CN115068341A - A composite set that is used for nutritive nose intestines tube and seal wire of human jejunum - Google Patents

Abstract

The invention relates to a combined device of a nasointestinal tube and a guide wire for human jejunum nutrition, belonging to the field of medical instruments. Including multi-functional joint, pipe, sacculus and seal wire, multi-functional joint connects on the pipe, and the seal wire setting is in the cavity of pipe, its characterized in that: the proximal end of the catheter is provided with a multifunctional joint, the distal end of the catheter is provided with a dissolvable blocking cap, and the dissolvable blocking cap is bonded or welded with the distal end of the catheter; the guide wire is inserted into the cavity of the catheter through the multifunctional joint, a soft head is arranged at one end of the guide wire, and the guide wire is inserted into the catheter in advance; the far end is provided with a sacculus which is communicated with the catheter cavity. According to the invention, through the design of the far-end balloon of the catheter, the nasointestinal tube can slide to the gastrointestinal tract and be connected with the pylorus under the action of gravity; through the design of the dissolvable blocking cap at the far end of the catheter, the blocking cap can prevent the guide wire from penetrating out during intubation to influence the intubation effect; the invention has the advantages of smooth introduction of the nasointestinal tube, convenient and safe operation, reduced operation risk, increased comfort of patients and the like.

Description

A composite set that is used for nutritive nose intestines pipe of human jejunum and seal wire

Technical Field

The invention relates to a combined device of a nasointestinal tube and a guide wire for human jejunal nutrition in the field of medical instruments, in particular to a nasointestinal tube for external intervention of gastrointestinal nutrition.

Background

At present, for patients who cannot take food or refuse to take food actively due to various diseases (neurological diseases, tumors, coma, mechanical trauma and the like), enteral nutrition and parenteral nutrition (intravenous injection) are mainly adopted to support nutrition of the patients so as to maintain the normal physiological function needs of the patients. However, parenteral nutrition does not conform to the physiological metabolism of human bodies, complications are easy to generate, and the cost is high, so that enteral nutrition is preferentially applied to patients with normal gastrointestinal tract functions in clinic by means of nasal feeding. Nasal feeding is a technique in which a catheter is inserted nasally into the gastrointestinal tract, and fluid food, moisture, and medication are infused from within the tube to maintain the nutritional and therapeutic needs of the patient. After gastric surgery, for example, gastric cancer, gastrectomy, or other patients with loss of gastric function, nutrients are delivered directly into the jejunum for enteral nutrition.

The nasointestinal tube or nasointestinal tube product that is used for nasal feeding nutrition and drainage clinically is many, for reducing the influence of catheterization to the human body, chooses flexible, the less pipe of diameter as far as possible, but because stomach cancer postoperative is cut and is removed and rebuild stomach, and structure is complicated at structure in stomach structure and intestines and stomach connection position, how to pass the lower part pylorus of stomach fast with the nasointestinal tube, intervene in the jejunum, bring very big difficulty for clinical intubate doctor.

At present, the clinical intubation technology is mainly blind intubation, the flexible nasointestinal tube is conveyed to a specified position by means of the thrust of a guide wire, and the guide wire extends out of an abraded intestinal tract due to the contraction of the flexible nasointestinal tube in the insertion process; the blind insertion is mainly realized by the operation feeling and experience of a doctor and the change of the body position of a patient, but the blind insertion of the nasointestinal tube is very difficult due to the special structure of the gastrointestinal connecting part. Clinically, intubation can also be carried out under the guidance of ultrasound or CT, but because the nasointestinal tube can not realize the steering function independently, a doctor can not smoothly enter the nasointestinal tube into the intestinal tract through the pylorus in the intubation process.

In addition, in the clinical use process of the currently marketed nasointestinal tube products, the following problems are also existed, namely after the nasointestinal tube is inserted into the gastrointestinal tract, because the bottom of the nasointestinal tube is closed, food residues are easy to accumulate and ferment and become smelly when the gastrointestinal tract is subjected to long-term nutrition (generally, a single nasointestinal tube is inserted into a human body for about 1 month), bacteria are easy to breed, and the colony imbalance of the gastrointestinal tract is caused; secondly, after food residues are accumulated at the bottom of the nasointestinal tube, the liquid discharge hole at the upper part is easy to be gradually blocked. And thirdly, after the nasointestinal tube is inserted into the jejunum, the nasointestinal tube is easy to slide out of the jejunum due to the movement of a patient during retention period because no fixed structure is arranged in the jejunum.

Disclosure of Invention

The invention aims to provide a nasointestinal tube and guide wire combined device for human jejunum nutrition, which solves the problems that the intubation is difficult and the nasointestinal tube is easy to block when the gastrointestinal nutrition is clinically performed through the nose.

