CN114190873A - Portable swallowing examination evaluation hose endoscope system - Google Patents

Abstract

The invention discloses a portable swallowing examination evaluation hose endoscope system, which comprises a containing box with a box body and a cover body and an endoscope body contained in the containing box; wherein: the endoscope body comprises an endoscope, a working host, a display screen and a negative pressure suction device; the endoscope comprises an operation part, an insertion tube, a bending part and a head end part which are connected in sequence; the head end part is provided with an endoscope head, a pattern sensor and a light source; the working channel starts from a forceps channel opening at the position of the side wall of the insertion tube, penetrates through the bent part and reaches the head end part; the invention provides a portable swallowing examination evaluation hose endoscope system which is characterized by being convenient to carry, having a negative pressure suction function and having a working channel by arranging an endoscope body and a containing box for containing, is formed based on swallowing examination evaluation requirements of most clinical cases, and can meet the requirements of most clinical cases.

Description

Portable swallowing examination evaluation hose endoscope system

Technical Field

The invention relates to the field of clinical medicine diagnosis and treatment, in particular to a portable swallowing examination evaluation hose endoscope system.

Background

Swallowing disorders can occur during the progression of many diseases, including natural aging, neurological diseases, craniocerebral trauma, degeneration, autoimmune diseases, systemic diseases, tumors, infectious diseases, and the like. The incidence rate of dysphagia after acute stroke is as high as 64% -78%, dysphagia causes 72% of hospitalization aspiration pneumonia, and aspiration pneumonia is the third leading cause of death within 1 month after stroke. In addition, dysphagia following stroke is an independent risk factor for malnutrition. Meanwhile, up to 50% of the elderly have difficulty eating, resulting in malnutrition and weight loss; due to weak constitution, the risk of falling is increased, the susceptibility to other diseases is increased, and the like. Swallowing dysfunction is a symptom that seriously harms the health of patients and affects the recovery from disease.

At present, for the evaluation of swallowing dysfunction, clinical symptoms and various screening scales (such as EAT-10, hole drinking experiment and the like) are mainly used as mainstream, and part of hospitals can carry out swallowing contrast examination to evaluate the swallowing function; in the aspect of treatment, the treatment method mainly adopts therapists' techniques, physical factors and myoelectric feedback as mainstream, and partial hospitals can carry out balloon dilatation to treat the dysphagia. However, the above evaluation and treatment means lack the operation and data under direct vision, and no clear explanation can be given for the mechanism research of dysphagia. For example, in the aspect of evaluation, although a swallowing radiography examination is a gold standard for diagnosing swallowing disorders, the swallowing radiography examination can be used for comprehensively evaluating swallowing from the lip to the stomach, but the swallowing radiography examination is required to be carried out in a strict radiation-proof field, and a patient needs to go to a radiology department, so that the cooperation of radiology department personnel is required, the popularization and the application of the department of rehabilitation are not facilitated, and the risk of lung function damage and even respiratory failure caused by mistaken barium absorption is existed. In the aspect of treatment, electrical stimulation, sensory stimulation and posture compensation training carried out on patients with pharyngeal dysphagia are external muscle stimulation or indirect stimulation, and the effectiveness of the compensation training cannot be visually observed without direct vision of pharyngeal stimulation.

In view of the above-mentioned situation, domestic researchers have proposed that swallowing dysfunction can be assessed and sensory stimulation treatment can be performed using a hose-throat endoscope. The evaluation of the swallowing function of the hose laryngeal endoscope is firstly proposed by American scholars in 1988 by researching abroad and by using a hose nasopharyngeal laryngoscope to enter the oropharynx and the hypopharynx of a patient, structures such as epiglottis, epiglottis valley, tongue root pharyngeal wall, larynx, piriform crypt and the like and the movement of the structures during respiration, pronunciation, cough, breath holding and food swallowing are observed, and the method evaluates the bolus transport in the swallowing process through the movement function and the food retention condition of the laryngeal before and after swallowing in the pharyngeal period. This is limited to the evaluation aspect, and is shallow for the treatment aspect. At present, only Guangzhou is clinically relevant evaluation and sensory stimulation treatment in China, deeper treatment means are not developed, and the mechanism research is in the initial stage.

At present, the swallowing laryngoscopy is clinically developed and is carried out by using an electronic laryngoscope device in the ear-nose-throat department. The electronic laryngoscope is generally divided into a pure examination laryngoscope with a working channel and a pure examination laryngoscope without the working channel, and the electronic laryngoscope with the working channel in the market is thicker in hose and poorer in comfort level because the electronic laryngoscope with the working channel is required to be provided with a negative pressure suction device and a working embedding channel, more importantly, the whole device is larger, and a working vehicle or a working table is required to be equipped and cannot be carried to the bedside; the simple laryngoscope without the working channel can only observe the structure and the empty swallowing in the process of swallowing the laryngoscope by people, the ingestion swallowing examination has the risk of aspiration and even asphyxia because of not having a negative pressure suction device, and more importantly, the endoscopic treatment can not be carried out.

