CN112472940A - Breathing assembly supporting voice function, ventilation method thereof and breathing machine - Google Patents
Breathing assembly supporting voice function, ventilation method thereof and breathing machine Download PDFInfo
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- 238000009423 ventilation Methods 0.000 title claims abstract description 42
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- 238000012544 monitoring process Methods 0.000 claims abstract description 33
- 210000001260 vocal cord Anatomy 0.000 claims abstract description 16
- 210000004072 lung Anatomy 0.000 claims abstract description 15
- 238000004519 manufacturing process Methods 0.000 claims abstract description 13
- 230000008602 contraction Effects 0.000 claims abstract description 6
- 210000005077 saccule Anatomy 0.000 claims description 9
- 238000003780 insertion Methods 0.000 claims description 3
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- 238000013022 venting Methods 0.000 claims 1
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- 230000009286 beneficial effect Effects 0.000 abstract description 6
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- 230000002349 favourable effect Effects 0.000 description 7
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- 208000000059 Dyspnea Diseases 0.000 description 1
- 206010013975 Dyspnoeas Diseases 0.000 description 1
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- 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
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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. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0051—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes with alarm devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0402—Special features for tracheal tubes not otherwise provided for
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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. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0434—Cuffs
- A61M16/0436—Special fillings therefor
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- G—PHYSICS
- G08—SIGNALLING
- G08B—SIGNALLING OR CALLING SYSTEMS; ORDER TELEGRAPHS; ALARM SYSTEMS
- G08B21/00—Alarms responsive to a single specified undesired or abnormal condition and not otherwise provided for
- G08B21/02—Alarms for ensuring the safety of persons
- G08B21/04—Alarms for ensuring the safety of persons responsive to non-activity, e.g. of elderly persons
- G08B21/0438—Sensor means for detecting
- G08B21/0453—Sensor means for detecting worn on the body to detect health condition by physiological monitoring, e.g. electrocardiogram, temperature, breathing
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- G—PHYSICS
- G08—SIGNALLING
- G08B—SIGNALLING OR CALLING SYSTEMS; ORDER TELEGRAPHS; ALARM SYSTEMS
- G08B7/00—Signalling systems according to more than one of groups G08B3/00 - G08B6/00; Personal calling systems according to more than one of groups G08B3/00 - G08B6/00
- G08B7/06—Signalling systems according to more than one of groups G08B3/00 - G08B6/00; Personal calling systems according to more than one of groups G08B3/00 - G08B6/00 using electric transmission, e.g. involving audible and visible signalling through the use of sound and light sources
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
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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
- A61M2205/00—General characteristics of the apparatus
- A61M2205/18—General characteristics of the apparatus with alarm
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Abstract
A respiratory component supporting voice function, a ventilation method thereof and a respirator are disclosed, wherein the respiratory component comprises: the monitoring module is used for monitoring the mouth end pressure and the expiratory pressure of the patient; the inhalation module is used for providing gas for a patient during inhalation; the expiration module, expiration module are used for the gas that the exhaust patient exhales the production, and expiration module still is used for according to the mouth end pressure of monitoring module monitoring, and control expiration branch road pressure is greater than mouth end pressure, simultaneously because the contraction of lung causes expiration way pressure to rise among the patient expiration process for the gas in patient's the expiration way is not through the expiration branch road, but flows to the mouth, and patient's vocal cords vibration sound production. Compared with the voice valve in the prior art, the breathing assembly does not need to be disassembled, so that the abrasion of elements can be avoided, the cost is reduced, and meanwhile, the voice valve does not need to be disassembled, is simple in clinical operation and is beneficial to rapidly meeting the sounding requirement of a patient.
Description
Technical Field
The invention belongs to the technical field of medical treatment, and particularly relates to a breathing assembly supporting a voice function, a ventilation method of the breathing assembly and a breathing machine.
Background
Tracheotomy refers to cutting the neck trachea of a patient and putting an intubation tube into the patient to solve the problems of dyspnea, respiratory dysfunction and the like. The patient who uses tracheotomy needs the intubate to assist breathing clinically, carries out gas exchange with the external world, and gas does not flow through upper airway and vocal cords, can't make a sound, brings the hindrance for doctors and patients to communicate. At present, a voice valve is used for helping a patient to sound clinically, and the principle is that a one-way valve is used for forbidding exhaled air to pass through an exhalation branch of a tracheal cannula, so that vocal cords are vibrated to sound through an upper airway.
