CN111956505A - Nose intestines pipe convenient to judge and put tub position - Google Patents

Abstract

The invention relates to a nasal-intestinal tube convenient for judging the tube placement position, which comprises a nasal-intestinal tube body, wherein a main cavity for placing a guide wire and feeding medicine is axially arranged in the nasal-intestinal tube body, an outlet of the main cavity is positioned on the side wall of the head end of the nasal-intestinal tube body, and a guide slope surface is arranged between the outlet and the main cavity; the positive preceding fixed mounting of nose intestines pipe body head end has the sensor that can respond to pH value in real time, the sensor is connected with the wire, the wire is worn to establish in the inside axial threading hole of nose intestines pipe body, and the wire rear end is drawn forth and is connected with the display that can show pH value in real time from the lateral wall of nose intestines pipe body rear end. The invention has the advantages of ingenious structure, reasonable design and convenient use, can quickly assist in judging whether the tube is put in place or not, and effectively overcomes the defects of poor timeliness, radioactive damage and the like caused by the traditional shooting judgment.

Description

Nose intestines pipe convenient to judge and put tub position

Technical Field

The invention relates to a tube feeding device, in particular to a nasointestinal tube convenient for judging the tube placing position, and belongs to the technical field of medical instruments.

Background

Severe patients have higher nutritional risks in severe trauma, infection and other stress states and need to intervene in time. Enteral Nutrition (EN), particularly Early Enteral Nutrition (EEN) implemented within 24-48 h, not only can provide nutrient substrates, but also can improve intestinal mucosal barrier and immune function, and maintain intestinal micro-ecology, and has been increasingly clinically accepted and applied. Some critically ill patients, such as gastroparesis, severe gastroesophageal reflux, high aspiration risk, duodenal obstruction, gastric fistula, duodenal fistula, severe pancreatitis and the like, are not suitable for enteral nutrition therapy through nasogastric tube. For patients who are not suitable for nasogastric tube nutrition, a nasointestinal tube needs to be placed for enteral nutrition support through the jejunum. "expert consensus on early enteral nutrition clinical practice for critically ill patients", published by the domestic emergency/critical care related expert group in 2018, suggests that pyloric postfeeding routes, such as naso-intestinal tube and the like, are adopted for patients who cannot tolerate gastric feeding, suffer from gastric discharge obstruction, gastroparesis or have a high risk of aspiration [ recommended intensity: (8.6. + -. 0.8 min.).

The currently clinically common nasointestinal tube placing method comprises the following steps: gastroscope under-placed tube, X-ray under-placed tube, ultrasonic guided under-placed tube, bare-handed tube, and external electromagnetic guided tube. The gastroscope lower placing tube and the X-ray lower placing tube are often assisted by an endoscope center and imaging personnel, and the X-ray auxiliary placing tube has the defects of long tube inserting time, long X-ray radiation receiving time of doctors and patients and the like; although the ultrasonic guide catheter can directly provide ultrasonic projection of the gastrointestinal part of a patient for an operator, the operation is simple, the accuracy is high, and the complications are few, the limitation that a certain professional basis is needed and the operation is often needed by an ultrasonic professional doctor still exists, and the ultrasonic guide catheter is not suitable for critically ill patients. The external electromagnetic guide tube placement can overcome the defects of the two tube placement methods, the placement track of the pipeline can be visually displayed by guiding the placement of the nasal and intestinal tubes through electromagnetic guide, the step of confirming the X-ray film by inserting the nasal and intestinal tubes by bare hands in a blind way is omitted, the operation burden is reduced, and the cost of the external electromagnetic navigation instrument is higher. The most common tube placing method in clinic at present is still a bare-handed tube placing method, the success rate of placing the nasal intestinal tube can reach 92%, the accurate judgment of the position of the tube is one of the keys of the success of blind insertion of the nasal intestinal tube, and the common judgment methods at present comprise auscultation of water passing sound, liquid pumping observation characters and pH values, and X-ray radiography judgment. The auscultation of the underwater sound is influenced by the self condition of the patient, the auscultation level of the auscultator and subjective judgment, so the specificity and the diagnosis consistency of the auscultation method are low. X-ray radiography is judged to be the gold standard, but frequent radio examination not only can cause harm to patients, but also can cause interference to clinical treatment. The characteristics of gastric juice and intestinal juice are greatly different, the intestinal juice is golden yellow and has high transparency, most of the gastric juice is yellow green and turbid with impurities, and the position of the pipeline can be judged by using the point; the research finds that the pH value of gastric juice is 5.70 +/-0.32, the pH value of intestinal juice is 7.50 +/-1.18, and the position of the pipeline can be judged by detecting the pH value of the extracted liquid, but the pH value of gastric juice of critical patients has more influencing factors such as enteral nutrition, the use of proton pump inhibitors and the like, and meanwhile, in the clinical operation, the position of the pipeline cannot be judged in time because the contents cannot be extracted immediately by a patient who puts part of nasointestinal tubes into the intestinal tract.

