CN105363112B - End-expiratory carbon dioxide guiding airway surface anesthesia tube combines stomach tube two-purpose tube - Google Patents
End-expiratory carbon dioxide guiding airway surface anesthesia tube combines stomach tube two-purpose tube Download PDFInfo
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- CN105363112B CN105363112B CN201510898530.7A CN201510898530A CN105363112B CN 105363112 B CN105363112 B CN 105363112B CN 201510898530 A CN201510898530 A CN 201510898530A CN 105363112 B CN105363112 B CN 105363112B
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Abstract
The present invention relates to a kind of end-expiratory carbon dioxide guiding airway surface anesthesia tubes to combine stomach tube two-purpose tube, including big conduit, the big conduit cavity is divided into end-expiratory carbon dioxide channel lumens and stomach tube chamber, the stomach tube chamber and end-expiratory carbon dioxide channel lumens, which are divided into, is divided into big tube chamber and lumen, the intraluminal lumen of stomach is equipped with intranasal pathway surfaces anesthesia tube, and the lumen in the end-expiratory carbon dioxide channel lumens is equipped with larynx and glottis lower surface anesthesia tube；The stage casing side wall of the big conduit offers end-expiratory carbon dioxide acquisition port, the end of the larynx and glottis lower surface anesthesia tube is stretched out from end-expiratory carbon dioxide acquisition port close to the end side of big conduit, the end side wall of the big conduit offers gastric content pump orifice, and the end of the intranasal pathway surfaces anesthesia tube is stretched out from the end of big conduit.The present invention provides better condition for awake trachea cannula and bronchoscopy, can also be that the patient of non-fasting aspirates gastric content when necessary.
Description
Technical field
The present invention relates to medical instruments fields, are anaesthetized more particularly to a kind of end-expiratory carbon dioxide guiding airway surface
Pipe combines stomach tube two-purpose tube.
Background technology
Awake trachea cannula is one of major measure of anesthetist association of U.S. difficult airway management Practical Rules.If
It is likely difficult to ensure that effective ventilation and oxygen close, and suspect the danger that patient has gastric content accidentally to inhale after estimation patient with operation induction
Danger should keep patient awoke to carry out trachea cannula at this time.For awake trachea cannula, either branchofiberoscope guides
Or blind tracheal intubation, intranasal path is all easier to, this is because narrow nasal cavity has FOB or tracheal catheter certain branch
Support and guiding function, FOB or tracheal catheter, which go out after choana to be relatively easy to cross epiglottis, enters glottis.Therefore awake trachea cannula
When intranasal path it is more common.During awake nasal trachea cannula, airway surface anesthesia is mainly comprising several parts, such as pharynx nasalis surface fiber crops
Liquor-saturated to mitigate throat reflection, the surface anesthesia in glottis portion can reduce the activity of glottis, and glottis following table facial anesthesia can increase tracheae pair
The tolerance of conduit.Careful and effective airway surface anesthesia can also reduce the dosage of downern, and can improve matching for patient
It closes.The oral laryngotracheal topical anesthesia kit spraying compound thyrocricocentesis glottis following table facial anesthesia of bottleneck throat surface anesthesia is more common, but ring first film is worn
It is aggressive operation to pierce art, and the patients such as throat portion huge tumor, cicatricial contracture at neck can not then be implemented, and is stranded for dehiscing
Difficult patient, oral laryngotracheal topical anesthesia kit sprays local anaesthetics performance difficulty, even dehiscing normal patient, due to cannot look at straight down into
Row, therefore local anaesthetics can not accurately arrive at supraglottic region and vocal area, anaesthetic effect is unsatisfactory.Though local anaesthetics Neulized inhalation
It is noninvasive operation, but needs special device, and is time-consuming, emergency case is often not easy to implement.Local anaesthetics is sprayed by FOB scopes access
（spray-as-you-go）May be preferable surface anesthesia method, but FOB is expensive, major part base in China's cures at present
Institute can not still be equipped with this instrument.For bronchoscopy patient, since condition is limited, spray-as-you-go surfaces fiber crops
Liquor-saturated also less use.Therefore, it clinically needs to find a kind of technology for easily and effectively carrying out airway surface anesthesia.
Invention content
In view of the deficiencies in the prior art, the technical problems to be solved by the invention are to provide one kind and can be not only used for various intranasals
The surface anesthesia of awake trachea cannula, and available for the surface anesthesia of bronchoscopy, it can be accurately to larynx portion harmony
Door is lower to carry out surface anesthesia, and better condition is provided for awake trachea cannula and bronchoscopy, can also be not prohibit when necessary
The patient of food aspirates the end-expiratory carbon dioxide guiding airway surface anesthesia tube joint stomach tube two-purpose tube of gastric content.
