CN115581838B - Tracheal unilateral bronchial catheter - Google Patents
Tracheal unilateral bronchial catheter Download PDFInfo
- Publication number
- CN115581838B CN115581838B CN202211413908.6A CN202211413908A CN115581838B CN 115581838 B CN115581838 B CN 115581838B CN 202211413908 A CN202211413908 A CN 202211413908A CN 115581838 B CN115581838 B CN 115581838B
- Authority
- CN
- China
- Prior art keywords
- catheter
- tracheal
- bronchial
- bronchial catheter
- opening
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active
Links
- 210000004072 lung Anatomy 0.000 claims abstract description 95
- 238000002627 tracheal intubation Methods 0.000 claims abstract description 26
- 210000000621 bronchi Anatomy 0.000 claims description 123
- 210000003437 trachea Anatomy 0.000 claims description 42
- 230000002685 pulmonary effect Effects 0.000 claims description 12
- 230000029058 respiratory gaseous exchange Effects 0.000 claims description 8
- 238000007689 inspection Methods 0.000 claims description 5
- 230000002093 peripheral effect Effects 0.000 claims description 5
- 230000000149 penetrating effect Effects 0.000 claims description 2
- 238000009423 ventilation Methods 0.000 abstract description 73
- 230000009286 beneficial effect Effects 0.000 abstract description 10
- 238000002955 isolation Methods 0.000 abstract description 4
- 230000003902 lesion Effects 0.000 abstract description 3
- 239000007789 gas Substances 0.000 description 17
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 9
- 239000001301 oxygen Substances 0.000 description 9
- 229910052760 oxygen Inorganic materials 0.000 description 9
- 230000000903 blocking effect Effects 0.000 description 6
- 206010011409 Cross infection Diseases 0.000 description 5
- 206010029803 Nosocomial infection Diseases 0.000 description 5
- 238000009792 diffusion process Methods 0.000 description 4
- 238000003780 insertion Methods 0.000 description 4
- 230000037431 insertion Effects 0.000 description 4
- 230000028327 secretion Effects 0.000 description 4
- 238000013276 bronchoscopy Methods 0.000 description 3
- 210000004704 glottis Anatomy 0.000 description 3
- 210000000214 mouth Anatomy 0.000 description 3
- 241001631457 Cannula Species 0.000 description 2
- 206010021143 Hypoxia Diseases 0.000 description 2
- 208000007123 Pulmonary Atelectasis Diseases 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 239000008280 blood Substances 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 201000010099 disease Diseases 0.000 description 2
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 2
- 238000006073 displacement reaction Methods 0.000 description 2
- 230000009977 dual effect Effects 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 238000000605 extraction Methods 0.000 description 2
- 239000012530 fluid Substances 0.000 description 2
- 230000007954 hypoxia Effects 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- 210000003928 nasal cavity Anatomy 0.000 description 2
- 244000052769 pathogen Species 0.000 description 2
- 230000001717 pathogenic effect Effects 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 208000032376 Lung infection Diseases 0.000 description 1
- 206010036790 Productive cough Diseases 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 238000002555 auscultation Methods 0.000 description 1
- 238000005452 bending Methods 0.000 description 1
- 238000004891 communication Methods 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 210000002409 epiglottis Anatomy 0.000 description 1
- 230000002349 favourable effect Effects 0.000 description 1
- 239000000835 fiber Substances 0.000 description 1
- 210000003128 head Anatomy 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 230000036445 liquid secretion Effects 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 229920002529 medical grade silicone Polymers 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 229920000642 polymer Polymers 0.000 description 1
- 230000001681 protective effect Effects 0.000 description 1
- 238000007789 sealing Methods 0.000 description 1
- 210000003802 sputum Anatomy 0.000 description 1
- 208000024794 sputum Diseases 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
- 230000032334 trachea development Effects 0.000 description 1
- 210000004916 vomit Anatomy 0.000 description 1
- 230000008673 vomiting Effects 0.000 description 1
Classifications
-
- 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
- A61M16/0486—Multi-lumen tracheal tubes
-
- 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
-
- 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
- A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes
- A61M16/0497—Tube stabilizer
-
- 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
- A61M2205/32—General characteristics of the apparatus with radio-opaque indicia
Landscapes
- Health & Medical Sciences (AREA)
- Pulmonology (AREA)
- Emergency Medicine (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Hematology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Otolaryngology (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
The embodiment of the application provides a single-sided tracheal catheter, which comprises a tracheal catheter, a bronchial catheter, a central cavity and a bronchial cuff assembly. According to the application, two catheters are designed aiming at different requirements of single-lung ventilation on the left side and the right side, and the diameter of an intubation tube is reduced by adopting a single-cavity tube, so that the catheter is more beneficial to the use of the catheter by the young children. The application is suitable for the operation that the single lung has lesions and needs lung isolation or only one side of single lung ventilation is needed in the operation, and can meet the use requirements of low-age children to adults according to the age and height of patients. Has advantages for the young children compared with the prior art; for adults, the application can reduce damage to patients relative to thicker double-lumen tracheal intubation.
Description
Technical Field
The application relates to the field of medical equipment, in particular to an endotracheal intubation catheter capable of ventilating double lungs and ventilating appointed side lungs and single lungs.
Background
The double-cavity bronchus intubation aims to isolate and ventilate the air passages of the healthy lung and the sick side lung, and can also prevent sputum or blood of the sick side lung from flowing to the healthy lung, thereby achieving good lung isolation effect and achieving the aims of preventing cross infection and preventing germ diffusion; can also prevent lung inflation at the operation side, and is favorable for smooth operation.
The application requirement of single-lung ventilation for children in heart chest surgery is increasing, mature double-cavity bronchial cannulas are available in adults, and due to limitation of the size of the trachea, the application of the double-cavity bronchial cannulas in children is limited, and particularly for low-age children, single-lung ventilation is very challenging.
As shown in FIG. 2, for the conventional double-lumen bronchial intubation, the ventilation branch tube and the bronchial intubation are respectively communicated with two ends of the same lumen of the double-lumen tube, the ventilation main tube is communicated with the other lumen of the ventilation branch tube, the main tracheal tube sleeve bag is arranged on the double-lumen tube, the bronchial intubation is provided with the bronchial tube sleeve bag, in order to ensure that the two lumens of the double-lumen tube can ventilate, the inner diameter of the lumen cannot be too small, thus limiting the diameter of the double-lumen tube not to be too small, when the double-lumen bronchial intubation is used for a child of low age, the conventional double-lumen bronchial intubation can cause certain damage to the trachea of the child of low age due to the thinner trachea of the child of low age, and therefore, the minimum double-lumen bronchial intubation which is practically applied nowadays can only be used for children of above 8 years.
Disclosure of Invention
The embodiment of the application provides a single-sided bronchial catheter for a trachea, which adopts a single-cavity tube to reduce the diameter of an intubation, can realize double-lung ventilation and appointed-side single-lung ventilation, and is more beneficial to the use of low-age children compared with the conventional double-cavity tracheal intubation although the function of the single-sided bronchial catheter is sacrificed. Compared with other single-lung ventilation modes (such as bronchus blocking and the like) which can be realized in children, the application can be well fixed, is difficult to shift, and can be randomly switched between double-lung ventilation and appointed side single-lung ventilation. The application is suitable for the operation (such as a side thoracoscope operation and the like) that the single lung (left lung or right lung) has lesions and needs to be isolated from the lung or only one side of ventilation is needed to be implemented in the operation, thereby meeting the use requirement of the low-age children and reducing the damage to the children. The application also has adult model, can realize single-lung ventilation for the adult with narrow trachea, and can reduce the damage caused by double-cavity bronchial intubation for normal adult.
The embodiment of the application provides a single-sided tracheal catheter, which comprises a tracheal catheter and a bronchial catheter, wherein the tracheal catheter and the bronchial catheter are integrally formed to form an outer catheter, the tracheal catheter is communicated with the bronchial catheter, the tracheal catheter and the bronchial catheter are plastically fixed to form a certain included angle through an intubation guide wire, the end part of the bronchial catheter is provided with a bronchial catheter opening, the joint of the tracheal catheter and the bronchial catheter is provided with a side opening, the side opening is positioned on the opposite side of the bronchial catheter, facing towards the opening side, of the side opening, and the opening direction of the side opening faces away from the opening side of the bronchial catheter.
