CN106581833A - Breathing machine - Google Patents
Breathing machine Download PDFInfo
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- CN106581833A CN106581833A CN201710034070.2A CN201710034070A CN106581833A CN 106581833 A CN106581833 A CN 106581833A CN 201710034070 A CN201710034070 A CN 201710034070A CN 106581833 A CN106581833 A CN 106581833A
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- pressure
- interface
- negative pressure
- respirator
- expectoration
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- 230000029058 respiratory gaseous exchange Effects 0.000 title abstract description 33
- 206010036790 Productive cough Diseases 0.000 claims abstract description 85
- 210000003019 respiratory muscle Anatomy 0.000 claims description 57
- 230000001360 synchronised effect Effects 0.000 claims description 22
- 238000000034 method Methods 0.000 claims description 20
- 230000004308 accommodation Effects 0.000 claims description 8
- 238000012544 monitoring process Methods 0.000 claims description 8
- 238000011156 evaluation Methods 0.000 claims description 7
- 238000009423 ventilation Methods 0.000 claims description 6
- 230000003434 inspiratory effect Effects 0.000 claims description 5
- 238000005086 pumping Methods 0.000 claims description 5
- 238000004891 communication Methods 0.000 claims description 2
- 208000024794 sputum Diseases 0.000 abstract description 22
- 210000003802 sputum Anatomy 0.000 abstract description 22
- 206010011224 Cough Diseases 0.000 abstract description 17
- 238000005399 mechanical ventilation Methods 0.000 abstract description 12
- 230000001105 regulatory effect Effects 0.000 abstract description 3
- 230000029142 excretion Effects 0.000 abstract 5
- 206010059685 Sputum retention Diseases 0.000 abstract 1
- 239000007789 gas Substances 0.000 description 51
- 229910052760 oxygen Inorganic materials 0.000 description 10
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 9
- 239000001301 oxygen Substances 0.000 description 9
- 230000008030 elimination Effects 0.000 description 8
- 238000003379 elimination reaction Methods 0.000 description 8
- 230000008569 process Effects 0.000 description 8
- 230000004936 stimulating effect Effects 0.000 description 6
- 210000003489 abdominal muscle Anatomy 0.000 description 5
- 238000001514 detection method Methods 0.000 description 5
- 230000006870 function Effects 0.000 description 5
- 230000003387 muscular Effects 0.000 description 5
- 230000007383 nerve stimulation Effects 0.000 description 5
- 230000033228 biological regulation Effects 0.000 description 4
- 230000000694 effects Effects 0.000 description 4
- 230000002685 pulmonary effect Effects 0.000 description 4
- 230000009286 beneficial effect Effects 0.000 description 3
- 210000004072 lung Anatomy 0.000 description 3
- 230000010355 oscillation Effects 0.000 description 3
- 230000000241 respiratory effect Effects 0.000 description 3
- 230000000638 stimulation Effects 0.000 description 3
- 208000008784 apnea Diseases 0.000 description 2
- 230000015572 biosynthetic process Effects 0.000 description 2
- 230000008602 contraction Effects 0.000 description 2
- 230000001276 controlling effect Effects 0.000 description 2
- 239000003172 expectorant agent Substances 0.000 description 2
- 230000003419 expectorant effect Effects 0.000 description 2
- 239000007788 liquid Substances 0.000 description 2
- 210000003205 muscle Anatomy 0.000 description 2
- 210000003105 phrenic nerve Anatomy 0.000 description 2
- 238000011897 real-time detection Methods 0.000 description 2
- 210000001139 rectus abdominis Anatomy 0.000 description 2
- 238000004088 simulation Methods 0.000 description 2
- 238000005303 weighing Methods 0.000 description 2
- 206010002027 Amyotrophy Diseases 0.000 description 1
- 241000894006 Bacteria Species 0.000 description 1
- 206010021133 Hypoventilation Diseases 0.000 description 1
- CBENFWSGALASAD-UHFFFAOYSA-N Ozone Chemical compound [O-][O+]=O CBENFWSGALASAD-UHFFFAOYSA-N 0.000 description 1
- 208000004756 Respiratory Insufficiency Diseases 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 230000007423 decrease Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 230000001419 dependent effect Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 230000005611 electricity Effects 0.000 description 1
- 238000005265 energy consumption Methods 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 239000008246 gaseous mixture Substances 0.000 description 1
- 230000006872 improvement Effects 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 230000003601 intercostal effect Effects 0.000 description 1
- 230000007794 irritation Effects 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 230000036651 mood Effects 0.000 description 1
- 238000005457 optimization Methods 0.000 description 1
- 210000003540 papillary muscle Anatomy 0.000 description 1
- 230000002265 prevention Effects 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 230000009711 regulatory function Effects 0.000 description 1
- 201000004193 respiratory failure Diseases 0.000 description 1
- 230000004202 respiratory function Effects 0.000 description 1
- 230000028327 secretion Effects 0.000 description 1
- 238000012360 testing method Methods 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES 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
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/389—Electromyography [EMG]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
- A61H23/04—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with hydraulic or pneumatic drive
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES 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
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES 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
