CN106063966A - 一种可保留自主呼吸的吸入麻醉系统 - Google Patents
一种可保留自主呼吸的吸入麻醉系统 Download PDFInfo
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Abstract
本发明提供一种可保留自主呼吸的吸入麻醉系统，该吸入麻醉系统由麻醉机、负压吸引装置、吸入麻醉头罩、监测装置构成，其中吸入麻醉头罩包括头罩本体(1)和附件(11)，所述头罩本体(1)设有监测导线连接装置(2)、气体监测装置(3)、声音播放装置(4)、透明观察窗(5)、气体排除连接装置(6)、负压吸引连接装置(7)、气体供应连接装置(8)、对讲装置(9)、密封圈(10)。该吸入麻醉系统能够保留自主呼吸，不会造成任何损伤，克服现有面罩、喉罩通气密闭性差的缺点，加快麻醉诱导和苏醒，并能在麻醉过程中实时观察患者的麻醉状态。本发明具有安全、有效、简单的特点。
Description
技术领域
本发明涉及一种可保留自主呼吸的吸入麻醉系统，所述吸入麻醉系统由麻醉机、吸入麻醉头罩、负压吸引装置、监测装置构成。
背景技术
吸入麻醉药经肺通气进入体内和排除，其麻醉深度的调节较其他静脉麻醉更为容易。吸入麻醉剂如七氟烷，具有良好的镇痛和麻醉作用，且对呼吸抑制轻，能在保留自主呼吸的情况下完成体表和四肢的手术，如前列腺电切术、子宫锥形切除术等。
目前常用的吸入麻醉使用的工具有：面罩、喉罩和气管插管。面罩由于不能很好密封患者口鼻，易造成麻醉剂泄漏，导致手术室污染，目前只用于麻醉诱导时的几分钟时间的使用；且由于面罩空间小，婴幼儿等患者难以接受；喉罩置入时常需要使用一定剂量的镇静药、肌松剂，难以保留患者的自主呼吸，且喉罩置入可带来一定的损伤和并发症；气管插管置入时需要使用更多的镇静药、肌松剂，无法保留患者的自主呼吸，且气管导管置入的并发症更多。
目前关于吸入麻醉工具的研究主要集中在面罩的改良，通过改良增强面罩的密闭性(防漏性)，但未能改变面罩用于麻醉诱导的局限。如发明专利“防漏麻醉面罩”(申请号201010228941.2)公开了一种防漏的麻醉面罩，该面罩通过增加了防漏气囊的设计，使得面罩更加紧贴于患者面部达到防漏的目的。如发明专利“一种指扣型麻醉面罩”(申请号201110280425.9)公开了一种新型的指扣型装置，使得扣面罩的过程中不至因无有效着力点而造成双手滑脱导致面罩扣不紧的现象，进而减少漏气发生。如实用新型专利“麻醉面罩”(申请号201320248821.8)公开了一种包括面罩体、底座、进气口和挂钩的麻醉面罩，其底座位于面罩体的下方，进气口位于面罩体的上方，挂钩与底座固定，达到固定牢靠，防止脱落的目的。
因此，目前临床缺乏一种可以保留自主呼吸、简单、有效、安全的吸入麻醉工具和吸入麻醉系统。
发明内容
本发明公开了一种可保留自主呼吸的吸入麻醉系统，所述吸入麻醉系统由麻醉机、吸入麻醉头罩、负压吸引装置、监测装置构成。
本发明公开了一种吸入麻醉头罩(见附图)，所述的吸入麻醉头罩包括头罩本体(1)和附件(11)，所述头罩本体(1)设有监测导线连接装置(2)、气体监测装置(3)、声音播放装置(4)、透明观察窗(5)、气体排除连接装置(6)、负压吸引连接装置(7)、气体供应连接装置(8)、对讲装置(9)、密封圈(10)。
