CN116271383A - Method and device for guiding tunnel type tracheal catheter forward direction into airway - Google Patents
Method and device for guiding tunnel type tracheal catheter forward direction into airway Download PDFInfo
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- CN116271383A CN116271383A CN202310066788.5A CN202310066788A CN116271383A CN 116271383 A CN116271383 A CN 116271383A CN 202310066788 A CN202310066788 A CN 202310066788A CN 116271383 A CN116271383 A CN 116271383A
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- 230000007246 mechanism Effects 0.000 claims abstract description 47
- 238000002627 tracheal intubation Methods 0.000 claims abstract description 37
- 230000002441 reversible effect Effects 0.000 claims abstract description 25
- 230000003014 reinforcing effect Effects 0.000 claims abstract description 9
- 230000000007 visual effect Effects 0.000 claims abstract description 4
- 210000004704 glottis Anatomy 0.000 claims description 20
- 210000000214 mouth Anatomy 0.000 claims description 16
- 210000003800 pharynx Anatomy 0.000 claims description 10
- 230000008569 process Effects 0.000 claims description 9
- 230000008859 change Effects 0.000 claims description 6
- 238000012544 monitoring process Methods 0.000 claims description 6
- 238000005452 bending Methods 0.000 claims description 4
- 230000001105 regulatory effect Effects 0.000 claims description 4
- 238000002513 implantation Methods 0.000 claims description 2
- 210000001503 joint Anatomy 0.000 claims description 2
- 239000010687 lubricating oil Substances 0.000 claims description 2
- 210000003437 trachea Anatomy 0.000 abstract description 9
- 210000003300 oropharynx Anatomy 0.000 abstract 1
- 238000003780 insertion Methods 0.000 description 5
- 230000037431 insertion Effects 0.000 description 5
- 238000001514 detection method Methods 0.000 description 4
- 230000029058 respiratory gaseous exchange Effects 0.000 description 4
- 210000003238 esophagus Anatomy 0.000 description 3
- 239000000835 fiber Substances 0.000 description 3
- 239000012634 fragment Substances 0.000 description 3
- 238000009423 ventilation Methods 0.000 description 3
- 206010021143 Hypoxia Diseases 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
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- 210000002409 epiglottis Anatomy 0.000 description 2
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- 239000002184 metal Substances 0.000 description 2
- 230000000241 respiratory effect Effects 0.000 description 2
- 206010002091 Anaesthesia Diseases 0.000 description 1
- 208000019743 Cranial nerve injury Diseases 0.000 description 1
- 208000009481 Laryngeal Edema Diseases 0.000 description 1
- 206010023845 Laryngeal oedema Diseases 0.000 description 1
- 208000005248 Vocal Cord Paralysis Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 230000037005 anaesthesia Effects 0.000 description 1
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- 230000006378 damage Effects 0.000 description 1
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- 238000002695 general anesthesia Methods 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 210000000867 larynx Anatomy 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000003680 myocardial damage Effects 0.000 description 1
- 210000003928 nasal cavity Anatomy 0.000 description 1
- 229910052760 oxygen Inorganic materials 0.000 description 1
- 239000001301 oxygen Substances 0.000 description 1
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Classifications
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- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments 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
- A61B1/04—Instruments 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments 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
- A61B1/04—Instruments 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
- A61B1/045—Control thereof
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments 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
- A61B1/267—Instruments 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
-
- Y—GENERAL 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
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
Abstract
The invention provides a method and a device for guiding a tunnel type tracheal catheter forward to an airway, comprising a guiding shell, wherein the end part of the guiding shell is connected with an arc-shaped guiding shell, the arc-shaped guiding shell is extended with an arc-shaped reverse folding shell, the side surface of the guiding shell is provided with a sliding mechanism, a pull type tongue plate passes through the middle of the sliding mechanism, the upper surface of the pull type tongue plate is connected with a guide rail by virtue of a reinforcing column, the front lower part of the guide rail is connected with a V-shaped elastic piece, and the inner wall of the V-shaped elastic piece is provided with a camera; the drawing type tongue plate can slide and lock in the tongue plate sliding groove, the groove of the guide rail and the inner surface of the guide shell form a tunnel for the tracheal catheter to move forward, and the tracheal catheter is folded back along the radian of the guide rail after being placed in the tunnel, so that the forward direction of the catheter is changed, and the tracheal catheter is guided into the trachea of a patient along the trend. The device is placed in the oropharynx and the laryngeal part, the tracheal catheter moves forwards and is folded reversely in the device, the tracheal catheter can be pushed into the trachea of a patient without visual observation, and the tracheal cannula can be used for realizing the blind tracheal intubation.