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/20—Valves specially adapted to medical respiratory devices
- A61M16/201—Controlled valves
- A61M16/202—Controlled valves electrically actuated
- A61M16/203—Proportional
- A61M16/205—Proportional used for exhalation control
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES 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
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES 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
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES 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
- A61M2205/00—General characteristics of the apparatus
- A61M2205/33—Controlling, regulating or measuring
- A61M2205/3331—Pressure; Flow
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES 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
- A61M2230/00—Measuring parameters of the user
- A61M2230/40—Respiratory characteristics
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Heart & Thoracic Surgery (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Pulmonology (AREA)
- Hematology (AREA)
- Anesthesiology (AREA)
- Emergency Medicine (AREA)
- Biophysics (AREA)
- Physics & Mathematics (AREA)
- Pathology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Surgery (AREA)
- Physiology (AREA)
- Epidemiology (AREA)
- Pain & Pain Management (AREA)
- Physical Education & Sports Medicine (AREA)
- Rehabilitation Therapy (AREA)
- Percussion Or Vibration Massage (AREA)
- Respiratory Apparatuses And Protective Means (AREA)
Abstract
The invention relates to a breathing machine which comprises a control system, an inhalation module and an exhalation module, wherein the exhalation module comprises a switching valve, an exhalation branch, a sputum excretion branch and a pressure regulating valve; the switching valve comprises a first joint, a second joint, and a switching element used for connecting or disconnecting the first joint and the second joint; the first end of the exhalation branch is connected with a patient end, and the second end of the exhalation branch is connected with the first joint of the switching valve; the first end of the sputum excretion branch is connected with the second joint of the switching valve, and the second end of the sputum excretion branch is connected with a negative pressure joint of a negative pressure source; the pressure regulating valve is arranged on the exhalation branch and is used for maintaining gas pressure of the exhalation branch to be in a preset range; and the gas pressure comprises positive pressure P+ and negative pressure P-. Therefore, the breathing machine disclosed by the invention has the advantages that a negative pressure sputum excretion function is increased on the basis of the existing breathing machine, normal human coughing can be simulated, and the problem that a clinical mechanical ventilation patient has sputum excretion difficulty is solved. Moreover, compared with the existing breathing machine and sputum excretion machine combination, the breathing machine disclosed by the invention is simple and compact in structure.
Description
Technical field
The invention belongs to medicine and hygiene fieldses, more particularly to a kind of respirator.
Background technology
Respirator is widely used in clinical treatment, is that one kind can play prevention and treatment respiratory failure, reduces complication, draws
Rescue and extend the vital armarium of patients ' lives；Can replace, control or change the normal physiologic respiration of people, increase
Pulmonary ventilation volume, improves respiratory function, mitigates work of breathing ozone.
In use, for the different patient of autonomous respiration ability, the respiration parameter of setting is often different for respirator.
But, existing respirator can not all assess the autonomous respiration ability of patient, it is impossible to provide the parameter setting of suggestion.Therefore, mesh
It is front for whether arrange parameter reasonably judges, be largely dependent upon the experience of doctor, especially patient slowly departs from and exhales
The process of suction machine, needs doctor's trial slowly.
It is often necessary to carry out the patient of mechanical ventilation using respirator, often weak with autonomous expectoration ability, there is expectorant in pulmonary
The problem of liquid alluvial.The patient of many mechanical ventilations, can be because the Arterial blood gas difference of apparatus causes serious pulmonary infection, seriously
Meeting cause death.At present, expectoration means clinically include sputum aspirator tube suction sputum, extrasomatic vibration sputum discharge machine, mechanical suction and discharge formula
Sputum elimination machine, and the negative pressure sputum elimination machine that can be used in conjunction with respirator.But, existing these expectoration means are respectively provided with certain limitation
Property, for example：Sputum aspirator tube cannot clear up the sputum in lung deep, and be intrusive mood operation, easily cause air flue to scratch, and bring into thin
Bacterium；External vibration type sputum elimination machine loosens can only sputum, need to coordinate other means to excrete sputum；Mechanical suction and discharge formula
Sputum elimination machine needs to disconnect respirator, affects larger to Patients with Mechanical Ventilation；The sputum elimination machine that can be used in conjunction with respirator, although very
Can solve the above problems in big degree, but be still unavoidable from the mechanical ventilation on patient and produce impact, and can cause to exhale
Suction machine is reported to the police, and is made troubles to Clinical practice.It follows that current respirator all cannot bring foot in terms of expectoration to patient
Enough help.