To solve the above-mentioned problems, the technical scheme is that：A kind of end-expiratory carbon dioxide guiding airway surface
Anesthesia tube combines stomach tube two-purpose tube, and including big conduit, the big conduit cavity is divided into end-expiratory carbon dioxide channel lumens by diaphragm
With stomach tube chamber, the stomach tube chamber is distributed along big conduit overall length, and the head end of end-expiratory carbon dioxide channel lumens from the big conduit is opened
Beginning terminad local distribution, the stomach tube chamber and end-expiratory carbon dioxide channel lumens are divided into big tube chamber and small by respective diaphragm
Tube chamber, the intraluminal lumen of stomach are equipped with intranasal pathway surfaces anesthesia tube, in the end-expiratory carbon dioxide channel lumens
Lumen be equipped with larynx and glottis lower surface anesthesia tube；The big conduit is in end-expiratory carbon dioxide channel lumens end
Side wall offers end-expiratory carbon dioxide acquisition port, and the end of the larynx and glottis lower surface anesthesia tube is from end-tidal titanium dioxide
Carbon acquisition port is stretched out close to the end side of big conduit, and side wall of the big conduit in stomach tube chamber end offers gastric content
Pump orifice, the end of the intranasal pathway surfaces anesthesia tube are stretched out from the end of big conduit.
In further preferred embodiment, the head end of the big conduit extends outward the extraction of end-expiratory carbon dioxide channel
Pipe, stomach tube fairlead and two tubule fairleads, the end-expiratory carbon dioxide channel fairlead lead to end-expiratory carbon dioxide
The big tube chamber of road intracavitary is connected, and the stomach tube fairlead is connected with the intraluminal big tube chamber of stomach, and two tubules are drawn
Lumen of the pipe respectively in lumen intraluminal with stomach and end-expiratory carbon dioxide channel lumens is connected.
In further preferred embodiment, the end-expiratory carbon dioxide channel fairlead head end be provided with on Anesthesia machine
PETCO2Acquire the matched modular connection of tube inlet.
In further preferred embodiment, the head end of the stomach tube fairlead is provided with to be connect with what syringe front end matched
Head.
In further preferred embodiment, the intranasal pathway surfaces anesthesia tube and larynx and glottis lower surface anesthesia tube
Head end stretches out from corresponding tubule fairlead and is provided with the crossover sub for connecting syringe respectively, the intranasal routing table
The end of facial anesthesia pipe and larynx and glottis lower surface anesthesia tube offers multiple pin holes.
In further preferred embodiment, the material of the big conduit is silica gel material.
In further preferred embodiment, the intranasal pathway surfaces anesthesia tube and larynx and glottis lower surface anesthesia tube
Material is PVC material.
In further preferred embodiment, the length of the stomach tube chamber is 50 ~ 70cm, the end-expiratory carbon dioxide channel
The length of chamber is 20 ~ 30cm.
In further preferred embodiment, the big conduit is respectively opened up in the both sides of stomach tube chamber end there are one stomach content
Object pump orifice.
In further preferred embodiment, the end-expiratory carbon dioxide acquisition port and gastric content pump orifice are 3mm
The elliptical openings of × 5mm.
Compared with prior art, the present invention has the advantage that when carrying out airway surface anesthesia：（1）Pass through PETCO2Waveform
It can determine whether big conduit stage casing side opening faces glottis, then accurately surface anesthesia carried out to glottis；（2）Observe PETCO2Wave
Shape sprays local anaesthetics to glottis in wave crest and trough respectively, local anaesthetics can be made to enter under glottis；（3）Two are anaesthetized pipe end
Porous structure makes the sprinkling of local anaesthetics evenly, and the contact area bigger of local anaesthetics and airway mucus, topical analgesic effects are more preferably；
（4）Big conduit can be retained, make its position constant, it is a small amount of repeatedly to local anaesthetics by the certain intervals time, local anaesthetics blood can be reduced
Concentration is starched, reduces the risk of toxic reaction, increases topical analgesic effects；（5）Big conduit also has the function of stomach tube, for not prohibiting
Patient is eaten, can gastric content be aspirated by end side opening when necessary.
Description of the drawings
Fig. 1 is the structure diagram of the embodiment of the present invention.