In a possible implementation manner, the tracheal unilateral bronchial catheter further comprises a central cavity, wherein the central cavity is arranged in the outer catheter, one end of the central cavity penetrates out of the tracheal catheter from a third position on the side wall of the tracheal catheter and is connected with a joint with a cap of the central cavity, and the other end of the central cavity extends to the opening of the bronchial catheter and is provided with a central cavity opening;
the outer wall of the central cavity is connected with the inner wall of the tracheal catheter or the bronchial catheter, and the central cavity is opposite to the side opening.
In one possible implementation, the tracheal unilateral bronchial catheter further comprises a bronchial cuff assembly comprising a bronchial cuff and a bronchial cuff inflation lumen;
the bronchial catheter sleeve bag is arranged on the bronchial catheter and comprises an inner air bag and an outer air bag, the inner air bag is arranged on the inner wall of the bronchial catheter, and the outer air bag is arranged on the peripheral surface of the outer wall of the bronchial catheter;
the bronchial catheter is characterized in that the bronchial catheter sleeve bag inflation cavity is arranged in the tracheal catheter and the bronchial catheter, one end of the bronchial catheter sleeve bag inflation cavity is communicated with the inner air bag and the outer air bag, and the other end of the bronchial catheter sleeve bag inflation cavity penetrates out of the tracheal catheter from a first position on the side wall of the tracheal catheter.
In one possible implementation, the bronchial cuff assembly further comprises a connecting sheet, the connecting sheet is fixedly arranged on the inner wall of the bronchial catheter, the connecting sheet is opposite to the side opening, the central cavity penetrates through the connecting sheet, and the inner air bag is fixedly arranged on the connecting sheet.
In one possible implementation, the tracheal unilateral bronchial catheter further comprises an X-ray opaque identification band comprising a first X-ray opaque identification band and a second X-ray opaque identification band;
The first X-ray impermeable identification belt is arranged on the inner wall of the outer catheter, the first X-ray impermeable identification belt is positioned on the opposite side of the side opening, one end of the first X-ray impermeable identification belt is positioned at the end part of the tracheal catheter and is terminated, and the other end of the first X-ray impermeable identification belt is positioned at the opening part of the bronchial catheter and is terminated;
the second X-ray impermeable identification band is arranged on the inner wall of the outer catheter, the second X-ray impermeable identification band is positioned on the opposite side of the first X-ray impermeable identification band, one end of the second X-ray impermeable identification band is positioned at the end part of the tracheal catheter to be terminated, and the other end of the second X-ray impermeable identification band is positioned at the upper edge part of the side opening to be terminated.
In one possible implementation, the tracheal unilateral bronchial catheter is divided into a tracheal left bronchial catheter and a tracheal right bronchial catheter, and the left and right bronchial catheters are different:
the outer balloon of the bronchus tube sleeve bag is nearly spherical or ellipsoidal in the bronchus at the left side of the trachea, and the symmetrical long axis of the outer balloon is perpendicular to the central axis of the bronchus catheter; the outer air bag is shaped in the bronchus at the right side of the trachea, and the included angle between the symmetrical long axis of the outer air bag and the central axis of the bronchus catheter is smaller than 90 degrees;
The included angle between the bronchial catheter and the tracheal catheter is 130 degrees at the left side of the trachea and 150 degrees at the right side of the trachea, and the included angle is plastically fixed by the intubation guide wire and can be adjusted;
the bronchial catheter has only a distal bronchial catheter opening on the left side of the trachea, and has an upper right lung lobe bronchial opening on the opposite side of the side opening except the distal bronchial catheter opening on the right side of the trachea;
the central cavity is a tiny cavity penetrating through the side wall of the tracheal catheter and the side wall of the bronchial catheter, and an opening is arranged at a far-end opening; on the right side of the tracheal catheter, the upper lobe bronchial opening of the right lung is arranged, the central cavity is arranged at the corresponding position of the central cavity to surround the upper lobe bronchial opening of the right lung, and a plurality of upper lobe openings of the central cavity corresponding to the upper lobe bronchial opening of the right lung are arranged in the surrounding area;
the first X-ray impermeable identification bands are different, in the left tracheal bronchial catheter, the first X-ray impermeable identification bands are bands which move along with the central cavity, and in the right tracheal bronchial catheter, due to the fact that the upper right pulmonary lobe bronchus openings are arranged, the central cavity moves around at the corresponding positions, and the first X-ray impermeable identification bands move semi-around the upper right pulmonary lobe bronchus openings.
In one possible implementation, the tracheal unilateral bronchial catheter further comprises an intubation connector, wherein the intubation connector is detachable and arranged at the end part of the tracheal catheter;
the intubation joint is provided with an endotracheal tube interface, a breathing machine interface and an inspection inlet, and the endotracheal tube interface is connected with the endotracheal tube;
after the cannula fitting is removed, the endotracheal tube may be directly connected to an external ventilator.
In one possible implementation, the tracheal unilateral bronchial catheter further comprises a central lumen connection assembly comprising a central lumen aspirator joint and a central lumen ventilator joint;
the conical end of the central cavity aspirator joint is inserted into the central cavity capped joint;
the small hole end of the central cavity breathing machine connector is inserted into the central cavity connector with the cap.
In one possible implementation, the tracheal unilateral bronchial catheter further comprises a tracheal cuff assembly, the tracheal cuff assembly comprises a tracheal cuff and a tracheal cuff inflation cavity, the tracheal cuff is arranged on the peripheral surface of the outer wall of the tracheal catheter, the tracheal cuff inflation cavity is positioned in the tracheal catheter, one end of the tracheal cuff inflation cavity is communicated with the tracheal cuff, and the other end of the tracheal cuff inflation cavity penetrates out of the tracheal catheter from the second position of the lateral wall of the tracheal catheter.
In one possible implementation manner, the tracheal unilateral bronchial catheter is further provided with two depth marks, wherein the two depth marks are arranged on the outer wall of the outer catheter and are symmetrically arranged left and right, and the depth marks start from two X-ray impermeable marks, namely, start from the opening of the bronchial catheter and the upper edge of the side opening respectively, and end at the joint of the tracheal catheter.
The embodiment of the application provides a single-sided bronchial catheter for a trachea, which is formed by integrally forming an tracheal catheter and a bronchial catheter, wherein a central cavity is arranged in the wall of the outer catheter, and the bronchial catheter and the central cavity are partially inserted into a main bronchus at one side (left side or right side) of a patient; a side opening is arranged at the joint of the tracheal catheter and the bronchial catheter, a bronchial catheter opening is arranged on the bronchial catheter, a central cavity opening is arranged on the central cavity, and a bronchial catheter sleeve bag (comprising an inner air bag and an outer air bag) is arranged on the bronchial catheter;
the cannula procedure is described briefly: first, it is necessary to examine the airway tissues of the oral cavity, nasal cavity, etc. of a patient to eliminate the case where secretions or vomit remain inside. Secondly, keep the patient's head to lean backwards, and make the oral cavity, the throat and the trachea on the same axis. Medical staff holds the endoscopic laryngoscope by one hand, inserts slowly along the bending degree of the back of the tongue until the root part of the tongue gently lifts the epiglottis of the patient, and after the glottis is exposed, the special catheter is introduced from the oral cavity or the nasal cavity of the patient, and the tip of the catheter passes through the front of the glottis and the tip (the bronchus end) is upwards. After the tip of the catheter has passed the glottis, the catheter is rotated 90 ° after the cannula guide post is withdrawn, pointing the tip of the catheter towards the side bronchi to be inserted (if a left-sided bronchial catheter for the trachea is selected, the tip is rotated 90 ° to the left or counter-clockwise). Then gradually delivering the airway tube into the breathing machine, and correspondingly adjusting the breathing machine. Auscultation, fiberoptic bronchoscopy or X-ray examination, etc. are required to ensure that the catheter is in the correct position after the cannula is completed. And a proper amount of gas is injected into the tracheal tube sleeve bag, so that the gas leakage during ventilation of the respirator is prevented.
