CN116077782A - Fluorescence visualization trachea cannula system and cannula pre-adjustment method - Google Patents

Fluorescence visualization trachea cannula system and cannula pre-adjustment method Download PDF

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Publication number
CN116077782A
CN116077782A CN202211688555.0A CN202211688555A CN116077782A CN 116077782 A CN116077782 A CN 116077782A CN 202211688555 A CN202211688555 A CN 202211688555A CN 116077782 A CN116077782 A CN 116077782A
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China
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module
fluorescent
cannula
trachea cannula
terminal equipment
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CN202211688555.0A
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Chinese (zh)
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伍佳莉
苏松
方程
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Affiliated Hospital of Southwest Medical University
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Affiliated Hospital of Southwest Medical University
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Priority to CN202211688555.0A priority Critical patent/CN116077782A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04Tracheal tubes
    • A61M16/0402Special features for tracheal tubes not otherwise provided for
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131Accessories for endoscopes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131Accessories for endoscopes
    • A61B1/00137End pieces at either end of the endoscope, e.g. caps, seals or forceps plugs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A61B1/043Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances for fluorescence imaging
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A61B1/046Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances for infrared imaging
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/267Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
    • A61B1/2676Bronchoscopes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04Tracheal tubes
    • A61M16/0402Special features for tracheal tubes not otherwise provided for
    • A61M16/0411Special features for tracheal tubes not otherwise provided for with means for differentiating between oesophageal and tracheal intubation
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02ATECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A50/00TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
    • Y02A50/30Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Abstract

The invention belongs to the technical field of medical equipment, and discloses a fluorescence visualization trachea cannula system which is used for assisting in feeding back a specific position of a trachea cannula inserted into a throat to realize visualization cannula, and comprises a trachea cannula and terminal equipment; wherein, the trachea cannula is provided with a fluorescent medium layer at the plug part thereof; the terminal equipment is provided with a laser emitting module and a fluorescent camera module, a display screen arranged on the terminal equipment displays an image transmitted back from the fluorescent camera module, and the image is provided with a fluorescent patch reflected by a fluorescent medium layer inserted into the esophagus and irradiated by the laser emitting module. Meanwhile, an intubation pre-adjustment method is also disclosed, and the imaging parameters of the terminal equipment are adjusted aiming at a non-biological module intubation simulating the laryngeal tube, wherein the non-biological module has an airway and an esophagus similar to those of a human body.

Description

Fluorescence visualization trachea cannula system and cannula pre-adjustment method
Technical Field
The invention belongs to the technical field of medical treatment, and particularly relates to a fluorescence visualization trachea cannula system and a cannula pre-adjustment method.
Background
The tracheal intubation technology is often applied to the rescue process of patients with critical illness accompanied with respiratory dysfunction in general anesthesia operation and cardiopulmonary resuscitation. With the improvement of the living standard of people and the aging of the population of society, the increase of general anesthesia operation patients also means that more airway risks and difficulties exist in the anesthesia trachea cannula process than in the past.
In the traditional intubation mode, medical staff uses a laryngoscope to perform tracheal intubation, glottis is not fully exposed, even some patients with glottis exposure difficulty cannot be exposed at all, often only the tracheal intubation can be performed under blind detection by means of personal experience, and the position of the tracheal catheter cannot be determined in real time in a visualized mode, so that the tracheal intubation has certain blindness and is time-consuming. The tracheal catheter is inserted too deeply, and one side bronchus can be wrongly inserted and damaged, so that the oxygen supply of a patient is insufficient, and the lung is not expanded.
In addition, as the esophagus is positioned below the trachea in the supine position, the esophagus is of an open pipeline structure, the opening is close to the trachea, and medical staff can not identify the glottis under the conditions of unclear glottis exposure or excessive secretion of the respiratory tract and the like, so that the trachea cannula is wrongly inserted into the esophagus;
meanwhile, even under the condition that the exposed glottis is clear, the situation that the laryngoscope is withdrawn prematurely or the tracheal catheter is taken out of the laryngoscope and is wrongly put into the esophagus occurs.