Disclosure of Invention

The invention aims to overcome the defects in the prior art, provides the nasointestinal tube convenient for judging the tube placement position, has the advantages of ingenious structure, reasonable design and convenient use, can quickly assist in judging whether the tube placement is in place or not, and effectively overcomes the defects of poor timeliness, radioactive damage and the like caused by traditional radiography judgment.

According to the technical scheme provided by the invention: the nasointestinal tube comprises a nasointestinal tube body, wherein a main cavity for placing a guide wire and feeding medicine is axially formed in the nasointestinal tube body, an outlet of the main cavity is positioned on the side wall of the head end of the nasointestinal tube body, and a guide slope surface is arranged between the outlet and the main cavity; the positive preceding fixed mounting of nose intestines pipe body head end has the sensor that can respond to pH value in real time, the sensor is connected with the wire, the wire is worn to establish in the inside axial threading hole of nose intestines pipe body, and the wire rear end is drawn forth and is connected with the display that can show pH value in real time from the lateral wall of nose intestines pipe body rear end.

As a further improvement of the invention, the sensor comprises an outer tube, a measuring electrode and a reference electrode, wherein the measuring electrode and the reference electrode are fixedly arranged in the outer tube side by side, a first protection tube is arranged outside the measuring electrode, a second protection tube is arranged outside the reference electrode, and the outer tube, the first protection tube and the second protection tube are all flexible silica gel hoses.

As a further improvement of the invention, the rear end of the outer tube of the sensor is provided with a connecting tube section with a reduced outer diameter, the outer surface of the connecting tube section is provided with a plurality of annular corrugated outer grooves, the inner surface of the connecting tube section is provided with a plurality of annular corrugated inner grooves, the head end of the nose and intestine tube body is matched with the inner and outer shapes of the connecting tube section, and the connecting tube section is welded or bonded at the head end of the nose and intestine tube body.

As a further development of the invention, the measuring electrode is a metal/metal oxide electrode, a glass electrode or an ISFET electrode.

As a further improvement of the invention, the metal/metal oxide electrode is an antimony electrode or a tungsten electrode.

As a further improvement of the invention, the reference electrode adopts a silver-silver chloride electrode, the silver-silver chloride electrode is arranged in a second protection tube, the head of the second protection tube is provided with a porous material, the part of the second protection tube, which is positioned between the silver-silver chloride electrode and the porous material, is filled with potassium chloride gel, and the potassium chloride gel is doped with conductive fibers.

As a further improvement of the invention, the conductive fiber is a high molecular conductive fiber.

As a further improvement of the invention, the high molecular type conductive fiber is an organic conductive fiber prepared by directly spinning polyacetylene, polyaniline, polypyrrole or polythiophene high molecular conductive materials.

As a further improvement of the invention, the head end of the sensor is arranged in a circular arc shape.

