CN103330985A

CN103330985A - Blocking sleeve tube with double bronchi alternated

Info

Publication number: CN103330985A
Application number: CN2013102759271A
Authority: CN
Inventors: 李伟
Original assignee: Individual
Current assignee: Individual
Priority date: 2013-07-03
Filing date: 2013-07-03
Publication date: 2013-10-02
Anticipated expiration: 2033-07-03
Also published as: CN103330985B

Abstract

The invention belongs to the field of medical instruments, and particularly relates to a blocking sleeve tube with double bronchi alternated. The blocking sleeve tube with the double bronchi alternated is composed of a double-bronchus block tube, a trachea catheter and a molding guide wire. A Y-shaped protruding fork is arranged at the tail end of the double-bronchus block tube, after being inserted, the double-bronchus block tube crosses at the trachea carina, the two sub-forks of the Y-shaped protruding fork are respectively provided with a sleeve bag, and therefore the two lungs on the healthy side and on the affected side can be fast located, fixed and separated, and single-lung ventilation is achieved. A lower opening of a catheter head of the trachea catheter and an upper opening of a catheter body are respectively provided with a clamping opening, and after the two clamping openings are connected in a butting mode, the double-bronchus block tube is fixed. The blocking sleeve tube with the double bronchi alternated is simple in structure and reasonable in design, and has the greatest advantage that the double-sleeve-bag structures are arranged on the block tube sub-forks and can be more safely and reasonably used for wet lung disease and lung bulla patients. Besides, when the blocking sleeve tube with the double bronchi alternated is inserted, accurate locating and separation of the two lungs can be achieved without assisting of a fiber bronchoscope; meanwhile, if a breathing machine is needed after an operation, only the bronchus block tube needs to be pulled out, and second-time tube inserting and second-time tube replacing are avoided after the double-cavity bronchus catheter is used in the operation.

Description

Two bronchus replace the shutoff sleeve pipe

Technical field

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

Background technology

Unilateral lung ventilation is the management of respiratory method of using always in the operations such as open chest surgery such as esophageal carcinoma excision, lobectomy of lungs, stripping of the pleura operation, thoracic vertebra anterior approach, thoracoscope.Can make art side lung static, wither, make things convenient for operation technique; Also play the effect that strong Ipsilateral lung is isolated, prevent that the secretions, blood, abscess etc. of Ipsilateral lung from flowing into strong side.The one-lung ventilation device of using always clinically mainly contains the double lumen endobronchial tube intubate at present, bronchus is stopped up conduit and single lumen endobronchial tube, yet has certain technological deficiency separately.

The double lumen endobronchial tube intubate is location difficulty at first, often needs debugging repeatedly, even need locate by fibre bronchus mirror, easily causes the air flue mucosa injury; Secondly, the ventilation complex management is had relatively high expectations to anesthesia doctor level, otherwise is prone to serious consequence such as hypoxemia; Again, the double lumen endobronchial tube external diameter is bigger, and each lumen diameter is less, is not suitable for the child, and airway pressure is higher during mechanical ventilation, and long-time high airway pressure ventilation easily causes the mechanicalness injury of lung; Also have, if postoperative patient needs mechanical ventilation, the secondary intubate of having to is replaced by single-lumen bronchial tube.

Bronchus commonly used stop up conduit have Univent conduit, Arndt conduit, Forgaty conduit etc. several, so all need realize the location by fibre bronchus mirror, can't use at some basic hospitals that do not possess fibre bronchus mirror.Cao Hui discloses a kind of branch type bronchial obstruction conduit tube component (application number 201120191745.2), under the situation of not using fibre bronchus mirror, can utilize trachea carina directly to locate, conduit is the same to have a following defective yet it stops up with bronchus commonly used on the market, the patient who at first is used for wet lung has and faces the risk that strong side lung is flooded, although stopping up conduit, bronchus has the attraction function, if can in actual application, its obstruction cover capsule its attraction effect under inflated condition be very little, and in case the cover capsule attraction that comes loose, secretions in the Ipsilateral lung, blood or pus will certainly flow into strong side lung, lead to grave consequences; Moreover the lung inflation that needs in the art Ipsilateral is withered must cause the excessive expansion of offside lung when opening again, if there are pathological changes such as bulla in the offside lung, cause possibly and breaks, and causes consequences such as pneumothorax.

There are all deficiencies in single lumen endobronchial tube because of it, clinical seldom use.