When the bronchus tube sleeve bag is deflated and is ventilated through the tracheal catheter, gas can enter the main bronchi at two sides of the patient through the side opening and the opening of the bronchus catheter, so that double-lung ventilation is realized;
when the bronchus tube sleeve bag is inflated, single-lung ventilation can be implemented, at the moment, the inner air bag and the outer air bag of the bronchus tube sleeve bag are inflated, the inner air bag is inflated to enable the inside of the bronchus tube to be sealed, gas cannot be introduced into the side main bronchus where the bronchus tube is located from the inside of the tube, the outer air bag is inflated to enable the bronchus tube to be sealed with the side main bronchus of a patient, and gas cannot be introduced into the side main bronchus where the bronchus tube is located from the outside of the tube, so that the side lung of the patient is isolated, liquid secretion or blood of the side lung can be prevented from flowing into the opposite side lung, and cross infection and germ diffusion are prevented; at this time, if ventilation is performed through the tracheal catheter, the gas only enters the main bronchus of the healthy side lung of the patient through the side opening, so that single-lung ventilation of the appointed side is realized;
when the single lung is ventilated, if the central cavity is opened, the lung can be deflated, the collapse of the lung on the disease side is facilitated, and the surgical field of vision is better. Meanwhile, the central cavity can also be connected with an aspirator to accelerate the collapse of the lung at the side of the disease, and can also supply oxygen to provide certain oxygen supply support or realize continuous positive airway pressure if necessary.
Compared with the conventional double-cavity bronchial catheter, the double-cavity bronchial catheter is functionally sacrificed, is more beneficial to the use of the double-cavity bronchial catheter by the young children, can be well fixed and difficult to shift (other children's single-lung ventilation such as bronchus blocking and easy to shift) and can be randomly switched between double-lung ventilation and appointed side single-lung ventilation, and the double-cavity bronchial catheter is suitable for the operation (such as a side thoracoscopy operation and the like) in which the single-lung (left lung or right lung) has lesions and needs lung isolation or only one side single-lung ventilation is needed in the operation.
Drawings
FIG. 1 is a schematic diagram of the structure of the trachea and bronchi of a human body;
FIG. 2 is a schematic view of a conventional left side double lumen bronchial catheter;
FIG. 3 is a schematic view of the left bronchial catheter of the tracheal tube according to the present application;
FIG. 4 is a cross-sectional view taken along the plane N1-N1 in FIG. 3;
FIG. 5 is a table showing the partial structural dimensions of the left bronchial catheter of the present application;
FIG. 6 is a front cross-sectional view of a left tracheal tube provided by the present application;
FIG. 7 is an enlarged view of region K1 of FIG. 6;
FIG. 8 is a schematic view of the structure of the central lumen connection assembly of the tracheal unilateral bronchial catheter provided by the application;
FIG. 9 is a schematic view showing the state of the inner and outer balloons of the left bronchus tube for inflating and blocking the left main bronchus;
FIG. 10 is a schematic illustration of the inner and outer balloons of the left tracheal tube of the present application, deflated and the left main bronchus breathable;
FIG. 11 is a schematic view of the structure of the right bronchial catheter of the present application;
FIG. 12 is a cross-sectional view taken along the plane N2-N2 in FIG. 11;
FIG. 13 is a table showing a partial structural dimension of the right bronchial catheter of the present application;
FIG. 14 is an enlarged schematic view of a part of the bronchial catheter and the central lumen structure of the right bronchial catheter for use in the present application;
FIG. 15 is a front cross-sectional view of a right-side endotracheal tube provided by the present application;
FIG. 16 is an enlarged view of region K2 of FIG. 15;
FIG. 17 is a schematic view of the right main bronchus blocked by inflation of the inner and outer balloons of the right bronchus catheter;
fig. 18 is a schematic view showing a state in which the inner and outer balloons of the tracheal right side bronchial catheter according to the present application are deflated and the right main bronchus is ventilated.
Reference numerals illustrate:
100-tracheal tube; 200-bronchial catheter; 300-central lumen; 400-bronchial cuff assembly; 500-a tracheal tube cuff assembly; 600-an X-ray opaque identification band; 700-cannula fitting; 800-a central lumen connection assembly;
210-bronchial catheter opening; 220-side opening; 230-upper right lung leaf bronchial opening (only tracheal right side bronchial catheter); 310-central lumen opening; 320-cap joint of central cavity; 330-central lumen upper lobe opening (tracheal right side bronchial catheter only); 410-bronchial cuffs; 420-bronchial cuff inflation lumen; 430-connecting pieces; 440-bronchial cuff pressure indicating balloon; 450-bronchial catheter sac check valve; 510-tracheal cuff; 520-balloon catheter balloon inflation lumen; 530-tracheal cuff pressure indication balloon; 540-tracheal tube sac check valve; 610-a first X-ray opaque identification band; 620-a second X-ray opaque identification band; 710-tracheal tube interface; 720-ventilator interface; 730-checking for an entry; 810-a central lumen aspirator joint; 820-central lumen ventilator joint;
411-inner balloon; 412-an outer balloon; 431—connection face.
Detailed Description
In order to make the technical solution of the present application better understood by those skilled in the art, the technical solution of the present application will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present application, and it is apparent that the described embodiments are only some embodiments of the present application, not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the present application without making any inventive effort, shall fall within the scope of the present application.
Fig. 1 is a schematic diagram of the structure of the trachea and bronchi of a human body. Referring to fig. 1, in which: a is the main bronchus, B is the right main bronchus, C is the upper lobe bronchus of the right lung, D is the upper lobe bronchus of the left lung, E is the upper lobe bronchus of the left lung, and the following structural differences exist between the right main bronchus B and the left main bronchus D of the human body as seen in FIG. 1:
1. the included angle alpha 1 between the right main bronchus B and the main bronchus A is larger than the included angle alpha 2 between the left main bronchus D and the main bronchus A;
2. the length L1 of the right main bronchus B is much smaller than the length L2 of the left main bronchus D.
Fig. 2 is a schematic view of a conventional left side double lumen bronchial cannula. Referring to fig. 2, F is a double-lumen tube, G is a right lung ventilation tube, H is a left lung ventilation tube, I is a bronchus cannula, J is a main bronchus cuff, K is a bronchus cuff, the right lung ventilation tube G and the left lung ventilation tube H are arranged in parallel in the double-lumen tube F, the main bronchus cuff J is arranged on the double-lumen tube F, and the bronchus cuff K is arranged on the bronchus cannula I; in order to ensure that the two cavities of the double-cavity tube F can be ventilated, the inner diameter of the cavity cannot be too small, so that the diameter of the double-cavity tube F cannot be limited to be too small, when the double-cavity tube F is used for a low-age child, the conventional double-cavity bronchial tube can cause certain damage to the trachea of the low-age child because the trachea of the low-age child is thinner, and the conventional double-cavity bronchial tube can only be used for a child 8 years old at the minimum.
Embodiment one: left bronchus conduit of trachea
The application provides a single-sided bronchial catheter of a trachea, which is beneficial to the use of low-age children and is matched with a main tracheal structure on the left side of a human body, namely a left-sided bronchial catheter of a trachea.
Referring to fig. 3 to 10, the left bronchial catheter for the trachea provided by the embodiment of the application comprises an endotracheal tube 100 and a bronchial tube 200, and the endotracheal tube 100 and the bronchial tube 200 are integrally formed to form an outer catheter.
The tracheal catheter 100 is a medical straight hose, as shown in fig. 5, the model of the tracheal catheter 100 can be ID 3.0-8.0, when the tracheal catheter 100 is used for treating adults with finer trachea or low-age children, a small-diameter hose can be selected according to the thickness of the trachea, for example, a 1-year-old child with normal trachea development can use the tracheal catheter with the model ID 4.0; when used for adult treatment, a slightly larger diameter hose, such as an endotracheal tube of model ID 7.0-8.0, can be selected, with an endotracheal tube ID 7.0-8.0 meeting almost all adult use.
The bronchial catheter 200 is a medical reducing hose, the tracheal catheter 100 and the bronchial catheter 200 are integrally formed to form an outer catheter, the bronchial catheter 200 is provided with a large-diameter end and a small-diameter end, the large-diameter end of the bronchial catheter 200 is equal to the tracheal catheter 100 in size, the large-diameter end of the bronchial catheter 200 is communicated with the end of the tracheal catheter 100, the small-diameter end of the bronchial catheter 200 is provided with a bronchial catheter opening 210, an intubated guide wire is arranged in the outer catheter, the tracheal catheter 100 and the bronchial catheter 200 are plastically fixed through the intubated guide wire to form a certain included angle, the included angle can be 130 degrees, for example, when the device is specifically arranged, the included angle between the bronchial catheter 200 and the tracheal catheter 100 can be properly set to be 137 degrees, 140 degrees or 145 degrees according to the situation, and the like, and the specific included angle can be adjusted according to the X-ray film of the lung of a patient, so that the included angle alpha 2 is matched with the left main bronchus D and the main bronchus A of the patient, a side opening 220 is arranged at the joint of the tracheal catheter 100 and the bronchial catheter 200, and the opening 220 is oriented towards the side far away from the side of the bronchial catheter opening 210.