Description
Technical Field
The invention belongs to the field of trachea cannula in medical treatment, and particularly relates to a method and a device for guiding a tunnel type tracheal catheter forward to an airway.
Background
At present, when an artificial airway is established in emergency treatment and general anesthesia, an endotracheal tube is required to be placed into a human trachea for a certain depth, and then an artificial ventilation balloon or a respirator is connected for artificial ventilation, which is the conventional operation of the endotracheal tube in medical treatment. The patient needing trachea cannula has the advantages that the patient is either extremely rapid in breathing, slow in breathing, slightly about to stop or passively stops spontaneous breathing after anesthesia intervention for a moment, the patient must immediately breathe artificially by placing a tracheal catheter and connecting a breathing machine, if the patient cannot quickly establish an artificial airway to ventilate artificially, the patient can be lack of oxygen to cause myocardial damage and brain cell apoptosis, and the patient is dead due to time delay. The laryngeal mask can be used for replacing artificial ventilation under the condition of difficult airways or unsuccessful trachea cannula for many times, but the laryngeal mask method can cause air leakage, uvula injury, vocal cord paralysis and other tissue injuries, and complications such as aspiration, pharyngalgia, cranial nerve injury and the like are reported to be easily caused by the laryngeal mask, so the laryngeal mask is not an ideal cannula substitute; tracheotomy can also be performed in emergency situations, but this is an invasive procedure that is unacceptable to the patient.
When the emergency endotracheal intubation is carried out, the endotracheal intubation through the oral cavity and the nasal cavity can be carried out, but the oral intubation is the preferred method, the operation time of the endotracheal intubation is strictly limited in medical treatment, the operation time of each intubation should not exceed 30 seconds, 45 seconds are the limit, the serious hypoxia of a patient can be caused when the endotracheal intubation is used for establishing an oral artificial airway, a direct laryngoscope or a visible laryngoscope is usually used as a tool for assisting intubation, and a fiber bronchoscope is also used for guiding and implementing the endotracheal intubation in partial difficult endotracheal intubation, but the application of the fiber bronchoscope for assisting intubation has higher technical requirements on operators, more complicated process and longer time.
Blind tracheal intubation was a respiratory noun approved and released by the national science and technology noun approval committee in 2018. Refers to an operation method for directly placing an endotracheal intubation tube into a trachea by an operator according to the anatomical characteristics of an upper airway and the characteristics of respiratory airflow under the condition that epiglottis and glottis are displayed without a pharyngoscope or a fiberbronchoscope, and is mainly used for transnasal endotracheal intubation.
Examples of real blinding endotracheal intubation: in actual treatment, if the operation and the attempt of the tracheal intubation are carried out once, twice and three times under the condition that the exposed throat part is not clear and the glottis cannot be exposed when the tracheal intubation is carried out by using the laryngoscope, the operation and the attempt fail, in order to save the life of a patient, under the emergency, the medical staff can also insert the tracheal catheter shaped by using the metal guide wire in the oral cavity in a blind detection mode only by hand feeling towards the throat part, and the situation that the tracheal catheter is inserted by happening after a long time and multiple attempts exists, but the probability of successful blind insertion is very small, the hypoxia of the patient is aggravated due to long time consumption, and even the death of the patient is caused due to delay. Therefore, the method for trying to insert blindly is not clinically claimed, and is not advocated in textbooks.
The average intubation time (4.1+/-1.3) min of 30 cases of oral blind intubation using the blind intubation device is reported to be slightly longer than the average time (3.8+/-1.2) min of 30 cases of guide intubation of a fiber bronchoscope; in addition, 17 cases of nasal blind intubation using the blind intubation device take 5-20 min, wherein one success is 9 cases, the other cases are successfully intubated for 2-3 times, and the success rate of one intubate is 52.94%; the blind detection trachea cannula device consists of an esophagus trachea guide tube, a light beam with a lamp and a power supply box, the cannula principle is similar to that of a light rod guide cannula used in medical treatment at present, and the implementation process is divided into a plurality of steps, so that the blind detection method has long operation time which is close to 300s, such as unskilled operation, and the operation time which is as long as 20 minutes is greatly longer than a time window which is allowed by cannula operation within 45 s.