Therefore, there is a need to develop a portable swallowing assessment hose endoscope apparatus with negative pressure suction and a simple working channel to solve the above problems.

Disclosure of Invention

The invention aims to overcome the defects in the prior art and provides a portable swallowing examination evaluation hose endoscope system which has the characteristics of convenience in carrying, negative pressure suction function and working channel by arranging an endoscope body and a containing box for containing, is formed based on the swallowing examination evaluation requirements of most clinical cases, and can meet the requirements of most clinical cases.

In order to achieve the above purpose, the present invention mainly provides the following technical solutions:

a portable swallow examination assessment hose endoscope system,

comprises a containing box with a box body and a cover body and an endoscope body contained in the containing box; wherein:

the endoscope body comprises an endoscope, a working host, a display screen and a negative pressure suction device;

the endoscope comprises an operation part, an insertion tube, a bending part and a head end part which are connected in sequence; the operating part is arranged at the rear end of the insertion tube, and the front end of the insertion tube is sequentially provided with a bending part and a head end part; the head end part is provided with an endoscope head, a pattern sensor and a light source;

the working channel starts from a forceps channel opening at the position of the side wall of the insertion tube, penetrates through the bent part and reaches the head end part; a negative pressure suction port is arranged beside the jaw opening and is used for connecting a negative pressure suction tube;

the working host is arranged in the box body and is electrically connected with a cable plug at the operating part of the endoscope through a connecting cable;

the display screen is embedded in the cover body and is electrically connected with the working host through a wire.

Furthermore, the insertion pipe is a corrosion-resistant food-grade hose, and the front end of the insertion pipe is connected with the tail end of the bending part in a welding mode;

the effective length of the insertion tube is 550mm, and the outer diameter of the insertion tube is 3.9 mm;

the bending direction of the bending part is coaxial up and down, the bending angle is 130 degrees from top to bottom, and the angle of field of view is not less than 50 degrees.

Furthermore, the working host comprises a shell, a control system arranged in the shell, a touch operation interface arranged on the top surface of the shell, a charging indicator lamp, an interface component and a switch component;

the control system comprises a PCB circuit board, a microprocessor and a power supply assembly, wherein the microprocessor and the power supply assembly are integrated on the PCB circuit board;

the interface assembly comprises a BNC interface, a 14pin aerial plug interface, an HMDI high-definition interface and a USB interface;

the switch assembly comprises a CCD switch and a power switch;

the interface assembly is electrically connected with the microprocessor respectively, and the switch assembly is electrically connected with the power supply assembly respectively.

Further, the power supply assembly comprises a rechargeable battery and a power supply module; the rechargeable battery is a lithium battery;

the power supply module is a Liner LTC4065 charging chip.

Further, a lower cushion body is arranged in the box body, and a storage groove body used for storing the working host, the negative pressure suction device, the charger and the endoscope is formed in the lower cushion body;

an upper cushion body is arranged in the cover body, and a storage groove body used for storing the display screen is formed in the upper cushion body;

the shape of each storage groove body is consistent with that of the stored article;

the lower cushion body and the upper cushion body are both sponge cushion bodies.

Furthermore, one end of the box body is hinged with one end of the cover body through a movable hinge, and the other end of the box body is connected with the other end of the cover body through a lock catch;

the front side walls of the box body and the cover body are respectively provided with a handle;

a crank supporting frame is arranged between the box body and the cover body, one end of the crank supporting frame is connected with the inner wall of the cover body, and the other end of the crank supporting frame is connected with the inner wall of the same side of the box body.

Further, the operating portion includes a bending control device acting on the head end portion, a cable plug, and a plurality of button assemblies;

the cable plug is used for inserting a 26pin Ramo joint of a connecting cable, and a 14pin aerial plug joint of the connecting cable is connected with the 14pin aerial plug interface in an inserted manner;

the button assembly comprises a video recording button, a freezing button and an attraction button, and is uniformly arranged on the side wall of the operation part;

the freezing button and the video recording button are connected with a working control unit of the image sensor to realize image interception and video recording operation;

the suction button is connected with a work control unit of the negative pressure suction device to realize suction operation.

Further, the bending control device controls bending movement of the bending portion in multiple directions;

the bending control device comprises N hand wheels, the front end of the bending portion is provided with 2N connection points at equal intervals, each hand wheel is connected with two steel wires, the front end of each steel wire is connected to the connection points, and the steel wires are pulled or released by rotating the hand wheels to realize the bending motion control of the bending portion.

Furthermore, the negative pressure suction device comprises a portable suction bottle, a negative pressure suction pipe and a negative pressure pump, the negative pressure suction pipe is communicated with the position of the negative pressure suction interface on one side of the clamp passage opening, and the negative pressure pump is electrically connected with the microprocessor and is arranged in the working host machine.

Furthermore, the endoscope is a snake-shaped electronic endoscope, and the end face of a lens of the endoscope is a cylindrical cambered surface; the diameter of the lens is larger than the outer diameter of the lens body.