As shown in fig. 5 and 7, L3 in fig. 7 represents the length of the left side bronchial catheter 200, T1 in the drawing represents the long diameter of the side opening 220, and the length of the left side bronchial catheter 200 and the long diameter of the side opening 220 are both matched with the model of the tracheal catheter 100, for example, the model of the tracheal catheter 100 is ID5.0, the length of the left side bronchial catheter 200 is preferably 27mm, and the long diameter of the side opening 220 is preferably 7mm.
Compared with the conventional double-cavity bronchial catheter, the tracheal left-side bronchial catheter provided by the application has the advantages that the diameter of the catheter is reduced by adopting the single-cavity catheter, and the catheter is more beneficial to the use of the low-age children although the function is sacrificed, so that the damage to the trachea and the bronchus of the child patient can be effectively reduced during the catheterization;
meanwhile, when the large-diameter tracheal catheter is adopted, the double-cavity bronchial catheter is thinner than a normal double-cavity bronchial catheter used by an adult, and is also applicable to the situation that the adult with the narrow trachea cannot pass through the conventional double-cavity bronchial catheter, so that the damage of the conventional double-cavity bronchial catheter to a patient due to the large-diameter tracheal catheter can be reduced.
The included angle between the bronchial catheter 200 and the tracheal catheter 100 is adjusted by intubation guide wires, and the included angle is adjusted to be about 130 degrees, for example, a proper angle of 137 degrees, 140 degrees or 145 degrees, so as to be matched with the included angle alpha 2 between the left main bronchus D and the main bronchus A of a patient, thereby facilitating the insertion of the left bronchus of the trachea.
Referring to fig. 6 and 7, in some embodiments, the left tracheal catheter further includes a central lumen 300, the central lumen 300 is a medical fine hard tube, the central lumen 300 is disposed in the tracheal catheter 100 and the bronchial catheter 200, the central lumen 300 is fixed on the inner wall of the bronchial catheter 200, one end of the central lumen 300 passes through the tracheal catheter 100 from the third position c of the sidewall of the tracheal catheter 100, a certain margin is provided after the central lumen 300 passes through the tracheal catheter 100, and is connected with the cap joint 320 of the central lumen, and the other end of the central lumen 300 extends to the opening 210 of the bronchial catheter and is provided with the central lumen opening 310.
With continued reference to fig. 6 and 7, in some embodiments, the left tracheal bronchial catheter further comprises a bronchial cuff assembly 400, the bronchial cuff assembly 400 comprising a bronchial cuff 410 and a bronchial cuff inflation lumen 420, the bronchial cuff 410 being disposed on the bronchial catheter 200, the bronchial cuff 410 comprising an inner balloon 411 and an outer balloon 412;
the inner balloon 411 is arranged on the inner wall of the bronchial catheter 200, and when the inner balloon 411 is inflated, the outer wall of the inner balloon 411 is attached to the inner wall of the bronchial catheter 200, so that the bronchial catheter 200 is closed, and gas is prevented from entering the left lung from the inside of the catheter during ventilation (right single lung ventilation is realized); conversely, when the inner balloon 411 is deflated, the outer wall of the inner balloon 411 is separated from the inner wall of the bronchial catheter 200, thereby allowing the bronchial catheter 200 to be unobstructed and allowing the gas to enter the left lung (realizing double-lung ventilation) from inside the bronchial catheter 200;
The outer air bag 412 is arranged on the peripheral surface of the outer wall of the bronchial catheter 200, when the outer air bag 412 is inflated, the outer wall of the outer air bag 412 is attached to the inner wall of the left main bronchus of a patient, so that the bronchial catheter 200 is sealed with the left main bronchus of the patient, the bronchial catheter 200 is stably fixed, displacement is avoided, and gas is prevented from entering the left lung from the outside of the catheter during ventilation (right single-lung ventilation is realized); conversely, when outer balloon 412 is deflated, outer balloon 412 is separated from the inner wall of the patient's left main bronchus, thereby facilitating insertion or withdrawal of bronchial catheter 200 from the patient's left main bronchus;
the bronchial cuff inflation lumen 420 is disposed within the endotracheal tube 100 and the bronchial tube 200, and an outer wall of the bronchial cuff inflation lumen 420 is fixedly connected to an inner wall of the endotracheal tube 100 and the bronchial tube 200. One end of the bronchial cuff inflation lumen 420 is in communication with the inner balloon 411 and the outer balloon 412, and the bronchial cuff inflation lumen 420 inflates or deflates the inner balloon 411 and the outer balloon 412, i.e., the inner balloon 411 and the outer balloon 412 are inflated or deflated simultaneously. The other end of the bronchial cuff inflation lumen 420 passes through the air outlet pipe catheter 100 from the first position a of the side wall of the air pipe catheter 100, and a certain allowance is reserved after the bronchial cuff inflation lumen 420 passes through the air outlet pipe catheter 100.
By providing a side opening 220 at the junction of endotracheal tube 100 and bronchial tube 200, providing a bronchial tube opening 210 on bronchial tube 200, providing a central lumen opening 310 on central lumen 300, and providing a bronchial cuff 410 on bronchial tube 200;
after the left tracheal intubation of the present application is inserted (description of the procedure is given above), the left tracheal catheter is fixed after the tracheal cuff 510 is inflated and positioned (recommended) by a fiber bronchoscopy or auscultatory positioning. When the bronchial cuff 410 is deflated, gas may enter the patient's right main bronchi through the side opening and enter the patient's left main bronchi through the bronchial catheter 200 when ventilating through the tracheal catheter 100, i.e., double lung ventilation (as shown in fig. 10);
as shown in fig. 7 and 9, when the bronchial cuff 410 is inflated, that is, the inner balloon 411 and the outer balloon 412 are inflated, the inner balloon 411 is inflated to seal the inside of the bronchial catheter 200, and the outer balloon 412 is inflated to seal between the outside of the bronchial catheter 200 and the left main bronchus of the patient, thereby realizing right single lung ventilation, the operation can also realize the isolation of the left lung (sick side lung) of the patient, prevent the secretion of liquid from flowing into the healthy lung, and prevent cross infection and germ diffusion; at this time, if ventilation is performed through the tracheal catheter, the input gas through the application only enters the right main bronchus of the patient through the side opening, so that single-lung ventilation (right lung ventilation) is realized;
As shown in fig. 7 and 9, when the right lung is ventilated with a single lung, the open central cavity 300 can deflate the left lung (non-ventilated side lung), which is more beneficial to left lung collapse and has a better surgical field of view. At the same time, the central lumen may also be connected to an aspirator to accelerate left lung collapse, and if desired, the central lumen 300 may also provide oxygen delivery, provide some oxygen delivery support, or achieve continuous positive airway pressure, thereby reducing the incidence of hypoxia.
As shown in FIG. 7, when the bronchial cuff 410 is inflated, the outer wall of the inner balloon 411 is attached to the inner wall of the bronchial catheter 200, and the outer wall of the outer balloon 412 is attached to the inner wall of the left main bronchus of the patient, thereby stably fixing the bronchial catheter 200 and preventing displacement. Conversely, when the bronchial cuff 410 is deflated, the outer cuff 412 is separated from the inner wall of the patient's left main bronchus, thereby facilitating insertion or withdrawal of the bronchial catheter 200 into or out of the patient's left main bronchus.
Compared with the conventional double-cavity bronchial catheter, the double-cavity bronchial catheter has the advantages that the function is sacrificed, the single-lung ventilation and the double-lung ventilation at any side can not be switched, and only the single-lung ventilation and the double-lung ventilation at the appointed side (right side) can be switched. However, the application is more beneficial for use by young children. Compared with other single-lung ventilation which can be realized in children, the application can be well fixed and is difficult to shift (other single-lung ventilation of children such as bronchus blocking and easy to shift).
Referring to fig. 3 and 4, in other examples, the outer balloon is ellipsoidal or approximately spherical, and the axis of symmetry of the outer balloon is perpendicular to the central axis of the bronchial catheter, i.e., the axis of symmetry of the outer balloon forms an angle of 90 ° with the central axis of the bronchial catheter, and the conventional nearly spherical balloon can be fixed within the left main bronchus D because of the length of the left main bronchus D.