However, when the voice valve is used, the insertion tube needs to be detached to attach the voice valve, and the voice valve needs to be detached after use. Some patients can adapt to the voice valve fast, and some patients need to gradually increase the time of wearing the voice valve through training, and repeated disassembly of the voice valve can cause the clinical operation to be complicated, and also can cause component abrasion, resulting in increased cost. There are also some voice valves designed to be inserted inside the cannula, but they still need to be reinstalled, the operation steps are not simplified, and at the same time, they need to be designed in accordance with respiratory mechanics, increasing the production cost. Therefore, the existing voice valve device has the problem of inconvenient use.
Therefore, it is critical how to design a breathing assembly that does not require repeated disassembly to replace the voice valve.
Disclosure of Invention
The invention aims to provide a breathing assembly supporting a voice function, a ventilation method thereof and a breathing machine, which can replace a voice valve, do not need to be disassembled, can avoid the abrasion of elements, reduce the cost and have simple clinical operation.
In order to realize the purpose of the invention, the invention provides the following technical scheme:
in a first aspect, the present invention provides a respiratory assembly for supporting speech functions, the respiratory assembly comprising: a monitoring module for monitoring a mouth end pressure and an expiratory tract pressure of a patient; an inhalation module for providing gas to a patient upon inhalation; exhale the module, it includes the exhale branch road with patient's exhale the trachea intercommunication to exhale the module, it is used for the gas that the patient exhales the production to exhale the module, it still is used for the basis to exhale the module monitoring mouth end pressure with exhale the trachea pressure, control exhale branch road pressure and be greater than mouth end pressure, when the patient carries out spontaneous expiration simultaneously, because the contraction of patient expiration in-process lung causes exhale the trachea pressure to rise simultaneously for the gas in the patient exhales the trachea flows to the mouth, and the mobile gas drives the vocal cords vibration and the sound production of patient.
In one embodiment, the exhalation module includes an adjusting part disposed on the exhalation branch, and the adjusting part is configured to adjust a difference between the exhalation branch pressure and the mouth end pressure to a first preset value, where the first preset value is greater than zero.
In one embodiment, the breathing assembly further comprises an alarm module, and the alarm module is used for executing an alarm action when the mouth end pressure or the expiratory pressure is greater than a second preset value.
In one embodiment, the expiratory module is further configured to control the expiratory limb pressure to be the same as the mouth end pressure to cause gas stagnation in the expiratory limb.
In one embodiment, the exhalation module is further configured to control the breathing branch pressure to zero.
In one embodiment, the respiratory assembly further comprises an intubation tube and a balloon, the intubation tube is used for inserting the respiratory tract, the balloon is arranged on the periphery of the intubation tube, and the monitoring module is further used for acquiring the pressure inside the balloon in real time.
In one embodiment, the alarm module is further configured to perform an alarm action when the pressure inside the balloon is greater than a third preset value.
In one embodiment, the respiratory assembly further comprises an analysis module, wherein the analysis module is used for analyzing the expiratory pressure and the mouth end pressure acquired by the monitoring module to judge whether the patient exhales or inhales and record the number of respiratory cycles of the patient.
In a second aspect, the invention also provides a ventilator comprising the breathing assembly according to any one of the embodiments of the first aspect.
In a third aspect, the present invention also provides a method of ventilating a respiratory assembly that supports speech functionality, the respiratory assembly including an expiratory limb in communication with an expiratory airway of a patient, the method comprising: monitoring the pressure at the mouth end and the pressure in the expiratory tract of the patient; providing gas to the patient while inhaling; when the patient exhales, the gas that the exhaling of exhaust patient produced, or control exhale branch road pressure and be greater than mouth end pressure, because the lung contracts in the patient exhales simultaneously and causes exhaling the way pressure rises, makes the interior gas of exhaling the way of patient flow to the mouth, and the vocal cords of patient vibrate the sound production.
In one embodiment, the respiratory component includes an adjusting member disposed on the expiratory limb, and when the patient exhales, the expiratory limb is exhausted to generate gas, or the expiratory limb pressure is controlled to be greater than the mouth end pressure, and the expiratory limb pressure rises due to the contraction of the lung during the patient exhaling, so that the gas in the expiratory limb of the patient flows to the mouth, and the flowing gas drives the vocal cords of the patient to vibrate to generate sound, including: and the difference between the pressure of the expiration branch and the pressure of the mouth end is adjusted to be a first preset value through the adjusting piece.