Summary of the invention: the present invention has the plurality of advantages of existing one-lung ventilation device and has overcome above-mentioned all technological deficiencies.It is simple to operate, does not use fibre bronchus mirror just can easily realize quick and precisely locating, and two lung isolation effects are definite; When attracting Ipsilateral secretions, blood or pus, earlier strong side is propped up the shutoff sleeve bag gas-filling, make Ipsilateral prop up the venting of shutoff cover capsule then, fully attract through shutoff pipe or endotracheal tube, thoroughly remove Ipsilateral secretions, effectively the strong side lung of protection is flooded, and is safe and reliable; Prop up the shutoff sleeve bag gas-filling in strong side, Ipsilateral props up the descending Ipsilateral lung inflation of state of shutoff cover capsule venting and opens again, can effectively avoid strong side lung excessive expansion, and is particularly suitable to the bulla patient; The shutoff external diameter of pipe is much smaller than the endotracheal tube internal diameter among the present invention, and when inserting without the conductor housing of endotracheal tube (the conductor housing end opening is the narrow positions of endotracheal tube), at utmost reduce aeration resistance, reduce the mechanical ventilation airway pressure, reduce the injury of lung probability greatly, it is more outstanding to be used for child's effect; This sleeve pipe is regardless of left right model, has avoided the trouble of pipe about choosing; Postoperative can conveniently be pulled out the shutoff pipe, keeps endotracheal tube and connects respirator, avoids intubate again.

Technical scheme of the present invention realizes in the following manner: a kind of pair of bronchus replaces the 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, the strong side of shutoff pipe are propped up, shutoff pipe Ipsilateral props up, strong side is propped up and Ipsilateral props up bronchus Plugging brusa, Plugging brusa charge valve, Plugging brusa gas tube.Described moulding seal wire is the 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 there is flank both sides, joint middle part, and one of them flank is provided with small structure.Catheter wall is embedded with C shape elastic ring around the described endotracheal tube body U-shaped bayonet socket that is provided with suitable for reading, U-shaped bayonet socket, can be metal, when inserting, plays conductor housing closely fixing effect, can be embedded with the cyclic spring filament in the tube wall of U-shaped bayonet socket bottom, support tube wall, prevent body discounting occludes lumen.U-shaped bayonet socket below tube wall fixedly has connecting line, and the connecting line other end is fixed on the aperture of conductor housing flank, prevents that conductor housing from losing.Described conduit capsule charge valve connecting duct capsule gas tube, the traveling in the endotracheal tube wall of a gas tube part is opened on the conduit capsule; Described conduit capsule is positioned at conduit end opening top, the space between the inflation airtight conduit outer wall in back and the inner surface of trachea; Described endotracheal tube end opening is oblique concave surface, makes things convenient for endotracheal tube to enter glottis, and concave structure is avoided the adherent obstruction of conduit end opening.

Described pair of bronchus shutoff pipe detachably inserts endotracheal tube.The described pair of bronchus shutoff pipe tube chamber be suitable for reading to be used for attracting and inserting moulding seal wire; Described tube chamber upper flap line is fixed in shutoff pipe upper end, and fastening when Ipsilateral lung or two pulmonary ventilation is used 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 the Plugging brusa gas tube, two Plugging brusa gas tubes in two bronchus shutoff tube walls separately traveling be opened on strong side respectively and prop up the Plugging brusa that props up with Ipsilateral; Described and Ipsilateral prop up the charge valve that Plugging brusa is connected and are marked with " trouble " word or relevant letter, and described and strong side is propped up charge valve that Plugging brusa is connected and is marked with " being good for " word or is correlated with alphabetically, and perhaps two charge valve colors are distinguished; Knuckle fork in described shutoff pipe body lower end is Y shape structure, is propped up and Ipsilateral props up and constitutes by shutoff pipe body lower end, strong side; Described strong side is propped up to prop up by shutoff pipe body end with Ipsilateral and is told, the tube chamber of shutoff pipe only with Ipsilateral Zhi Xiangtong, two are branched off into nature angle, be elastomeric material, during use two branches being closed up the back, to insert the endotracheal tube body suitable for reading, across descending in two guide recess, passing the back angle from the conduit end opening separates automatically, pasting inner surface of trachea continues to insert, strong side is propped up and is entered strong side main bronchus, and Ipsilateral inserts after propping up and entering the Ipsilateral main bronchus again, until meeting obstructions, this moment, the knuckle fork straddled on the knuckle, finished the location; Ipsilateral is isolated the Ipsilateral lung after propping up the shutoff sleeve bag gas-filling, realizes strong side lung one-lung ventilation.