Referring to fig. 4 and 7, in other examples, bronchial cuff assembly 400 may further include a connecting piece 430, connecting piece 430 may be a medical silicone sheet, may be curved to some extent, one side of connecting piece 430 may be a curved surface matching the inner wall of bronchial catheter 200, the other side may be a square plane, connecting piece 430 may be disposed on the inner wall of bronchial catheter 200, connecting piece 430 may be opposite to side opening 220, connecting piece 430 may be disposed between side opening 220 and bronchial catheter opening 210, and central lumen 300 may extend through connecting piece 430;
the bronchial cuff 410 is arranged at the position of the bronchial catheter 200, where the connecting sheet 430 is arranged, the inner balloon 411 can be an ellipsoidal balloon, the inner balloon 411 is arranged on the square plane of the connecting sheet 430, the end part of the open end of the inner balloon 411 is fixedly connected with the end part of the square plane of the connecting sheet 430, when the inner balloon 411 is inflated towards the side far away from the connecting sheet 430, the outer wall of the inner balloon 411 is attached to the inner wall of the bronchial catheter 200, so that the bronchial catheter 200 is closed; conversely, when the inner balloon 411 is deflated, the outer wall of the inner balloon 411 is separated from the inner wall of the bronchial catheter 200, thereby leaving the bronchial catheter 200 clear.
The connecting surface 431 is arranged on the outer wall of the connecting sheet 430 towards the central axis side of the bronchial catheter 200, the connecting surface 431 can be a plane or a curved surface, preferably a plane, the end part of the connecting surface 431 of the connecting sheet 430 in the width direction is connected with the inner wall of the bronchial catheter 200, the inner balloon 411 is arranged on the connecting surface 431 of the connecting sheet 430, the end part of the open end of the inner balloon 411 is connected with the end part of the connecting surface 431 of the connecting sheet 430, and therefore all gaps between the bronchial catheter 200 and the connecting sheet 430 can be filled after the inner balloon 411 is inflated, no dead angle exists, and the sealing performance of the bronchial catheter 200 is guaranteed.
Referring to fig. 3, in other examples, the outer wall of the outer catheter is provided with depth markers, two depth markers are symmetrically arranged on the outer wall of the outer catheter, the two depth markers respectively start from two X-ray impermeable markers, namely, respectively start from the bronchial catheter opening 210 and the upper edge of the side opening 220, and end at the tracheal catheter interface 710, and the depth markers can indicate the depth of the intubation (namely, the depth of the two openings of the tracheal bronchial catheter) so as to facilitate positioning, fixing and reference for later position adjustment.
Referring to fig. 6, in still other examples, the left tracheal catheter may further comprise a tracheal cuff assembly 500, the tracheal cuff assembly 500 comprising a tracheal cuff 510 and a tracheal cuff inflation lumen 520, the tracheal cuff 510 being disposed on the outer peripheral surface of the tracheal catheter 100, the tracheal cuff 510 being an annular balloon, when the tracheal cuff 510 is inflated, the outer wall of the tracheal cuff 510 being fitted to the inner wall of the patient's main trachea, thereby securing the tracheal catheter 100 and preventing leakage of gas fed through the catheter, ensuring effective ventilation; conversely, when the tracheal tube 510 is deflated, the tracheal tube 510 is separated from the inner wall of the main trachea of the patient, and then intubation, tube drawing or adjustment of the position of the tracheal bronchial catheter can be performed;
The tracheal catheter 100 is internally provided with a tracheal catheter balloon inflation cavity 520, one end of the tracheal catheter balloon inflation cavity 520 is communicated with the tracheal catheter balloon 510, the other end of the tracheal catheter balloon inflation cavity 520 penetrates through the tracheal catheter 100 from a second position b on the side wall of the tracheal catheter 100, and a certain allowance is reserved after the tracheal catheter balloon inflation cavity 520 penetrates through the tracheal catheter 100;
the tracheal catheter balloon assembly 500 may further include a tracheal catheter balloon pressure indicating balloon 530 and a tracheal catheter balloon check valve 540, the tracheal catheter balloon pressure indicating balloon 530 is a balloon capable of indicating air pressure, both ends of the tracheal catheter balloon pressure indicating balloon 530 are provided with air holes, one air hole of one end of the tracheal catheter balloon pressure indicating balloon 530 is communicated with the outer end of the tracheal catheter balloon inflating cavity 520, the air hole of the other end of the tracheal catheter balloon pressure indicating balloon 530 is communicated with the tracheal catheter balloon check valve 540, the tracheal catheter balloon check valve 540 is an inflatable and deflatable valve, when the syringe is connected to the check valve and is forcefully inserted inwards, the syringe can be inflated into the tracheal catheter balloon as required, and after the syringe is taken away, the air in the tracheal catheter balloon is stored in the balloon, so that the interior of the tracheal catheter balloon is kept full of air. Similarly, when the tracheal catheter cuff is required to be deflated, the syringe is connected to the check valve and is forced inwards to tightly contact with the air, so that the air in the tracheal catheter cuff can be pumped back, and after the syringe is taken away, the air in the tracheal catheter cuff is pumped out, so that the deflation state of the tracheal catheter cuff can be maintained.
The balloon catheter sheath 510 and the outer balloon 412 are both high-volume, low-pressure balloons.
With continued reference to fig. 6, in some other examples, the bronchial cuff assembly 400 further includes a bronchial cuff pressure indicating balloon 440 and a bronchial cuff check valve 450, the bronchial cuff pressure indicating balloon 440 is a balloon capable of indicating air pressure, both ends of the bronchial cuff pressure indicating balloon 440 are provided with air holes, one end air hole of the bronchial cuff pressure indicating balloon 440 is communicated with the outer end of the bronchial cuff inflation chamber 420, the other end air hole of the bronchial cuff pressure indicating balloon 440 is communicated with the bronchial cuff check valve 450, and when the bronchial cuff pressure indicating balloon 440 is inflated through the bronchial cuff check valve 450, the inner balloon 411 and the outer balloon 412 can be inflated synchronously, thereby guaranteeing the tightness of the bronchial cuff 410; when the air is discharged through the bronchial cuff check valve 450, the bronchial cuff 410 can be discharged, so that the inner balloon 411 and the outer balloon 412 are synchronously deflated under the self elastic force.
When the device is arranged, the distance between the first position a, the second position b and the third position c and the side opening 220 is gradually increased, and the first position a, the second position b and the third position c are all positioned on the inclined side of the tracheal catheter 100, which is close to the bronchial catheter 200, so that the insertion direction of the bronchial catheter 200 is convenient to observe, namely, for the left tracheal bronchial catheter, the first position a, the second position b and the third position c are all positioned on the left side of the tracheal catheter 100.
With continued reference to fig. 6, in other examples, the endotracheal unilateral bronchial catheter further includes an intubation adapter 700, the intubation adapter 700 having an endotracheal tube interface 710, a ventilator interface 720, and an inspection portal 730, the endotracheal tube interface 710 being fixedly connected or removably connected to the endotracheal tube 100, the ventilator interface 720 being for connection to an external ventilator, the inspection portal 730 being provided with a protective cap, the inspection portal 730 being for use in a fiberoptic bronchoscopy, suction, or the like. In use, the cannula connector 700 can facilitate the completion of the fiberbronchoscopy after the cannula connection is completed, and the accurate cannula position is determined; after complete fixation, the cannula fitting 700 may be removed, connecting the catheter directly to the ventilator, and removing the cannula fitting 700 may reduce the ventilation dead space for infants and very low weight infants.