When the tracheal cannula is mistakenly inserted into the esophagus during the emergency airway operation, the tracheal cannula needs to be tried for a plurality of times at the moment to repeatedly confirm the position of the tracheal cannula, so that the tracheal cannula can be successfully used. Repeated trachea cannula actions not only increase the risks of related complications of patients, but also delay the optimal treatment time of the patients, thereby causing serious consequences.
The luminous tracheal catheter (patent application numbers 201110227849.9, 201811570741.8 and 202220004601. X) of the currently filed patent tries to place an LED lamp and a light guide optical fiber on the tracheal catheter wall as visible light sources, and the position of the tracheal intubation is judged by utilizing the spot position of the visible light.
However, the tracheal cannula has a plurality of defects in the clinical use process: (1) Because the visible light wavelength is shorter (the LED lamp and the light guide optical fiber can emit visible light with the wavelength of 400-700 nm), the penetration depth to the skin is shallower, the thickness of the skin and subcutaneous tissue is only 4-5 mm, the thickness of the skin and subcutaneous tissue is generally 6-10 mm, and the scattering rate and the absorption rate of the visible light in human tissues are higher, so that the light is difficult to penetrate out of the neck skin tissues, and visible light spots cannot be observed on the skin surface; (2) If the trachea cannula is mistakenly inserted into the esophagus deeper from the body surface, an operator cannot clearly determine the position of the trachea cannula in the body, and serious medical accidents can be caused; (3) In addition, the scattering degree of visible light entering the tissue is extremely high, and even if light spots are formed on the surface of the skin of a thinner neck patient, the light spot range is dispersed at the moment, and the position of the tip of the tracheal catheter still cannot be accurately judged; (4) The LED lamp and the light guide optical fiber can generate heat in the process of generating visible light, and can cause thermal damage to internal tissues; (5) The special LED lamp and the light guide optical fiber are high in price, and the optical fiber is easy to damage in repeated bending and use and cannot be popularized and applied in clinical operation; (6) The light source in the trachea cannula can fall off when the trachea cannula is used or the position of a patient changes, so that the life of the patient is threatened. In summary, these drawbacks greatly limit the clinical use of such endotracheal tubes.
Disclosure of Invention
In order to solve the problems in the prior art, the invention provides a fluorescence visualization trachea cannula system and a cannula pre-adjustment method, wherein the existing trachea cannula system is optimized through a laser fluorescence marking method, cannula judgment is assisted through terminal equipment with higher integration level, and meanwhile, equipment is adjusted to an optimal state before operation through the pre-adjustment method.
The technical scheme adopted by the invention is as follows:
the invention discloses a fluorescence visualization trachea cannula system, which is used for assisting in feeding back the specific position of a trachea cannula inserted into a throat to realize visualization cannula, and comprises a trachea cannula and terminal equipment;
wherein, the trachea cannula is provided with a fluorescent medium layer at the plug part thereof;
the terminal equipment is provided with a laser emitting module and a fluorescent camera module, a display screen arranged on the terminal equipment displays an image transmitted back from the fluorescent camera module, and the image is provided with a fluorescent patch reflected by a fluorescent medium layer inserted into the esophagus and irradiated by the laser emitting module.
With reference to the first aspect, the present invention provides a first implementation manner of the first aspect, wherein the fluorescent medium layer is a coating material covering the surface of the tracheal cannula plug.
With reference to the first aspect, the present invention provides a second implementation manner of the first aspect, wherein the fluorescent medium layer is a fluorescent material filled in a sleeve layer covering the surface of the tracheal cannula plug.
With reference to the first aspect or various embodiments of the first aspect, the present invention provides a third embodiment of the first aspect, wherein the tracheal cannula sequentially includes a joint, a tube portion, a cuff, and a plug, and the indication balloon is disposed on the tube portion near the joint.