In addition, for life-time service respirator carries out the patient of mechanical ventilation, the useless property that respiratory muscle often occurs is withered
Contracting, makes patient produce ventilator dependency, it is impossible to off line.Although current respirator can help patient to solve asking for hypoventilation
Topic, but can do nothing to help the ability that patient recovers autonomous respiration.
For example, the Chinese invention patent application of Application No. CN201310010089.5 is provided and a kind of has expectoration function
Respirator, respirator in combination with sputum elimination machine, with realization while human body respiration is aided in, is assisted patient to discharge pulmonary's expectorant by it
Liquid.But it still has the disadvantage that：Firstth, respiratory muscle is not monitored and treated；Secondth, it is remained as in respirator
Increase single negative pressure branch road outside gas circuit, the branch road of expectoration is not really dissolved into into respirator gas circuit, increased system and answer
It is miscellaneous while spend, it is impossible to coordinate the work of the two well；3rd, the negative pressure source of the respirator is by air accumulator and vacuum pump group
Into structure is excessively simple, it is difficult to the requirement of balancing equipment volume and equipment effectiveness：If the volume of air accumulator is little or vacuum
The flow of pump is little, and when expectoration operation is carried out, the pressure of air accumulator is difficult quick foundation, forms continuous effective expectoration, very
Can extremely cause patient's aerofluxuss insufficient；If the volume of air accumulator is sufficiently large or flow of vacuum pump is enough big, machine can seem
It is heavy；4th, its negative pressure branch road does not have enough safety and monitoring mechanism to ensure the safety of patient.
In sum, this area needs a kind of more excellent solution, can preferably solve Patients with Mechanical Ventilation process
In the expectoration that runs into is smooth, breathing amyotrophy the problems such as.
The content of the invention
(1) technical problem to be solved
In order to solve the problems referred to above of prior art, the present invention provides a kind of respirator, its can by breathing, expectoration, exhale
Inhale flesh monitoring and treatment is organically integrated into a whole, while Breathing Suppotion is provided, patient respiratory flesh can be monitored
State, the setting ventilator parameter for helping medical personnel more excellent；The cough of intelligent simulation people during expectoration, helps patient by lung depth
The secretions in portion are discharged；And the respiratory muscle that can help patient recovers as early as possible, contribute to removing machine ahead of time.
(2) technical scheme
In order to achieve the above object, the main technical schemes that the present invention is adopted include：
A kind of respirator, it includes：
Control system；
Air-breathing module, is connected with control system；
Expiration module,
Characterized in that, the expiration module includes：
Switching valve, is connected with control system, and it has first interface, second interface, and for switching on or off first
The switch member of interface and second interface,
Expiration branch road, its first end connection patient end, its second end connects the first interface of switching valve,
Expectoration branch road, its first end connects the second interface of switching valve, and its second end connects the negative port of negative pressure source,
Pressure regulator valve, located at expiration branch road, is connected with control system, for maintaining the gas pressure of expiration branch road in predetermined model
In enclosing, gas pressure includes malleation P+With negative pressure P-。
By the setting of said structure, the respirator of the present invention, negative pressure expectoration is increased on the basis of existing respirator
Function, can simulate the normal cough of people, solve the problems, such as undergoing mechanical ventilation in clinical patient's expectoration difficulties；And, relative to existing
For some respirators are applied in combination with sputum elimination machine, the structure of the present invention is simpler, compact, specifically refers to, during expiration, switching
Valve is in closed mode, only uses expiration branch road, and using malleation P of pressure regulation valve regulation expiration branch road+, during expectoration, switching valve is in
Open mode, is connected in series expiration branch road and expectoration branch road for expectoration using switching valve, and using pressure regulation valve regulation expectoration
Negative pressure P of branch road-。
The respirator of one embodiment of the invention, its negative pressure source is provided with gas appearance, blower fan and air pump, wherein, gas container has
Accommodation space and first interface in communication, second interface and the 3rd interface, blower fan holds pumping by first interface to gas, makes
Obtain accommodation space and reach the first negative pressure P1, air pump holds pumping by second interface to gas so that accommodation space reaches the second negative pressure
P2, the absolute value of the first negative pressure P1 is less than the absolute value of the second negative pressure P2, and the 3rd interface that gas holds constitutes the negative pressure of negative pressure source and connects
Mouthful.Whereby, the following defect that the negative pressure source in existing respirator can be overcome to exist：Because flow is mutually restricted with negative pressure causing
It is difficult to while realize big flow and big negative pressure, at the same meet the two often bring the volume of negative pressure source, the problems such as noise is excessive,
Negative pressure source in the respirator of the present invention can simultaneously realize high negative pressure and big flow, and can reach lower noise water
Flat, less volume and lower energy consumption etc., especially, when starting expectoration, quickly will be extracted into certain using blower fan in gas appearance
Negative pressure value, the pressure during then air pump further holds gas is extracted into lower predetermined negative pressure so that the cough incipient stage forms peak
The flow velocity of value, later stage flow velocity has declined, and pressure value also drops to relatively low negative pressure, makes on airflow waveform closer to normal cough
Air-flow, later stage less negative pressure is also preferably protection to patient, and the whole exhalation process of patient can all feel much smoother.