Described endotracheal tube body and shutoff pipe body reach and are good for, Ipsilateral props up long axis direction and is equipped with X-ray position line and scale;

Description of drawings

Fig. 1 is the overall structure sketch map

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

Fig. 3 is the planar structure sketch map of conductor housing flank and aperture

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

In the 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 pipes; 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 fork; 2-8. strong side is propped up; 2-9. Ipsilateral props up; 3. moulding seal wire.

The specific embodiment:

Referring to Fig. 1, the two bronchus of the present invention replace the shutoff sleeve pipe and are made up of endotracheal tube (1), two bronchus shutoff pipes (2) and moulding seal wire (3).Described pair of bronchus shutoff pipe (2) passes the catheter body (1-7) of endotracheal tube (1), fixing two bronchus shutoff pipes (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) that is connected to a fixed with conductor housing (1-1) and catheter body (1-7), the n type 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) on every side, 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, thereby can inflate it, be that axis of symmetry is provided with two guide recess (1-16) with the tube chamber centrage on catheter body (1-7) medial wall.

Described pair of bronchus shutoff pipe (2) comprise that 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) that are attached thereto, the terminal strong side of shutoff body (2-3) are propped up (2-8) and Ipsilateral props up (2-9), be good for that side is propped up (2-8) and Ipsilateral props 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.

(endotracheal tube end opening 1-15 approximately is positioned at the trachea middle part to correct position to use the common single-lumen bronchial tube of time image insertion to insert endotracheal tube (1) like that, the two clear symmetries 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 pipes (2) to crotch, its radian is consistent with the endotracheal tube radian that inserts, strong side is propped up (2-8) corresponding strong side main bronchus direction, Ipsilateral props up (2-9) corresponding Ipsilateral main bronchus, strong side props up (2-8) and Ipsilateral (2-9) closes up, insert through catheter body (1-8) suitable for reading, keep same direction to pass catheter body (1-7), pass that the strong side in conduit end opening (1-15) back is propped up (2-8) and Ipsilateral props up (2-9) and separates automatically, pasting inner surface of trachea continues to insert, strong side is propped up (2-8) and is entered strong side main bronchus, Ipsilateral props up and runs into obvious resistance after (2-9) enters the Ipsilateral main bronchus, illustrate that knuckle fork (2-7) has straddled on the knuckle, pull out moulding seal wire, finish the location.The guiding of also can moulding seal wire and utilizing guide recess (1-16) to finish two bronchus shutoff pipes (2) is inserted, endotracheal tube (1) is arc, it is consistent with the radian of oral cavity-larynx-trachea axis to insert the back, guide recess (1-16) symmetry is positioned at its left and right sides, to be good for that side is propped up (2-8) and Ipsilateral props up (2-9) across descending insertion in two guide recess (1-16), and straddle and finish the location on the knuckle until running into obvious resistance.The shutoff body (2-3) that will expose then snaps 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 type bayonet socket (1-6) blocks shutoff body (2-3), and U-shaped bayonet socket (1-9) the interior C type elastic ring (1-10) of endotracheal tube wall is on every side closely fixed conductor housing (1-1).Conductor housing (1-2) suitable for reading connects respirator or anesthetic machine loop mechanical ventilation.When needing one-lung ventilation, to Plugging brusa charge valve (2-4) inflation that the Plugging brusa (2-6) that props up with Ipsilateral on (2-9) links to each other, realize two lungs isolation, strong side pulmonary ventilation.In the art as when need attracting Ipsilateral secretions, blood or pus; to be good for side earlier and prop up shutoff cover capsule (2-6) inflation on (2-8); again Ipsilateral is propped up shutoff cover capsule (2-6) venting on (2-9); fully attract through shutoff pipe tube chamber (2-1) suitable for reading or with sputum aspirator tube transtracheal catheters (1); thoroughly remove Ipsilateral secretions; effectively the strong side lung of protection is avoided being flooded, and is safe and reliable.In the art or art when finishing the lung that Ipsilateral is withered and opening again, to be good for side and prop up Plugging brusa (2-6) inflation on (2-8), Ipsilateral props up Plugging brusa (2-6) venting on (2-9), close tube chamber upper flap (2-2) behind the clearing pneogaster, transtracheal catheters (1) is pressure-vent gradually, fully multiple opening of Ipsilateral lung can not only be made, the strong unnecessary excessive expansion of side lung can also be effectively avoided.Postoperative such as need respirator mechanical ventilation, earlier Plugging brusa (2-6) is exitted, extract endotracheal tube head (1-1) again, this moment just can be easily with two bronchus shutoff pipes (2) removal, again insert endotracheal tube head (1-1) then and rotate to n type bayonet socket (1-6) and position that U-shaped bayonet socket (1-9) fully staggers, be seated fixingly, connect the respirator loop and get final product.

