CN105343944A - Expectoration system - Google Patents

Expectoration system Download PDF

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Publication number
CN105343944A
CN105343944A CN201510657436.2A CN201510657436A CN105343944A CN 105343944 A CN105343944 A CN 105343944A CN 201510657436 A CN201510657436 A CN 201510657436A CN 105343944 A CN105343944 A CN 105343944A
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CN
China
Prior art keywords
expectoration
joint
air pump
patient
air
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CN201510657436.2A
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Chinese (zh)
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CN105343944B (en
Inventor
许庆宾
徐恒谦
白海波
韩广
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濡新(北京)科技发展有限公司
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Publication of CN105343944A publication Critical patent/CN105343944A/en
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Publication of CN105343944B publication Critical patent/CN105343944B/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/0023Suction drainage systems
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/0023Suction drainage systems
    • A61M1/0031Suction control
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003Accessories therefor, e.g. sensors, vibrators, negative pressure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M16/0009Accessories therefor, e.g. sensors, vibrators, negative pressure with sub-atmospheric pressure, e.g. during expiration
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0051Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes with alarm devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0057Pumps therefor
    • A61M16/0066Blowers or centrifugal pumps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • A61M16/022Control means therefor
    • A61M16/024Control means therefor including calculation means, e.g. using a processor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/08Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0816Joints or connectors
    • A61M16/0833T- or Y-type connectors, e.g. Y-piece
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/20Valves specially adapted to medical respiratory devices
    • A61M16/201Controlled valves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/20Valves specially adapted to medical respiratory devices
    • A61M16/201Controlled valves
    • A61M16/202Controlled valves electrically actuated

Abstract

An expectoration system comprises an expectoration line (20) comprising a throttling device (21) and a balloon valve (19); an expectoration apparatus (1), comprising a main line assembly (15), an air pump assembly (2) and a control system (8), the main line assembly (15) comprises a fan (16) and a shutter valve (17); the air pump assembly (2) comprises a first air pump (6) and a second air pump (3); the control system (8) comprises a first sensor (12) for measuring air pressure of the throttling device (21) and a microcomputer control unit; the microcomputer control unit judges a patient being in an exhaling or inhaling stage through an air pressure difference detected by the first sensor (12), during expectoration, the first air pump (6) supplies air to the balloon valve (19) to disconnect a respirator air circuit, the fan (16) and shutter valve (17) are started to control the second air pump (3) to supply air to the throttling device (21), and a respirator never stops running in the expectoration sage. The expectoration system is friendly to normal running of the respirator.

Description

Expectoration system
Technical field
The present invention relates to a kind of medical nursing equipment, specifically, relate to a kind of expectoration system.
Background technology
For because a variety of causes caused by respiratory failure, the patient comprised in respiratory distress syndrome (ARDS), severe acute pulmonary edema and asthma, respiratory insufficiency and major operation, respirator is necessary important life support equipment.For the upper patient of respirator, the timely and effective removing of sputum is very important, if expectorant is discharged not in time in respiratory tract, thick sputum and expectorant crust are easily assembled and are blocked bronchus tube chamber, have a strong impact on the ventilatory function of patient, increase the weight of respiratory failure, even cause Secondary cases pulmonary atelectasis.Sputum or vegetative hotbed, antibacterial causes infection to patient respiratory organ, makes patient be easy to Ventilator-associated pneumonia (VAP).But, ventilated patients because losing cough function, the reason such as pulmonary function slump of disastrous proportions, respiratory muscle are unable, patient often can not expectoration voluntarily, and secretions significantly increases; In addition, ventilated patients many places in disturbance of consciousness, cachexia state, coughing up of sputum function reduce, original respiratory system disease and respiratory failure are increased the weight of; Tracheal intubation and tracheotomy make bottleneck throat natural cover destroy, and weaken the cleaning action of air flue cilium, weaken the reflex mechanism of cough, expectoration.Therefore, for ventilated patients, the sputum of dispelling of continuous and effective is prevention airway obstruction, maintains the key of mechanical ventilation.
Conventional suction sputum mode is sputum aspirator tube suction sputum, it be with a tiny conduit through tracheal intubation or Tracheostomy tube, insert the air flue of patient, by vacuum suction lasting in tiny conduit, sputum from sucking-off in patient body.When conduit and secretions close to time, secretions is sucked away.But the shortcoming of this inhaling-conveying mode is also obvious, first it is a kind of suction sputum of intrusive mood, and due to insertion and the movement of conduit, easily damaging even air flue cicatrix to air flue increases the generation of airway secretions, makes expectorant inhale more and more.Meanwhile, increase the weight of hypoxemia, immediately can not remove sputum, increase and infect and hemorrhage danger.Very painful experience for most patient.