The respirator of one embodiment of the invention, wherein, negative pressure source is additionally provided with check valve, check valve hold located at gas the
Between one interface and the negative pressure end of blower fan, optionally held to blower fan ventilation from gas.For example, after exhaust fan terminates or
Before air pump pumping, check valve is closed, be conducive to the formation of further negative pressure.
The respirator of one embodiment of the invention, wherein, negative pressure source also includes relief valve and baroceptor, located at expectoration
Between the 3rd interface that second end of branch road and gas hold.Preferably, relief valve is installed near gas putting, baroceptor is near the 3rd
Interface is arranged.
The respirator of one embodiment of the invention, wherein, pressure regulator valve is provided with positive pressure interface and negative port simultaneously, just crimps
Mouth is used to maintain malleation P+Within a predetermined range, negative port is used to maintain negative pressure P-Within a predetermined range.
Preferably, pressure regulator valve is located at expiration branch road near one end of switching valve.
The respirator of one embodiment of the invention, wherein, the positive pressure interface and negative port of pressure regulator valve are set up in parallel
Two interfaces.
The respirator of one embodiment of the invention, wherein, the positive pressure interface and negative port of pressure regulator valve are same interface,
It is positive pressure interface when interface forward direction is opened, is negative port when the reverse interface is opened.
The respirator of one embodiment of the invention, wherein, malleation P+Predetermined adjustment scope be 0～80cmH2O。
The respirator of one embodiment of the invention, wherein, negative pressure P-Predetermined adjustment scope be -10～-150cmH2O。
The respirator of one embodiment of the invention, it is also synchronized with the movement module including respiratory muscle, and respiratory muscle is synchronized with the movement mould
Block includes the respiratory muscle checking with EMG method submodule for monitoring respiratory muscle electromyographic signal.Whereby, the respiratory muscle of patient can be detected
Moving situation.
The respirator of a preferred embodiment of the present invention, it also includes that respiratory muscle strength evaluates submodule, for breathing
Flesh muscular strength is evaluated, and the reference signal used during evaluation includes respiratory muscle electromyographic signal, such as respiratory muscle checking with EMG method
The respiratory muscle electromyographic signal that module detection is obtained.
Wherein, evaluate respiratory muscle strength method be, autonomous getter capacity, dynamics of coughing of choking according to patient, diaphram myoelectricity
Signal intensity, by the autonomous respiration ability of patient some levels are divided into.For example, lowest level is complete apnea, it is proposed that used
Control model is ventilated；Highest level is can be with entirely autonomous breathing, it is proposed that using autonomous respiration ventilating mode or trial off line.
The respirator of a preferred embodiment of the present invention, it is also included for optimizing man-machine synchronous man-machine Synchronous fluorimetry
Module, the reference signal that the man-machine synchronization of optimization is used includes respiratory muscle electromyographic signal, such as respiratory muscle checking with EMG method submodule
The respiratory muscle electromyographic signal that detection is obtained.
The respirator of a preferred embodiment of the present invention, its respiratory muscle is synchronized with the movement module also including respiratory muscle stimulation submodule
Block, the respiratory muscle activity and the positive airway pressure of respirator for synchronous patient.Whereby, patient respiratory flesh can be stimulated to produce it
The muscular movement synchronous with positive airway pressure, more preferable simulation eupnea is reduced and moved back because respiratory muscle is useless caused by mechanical ventilation, is had
Beneficial to the vigor for keeping respiratory muscle, patient is made to recover as early as possible, off line.
Wherein, respiratory muscle stimulates submodule preferably to include diaphragm nerve stimulation unit and abdominal muscle stimulating unit.
During enforcement, the stimulation sites of diaphragm nerve stimulation unit are Huo Zhexiang at both sides sternocleidomastoids lower edge 1/3rd
At portion's phrenic nerve root；The stimulating electrode of abdominal muscle stimulating unit is located at rectus abdominis m. and/or transversus abdominis m..
The respirator of one embodiment of the invention, it also includes parameter display module, and parameter display module is examined including myoelectricity
Survey result display sub-module and respiratory muscle strength for patients evaluation result display sub-module.For example, show checking with EMG method waveform and
Scoring to respiratory muscle strength for patients.
The respirator of one embodiment of the invention, its control system includes parameter setting module, wherein, parameter setting module
Including：Expectoration negative pressure arranges son when pressure of inspiration(Pi) arranges submodule, expectoration when air-breathing tidal volume arranges submodule, expectoration during expectoration
Module, inspiratory airflow vibration arrange submodule, expiratory airflow vibration and arrange the submodule and respiratory muscle module parameter that is synchronized with the movement and set
Put any one in submodule or appoint several.