Referring to fig. 6 and 7, in other examples, the left tracheal side bronchial catheter further comprises an X-ray impermeable identification band 600, the X-ray impermeable identification band 600 being a strip-shaped X-ray impermeable polymer, the X-ray impermeable identification band being disposed on the inner walls of the tracheal catheter 100 and the bronchial catheter 200, or embedded within the inner walls of the tracheal catheter 100 and the bronchial catheter 200, the X-ray impermeable identification band 600 comprising a first X-ray impermeable identification band 610 and a second X-ray impermeable identification band 620;
The first X-ray impermeable identification band 610 is disposed on the inner wall of the outer catheter, the first X-ray impermeable identification band 610 is located on the opposite side of the side opening 220, one end of the first X-ray impermeable identification band 610 is located at the end of the endotracheal tube 100, and the other end of the first X-ray impermeable identification band 610 is located at the bronchial catheter opening 210;
the second X-ray impermeable identification band 620 is disposed on the inner wall of the outer catheter, the second X-ray impermeable identification band 620 is disposed on the opposite side of the first X-ray impermeable identification band 610, one end of the second X-ray impermeable identification band 620 is disposed at the end of the tracheal catheter 100, the other end of the second X-ray impermeable identification band 620 is disposed at the upper edge of the lateral opening 220, and during treatment, the tracheal catheter 100, the bronchial catheter 200 and the lateral opening 220 can be visually seen to be disposed at specific positions in the patient body according to the first X-ray impermeable identification band 610 and the second X-ray impermeable identification band 620 by X-ray irradiation, and the positions of the tracheal and the bronchial tubes of the patient are combined, so that the accurate positioning or the position adjustment can be conveniently performed under X-rays.
Referring to fig. 8, in other examples, the tracheal unilateral bronchial catheter further comprises a central lumen connection assembly 800, the central lumen connection assembly 800 comprising a central lumen aspirator tip 810 and a central lumen ventilator tip 820, the tapered end of the central lumen aspirator tip 810 being plugged into the central lumen capped tip 320, the other end of the central lumen aspirator tip 810 being connected to an external aspirator, facilitating collapse of the non-ventilated side lung during ventilation of the single lung, thereby facilitating surgical procedures; the small hole end of the central cavity breathing machine connector 820 is inserted into the central cavity capped connector 320, and the other end of the central cavity breathing machine connector 820 is connected with an external breathing machine for supplying oxygen or providing simple continuous positive pressure oxygen supply, thereby reducing the occurrence of hypoxia during single lung ventilation.
Referring to fig. 9, the direction of the arrow indicates the direction of the flow of the air, at this time, the tracheal cuff 510 is inflated, the tracheal tube 100 is fixed in the main trachea of the patient, the bronchial cuff 410 is inflated, the bronchial tube 200 is closed, and the left main bronchus of the patient is closed;
when connected to an external ventilator via ventilator interface 720, gas will only enter the patient's right main bronchi through side opening 220, thereby achieving single lung ventilation (right lung ventilation), where the left lung (patient's side lung) may be ventilated, oxygenated, continuous positive airway pressure, etc. via central lumen 300. Inflation of the bronchial cuff 410 isolates the left lung from the patient's side, thereby preventing fluid secretions from flowing into the healthy right lung, preventing cross-infection and pathogen spread.
When ventilation is required, referring to fig. 10, the direction of the arrow in the figure indicates the direction of airflow, at this time, the tracheal cuff 510 is inflated, the outer wall of the tracheal cuff 510 is attached to the inner wall of the main trachea of the patient, so as to prevent air leakage, that is, prevent air from overflowing the airway, and the tracheal catheter 100 is fixed in the main trachea of the patient; the central cavity capped interface 320 is closed; the bronchocuff 410 is deflated, the bronchial catheter 200 is clear, and the left and right main bronchi of the patient are clear (i.e., double lung ventilation is achieved);
When connected to an external ventilator through ventilator interface 720, gas may enter the left and right main bronchi of the patient through side opening 220 and bronchial catheter opening 210, thereby achieving double lung ventilation.
The present application is functionally sacrificed relative to conventional dual lumen bronchial catheters. But is more beneficial for the use of the children of low ages. Compared with other single-lung ventilation which can be realized in children, the application can be well fixed and is difficult to shift (other single-lung ventilation of children such as bronchus blocking and easy to shift). The application can be switched between double lung ventilation and one-side (right side) single lung ventilation at will.
Embodiment two: tracheal right side bronchial catheter
The application also provides a single-sided bronchial catheter of the trachea, namely a right-sided bronchial catheter of the trachea, which is beneficial to the use of the child with low age and is used for realizing left single-lung ventilation.
Referring to fig. 8 and 11-18, the right and left tracheal tubes differ in that, in addition to the orientation of the bronchial tube 200 and the side opening 220, the following are:
1. the bronchial cuff 410 is positioned and shaped differently within the bronchial catheter 200.
The outer balloon 412 of the bronchial catheter on the left side of the trachea is ellipsoidal or nearly spherical with the symmetry axis intersecting the bronchial catheter 200 vertically (as shown in fig. 3, 6, 7); the outer balloon 412 of the right bronchial catheter is a shaped balloon with a shape similar to an ellipsoid, and the long axis of symmetry of the outer balloon forms an angle with the bronchial catheter 200 (as shown in fig. 11, 15, 16), and the angle between the long axis of symmetry of the outer balloon and the central axis of the bronchial catheter 200 is smaller than 90 °. The reason for this design is to take into account the differences in normal human anatomy: the length L1 of the right main bronchus B is much smaller than the length L2 of the left main bronchus D (see fig. 1). For the left main bronchus D, since it has a certain length, the conventional near-spherical balloon can be fixed in the left main bronchus D, while the right main bronchus B has a shorter length, if the conventional near-spherical balloon is still adopted, it is easy to block the upper right bronchus or displace, and it may enter the main bronchus a or block the upper right bronchus C, so the outer balloon 412 of the right bronchus catheter is a special-shaped balloon (as shown in fig. 11, 15 and 16).
2. The endotracheal tube 100 and the bronchial tube 200 form different angles.
As before, the left tracheal catheter has an included angle of 130 degrees between the tracheal catheter 100 and the bronchial catheter 200, and can be finely adjusted; referring to fig. 11, when the left single-lung ventilation is performed by using the right tracheal bronchial catheter, the included angle formed by the tracheal catheter 100 and the bronchial catheter 200 is adjusted by the catheterization guide wire, and the included angle is about 150 degrees, and can be finely adjusted, for example, the included angle can be adjusted to be 145 degrees, 155 degrees, 160 degrees or other suitable angles, and the specific included angle can be adjusted according to the X-ray film of the lung of the patient, so as to be approximately matched with the included angle alpha 1 of the right main bronchus B and the main bronchus a of the patient.
3. The bronchial end openings are different.
The left tracheal bronchial catheter has only one opening at the distal end of the bronchial catheter 200, i.e., bronchial catheter opening 210; the right tracheal bronchial catheter has a right upper pulmonary lobe bronchial opening 230 (see fig. 15 and 16) in the bronchial catheter 200, in addition to the distal bronchial catheter opening 210, on the opposite side of the side opening 220 from the outer balloon 412 and in close proximity to the outer balloon 412.
4. The central lumen 300 is structurally different.
The central cavity 300 is provided with an annular part corresponding to the position of the upper right lung lobe opening 230, the annular part is provided with a plurality of upper central cavity lobe openings 330, as shown in fig. 14, the upper central cavity lobe openings 330 with 6 upper central cavity lobe openings 330,6 are uniformly distributed in an annular shape, other numbers of upper central cavity lobe openings 330 can be arranged according to actual needs or different models, at least partial areas of the upper central cavity lobe openings 330 are positioned in the upper right lung lobe opening 230, preferably, all the areas of the upper central cavity lobe openings 330 are positioned in the upper right lung lobe opening 230 exactly, namely, the upper central cavity lobe opening 330 is not shielded by the bronchial catheter 200, so that the right side bronchus including the upper right lung lobe can be conveniently sucked through the central cavity during left side single lung ventilation, the right lung is accelerated, oxygen can be supplied to the right side bronchus including the upper right lung lobe through the central cavity if necessary, or continuous positive airway pressure ventilation can be realized;
When the two lungs are ventilated, gas may enter the patient's right upper lobe bronchi from right upper lobe bronchi opening 230;
when the left lung (ventilation side lung) is ventilated, the right lung (non-ventilation side lung) can be subjected to treatment such as air extraction, oxygen supply, continuous positive airway pressure ventilation and the like through the central cavity, and the right upper lobe bronchus of the patient can be subjected to air extraction and the like through the upper lobe opening 330 of the central cavity.