Compared with the prior art, the invention has the following beneficial effects:

the portable swallowing examination evaluation hose endoscope system is formed by combining and connecting the existing devices such as a light source, a hose, a camera, a negative pressure suction device and the like into the endoscope system according to the application, and can meet the requirements of most clinical cases for swallowing examination evaluation based on the majority of clinical cases;

according to the portable swallowing examination evaluation hose endoscope system, the endoscope body is accommodated in the special accommodating box, and the portable characteristic can be realized, so that the problem that the portable hose endoscope system cannot be carried when a working electronic laryngoscope is used for swallowing function examination evaluation is solved;

the portable swallowing examination and evaluation hose endoscope system solves the problem that the working electronic laryngoscope cannot be carried portably when used for swallowing function examination and evaluation; the popularization of swallowing function examination and evaluation is facilitated, and the problems of inhalation pneumonia, malnutrition and the like caused by swallowing dysfunction are effectively prevented; meanwhile, the system can perform bedside examination of critical diseases, assist in early understanding of swallowing function conditions of critically ill patients, and make full and objective evaluation and preparation for pulling out the gastrointestinal nutrition tube and recovering oral feeding.

The invention discloses a portable swallowing examination and evaluation hose endoscope system, which solves the problems of aspiration and asphyxia caused by no negative pressure aspiration in the swallowing function examination and evaluation process by using a simple laryngoscope. The process that the patient swallows food of different textures can be observed under the direct vision, the swallowing process and the problem that probably exist are truly and objectively reflected to thereby can in time vacuum suction food and avoid the aspiration under the condition that swallowing dysfunction appears and can not swallow safely.

The invention discloses a portable swallowing examination evaluation hose endoscope system, which solves the problem that endoscopic treatment cannot be carried out due to the fact that a simple examination laryngoscope does not have a working passband in the swallowing function examination evaluation process. The negative pressure suction channel can be used for air pulse or ice water stimulation to promote the sensory recovery of the throat part of the swallowing dysfunction.

The foregoing is a summary of the present invention, and in order to provide a clear understanding of the technical means of the present invention and to enable the same to be carried into effect in accordance with the present specification, the following detailed description of the preferred embodiments of the present invention is provided in conjunction with the accompanying drawings.

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 for those skilled in the art, other drawings can be obtained according to the drawings without creative efforts.

FIG. 1 is a schematic structural view of a portable swallow examination assessment hose endoscope system of the present invention;

FIG. 2 is a schematic structural view of the endoscope body of the present invention;

FIG. 3 is a schematic diagram of the structure of a working host;

FIG. 4 is a schematic structural view of an endoscope;

FIG. 5 is a block diagram of the internal circuitry of the portable swallow examination assessment hose endoscope system of the present invention;

FIG. 6 is a functional block diagram of the portable swallow examination assessment hose endoscope system of the present invention;

description of reference numerals:

1. an accommodating box; 11. a box body; 12. a cover body; 13. a lower cushion body; 14. an upper cushion body; 15. a storage tank body; 16. a movable hinge; 17. locking; 18. a handle; 19. a crank support frame;

2. an endoscope body; 21. a display screen; 22. a negative pressure suction device; 221. a portable suction bottle; 222. a negative pressure suction tube; 223. an external pedal;

3. an endoscope; 31. an operation section; 32. an insertion tube; 33. a bending section; 34. a head end portion; 35. a channel opening is clamped; 36. a negative pressure suction port;

311. a cable plug; 312. a bending control device; 313. a button assembly; 3131. a video recording key; 3132. freezing the key; 3133. an attraction button;

341. an endoscope head; 342. a graphic sensor; 343. a light source;

4. a working host; 41. a housing; 42. a control system; 43. a touch type operation interface; 44. a charging indicator light; 45. an interface component; 46. a switch assembly;

421. a PCB circuit board; 422. a microprocessor; 423. a power supply component; 424. a charger;

451. a BNC interface; 452. 14pin aerial plug interface; 453. an HMDI high definition interface; 454. a USB interface;

461. a CCD switch; 462. a power switch;

5. a working channel;

6. connecting a cable; 61. 26pin remo linker; 62. the aerial plug connector is 14 pin;

Detailed Description

To further illustrate the technical means and effects of the present invention for achieving the predetermined objects, the following detailed description will be given of the embodiments, structures, features and effects of the portable swallow examination evaluation hose endoscope system according to the present invention with reference to the accompanying drawings and preferred embodiments.

As shown in fig. 1-6, the portable swallow examination assessment hose endoscope system of the present invention,

comprises a containing box 1 with a box body 11 and a cover body 12 and an endoscope body 2 contained in the containing box 1; wherein:

the endoscope body 2 comprises an endoscope 3, a working host 4, a display screen 21 and a negative pressure suction device 22;

the endoscope 3 includes an operation portion 31, an insertion tube 32, a bending portion 33, and a head end portion 34 connected in this order; the operation part 31 is arranged at the rear end of the insertion tube 32, and the front end of the insertion tube 32 is provided with a bending part 33 and a head end part 34 in sequence; an endoscope head, a pattern sensor 342 and a light source 343 are provided at the head end 34;

a working channel 5, starting from a jaw opening 35 at the side wall of the insertion tube 32, extending through the bend 33 up to the head end 34; a negative pressure suction port 36 is arranged beside the jaw opening 35 and is used for connecting a negative pressure suction tube 222;

the working main machine 4 is arranged in the box body 11 and is electrically connected with a cable plug 311 at the operating part 31 of the endoscope 3 through a connecting cable 6;

the display screen 21 is embedded in the cover body and is electrically connected with the working host 4 through a wire.