In one embodiment, before the adjusting the difference between the expiratory limb pressure and the mouth end pressure to the first preset value by the adjusting piece, the method comprises: and when the pressure at the mouth end or the pressure in the exhalation passage is greater than a second preset value, executing an alarm action.
In one embodiment, before performing the alarm action when the mouth end pressure or the expiratory pressure is greater than a second preset value, the method includes: when the patient is exhaling for the first time, the expiratory limb is filled with gas through multiple exhalations.
In one embodiment, before filling the expiratory limb with gas through multiple exhalations when the patient is an initial exhalation, the method comprises: adjusting the expiratory limb pressure through the adjusting piece so that the expiratory limb pressure is the same as the mouth end pressure.
In one embodiment, the expiratory limb pressure is made zero by adjusting the adjustment member after the patient has been breathing in the voice ventilation mode for a predetermined number of breathing cycles.
In one embodiment, the ventilator further comprises an endotracheal tube and a balloon, the endotracheal tube is arranged in the expiration channel of the patient, the balloon is arranged on the periphery of the endotracheal tube, and when the voice ventilation mode is not started, the balloon is filled with gas and blocks the expiration channel; before monitoring the mouth end pressure and the expiratory pressure of the patient, the method comprises the following steps: and exhausting air in the saccule, starting a voice ventilation mode, and simultaneously acquiring the pressure in the saccule in real time.
In one embodiment, after the exhausting air in the balloon to start the voice ventilation mode and acquiring the pressure inside the balloon in real time, the method comprises the following steps: and when the pressure inside the saccule is greater than a third preset value, executing an alarm action.
The pressure of the mouth end and the pressure of an expiratory channel of a patient are monitored by the monitoring module, when the patient needs to produce sound, the expiratory module can enable the pressure of the expiratory branch of the patient to be larger than the pressure of the mouth end, and therefore a breathing mode capable of sending out a voice function is provided for the patient; when the patient does not need to produce speech, the inhalation module and the exhalation module can provide the patient with a breathing pattern that is independent of the outside world. Compared with the voice valve in the prior art, the breathing assembly does not need to be disassembled, so that the abrasion of elements can be avoided, the cost is reduced, and meanwhile, the voice valve does not need to be disassembled, is simple in clinical operation and is beneficial to rapidly meeting the sounding requirement of a patient.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments of the present invention, and other drawings can be obtained by those skilled in the art without creative efforts.
FIG. 1 is a schematic view of a respiratory assembly provided by the present invention in operation;
FIG. 2 is a schematic representation of the airway of a patient using a cannula and balloon;
FIG. 3 is a schematic diagram of the flow of gas with the respiratory assembly during inspiration of the patient in the assisted ventilation mode;
FIG. 4 is a schematic diagram of the flow of gas with the respiratory assembly during exhalation of the patient in the assisted ventilation mode;
FIG. 5a is a schematic diagram of the flow of gas to the respiratory component during inspiration by the patient in the voice ventilation mode, according to one embodiment;
FIG. 5b is a schematic diagram of the flow of gas to the respiratory assembly during inspiration by the patient in the voice ventilation mode in accordance with another embodiment;
FIG. 5c is a schematic diagram of the flow of gas to the respiratory assembly during inspiration by the patient in the voice ventilation mode in accordance with another embodiment;
FIG. 6 is a flow chart illustrating a voice ventilation mode of a ventilation method of a respiratory assembly according to the present invention;
fig. 7 is a schematic flow chart of a balloon pressure alarm of the respiratory component provided by the present invention.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention, and it is apparent that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be obtained by a person skilled in the art without any inventive step based on the embodiments of the present invention, are within the scope of the present invention.
Referring to fig. 1 to 3, an embodiment of the present invention provides a respiratory component supporting a voice function, where the respiratory component is applicable to a breathing assistance device such as a ventilator or an oxygen machine, and the respiratory component may be a component of the respiratory component or an external component of the respiratory component. Wherein the breathing assembly is preferably applied to an invasive ventilator. The breathing assembly includes:
a monitoring module for monitoring the mouth end pressure (P) of a patientmouth) And expiratory airway pressure;
the inhalation module is used for providing gas for a patient during inhalation;
the expiration module, the expiration module includes exhale branch road (2) with exhale air flue (1) intercommunication, exhale the module and be used for discharging the gas that the patient exhales the production, exhale the module and still be used for according to the mouth end pressure of monitoring module monitoring, control exhale branch road pressure (P)exp) Is larger than the pressure at the mouth end, and simultaneously, under the influence of the rise of the pressure of the expiratory tract caused by the contraction of the lung, the gas in the expiratory tract of the patient flows to the mouth part (7), and the flowing gas drives the vocal cords of the patient to vibrate and generate sound.