The respirator of one embodiment of the invention, air-breathing tidal volume arranges submodule and normal it is provided with expectoration simultaneously when
Tidal volume during breathing arranges submodule, and the two can be independently arranged.
The respirator of one embodiment of the invention, pressure of inspiration(Pi) arranges submodule and normally exhales it is provided with expectoration simultaneously when
Pressure of inspiration(Pi) during suction arranges submodule, and the two can be independently arranged.
(3) beneficial effect
The invention has the beneficial effects as follows：
The respirator of the present invention increased negative pressure expectoration function on the basis of existing respirator, can simulate the normal of people
Cough, solves the problems, such as undergoing mechanical ventilation in clinical patient's expectoration difficulties, and its structure is simpler, compact.
The respiratory muscle of respirator of the present invention is synchronized with the movement module, can be tied with the respiratory muscle active situation of real-time detection patient
Breathing mechanics parameters are closed, preferably the respiration capability of assessment patient, provide objective respiration capability evaluation, helped clinic to determine and control
Treatment measure.Meanwhile, respiratory muscle stimulating module can synchronous patient respiratory muscle activity and the positive airway pressure of respirator, help patient
The muscular strength of respiratory muscle is kept and replys, while reducing the generation for just weighing wounded.
Description of the drawings
Fig. 1 is the gas circuit schematic diagram of the respirator of one embodiment of the invention.
【Description of reference numerals】
1：Turbofan；2：Pressure maintaining valve；3：Flow control valve；4：Effusion meter；5：Hybrid chamber；6：Switch valve；7：Agitator；
8：Effusion meter；9：Relief valve；10：Baroceptor；11：Baroceptor；12：Turbofan；13：Air pump；14：Gas holds；15：
Relief valve；16：Switching valve；17：Pressure regulator valve；18：Agitator；19：Effusion meter；20：Baroceptor；21：Pressure transducer；
22：Check valve；23：Filter.
Specific embodiment
In order to preferably explain the present invention, in order to understand, below in conjunction with the accompanying drawings, by specific embodiment, to this
It is bright to be described in detail.
The respirator of one embodiment of the invention, it includes control system, air-breathing module and expiration module, the expiration mould
Block includes：
Switching valve, it has first interface, a second interface, and for switching on or off first interface and second interface
Switch member；
Expiration branch road, its first end connection patient end, its second end connects the first interface of switching valve；
Expectoration branch road, its first end connects the second interface of switching valve, and its second end connects the negative port of negative pressure source；
Pressure regulator valve, located at expiration branch road, for maintain expiration branch road gas pressure within a predetermined range, gas pressure bag
Include malleation P+With negative pressure P-。
By the setting of said structure, the respirator of the present invention, negative pressure expectoration is increased on the basis of existing respirator
Function, can simulate the normal cough of people, solve the problems, such as undergoing mechanical ventilation in clinical patient's expectoration difficulties, and, relative to existing
For some respirators are applied in combination with sputum elimination machine, the ventilator-structure of the present invention is simpler, compact.
Referring to Fig. 1, the respirator of a preferred embodiment of the present invention, it goes back while Breathing Suppotion is provided for patient
Patient's expectoration can be helped, the sputum in lung deep is cleared up；The module while respiratory muscle is synchronized with the movement, can detect the respiratory muscle of patient
Moving situation, it is also possible to stimulate patient respiratory flesh to make it produce the muscular movement synchronous with positive airway pressure.
Respirator in the present embodiment includes control system, air-breathing module and expiration module, wherein：
Control system, including central control unit, human-computer interaction interface, and the driving of ancillary equipment, for entirely exhaling
The control of suction machine；
Air-breathing module, for producing malleation air-flow, for patient Breathing Suppotion is provided, and air-breathing module is connected by inspiration limb
To patient；
Expiration module, for patient exhalation air and help patient's expectoration, its expectoration branch road is connected by expiration branch road
To patient.
Wherein, air-breathing module includes：The source of the gas or external air source interface of positive pressure air are produced, and high pressure oxygen connects
Mouth, mixed oxide structure and oxygen concentration testing agency, the control inspiration limb switch valve connected with patient, the pressure limiting for limiting positive pressure range
What valve (relief valve) 9, the agitator 7 for making the interior generation air-flow vibration of inspiration limb, control air-breathing module were connected with inspiration limb opens
Close valve 6.