It is marked in figure：The big conduits of 100-, 110- end-expiratory carbon dioxide channel lumens, the big tube chambers of 111-, 112- lumens,
113- end-expiratory carbon dioxide acquisition ports, 120- stomach tube chambers, the big tube chambers of 121-, 122- lumens, 123- gastric content pump orifices,
130- end-expiratory carbon dioxide channel fairleads, 131- modular connections, 140- stomach tube fairleads, 141- connectors, 150,160- it is small
Pipe fairlead, 200- intranasal pathway surfaces anesthesia tubes, 210- crossover subs, 220- pin holes, 300- larynxes and glottis lower surface fiber crops
Liquor-saturated pipe, 310- crossover sub 320- pin holes.
Specific embodiment
In order to which features described above of the invention and advantage is allowed to be clearer and more comprehensible, special embodiment below, and coordinate attached drawing, make detailed
Carefully it is described as follows.
As shown in Figure 1, a kind of end-expiratory carbon dioxide guiding airway surface anesthesia tube joint stomach tube two-purpose tube, including big
Conduit 100, big 100 inner cavity of conduit are divided into end-expiratory carbon dioxide channel lumens 110 and stomach tube chamber by the diaphragm of axis
120, the stomach tube chamber 120 is distributed along big 100 overall length of conduit, and the end-expiratory carbon dioxide channel lumens 110 are from big conduit 100
Head end starts terminad local distribution, the stomach tube chamber 120 and end-expiratory carbon dioxide channel lumens 110 is led greatly by respectively close
Diaphragm at 100 axis of pipe is divided into big tube chamber 121,111 and lumen 122,112, the lumen 122 in the stomach tube chamber 120
It is equipped with intranasal pathway surfaces anesthesia tube 200, the lumen 112 in the end-expiratory carbon dioxide channel lumens 110 is equipped with larynx
Head and glottis lower surface anesthesia tube 300；Side wall of the big conduit 100 in 110 end of end-expiratory carbon dioxide channel lumens is opened
Equipped with end-expiratory carbon dioxide acquisition port 113, the end of the larynx and glottis lower surface anesthesia tube 300 is from end-tidal titanium dioxide
Carbon acquisition port 113 is stretched out close to the end side of big conduit 100, and side wall of the big conduit 100 in 120 end of stomach tube chamber is opened
Equipped with gastric content pump orifice 123, the end of the intranasal pathway surfaces anesthesia tube 200 is stretched out from the end of big conduit 100.
In embodiments of the present invention, in order to facilitate the operation, the head end of the big conduit 100 extends outward end-tidal dioxy
Change carbon channel fairlead 130, stomach tube fairlead 140 and two tubule fairleads 150,160, the end-expiratory carbon dioxide channel
Fairlead 130 is connected with the big tube chamber 111 in end-expiratory carbon dioxide channel lumens 110, the stomach tube fairlead 140 and stomach tube
Big tube chamber 121 in chamber 120 is connected, two tubule fairleads 150,160 respectively with the lumen in stomach tube chamber 120
122 are connected with the lumen 112 in end-expiratory carbon dioxide channel lumens 110, and four fairleads are in the shape that scatters.
In embodiments of the present invention, it connects for convenience, 130 head end of the end-expiratory carbon dioxide channel fairlead setting
Have and the P on Anesthesia machineETCO2Acquire the matched modular connection 131 of tube inlet, the end-expiratory carbon dioxide channel fairlead
130 is longer than other fairleads 140,150,160.The head end of the stomach tube fairlead 140 is provided with what is matched with syringe front end
Connector 141, the syringe preferentially select 20ml injection needle tubes.
In embodiments of the present invention, it connects for convenience, under the intranasal pathway surfaces anesthesia tube 200 and larynx and glottis
The head end of surface anaesthetic tube 300 stretches out from corresponding tubule fairlead 150,160 and is provided with to connect syringe respectively
Crossover sub 210,310.The intranasal pathway surfaces anesthesia tube 200 and the end 5mm of larynx and glottis lower surface anesthesia tube 300
Multiple pin holes 220,320 are inside offered, pin hole and end side wall surrounding of the pin hole 220,320 including end top spherical surface
Pin hole.
In embodiments of the present invention, the material of the big conduit 100 preferentially selects silica gel material, suppleness with clinically
Common silica gel ivory tracheal catheter is similar, and pipe diameter size is consistent with the caliber of average adult's stomach tube.The intranasal pathway surfaces
The material of anesthesia tube 200 and larynx and glottis lower surface anesthesia tube 300 preferentially selects PVC material, and pipe diameter size is led with Epidural cavity
It manages equal.