Compared with the prior art, the invention has the following advantages:

1) the nose intestine guide wire real-time monitoring device is ingenious in structure, reasonable in design and convenient to use, the sensor capable of sensing the pH value in real time is fixedly installed in front of the head end of the nose intestine body, the sensor is connected with the display through the wire, the pH value of liquid contacted with the sensor is transmitted to the display in real time in the tube placing process through the sensor, so that the change condition of the pH value at the front end of the nose intestine guide wire can be monitored in real time, when the head end of the nose intestine passes through the pylorus, the pH value of the liquid contacted with the sensor is rapidly changed, whether the head end of the nose intestine passes through the pylorus can be rapidly confirmed, whether the tube placing is in place can be rapidly judged, the defects of poor timeliness, radioactive damage and the like caused by traditional film shooting judgment are effectively overcome, convenience is provided for clinical work, and tube placing time and.

2) The sensor has the advantages of ingenious structure, good reproducibility and stability, high measurement accuracy and safe and reliable use.

3) The nasointestinal tube can be applied to various enteral nutrition support patients needing to be left, has wide application range, and can be used in departments such as ICU, oncology, geriatrics, gastrointestinal surgery, neurology, neurosurgery and the like.

Drawings

Fig. 1 is a schematic overall structure diagram of an embodiment of the present invention.

Fig. 2 is an enlarged cross-sectional view of a sensor portion in an embodiment of the invention.

Description of reference numerals: the device comprises a nasal intestinal tube body, a main cavity, an outlet, a guide slope surface, a thread hole, a lead wire, a sensor, an outer tube, a measuring electrode, a reference electrode, a protective tube, a conductive fiber, a porous material, a potassium chloride gel, a conductive fiber, a connecting tube and a display, wherein the main cavity is 1a, the outlet is 1b, the guide slope surface is 1c, the axial thread hole is 1d, the lead wire is 2, the sensor is 3, the outer tube is 3.1, the measuring electrode is 3.2, the reference electrode is 3.3, the protective tube is 3.4, the protective tube is 3.5, the.

Detailed Description

The invention is further illustrated by the following specific figures and examples.

As shown in fig. 1 and 2, the embodiment discloses a nasointestinal tube convenient for judging the tube placement position, which comprises a nasointestinal tube body 1, wherein a main cavity 1a for placing a guide wire and administering a drug is axially arranged in the nasointestinal tube body 1, an outlet 1b of the main cavity 1a is positioned on the side wall of the head end of the nasointestinal tube body 1, and a guide slope surface 1c is arranged between the outlet 1b and the main cavity 1 a; the positive preceding fixed mounting of 1 head end of nose intestines tube body has sensor 3 that can respond to pH value in real time, sensor 3 is connected with wire 2, wire 2 wears to establish in 1 inside axial through wires hole 1d of nose intestines tube body, and 2 rear ends of wire are drawn forth and are connected with display 4 that can show pH value in real time from the lateral wall of 1 rear end of nose intestines tube body.

When the device is used specifically, medical staff carries out the operation of putting the tube of the nose intestine tube according to the conventional tube putting method, in the tube putting process, the sensor 3 transmits the pH value of the liquid in contact with the sensor to the display 4 in real time, so that the change condition of the pH value at the front end of the nose intestine tube body 1 can be monitored in real time, when the head end of the nose intestine tube passes through the pylorus, the pH value of the liquid in contact with the sensor 3 changes rapidly [ the pH value of gastric juice is generally 0.9-1.8, and the pH value of the small intestine liquid is generally 8-9 ], so that whether the head end of the nose intestine tube passes through the pylorus can be quickly confirmed, whether the tube putting is in place can be quickly judged, the defects of poor timeliness, radioactive damage and the like caused by the traditional film shooting judgment are effectively overcome, convenience is provided for clinical work, and the tube putting time and manpower are. The nasointestinal tube can be applied to various enteral nutrition support patients needing to be retained, has wide application range, and can be used in departments such as ICU, oncology, geriatrics, gastrointestinal surgery, neurology, neurosurgery and the like.