With reference to the third implementation manner of the first aspect, the present invention provides a fourth implementation manner of the first aspect, wherein a detachable light shielding cap is disposed at the joint, and the light shielding cap covers the fluorescent medium layer when the light shielding cap is sleeved on the joint.
With reference to the fourth implementation manner of the first aspect, the present invention provides a fifth implementation manner of the first aspect, where the terminal device is in a handheld flat structure, a processing module and a storage battery are built in the handheld flat structure, and a transmitting end of the laser transmitting module and a receiving end of the fluorescent camera module are both disposed on the same end surface of the terminal device.
With reference to the fifth implementation manner of the first aspect, the present invention provides a sixth implementation manner of the first aspect, where the laser emission module is a near infrared light source, and includes an infrared laser module and a lens group, and the lens group filters and diverges the light source emitted by the infrared laser module to form a laser beam emitted from the emission end; the infrared laser module is powered by a storage battery.
With reference to the fifth implementation manner of the first aspect, the present invention provides a seventh implementation manner of the first aspect, wherein the terminal device is further provided with an alarm module, an image analysis program is preset in the processing module, the light spot data analysis is performed according to the image returned by the fluorescent camera module in real time, and when the light spot brightness and the range are both smaller than the set threshold, an audible and visual alarm is sent out by the alarm module.
With reference to the fifth implementation manner of the first aspect, the present invention provides an eighth implementation manner of the first aspect, and the receiving end of the fluorescent camera module is provided with an optical filter.
In a second aspect, the invention further discloses a method for pre-adjusting an intubation, which adopts the fluorescence visualization tracheal intubation system in the eighth implementation manner of the first aspect, and adjusts the imaging parameters of the terminal device for the non-biological module intubation of the simulated larynx, wherein the non-biological module has an airway and an esophagus similar to those of a human body, and the method specifically comprises the following steps:
s1, firstly, taking out an trachea cannula with a shading cap, arranging a black medium at the lower part of a non-biological module with a channel, and inserting the trachea cannula from the channel by one end of a plug after arranging;
s2, the terminal equipment is arranged above a channel of the non-biological module, the red laser emission module irradiates the channel of the non-biological module, and an image is checked from the display screen;
s3, after corresponding light spots appear in the image, adjusting display parameters according to the brightness of the light spots to obtain a clear light spot image in the pseudo-color mapping image.
The beneficial effects of the invention are as follows:
(1) The tracheal intubation with the fluorescent material is matched with the laser emission module to perform real-time feedback guidance on the throat of a thinner human body, so that medical staff can be assisted in avoiding damage of a socket to esophagus or airway during intubation, and the technical problems that the success rate of intubation is low, the position of a catheter cannot be accurately judged in time after intubation, the position of the tracheal intubation cannot be visualized in real time, the cost performance is low, the risk of trauma is high and the like when the glottis exposure of the traditional tracheal intubation operation equipment is insufficient are solved;
(2) The invention provides a terminal device matched with an trachea cannula with fluorescent substances, which is provided with a laser emission module and a fluorescent camera module, can be conveniently operated through an integrated structural design, simultaneously emits near infrared laser beam irradiation which has almost no influence on a patient, simultaneously performs fluorescent image acquisition on the terminal device through the fluorescent camera module with an optical filter, can display images in bright light spots different from other parts, and judges whether the trachea cannula is inserted into the esophagus or not according to the characteristic that an air passage and the esophagus have obvious brightness difference, and improves the accuracy of the cannula;
(3) The invention also provides a pre-image adjusting method aiming at the equipment, because each tracheal cannula with fluorescent materials is made of disposable materials, a shading cap is arranged for shading before use, and when the tracheal cannula is taken down during use, the image adjustment is required to be simulated before the tracheal cannula, so that the phenomenon that the progress of the tracheal cannula is not obviously influenced by the fluorescent effect caused by direct insertion into the throat is avoided.