Specifically, the mouth end pressure is the pressure of the mouth (oral cavity) of the patient during exhalation, the expiratory tract pressure is the pressure of the expiratory tract (lower respiratory tract) of the patient during exhalation, and the expiratory limb pressure is the pressure provided by a positive end expiratory pressure valve (PEEP valve). Preferably, the monitoring of the monitoring module has real-time performance, and can acquire the pressure at the mouth end and the pressure in the exhalation tract in real time. It can be understood that, referring to fig. 3 and 4, when the patient does not need to send out voice, the patient can inhale gas through the inspiration module, exhale gas from the expiration module, and both air intake and air exhaust are completed through the breathing assembly, which is beneficial to improving the comfort of the patient. When the patient needs to send out voice, referring to fig. 5a, the inhalation module can be used as the only air source for the patient, and the patient only sucks the air provided by the inhalation module; referring to fig. 5b, the inhalation module can be closed to allow the patient to inhale air from the outside only through the mouth; referring to fig. 5c, the inspiration module can also act as an auxiliary gas supply, and when the patient has insufficient gas to suck from the outside, the inspiration module supplements the gas to make the patient fully complete the pulmonary circulation. Regarding the exhalation aspect, please refer to fig. 6, under the control of the exhalation module, the pressure of the exhalation branch is greater than the pressure at the mouth end, when the patient exhales spontaneously, due to the influence of the exhalation tract pressure, a small portion of the gas is discharged from the exhalation module (the exhalation module needs to release a portion of the gas to control the exhalation tract pressure), and a large portion of the gas is discharged from the mouth from the exhalation tract, so that the large portion of the gas can reach the mouth along the exhalation tract, and the gas passes through the vocal cords in the middle of the laryngeal cavity, so that the vocal cords vibrate, and the patient can make a sound, thereby implementing the voice function. The expiration module controls the pressure of the expiration branch to be greater than the pressure of the mouth end so that the patient can make a sound to be in a voice ventilation mode, and the expiration module is used for exhausting the gas exhaled by the patient to be in an auxiliary ventilation mode.
The pressure of the mouth end and the pressure of an expiratory channel of a patient are monitored by the monitoring module, when the patient needs to produce sound, the expiratory module can enable the pressure of the expiratory branch of the patient to be larger than the pressure of the mouth end, and therefore a breathing mode capable of sending out a voice function is provided for the patient; when the patient does not need to produce speech, the inhalation module and the exhalation module can provide the patient with a breathing pattern that is independent of the outside world. Compared with the voice valve in the prior art, the breathing assembly does not need to be disassembled, so that the abrasion of elements can be avoided, the cost is reduced, and meanwhile, the voice valve does not need to be disassembled, is simple in clinical operation and is beneficial to rapidly meeting the sounding requirement of a patient.
In one embodiment, referring to fig. 3 and 6, the exhalation module further includes an adjusting element (3) disposed on the exhalation branch, and the adjusting element is configured to adjust a difference between the pressure of the exhalation branch and the pressure of the mouth end to be a first preset value (δ). Specifically, the value of the first preset value is greater than zero, and can be selected as 0.1H2O～1cmH2And O. The first preset value is a parameter depending on the physical qualities such as age, BMI (body height and body weight index) and physical conditions of the patient. When the difference between the pressure of the expiratory branch and the pressure of the mouth end is too large, the pressure of the expiratory duct is easily too large, and the lung of a patient is damaged. When the difference between the pressure of the expiration branch and the pressure of the mouth end is too small, most of gas is easily discharged from the expiration branch without passing through the expiration air passage, and the patient is not favorable to sound production. Through setting up the regulating part that is located expiration branch road inside, the regulating part will exhale the difference of branch road pressure and mouth end pressure and adjust to first default, and the patient has comparatively suitable pressure differential at the expiration branch road and the mouth of expiration in-process, can not injure patient's lung promptly, also can not influence patient's vocal production.
In addition, before the voice ventilation mode is turned on, Positive End Expiratory Pressure (PEEP) needs to be set to zero by the adjusting member. The inhalation module comprises an inhalation branch, which is mainly used for delivering gas to a patient. An inhalation valve (not shown) may be provided in the inhalation branch, and an exhalation valve (not shown) may be provided in the exhalation branch.