The another kind of method that ventilated patients airway secretions is removed uses common expectoration machine, the coughassist of such as PHILIPS Co., it is when expectoration, first, the lung of patient sucks the air close to maximum tidal volume, then the air in lung is sucked fast and suddenly with flank speed exhalation, because air is breathed out in patient's lung with high speed, it is up that air-flow can carry secretions, and flow out with very high flow velocity in patient airway, thus reach the object removing patient's secretions.It removes secretions essence is a kind of mode simulating expectoration, and this expectoration machine can be connected with patient airway by tracheal intubation, trachea cutting-pipe or face shield.This expectoration mode should be well more a lot of than aforesaid sputum aspirator tube suction sputum, and first, it is a kind of non-intrusion type suction sputum.Secondly, what expectoration machine produced is the high velocity air flowed in the whole airway diameter of patient, length range, therefore can play the effect of removing secretions from whole air flue.And the low speed flow that sputum aspirator tube suction sputum just produces in tiny catheter interior, secondly, due to the restriction of sputum aspirator tube size, sputum aspirator tube can only close to larger air flue, and for those little more multistage branching airways, then helpless.Also have the bronchial branch shape in patient left and right, determine sputum aspirator tube when inserting patient's bronchus suction sputum, usually can only insert the air flue on the right, the air flue on the left side cannot suction sputum.When suction sputum, the overwhelming majority in patient respiration road is not with sputum aspirator tube and attract air flow contacts, can only absorb a little sputum near sputum aspirator tube.And the expectoration of expectoration machine, secretions is then removed by the air-flow entirety in patient airway.
Such as, but expectoration machine also has shortcoming, during to ventilated patients expectoration, need the vent line cutting off respirator and patient, expectoration machine is connected with patient and could performs expectoration and operate.But for the upper ventilated patients of respirator, especially for critical patient, the vent line cutting off respirator and patient continually may cause that sb.'s illness took a turn for the worse.Expectoration machine adopts loop cycle to stop the patient inhales stage, and it may be with the problem of serving, because for ventilation patient, volume circulation or flow circulation pattern are safer, more effective.In addition, expectoration machine does not have end expiratory positive pressure function (PEEP), and its pressure in expectoration latter end air flue can only approximate atmospheric pressure.And end expiratory positive pressure plays an important role when treating respiratory distress syndrome ARDS, non cardiogenic pulmonary edema, pneumorrhagia, sputum clearance can be promoted simultaneously.And expectoration machine is inapplicable for above-mentioned symptom patient, in addition, the warning system that expectoration machine does not have life support equipment to be equipped with, the safety of use also cannot be guaranteed.
No matter conventional expectoration machine expectoration is air-breathing or expectoration, all adopt same pipeline, air-flow during expectoration comprises the secretions of patient, these secretions may contain a large amount of antibacterial, these secretions is piled up and is exposed in trachea, repeatedly contact with patient inhales air-flow, bring the risk of superinfection to patient.
Also have, the air-breathing of expectoration machine and expectoration all adopt same blower fan, when air-breathing and expectoration, blower fan is faced directly and may be contained germy air-flow and sputum, and the patient as different uses same expectoration machine, potentially reduces the service life of blower fan and adds the risk of cross infection between different patient.
Patent WO2007054829 proposes a kind of and respirator associated working, assisting patient is breathed, cough, remove the expectoration machine of patient airway secretions, the difference of it and Philip coughassist is: the source of the gas carrying out positive airway pressure to patient does not re-use the blower fan of expectoration machine inside, but adopts to the respirator of patient's mechanical ventilation.The breathing of patient and expectoration adopt different pipelines, are respectively equipped with switch valve at breathing pipeline and expectoration pipeline, and when respirator bio-occlusion patient ventilating, the switch valve be located on breathing pipeline is opened, and the switch valve on expectoration pipeline is in closed condition.When patient inhales terminates, when being about to enter expiration state, the valve open on expectoration pipeline, expectoration machine starts expectoration.After expectoration terminates, the valve closing on expectoration pipeline, the valve open on breathing pipeline, patient enters suction condition, circulates according to this.
Compared with the coughassist expectoration machine of Philip, do not need to dismantle when performing suction sputum the connecting line of patient and respirator, therefore, patient can not interrupt respirator treatment, especially for needing by giving the respirator PEEP patient for the treatment of, interim interruption is disadvantageous especially, and PEEP is more conducive to expectoration.Meanwhile, because Philip expectoration machine needs respirator ability expectoration of dismantling, therefore, can only every the expectoration of certain phase ability, sputum can not be removed immediately.And patent WO2007054829 tears the problem of respirator open owing to there is not expectoration, therefore, can at any time, instant expectoration.Patient inhales and expectoration adopt different pipelines, reduce the risk of patient's superinfection, adopt the negative-pressure air fan of respirator and expectoration machine inside to patient's positive airway pressure and negative pressure expectoration respectively, avoid the cross infection between patient, improve service life of fan.
But WO2007054829 invention still has a lot of problem in force, such as noise is excessive, dispel the heat bad, the work that can affect respirator when expectoration is even reported to the police, there is hidden danger in the safety of system, poor etc. to clinical adaptive capacity, the present invention efficiently solves WO2007054829 invention Problems existing, be the engineering construction of the block diagram scheme to this invention, and further refinement, abundant and perfect carried out to WO2007054829 patent.