In embodiments of the present invention, the length of the stomach tube chamber 120 is 50 ~ 70cm, preferential to select 60cm or so；It is described to exhale
The length of gas end carbon dioxide channel chamber 110 is 20 ~ 30cm, preferential to select 25cm or so.Lumen in the stomach tube chamber 120
As long as the diameter of the lumen 112 in 122 and end-expiratory carbon dioxide channel lumens 110 can pass through the conduit of epidural catheter size
.
In embodiments of the present invention, in order to improve pumping efficiency, the big conduit 100 is the two of 120 end of stomach tube chamber
Side is respectively opened up there are one gastric content pump orifice 123.Wherein, the end-expiratory carbon dioxide acquisition port 113 and gastric content are taken out
Suction inlet 123 is the elliptical openings of 3mm × 5mm, and long axis is along big 100 length direction of conduit.
During use：First intranasal pathway surfaces anesthesia tube 200 from corresponding 150 head end entrance of tubule fairlead is inserted into, is passed through
After lumen 122 in stomach tube chamber 120 5mm or so is stretched out from the end of big conduit 100（It can be firm with black line using black line as mark
Subject to good exposing）, the head end tipping of intranasal pathway surfaces anesthesia tube 200 has the syringe of 2% lidocaine injection；Then will
The 100 surface sufficient lubrication of big conduit, the nostril through side are softly inserted into, and 2% lidocaine is sprayed in advance to carry out nose
Intranasal pathway surfaces anesthesia tube 200 when big conduit 100 is inserted into 15 ~ 16cm or so, can be retreated 1cm, make it by pharyngeal surface anesthesia
End is retracted into the lumen 122 in stomach tube chamber 120 Nei in order to avoid scratching pharyngeal mucosa, and patient is enjoined to swallow, enters big conduit 100
Oesophagus；When big conduit 100 is inserted into 50cm or so, by the modular connection 131 of 130 head end of end-expiratory carbon dioxide channel fairlead
With the P on Anesthesia machineETCO2Acquisition tube inlet is connected, and in big 100 progradation of conduit, observes PETCO2Waveform and numerical value,
Work as PETCO2Waveform suddenly disappears, and illustrates that the end-expiratory carbon dioxide acquisition port 113 of big conduit 100 has been enter into oesophagus, at this moment can delay
Big conduit 100 is slowly retreated, and rotates tube chamber, while close observation PETCO2Waveform and numerical value, work as PETCO2Waveform and numerical value are most
Close to it is normal when, illustrate the 113 face glottis of end-expiratory carbon dioxide acquisition port of big conduit 100 at this time, can be fixed with adhesive tape greatly
Conduit 100.Larynx and glottis lower surface anesthesia tube 300 from corresponding 160 head end entrance of tubule fairlead are inserted into again, work as larynx
And the end of glottis lower surface anesthesia tube 300 from end-expiratory carbon dioxide acquisition port 113 stretch out when, can face glottis, observation
PETCO2Waveform sprays 2% lidocaine 2ml to glottis respectively in its wave crest and trough.Current study show that local anesthetic
Low dose of repeatedly sprinkling, can reduce local anaesthetics plasma concentration, reduce the risk of toxic reaction, increase topical analgesic effects, therefore 5
After minute, 2% lidocaine 2ml can be sprayed to glottis again through larynx and glottis lower surface anesthesia tube 300.In addition, for not prohibiting
Patient is eaten, in the intermittent time of surface anesthesia twice, the connector 141 of stomach tube fairlead 140 can be connect with 20ml syringes to aspirate stomach
Content.
The present invention is not limited to above-mentioned preferred forms, anyone can show that other are each under the enlightenment of the present invention
The end-expiratory carbon dioxide guiding airway surface anesthesia tube joint stomach tube two-purpose tube of kind form.It is all according to the present patent application patent model
Done equivalent changes and modifications are enclosed, should all belong to the covering scope of the present invention.
Claims (10)
1. a kind of end-expiratory carbon dioxide guiding airway surface anesthesia tube combines stomach tube two-purpose tube, including big conduit, feature
It is：The big conduit cavity is divided into end-expiratory carbon dioxide channel lumens and stomach tube chamber by diaphragm, and the stomach tube chamber is along big conduit
Overall length is distributed, end-expiratory carbon dioxide channel lumens terminad local distribution since the head end of big conduit, the stomach tube chamber
Big tube chamber and lumen are divided by respective diaphragm with end-expiratory carbon dioxide channel lumens, the intraluminal lumen of stomach is worn
Equipped with intranasal pathway surfaces anesthesia tube, the lumen in the end-expiratory carbon dioxide channel lumens is equipped with larynx and glottis following table
Facial anesthesia pipe；Side wall of the big conduit in end-expiratory carbon dioxide channel lumens end offers end-expiratory carbon dioxide acquisition
The end of mouth, the larynx and glottis lower surface anesthesia tube is from end-expiratory carbon dioxide acquisition port close to the end side of big conduit
It stretches out, side wall of the big conduit in stomach tube chamber end offers gastric content pump orifice, the intranasal pathway surfaces anesthesia
The end of pipe is stretched out from the end of big conduit.