In one embodiment, referring to fig. 1 and 7, the respiratory assembly further comprises an alarm module for indicating that the pressure at the mouth end or the expiratory pressure is greater than a second predetermined value (P)limit) And executing an alarm action. Specifically, the second preset value is a safety limit pressure according to the age, BMI, physical condition, and other physical qualities of the patient. It will be appreciated that excessive pressure at the mouth end or in the exhalation tract may be likely to cause respiratory difficulties or lung damage to the patient. In general, the second predetermined value will not exceed 60cmH2And O. Through setting up alarm module, alarm module carries out the warning action when mouth end pressure or expiratory duct pressure are greater than the second default to medical personnel in time discover patient's abnormal conditions, and carry out relevant measure as early as possible, be favorable to improving patient respiratory security.
In one embodiment, referring to fig. 1, the respiratory component further comprises an analysis module. The analysis module is used for analyzing the expiratory pressure and the mouth end pressure acquired by the monitoring module so as to judge whether the patient exhales or inhales and record the respiratory cycle number (k) of the patient. It can be understood that after the voice ventilation mode is started (the exhalation module controls the pressure of the exhalation branch to be higher than the pressure at the mouth end), the patient is easy to have various symptoms of physical discomfort along with the increase of the number of respiration cycles of the patient. The number of respiratory cycles that each patient can withstand varies and can be set according to the patient's age, BMI, physical condition, and other physical attributes.
In one embodiment, referring to fig. 1 and 6, the expiratory module is further configured to control the pressure of the breathing branch to zero. The respiratory cycle times of the patient are acquired through the analysis module, so that when the patient reaches the limit respiratory cycle times, the pressure of the expiratory branch is adjusted to be zero, the gas of the expiratory channel is completely released through the expiratory module, and the discomfort of the patient is eliminated.
In one embodiment, referring to fig. 1 and 6, after the gas in the expiratory tract is released by the expiratory module, the expiratory limb needs to be refilled with gas. It will be appreciated that after the patient reaches the limit number of respiratory cycles and sets the expiratory limb pressure to zero, there is little air in the expiratory limb. When the patient needs to make a sound again, the pressure of the expiratory branch is adjusted by arranging the PEEP valve, so that the expiratory branch is filled with the expired gas firstly (the process is called as Ttrain for short, and the expiratory branch can be filled in 3 breaths generally). After filling, the gas that produces when the patient exhales can mostly all be discharged from the mouth, is favorable to the vocal cords abundant vibration sound production.
In other embodiments, the expiratory limb may also be filled with gas via the inspiratory module to reduce the Ttrain time.
In one embodiment, referring to fig. 1 and 6, the expiratory module is further configured to control the expiratory limb pressure to be the same as the mouth end pressure, so as to retain the gas in the expiratory limb. It can be understood that, if the pressure of the expiratory branch is greater than the pressure of the mouth end, the gas filled into the expiratory branch is easy to escape from the mouth, which is not favorable for rapidly completing the gas filling of the expiratory branch. If the pressure of the expiration branch is less than the pressure of the mouth end, the gas of the expiration branch can easily flow into the lung, and the gas is also not beneficial to filling the expiration branch.
In one embodiment, referring to fig. 3 and 5a, the respiratory assembly further comprises a cannula (5) for insertion into the respiratory tract and a balloon (6) disposed about the periphery of the cannula. The monitoring module is also used for acquiring the pressure inside the balloon in real time. Specifically, the exhalation module and the inhalation module are both communicated with the cannula. Gas exhaled by the patient may pass from the cannula into the exhalation module, and gas inhaled by the patient may pass from the inhalation module from the cannula into the airway. Typically, before entering the voice ventilation mode, the balloon needs to be deflated so that the pressure inside the balloon is reduced (the balloon no longer blocks the exhalation path). The pressure inside the sacculus is monitored through the monitoring module so as to discover the abnormity of the sacculus pressure in time (generally caused by incomplete exhaust of the sacculus), perform related treatment as early as possible (closing a voice ventilation mode and the like), and reduce the suffocation risk of a patient.
Specifically, the specification of the intubation tube in the human body is 4 mm-12 mm, the specification of the human body is 15mm, and the intubation tube is easy to fill when the gas of the expiration branch is filled.
At present, the existing detachable voice valve can automatically open and leak partial gas when the internal pressure of the device is overlarge by arranging an exhaust hole. However, the existing voice valve devices are all detachable elements, and an alarm cannot be mounted on the voice valve devices, so that real-time alarm when air in the saccule is not completely removed is difficult to realize, and the suffocation risk of a patient is further reduced.