Summary of the invention
For above-mentioned prior art Problems existing, the present invention proposes a kind of expectoration system, comprising: expectoration machine and expectoration pipeline,
Expectoration pipeline comprises throttling arrangement and saccule valve, and wherein saccule valve is a two-way valve, and an one port is respirator port, be connected to respirator by throttling arrangement, another port is divided into two, and one is expectoration machine port, connect expectoration machine, another is patient ports, connects patient;
Expectoration machine comprises main line assembly, air pump assembly and control system, and main line assembly comprises the blower fan producing negative pressure and the fast family of power and influence opened when expectoration; Air pump assembly comprises the first air pump to saccule valve air feed and the second air pump to throttling arrangement air feed; And control system is for controlling main line assembly and air pump assembly, control system comprises first sensor and the microcomputer control unit of the air pressure for measuring throttling arrangement place;
Wherein, by the draught head that first sensor detects, microcomputer control unit judges that patient is in respiration phase or expiratory phase, when patient be in expiratory phase change to expiration phase time, microcomputer control unit controls the sacculus air feed of the first air pump to saccule valve to disconnect the gas circuit of respirator port to patient ports, control system opens blower fan and the fast family of power and influence with assisting patient expectoration, and meanwhile, microcomputer control unit controls the second air pump to throttling arrangement air feed, during expectoration, respirator does not quit work.
The expectoration suction sputum that the present invention proposes can fully automatic working, with respirator with the use of time without the need to the machine of ceasing breathing, and the normal work of respirator can not be affected.
Accompanying drawing explanation
Fig. 1 is full-automatic expectoration system schematic diagram of gas circuit of the present invention.
Fig. 2 is the force analysis figure of saccule valve.
Fig. 3 is the gas circuit connection layout of gas circuit assembly.
Detailed description of the invention
Describe embodiments of the present invention with reference to the accompanying drawings, the identical Reference numeral of wherein identical parts represents.
Fig. 1 compares the gas circuit principle that describe in detail full-automatic expectoration system of the present invention.Wherein full-automatic expectoration system is made up of two parts: expectoration machine 1 and expectoration pipeline 20.Expectoration pipeline 20 is disposable products, such as, can make with medical plastic.
The major function of expectoration machine 1 is to provide the negative pressure producing high velocity air, the data such as pressure, flow, tidal volume, time of whole system to be monitored, and according to monitoring result simultaneously, carry out analyzing, judge, calculate, thus system implementation is effectively controlled, and trigger and stop expectoration.
The core component of expectoration pipeline 20 is throttling arrangement 21 and saccule valve 19, expectoration pipeline 20 patient, formed between respirator and expectoration machine 1 gas circuit be communicated with, interface is provided to carry out data acquisition for various pressure, flow transducer, simultaneously under the control of expectoration machine 1, the gas circuit completed between respirator-patient and expectoration machine-patient switches.
Particularly, the throttling arrangement 21 of expectoration pipeline 20 has interface A and interface B above.Second air pump 3, second air pump 3 of the air pump assembly 2 (describing in detail below) that interface A is connected in expectoration machine 1 can docking port A air feed.3rd air pump the 5, three air pump 5 of the air pump assembly 2 that interface B is connected in expectoration machine 1 can docking port A air feed.In addition, interface A, B are connected with two input ports of the differential pressure pickup 12 (first sensor) in expectoration machine 1 respectively, constitute substantial differential pressure flowmeter.Alternatively, interface A is connected to pressure transducer 12, interface B is connected to pressure transducer 11 (the second sensor), detect the pressure of these two mouths respectively, thus pressure transducer 12 and pressure transducer 11 forms substantial differential pressure flowmeter with these two sensors.
Saccule valve 19 is two-way valves, and comprise the respirator port connecting respirator, the other end is divided into two, and one is the expectoration machine port connecting expectoration machine, and another is the patient ports connecting patient.The passage of respirator port and patient ports is often opened, and supplies gas to patient for respirator, but can close this gas circuit by saccule valve 19.The implementation of closing arranges a sacculus in saccule valve 19 inside, and when sacculus is charged gas expansion, volume increases, blocking valve port, thus cut off respirator-patient's gas circuit.The passage of expectoration machine port and patient ports is normal open, but because the fast family of power and influence 17 is normally closed, therefore the air feed of respirator to patient can not be affected, the fast family of power and influence 17 only just opens when expectoration machine works, and during the work of expectoration machine, by closing respirator-patient's gas circuit to the inflated of saccule valve 19 inside, not affect the work of expectoration machine.After expectoration terminates, the fast family of power and influence 17 closes, and the sacculus of saccule valve 19 inside is deflated, and balloon volume diminishes, and produces comparatively wide arc gap between valve port and sacculus, and air-flow can pass through, and realizes the function connecting gas circuit.In addition, saccule valve 19 is by the first air pump 6 air feed of the air pump assembly 2 in expectoration machine 1, and the air feed of the first air pump 6 controls by the electromagnetic valve 4 in gas circuit assembly 2 (describing in detail below).