The technical scheme provided by the invention is as follows:

the utility model provides a composite set that is used for nutritive nose intestines pipe of human jejunum and seal wire, includes multifunctional joint, pipe, sacculus and seal wire, and multifunctional joint connects on the pipe, and the seal wire setting is in the cavity of pipe, its characterized in that: the proximal end of the catheter is provided with a multifunctional joint, the distal end of the catheter is provided with a dissolvable blocking cap, and the dissolvable blocking cap is bonded or welded with the distal end of the catheter; the guide wire is inserted into the cavity of the catheter through the multifunctional joint, a soft head is arranged at one end of the guide wire, and the guide wire is inserted into the catheter in advance; the far end of the catheter is provided with a saccule, and the saccule is communicated with the cavity of the catheter; the technical scheme is further explained as follows: the soluble plugging cap is formed by mixing and injection molding one or more of gelatin, polysaccharide and cellulose, a plasticizer and water; the soluble blocking cap can be dissolved in gastric juice within 1 h; the technical scheme is further explained as follows: the balloon is a compliance balloon and is made of TPU or silica gel; the length range of the saccule is 50-80 mm, and the rated blasting pressure range is 2-6 atm; the distance between the far end of the saccule and the end point of the catheter is 20-40 mm; the technical scheme is further explained as follows: the catheter is of a double-cavity or three-cavity structure and comprises a main cavity and an auxiliary cavity, the balloon is communicated with the cavity of one auxiliary cavity, and water or air can be directionally injected into the balloon through the multifunctional joint; the technical scheme is further explained as follows: the guide wire is made of stainless steel or nickel-titanium alloy and is formed by weaving single strands or multiple strands; the soft head part is a spring guide wire or a TPU coating layer; the outer diameter of the guide wire is 0.8-1.5 mm, and the length of the guide wire is more than or equal to 120% of the length of the catheter; the technical scheme is further explained as follows: the outer walls of the catheter and the guide wire are coated with hydrophilic coatings.

According to the invention, through the design of the far-end balloon of the catheter, when the catheter is inserted into a tube, water is injected into the balloon, and the nasointestinal tube slides down to the gastrointestinal tract and is connected with the pylorus under the action of gravity; through the design of the dissolvable blocking cap at the far end of the catheter, the blocking cap can prevent the guide wire from penetrating out during intubation to influence the intubation effect; when nutrition is supplied in the intestines, the blocking cap is dissolved to form a passage at the far end of the catheter, so that the catheter can be prevented from being blocked; in addition, the invention also has the characteristics of smooth introduction of the nasointestinal tube, convenient and safe operation, reduction of operation risk, increase of comfort of patients and the like.

Drawings

FIG. 1 is a view of the structure of the combination device of a nasointestinal tube and a guide wire;

FIG. 2 is a diagram showing the state of dissolving a blocking cap and injecting water into a balloon of the combined device of the nasointestinal tube and the guide wire;

fig. 3 is a schematic view of the gastrointestinal structure.

In the figure: the multifunctional catheter comprises a multifunctional joint 1, a multi-cavity catheter 2, a balloon 3, a soluble blocking cap 4, a one-way water injection valve 5 and a guide wire 6.

Detailed Description

The invention is further described with reference to the following figures and specific application examples:

as shown in the figure, the combined device comprises a multifunctional joint 1, a multi-cavity catheter 2, a balloon 3, a soluble blocking cap 4, a one-way water injection valve 5 and a guide wire 6, the working mechanism of the device is that the guide wire penetrates into the inside of a nasointestinal tube, during intubation, the nasointestinal tube is inserted into the stomach under the supporting and pushing of the guide wire, the soluble blocking cap at the far end of the nasointestinal tube is dissolved by being immersed in gastric juice to form a passage, then water is injected into the nasointestinal tube balloon to take the lateral position of a patient, the catheter can slide to the pylorus connected with the stomach and intestine under the gravity, then the guide wire is pushed to smoothly enter the small intestine, and then under the guiding of the guide wire, the nasointestinal tube is pushed to enter the small intestine, and intubation can be easily realized.