Drawings
FIG. 1 is a schematic view of an embodiment of the present invention in use of a cannula system;
FIG. 2 is a plan view of an endotracheal tube structure in accordance with an embodiment of the present invention in use;
FIG. 3 is an isometric view of an endotracheal tube structure in use in an intubation system according to an embodiment of the present invention;
FIG. 4 is an isometric view of an endotracheal tube structure with a light shielding cap in an intubation system according to an embodiment of the present invention;
FIG. 5 is a plan view of an endotracheal tube structure with a light shielding cap in an intubation system according to an embodiment of the present invention;
FIG. 6 is a first isometric view of a terminal device for detection feedback in a cannula system according to an embodiment of the invention;
FIG. 7 is a top view of a terminal device for detection feedback in a cannula system according to an embodiment of the present invention;
FIG. 8 is a second isometric view of a terminal device for probe feedback in a cannula system according to an embodiment of the invention;
FIG. 9 is a bottom view of a terminal device for probing feedback in a cannula system according to an embodiment of the invention;
FIG. 10 is a view showing the operation of inserting the intubation system into the airway of a pig during a test for the throat of a pig according to an embodiment of the present invention;
FIG. 11 is a near infrared fluorescence image obtained by the terminal device while performing the operation of FIG. 10 in accordance with the present invention;
FIG. 12 is a view showing the operation of inserting the cannula system into the esophagus of a pig in the test of the throat of a pig according to the embodiment of the present invention;
fig. 13 is a near infrared fluorescence image obtained by the terminal device when the present invention is operated in fig. 12.
In the figure: the device comprises a 1-connector, a 2-tube part, a 3-sleeve bag, a 4-fluorescent medium layer, a 5-plug, a 6-indicating balloon, a 7-shading cap, 8-terminal equipment, a 9-display screen, a 10-mounting groove, an 11-infrared laser module, a 12-lens group, a 13-fluorescent camera module, a 14-first back cover and a 15-second back cover.
Detailed Description
The invention is further illustrated by the following description of specific embodiments in conjunction with the accompanying drawings.
For the purposes of making the objects, technical solutions and advantages of the embodiments of the present application more clear, the technical solutions of the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application, and it is apparent that the described embodiments are some embodiments of the present application, but not all embodiments. The components of the embodiments of the present application, which are generally described and illustrated in the figures herein, may be arranged and designed in a wide variety of different configurations.
Thus, the following detailed description of the embodiments of the present application, as provided in the accompanying drawings, is not intended to limit the scope of the application, as claimed, but is merely representative of selected embodiments of the application. All other embodiments, which can be made by one of ordinary skill in the art without undue burden from the present disclosure, are within the scope of the present disclosure.
It should be noted that: like reference numerals and letters denote like items in the following figures, and thus once an item is defined in one figure, no further definition or explanation thereof is necessary in the following figures.
In the description of the present application, it should be noted that, if the terms "center," "upper," "lower," "left," "right," "vertical," "horizontal," "inner," "outer," and the like indicate an azimuth or a positional relationship based on that shown in the drawings, or an azimuth or a positional relationship that a product of the application conventionally puts in use, it is merely for convenience of describing the present application and simplifying the description, and does not indicate or imply that the device or element to be referred to must have a specific azimuth, be configured and operated in a specific azimuth, and thus should not be construed as limiting the present application. Furthermore, the terms "first," "second," and the like in the description of the present application, if any, are used for distinguishing between the descriptions and not necessarily for indicating or implying a relative importance.
Furthermore, the terms "horizontal," "vertical," and the like in the description of the present application, if any, do not denote a requirement that the component be absolutely horizontal or overhang, but rather may be slightly inclined. As "horizontal" merely means that its direction is more horizontal than "vertical", and does not mean that the structure must be perfectly horizontal, but may be slightly inclined.
