CN116172877A - 一种鼻胃空肠管 - Google Patents

一种鼻胃空肠管 Download PDF

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CN116172877A
CN116172877A CN202310231739.2A CN202310231739A CN116172877A CN 116172877 A CN116172877 A CN 116172877A CN 202310231739 A CN202310231739 A CN 202310231739A CN 116172877 A CN116172877 A CN 116172877A
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cavity
tube
double
nasal
main body
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张革
顾正宇
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
    • A61J15/00—Feeding-tubes for therapeutic purposes
    • A61J15/0003—Nasal or oral feeding-tubes, e.g. tube entering body through nose or mouth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
    • A61J15/00—Feeding-tubes for therapeutic purposes
    • A61J15/0003—Nasal or oral feeding-tubes, e.g. tube entering body through nose or mouth
    • A61J15/0007—Nasal or oral feeding-tubes, e.g. tube entering body through nose or mouth inserted by using a guide-wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
    • A61J15/00—Feeding-tubes for therapeutic purposes
    • A61J15/0026—Parts, details or accessories for feeding-tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
    • A61J15/00—Feeding-tubes for therapeutic purposes
    • A61J15/0026—Parts, details or accessories for feeding-tubes
    • A61J15/0069—Tubes feeding directly to the intestines, e.g. to the jejunum
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/84—Drainage tubes; Aspiration tips
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/84—Drainage tubes; Aspiration tips
    • A61M1/87—Details of the aspiration tip, not otherwise provided for
    • 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
    • A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
    • 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
    • A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
    • A61M25/0026—Multi-lumen catheters with stationary elements

Abstract

一种鼻胃空肠管，属于医疗器械，适用于胃肠营养不耐受、易发生返流或误吸的高危重症患者。它是由一根胃肠管、一根可弯曲金属导丝组合而成，胃空肠管主体为双腔，体内侧为双腔单根，远端为单腔，体外侧近端双腔分叉为两根单腔。鼻空肠管置入患者后，双腔管体内侧开口分别在肠腔和胃腔。鼻空肠管双腔管体内侧开口具有多个侧孔。鼻空肠管双腔管体外侧开口处具有硬质支持圈，开口管径能与金属导丝手柄、流质输液管、注射器、塑料塞匹配连接。本发明除了具有普通鼻空肠管营养支持功能，还具有胃肠减压防止胃食道返流误吸继发肺部感染的作用，同时能协助胃蠕动功能恢复。