Preferably, when saccule valve 19 is exitted, gas in saccule valve 19 is not be discharged in air, but in main breathing pipeline, its objective is: if the space in saccule valve 19 is direct and air communications and liaison, due to the autonomous respiration of some patient, the subnormal ambient in main breathing pipeline may be caused, under the effect of atmospheric pressure and main breathing pipeline negative pressure pressure reduction, partially soft partially thin saccule valve 19 may be made to cut off breathing pipeline or breathing pipeline is narrowed, thus jeopardize patients ' lives (see Fig. 2), simultaneously, after each expectoration, the gas of releasing from saccule valve 19 can also purge the observing and controlling pipeline of the pressure transducer 9 (the 3rd sensor) detecting patient ports (in Fig. 1 C) pressure in passing, prevent having water droplet or sputum in the observing and controlling pipeline of this sensor, affect working sensor.
Be described below in detail expectoration machine 1, expectoration machine 1 is made up of five parts, comprising: air pump assembly 2, gas circuit assembly 22, main line assembly 15, control system 8 and noise elimination noise reduction system 18.
Air pump assembly 2 comprises three micro air pumps: the first air pump 6, second air pump 3 and the 3rd air pump 5.The sacculus of the first air pump 6 pairs of saccule valves 19 carries out air feed.The interface A of the second air pump 3 pairs of throttling arrangements 21 carries out air feed, and the interface B of the 3rd air pump 5 pairs of throttling arrangements 21 carries out air feed.Second air pump 3 and the 3rd air pump 5 have two effects, and first effect avoids respirator normally to work alarm at expectoration machine.After expectoration starts, because respirator gas circuit is cut off, the gas not having patient to breathe out enters respirator expiration loop, and respirator can think that patient suffocates, trachea is thrown off or occurs other unusual conditions, thus can report to the police by mistake.Second air pump 3 and the 3rd air pump 5 now can provide the air-flow of enough flows, enter respirator expiration return passage and purge, thus avoid ventilator alarm by throttling arrangement 21.Except avoiding ventilator alarm.In addition, respirator in actual use, moistening in order to ensure the air or oxygen that patient sucks, need to be connected in series humidification bottle in pipeline, therefore can condense in breathing pipeline a large amount of aqueous waters at any time, the gas that patient breathes out is also containing moisture, also have, giving in patient phlegm-suction process, the sputum of sucking-off also likely adheres to or is bonded on pipeline, the pipeline environment of this complexity is unfavorable for the accurate detection signal of various sensor very much, and especially aqueous water or sputum are deposited in the superfine pipeline for observing and controlling.Therefore, second effect of the second air pump 3 and the 3rd air pump 5 regularly purges pressure transducer 11, pipeline between differential pressure pick-up 12 and throttling arrangement 21, affects working sensor to prevent aqueous water or sputum.Wherein, produce the dynamical element purging air-flow and be not limited to air pump, mini air compressor, also the high pressure storage tank of blower fan, stored-gas can be used, above dynamical element or energy-storage travelling wave tube is independent, multiple or conbined usage, or collect the expiration loop replacement purging etc. that blower fan expellant gas blows back respirator, two high pressure second air pump 3 and 5 air feed in parallel are adopted, to meet the demand of instantaneous large discharge in the present embodiment.Alternatively, an air pump also can be adopted to carry out air feed to the interface A of throttling arrangement 21 and interface B simultaneously.
The function of gas circuit assembly 22 has been that expectoration machine 1 is communicated with and control connection with the gas circuit of expectoration pipeline 20, and the core component of gas circuit assembly 22 is electromagnetic valves 4.Electromagnetic valve is preferably two-bit triplet, but is not limited to two-bit triplet, such as 2/2-way, four-way, five-way, three-position electromagnetic valve etc.The effect that electromagnetic valve 4 controls the first air pump 6, first air pump 6 is to saccule valve 19 air feed and aerofluxus under the control of two-bit triplet electromagnetic valve 4.Gas circuit assembly 22 can also comprise another two-bit triplet electromagnetic valve 7; it belongs to standby electricity magnet valve; play the effect of dual security protection; namely when two-bit triplet electromagnetic valve 4 breaks down; the gas of saccule valve 19 inside cannot be discharged, and breathing circuit cannot be connected, when cannot implement mechanical ventilation to patient; two-position three-way valve 7 will electricly to open, the gas in saccule valve 19 is discharged.
Main line assembly 15 comprises the fast family of power and influence 17, mass flowmenter 14, pressure transducer 13 (the 5th sensor) and blower fan 16.Preferably, due to negative-pressure air fan 16 work aerofluxus time can produce high-decibel rotational noise and eddy current crack, main line assembly 15 also comprises noise elimination noise reduction system 18, for effectively reducing the impact of Noise upon Environment.The negative pressure that blower fan 16 needs for generation of expectoration.Pressure transducer 13 detects the pressure of blower fan 16 immediately, and is transferred to control system 8.Blower fan 16 such as can adopt centrifugal, axial fan, but is not limited to blower fan, comprises the dynamical element that all can produce negative pressure, such as vacuum pump, vacuum generator etc.Suction flow when mass flowmenter 14 detects expectoration is also supplied to control system 8, with detect described suction flow close to 0 time or close the fast family of power and influence 17 to cut off expectoration loop by control system 8 as required.Mass flowmenter 14 also can be other any type of mass flowmenters such as differential pressure type, hot type, turbine type, ultrasound wave, preferably differential pressure type quality flow meter or thermal mass flow meter.The fast family of power and influence 17 is normally closed, is only just opened by control system 8 when expectoration machine works.Meanwhile, it possesses fast opening and closing, realizes the function of flow perturbation, can strengthen expectoration effect.