本发明公开的吸入麻醉头罩(见附图)，除已经标注的功能和装置外，可以根据临床需要，增加功能和装置，如用于胃镜、纤维支气管镜等检查麻醉时，增加镜头或器具伸入口、鼻的插入孔。
本发明所述的麻醉机其主体中包括吸入麻醉剂挥发罐、废气回收装置、调节装置，其中调节装置用于调节气量以及氧气与麻醉剂的比例。氧气通过临床使用的氧气瓶、氧气发生器以及输氧管道供应。
本发明所述负压吸引装置选自中心负压吸引系统、电动负压吸引器、负压吸引袋、负压吸引球、负压吸引瓶，优选中心负压吸引系统。
本发明所述监测装置包括脑组织氧饱和度监测装置、麻醉深度监测装置。
本发明所述监测装置与吸入麻醉头罩通过监测导线连接装置(2)连接，所述负压吸引装置与吸入麻醉头罩通过负压吸引连接装置(6)连接，所述麻醉机与吸入麻醉头罩通过气体供应连接装置(8)和气体排除连接装置(6)连接。
本发明公开的吸入麻醉系统无需使用其他的镇静药和肌松剂，患者佩戴吸入麻醉头罩，仅靠麻醉机吸入麻醉剂如七氟烷即可达到一定的麻醉深度，能满足大多数手术的麻醉需要。如头颈部以下的体表和四肢的手术，无需很强肌松要求的部分体腔内手术如内镜下前列腺电切术、子宫锥形切除术等，以及用于胃镜、肠镜、纤维支气管镜、逆行胰胆管造影(ERCP)等经过口腔、鼻腔行内镜下检查和治疗的麻醉。
本发明公开的吸入麻醉系统可以单独使用，也可以与其他如右美托嘧啶、地佐辛等镇静、镇痛药联合使用。
本发明公开的吸入麻醉系统对于肥胖、睡觉打鼾等在麻醉时可能出现上呼吸道梗阻的患者，在麻醉时需要联合使用口咽或鼻咽通气道以保持上呼吸道通畅。
本发明公开的吸入麻醉系统体现人文关怀，麻醉头罩上设有扬声器可以播放音乐，充分缓解病人的紧张情绪和恐惧感，使患者在自然呼吸状态下伴随音乐进入麻醉状态，同时也免除了患者在麻醉前遭受打针的痛苦，这对婴幼儿患者的麻醉诱导尤其有利；头罩还可以实现各种卡通造型，利于患儿接受；对讲装置使医生和患者能够在诱导过程中相互交流，且能在手术结束后唤醒病人。
本发明公开的麻醉系统，由于吸入麻醉头罩罩住了整个头部，在患者自主呼吸的情况下不会引起麻醉气体的泄漏，有效克服现有面罩、喉罩通气密闭性差的缺点；由于吸入麻醉头罩没有侵入患者的气道，因此不会造成任何损伤，还可避免机械正压通气(气管插管)导致的胃胀气及肺不张、机械通气性肺损伤等其他损伤并发症；由于吸入麻醉头罩保留患者自主呼吸，患者在手术过程中通过呼吸频率和潮气量的改变而自主调节麻醉的深度；由于吸入麻醉头罩上设有透明的观察窗以及本麻醉系统中配有气体监测装置、麻醉深度监测装置、脑氧饱和度监测装置等一系列监测装置，麻醉医生可以在麻醉过程中实时观察患者的麻醉深度。由于本麻醉系统具备负压吸引装置，负压吸引装置通过加速气体在头罩内的单向流动，能够在麻醉诱导和麻醉苏醒阶段通过加大新鲜气流量和流速，达到快速升高或降低头罩内麻醉气体浓度的目的，缩短患者麻醉诱导时的起效时间和麻醉结束后的苏醒时间，并且即使在高流量新鲜气流条件下头罩内压力也能保持在5cmH2O以下，使头罩内的压力一直控制在-5cmH2O～5cmH2O压力水平，这一方面降低头罩密封的压力要求，同时也增加了患者颈部的舒适感和防止了密封圈对颈部压迫伤的发生；另一方面也降低了麻醉剂的泄漏风险。因此，本吸入麻醉系统具有安全、有效、简单的特点，具有显著的新颖性、创造性和实用性。