One end of the catheter is an operation end and is provided with a multifunctional joint, the other end of the catheter is a leading-in end and is provided with a dissolvable blocking cap, and the dissolvable blocking cap is bonded or welded with the far end of the catheter; the guide tube is a flexible nasointestinal tube, the nasointestinal tube is conveyed to a specified position by means of the thrust of the guide wire, the guide wire is inserted into a cavity of the guide tube through the multifunctional joint, a soft head is arranged at one end of the guide wire, the guide wire is inserted into the guide tube in advance, and the soft head of the guide wire pushes the dissoluble plugging cap at the front end of the guide tube to push the guide tube to the specified position; in order to enable the front end of the catheter to smoothly enter the intestinal body from a stomach pylorus, a balloon is arranged at the far end of the catheter and is a compliance balloon, the balloon is communicated with a catheter cavity, in the technical scheme, the guide wire is penetrated into the interior of the catheter through a multifunctional joint, during intubation, the nasointestinal tube is inserted into the stomach under the support of the guide wire, a soluble blocking cap at the far end of the nasointestinal tube is dissolved by being immersed in gastric juice to form a passage, then the multifunctional joint injects water into the nasointestinal tube balloon through the catheter cavity to get a lateral lying position of a patient, the catheter can slide to the pylorus connected with the stomach and intestine under the gravity, then the push guide wire is smoothly immersed into the small intestine, and then the push nasal intestinal tube is pushed to enter the small intestine under the guide of the guide wire, so that intubation can be easily realized. Compared with the traditional nasointestinal tube, the invention has the following advantages: firstly, when the guide wire and the nasal intestinal canal are inserted, the guide wire can be extended out due to the shrinkage of the flexible nasal intestinal canal during the insertion, so that the guide wire can be prevented from penetrating out of the catheter to damage the mucous membrane of the digestive tract; secondly, after the distal end of the nasointestinal tube smoothly enters the stomach, the soluble blocking cap is quickly dissolved, and at the moment, the distal end of the nasointestinal tube forms a passage to facilitate the entering and exiting of a guide wire; injecting water into the nasointestinal tube saccule, taking the lateral lying position of the patient (the pyloric opening is vertical to the bottom of the stomach), sliding the open far end of the nasointestinal tube to the pyloric opening under the action of gravity, pushing the guide wire at the moment, and enabling the guide wire to quickly pass through the pylorus and enter the small intestine; fourthly, after the guide wire enters the small intestine, water in the nasal-intestinal canal saccule is emptied, and then the guide wire is inserted to push the nasal-intestinal canal to enter the small intestine; the nasal-intestinal tube with the saccule and the guide wire are guided mutually, and the nasal-intestinal tube can be inserted into the intestine smoothly under blind insertion (without the help of X-ray and B-ultrasonic machine). After entering the small intestine, the nasointestinal tube is properly injected with water in the saccule, so that the nasointestinal tube can be prevented from slipping out of the small intestine. The opening at the far end of the nasal and intestinal tube can avoid the bottom blockage when nutrient substances are conveyed, and avoid the risks of fermentation and intestinal infection caused by long-term accumulation of food residues.

The main body of the catheter is a full-developing catheter, the catheter is made of 60-90% of TPU (thermoplastic polyurethane), 10-40% of barium sulfate developer, the catheter is a three-cavity catheter, the main cavity of the catheter is used as a guide wire channel and a jejunum nutrition channel, the first auxiliary cavity is a stomach decompression channel, and the second auxiliary cavity is controlled by a water injection one-way valve to inject water into the saccule;

the far end of the conduit is designed to be a rounded tip, so that the damage of the nasointestinal tube to the intestinal wall during jejunum nutrition can be prevented. The soluble blocking cap material is the same as the gastric soluble capsule material, and is mainly made of gelatin material, certain plasticizer is added, and the soluble blocking cap material and the gastric soluble capsule material are mixed, granulated and then injection-molded through an injection molding machine. The catheter and the dissolvable blocking cap are bonded by medical epoxy glue; the catheter balloon is a compliance balloon, and the balloon is made of TPU.

The multifunctional joint is a three-cavity joint, the joint material is TPU, the multifunctional joint respectively corresponds to a main cavity and an auxiliary cavity of the three-cavity catheter, and the catheter and the joint are bonded by UV glue; the end part of the auxiliary cavity joint connected with the saccule is connected with a one-way valve to control the water injection or discharge into the saccule. The guide wire is a nickel-titanium alloy guide wire coated with TPU or PTFE, the far end of the guide wire is a soft head coated with TPU, a hydrophilic super-lubricating coating is coated outside the TPU coating, the super-lubricating coating can reduce the friction resistance of the guide wire in the catheter during movement, and the soft head can avoid the damage of the guide wire to the gastrointestinal mucosa after penetrating out of the catheter. The outer diameter of the guide wire is 0.8-1.5 mm, and the length of the guide wire is more than or equal to 120% of the length of the catheter. The outer diameter of the guide wire is 1.2mm, and the length of the guide wire is 130% of the length of the catheter. The size of the outer diameter of the guide wire determines the support performance of the guide wire and the smoothness of the movement of the guide wire in the catheter, and the length of the guide wire influences the operability of the guide wire and the catheter during the guiding process.

Examples

(1) Material preparation

The material of the conduit: 14fr TPU full-developing three-cavity catheter with balloon, the length of which is 1500 mm;

the main material of the soluble plug cap is as follows: edible gelatin, plasticizer, purified water, etc.;

a three-cavity multifunctional joint;

the outer diameter of the TPU guide wire is 1.2mm, and the length of the TPU guide wire is 1950 mm;

(2) soluble plug cap manufacturing method

Sol: dissolving gelatin in purified water at 80 deg.C, heating to dissolve it to obtain uniform and transparent solution, and adding plasticizer; and incubated at 50 ℃.