In the description of the present application, it should also be noted that, unless explicitly stated and limited otherwise, the terms "disposed," "mounted," "connected," and "connected" should be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; can be directly connected or indirectly connected through an intermediate medium, and can be communication between two elements. The specific meaning of the terms in this application will be understood by those of ordinary skill in the art in a specific context.
Example 1:
the embodiment discloses visual trachea cannula system of fluorescence improves on the basis of current trachea cannula structure, under the prerequisite that does not change basic function and the structure of current structure, through increasing discernment feedback structure, can carry out supplementary radiography with the help of laser emission equipment in vitro to guide medical personnel improves the intubate success rate.
In particular, as shown in fig. 1, a schematic representation of the use of the system is shown in fig. 1, wherein the system comprises an endotracheal tube and a terminal device 8, mainly in the manner of laryngeal use; wherein the tracheal cannula is provided with a fluorescent medium layer 4 at the plug 5 part thereof.
Further, the terminal device 8 is provided with a laser emitting module and a fluorescent camera module 13, the display screen 9 arranged on the terminal device 8 displays an image transmitted back from the fluorescent camera module 13, and the image is provided with a fluorescent patch reflected by the fluorescent medium layer 4 inserted into the esophagus and irradiated by the laser emitting module.
In some embodiments, the fluorescent medium layer 4 is a coating material covering the surface of the tracheal cannula plug 5, and the coating material comprises various setting modes, and the tracheal cannula is made of medical silica gel material, so that the coating is convenient to set. The fluorescent material is coated on the surface of the fluorescent material in a direct coating mode, and the outer layer of the fluorescent material is covered with a light-transmitting covering layer, so that the fluorescent material is prevented from being dissolved or erased to influence the use when the fluorescent material is inserted into a human body.
The coating layer is generally made of medical resin material and is directly coated on the surface with fluorescent material. The fluorescent material itself is a medical grade material, and even if it leaks, it does not affect it.
In some embodiments, the fluorescent medium layer 4 is a fluorescent material filled in a sleeve layer covering the surface of the endotracheal tube plug 5. In this way, a double-layer structure is provided at the plug 5 of the endotracheal tube, and a fluorescent layer is formed by filling a fluorescent material into the inside of the double-layer structure. Compared with the embodiment, the stability is better.
Further, the tracheal cannula sequentially comprises a joint 1, a tube part 2, a sleeve bag 3 and a plug 5, and an indication balloon 6 is arranged on the tube part 2 close to the joint 1.
Meanwhile, in order to avoid that the fluorescent material is worn before use, a detachable shading cap 7 is arranged at the joint 1, and the shading cap 7 covers the fluorescent medium layer 4 when being sleeved on the joint 1.
Furthermore, the fluorescent material in this embodiment is indocyanine green, which is generally used as a dye drug for checking liver function and liver effective blood flow, and since indocyanine green is a drug which has been used for a long time in clinic, it is widely used in liver metabolism, tissue development, angiography, and its safety is ensured.
Further, the terminal device 8 is in a handheld flat structure, a processing module and a storage battery are arranged in the handheld flat structure, and a transmitting end of the laser transmitting module and a receiving end of the fluorescent camera module 13 are arranged on the same end face of the terminal device 8. The processing module is a built-in circuit board, a processor, a memory and other chips are arranged on the circuit board, the power is supplied through a storage battery, and an interface is arranged on the terminal equipment 8 and used for connecting with external equipment for charging or data transmission. The processor is mainly used for controlling the work of the laser emission module and the fluorescent camera module 13, and simultaneously, the data of the fluorescent camera module 13 is displayed on the display screen 9 after being processed.
In fig. 9, the back of the terminal device 8 is shown with a first back cover 14 and a second back cover 15, which are detachable, a battery being provided in the first back cover 14 and a circuit board being provided in the second back cover 15.