Control system 8 is made up of microcomputer control unit, the man machine interface parameter of full-automatic expectoration system (be used for arrange), various pressure differential pressure sensor.Control system 8 collects the various parameters of described sensor acquisition, and carries out other parts of control output (such as the fast family of power and influence 17, electromagnetic valve 4), human-computer interaction.
Control system 8 comprises pressure transducer 11, pressure transducer 12, the pressure of pressure transducer 11,12 Real-Time Monitoring throttling arrangement 21 both sides and pressure reduction, namely pressure transducer 11 detects the pressure at the interface A place of throttling arrangement 21, pressure transducer 12 detects the pressure at the interface B place of throttling arrangement 21, and transfers data to microcomputer control unit.As previously mentioned, the pressure at interface A and interface B place also only can be detected respectively with a differential pressure pickup 12.It is to judge that patient is in inspiratory phase or expiratory phase that pressure transducer 11,12 monitors the pressure of throttling arrangement 21, carries out data encasement for whether opening expectoration machine.
Preferably, control system 8 preferably also comprises pressure transducer 9, and pressure transducer 9 detects the pressure at the patient ports place (the C place in Fig. 1) of saccule valve 19 in real time, and transfers data to microcomputer control unit.
In fact, the pressure of what pressure transducer 9 and pressure transducer 11 detected is saccule valve 19 both sides, for the pressure differential of both sides, in the eupnea stage, if the pressure at both sides value of saccule valve 19 is greater than a threshold value (such as 5 centimeter water columns), microcomputer control unit is reported to the police, the object done like this is: if electromagnetic valve 4 lost efficacy, saccule valve 19 opens malfunctioning can not venting, and double protection electromagnetic valve 7 is when can not make saccule valve exit, breathing circuit can be caused blocked, patient's air feed can not be given, then control system 8 is reported to the police, inform that staff can check system immediately, thus give patient's triple protection.
Preferably, control system 8 preferably also comprises pressure transducer 10 (four-sensor), and pressure transducer 10 is for detecting the pressure transducer 10 of the pressure in the first air pump 6 exit.Pressure transducer 10 can be arranged between the first air pump 6 and electromagnetic valve 4, or between electromagnetic valve 4 and saccule valve 19.In order to prevent the outlet pressure of the first air pump 6 too high, blocking so that motor damage or blow brokenly the sacculus of saccule valve 19, wherein the first string is increase air accumulator, air accumulator has aperture, can slowly exit, thus avoids air pump outlet pressure too high.More preferably, pressure transducer 10 (the second pressure transducer) is set up in the first air pump 6 exit, according to the outlet pressure of the first air pump 6, utilize PWM mode, automatically regulate the rotating speed of the first air pump 6 (namely, when air pump outlet pressure is low, increase air pump rotating speed, during outlet pressure height, reduce rotating speed or the stopping of pump), thus make the delivery outlet of the first air pump 6 keep a constant pressure, ensure air pump safety.Reduce the volume of equipment simultaneously, reduce energy consumption, add the reliability of system.
Fig. 3 shows the annexation figure of an example of gas circuit assembly 22.Gas circuit assembly 22 comprises 10 joints in addition: the first joint 207, second joint 206, the 3rd joint 204, the 4th joint 203, the 5th joint 258, the 6th joint 205, and four joints the 7th joint 226, the 8th joint 228, the 9th joint the 229, ten joint 230 to be connected with property expectoration pipeline 20.
Particularly, first joint 207 one end is connected to the second air pump 3, one end connects the 7th joint 226, and then be connected to the A mouth of the throttling arrangement 21 in expectoration pipeline 20, the compressed air that second air pump 3 exports, by the A mouth through the first joint 207 and the 7th joint 226 output throttling device 21, realizes the air blowing of the second air pump 3 pairs of A mouths.Second joint 206 and differential pressure pick-up 12 1 input ports are communicated with, and by this road, realize the pressure data collection of A point on differential pressure pick-up 12 pairs of throttling arrangements 21.3rd joint 204 is communicated with another input port of differential pressure pick-up 12 (or being communicated with pressure transducer 11), 3rd joint 204 is connected to the B mouth of throttling arrangement 21 by the 9th joint 229, by this road, realize the pressure data collection of B mouth on differential pressure pickup 12 pairs of throttling arrangements 21.Similarly, the 4th joint 203 is communicated with the 3rd air pump 5, and then is connected with the B mouth of the throttling arrangement 21 in expectoration pipeline 20 by the 9th joint 229, realizes the air blowing of the 3rd air pump 5 pairs of B mouths.
