CN111214741B - Artificial air-controlled cough assisting device and assisting method - Google Patents
Artificial air-controlled cough assisting device and assisting method Download PDFInfo
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- CN111214741B CN111214741B CN202010167228.5A CN202010167228A CN111214741B CN 111214741 B CN111214741 B CN 111214741B CN 202010167228 A CN202010167228 A CN 202010167228A CN 111214741 B CN111214741 B CN 111214741B
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- 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. ventilators; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
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- 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. ventilators; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M16/0006—Accessories therefor, e.g. sensors, vibrators, negative pressure with means for creating vibrations in patients' airways
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Abstract
本发明公开了一种人工气控咳嗽辅助装置，包括气控开关阀和气囊，所述气控开关阀为常开阀体，所述气控开关阀沿通气气管布置并设于靠近病人嘴部的位置，所述气囊设于体外并与所述气控开关阀通过管路连接。该装置使用气控开关阀与简单的气囊相结合，通过气控开关阀使得患者能够屏气，通过手中所握持的气囊来自主控制屏气时机，在患者觉得需要咳嗽时，患者可以自行深吸气，并在呼气前握紧气囊，使得气控开关阀关闭，再松开，形成较高的出气流量，从而达到清除小气道内痰液、促进肺部感染的控制及患者康复、降低院内感染风险的目的，装置整体结构简单，成本较低，同时操作方便。
The present invention discloses an artificial pneumatic cough assist device, comprising a pneumatic switch valve and an air bag, wherein the pneumatic switch valve is a normally open valve body, the pneumatic switch valve is arranged along the ventilation trachea and is located near the patient's mouth, and the air bag is located outside the body and is connected to the pneumatic switch valve through a pipeline. The device uses a pneumatic switch valve in combination with a simple air bag, and the pneumatic switch valve enables the patient to hold his breath, and the air bag held in the hand can be used to autonomously control the breath holding time. When the patient feels the need to cough, the patient can take a deep breath on his own, and hold the air bag tightly before exhaling, so that the pneumatic switch valve is closed, and then released to form a higher air flow rate, thereby achieving the purpose of clearing sputum in the small airways, promoting the control of lung infection and patient recovery, and reducing the risk of nosocomial infection. The overall structure of the device is simple, the cost is low, and it is easy to operate.
Description
Technical Field
The invention relates to the technical field of medical equipment, in particular to an artificial pneumatic cough assisting device and an assisting method.
Background
Currently, the tracheal intubation technology is widely used in rescuing and nursing of critical patients, the glottis of the patients using the tracheal intubation are limited by the intubation, even if the patients are conscious, the glottis can not be closed autonomously, so that autonomous cough can not be generated, sputum in the respiratory tract of the patients is deposited, mucus embolism can be generated to block the respiratory tract, tiny and undischarged pulmonary lobule or alveolus can be formed, inflammation is caused or aggravated, oxygenation is reduced, and even dyspnea, asphyxia and other conditions occur. Therefore, it is important to discharge the sputum in the respiratory tract, especially in deep part.
The prior art mainly adopts a sputum suction tube and auxiliary sputum discharging equipment to clean sputum. The sputum aspirator technique is to slowly pull the rotating sputum aspirator after inserting the sputum aspirator from the oral cavity or nasal cavity of the patient to a certain depth. The method is low in price and thorough in cleaning, but is easy to cause infection of patients, and meanwhile, a nurse is required to perform timing manual operation, and the nurse is required to have high technical level and abundant experience. The technique of the auxiliary sputum excretion device is that the sputum excretion device sequentially applies positive and negative pressure through a mask or a catheter connected to the artificial respiratory tract, thereby deeply breathing (blowing) into the lungs, followed by immediate (10 ms) deep exhalation (inhalation). The purpose of insufflation is to fill the lungs, while the purpose of inhalation is to empty the lungs of air. The rapid transition from positive to negative pressure is intended to mimic the airflow changes that occur during normal cough, which helps clear secretions. Which can make up for the shortages of inspiration and expiration. Parameter adjustment of the auxiliary sputum excretion device involves adjusting the positive and negative pressure, the inspiration, expiration and pause times (seconds) and the inspiration flow rate (L/min). A mechanical inhalation and exhalation process typically includes multiple phases, such as cough and rest periods. These cycle periods are repeated several times or not ended until the secretions are substantially expelled.