In one embodiment of the present of invention, air-breathing module includes turbofan 1, for obtaining positive pressure air；Pressure maintaining valve 2,
The pressure of the high pressure oxygen for being stably input into；Flow control valve 3, for controlling the flow of oxygen and/or air；Effusion meter 4,
For oxygen and/or air mass flow size that detection needs mixing；Hybrid chamber 5, for by oxygen and air mix homogeneously；Switch
Valve 6, controls the air-flow break-make of respirator inspiration limb；Agitator 7, for the air-flow in inspiration limb vibration is produced, its vibration
Frequency can be set as 10～30Hz；Effusion meter 8, for determining the gas flow sucked during air-breathing, and can be calculated accordingly
Air-breathing tidal volume；Relief valve 9, automatically opens up when malleation is too high in gas circuit, prevents airline pressure too high, protects patient safety,
For example, it can be set to safe pressure is 8KPa；Filter 23, filters the oxygen and air into respirator；Baroceptor 10,
For monitoring into the air of respirator and the pressure of oxygen；Baroceptor 11, for monitoring the gaseous mixture of oxygen and air
The pressure of body.
Wherein, agitator 7 could be arranged to be vibrated in expiratory phase, or the only vibration when holding one's breath, it is also possible to shake all the time
Swing or be closed all the time.
Wherein, expiration module includes negative pressure source, expectoration branch road, switching valve, pressure regulator valve and expiration branch road.
Wherein, negative pressure source includes that turbofan 12, negative pressure air pump 13, gas hold 14.
When using, turbofan 12 is quick will to be extracted into certain negative pressure value in gas appearance 14, and then air pump 13 is further gas
The pressure held in 14 is extracted into lower predetermined negative pressure.
Preferably, also including check valve 22, pressure limiting valve 15 and pressure transducer 21.
In one embodiment of the present of invention, expiration module includes turbofan 12, for producing low pressure and mass flow air-flow, example
The flow more than 150L/min can such as be produced；Air pump 13, for producing high negative, for example, can produce 200cmH2The negative pressure of O；
Gas holds 14 and is used as negative pressure cavity, and sufficiently large negative pressure and volume are prepared before expectoration starts, and such as its capacity can be 2～5L；Peace
Full valve (negative pressure pressure limiting valve) 15, for preventing gas from holding, 14 negative pressure are too high, and protection gas circuit safety reaches one when gas holds the negative pressure in 14
When determining threshold value, relief valve (pressure limiting valve) 15 automatically opens up pressure release；Switching valve 16, for switching expectoration branch road, expiration branch road, normally
Switching valve 16 is closed during expiration, and negative pressure gas holds and 14 isolate with expiration branch road, during expectoration switching valve 16 open make negative pressure gas appearance 14 and
Expiration branch road is connected；Pressure regulator valve 17, in expectoration pattern, for controlling gas circuit vacuum magnitude, such as negative pressure range of accommodation is -10
～-150cmH2O, in normal exhalation pattern, for adjusting end expiratory positive pressure, such as malleation range of accommodation is 0～80cmH2O；
Agitator 18, for making air-flow in air flue produce vibration, promotes the loosening of sputum, for example frequency of oscillation can for 10～
30Hz；Effusion meter 19, exhales/expellant gas flow during for determining expiration/expectoration；Baroceptor 20, exhales for monitoring
Pressure in branch road；Pressure transducer 21, for monitoring the pressure size in gas appearance 14；Check valve 22, it is allowed to which air-flow holds from gas
14 arrive the one-way flow of turbofan 12.
Wherein, when starting expectoration, turbofan 12 is quick will to be extracted into certain negative pressure value in gas appearance 14, and then air pump 13 enters
One step holds the pressure in 14 and is extracted into lower predetermined negative pressure gas, and now check valve 22 is automatically switched off.Early stage during expectoration,
Gas holds the cough air-flow that the high negative pressure in 14 sets up superhigh speed in expiration branch road, as the tidal volume of patient expiration increases, gas
Hold the pressure drop in 14, the expiratory airflow of patient also begins to decline.The later stage of cough process, the pressure drop that gas holds in 14 is arrived
When below the swabbing pressure of turbofan 12, check valve 22 is opened, and patient's quick exhalation in the presence of turbofan 12 is remaining
Gas.Then incipient stage of coughing forms the flow velocity of peak value, and later stage flow velocity declined, and pressure value also drops to relatively low negative
Pressure.From on airflow waveform closer to the air-flow of normal cough, later stage less negative pressure is also preferably protection to patient, and
The whole exhalation process of patient can all feel much smoother.Negative pressure pressure limiting valve 15 and sensor 21 can ensure that the negative pressure that gas holds in 14 exists
Below 20Kpa.
In a preferred embodiment of the present invention, when the switching valve 16 is closed, will not produce under the pressure of 20Kpa and let out
Dew；When the switching valve 16 is opened, under the flow of 300L/min, the pressure drop of formation is not over 1Kpa.
Wherein, positive/negative-pressure regulating valve 17 includes malleation and negative pressure regulatory function.Malleation in expiration branch road exceedes in malleation
During limit value, positive port is automatically opened up, and positive port is automatically switched off when malleation is less than malleation higher limit.When being negative in expiration branch road
During pressure, positive port is closed all the time.When negative pressure in expiration branch road exceedes negative pressure higher limit, negative port is automatically opened up, negative pressure
It is automatically switched off less than negative port during negative pressure higher limit.When in expiration branch road being malleation, negative port is closed all the time.