The portable swallowing examination assessment hose endoscope system of the embodiment of the application, during the use:

the endoscope body 2 is accommodated in the accommodating box 1, and medical staff lift up the accommodating box 1 to a place needing to be used; the cover body 12 is opened, and the box body 11 can keep staying at any angle with the box body 11 due to the arrangement of the crank support frame 19, so that the camera shooting content presented on the display screen 21 arranged in the cover body 12 can be observed at any time in the examination process of medical personnel;

the medical staff connects one end of the cable plug 311 of the connecting cable 6 with the operation part of the endoscope 3, and the other end of the connecting cable 6 is inserted into the 14pin aerial insertion interface 452 on the working host 4, so that the endoscope 3 and the working host 4 can be electrically connected;

meanwhile, the negative pressure suction tube 222 is communicated with the position of the negative pressure suction port 36 on one side of the jaw opening 35 so as to fulfill the aim of negative pressure suction in the evaluation process;

after the connection is finished, the endoscope 3 is inserted into the nose, and the mucosa and the tissue structure of the nose, the nasopharynx, the laryngopharynx and the upper end of the esophagus, the movement of each part in the air swallowing process and the like are observed in the advancing process of the endoscope 3; in the process, the position and the direction of the lens are adjusted at any time according to the difference of the observation part and the observation content, and negative pressure suction can be carried out at any time for cleaning when the lens is fuzzy or the observation part has more mucus;

and after the observation is finished, food swallowing is evaluated, the endoscope 3 is arranged above the structure to be observed, the patient swallows food normally, the functional state of the swallowing related physiological structure is judged according to the motion track, the residual position and the like of the food, and when the food leaks and overflows to the laryngeal vestibule and the patient cannot clear away automatically in time, the negative pressure suction device 22 is used for carrying out quick suction, so that the food or saliva is prevented from being sucked to the lung by mistake.

As shown in FIG. 1, the portable swallow examination assessment hose endoscope system of the invention is characterized in that the insertion tube 32 is a corrosion-resistant food grade hose, and the front end of the insertion tube is connected with the tail end of the bending part 33 in a welding manner;

the effective length of the insertion tube 32 is 550mm, and the outer diameter thereof is 3.9 mm;

the bending direction of the bending part 33 is coaxial up and down, the bending angle is 130 degrees from top to bottom, and the angle of view is not less than 50 degrees.

The portable swallowing examination evaluation hose endoscope system is characterized in that the outer diameter of the insertion tube 32 is 3.9mm, and the bending part 33 is arranged on the insertion tube, so that the endoscope 3 has the characteristics of thin tube diameter, high comfort and capability of meeting the use requirement, and is also provided with the characteristics of negative pressure suction and a working channel 5; effectively solves the problems encountered in the prior art.

The portable swallowing examination evaluation hose endoscope system of the embodiment of the application has the following characteristics:

1) the portable swallowing examination evaluation hose endoscope system of the embodiment of the application adopts an advanced true-color micro COMS image technology, the resolution ratio of the system is greatly higher than that of the optical fiber endoscope 3, and the image is enlarged clearly;

2) the swallowing examination evaluation hose endoscope 3 has the bending directions of an upper direction and a lower direction which are coaxial, the bending angles of the upper direction and the lower direction are both 130 degrees, the angle of field is not less than 50 degrees, and the internal conditions of organs can be effectively observed. The insertion tube 32 is a corrosion-resistant food grade hose with an effective length of 550mn, and the wire diameter of the insertion tube 32 is 3.9 mm.

3) The electronic endoscope system adopts the LED with high brightness, low heat, long service life, quick response, no toxicity, firmness and durability as the light source 343 of the endoscope 3, so that the endoscope body becomes thin; meanwhile, because the heat of the LED is very small, and the LED radiates heat through the inner lens end part 34, the lens body and the human body, the danger that the mucous membrane tissue is burnt by the illumination of the cold light source 343 optical fiber is avoided.

As shown in fig. 4, the portable swallow examination evaluation hose endoscope system of the present invention, the work host 4 comprises a housing 41, a control system 42 disposed in the housing 41, a touch operation interface 43 disposed on the top surface of the housing 41, a charging indicator 44, an interface assembly 45 and a switch assembly 46;

the control system 42 comprises a PCB circuit board 421, a microprocessor 422 and a power supply component 423 integrated on the PCB circuit board 421;

the interface component 45 comprises a BNC interface 451, a 14pin aerial socket interface 452, an HMDI high definition interface 453 and a USB interface 454;

the switch assembly 46 includes a CCD switch 461 and a power switch 462;

the interface components 45 are electrically connected to the microprocessor 422, and the switch components 46 are electrically connected to the power supply components.