In the present invention, the sensor 3 may be a conventional product in the prior art. This provides a usable sensor 3, its structure is shown in fig. 2, sensor 3 includes outer tube 3.1, measuring electrode 3.2 and reference electrode 3.3 are fixed mounting in outer tube 3.1 side by side, and measuring electrode 3.2 sets up first protective tube 3.4 outward, and reference electrode 3.3 sets up second protective tube 3.5 outward, outer tube 3.1, first protective tube 3.4 and second protective tube 3.5 are flexible silica gel hose. So set up, during the use, measuring electrode 3.2 constitutes the electrode pair with reference electrode 3.3, converts the pH valve signal into voltage signal output. The reference electrode 3.3 is used to provide electrical continuity for the liquid measurement and the potential is substantially independent of the measured liquid change. The first protective tube 3.4 and the second protective tube 3.5 each provide a sealing, protecting and supporting function for the measuring electrode 3.2 and the reference electrode 3.3. In addition, because the reference electrode 3.3 in the sensor 3 directly enters the body, the reproducibility and the stability are better, and the measurement accuracy is higher.

Because the nose intestines tube is putting the pipe in-process, the head end of nose intestines tube body 1 can have actions such as drawing rotation, so sensor 3 must install reliably, can not unexpected the drop. Therefore, this embodiment provides a safe and reliable mounting structure, as shown in fig. 2 specifically, the rear end of the outer tube 3.1 of the sensor 3 is provided with a connecting tube section with a reduced outer diameter, the outer surface of the connecting tube section is provided with a plurality of annular corrugated outer grooves, the inner surface of the connecting tube section is provided with a plurality of annular corrugated inner grooves, the head end of the nose intestine tube body 1 is matched with the inner and outer shapes of the connecting tube section, and the connecting tube section is welded or bonded to the head end of the nose intestine tube body 1. So set up, 1 head end of nose intestines pipe body is drawing when rotatory, and sensor 3 also can firmly be connected at the head end of nose intestines pipe body 1, can not drop, and is very safe.

In the present invention, the measuring electrode 3.2 can be an existing metal/metal oxide electrode, a glass electrode or an ISFET electrode. However, the glass electrode has high impedance, large volume, large processing difficulty and easy damage, and the ISFET electrode has high packaging difficulty and unstable performance, so that a metal/metal oxide electrode, such as an antimony electrode or a tungsten electrode, is preferably adopted.

In this embodiment, the reference electrode 3.3 is preferably a silver-silver chloride electrode, the silver-silver chloride electrode is disposed in the second protective tube 3.5, the head of the second protective tube 3.5 is disposed with a porous material 3.6, a portion of the second protective tube 3.5 between the silver-silver chloride electrode and the porous material 3.6 is filled with a potassium chloride gel 3.7, and the potassium chloride gel 3.7 is doped with conductive fibers 3.8. So set up, reference electrode 3.3 contacts with liquid through the porous material 3.6 of head, and porous material 3.6 has both guaranteed the electrical contact of gel 3.7 liquid and gastric juice or small intestine liquid, has reduced the exchange of potassium chloride gel 3.7 and gastric juice or small intestine liquid again, and potassium chloride gel 3.7 is stable in human state, and silver-silver chloride electrode and human internal organ have the potassium chloride gel 3.7 to separate from, can not direct contact, can not form the poison to the human body. In addition, the conductive fiber 3.8 doped in the potassium chloride gel 3.7 can further ensure the smoothness of a circuit and improve the accuracy and timeliness of measurement.

In this embodiment, the porous material 3.6 and the conductive fiber 3.8 may be both products that are currently used for medical purposes, for example, the porous material 3.6 may be VX-100 type produced by Verax corporation, and the conductive fiber 3.8 may be a high molecular conductive fiber 3.8, for example, an organic conductive fiber 3.8 that is directly spun from a high molecular conductive material such as polyacetylene, polyaniline, polypyrrole, polythiophene, or the like.

In this embodiment, the display 4 may be a conventional product in the prior art, such as a pH controller manufactured by mecacon corporation, and is connected to the sensor 3 in a conventional manner, which is not described herein again.