Further, the laser emission module is a near infrared light source and comprises an infrared laser module 11 and a lens group 12, and the lens group 12 filters and diverges the light source emitted by the infrared laser module 11 to form a laser beam emitted from an emission end; the infrared laser module 11 is powered by a storage battery.
In the prior art, the wavelength range of halogen light is wider (350-2500 nm), the light wave contains near infrared light about 800nm, the near infrared light has stronger penetrating power to tissues, and the light wave can penetrate deeper human tissues (the penetrating depth of the tissues is about 10 mm), but the light wave still has large scattering range when penetrating the human tissues, and is not suitable for being directly arranged on a catheter to guide a cannula.
In addition, when the halogen lamp emits light, the heat generated is more, if the halogen lamp is directly arranged on the tracheal cannula catheter, the heat damage to the tracheal mucosa human tissue can be caused after the halogen lamp enters a human body; meanwhile, equipment such as a light source and the like is arranged at the front end of the catheter, and serious iatrogenic complications can be caused once the catheter falls into the airway.
Therefore, the halogen light is comprehensively considered as an in-vitro excitation light source, and the skin on the surface of the human cricoid film is irradiated in vitro, so that indocyanine green in the front end of the tracheal cannula catheter is excited to emit fluorescence, and the fluorescence is used for guiding puncture, so that the influence is avoided.
The fluorescent medium indocyanine green is placed in an interlayer at the trachea cannula plug 5 and is used as an internal reflection light source, and the principle is as follows: the light reflected by the excitation light generated after the indocyanine green is excited is near infrared fluorescence, the wavelength of the light is longer than that of visible light (the wavelength can reach 650-950 nm), the tissue penetrating power is strong (about 10-13 mm), and the light can completely penetrate the surface skin (about 8-10 mm) at the cricoid membrane, so that the position of the trachea is displayed by detecting the insertion tube entering through equipment in vitro.
And near infrared fluorescence is less scattered than visible light tissues, and light spots formed in vitro after penetrating the tissues are more concentrated, so that the position of the front end of the trachea can be accurately visualized in real time in the display screen 9 of the device. Near infrared fluorescence generates little heat in the body and thus does not cause thermal damage to tissue.
As can be seen from fig. 6 to fig. 9, the middle part of the whole terminal device 8 is provided with a mounting groove 10, an infrared laser module 11 is transversely arranged in the mounting groove 10, and considering the overall power consumption and the use requirement of the device, the infrared laser module 11 in this embodiment adopts a 500mw infrared point-shaped laser emitter with the wavelength of 800nm, the working voltage of the laser module is 5V, the laser module is a fixed focal section, and the light spot at the position of 10 meters is elliptical, and the size is smaller than 15×20mm. When the throat is irradiated in vitro, the irradiation range needs to be enlarged, and a lens group 12 is further provided at the end of the infrared laser module 11.
The lens group 12 is an integral structure, and comprises a plurality of filters and lenses which are arranged in parallel, and meanwhile, a prism is arranged at one end of the lens group, which is far away from the infrared laser module 11, and light is reflected by 90 degrees and vertically emitted from the bottom of the terminal equipment 8. Due to the processing of the multiple filters and lenses, the emitted laser beam is expanded, and stray light is filtered at the same time, thereby improving the effectiveness.
In some embodiments, for convenience of use, a fiber optic tube may be provided on the terminal device 8 in place of the lens group 12, with the illumination angle and object distance being optionally adjusted by the fiber optic tube. The infrared laser emission module is used for emitting halogen light with the wavelength range of 350-2500nm as excitation light; the optical fiber tube is used for conducting the excitation light; an adapter device is arranged between the laser and the optical fiber tube for connection. The end of the optical fiber is provided with a beam expander which diverges the excitation light guided out of the optical fiber into a laser beam.