In the portable swallowing examination evaluation hose endoscope system according to the embodiment of the present application, the work host 4 is another core component of the swallowing examination evaluation hose endoscope system, and integrates the PCB 421, the microprocessor 422 and the power supply 423 integrated on the PCB 421, and the work host is connected to the endoscope 3 through the connection cable 6, so that the control of the endoscope 3 can be realized by controlling the switch component 46 and the touch operation interface 43 on the work host 4;

as shown in fig. 1, the portable swallow examination assessment hose endoscope system of the present invention, the power supply assembly 423 includes a rechargeable battery and a power supply module; the rechargeable battery is a lithium battery; the power supply module is a Liner LTC4065 charging chip.

In the portable swallowing examination and evaluation hose endoscope system according to the embodiment of the present application, the power supply module 423 is a rechargeable battery, and a charging cord of the rechargeable battery is also received in the housing 11; the endoscope system can be carried and used at any time;

as shown in fig. 2, in the portable hose endoscope system for evaluation of swallowing examination of the present invention, a lower pad 13 is disposed in the box body 11, and a storage slot 15 for storing the working host 4, the negative pressure suction device 22, the charger 424 and the endoscope 3 is disposed thereon; an upper cushion body 14 is arranged in the cover body 12, and a storage groove body 15 used for storing the display screen 21 is arranged on the upper cushion body; the shape of each storage groove body 15 is consistent with the shape of the stored articles; the lower cushion body 13 and the upper cushion body 14 are both sponge cushion bodies.

In the portable swallowing examination evaluation hose endoscope system according to the embodiment of the present application, the work host 4, the negative pressure suction device 22, the charger 424, and the endoscope 3 are all stored in the storage tank 15 in the lower cushion body 13, so that the portable swallowing examination evaluation hose endoscope system can be conveniently carried and used.

As shown in FIG. 2, in the portable swallow examination assessment hose endoscope system of the invention, one end of the box body 11 and one end of the cover body 12 are hinged through a movable hinge 16, and the other end is connected through a lock catch 17;

a handle 18 is respectively arranged on the front side walls of the box body 11 and the cover body 12;

a crank support 19 is arranged between the box body 11 and the cover body 12, one end of the crank support is connected with the inner wall of the cover body 12, and the other end of the crank support is connected with the inner wall of the box body 11 at the same side.

In the portable swallowing examination and evaluation hose endoscope system of the embodiment of the application, the box body 11 and the cover body 12 are connected through the movable hinge 16, and a crank support 19 is arranged between the box body and the cover body, so that the cover body 12 can be stopped at any opening angle.

As shown in fig. 3, the portable swallowing examination evaluation hose endoscope system of the present invention, the operation portion 31 includes a bending control means 312 acting on the head end portion 34, a cable plug 311, and a plurality of button assemblies 313;

the cable plug 311 is used for inserting a 26pin Raymond connector 61 of the connecting cable 6, and a 14pin aerial plug connector 62 of the connecting cable 6 is connected with the 14pin aerial plug interface 452 in an inserting manner;

the button assembly 313 includes a recording button 3131, a freezing button 3132, and an attraction button 3133, which are uniformly disposed on a sidewall of the operating portion 31;

the freezing button 3132 and the video recording button are connected with a working control unit of the image sensor to realize image interception and video recording operation;

the suction button 3133 is connected to a work control unit of the negative pressure suction device 22, and performs a suction operation.

As shown in fig. 3, in the portable swallowing examination evaluation hose endoscope system of the present invention, the bending control means 312 controls bending movements of the bending portion 33 in a plurality of directions;

crooked controlling means 312 includes N hand wheels, the front end of flexion 33 equidistant 2N tie points that set up, two steel wires of every hand wheel connection, the front end of every steel wire is all connected on the tie point, through rotating the hand wheel, the pulling or release steel wire realize the bending motion control of flexion 33.

As shown in fig. 2, in the portable swallowing examination evaluation hose endoscope system according to the present invention, the negative pressure suction device 22 includes a portable suction bottle 221, a negative pressure suction tube 222, and a negative pressure pump (not shown), the negative pressure suction tube 222 communicates with the position of the negative pressure suction port 36 on the side of the forceps opening 35, and the negative pressure pump is electrically connected to the microprocessor 422 and is provided in the work machine 4.

The portable swallowing examination and evaluation hose endoscope system further comprises an external pedal 223, and the external pedal 223 is connected to a corresponding interface on the working host 4 through a connecting line;

the negative pressure pump is arranged in the working host 4 and is started through the suction button 3133 or the external pedal 223, so that the purpose of negative pressure suction is realized; the external pedal 223 is disposed in the case 11 and connected to the work machine 4 through a connection line.

As shown in fig. 3, in the portable swallowing examination evaluation hose endoscope system of the present invention, the endoscope 3 is a snake-shaped electronic endoscope 3, and the lens end surface of the endoscope 3 is a cylindrical arc surface; the diameter of the lens is larger than the outer diameter of the lens body.