Wherein, agitator 18 could be arranged to be vibrated in expiration phase, or be closed.
In one preferred embodiment of the present invention, respirator is also synchronized with the movement module, including respiratory muscle flesh including respiratory muscle
Electro-detection submodule and respiratory muscle stimulate submodule.Respiratory muscle checking with EMG method submodule is used to monitor the electromyographic signal of respiratory muscle,
As respiratory muscle strength is judged and man-machine synchronous reference signal can be optimized.Be conducive to the improvement of ventilation quality, help exhale
The recovery of flesh is inhaled, contributes to lifting the effect of expectoration again.
Wherein, checking with EMG method includes the detection to diaphram myoelectricity.Diaphram checking with EMG method electrode is located at midclavicular line and the 7th
8th intercostal cross point.
The evaluation methodology of patient's muscular strength is that autonomous getter capacity, dynamics of coughing of choking according to patient, diaphram electromyographic signal are strong
Degree, by the autonomous respiration ability of patient some levels are divided into.Lowest level is complete apnea, it is proposed that logical using control model
Gas；Highest level is can be with entirely autonomous breathing, it is proposed that using autonomous respiration ventilating mode or trial off line.
Wherein, respiratory muscle stimulates includes that diaphragm nerve stimulation and abdominal muscle stimulate.The stimulation sites of diaphragm nerve stimulation are two pleurobranch
At lock Papillary muscle lower edge 1/3rd, or at napex phrenic nerve root；Abdominal muscle stimulating electrode is located at rectus abdominis m. and/or transversus abdominis m.
Place.
When breathing process starts, control system control respiratory muscle muscle of module when producing air-breathing that is synchronized with the movement is moved
Make, for example, make contraction of diaphragm；When exhalation process starts, control system control respiratory muscle is synchronized with the movement module when producing expiration
Muscle movement, for example make contraction of abdominal muscle.
The respiratory muscle is synchronized with the movement in module, the mode of diaphragm nerve stimulation, can be electricity irritation, or magnetic thorn
Swash.
Wherein, the parameter setting aspect of control system, in addition to the parameter often having comprising existing respirator, also including during expectoration
Expectoration negative pressure is arranged when pressure of inspiration(Pi) setting, expectoration when the setting of air-breathing tidal volume, expectoration, inspiratory airflow vibration is arranged, expiration gas
Module parameter setting that stream vibration is arranged, respiratory muscle is synchronized with the movement.Wherein expectoration when air-breathing tidal volume and during expectoration pressure of inspiration(Pi) with
Tidal volume, pressure of inspiration(Pi) during eupnea arranges mutually independent.
Parameter display aspect, in addition to conventional ventilator parameter shows, may also display the waveform of checking with EMG method and to patient
The scoring of respiratory muscle strength.
The respirator of one embodiment of the invention can run as follows.
During eupnea, inspiratory phase switch valve 6 is opened, and makes air-breathing module pass through inspiration limb and patient UNICOM, to patient
Implement positive airway pressure, switching valve 16 is closed, the malleation of pressure regulator valve 17 is limited and is set to the pressure of inspiration(Pi) upper limit.Oscillation module 7 is according to setting
Definite value starts or closes vibration.Control system according to the mode of operation and state modulator source of the gas and valve of setting to patient ventilation,
Such as air-breathing tidal volume and pressure of inspiration(Pi), and the flow and pressure of positive airway pressure are detected by flow valve 4 and baroceptor 11.Exhale
Gas phase, switch valve 6 is closed, and the malleation of pressure regulator valve 17 is limited and is set to end expiratory positive pressure, and patient is by expiration branch road and pressure regulator valve
17 positive pressure side is exhaled.In exhalation process, agitator 18 starts according to setting value or closes.Pattern of the control system according to setting
With state modulator pressure regulator valve, and the flow and pressure of expiration branch road are detected by effusion meter 19 and baroceptor 20.
During cough, inspiratory phase switch valve 6 is opened, and switching valve 16 is closed, and the malleation of pressure regulator valve 17 is limited and is set to pressure of inspiration(Pi)
The upper limit, the negative pressure upper limit is set to negative pressure value during expectoration；Oscillation module 7 starts or closes vibration according to setting value.Control system root
According to the mode of operation and state modulator source of the gas and valve of setting to suction during patient ventilation, such as expectoration when air-breathing tidal volume, expectoration
Atmospheric pressure is arranged, and detects the flow and pressure of positive airway pressure by effusion meter 8 and baroceptor 11.Expiratory phase, switch valve 6
Close, the negative pressure of pressure regulator valve 17 is limited and is set to negative pressure value during expectoration.Switching valve 16 is quickly opened, and makes expiration gas circuit sudden and violent suddenly
It is exposed at negative pressure gas and holds the cough air-flow that high speed is produced under 14 negative pressure.During cough, agitator 18 starts according to setting value
Or close.Control system is examined according to the pattern and state modulator pressure regulator valve for setting by effusion meter 19 and baroceptor 20
The flow and pressure of expiration branch road are surveyed, when the tidal volume of the close patient's suction of expiration tidal volume is detected, or expiratory airflow
Patient is set to isolate with negative pressure gas appearance 14 less than switching valve 16 is closed during a certain threshold value immediately.