As shown in fig. 1, in the present embodiment, the head end of the sensor 3 is configured in a circular arc shape. So set up, put the pipe in-process at nose intestines pipe, convex head end makes nose intestines pipe both be convenient for put into and can avoid the damage again, the protection patient.

The above description is only for the preferred embodiment of the present invention, and the above specific embodiments are not intended to limit the present invention. Various modifications and alterations may occur to those skilled in the art without departing from the spirit and scope of the invention, and such modifications and alterations should be accorded the broadest interpretation so as to encompass all such modifications and alterations.

Claims (9)

1. The nasointestinal tube convenient for judging the tube placement position comprises a nasointestinal tube body (1), wherein a main cavity (1a) used for placing a guide wire and feeding medicine is axially arranged in the nasointestinal tube body (1), an outlet (1b) of the main cavity (1a) is positioned on the side wall of the head end of the nasointestinal tube body (1), and a guide slope surface (1c) is arranged between the outlet (1b) and the main cavity (1 a); the positive preceding fixed mounting of nose intestines tube body (1) head end has sensor (3) that can respond to pH value in real time, sensor (3) are connected with wire (2), wire (2) are worn to establish in inside axial through wires hole (1d) of nose intestines tube body (1), and wire (2) rear end is drawn forth and is connected with display (4) that can show pH value in real time from the lateral wall of nose intestines tube body (1) rear end.

2. The nasointestinal tube facilitating the determination of the tube placement position as claimed in claim 1, wherein: sensor (3) include outer tube (3.1), measuring electrode (3.2) and reference electrode (3.3) are fixed mounting side by side in outer tube (3.1), and measuring electrode (3.2) set up first protective tube (3.4) outward, and reference electrode (3.3) set up second protective tube (3.5) outward, outer tube (3.1), first protective tube (3.4) and second protective tube (3.5) are the flexible silica gel hose.

3. The nasointestinal tube facilitating the determination of the tube placement position as claimed in claim 2, wherein: the sensor is characterized in that a connecting pipe section (3.9) with a reduced outer diameter is arranged at the rear end of an outer pipe (3.1) of the sensor (3), a plurality of annular corrugated outer grooves are formed in the outer surface of the connecting pipe section (3.9), a plurality of annular corrugated inner grooves are formed in the inner surface of the connecting pipe section, the head end of the nasal intestinal pipe body (1) is matched with the inner and outer shapes of the connecting pipe section (3.9), and the connecting pipe section (3.9) is welded or bonded at the head end of the nasal intestinal pipe body (1).

4. The nasointestinal tube facilitating the determination of the tube placement position as claimed in claim 2, wherein: the measuring electrode (3.2) adopts a metal/metal oxide electrode, a glass electrode or an ISFET electrode.

5. The nasointestinal tube facilitating the determination of the tube placement position as claimed in claim 4, wherein: the metal/metal oxide electrode is an antimony electrode or a tungsten electrode.

6. The nasointestinal tube facilitating the determination of the tube placement position as claimed in claim 2, wherein: the reference electrode (3.3) adopts a silver-silver chloride electrode, the silver-silver chloride electrode is arranged in a second protection pipe (3.5), the head part of the second protection pipe (3.5) is provided with a porous material (3.6), the part, between the silver-silver chloride electrode and the porous material (3.6), in the second protection pipe (3.5) is filled with potassium chloride gel (3.7), and the conductive fibers (3.8) are doped in the potassium chloride gel (3.7).

7. The nasointestinal tube facilitating determination of the tube placement position as claimed in claim 6, wherein: the conductive fiber (3.8) is a high-molecular conductive fiber (3.8).

8. The nasointestinal tube facilitating determination of the tube placement position as claimed in claim 7, wherein: the polymer type conductive fiber (3.8) is an organic conductive fiber (3.8) prepared by directly spinning polyacetylene, polyaniline, polypyrrole or polythiophene polymer conductive materials.

9. The nasointestinal tube convenient for judging the tube placing position according to any one of claims 1 to 8, wherein: the head end of the sensor (3) is arranged to be arc-shaped.

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