5th joint 258 connects the first ((1) in Fig. 3) of the first air pump 6 and electromagnetic valve 4.Second mouthful ((2) in Fig. 3) of the 8th joint 228 connected electromagnetic valve 4, and then be connected to saccule valve 19.3rd mouthful ((3) in Fig. 3) of the 6th joint 205 connected electromagnetic valve 4 and pressure transducer 9.(3) mouth of the tenth joint 230 connected electromagnetic valve 4 and patient ports C.Joint 205 is communicated with the tenth joint 230 in fact, and pressure transducer 9 can be made can to monitor the pressure near patient end in main breathing pipeline.The pressure detected herein is very useful, may be used for the foundation judging whether main breathing pipeline blocks as already mentioned previously.The compressed air that first air pump 6 exports, through the 5th joint 258, enters electromagnetic valve 4 by (1) mouth of electromagnetic valve 4.
When electromagnetic valve 4 dead electricity, can be seen by Fig. 3, (1) mouth is closed, and gas circuit is cut off thus.When electromagnetic valve 4 electric after, (1) mouth and (2) mouth are connected, air-flow by electromagnetic valve 4 (2) mouth out, directly be communicated with saccule valve 19 by the 8th joint 228, therefore electric by obtaining of electromagnetic valve 4, can realize the inflation of the first air pump 6 pairs of saccule valves 19, therefore saccule valve closes, and realizes the cut-out (see Fig. 2) to breathing circuit.When needs saccule valve is exitted, electromagnetic valve 4 dead electricity, (2) mouth and (3) mouth of electromagnetic valve 4 are connected, gas in saccule valve air bag is discharged through (2) mouth of the 8th joint 228, electromagnetic valve 4, (3) mouth of electromagnetic valve 4, arrive the tenth joint 230 place, tenth joint 230 is communicated with a pressure acquisition mouth of the close patient end in disposable expectoration pipeline 20, and therefore saccule valve expellant gas eventually passes through this mouth and enters main breathing pipeline.Saccule valve expellant gas does not enter air and is discharged to the reason in main breathing pipeline, before set forth.
As previously mentioned, the effect of electromagnetic valve 7 is when electromagnetic valve 4 switches malfunctioning because of certain reason, saccule valve 19 can not be exitted, cause breathing circuit by unexpected cut-out, electromagnetic valve 7 can bleed off the gas in sacculus in time, ensure patient safety, its work process is such: when after electromagnetic valve 4 dead electricity, main system detects that saccule valve does not have aerofluxus, so electromagnetic valve 7 obtains electric, gas in saccule valve will enter the first (" 1 " in Fig. 3) of electromagnetic valve 7 through the 8th joint 228, now, electromagnetic valve 7 is electric owing to obtaining, first and second mouthful (" 2 " in Fig. 3) are connected, gas is from second mouthful of discharge of electromagnetic valve 7, through the tenth joint 230, main breathing pipeline is entered into by patient's pressure detecting mouth, thus complete the aerofluxus of saccule valve.
Just as described previously, expectoration system of the present invention can be operated in automatic mode, namely an interval time is set by operator's (being generally medical personnel), once to the time, full-automatic expectoration machine just enters armed state, system starts to detect patient and whether meets expectoration condition, once meet, namely expectoration starts.Another kind of working method is manual mode, operator normally has the patient of certain mobility, after patient presses manual expectoration button, it not expectoration immediately, equally also be that full-automatic expectoration machine enters armed state, until patient inhales terminates, before patient respiration starts, when meeting expectoration condition, expectoration machine just starts expectoration.Expectoration is not unconditional, if do not met some requirements, expectoration does not only reach expected effect by force, also may damage patient.
Referring to Fig. 1, when not carrying out expectoration, the pressure of the throttling arrangement 21 that control system 8 monitoring sensor 11,12 gathers, monitoring inspiratory flow.Now, saccule valve 19 is inflation not, and be normal open, the fast family of power and influence 17 is normally closed.Respirator continues to carry out mechanical ventilation to patient by the respiratory frequency of setting.Starting expectoration can be patient's manual triggers or interval (the such as 5 minutes) triggering according to expectoration operators setting.Expectoration process is as follows:
1, after expectoration starts, control system 8 opens the blower fan 16 of expectoration machine 1 inside, pipeline between blower fan 16 and the fast family of power and influence 17 will produce the negative pressure of expection, negative pressure can be between-10cmH2O to-200cmH2O, preferably between-50cmH2O to-150cmH2O, more preferably between-60cmH2O to-120mH2O, now, because the fast family of power and influence 17 closes, can not have any impact to the mechanical ventilation of patient.Pressure transducer 13 detects blower pressure immediately, and is transferred to control system 8, thus control system 8 can regulate the pressure of blower fan 16.
