出物然后可以被加湿。 
图2示出了装有复式接头11的气体供应和加湿装置4。复式接头11还在图3至5中详细显示。复式接头11优选为大致矩形插件,其能够插入装置4的引入端口9中。复式接头11具有凹入边缘12,用于配合在引入端口9的互补唇缘中,还具有氧气引入端口13,用于连接通向氧气供应罐或类似物的管件14或类似物。氧气端口13优选从复式接头11一侧延伸。复式接头11具有延伸区域15,其包括至少一个开口(尽管两个开口16、17显示于图3至5)。开口16、17允许通过泵或风扇的作用而将环境空气抽入装 置4。环境空气加上氧气的不同气体在装置4中被混合并且离开腔出口8,而加湿的空气加氧气被通过导管3输送到患者。 
过滤器(未示出),例如,由网状过滤材料或类似物形成的大致矩形元件,可以安置在开口16、17内,从而装配在延伸区域15内部并且过滤进入吹风机入口的所有气体。 
优点: 
本发明的所述呼吸辅助设备和复式接头提供了一种安全方法,用于向气体供应和加湿装置的输入空气流添加氧气。在装置被使用时,从供给氧气的管件向复式接头输出的全部氧气被抽入装置中,但是如果装置被关闭,则供给到复式接头中的氧气会通过开口16、17逸出,因此会留在装置4之外。因此,氧气不会积累在装置(例如,气体供应装置如吹风机)中并产生着火的危险。这样,复式接头降低了火花出现在吹风机或呼吸导管内部时发生火灾的危险。 
通过向气流产生装置的入口添加氧气,氧气能够与传送至患者的其它气体一起被完全加湿。现有技术系统通常在加湿气体之后添加氧气,从降低了到达患者的气体的完全加湿。 
另外,通过在气流源的入口侧添加氧气,使得可以检测装置4内部的组合气流中的氧气含量(比例),并且在气流源的显示器上显示氧气含量。因此,在进一步的实施例中,气体供应装置(吹风机或组合式吹风和加湿装置4)包括内部传感器(未示出),其能够检测流经装置4的氧气含量。内部传感器优选连接着装置中的控制器(如前所述),并且控制器引起内部传感器检测到的氧气含量测量值显示在显示器18(见图2)上,显示器优选布置在装置4顶部。随着氧气含量变化并且这种变化被内部传感器检测到, 优选实时地将这种变化更新显示在显示器上。 
在具有本发明复式接头的呼吸辅助设备中,在氧气回路没有连接该设备时,不要求使用单向阀或密封盖,并且因此而更安全且患者操作更简单。 

Claims (7)

1.一种用于向患者传送加湿气体的呼吸辅助设备,包括:
气体供应装置,其具有气体供应装置入口,环境气体通过该气体供应装置入口被抽取,
覆盖在所述气体供应装置入口上的复式接头,其用于将补充气体添加到进入所述气体供应装置的环境气体,所述复式接头包含:
所述复式接头内的延伸区域,
至少一个通到所述复式接头内的延伸区域中的环境气体入口,以允许将环境气体抽入所述复式接头,流经所述复式接头内的延伸区域到达所述呼吸辅助设备的所述气体供应装置入口,以及
通到所述复式接头内的延伸区域中的、以便将补充气体引入到所述复式接头内的环境气体流中的单独的补充气体入口,其中环境气体通过所述复式接头从所述环境气体入口流至所述气体供应装置入口,以使得如果所述呼吸辅助设备关机,则供入到所述复式接头内的补充气体能够通过所述环境气体入口从所述复式接头的延伸区域逸出。
2.根据权利要求1所述的呼吸辅助设备,其中,所述呼吸辅助设备还包括加湿器,其包括具有出口的加湿腔,其中所述环境气体和补充气体从所述入口流动通过所述加湿腔并从所述出口流出。
3.根据权利要求1或2所述的呼吸辅助设备,其中,所述补充气体是氧气。
4.根据权利要求1或2所述的呼吸辅助设备,其中,所述气体供应装置包括内部传感器,其可检测流经所述呼吸辅助设备的氧气含量。
5.根据权利要求4所述的呼吸辅助设备,其中,所述气体供应装置包括控制器,其连接着所述内部传感器。
6.根据权利要求4所述的呼吸辅助设备,其中,所述气体供应装置包括被所述控制器控制的显示器,并且所述控制器引起所述氧气含量在所述显示器上被显示和更新。
7.根据权利要求1或2所述的呼吸辅助设备,其中,所述复式接头包括过滤器,其布置在所述至少一个环境气体入口上。
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