Furthermore, the terminal device 8 is further provided with an alarm module, an image analysis program is preset in the processing module, the light spot data analysis is performed according to the image transmitted back by the fluorescent camera module 13 in real time, and when the light spot brightness and the light spot range are smaller than the set threshold value, the alarm module sends out an audible and visual alarm.
The halogen light is used as excitation light to excite the indocyanine green coating in the tracheal intubation layer, near infrared fluorescence is further emitted, a fluorescence signal is detected through in-vitro near infrared fluorescence detection equipment, and the position of the tracheal intubation in the trachea is visualized through the light spot position in the display screen 9. When the tracheal cannula is inserted into the esophagus by mistake, the in-vitro detection equipment cannot detect the near infrared fluorescent signal, the alarm system is started, and the equipment can immediately give out buzzes to prompt an operator of misoperation.
Further, a receiving end of the fluorescent camera module 13 is provided with an optical filter for filtering out optical signals outside the near infrared band.
The use flow of the system is as follows:
step 1: the operator performs normal trachea cannula preparation operation, simultaneously opens the excitation light emitting device, controls the terminal equipment 8 to enable the emitting end of the laser emitting module to be perpendicular to the front part of the neck when the human body lies on the prone position, and outputs a control signal to the fluorescence camera module 13 through the signal control unit of the processing module to enable the fluorescence camera to acquire fluorescence images;
step 2: the near infrared fluorescence image acquired in the step 1 is subjected to denoising and enhanced preprocessing through an image processing unit of a processing module;
step 3: and (3) performing pseudo-color mapping on the image preprocessed in the step (2) through an image processing unit of the processing module to obtain a pseudo-color superimposed image of the tracheal region at the front part of the neck, and displaying the pseudo-color superimposed image on an image display unit in real time, so that imaging of the near-infrared fluorescence real-time visualization tracheal intubation system is completed, an operator operates according to the imaging position and brightness, and once the brightness is found to be reduced, the operator judges that the tracheal intubation is mistakenly inserted into the esophagus and reminds the operator by an alarm module.
Meanwhile, in order to better adjust the image picture and facilitate the normal use of the disposable device, the embodiment also discloses a pre-adjustment method of the intubation, which adopts the fluorescence visualization tracheal intubation system in the eighth implementation manner of the first aspect to adjust the imaging parameters of the terminal device 8 for the non-biological module intubation of the simulated laryngeal tube, wherein the non-biological module has human-like airways and esophagus, and the specific steps are as follows:
firstly, taking out the trachea cannula with the shading cap 7, arranging a black medium at the lower part of a non-biological module with a channel, and inserting the trachea cannula from the channel by one end of a plug 5 after arranging;
the terminal equipment 8 is arranged above the channel of the non-biological module, the red laser emission module irradiates the channel of the non-biological module, and the image is checked from the display screen 9;
and when the corresponding light spots appear in the image, adjusting display parameters according to the brightness of the light spots to obtain a clear light spot image in the pseudo-color mapping image.
As shown in fig. 10-13, in the experiment of simulating the tracheal intubation of the human body by using the pig trachea, near infrared light can penetrate through the tissue of the tracheal surface, excite the fluorescent medium on the surface of the tracheal intubation to further display light spots, and meanwhile, when the tracheal intubation moves in the trachea, the movement track of the tracheal intubation can still be observed. On the contrary, after the tracheal cannula is inserted into the esophagus by mistake, near infrared light cannot penetrate through the tissue of the surface of the esophagus due to the deeper position of the esophagus, so that a light spot formed after the fluorescent medium is excited cannot be observed. In actual use, the non-biological module is adopted, the module adopts a silica gel simulation mode to simulate the thickness of common throat tissues and the throat structure, and is arranged in half, namely, the module has an open groove structure for simulating the throat, and the back-off is used for simulating the throat on the black light absorbing material layer, so that the module can be directly cleaned after being used.