According to the portable swallow examination evaluation hose endoscope system, according to the human anatomy and hydromechanics principle, the resistance of the endoscope 3 during insertion is reduced by designing the lens end face into a cylindrical cambered surface, and in order to further reduce the frictional resistance after the endoscope 3 is inserted, the endoscope 3 is designed into a large lens with a thin endoscope body and a snake-shaped appearance, so that the endoscope is called a snake-shaped electronic endoscope 3;

the swallow examination assessment hose endoscope system is formed by combining and connecting the existing light source 343, hoses, camera shooting, negative pressure suction devices and the like to meet the requirements of swallow examination assessment of most clinical cases, and can meet the requirements of most clinical cases.

Preparatory work before implementation

(1) Personnel: the swallowing function-related anatomical physiology training system is trained through professional knowledge such as swallowing function, FEES (flexible endoscopic surgery of swallowing) examination operation, result judgment and the like, and an assistant and a nursing staff.

(2) Preparing an article: the FEES examination requires the preparation of methylene blue/edible green pigment, fluroxypyr nasal drops, lidocaine mucilage, mineral water or warm boiled water, old yogurt, bread, paper cups, quantitative spoons, tongue depressors, cotton swabs, gloves, syringes, finger-clipped oximetry monitors or monitors, and the like.

(3) Patient preparation: the first step in the FEES examination is to fully explain the patient's examination process. Although the nasal endoscopy is safe and painless, it still brings discomfort to some patients. Interpretation is particularly important for patients who first receive this examination in order to gain collaboration. In addition, informed consent should be signed with the patient or his family members. Generally, the patient should sit up with the head upright, face forward and four limbs relaxed. It can also be performed in semi-reclining position for patients who cannot transfer or are bedridden. Before examination, the nasal cavity was cleaned as much as possible and vasoconstrictor (fluroxypyr nasal drops) was sprayed into the nose if necessary.

Operating procedure

After the flexible tube endoscope is connected with the suction apparatus, the cold light source 343 and the video recording device, the professional turns on the light source 343 and the video recording device. Then, the operator brings the glove, uses a piece of cubic gauze, lets the assistant pour a little surface anesthetic on the gauze, evenly coats 1/3 surfaces in front of the lens, holds the proximal somatic part of the mirror with one hand, and operates the control lever that can control the lens direction with the thumb, holds the distal end of the lens tube with the other hand, enters from one side nostril, puts gently it in the passageway (middle nasal passage) between inferior turbinate and middle turbinate and keeps away from the nasal septum, passes through the nasal cavity gap as far as possible, does not touch the nasal cavity mucous membrane. When the nasal meatus is small and the lens cannot pass easily, or the patient is tense and sensitive, the patient can frequently sneeze to affect the operation, and the nasal spray can be properly performed by using the liquid furoate and 1% tetracaine to reduce the operation difficulty. In the process of moving the lens, the lens cannot be inserted forcibly when the visual field becomes small or fuzzy, and needs to retreat in time and adjust the direction and the angle to go deep again. When entering the posterior nares, two pillows resembling hemispherical bulges, also known as eustachian tube bulges, can be seen, i.e. reaching the nasopharynx. The key point of the operation is that the lens goes deep into the oropharynx from the nasopharynx, at the moment, the mirror needs to pass through a slope-shaped structure, an operator needs to carefully adjust the control lever for controlling the direction of the lens by using the thumb of an operator, so that the front end of the mirror can be timely bent downwards after being close to a slope surface, the left hand slowly forwards delivers the lens to the oropharynx along the downward direction, and the control lever can be released when the epiglottis can be clearly seen. If the retention of sputum is more and the visual field of the lens is affected, the sputum can be sucked out in time by using the negative pressure suction apparatus. After entering the oropharynx, the lens is generally placed above the epiglottis, and the vision field is adjusted, so that the assistant can help to carry out feeding examination according to instructions.

Viewing content

The emphasis of observation is different depending on the purpose of evaluation. The FEES examination evaluation content includes the following six aspects:

(1) examination of the anatomy of the pharynx (including the structure of the larynx): when the lens reached the nasopharynx, the nasal cavity blocking function was evaluated by sounding and swallowing saliva, and based on the contraction of the soft palate and the posterior pharyngeal wall. Order the patient to pronounce humming, vowel, consonant, and phrase, and examine the nasopharyngeal structure. The patient was ordered a dry swallow and the soft crocodile motor function during swallowing was assessed. If nasopharyngeal reflux is suspected, the patient can be judged by observing the passage of saliva through the nasopharynx during dry swallowing. After observing the nasopharynx structure, the lens goes deep into the oropharynx and the laryngopharynx, and is placed on the epiglottis and under the uvula. The oropharynx and laryngeal structures including local mucous membrane color and glossiness, epiglottis shape size, inclination angle, follicular hyperplasia of tongue root and epiglottis valley, whether there is red swelling in the cleft, whether there is ulcer on both pharyngeal side walls and pharyngeal back wall, whether there is abnormal hyperplasia in laryngeal vestibule, vocal cords and artificial vocal cords, and whether there is symmetry in the piriform crypts (sinuses) on both sides can be clearly seen at this position. The inconsistency of the size and shape of the laryngeal vestibule determines the size and the size of the risk of laryngeal vestibule infiltration during swallowing. Granulomas in the retroglottic or subglottic region can be observed even in some patients with endotracheal intubation.