In sum, respirator of the present invention increased negative pressure expectoration function on the basis of existing respirator, can simulate
The normal cough of people, solves the problems, such as undergoing mechanical ventilation in clinical patient's expectoration difficulties.
The respiratory muscle of respirator of the present invention is synchronized with the movement module, can be tied with the respiratory muscle active situation of real-time detection patient
Breathing mechanics parameters are closed, preferably the respiration capability of assessment patient, provide objective respiration capability evaluation, helped clinic to determine and control
Treatment measure.Meanwhile, respiratory muscle stimulating module can synchronous patient respiratory muscle activity and the positive airway pressure of respirator, help patient
Respiratory muscle strength is kept and replys, while reducing the generation for just weighing wounded.
Claims (10)
1. a kind of respirator, it includes：
Control system；
Air-breathing module；
Expiration module,
Characterized in that, the expiration module includes：
Switching valve, it has first interface, second interface, and for switching on or off the switch of first interface and second interface
Part,
Expiration branch road, its first end connection patient end, its second end connects the first interface of switching valve,
Expectoration branch road, its first end connects the second interface of switching valve, and its second end connects the negative port of negative pressure source,
Pressure regulator valve, located at expiration branch road, for maintain expiration branch road gas pressure within a predetermined range, gas pressure is included just
Pressure P+With negative pressure P-。
2. respirator as claimed in claim 1, it is characterised in that：
Negative pressure source be provided with gas hold, blower fan and air pump, wherein, gas container have accommodation space and first interface in communication, the
Two interfaces and the 3rd interface, blower fan holds pumping by first interface to gas so that accommodation space reaches the first negative pressure P1, and air pump leads to
Cross second interface and pumping is held to gas so that accommodation space reaches the second negative pressure P2, the absolute value of the first negative pressure P1 is negative less than second
The absolute value of pressure P2, the 3rd interface that gas holds constitutes the negative port of negative pressure source.
3. respirator as claimed in claim 2, it is characterised in that：
Negative pressure source is additionally provided with check valve, relief valve and baroceptor, first interface and blower fan that check valve holds located at gas
Between negative pressure end, optionally held to blower fan ventilation from gas, relief valve and baroceptor located at the second end of expectoration branch road with
Between the 3rd interface that gas holds.
4. respirator as claimed in claim 1, it is characterised in that：
Pressure regulator valve is provided with positive pressure interface and negative port simultaneously, and positive pressure interface is used to maintain malleation P+Within a predetermined range, negative pressure connects
Mouth is used to maintain negative pressure P-Within a predetermined range.
5. respirator as claimed in claim 4, it is characterised in that：
The positive pressure interface and negative port of pressure regulator valve is two interfaces being set up in parallel；Or
The positive pressure interface and negative port of pressure regulator valve is same interface, is positive pressure interface when interface forward direction is opened, the interface
It is negative port when reversely opening.
6. respirator as claimed in claim 1, it is characterised in that：
Also it is synchronized with the movement module including respiratory muscle, it includes the respiratory muscle checking with EMG method submodule for monitoring respiratory muscle electromyographic signal
Block.
7. respirator as claimed in claim 6, it is characterised in that：
Also include that respiratory muscle strength evaluates submodule, for evaluating respiratory muscle strength, the reference letter used during evaluation
Number include respiratory muscle electromyographic signal.
8. respirator as claimed in claim 7, it is characterised in that：
Also include parameter display module, parameter display module includes checking with EMG method result display sub-module and respiratory muscle strength for patients
Evaluation result display sub-module.
9. respirator as claimed in claim 1, it is characterised in that：
Control system includes parameter setting module, wherein, parameter setting module includes：Air-breathing tidal volume arranges submodule during expectoration
When pressure of inspiration(Pi) arranges submodule, expectoration when block, expectoration expectoration negative pressure arrange submodule, inspiratory airflow vibration arrange submodule,
Expiratory airflow vibration arranges the submodule and respiratory muscle module parameter that is synchronized with the movement and arranges any one in submodule or appoint several.
10. respirator as claimed in claim 9, it is characterised in that：
When expectoration is provided with, air-breathing tidal volume arranges submodule, tidal volume when being additionally provided with eupnea arranges submodule
Block, and the two can be independently arranged；And/or
When expectoration is provided with, pressure of inspiration(Pi) arranges submodule, pressure of inspiration(Pi) when being additionally provided with eupnea arranges submodule
Block, and the two can be independently arranged.
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