Disclosure of Invention
In order to solve the technical problems, the invention provides a method and a device for forward introducing a tunnel type tracheal catheter into an airway, which is initiated and implemented by the method, wherein the method adopts a novel tracheal intubation method that the tunnel type tracheal catheter is used for forward introducing the airway device, the epiglottis and the glottis of a patient do not need to be exposed, metal guide wires do not need to be placed for shaping, a light source is not needed, any body position requirements on the patient are not needed, even the lateral position intubation which cannot be achieved at present can be implemented, the rapid oral tracheal intubation which is completely blind in detection is realized, the easy tube placement only needs about 5 seconds, and the success rate of one intubation is about 90 percent; if the V-shaped elastic sheet is provided with the monitoring camera with a variable angle, the monitoring camera becomes an insertion tube under the condition of monitoring direct vision, and the success rate of one insertion tube is more than 90%. The method does not require the three axes of the patient's mouth, throat and larynx' to be in line, and the patient can only have a mouth opening degree of 30 mm (the mouth opening degree of a normal adult is 35-56 mm). The patient can be placed smoothly as long as the glottis of the patient can be opened normally, and as long as the pharyngeal throat of the patient is free from the blockage of the new-born protrusion, the laryngeal edema and the tonsil extremely swelling, and the like, so that the tracheal intubation is used for solving the clinical problem of difficult tracheal intubation in the background technology.
A method for guiding a tunnel-type tracheal catheter into an airway in a forward direction, comprising the following steps:
s1: the guide rail, the arc-shaped guide shell, the inner surface of the arc-shaped reverse folding shell and the front end of the tracheal catheter are rubbed by sterile lubricating oil, the tracheal catheter is placed into the device from the inlet of the guide shell, and the tracheal catheter is pushed forward in the tunnel along the guide rail;
s2: the distal end of the tracheal catheter exceeds the arc-shaped reverse folding shell and is exposed for about 5 mm, and the pin column is checked to be pinned into the pin hole;
s3: the foldable handle is unfolded, the connecting handle of the display screen is inserted into the display screen seat rod and locked by the fixed locking mechanism, the cable male connector is in butt joint with the cable female connector, the power switch is turned on, and the monitoring state is achieved;
s4: opening the oral cavity of a patient, laterally placing the front end of the device into the oral cavity, turning over until the middle part of the oral cavity is reached, enabling the bottom surface of the pull-type tongue plate to be close to the tongue body, simultaneously pushing the bottom surface of the pull-type tongue plate into the back wall of the pharyngeal cavity, observing the image of the pharyngeal part in the display screen at the moment, and directly pushing the distal end of the tracheal tube into the airway if the distal end of the tracheal tube is opposite to the glottis of the pharyngeal part;
s5: if the display screen observes that the glottis angle is poor at this moment, the adjusting bolt can be finely adjusted to push the angle adjusting rod and tighten the traction wire so as to compress the angle of the V-shaped elastic sheet, the visual angle of the camera is driven to change, clear images of the tracheal catheter and the glottis are seen, and then the tracheal catheter is pushed into the glottis and the air passage to a certain depth in a forward direction;
s6: if the emergency happens and the power supply is in a shortage or the monitored line fails, the blind tracheal intubation can be implemented: at this time, a display screen is not needed, a foldable handle of the device is held, the device (shown in fig. 3) with the tracheal catheter placed in is propped against the back wall of the pharynx and the distal end of the catheter is slightly tilted forwards, the tracheal catheter is gently pushed, if no resistance exists, the catheter is pushed forward, if resistance exists, the tracheal catheter is gently pushed inwards by one hand, the handle end of the device is adjusted by swinging forwards and backwards by one hand, the catheter is slid into the airway at the moment when the resistance disappears, and the intubation is successful;
s7: the tracheal catheter can be connected with a ventilator pipeline after entering the airway, the catheter sleeve bag is inflated, the overhead column is loosened, the pull-out type tongue plate is pulled out, the tracheal catheter exits from the semi-tubular guide shell, the depth of the tracheal catheter is regulated if necessary, and the tracheal catheter implantation process is completed.