(2) Assessment of movements of laryngeal structures: techniques for assessing pharyngeal activity include ordering the patient to sound a false voice, doing valsalva maneuvers, and swallowing various foods. Order the patient to send out the sound of o and i coating, check the motion function of abduction of arytenoid epiglottis and vocal cord. The artificial sound can promote the lateral pharyngeal wall to move towards the medial side and evaluate whether the lateral pharyngeal function is reduced or not. The patient can also be ordered to perform a valsalva maneuver, which is a method of unfolding the pharynx, helping to clarify minor shifts in the anatomy or to suggest a reduction in lateral pharyngeal function.

(3) Checking for secretion accumulation: after the laryngoscope enters the pharyngeal portion, whether secretion retention exists in the epiglottis vallecula, the piriform crypt (sinus) and the like can be observed, so that the pharyngeal contraction function and the pharyngeal sensory function can be evaluated, because the secretion retention of the epiglottis vallecula and the piriform crypt can only exist if the pharyngeal contraction function or the pharyngeal sensory function is reduced. According to the division of Rong-Yi from Japanese scholars, the accumulation of laryngeal secretions can be divided into 4 grades (Scale 0-3): the throat is called 0 grade when there is no secretion accumulation or a slight accumulation state; the state that the throat part accumulates more secretion, but no secretion accumulates in the laryngeal vestibule is called grade 1; the state in which there is accumulation of secretions at the laryngeal vestibule but coughing up is called grade 2; the presence of secretions at the laryngeal vestibule but failure to expectorate is defined as grade 3. For example, when patients with dysphagia caused by real bulbar paralysis of cerebral infarction undergo laryngoscopy, the epiglottis usually appears to be normal in shape and can move autonomously, but arytenoid cartilage and vocal cords on one side can be paralyzed, and unequal transparent viscous sputum accumulation can be seen at the entrance of the piriform crypts on the two sides, and the grade is 3 according to the grade of the just-vine.

(4) Swallowing function was assessed directly by eating liquid and solid foods: the pushing action of the tongue base on the food and the symmetry and timing of the tongue pushing the bolus backwards are evaluated by observing the movement of the tongue base while the patient chews the food. When eating, particularly liquid food, if food falls into the pharynx ahead of time (food spills), it is suggested that the tongue base is restricted from moving and lifting into contact with the soft palate. The ability of the larynx to lift can be assessed by observing where the bolus head reaches to initiate the swallowing reflex. By calculating the duration of the buccal period, and observing the size and viscosity of the bolus entering the pharynx, the efficiency of chewing and the ability to form the bolus can be assessed.

(5) Evaluating the efficacy of the compensated swallowing method: order the patient to swallow in the air and alternately under the endoscope, order the patient to swallow in the air or drink a small amount of water (1-2m) repeatedly for the patient with obvious residues after swallowing in the food, and observe whether the food block can be swallowed completely. And (3) for the patient with more food remained in the piriform crypts at the two sides of the pharynx, turning the patient left and right respectively, turning the head to swallow, and observing and removing the residual food. If one side of the pharyngeal cavity is paralyzed, the head side turns to the paralyzed side to swallow, and the food passing condition is observed. When the epiglottis food remains, the patient is ordered to do nodding empty swallowing action, and the curative effect is evaluated according to the condition of removing the food remaining.

(6) And (3) observing reflux conditions: in patients with potential reflux, an endoscope can be secured to the examination site for extended periods of time to observe reflux after several swallows, a phenomenon that often suggests upper esophageal sphincter dysfunction, or the presence of Zenker diverticula or severe esophageal loss of motility. When the endoscope is fixed on a part, the endoscope can be used for checking whether compensation methods, such as a rotor swallowing action and the like, are effective or not.

The present invention has been further described with reference to the examples, but the present invention is not limited to the above-described embodiments, and various changes can be made without departing from the spirit of the present invention within the knowledge of those skilled in the art.

Claims (10)

1. Portable deglutition examination evaluation hose endoscope system characterized by:

comprises a containing box (1) with a box body (11) and a cover body (12) and an endoscope body (2) contained in the containing box (1); wherein:

the endoscope body (2) comprises an endoscope (3), a working host (4), a display screen (21) and a negative pressure suction device (22);

the endoscope (3) comprises an operation part (31), an insertion tube (32), a bending part (33) and a head end part (34) which are connected in sequence; the operation part (31) is arranged at the rear end of the insertion tube (32), and the front end of the insertion tube (32) is sequentially provided with a bending part (33) and a head end part (34); an endoscope head (341), a pattern sensor (342) and a light source (343) are arranged at the head end part (34);

a working channel (5) starting from a jaw (35) at the location of the side wall of the insertion tube (32), extending through the bend (33) as far as the head end (34); a negative pressure suction port (36) is arranged beside the clamp port (35) and is used for connecting a negative pressure suction tube (222);

the working host (4) is arranged in the box body (11) and is electrically connected with a cable plug (311) at the operating part (31) of the endoscope (3) through a connecting cable (6);

the display screen (21) is embedded in the cover body (12) and is electrically connected with the working host (4) through a lead.