The invention is not limited to the alternative embodiments described above, but any person may derive other various forms of products in the light of the present invention. The above detailed description should not be construed as limiting the scope of the invention, which is defined in the claims and the description may be used to interpret the claims.

Claims (10)

1. A fluorescence visualization trachea cannula system for the specific position of supplementary feedback trachea cannula insertion throat realizes visual intubate, its characterized in that: comprises a trachea cannula and a terminal device (8);
wherein, the part of the plug (5) of the tracheal cannula is provided with a fluorescent medium layer (4);
the terminal equipment (8) is provided with a laser emitting module and a fluorescent camera module (13), a display screen (9) arranged on the terminal equipment (8) displays an image transmitted back from the fluorescent camera module (13), and the image is provided with a fluorescent patch reflected by a fluorescent medium layer (4) inserted into the esophagus and irradiated by the laser emitting module.
2. A fluorescence visualization endotracheal intubation system according to claim 1, wherein: the fluorescent medium layer (4) is a coating material covered on the surface of the trachea cannula plug (5).
3. A fluorescence visualization endotracheal intubation system according to claim 1, wherein: the fluorescent medium layer (4) is a fluorescent material filled in a sleeve layer covering the surface of the trachea cannula plug (5).
4. A fluorescence visualization endotracheal intubation system according to any of claims 1-3, wherein: the trachea cannula sequentially comprises a joint (1), a tube part (2), a sleeve bag (3) and a plug (5), wherein an indication balloon (6) is arranged on the tube part (2) close to the joint (1).
5. A fluorescence visualization endotracheal intubation system according to claim 4, wherein: the connector (1) is provided with a detachable shading cap (7), and the shading cap (7) covers the fluorescent medium layer (4) when sleeved on the connector (1).
6. A fluorescence visualization endotracheal intubation system according to claim 5, wherein: the terminal equipment (8) is of a handheld flat structure, a processing module and a storage battery are arranged in the handheld flat structure, and the transmitting end of the laser transmitting module and the receiving end of the fluorescent camera module (13) are arranged on the same end face of the terminal equipment (8).
7. A fluorescence visualization endotracheal intubation system according to claim 6, wherein: the laser emission module is a near infrared light source and comprises an infrared laser module (11) and a lens group (12), wherein the lens group (12) filters and diverges the light source emitted by the infrared laser module (11) to form a laser beam emitted from an emission end; the infrared laser module (11) is powered by a storage battery.
8. A fluorescence visualization endotracheal intubation system according to claim 6, wherein: the terminal equipment (8) is also internally provided with an alarm module, an image analysis program is preset in the processing module, the light spot data analysis is carried out according to the image transmitted back by the fluorescent camera module (13) in real time, and the alarm module sends out an audible and visual alarm when the light spot brightness and the range are smaller than the set threshold.
9. A fluorescence visualization endotracheal intubation system according to claim 6, wherein: the receiving end of the fluorescent camera module (13) is provided with an optical filter.
10. A cannula pre-alignment method, characterized by: the fluorescence visualization tracheal intubation system of claim 8 is adopted to adjust the imaging parameters of the terminal equipment aiming at the non-biological module intubation of the simulated larynx, wherein the non-biological module has human-like airways and esophagus, and the specific steps are as follows:
s1, firstly, taking out an trachea cannula with a shading cap (7), arranging a black medium at the lower part of a non-biological module with a channel, and inserting the trachea cannula from the channel by one end of a plug (5) after arranging;
s2, the terminal equipment (8) is arranged above the channel of the non-biological module, the red laser emission module irradiates the channel of the non-biological module, and meanwhile, the image is checked from the display screen (9);
s3, after corresponding light spots appear in the image, adjusting display parameters according to the brightness of the light spots to obtain a clear light spot image in the pseudo-color mapping image.
CN202211688555.0A 2022-12-27 2022-12-27 Fluorescence visualization trachea cannula system and cannula pre-adjustment method Pending CN116077782A (en)

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