It is easy to see that the sputum suction technique of the sputum suction tube requires the medical staff to operate regularly, meanwhile, the medical staff is required to have higher technical level and abundant experience, the technique is easy to increase the risk of infection in hospitals and is painful, the auxiliary sputum discharge equipment is relatively expensive, and meanwhile, the parameter setting and sputum suction time also need long-term experience of the medical staff to be completed smoothly. Therefore, the existing sputum suction tube and auxiliary sputum discharging device auxiliary sputum discharging mode is limited by operation experience and defects of the device, and better using effect is not brought to patients.
Therefore, how to provide a sputum excretion auxiliary apparatus with simple structure, convenient operation and low cost is a problem to be solved by those skilled in the art.
Disclosure of Invention
In view of the above, the invention provides an artificial pneumatic cough auxiliary device, which combines a pneumatic switching valve with a simple air bag, has simple integral structure, low cost and convenient operation. Solves the problems of complex structure, large operation difficulty coefficient and higher cost of the traditional auxiliary sputum excretion device.
In order to achieve the above purpose, the present invention adopts the following technical scheme:
In one aspect, the invention provides an artificial pneumatic cough auxiliary device, which comprises a pneumatic switching valve and an air bag, wherein the pneumatic switching valve is a normally open valve body, the pneumatic switching valve is arranged along a ventilation air pipe and is arranged at a position close to the mouth of a patient, and the air bag is arranged outside the body and is connected with the pneumatic switching valve through a pipeline.
The device has the advantages that the device combines the pneumatic control switch valve with the simple air bag, the patient can hold breath through the pneumatic control switch valve, the air bag held by the hand comes from the main control breath holding time, when the patient feels that the patient needs to cough, the patient can inhale deeply by himself, and before exhaling, the air bag is held tightly, so that the pneumatic control switch valve is closed and then loosened, and higher air outlet flow is formed, thereby achieving the purposes of clearing sputum in a small air passage, promoting the control of pulmonary infection and the rehabilitation of the patient, reducing the risk of nosocomial infection, and the device has simple integral structure, lower cost and convenient operation.
Further, the valve port area of the pneumatic control switch valve is larger than or equal to 11.8mm 2.
During normal cough, high pressure of 40KPa can be generated in the lung, and the patient can reach the pressure in the lung of 30 KPa.
According to the ISO6358 international standard, the mass flow formula through a proportional valve can be obtained:
Wherein q is the gas mass flow, A in is the effective cross-sectional area of the solenoid valve, R is the gas constant, T is the temperature, p s is the airway pressure, and also is the patient side inlet pressure, and b is the critical pressure ratio. In the working process, the ventilation pressure range is consistent with that of the breathing machine, and is 0-40 cmH 2 O, then p s/pf is always larger than the critical pressure ratio b, so the mathematical model of the electromagnetic proportional valve is as follows:
the volumetric flow equation is as follows:
Where Q is the volumetric flow rate and p a is the air density, then one can obtain:
the device was operated at standard atmospheric pressure at 20℃and an air density of 1.185kg/m 3. Since b is 0.528 and R is 287J/(kg.K), the valve port area of the pneumatic switching valve is required to be 11.8mm 2 or more.
Further, the distance between the pneumatic control switch valve and the mouth of the patient is 10 cm-25 cm. The pneumatic control switch valve is arranged along the ventilation air pipe, so that the air pipe connecting line of the pneumatic control part and the air bag is relatively short, the pneumatic control part can respond to the action of a patient relatively quickly, and meanwhile, the control circuit is short, so that the disorder and winding of various pipelines are avoided.
In another aspect, the present invention also provides an artificial pneumatic cough assisting method, which uses the device described above, comprising the steps of:
Before deep inspiration end expiration, the air bag is extruded, so that the pneumatic control switch valve is closed;
when the pressure in the lung is maximum, the air bag is released, so that the pneumatic control switch valve is quickly opened;
The high expiratory flow pushes out the sputum, thus completing the auxiliary sputum discharge once.