The utility model provides a tunnel type endotracheal tube is along leading-in airway's method and device, includes the guide shell, the end connection of guide shell has the arc guide shell, the proximal end of guide shell is the entry of endotracheal tube, the arc guide shell extends has the arc to turn over the roll-over shell, the side surface of guide shell is provided with slide mechanism, slide mechanism's centre has pull formula tongue plate to pass through, the end connection of pull formula tongue plate has the reverse flap, be connected with the enhancement angle between pull formula tongue plate and the reverse flap, the upper surface of pull formula tongue plate relies on the spliced pole to be connected with the guide rail, the front below of guide rail is connected with the V-arrangement shell fragment, the camera is installed to the inner wall of V-arrangement shell fragment, be provided with fixed establishment between guide shell and the pull formula tongue plate, the surface of guide rail has seted up the second and led out the hole, be provided with traction mechanism between V-arrangement shell fragment and the pull formula tongue plate, be close to traction mechanism's surface mounting has adjustment mechanism, the inside cable connection has the handle, but the folding cable connection has the end, but the display screen is provided with the display screen.
Preferably, the sliding mechanism comprises a connecting plate and a tongue plate chute, the side surface of the guide shell is extended with the connecting plate, the tongue plate chute is arranged on the inner side wall of the connecting plate, and the guide rail is semi-annular bending arch.
Preferably, each of two sides of the connecting plate is provided with a tongue plate chute, the tongue plate chute penetrates through the middle of the connecting plate, and the pull-type tongue plate is in sliding connection with the connecting plate through the tongue plate chute.
Preferably, the fixing mechanism comprises a pin hole, a pin lug and a pin column, the surface of the pull-type tongue plate is provided with the pin hole, the guide shell is provided with the pin lug at the door edge of the inlet, and the pin column penetrates through the pin lug.
Preferably, the pin hole and the pin lug are provided with two groups, the pin column is in a U shape and is in sliding connection with the pin lug, and the pin column and the pin hole form clamping connection.
Preferably, the traction mechanism comprises a traction wire, a shaft rod, a rotary table, an angle adjusting rod, a fixing bolt and an outer cover, wherein the traction wire is connected to the whole of the V-shaped elastic piece far-end blade and the camera, and the traction wire sequentially penetrates through the first guiding-out hole and the second guiding-out hole and is accompanied with the cable.
Preferably, the tail end of the pull-out tongue plate protrudes to form a shaft lever, a middle hole of the rotary table is inserted into the shaft lever, an angle adjusting rod is arranged on the side surface of the rotary table, a fixing bolt is connected to the side surface of the rotary table, the fixing bolt is fixedly connected with the traction wire, the top of the shaft lever is connected with an outer cover, and the outer cover is semicircular.
Preferably, the adjusting mechanism comprises a fixing nut and an adjusting bolt, the fixing nut is connected to the surface of the pull-out type tongue plate, the adjusting bolt penetrates through the fixing nut, the adjusting bolt is in threaded connection with the fixing nut, the cable is fixed to the surface of the pull-out type tongue plate through a fixing clamp, and the cable is arranged on the outer side of the outer cover.
Preferably, the display mechanism comprises a connecting handle, an element part, a joint part, a display screen, a photographing key, a power switch, a charging port, a storage bayonet, a cable female connector and a fixed locking mechanism, wherein the connecting handle is sleeved with a display screen seat rod and is provided with the fixed locking mechanism, the connecting handle is connected with the element part, the element part is continued to the joint part, the joint part is movably connected with the display screen, and the visual angle of the display screen can be changed.
Preferably, the top of display screen is installed and is shot and recorded key and switch key, the side of display screen is provided with the mouth that charges and stores the bayonet socket, the lower surface of display screen is provided with the jack of cable female joint, the bottom side surface mounting of connective handle has fixed latch mechanism.