2. The portable swallow examination assessment hose endoscope system according to claim 1, wherein:

the insertion pipe (32) is a corrosion-resistant food-grade hose, and the front end of the insertion pipe is connected with the tail end of the bending part (33) in a welding mode;

the effective length of the insertion tube (32) is 550mm, and the outer diameter of the insertion tube is 3.9 mm;

the bending direction of the bending part (33) is coaxial up and down, the bending angle is 130 degrees from top to bottom, and the angle of field of view is not less than 50 degrees.

3. The portable swallow examination assessment hose endoscope system according to claim 1, wherein:

the working host (4) comprises a shell (41), a control system (42) arranged in the shell (41), a touch operation interface (43) arranged on the top surface of the shell (41), a charging indicator lamp (44), an interface component (45) and a switch component (46);

the control system (42) comprises a PCB circuit board (421), a microprocessor (422) and a power supply component (423) which are integrated on the PCB circuit board (421);

the interface assembly (45) comprises a BNC interface (451), a 14pin aerial interface (452), an HMDI high definition interface (453), and a USB interface (454);

the switch assembly (46) comprises a CCD switch (461) and a power switch (462);

the interface assemblies (45) are respectively and electrically connected with the microprocessor (422), and the switch assemblies (46) are respectively and electrically connected with the power supply assembly (423).

4. The portable swallow examination assessment hose endoscope system according to claim 3, wherein:

the power supply assembly (423) comprises a rechargeable battery, a power supply module and a charger (424); the rechargeable battery is a lithium battery;

the power supply module is a Liner LTC4065 charging chip.

5. The portable swallow examination assessment hose endoscope system according to claim 1, wherein:

a lower cushion body (13) is arranged in the box body (11), and a storage groove body (15) used for storing the working host (4), the negative pressure suction device (22), the charger (424) and the endoscope (3) is arranged on the lower cushion body;

an upper cushion body (14) is arranged in the cover body (12), and a storage groove body (15) used for storing the display screen (21) is arranged on the upper cushion body;

the shape of each storage groove body (15) is consistent with that of the stored article;

the lower cushion body (13) and the upper cushion body (14) are both sponge cushion bodies.

6. The portable swallow examination assessment hose endoscope system according to claim 1, wherein:

one end of the box body (11) is hinged with one end of the cover body (12) through a movable hinge (16), and the other end of the box body is connected through a lock catch (17);

the front side walls of the box body (11) and the cover body (12) are respectively provided with a handle (18);

a crank supporting frame (19) is arranged between the box body (11) and the cover body (12), one end of the crank supporting frame is connected with the inner wall of the cover body (12), and the other end of the crank supporting frame is connected with the inner wall of the same side of the box body (11).

7. The portable swallow examination assessment hose endoscope system according to claim 1, wherein:

the operating section (31) includes a bending control device (312) acting on the head end section (34), a cable plug (311), and a plurality of button assemblies (313);

the cable plug (311) is used for inserting a 26pin Raymond connector (61) of a connecting cable (6), and a 14pin aerial plug connector (62) of the connecting cable (6) is connected with the 14pin aerial plug interface (452) in an inserted manner;

the button assembly (313) comprises a video recording button (3131), a freezing button (3132) and an attraction button (3133), which are uniformly arranged on the side wall of the operating part (31);

the freezing button (3132) and the video recording button are connected with a working control unit of the image sensor to realize image interception and video recording operation;

the suction button (3133) is connected with a work control unit of the negative pressure suction device (22) to realize suction operation.

8. The portable swallow examination assessment hose endoscope system according to claim 7, wherein:

the bending control device (312) controls bending movement of the bending part (33) in multiple directions;

crooked controlling means (312) include N hand wheels, the front end of flexion (33) is equidistant sets up 2N tie points, and two steel wires are connected to every hand wheel, and the front end of every steel wire is all connected on the tie point, through rotating the hand wheel, the crooked motion control of flexion (33) is realized to the pulling or release steel wire.

9. The portable swallow examination assessment hose endoscope system according to claim 3, wherein:

the negative pressure suction device (22) comprises a portable suction bottle (221), a negative pressure suction tube (222) and a negative pressure pump, the negative pressure suction tube (222) is communicated with the position of a negative pressure suction interface (36) on one side of the clamp port (35), and the negative pressure pump is electrically connected with the microprocessor (422) and is arranged in the working host (4).

10. The portable swallow examination assessment hose endoscope system according to claim 1, wherein:

the endoscope is a snake-shaped electronic endoscope, and the end face of a lens of the endoscope is a cylindrical cambered surface; the diameter of the lens is larger than the outer diameter of the lens body.

Images