2, the pressure at the pressure transducer 11 of the control system 8 inside now interface A place of Real-Time Monitoring throttling arrangement 21, the pressure at the interface B place of differential pressure pick-up 12 Real-Time Monitoring throttling arrangement 21, and transfer data to microcomputer control unit, instant flow and pressure in the expectoration pipeline 20 that microcomputer control unit calculates, analyze, judge residing for patient as expiratory phase or expiration phase, capture air-breathing to terminate, exhale and be about to some conversion time of beginning, when patient be in put this conversion time time, control system 8 opens the first air pump 6, two-bit triplet electromagnetic valve 4 obtains electric, connect the gas circuit of the first air pump 6 and saccule valve 19, saccule valve 19 is inflated, saccule valve 19 is caused to be closed, cut off respirator to the ventilation route of patient, almost at the same time, the normally closed fast family of power and influence 17 is opened rapidly by control system 8, the negative pressure line of blower fan 16 is communicated with the air flue of patient, this will cause one fast, unexpected expiratory airflow, spray in the lung of patient, relevant practice and theoretical research prove, when flow is greater than 170L/Min, can effectively expectoration, this flow is about equal to an ordinary people and coughs normally.Now, because saccule valve 19 is closed, under respirator can not be exposed to the negative pressure of blower fan, but have for some the respirator detecting patient exhales traffic engineering capability, it may be caused to report to the police, therefore, at that moment pent at saccule valve 19, the second air pump 3,5 in air pump assembly 2 also brings into operation simultaneously, the gas produced enters breathing pipeline respectively through the interface A of throttling arrangement 21 and interface B, flow to the expiration loop of respirator, thus patient exhales air-flow can be replaced, avoid ventilator alarm.
3, when being discharged in air from effluent air in patient's lung through the fast family of power and influence 17, flow transducer 14, blower fan 16, sound-attenuating system 18.Flow transducer 14 detects the expiratory gas flow of patient and sends data to microcomputer control unit, when detect the expiratory gas flow of patient close to zero time, microcomputer control unit closes the fast family of power and influence 17, simultaneously, two-bit triplet electromagnetic valve 4 dead electricity, saccule valve 19 starts venting, the gas of its inside flows into the main breathing pipeline of patient through three-way magnetic valve, therefore saccule valve 19 is opened, respirator and patient connect, now, patient starts air-breathing, respirator is triggered, patient with there is no expectoration before the same, proceed normal mechanical ventilation, now indicate that an expectoration completes.
Also it is noted that be in theory patient expiratory gas flow close to zero time, expectoration stops, but, due to the fast family of power and influence, the parts such as saccule valve need response time, if expiratory gas flow close to zero time send instruction again, may produce and take out, jeopardize patients ' lives, therefore, in actual moving process, the fast family of power and influence and saccule valve should be closed in advance, when flow transducer 14 to detect by the gas flow of the fast family of power and influence 17 lower than a threshold value, microcomputer control unit closes the fast family of power and influence 17, the desirable value of this threshold value can adjust according to the physiological feature of the hardware device of expectoration pipeline and patient, such as generally 17L/Min or more can be set to.
Simultaneously, the patient carrying out high PEEP (end expiratory positive pressure) value ventilation therapy is needed for respiratory distress syndrome etc., the fast family of power and influence can be closed more in advance, therefore, the flow value of closing in advance can be greater than 17L/MIN, to make patient's intra-pulmonary pressure still be kept above atmospheric pressure after expectoration terminates, subside to prevent alveolar collapse.This be also this expectoration system compared to the Philip coughassist described in background technology, the major reason of various state of an illness patient can be applied more broadly in.
By the continuous repetition to said process, can effectively the airway secretions of patient be progressively discharged to external from pulmonary's deep layer, and then by there being the sputum collection device of vacuum suction function, sputum being converged, is regularly outwelled by medical personnel or remove.
As described previously, this system can be operated in automatic mode, namely by operator, be generally medical personnel, set an interval time, once to the time, full-automatic expectoration machine just enters armed state, fan starting, and system starts to detect patient and whether meets expectoration condition, once meet, namely expectoration starts.Another kind of working method is manual mode, operator normally has the patient of certain mobility, after patient presses manual expectoration button, not being expectoration immediately, is equally also that full-automatic expectoration machine enters armed state, fan starting, until patient inhales terminates, before patient respiration starts, when meeting expectoration condition, expectoration machine just starts expectoration.
Above-described embodiment, just the present invention's more preferably detailed description of the invention, the usual change that those skilled in the art carries out within the scope of technical solution of the present invention and replacement all should be included in protection scope of the present invention.

Claims (10)

1. an expectoration system, is characterized in that, comprising: expectoration machine (1) and expectoration pipeline (20),
Expectoration pipeline (20) comprises throttling arrangement (21) and saccule valve (19), wherein saccule valve (19) is a two-way valve, an one port is respirator port, respirator is connected to by throttling arrangement (21), another port is divided into two, and one is expectoration machine port, connects expectoration machine (1), another is patient ports, connects patient;
Expectoration machine (1) comprises main line assembly (15), air pump assembly (2) and control system (8), and main line assembly (15) comprises the blower fan (16) producing negative pressure and the fast family of power and influence (17) opened when expectoration; Air pump assembly (2) comprises the first air pump (6) to saccule valve (19) air feed and the second air pump (3) to throttling arrangement (21) air feed; Control system (8) is for controlling main line assembly (15) and air pump assembly (2), control system (8) comprises the first sensor (12) of the air pressure for measuring throttling arrangement (21) place, and microcomputer control unit;
Wherein, based on the draught head that first sensor (12) detects, microcomputer control unit judges that patient is in respiration phase or expiratory phase, when patient be in expiratory phase change to expiration phase time, microcomputer control unit controls the sacculus air feed of the first air pump (6) to saccule valve (19) to disconnect the gas circuit of respirator port to patient ports, control system (8) opens blower fan (16) and the fast family of power and influence (17) with assisting patient expectoration, microcomputer control unit controls the second air pump (3) to throttling arrangement (21) air feed simultaneously, during expectoration, respirator does not quit work.