Compared with the prior art, the invention has the following beneficial effects:
1. in use, the pull-type tongue plate is arranged in the tongue plate chute of the guide shell and is locked by the pin post inserted into the pin hole, so that the pull-type tongue plate and the guide shell are combined into a whole, and at the moment, a guide tunnel of the tracheal catheter is formed between the guide rail above the pull-type tongue plate and the inner surfaces of the guide shell, the arc-shaped guide shell and the arc-shaped reverse folding shell. The tracheal catheter is inserted from the inlet in the middle of the pin lug, slides inwards along the guide tunnel above the pull-type tongue plate, bends along the arc direction when the distal end of the tracheal catheter moves to the inner wall of the arc guide shell, and then is blocked by the arc reverse folding shell to be reversely folded, so that the advancing direction of the tracheal catheter is further regulated, and the distal end opening of the tracheal catheter can be exposed out of the arc reverse folding shell for about 5 mm in the initial stage. Then the combination of the drawing type tongue plate and the guiding shell carries the tracheal catheter to be placed at the oral cavity and the pharyngeal throat of a patient, the far end of the tracheal catheter after bending and turning is opposite to the glottis and the airway direction of the patient, the arc guiding shell and the arc reverse folding shell shield the esophageal direction, the tracheal catheter can only enter the glottis and the airway after going forward, the situation that the tracheal catheter is wrongly placed into the esophagus is effectively avoided, the intubation failure caused by the wrong placement of the tracheal catheter into the esophagus is avoided, the difficulty of intubation is reduced, and the success rate of intubation is increased.
2. When the pull-out type tongue plate is pushed into the tongue plate sliding groove and drives the pin hole to move to the bottom of the pin, the pin is pushed to enter the pin hole to be locked quickly. When the device is placed in the oral cavity or the tracheal catheter is fixed at the relative position of the pull-type tongue plate and the guide shell in the advancing process, the operation can be effectively prevented from being influenced by sliding in the process of pressing the tongue of a patient by the pull-type tongue plate.
3. In use, the adjusting bolt can axially move in the fixing nut, the fixing nut axially moves to squeeze the angle adjusting rod, the angle adjusting rod is squeezed to drive the rotary table to rotate along the shaft rod, the rotary table rotates to drive the fixing bolt, the fixing bolt rotates to pull the traction wire, the traction wire is pulled to drive the far-end elastic piece of the V-shaped elastic piece, the far-end elastic piece can change an angle when being pulled, the angle of the V-shaped elastic piece can drive the camera to change, and the monitoring direction of the camera is further adjusted, so that images of the throat and the glottis can be clearly observed, and the tracheal catheter can accurately enter the glottis in the pushing process.
4. In use, the connecting handle is sleeved on the surface of the display screen seat rod and is locked quickly through the fixed locking mechanism, the cable male connector is plugged into the jack of the cable female connector, then the display screen is started through the power switch, and the shooting and recording key is pressed to shoot pictures or record videos, so that the device can be conveniently used, and the videos can be applied to teaching and also can be stored as medical records.
Drawings
FIG. 1 is a schematic diagram of a front view of an embodiment of the present invention;
FIG. 2 is a schematic side view of one embodiment of the present invention;
FIG. 3 is a schematic side view of an endotracheal tube insertion device according to one embodiment of the present invention;
FIG. 4 is a schematic top view of an embodiment of the present invention;
FIG. 5 is a schematic view of a guide housing according to an embodiment of the present invention;
FIG. 6 is a schematic view of the internal structure of a pull-out tongue plate according to an embodiment of the present invention;
FIG. 7 is a partial schematic view of an adjustment mechanism according to one embodiment of the present invention;
FIG. 8 is a partial exploded view of an adjustment mechanism according to one embodiment of the present invention;
FIG. 9 is a schematic diagram showing a front view of a display mechanism according to an embodiment of the present invention;
fig. 10 is a schematic bottom view of a display mechanism according to an embodiment of the present invention.
In the figure: 1. a guide housing; 2. an arc-shaped guide housing; 3. arc reverse folding shell; 4. a connecting plate; 5. a tongue plate chute; 6. a pull-out tongue plate; 7. a reinforcing column; 8. a guide rail; 9. a V-shaped spring plate; 10. a camera; 11. a pin hole; 12. a pin lug; 13. a pin; 14. a first lead-out hole; 15. a second lead-out hole; 16. traction wire; 17. a shaft lever; 18. a turntable; 19. an angle adjusting rod; 20. a fixing bolt; 21. an outer cover; 22. a fixing nut; 23. an adjusting bolt; 24. a cable; 25. a cable male connector; 26. a foldable handle; 27. a display screen seat bar; 28. a connecting handle; 29. an element section; 30. a joint; 31. a display screen; 32. a recording key; 33. a power switch; 34. a charging port; 35. a storage bayonet; 36. a cable female connector; 37. a fixed latch mechanism; 38. a fixing clip; 39. reinforcing the angle; 40. an inlet; 41. and a reverse folded plate.
Detailed Description
Embodiments of the present invention are described in further detail below with reference to the accompanying drawings and examples. The following examples are illustrative of the invention but are not intended to limit the scope of the invention.