In one embodiment, referring to fig. 1 and 7, the alarm module is further configured to perform an alarm action when the pressure inside the balloon is greater than a third preset value. It can be understood that when the voice ventilation mode is performed, if an accident happens, the pressure inside the balloon is increased, the breathing of the patient is not facilitated, and the patient has potential safety hazards. Through setting up alarm module, when the inside pressure of sacculus surpassed the third default, alarm module reported to the police, is favorable to medical personnel to rescue the patient the very first time. Because need not to set up the speech valve, the inside pressure of sacculus is acquireed comparatively easily, consequently also is convenient for alarm module and reports to the police.
In addition, the alarm action can be light flashing, sharp sound, alarm information sent to medical staff's smart phones, tablet computers, personal digital assistants, interphones, desktop computers and other electronic equipment, and the like. The setting can be carried out according to the requirements of specific scenes.
The embodiment of the invention also provides a breathing machine which comprises the breathing assembly provided by the invention. In particular, the ventilator is preferably an invasive ventilator. Ventilators in the assisted inspiration mode include, but are not limited to, SPONT (spontaneous breathing mode), PCV + (pressure controlled ventilation mode), PSIMV + (pressure controlled and spontaneous ventilation mode), CPAP (continuous positive airway pressure ventilation), and the like. The breathing assembly provided by the invention is added into the breathing machine, the breathing machine can carry out a voice ventilation mode (capable of sounding) and an auxiliary ventilation mode (incapable of sounding), the two modes are switched without disassembling parts, and the abrasion of elements can be avoided, so that the cost is reduced.
Referring to fig. 7, an embodiment of the present invention further provides a method for ventilating a respiratory module supporting a voice function, the respiratory module including an expiratory limb communicated with an expiratory channel, the method for ventilating the respiratory module including:
monitoring the pressure at the mouth end and the pressure in the expiratory tract of the patient;
providing gas to the patient while inhaling;
when a patient exhales, gas generated by the patient exhalation is discharged, or the pressure of an exhalation branch is controlled to be greater than the pressure of a mouth end, and meanwhile, the pressure of an exhalation passage rises due to the fact that the lung contracts in the patient exhalation process, so that the gas in the exhalation passage of the patient flows to the mouth, and the flowing gas drives the vocal cords of the patient to vibrate and generate sound.
Specifically, the mouth end pressure and the expiratory pressure of the patient are preferably monitored in real time, and the mouth end pressure and the expiratory pressure can be acquired in real time. By monitoring the pressure of the mouth end and the pressure of the expiratory limb of the patient, when the patient needs to produce sound, the pressure of the expiratory limb is adjusted to be larger than the pressure of the mouth end, and meanwhile, when the patient exhales spontaneously, the pressure of the expiratory limb rises due to lung contraction, and the gas passes through the expiratory limb, so that a breathing mode capable of sending out voice is provided for the patient; when the patient does not need to produce speech, a breathing pattern that is independent of the outside world can be provided for the patient. Compared with the use of a voice valve in the prior art, the ventilation method disclosed by the invention is switched without dismantling, so that the abrasion of elements can be avoided, the cost is reduced, and meanwhile, as the ventilation method is not required to be dismantled, the clinical operation is simple, and the requirement of a patient on sounding can be met quickly.
In one embodiment, referring to fig. 7, the respiratory component includes an adjusting element disposed on the expiratory branch for exhausting the gas generated by the expiration of the patient during expiration of the patient, or controlling the expiratory branch pressure to be greater than the pressure at the mouth end, so that the gas in the expiratory tract of the patient flows to the mouth, and the flowing gas drives the vocal cords of the patient to vibrate to generate sound, including:
the difference between the pressure of the expiratory limb and the pressure of the mouth end is adjusted to be a first preset value through the adjusting piece. Specifically, the value of the first preset value is greater than zero.
The difference between the expiratory branch pressure and the pressure at the mouth end is adjusted to a first preset value through the adjusting piece, and the expiratory channel and the mouth of the patient have a proper pressure difference in the expiratory process, so that the lung of the patient cannot be injured, and the sounding of the patient cannot be influenced.
In one embodiment, referring to fig. 7, before the adjusting element adjusts the difference between the expiratory pressure and the mouth end pressure to be the first predetermined value, the method includes:
and when the pressure at the mouth end or the pressure of the exhalation tract is greater than a second preset value, executing an alarm action.