Referring to fig. 13 and 16, in fig. 16, R represents the long diameter of the upper right lung lobe bronchus opening 230, L4 represents the distance between the center of the upper right lung lobe bronchus opening 230 and either end of the right side bronchus tube 200, two L4 represent the length of the right side bronchus tube 200, T2 represents the long diameter of the side opening 220 of the right side bronchus tube 200, the length of the right side bronchus tube 200, the long diameter of the side opening 220 and the long diameter of the upper right lung lobe bronchus opening 230 are all matched with the model of the tracheal tube 100, for example, the model of the tracheal tube 100 is ID6.0, the length of the right side bronchus tube 200 is preferably 30mm, the long diameter of the side opening 220 is preferably 9mm, and the long diameter of the upper right lung lobe bronchus opening 230 is preferably 4.5mm;
5. the first X-ray opaque markers are different.
Referring to fig. 14, a first X-ray impermeable identification band 610 is disposed on the inner wall of the outer catheter, the first X-ray impermeable identification band 610 is located at the opposite side of the side opening 220, one end of the first X-ray impermeable identification band 610 is located at the end of the tracheal catheter 100, the other end of the first X-ray impermeable identification band 610 is located at the bronchial catheter opening 210, an arc section corresponding to the position of the upper right pulmonary bronchus opening 230 is disposed on the first X-ray impermeable identification band 610, the arc section of the first X-ray impermeable identification band 610 surrounds either side of the upper right pulmonary bronchus opening 230, the first X-ray impermeable identification band 610 runs substantially alongside the central lumen 300, as shown in fig. 14, the first X-ray impermeable identification band 610 of the tracheal right bronchus catheter generally coincides with the central lumen running, but is different from the central lumen 300 at the upper right pulmonary bronchus opening 230, and the first X-ray impermeable identification band 610 only half surrounds the upper right pulmonary bronchus opening 230.
FIG. 17 is a schematic view showing a state in which an outer balloon of the right tracheal catheter of the present application is inflated to occlude the left main bronchus, and referring to FIG. 17, the direction of the arrow in the figure indicates the direction of the flow of the air, and at this time, an air cuff 510 is inflated, the tracheal catheter 100 is fixed in the main bronchus of the patient, an air cuff 410 is inflated, the bronchial catheter 200 is occluded, and the right main bronchus of the patient is occluded;
when connected to an external ventilator via the ventilator interface 720 for ventilation, gas will only enter the patient's left main bronchus through the side opening 220, thereby achieving single lung ventilation (left lung ventilation), at which time the right lung may be evacuated, oxygen administered, continuous positive airway pressure, etc. via the central lumen 300, and the right diseased lung may also be isolated by inflation of the bronchial cuff 410, preventing the flow of fluid secretions into the healthy left lung, preventing cross-infection and pathogen diffusion.
Fig. 18 is a schematic view showing a state where the outer balloon of the right bronchial catheter of the present application is deflated, referring to fig. 18, the direction of the arrow in the figure indicates the direction of the airflow, at this time, the balloon sheath 510 is inflated, the outer wall of the balloon 510 is attached to the inner wall of the main trachea of the patient, so as to prevent air leakage, that is, prevent air from overflowing the airway, and the tracheal catheter 100 is fixed in the main trachea of the patient; the central cavity capped interface 320 is closed; the bronchocuff 410 is deflated, the bronchial catheter 200 is clear, and the left and right main bronchi of the patient are clear (double lung ventilation);
When connected to an external ventilator through ventilator interface 720, gas may enter the patient's left and right side bronchi through side opening 220, bronchial catheter opening 210, and right upper pulmonary lobe bronchi opening 230, thereby achieving double pulmonary ventilation.
The present application is functionally sacrificed relative to conventional dual lumen bronchial catheters. But is more beneficial for the use of the children of low ages. Compared with other single-lung ventilation which can be realized in children, the application can be well fixed and is difficult to shift (other single-lung ventilation of children such as bronchus blocking and easy to shift). The ventilation can be switched between double lung ventilation and one-sided (left side) single lung ventilation at will.
It should be noted that, the numerical values and the numerical ranges related to the embodiments of the present application are approximate values, and may have a certain range of errors under the influence of the manufacturing process, and those errors may be considered to be negligible by those skilled in the art.
It is to be understood that, based on the several embodiments provided in the present application, those skilled in the art may combine, split, reorganize, etc. the embodiments of the present application to obtain other embodiments, which all do not exceed the protection scope of the present application.
The foregoing detailed description of the embodiments of the present application further illustrates the purposes, technical solutions and advantageous effects of the embodiments of the present application, and it should be understood that the foregoing is merely a specific implementation of the embodiments of the present application, and is not intended to limit the scope of the embodiments of the present application, and any modifications, equivalent substitutions, improvements, etc. made on the basis of the technical solutions of the embodiments of the present application should be included in the scope of the embodiments of the present application.
Claims (7)
1. A tracheal unilateral bronchial catheter, characterized in that: comprises the following steps of;
an endotracheal tube (100);
the medical device comprises a bronchial catheter (200), wherein the tracheal catheter (100) and the bronchial catheter (200) are integrally formed to form an outer catheter, the tracheal catheter (100) and the bronchial catheter (200) are communicated, the tracheal catheter (100) and the bronchial catheter (200) are fixedly shaped into a certain included angle through an intubation guide wire, a bronchial catheter opening (210) is formed in the end part of the bronchial catheter (200), a side opening (220) is formed in the joint of the tracheal catheter (100) and the bronchial catheter (200), the side opening (220) is located on the opposite side of the bronchial catheter (200) facing to the side, and the opening direction of the side opening (220) faces to the side far away from the bronchial catheter opening (210);
a central cavity (300), wherein the central cavity (300) is arranged in the outer catheter, one end of the central cavity (300) penetrates out of the tracheal catheter (100) from a third position on the side wall of the tracheal catheter (100) and is connected with a central cavity capped joint (320), the other end of the central cavity (300) extends to the position of the bronchial catheter opening (210) and is provided with a central cavity opening (310), the outer wall of the central cavity (300) is connected with the tracheal catheter (100) or the inner wall of the bronchial catheter (200), and the central cavity (300) is opposite to the side opening (220);
The bronchial catheter comprises a bronchial catheter body assembly (400), wherein the bronchial catheter body assembly (400) comprises a bronchial catheter body (410), a bronchial catheter body inflation cavity (420) and a connecting sheet (430), the connecting sheet (430) is fixedly arranged on the inner wall of the bronchial catheter body (200), the connecting sheet (430) is opposite to the side opening (220), the central cavity (300) penetrates through the connecting sheet (430), the bronchial catheter body (410) is arranged on the bronchial catheter body (200), the bronchial catheter body (410) comprises an inner balloon (411) and an outer balloon (412), the inner balloon (411) is fixedly arranged on the connecting sheet (430), the outer balloon (412) is arranged on the outer wall of the bronchial catheter body (200), one end of the bronchial catheter body inflation cavity (420) is communicated with the inner balloon (411) and the outer balloon body (412), and the other end of the bronchial catheter body (420) is connected with the first side wall (100) of the tracheal catheter body;
the single-sided tracheal bronchial catheter is divided into a left tracheal bronchial catheter and a right tracheal bronchial catheter, and the left and right tracheal catheters are different:
the bronchial catheter (200) has only a distal bronchial catheter opening (210) at the left tracheal bronchial catheter and an upper right pulmonary bronchial opening (230) on the right tracheal bronchial catheter opposite the side opening (220) from and against the outer balloon (412);
The central cavity (300) has different structures, and in the left-side tracheal catheter of the trachea, the central cavity (300) is a tiny cavity penetrating through the side wall of the tracheal catheter (100) and the side wall of the bronchial catheter (200), and an opening (310) is arranged at a far-end opening (210); on the right side of the tracheal catheter, due to the arrangement of the right upper lung lobe bronchus opening (230), the central cavity (300) runs around the right upper lung lobe bronchus opening (230) at the corresponding position, and a plurality of central cavity upper lobe openings (330) corresponding to the right upper lung lobe bronchus opening (230) are arranged in the surrounding area.
2. The tracheal unilateral bronchial catheter of claim 1, wherein: the tracheal unilateral bronchial catheter further comprises:
an X-ray opaque identification band (600), the X-ray opaque identification band (600) comprising a first X-ray opaque identification band (610) and a second X-ray opaque identification band (620);
the first X-ray impermeable identification band (610) is arranged on the inner wall of the outer catheter, the first X-ray impermeable identification band (610) is positioned on the opposite side of the side opening (220) and is accompanied by the central cavity (300), one end of the first X-ray impermeable identification band (610) is positioned at the end part of the tracheal catheter (100) and is terminated, and the other end of the first X-ray impermeable identification band (610) is positioned at the bronchial catheter opening (210);
The second X-ray impermeable identification band (620) is arranged on the inner wall of the outer catheter, the second X-ray impermeable identification band (620) is positioned on the opposite side of the first X-ray impermeable identification band (610), one end of the second X-ray impermeable identification band (620) is positioned at the end of the tracheal catheter (100) to be terminated, and the other end of the second X-ray impermeable identification band (620) is positioned at the upper edge of the side opening (220) to be terminated.