2. expectoration system according to claim 1, it is characterized in that, throttling arrangement (21) is supplied gas on airflow direction along respirator and is arranged interface A and interface B, air pump assembly (2) also comprises the 3rd air pump (5), control system (8) also comprises the second sensor (11)
And, first sensor (12) for detecting the pressure reduction of throttling arrangement (21) interface A and B place, the second sensor (11) for detecting the air pressure at throttling arrangement (21) interface B place,
Second air pump (3) is to throttling arrangement (21) interface A air feed, and the 3rd air pump (5) is to throttling arrangement (21) interface B air feed.
3. expectoration system according to claim 2, it is characterized in that, also comprise gas circuit assembly (22), gas circuit assembly (22) comprises the electromagnetic valve (4) controlled by microcomputer control unit, electromagnetic valve (4) is connected between the first air pump (6) and saccule valve (19), and electromagnetic valve (4) controls air inlet and the aerofluxus of saccule valve (19).
4. expectoration system according to claim 2, it is characterized in that, control system (8) also comprises: the 3rd sensor (9) detecting the pressure at the patient ports place of saccule valve (19), when the pressure differential between microcomputer control unit calculates pressure that the second sensor (11) and the 3rd sensor (9) detect is greater than a threshold value, microcomputer control unit is reported to the police.
5. expectoration system according to claim 1, it is characterized in that, main line assembly (15) also comprises effusion meter (14), effusion meter (14) is for detecting the gas flow by the fast family of power and influence (17), when lower than a threshold value, microcomputer control unit determination expectoration terminates, and close the fast family of power and influence (17), this threshold value is greater than 0.
6. expectoration system according to claim 5, it is characterized in that, main line assembly (15) also comprises the 5th pressure transducer (13) of the pressure for detecting blower fan (16), and microcomputer control unit regulates the rotating speed of blower fan (16) according to the pressure that the 5th pressure transducer (13) detects.
7. expectoration system according to claim 3, it is characterized in that, gas circuit assembly (22) also comprises: the first joint (207), the second joint (206), the 3rd joint (204), the 4th joint (203), the 5th joint (258), the 6th joint (205), 7th joint (226), the 8th joint (228), the 9th joint (229) and the tenth joint (230), wherein
First joint (207) one end is connected to the second air pump (3), and the other end is connected to the interface A of throttling arrangement (21) by the 7th joint (226),
Second joint (206) is connected to first sensor (12),
3rd joint (204) is connected to the second sensor (11),
4th joint (203) one end is connected to the 3rd air pump (5), and the other end is connected to the interface B of throttling arrangement (21) by the 9th joint (229),
5th joint (258) one end is connected to the first air pump (6), the first of other end connected electromagnetic valve (4),
6th joint (205) is connected to the 3rd mouthful of electromagnetic valve (4) and connects the 3rd sensor (9),
8th joint (228) one end is connected to the sacculus of saccule valve (19), second mouthful of other end connected electromagnetic valve (4), the tenth joint (230) is connected to the 3rd mouthful of electromagnetic valve (4) and connects the 3rd sensor (9).
8. expectoration system according to claim 7, it is characterized in that, gas circuit assembly (22) also comprises standby electricity magnet valve (7), the first of electromagnetic valve (7) is connected to the 8th joint (228), second mouthful of electromagnetic valve (7) is connected to the tenth joint (230), electromagnetic valve (7) electric after, the first of electromagnetic valve (7) and second mouthful of connection, the gas in the sacculus of saccule valve (19) is discharged via the 8th joint (228) and the tenth joint (230).
9. expectoration system according to claim 8, is characterized in that, the 6th joint (205) is connected to the breathing pipeline of respirator, and the gas in the sacculus of saccule valve (19) is discharged in the breathing pipeline of respirator.
10. expectoration system according to claim 4, it is characterized in that, control system (8) also comprises the four-sensor (10) of the air pressure for detecting the first air pump (6) exit, four-sensor (10) is arranged on the first air pump (6) exit, the pressure that microcomputer control unit detects according to four-sensor (10), utilize PWM mode to regulate the rotating speed of the first air pump (6), export constant pressure to make the first air pump (6).
CN201510657436.2A 2015-10-12 2015-10-12 Expectoration system CN105343944B (en)

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CN201510657436.2A CN105343944B (en) 2015-10-12 2015-10-12 Expectoration system
JP2018519860A JP6715924B2 (en) 2015-10-12 2016-09-26 Sputum system
KR1020187012310A KR102135746B1 (en) 2015-10-12 2016-09-26 Sputum system
PCT/CN2016/100104 WO2017063498A1 (en) 2015-10-12 2016-09-26 Expectoration system
AU2016339393A AU2016339393B2 (en) 2015-10-12 2016-09-26 Inexsufflation system
TW105132695A TW201713373A (en) 2015-10-12 2016-10-11 Expectoration system

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