Compared with the sputum suction technology of a sputum suction pipe, the method is beneficial to discharging and draining sputum and secretion in a deep small airway of a patient, so that the control and absorption of pulmonary infection are promoted, the time for retaining trachea cannula and mechanical ventilation of the patient is shortened, the hospitalization time is shortened, the risk of related infection of a breathing machine is reduced, medical and health resources are saved, the feeling of the patient is simultaneously followed, the cough time is mastered better, compared with the existing auxiliary sputum discharge equipment, the method is cheaper, the experience limit of medical staff is relatively reduced, and the method has an auxiliary effect on the exercise and rehabilitation of the sputum capacity of the patient.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings that are required to be used in the embodiments or the description of the prior art will be briefly described below, and it is obvious that the drawings in the following description are only embodiments of the present invention, and that other drawings can be obtained according to the provided drawings without inventive effort for a person skilled in the art.
FIG. 1 is a schematic diagram of an artificial pneumatic cough assist device according to the present invention;
FIG. 2 is a schematic view showing an installation state of an artificial pneumatic cough assist apparatus according to an embodiment of the present invention;
FIG. 3 is a schematic flow chart of an artificial pneumatic cough assisting method provided by the invention.
Detailed Description
The following description of the embodiments of the present invention will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that the embodiments described are only some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
On the one hand, referring to fig. 1 and 2, an embodiment of the invention discloses an artificial pneumatic cough auxiliary device, which comprises a pneumatic control switch valve 1 and an air bag 2, wherein the pneumatic control switch valve 1 is a normally open valve body, the pneumatic control switch valve 1 is arranged along a ventilation air pipe 3 and is arranged at a position close to the mouth of a patient, and the air bag 2 is arranged outside the body and is connected with the pneumatic control switch valve 1 through a pipeline.
The embodiment of the invention aims at a patient with autonomous consciousness and certain inspiration capacity, and a pneumatic control switch valve 1 is added at the outer end of a cannula. The pneumatic control switch valve 1 is a normally open valve, the pneumatic control end is connected to a small air bag 2 which can be held, and the pneumatic control switch valve 1 can be closed by holding the air bag 2. Through putting the little gasbag into patient's hand, when the patient felt needs cough, the patient holds gasbag 2 after deeply inhaling for gas accuse ooff valve 1 closes, realizes holding the breath function, unclamps again, makes gas accuse ooff valve 1 open rapidly, realizes high expiration air current, thereby mobilizes out the sputum. The invention is mainly aimed at the patient in the rehabilitation process, and takes care of the autonomy of the patient, and a combination mode with lower cost is also used, so that the on-off valve is equivalent to a manually controlled glottis.
In a specific embodiment, the valve port area of the pneumatic switching valve 1 is greater than or equal to 11.8mm 2.
During normal cough, high pressure of 40KPa can be generated in the lung, and the patient can reach the pressure in the lung of 30 KPa.
According to the ISO6358 international standard, the mass flow formula through a proportional valve can be obtained:
Wherein q is the gas mass flow, A in is the effective cross-sectional area of the solenoid valve, R is the gas constant, T is the temperature, p s is the airway pressure, and also is the patient side inlet pressure, and b is the critical pressure ratio. In the working process, the ventilation pressure range is consistent with that of the breathing machine, and is 0-40 cmH 2 O, then p s/pf is always larger than the critical pressure ratio b, so the mathematical model of the electromagnetic proportional valve is as follows:
the volumetric flow equation is as follows:
Where Q is the volumetric flow rate and p a is the air density, then one can obtain:
the device was operated at standard atmospheric pressure at 20℃and an air density of 1.185kg/m 3. Since b is 0.528 and R is 287J/(kg.K), the valve port area of the pneumatic switching valve is required to be 11.8mm 2 or more.
In particular, the ISO6358 mentioned in the present invention is described as follows, international Standard ISO6358 was promulgated in 10 months of 1989. It is the standard in the test method for determining the flow characteristics of pneumatic elements. The standard expresses the flow characteristics in its entirety with two characteristic parameters (pitch c and critical pressure ratio b) and specifies the method of measuring the c and b values.