3. The tracheal unilateral bronchial catheter of claim 2, wherein:
the left tracheal bronchial catheter and the right tracheal bronchial catheter also have the following differences;
the outer balloon (412) of the bronchial cuff (410) is nearly spherical or ellipsoidal in the left bronchus of the trachea, and the long axis of symmetry of the outer balloon (412) is perpendicular to the central axis of the bronchial catheter (200); the outer balloon (412) is shaped in the bronchus at the right side of the trachea, and an included angle between the symmetrical long axis of the outer balloon (412) and the central axis of the bronchus catheter (200) is smaller than 90 degrees;
the included angle between the bronchial catheter (200) and the tracheal catheter (100) is 130 degrees at the left side of the trachea and 150 degrees at the right side of the trachea, and the included angle is plastically fixed by the intubation guide wire and can be adjusted;
The first X-ray impermeable identification band (610) is different, in the left tracheal bronchial catheter, the first X-ray impermeable identification band (610) is a band which runs along with the central cavity (300), and in the right tracheal bronchial catheter, due to the arrangement of the upper right pulmonary lobe bronchial opening (230), the central cavity (300) runs around at the corresponding position, and the first X-ray impermeable identification band (610) runs semi-around the upper right pulmonary lobe bronchial opening (230).
4. A tracheal unilateral bronchial catheter according to claim 3, wherein: the tracheal unilateral bronchial catheter further comprises:
a cannula fitting (700), the cannula fitting (700) being detachably arranged at an end of the endotracheal tube (100);
the cannula hub (700) has an endotracheal tube interface (710), a ventilator interface (720) and an inspection inlet (730), the endotracheal tube interface (710) being connected with the endotracheal tube (100);
after the cannula hub (700) is removed, the endotracheal tube (100) may be directly connected to an external ventilator.
5. The tracheal unilateral bronchial catheter of claim 4, wherein: further comprises:
a central lumen connection assembly (800), the central lumen connection assembly (800) comprising a central lumen aspirator joint (810) and a central lumen ventilator joint (820);
The conical end of the central cavity aspirator joint (810) is inserted into the central cavity capped joint (320);
the small hole end of the central cavity breathing machine joint (820) is inserted into the central cavity capped joint (320).
6. The tracheal unilateral bronchial catheter of claim 5, wherein: further comprises:
the tracheal catheter comprises a tracheal catheter sleeve assembly (500), wherein the tracheal sleeve assembly (500) comprises a tracheal sleeve (510) and a tracheal sleeve inflation cavity (520), the tracheal sleeve (510) is arranged on the peripheral surface of the outer wall of the tracheal catheter (100), the tracheal sleeve inflation cavity (520) is positioned in the tracheal catheter (100), one end of the tracheal sleeve inflation cavity (520) is communicated with the tracheal sleeve (510), and the other end of the tracheal sleeve inflation cavity (520) penetrates out of the tracheal catheter (100) from the second position of the side wall of the tracheal catheter (100).
7. The tracheal unilateral bronchial catheter of claim 6, wherein: further comprises:
the two depth marks are arranged on the outer wall of the outer catheter and are symmetrically arranged left and right, and the two depth marks respectively start from two X-ray impermeable mark belts, namely respectively start from an opening (210) of the bronchial catheter and the upper edge of the side opening (220) and end at an interface (710) of the tracheal catheter.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN202211413908.6A CN115581838B (en) | 2022-11-11 | 2022-11-11 | Tracheal unilateral bronchial catheter |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN202211413908.6A CN115581838B (en) | 2022-11-11 | 2022-11-11 | Tracheal unilateral bronchial catheter |
Publications (2)
Publication Number | Publication Date |
---|---|
CN115581838A CN115581838A (en) | 2023-01-10 |
CN115581838B true CN115581838B (en) | 2023-10-24 |
Family
ID=84783563
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN202211413908.6A Active CN115581838B (en) | 2022-11-11 | 2022-11-11 | Tracheal unilateral bronchial catheter |
Country Status (1)
Country | Link |
---|---|
CN (1) | CN115581838B (en) |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN106110462A (en) * | 2016-07-23 | 2016-11-16 | 曾居华 | Single cavity double sac bronchial cannula |
CN208693973U (en) * | 2017-11-24 | 2019-04-05 | 烟台凯富医疗科技有限公司 | Bronchus closure type trachea cannula |
CN210078522U (en) * | 2017-12-26 | 2020-02-18 | 烟台凯富医疗科技有限公司 | Formula of can letting out trachea shutoff type trachea cannula |
CN111346285A (en) * | 2020-04-06 | 2020-06-30 | 江苏省人民医院(南京医科大学第一附属医院) | Improved single-cavity bronchial catheter |
CN112642037A (en) * | 2021-02-23 | 2021-04-13 | 重庆大学附属三峡医院 | Double-cavity bronchial catheter |
-
2022
- 2022-11-11 CN CN202211413908.6A patent/CN115581838B/en active Active
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN106110462A (en) * | 2016-07-23 | 2016-11-16 | 曾居华 | Single cavity double sac bronchial cannula |
CN208693973U (en) * | 2017-11-24 | 2019-04-05 | 烟台凯富医疗科技有限公司 | Bronchus closure type trachea cannula |
CN210078522U (en) * | 2017-12-26 | 2020-02-18 | 烟台凯富医疗科技有限公司 | Formula of can letting out trachea shutoff type trachea cannula |
CN111346285A (en) * | 2020-04-06 | 2020-06-30 | 江苏省人民医院(南京医科大学第一附属医院) | Improved single-cavity bronchial catheter |
CN112642037A (en) * | 2021-02-23 | 2021-04-13 | 重庆大学附属三峡医院 | Double-cavity bronchial catheter |
Also Published As
Publication number | Publication date |
---|---|
CN115581838A (en) | 2023-01-10 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US6609521B1 (en) | Endotracheal tube | |
US5291882A (en) | Multi-lumen ITPV endotracheal tube | |
EP0665029B1 (en) | Esophageal-tracheal double lumen airway | |
US10441735B1 (en) | Combined laryngeal-bronchial lung separation system | |
JP2008520290A (en) | Ventilation catheter and airway management system to remove secretions | |
US11426548B2 (en) | Combined laryngeal-bronchial lung separation system | |
BRPI1009310B1 (en) | flexible catheter for jet ventilation of an expiratory care patient | |
US20140305430A1 (en) | Probe for medical use | |
CN108498928B (en) | Tracheal cannula external member capable of guiding descending bronchus to block under bronchofiberscope | |
US20200030557A1 (en) | Medical tubes for selective mechanical ventilation of the lungs | |
US11478596B2 (en) | System and method for high flow oxygen therapy | |
CN115581838B (en) | Tracheal unilateral bronchial catheter | |
CN210205546U (en) | Tracheal tube for single lung ventilation | |
EP3749169B1 (en) | Supraglottic airway device with a dynamic cuff with superior ventilating capability | |
CN115738005A (en) | Air flue management system | |
CN211383297U (en) | Multipurpose breather | |
EP4028089A1 (en) | Combined laryngeal-bronchial lung separation system | |
CN211066837U (en) | Bronchus plugging device | |
CN211962767U (en) | Double-cavity bronchial catheter | |
CN208927330U (en) | It can be in the trachea cannula external member of Bronchofiberscope guidance downlink bronchial obstruction | |
JP3590705B2 (en) | Emergency resuscitation esophageal airway | |
CN217489473U (en) | Laryngeal mask compatible with nasal high-flow auxiliary ventilation | |
CN221771185U (en) | Multifunctional tracheal catheter | |
CN216629368U (en) | Sight glass anaesthetic mask | |
CN219963673U (en) | Double-balloon tracheal intubation catheter |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
PB01 | Publication | ||
PB01 | Publication | ||
SE01 | Entry into force of request for substantive examination | ||
SE01 | Entry into force of request for substantive examination | ||
GR01 | Patent grant | ||
GR01 | Patent grant |