Embodiment one: as shown in fig. 1-10, the present invention provides a method and a device for guiding a tunnel-type tracheal catheter forward to an airway, comprising a guiding shell 1, wherein an arc-shaped guiding shell 2 is connected to the end of the guiding shell 1, an inlet 40 is provided at the initial part of the guiding shell 1, a guide rail 8 above a pull-out tongue plate 6 can be accessed from the inlet 40, and the inlet 40 is also the inlet of the tracheal catheter. The arc-shaped guide shell 2 extends to form an arc-shaped reverse folding shell 3, a sliding mechanism is arranged on the side surface of the guide shell 1, a pull-out type tongue plate 6 is arranged on the inner side of the sliding mechanism, a reverse folding plate 41 is connected to the end portion of the pull-out type tongue plate 6, a reinforcing angle 39 is connected between the pull-out type tongue plate 6 and the reverse folding plate 41, a guide rail 8 is connected to the upper surface of the pull-out type tongue plate 6 by means of a reinforcing column 7, a camera 10 is mounted on the inner wall of a distal elastic piece of a V-shaped elastic piece 9,V of the guide rail 8, a fixing mechanism is arranged between the guide shell 1 and the pull-out type tongue plate 6, a first guide hole 14 is formed in the surface of the V-shaped elastic piece 9, a second guide hole 15 is formed in the surface of the guide rail 8, an adjusting mechanism is arranged between the V-shaped elastic piece 9 and the pull-out type tongue plate 6, an adjusting mechanism is mounted on the upper surface of the pull-out type tongue plate 6 close to the pull-out type tongue plate, a cable 24 is connected to the end portion of the cable 24 by means, a cable male connector 25 is mounted on the end portion of the cable 24, a handle 38 is fixedly connected to the inner surface of the guide shell 6, a handle 27 is fixedly arranged on the surface of the pull-side of the pull-out type tongue plate 6, a foldable display screen 27 is connected to the handle 27, and a display screen is mounted on the side surface of the display screen 27.
The sliding mechanism comprises a connecting plate 4 and a tongue plate chute 5, the side surface of the guiding shell 1 is connected with the connecting plate 4, the tongue plate chute 5 is arranged on the inner side wall of the connecting plate 4, and the guide rail 8 is semi-annular arched. The tongue plate chute 5 passes through the middle of the connecting plate 4, the pull tongue plate 6 is connected with the connecting plate 4 in a sliding way through the tongue plate chute 5, the tail end of the pull tongue plate 6 is provided with an angled reverse folded plate 41, a reinforcing angle 39 is arranged between the reverse folded plate 41 and the tongue plate, the reinforcing angle 39 is set at a certain angle according to the requirement, two sides are respectively provided, a tunnel is formed between the guide rail 8 and the inner surface of the guide shell 1, the lower surface of the pull tongue plate 6 can press the tongue body of a patient, and the upper surface of the guide rail 8 is a semi-annular track, so that the tracheal catheter can be conveniently inserted and moved forward through the tunnel and the track.
The fixing mechanism comprises a pin hole 11, a pin lug 12 and a pin column 13, the surface of the pull-out type tongue plate 6 is provided with the pin hole 11, the pin lug 12 is connected to the side of the inlet 40 of the guide shell 1, the pin column 13 penetrates through the inside of the pin lug 12, the pin hole 11 and the pin lug 12 are provided with two groups, the pin column 13 is U-shaped, two separated thin columns are arranged, sliding connection is formed between the pin column 13 and the pin lug 12, the pin column 13 and the pin hole 11 form clamping connection, the pin column 13 can be plugged into the pin lug 12 by external force, and thus the position of the pull-out type tongue plate 6 in the tongue plate chute 5 is relatively fixed.
The traction mechanism comprises a traction wire 16, a shaft rod 17, a rotary table 18, an angle adjusting rod 19, a fixing bolt 20 and an outer cover 21, wherein the traction wire 16 is connected to the integral inner surfaces of the far-end elastic pieces of the camera 10 and the V-shaped elastic pieces 9, the traction wire 16 sequentially penetrates through the first guide out hole 14 and the second guide out hole 15, the shaft rod 17 is arranged on the proximal end surface of the pull-type tongue plate 6, the rotary table 18 is provided with a middle hole, the shaft rod 17 can be sleeved in the rotary table 18, the rotary table 18 and the angle adjusting rod 19 are connected into a whole, the fixing bolt 20 is arranged on the side surface of the rotary table 18, the fixing bolt 20 is connected with and fixes the traction wire 16, the top of the shaft rod 17 is connected with the outer cover 21, the outer cover 21 is semicircular, and the whole angle adjusting rod 17 and the rotary table 18 can drive the traction wire 16 to reset automatically through the elastic force of the V-shaped elastic pieces 9 under the condition of not being subjected to external force.