2. end-expiratory carbon dioxide guiding airway surface anesthesia tube according to claim 1 combines stomach tube two-purpose tube,
It is characterized in that：The head end of the big conduit extends outward end-expiratory carbon dioxide channel fairlead, stomach tube fairlead and two
Tubule fairlead, the end-expiratory carbon dioxide channel fairlead are connected with the big tube chamber in end-expiratory carbon dioxide channel lumens
Logical, the stomach tube fairlead is connected with the intraluminal big tube chamber of stomach, and two tubule fairleads are intraluminal with stomach respectively
Lumen is connected with the lumen in end-expiratory carbon dioxide channel lumens.
3. end-expiratory carbon dioxide guiding airway surface anesthesia tube according to claim 2 combines stomach tube two-purpose tube,
It is characterized in that：The end-expiratory carbon dioxide channel fairlead head end is provided with and the P on Anesthesia machineETCO2Acquire tube inlet
The modular connection matched.
4. end-expiratory carbon dioxide guiding airway surface anesthesia tube according to claim 2 combines stomach tube two-purpose tube,
It is characterized in that：The head end of the stomach tube fairlead is provided with the connector to match with syringe front end.
5. end-expiratory carbon dioxide guiding airway surface anesthesia tube according to claim 2 combines stomach tube two-purpose tube,
It is characterized in that：The head end of the intranasal pathway surfaces anesthesia tube and larynx and glottis lower surface anesthesia tube is respectively from corresponding tubule
Fairlead stretches out and is provided with the crossover sub for connecting syringe, the intranasal pathway surfaces anesthesia tube and larynx and glottis
The end of lower surface anesthesia tube offers multiple pin holes respectively.
6. end-expiratory carbon dioxide guiding airway surface anesthesia tube according to claim 1 combines stomach tube two-purpose tube,
It is characterized in that：The material of the big conduit is silica gel material.
7. end-expiratory carbon dioxide guiding airway surface anesthesia tube according to claim 1 combines stomach tube two-purpose tube,
It is characterized in that：The material of the intranasal pathway surfaces anesthesia tube and larynx and glottis lower surface anesthesia tube is PVC material.
8. end-expiratory carbon dioxide guiding airway surface anesthesia tube according to claim 1 combines stomach tube two-purpose tube,
It is characterized in that：The length of the stomach tube chamber is 50 ~ 70cm, and the length of the end-expiratory carbon dioxide channel lumens is 20 ~ 30cm.
9. end-expiratory carbon dioxide guiding airway surface anesthesia tube according to claim 1 combines stomach tube two-purpose tube,
It is characterized in that：The big conduit is respectively opened up in the both sides of stomach tube chamber end there are one gastric content pump orifice.
10. the end-expiratory carbon dioxide guiding airway surface anesthesia tube joint stomach tube double-purpose according to claim 1 or 9
Pipe, it is characterised in that：The end-expiratory carbon dioxide acquisition port and gastric content pump orifice are that the ellipse of 3mm × 5mm is opened
Mouthful.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201510898530.7A CN105363112B (en) | 2015-12-08 | 2015-12-08 | End-expiratory carbon dioxide guiding airway surface anesthesia tube combines stomach tube two-purpose tube |
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| CN201510898530.7A CN105363112B (en) | 2015-12-08 | 2015-12-08 | End-expiratory carbon dioxide guiding airway surface anesthesia tube combines stomach tube two-purpose tube |
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| CN105363112B true CN105363112B (en) | 2018-06-15 |
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| CN109011073A (en) * | 2018-07-05 | 2018-12-18 | 佛山市易轩软件科技有限公司 | A kind of tracheal tube for anesthesia department |
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| US4180076A (en) * | 1977-05-06 | 1979-12-25 | Betancourt Victor M | Nasogastric catheters |
| US4334534A (en) * | 1980-09-18 | 1982-06-15 | The Regents Of The University Of California | Emergency airway management device |
| US4676778A (en) * | 1986-10-27 | 1987-06-30 | Nelson Jr Richard L | Long intestinal catheter with sump |
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| CN105363112A (en) | 2016-03-02 |
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