Molding: immersing the blocking cap forming mould into the gelatin heat-preservation solution, and slowly pulling out; standing and drying at 40 ℃, wherein the relative humidity is 60-70%; the required thickness can be obtained by repeated leaching and forming.

Thirdly, demoulding: taking the molded product down from the molding die;

cutting: cutting off redundant materials to obtain a soluble blocking cap;

(3) coating layer

Coating the full-developing catheter and the TPU guide wire by adopting a leaching and ultraviolet curing mode, wherein the main material of the coating liquid is PVP.

(3) Bonding of

Bonding the inner diaphragm of the full-developing guide pipe and the guide pipe with the three-cavity joint by using UV glue under the irradiation of an ultraviolet lamp; bonding the far end of the full-developing catheter with the soluble blocking cap by using UV glue; thus obtaining the nose intestine tube with the dissoluble blocking cap and the saccule.

(4) Assembly

And (3) penetrating the guide wire into the main cavity of the connected nasointestinal tube to obtain the nasointestinal tube and guide wire combined device for human jejunum nutrition.

The using method comprises the following steps:

(1) immersing the combined device of the nasointestinal tube and the guide wire into purified water to lubricate the surfaces of the nasointestinal tube and the guide wire;

(2) inserting a nasointestinal tube and a guide wire into the stomach of a patient, and determining whether the nasointestinal tube and the guide wire are in place;

(3) taking the right lateral clinostatism of the patient, and injecting purified water into the catheter balloon to enable the distal end of the nasointestinal tube to gradually slide to the pyloric opening until the soluble blocking cap is dissolved;

(4) after the soluble blocking cap is dissolved, pushing the guide wire, wherein the guide wire penetrates out of the catheter and passes through the pylorus hole to reach the inside of the jejunum;

(5) fixing the guide wire, pumping out purified water in the balloon, pushing the nasointestinal tube along the guide wire, and enabling the far end of the nasointestinal tube to enter the jejunum;

(6) the guide wire is pulled out, and a proper amount of purified water is injected into the saccule again to prevent the distal end of the nasointestinal tube from slipping out of the jejunum.

The above embodiments can be freely combined as required, and the above is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, several modifications and decorations can be made without departing from the principle of the present invention, and these modifications and decorations should also be regarded as the protection scope of the present invention.

Claims (6)

1. The utility model provides a composite set that is used for nutritive nose intestines pipe of human jejunum and seal wire, includes multifunctional joint, pipe, sacculus and seal wire, and multifunctional joint connects on the pipe, and the seal wire setting is in the cavity of pipe, its characterized in that: the proximal end of the catheter is provided with a multifunctional joint, the distal end of the catheter is provided with a dissolvable blocking cap, and the dissolvable blocking cap is bonded or welded with the distal end of the catheter; the guide wire is inserted into the cavity of the catheter through the multifunctional joint, a soft head is arranged at one end of the guide wire, and the guide wire is inserted into the catheter in advance; the far end of the catheter is provided with a saccule which is communicated with the cavity of the catheter.

2. The nasointestinal tube and guide wire combination for human jejunal nutrition of claim 1, wherein: the soluble blocking cap is formed by mixing and injection molding one or more of gelatin, polysaccharide and cellulose with a plasticizer and water, and can be dissolved in gastric juice within 1 h.

3. The combination nasointestinal tube and guide wire for human jejunal nutrition of claim 1, wherein: the balloon is a compliant balloon and is made of TPU or silica gel; the length range of the saccule is 50-80 mm, and the rated blasting pressure range is 2-6 atm; the distance between the far end of the saccule and the end point of the catheter is 20-40 mm.

4. The nasointestinal tube and guide wire combination for human jejunal nutrition of claim 1, wherein: the catheter is of a double-cavity or three-cavity structure and comprises a main cavity and an auxiliary cavity, the balloon is communicated with the cavity of one auxiliary cavity, and water or air can be injected into the balloon in a directional mode through the multifunctional joint.

5. The combination nasointestinal tube and guide wire for human jejunal nutrition of claim 1, wherein: the guide wire is made of stainless steel or nickel-titanium alloy and is formed by weaving single strands or multiple strands; the soft head part is a spring guide wire or a TPU coating layer; the outer diameter of the guide wire is 0.8-1.5 mm, and the length of the guide wire is more than or equal to 120% of the length of the catheter.

6. The combination nasointestinal tube and guide wire for human jejunal nutrition of claim 1, wherein: the outer walls of the catheter and the guide wire are coated with hydrophilic coatings.

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