Description

一种鼻胃空肠管
所属技术领域
本发明涉及一种医疗器械，适用于胃肠营养不耐受、易发生返流或误吸的高危重症患者。
背景技术
临床上胃蠕动功能差的患者常行置入鼻空肠管营养支持，普通鼻空肠管使用过程中常出现胃潴留腹胀返流误吸继发肺部感染，曾见1例胃癌胃部分切除术后3年同时患有2型糖尿病患者出现胃瘫，置入鼻空肠管，肠营养支持得到保证，但患者反复出现腹胀返流胃内胆汁等内容物误吸继发肺部感染，偿试经患者另一鼻腔置入一鼻胃管行持续胃肠减压，每天引流出约500m1黄色胆汁为主的液体，肺部感染很快得到控制，但患者两侧鼻腔均有胃肠管，通气受阻，呼吸困难明显，无法经鼻导管吸氧，患者被迫张口呼吸。为了减少局部感染需定期更换鼻胃管、鼻空肠管，反复经两侧鼻腔插管操作，患者非常痛苦。由于曾有胃部手术，解剖有异常，行胃造瘘进一步处理营养和潴留问题也有难度。另外胃肠手术后，重症胰腺炎等患者主张早期肠内营养，常规置入普通鼻空肠管后仍有部分患者出现胃食道返流误吸问题。这些患者的救治成为临床医生一大困惑。
发明内容
为了解决胃蠕动功能差患者胃肠营养支持问题，本发明提供一种制作简单，结构巧妙，方便实用的鼻胃空肠管。
本发明解决其技术问题所采用的技术方案是：双腔胃肠管一根、可弯曲金属导丝一根。按照消化科常规方法置入鼻胃空肠管，使鼻空肠管腔体内侧出入口位于空肠腔内，鼻胃管腔体内侧出入口位于胃腔内，经鼻空肠管腔输入流质营养支持，经鼻胃管腔行胃肠减压，必要时亦可输入流质营养支持。
本发明的有益效果是：按照消化科常规方法置入鼻胃空肠管，医生对方法熟悉，易操作；患者创伤小，依从性好；营养支持，防返流误吸感染，促进胃功能恢复多重功效。本发明为双腔管，除了具有普通鼻空肠管营养支持功能，还具有胃肠减压防止胃食道返流误吸继发肺部感染的作用，同时能协助胃蠕动功能恢复。经鼻空肠管腔持续小剂量输注流质营养支持同时可经鼻胃管腔持续胃肠减压，避免食道返流误吸继发肺部感染。若鼻胃管腔持续减压引流液体逐渐减少，可试验性渐进性经鼻胃管腔输注流质，刺激胃蠕动，协助功能恢复，逐渐转为完全鼻胃管营养支持，随着患者病情好转，拔除鼻胃空肠管，恢复正常经口进食营养。
附图说明
图1-图4是本发明的结构图。
图1中1、鼻空肠管腔体外出入口塑料塞2、鼻空肠管腔体外出入口3、鼻胃管腔体外出入口4、鼻胃管腔体外硬质支持圈5、鼻胃空肠管体外管腔6、鼻胃管腔胃腔内出入口8、鼻空肠管腔肠腔内出入口
图2中9、图1标注5处鼻空肠管腔横断面10、图1标注5处鼻胃管腔横断面11、图1标注7处鼻空肠管腔横断面
图3中12、金属导丝手柄13、可弯曲金属导丝
图4为图1、图3组合后
具体实施方式
首先采取盲插法，可弯曲金属导丝13经鼻空肠管体外出入口2插入经过9、11到达8附近，如图4，以常规放置胃管的方法将带有可弯曲金属导丝的鼻胃空肠管(图4)经一侧鼻腔插入远端放置入胃内，并继续缓慢推进，当有落空感时说明通过幽门，在逐步用力推进，当置管深度在110-120cm时到达屈氏韧带，双手分别握住鼻空肠管腔体外硬质支持圈(类似4)、金属导丝手柄12拔出可弯曲金属导丝13，在2处接注射器，回抽有金黄色肠液提示已经到达，此时8在空肠腔内，6在胃腔内。若盲插法困难，可借助内镜下放置，如上述带有可弯曲金属导丝的鼻胃空肠管(图4)经一侧鼻腔插入远端放置入胃内后，将胃镜和导管一同通过幽门或胃肠吻合口，多次操作后可以将导管插入近端空肠或吻合口远端，确定导管深度、位置后可撤出内镜，拔除可弯曲金属导丝13。胃肠手术过程中亦可以直接置入。鼻翼处固定管腔，在5处。双腔管两处体外出入口2、3可连结营养液输注管或持续胃肠减压管，停止使用时，用出入口塑料塞1封闭。

Claims (1)

1.一种鼻胃空肠管，它是由一根胃肠管、一根可弯曲金属导丝组合而成，其特征是：鼻胃空肠管主体为双腔，体内侧为双腔单根，远端为单腔，体外侧近端由单根双腔分叉为两根单腔；鼻空肠管置入患者后，双腔管体内侧开口分别在肠腔和胃腔；鼻空肠管双腔管体内侧开口具有多个侧孔；鼻空肠管双腔管体外侧两个开口处均具有硬质支持圈，开口管径能与金属导丝手柄、流质输液管、注射器、塑料塞匹配连接；弯曲金属导丝近端有手柄。
CN202310231739.2A 2023-03-10 2023-03-10 一种鼻胃空肠管 Pending CN116172877A (zh)

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