附图说明
图1：本发明的吸入麻醉头罩示意图
附图中1-头罩本体、2-监测导线连接装置、3-气体监测装置、4-声音播放装置、5-透明观察窗、6-气体排除连接装置、7-负压吸引连接装置、8-气体供应连接装置、9-对讲装置、10-密封圈、11-附件。
具体实施方式
为进一步公开本发明的技术方案，下面结合说明书附图通过实例做详细说明。
本可保留自主呼吸的吸入麻醉系统由麻醉机、吸入麻醉头罩、负压吸引装置、监测装置构成。
本发明所述的吸入麻醉头罩包括头罩本体(1)和附件(11)，所述头罩本体(1)设有监测导线连接装置(2)、气体监测装置(3)、声音播放装置(4)、透明观察窗(5)、气体排除连接装置(6)、负压吸引连接装置(7)、气体供应连接装置(8)、对讲装置(9)、密封圈(10)。
本发明所述的麻醉机其主体中包括吸入麻醉剂挥发罐、废气回收装置、调节装置，其中调节装置用于调节气量以及氧气与吸入麻醉剂的比例。氧气通过临床使用的氧气瓶、氧气发生器以及输氧管道供应。所述负压吸引装置选自中心负压吸引系统、电动负压吸引器、负压吸引袋、负压吸引球、负压吸引瓶，优选中心负压吸引系统、电动负压吸引器，最优选中心负压吸引系统。所述监测装置包括脑组织氧饱和度监测装置、麻醉深度监测装置，所述的麻醉深度监测装置优选通过放置在前额部的电极来进行监测的麻醉深度监测仪，所述的脑组织氧饱和度监测装置优选脑血氧饱和度监测仪。
本发明所述的监测装置与吸入麻醉头罩通过监测导线连接装置(2)连接，所述负压吸引装置与吸入麻醉头罩通过负压吸引连接装置(6)连接，所述麻醉机与吸入麻醉头罩通过气体供应连接装置(8)和气体排除连接装置(6)连接。
本发明所述的监测导线连接装置(2)是气密导线孔，优选具有气囊的孔，麻醉深度监测仪和脑氧饱和度监测仪的电极线通过气密导线孔接入到麻醉头罩内。
本发明所述的气体监测装置(3)是氧气、二氧化碳和吸入麻醉气体浓度检测仪，其采用红外复合测量技术，头罩内的气体以扩散的形式通过微孔过滤片进入检测仪，吸收特定波长的红外光，吸收强度与待测气体浓度满足朗伯-比尔吸收定律，通过分析吸收前后红外光强度的变化获得待测气体的实时浓度。
本发明所述声音播放装置(4)是扬声器，优选连接声源播放音乐以及其他特定声音，可以在麻醉前、麻醉开始以及苏醒过程中播放音乐，缓解患者手术紧张的情绪。
本发明所述透明观察窗(5)优选由高分子材料制成的透明面板，医生可以通过窗口观察患者的麻醉状态，同时也方便患者清醒状态下的对外交流。该透明观察窗与麻醉头罩主体可以是一体，也可以是可装卸。
本发明所述气体排除连接装置(6)是气密控制阀门，通过管道连接麻醉机进气口(气体回流)和吸入麻醉头罩，在麻醉整个过程中，含有麻醉剂、氧气、二氧化碳的混合气体从吸入麻醉头罩内回流到麻醉机进气口，循环利用或作为废气回收。