Specifically, when the pressure at the mouth end and the pressure at the expiratory channel are both less than or equal to a second preset value, the next step is carried out (the difference between the expiratory branch pressure and the pressure at the mouth end is adjusted to be a first preset value by the adjusting piece).
The alarm action is executed when the pressure at the mouth end or the pressure of the exhalation passage is greater than the second preset value, so that medical personnel can find the abnormal condition of the patient in time and carry out related measures as soon as possible, and the safety of breathing of the patient is improved.
In one embodiment, referring to fig. 7, after the patient has been in the speech ventilation mode for a predetermined number of breathing cycles, the pressure in the breathing circuit is set to zero. Specifically, the k number of respiration cycles is based on the completion of the k-th expiratory hold until the end of expiration. Through the breathing cycle number of times of acquireing the patient to when the patient reaches the breathing cycle number of times of limit, be zero through setting up expiration branch road pressure, release the gas of exhaling the way, thereby make the patient feel comfortable.
In one embodiment, referring to fig. 7, when the pressure at the mouth end or the pressure in the exhalation tract is greater than the second preset value, before performing the alarm action, the method includes:
when the patient exhales for the first time, the expiratory limb is filled with gas by multiple exhalations.
Specifically, when the patient is not initially exhaling after the initial exhalation, the next step (determining the magnitude of the mouth end pressure and the second preset value) is performed.
Exhale to exhaling the branch road through many times and pack gas for gas filling is full of and exhales the branch road, and the gas that the patient produced when exhaling can most all be discharged from the mouth, is favorable to the vocal cords fully to vibrate the sound production.
In one embodiment, referring to fig. 7, before filling the expiratory limb with gas through multiple exhalations when the patient is the initial exhalation, the method includes:
the expiratory limb pressure is regulated by the PEEP valve so that the expiratory limb pressure is the same as the mouth end pressure.
Specifically, the initial exhalation is initiated when the inhalation is maintained until the initial inhalation is completed. It can be understood that, if the pressure of the expiratory branch is greater than the pressure of the mouth end, the gas filled in the expiratory branch easily escapes from the mouth, which is not favorable for rapidly completing the gas filling of the expiratory branch. If the pressure of the expiratory duct is less than the pressure of the mouth end, the gas of the expiratory branch can easily flow into the lung, and the gas is not beneficial to filling the expiratory branch.
In one embodiment, please refer to fig. 7, the ventilator further includes an endotracheal tube and a balloon, the endotracheal tube is inserted into the breathing passage of the patient, the balloon is disposed at the periphery of the endotracheal tube, and when the voice ventilation mode (auxiliary ventilation mode) is not turned on, the balloon is filled with gas and blocks the breathing passage; prior to monitoring the patient's mouth end pressure and expiratory pressure, comprising:
and exhausting air in the balloon to start a voice ventilation mode, and acquiring the pressure in the balloon in real time.
Through monitoring the pressure in the sacculus to discover the abnormity of the pressure in the sacculus in time, carry out relevant treatment (closing the voice ventilation mode, etc.) as early as possible.
In one embodiment, referring to fig. 7, after exhausting air in the balloon to start the voice ventilation mode and acquiring the pressure inside the balloon in real time, the method includes:
and when the pressure inside the saccule is greater than a third preset value (Thre), executing an alarm action.
When the pressure in the saccule exceeds the third preset value, the balloon is executed to give an alarm, so that medical staff can rescue a patient at the first time.
While the invention has been described with reference to a preferred embodiment, it will be understood by those skilled in the art that various changes in form and detail may be made therein without departing from the spirit and scope of the invention as defined by the appended claims.
Claims (17)
1. A respiratory component that supports voice functionality, comprising:
a monitoring module for monitoring a mouth end pressure and an expiratory tract pressure of a patient;
an inhalation module for providing gas to a patient upon inhalation;
exhale the module, it includes the exhale branch road with patient's exhale the way intercommunication to exhale the module, it is used for the gas that the patient exhales the production to exhale the module, it still is used for the basis to exhale the module monitoring mouth end pressure, control exhale branch road pressure and be greater than mouth end pressure, simultaneously because the patient exhales the in-process lung shrink and causes exhale the way pressure rise for the gas in patient's exhale the way flows to the mouth, and the mobile gas drives patient's vocal cords vibration and sound production.
2. The respiratory assembly of claim 1, wherein the exhalation module includes an adjustment member disposed on the exhalation limb, the adjustment member being configured to adjust a difference between the exhalation limb pressure and the mouth end pressure to a first predetermined value, the first predetermined value being greater than zero.