In a specific embodiment, the distance between the air-controlled switch valve 1 and the mouth of the patient is 10 cm-25 cm. The pneumatic control switch valve 1 is arranged along the ventilation air pipe 3, the position of the lung 4 is also shown in the figure, and the installation position and the installation state are shown in the figure 2, so that the connecting line of the air pipe of the pneumatic control part and the air bag is relatively short, the pneumatic control part can respond to the action of a patient more quickly, and meanwhile, the control circuit is short, and various pipelines are prevented from being disordered and wound.
On the other hand, referring to fig. 3, the embodiment of the invention also discloses an artificial pneumatic cough assisting method, which uses the device and comprises the following steps:
S1, before deep inspiration end expiration, squeezing an air bag to enable a pneumatic control switch valve to be closed;
S2, when the pressure in the lung is maximum, loosening the air bag to enable the pneumatic control switch valve to be opened rapidly;
And S3, pushing out the sputum by high expiratory flow to finish primary auxiliary sputum discharge.
In summary, the artificial pneumatic cough assisting device disclosed by the embodiment of the invention has the following advantages compared with the prior art:
1. The air control switch valve is combined with the simple air bag, so that a patient can hold breath through the air control switch valve, the air bag held in the hand is used for master control of breath holding time, when the patient feels that cough is needed, the patient can inhale deeply by himself and grasp the air bag before exhaling, so that the air control switch valve is closed and then loosened, and higher air outlet flow is formed, thereby achieving the purpose of removing sputum, particularly sputum in deep and small airways (which cannot be achieved by common sputum sucking operation), and the whole structure of the device is simple;
2. The automatic auxiliary cough of the patient is realized, compared with the sputum suction technology of a sputum suction tube, the risk of infection is small, the self feeling of the patient is followed, the cough timing is better controlled, compared with auxiliary sputum discharge equipment, the automatic auxiliary cough of the patient is cheaper, the experience limit of medical staff is reduced, and the automatic auxiliary cough has auxiliary effects on the recovery of the sputum expectoration capability and respiratory muscle strength of the patient;
3. The device has the advantages of utilizing the expectoration capability of the exercise patient, being beneficial to expectoration and drainage of deep sputum, being safer and more thorough in sputum discharge compared with the sputum suction operation of general nurses, thereby promoting the control and absorption of pulmonary infection, shortening the time of the patient for reserving trachea cannula and mechanical ventilation, shortening the hospitalization time, reducing the risk of related infection of a breathing machine, saving medical and health resources and having remarkable social benefit.
In the present specification, each embodiment is described in a progressive manner, and each embodiment is mainly described in a different point from other embodiments, and identical and similar parts between the embodiments are all enough to refer to each other. For the device disclosed in the embodiment, since it corresponds to the method disclosed in the embodiment, the description is relatively simple, and the relevant points refer to the description of the method section.
The previous description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments without departing from the spirit or scope of the invention. Thus, the present invention is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.
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| CN112857922A (en) * | 2021-03-09 | 2021-05-28 | 北京大学第三医院（北京大学第三临床医学院） | Simple exhaled air condensate collecting device |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2633298Y (en) * | 2003-07-17 | 2004-08-18 | 王道福 | Manual operate sputum aspirator |
| CN204798534U (en) * | 2015-04-24 | 2015-11-25 | 刘建君 | High -efficient artificial respirator |
| CN212880495U (en) * | 2020-03-11 | 2021-04-06 | 北京大学第三医院（北京大学第三临床医学院） | An artificial air-controlled cough assist device |
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| SE7411883L (en) * | 1974-09-20 | 1976-03-22 | Testa Lab A S | VALVE DEVICE FOR LUNG VENTILATION SYSTEM |
| CN108654014A (en) * | 2018-05-31 | 2018-10-16 | 尹正录 | The simple respiratory training sacculus of adult type and its application method |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2633298Y (en) * | 2003-07-17 | 2004-08-18 | 王道福 | Manual operate sputum aspirator |
| CN204798534U (en) * | 2015-04-24 | 2015-11-25 | 刘建君 | High -efficient artificial respirator |
| CN212880495U (en) * | 2020-03-11 | 2021-04-06 | 北京大学第三医院（北京大学第三临床医学院） | An artificial air-controlled cough assist device |
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