本发明所述的负压吸引连接装置(7)是气密控制阀门，通过管道连接负压吸引装置和吸入麻醉头罩。在麻醉过程中，当麻醉机显示的罩内压力5cmH2O以下时，负压吸引连接装置处于关闭状态。当在诱导麻醉时，因为氧气流量较高，在高流量气流时可升高头罩内的压力，增加头罩密闭所需的压力和麻醉剂泄露的风险，因此在麻醉诱导时打开负压吸引连接装置，在高流量新鲜气流下，可以使头罩内的吸入麻醉剂浓度快速上升，实现快速的麻醉诱导，还可以降低高流量新鲜气流下头罩内的压力，使之保持在5cmH2O以下，有效防止麻醉气体的泄露。当麻醉过程中麻醉机显示的罩内压力5cmH2O以上时，打开负压吸引连接装置，快速降低头罩内的压力，有效防止麻醉气体的泄露。当手术结束时，关闭吸入麻醉剂(挥发罐)后打开负压吸引连接装置的同时加大氧气流量，可以快速降低头罩内吸入麻醉剂的浓度，加快患者苏醒，另外还可以把头罩内残留的麻醉气体抽吸掉，防止打开头罩时残留麻醉气体的泄漏。
本发明所述气体供应连接装置(8)是气密控制阀门，通过管道连接麻醉机的出气口和吸入麻醉头罩，麻醉机将含有麻醉剂和氧气的混合气体通过麻醉机的出气口输送到吸入麻醉头罩内，达到麻醉的目的。
本发明所述对讲装置(9)是具有对讲功能的便携式对讲机，可以在麻醉前、麻醉开始时以及唤醒后患者和医生的交流，便于缓解患者的紧张情绪和恐惧感，也能够传达医生的指示以及患者的主诉，利于医生实时全面掌控患者的麻醉情况。
本发明所述的密封圈(10)选自硅胶密封圈、天然橡胶密封圈、气囊密封圈、弹性密封圈、涂有密封胶的高分子材料，优选硅胶密封圈、天然橡胶密封圈、气囊密封圈和弹性密封圈，最优选硅胶密封圈、弹性密封圈。该密封圈与麻醉头罩主体可以是一体，也可以是可装卸。
本发明所述的附件(11)优选织物、高分子材料制备的膜，最优选织物，主要起吸入麻醉头罩固定以及患者机体保护、遮挡、保暖的作用。
Claims (4)
1.一种可保留自主呼吸的吸入麻醉系统，其特征在于所述吸入麻醉系统由麻醉机、负压吸引装置、吸入麻醉头罩、监测装置构成，所述的吸入麻醉头罩包括头罩本体(1)和附件(11)，所述头罩本体(1)设有监测导线连接装置(2)、气体监测装置(3)、声音播放装置(4)、透明观察窗(5)、气体排除连接装置(6)、负压吸引连接装置(7)、气体供应连接装置(8)、对讲装置(9)、密封圈(10)。
2.权利要求1所述负压吸引装置选自中心负压吸引系统、电动负压吸引器、负压吸引袋、负压吸引球、负压吸引瓶，所述监测装置包括脑氧饱和度监测装置、麻醉深度监测装置。
3.权利要求1所述监测装置与吸入麻醉头罩通过监测导线连接装置(2)连接，所述负压吸引装置与吸入麻醉头罩通过负压吸引连接装置(7)连接，所述麻醉机与吸入麻醉头罩通过气体供应连接装置(8)和气体排除连接装置(6)连接。
4.权利要求1所述的监测导线连接装置(2)是气密导线孔，所述的气体监测装置(3)是氧气、二氧化碳和麻醉剂浓度监测仪，所述声音播放装置(4)是扬声器，所述透明观察窗(5)是由高分子材料制成的透明面板，所述气体排除连接装置(6)是气密控制阀门，所述负压吸引连接装置(7)是气密控制阀门，所述气体供应连接装置(8)是气密控制阀门，所述对讲装置(9)是具有对讲功能的便携式对讲机，所述的密封圈(10)选自硅胶密封圈、天然橡胶密封圈、弹性密封圈、气囊密封圈、涂有密封胶的高分子材料。
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