Claims

1. two bronchus replace the shutoff sleeve pipe, it is characterized in that: by endotracheal tube (1), two bronchus shutoff pipes (2) and moulding seal wire (3) are formed, two bronchus shutoff pipes (2) pass endotracheal tube (1) and are used in combination, both are detachable, described endotracheal tube (1) comprises conductor housing (1-1) and the catheter body (1-7) that is 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) links to each other with conduit capsule charge valve (1-12) by conduit capsule gas tube (1-13), described pair of bronchus shutoff pipe (2) comprises tube chamber (2-1) suitable for reading and the tube chamber upper flap (2-2) that is attached thereto, shutoff pipe body (2-3), the knuckle fork (2-7) of shutoff pipe body (2-3) lower end, the strong side of the shutoff pipe that knuckle fork (2-7) is told is propped up (2-8), shutoff pipe Ipsilateral props up (2-9), strong side is propped up with Ipsilateral and is propped up set bronchus Plugging brusa (2-6) composition, and described bronchus Plugging brusa (2-6) is connected with Plugging brusa charge valve (2-4) by Plugging brusa gas tube (2-5).

2. a kind of pair of bronchus according to claim 1 replaces the shutoff sleeve pipe, it is characterized in that: catheter body (1-7) internal diameter of described endotracheal tube (1) significantly props up (2-8) greater than the strong side of two bronchus shutoff pipes (2) and Ipsilateral props up the external diameter sum of (2-9), thereby makes two bronchus shutoff pipes (2) can pass catheter body (1-7) smoothly.

3. a kind of pair of bronchus according to claim 1 replaces the shutoff sleeve pipe, it is characterized in that: there is flank (1-3) both sides, described conductor housing (1-1) middle part, one of them flank (1-3) is provided with aperture (1-4) structure, connecting line (1-11) end is fixed in aperture (1-4), 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.

4. a kind of pair of bronchus according to claim 1 replaces the shutoff sleeve pipe, it is characterized in that: the lower ending opening of described endotracheal tube (1) is that conduit end opening (1-15) is oblique concave structure.

5. a kind of pair of bronchus according to claim 1 replaces the shutoff sleeve pipe, it is characterized in that: 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), the strong side that is used for the two bronchus shutoff pipes of guiding is propped up (2-8) and Ipsilateral props up (2-9) and inserts along correct direction, catheter body (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) catheter wall on every side is embedded with C shape elastic ring (1-10), can be metal material, the conductor housing (1-1) that inserts is played fixing airtight effect, catheter body (1-7) wall of U-shaped bayonet socket (1-9) below is embedded with helical form elastic metallic filament supporting tube, prevents that catheter body (1-7) is converted into the dead angle and blocks ventilation.

6. a kind of pair of bronchus according to claim 1 replaces the 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 the trachea carina after the insertion, thereby finish location to two bronchus shutoff pipes (2) fast accurately.

7. a kind of pair of bronchus according to claim 1 replaces the shutoff sleeve pipe, it is characterized in that: described knuckle fork (2-7) tells that the strong side of shutoff pipe is propped up (2-8) and shutoff pipe Ipsilateral props up (2-9), the tube chamber of two bronchus shutoff pipes (2) only props up (2-9) and communicates with Ipsilateral, two are branched off into nature angle, angle is between 60 ° to 85 °, be elastomeric material, can pass through catheter body (1-7) smoothly after closing up, flick voluntarily after passing conduit end opening (1-15), strong side is propped up (2-8) and Ipsilateral props up and is equipped with bronchus Plugging brusa (2-6) on (2-9), the strong side of shutoff pipe is propped up the color of (2-8) and the Plugging brusa on it (2-6) and to Plugging brusa charge valve (2-4) solid colour of its inflation, and is different with the Ipsilateral plugging system.

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

9. a kind of pair of bronchus according to claim 1 replaces the shutoff sleeve pipe, it is characterized in that: the long axis direction that the strong side of described catheter body (1-7), shutoff pipe body (2-3), shutoff pipe is propped up (2-8) and Ipsilateral props up (2-9) is equipped with radiopaque strip-like developing pipe and length scale.

10. a kind of pair of bronchus according to claim 1 replaces the shutoff sleeve pipe fast, and it is characterized in that: described moulding seal wire (3) is the flexible arc tinsel, can insert two bronchus shutoff pipes to crotch.