3. The respiratory assembly of claim 2, further comprising an alarm module for performing an alarm action when the mouth end pressure or expiratory pressure is greater than a second predetermined value.
4. The respiratory assembly of claim 1, wherein the expiratory module is further to control the expiratory limb pressure to be the same as the mouth end pressure to cause gas stagnation in the expiratory limb.
5. The respiratory assembly of claim 1, wherein the exhalation module is further configured to control the exhalation limb pressure to zero.
6. The respiratory assembly of claim 3, further comprising a cannula for insertion into the expiratory passageway and a balloon disposed about a periphery of the cannula, wherein the monitoring module is further configured to obtain pressure within the balloon in real-time.
7. The respiratory assembly of claim 6, wherein the alarm module is further configured to perform an alarm action when the pressure inside the balloon is greater than a third preset value.
8. The respiratory assembly of claim 1, further comprising an analysis module configured to analyze the expiratory airway pressure and the mouth end pressure obtained by the monitoring module to determine whether the patient is exhaling or inhaling and to record the number of respiratory cycles of the patient.
9. A ventilator comprising a breathing assembly according to any one of claims 1 to 8.
10. A method of ventilating a respiratory assembly that supports voice functionality, the respiratory assembly including an expiratory limb in communication with an expiratory airway of a patient, the method comprising:
monitoring the pressure at the mouth end and the pressure in the expiratory tract of the patient;
providing gas to the patient while inhaling;
when the patient exhales, the gas generated by the patient exhalation is discharged, or the pressure of the exhalation branch is controlled to be greater than the pressure of the mouth end, and meanwhile, the pressure of the exhalation passage rises due to the fact that the lung contracts in the patient exhalation process, so that the gas in the exhalation passage of the patient flows to the mouth, and the flowing gas drives the vocal cords of the patient to vibrate and generate sound.
11. The method of ventilating a respiratory module as claimed in claim 10, wherein the respiratory module further comprises an adjusting member disposed on the expiratory limb for exhausting the gas generated by the expiration of the patient during the expiration of the patient, or controlling the pressure of the expiratory limb to be greater than the pressure at the mouth end, and the pressure of the expiratory tract is increased due to the contraction of the lungs during the expiration of the patient, so that the gas in the expiratory tract of the patient flows to the mouth, and the flowing gas drives the vocal cords of the patient to vibrate to generate sound, comprising:
and adjusting the difference between the pressure of the expiration branch and the pressure of the mouth end to be a first preset value through the adjusting piece, wherein the first preset value is larger than zero.
12. The method of ventilating a respiratory assembly of claim 11, wherein adjusting the difference between the expiratory limb pressure and the mouth end pressure to a first predetermined value by the adjustment member comprises:
and when the pressure at the mouth end or the pressure in the exhalation passage is greater than a second preset value, executing an alarm action.
13. The respiratory assembly ventilation method of claim 12, wherein prior to performing an alarm action when the mouth end pressure or the expiratory pressure is greater than a second predetermined value, comprising:
when the patient is exhaling for the first time, the expiratory limb is filled with gas through multiple exhalations.
14. The method of ventilating a respiratory assembly of claim 13, wherein said prior to filling said expiratory limb with gas via a plurality of exhalations when the patient is an initial exhalation, comprises:
adjusting the expiratory limb pressure through the adjusting piece so that the expiratory limb pressure is the same as the mouth end pressure.
15. The respiratory assembly ventilation method of claim 12, wherein the breathing branch pressure is brought to zero by adjusting the adjustment member after a patient has been breathing in the voice ventilation mode for a predetermined number of breathing cycles.
16. The method of ventilating a respiratory assembly of claim 10, wherein the ventilator further comprises an endotracheal tube disposed through a patient's breathing passageway and a balloon disposed about a periphery of the endotracheal tube, the balloon being filled with a gas and blocking the breathing passageway when the voice ventilation mode is not activated; before monitoring the mouth end pressure and the expiratory pressure of the patient, the method comprises the following steps:
and exhausting air in the saccule, starting a voice ventilation mode, and acquiring the pressure in the saccule in real time.
17. The method of ventilating a respiratory assembly of claim 16, wherein said venting air from within said balloon and activating a voice ventilation mode, after acquiring pressure within said balloon in real time, comprises:
and when the pressure inside the saccule is greater than a third preset value, executing an alarm action.
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