The adjusting mechanism comprises a fixing nut 22 and an adjusting bolt 23, wherein the fixing nut 22 is connected to the surface of the pull-type tongue plate 6, the adjusting bolt 23 penetrates through the inside of the fixing nut 22, the adjusting bolt 23 is in threaded connection with the fixing nut 22, a cable 24 is fixed at the side of the pull-type tongue plate 6 through a fixing clamp 38, the cable 24 can pass through the outer side of the outer cover 21, the adjusting bolt 23 generates axial movement when the fixing nut 22 rotates, and the adjusting bolt 23 can push the angle adjusting rod 19 when axially moving, so that a traction wire generates tension and tightens up a V-shaped elastic sheet, and the angle adjustment of the camera is realized.
The display mechanism comprises a connecting handle 28, an element part 29, a joint part 30, a display screen 31, a shooting key 32, a power switch 33, a charging port 34, a storage bayonet 35, a cable female connector 36 and a fixed locking mechanism 37, wherein the connecting handle 28 is sleeved on the surface of a display screen seat rod 27, the element part 29 is connected with the connecting handle 28, the joint part 30 is arranged at the top of the element part 29, the display screen 31 is movably connected with the joint part 30, the shooting key 32 and the power switch 33 are arranged at the top of the display screen 31, the charging port 34 and the storage bayonet 35 are arranged on the side surface of the display screen 31, the cable female connector 36 is arranged on the lower surface of the display screen 31, and the fixed locking mechanism 37 is arranged on the side surface of the bottom of the connecting handle 28.
Embodiment two: when the tunnel type tracheal catheter is used for guiding the airway in the forward direction, firstly, the pull-out type tongue plate 6 is placed in the tongue plate chute 5 of the guiding shell 1 and is locked by the pin post 13 through the pin lug 12 inserted into the pin hole 11, the locking state can prevent the position movement from influencing the operation in the process of pressing the tongue of a patient by the pull-out type tongue plate 6, at the moment, the pull-out type tongue plate 6 and the guiding shell 1 are combined into a whole, and a guiding tunnel of the tracheal catheter is formed between the guide rail 8 above the pull-out type tongue plate 6 and the inner surfaces of the guiding shell 1, the arc-shaped guiding shell 2 and the arc-shaped reverse folding shell 3. The tracheal tube is inserted from the inlet 40 in the middle of the pin lug 12 and slides inwards along the guide tunnel, the end part of the tracheal tube bends along the arc direction when moving to the inner wall of the arc guide shell 2, and then the tracheal tube is blocked by the arc reverse folding shell 3 to be reversely folded, so that the advancing direction of the tracheal tube is regulated, and the distal end of the tracheal tube passes through the arc reverse folding shell 3 and is exposed for about 5 mm as an initial state for standby. Then the combination of the drawing tongue plate 6 and the guiding shell 1 carries the tracheal catheter to be placed into the oral cavity, the pharyngeal throat of the patient, the distal end of the tracheal catheter after bending and turning is opposite to the glottis and the airway direction of the patient, the arc guiding shell 2 and the arc reverse folding shell 3 shield the esophageal direction of the patient, the tracheal catheter is pushed to move forward continuously and only can enter the glottis and the airway, the intubation failure caused by the mistaken insertion of the tracheal catheter is avoided, and the intubation success rate is increased.
The rotation adjusting bolt 23 can axially move in the fixing nut 22, the fixing nut 22 axially moves to squeeze the angle adjusting rod 19, the angle adjusting rod 19 is squeezed to drive the rotary disc 18 to rotate on the surface of the shaft rod 17, the rotary disc 18 rotates to drive the fixing bolt 20, the fixing bolt 20 rotates to pull the traction wire 16, the traction wire 16 is pulled to drive the V-shaped elastic sheet 9 to generate pulling force, the V-shaped elastic sheet 9 is pulled to change angles, the V-shaped elastic sheet 9 can drive the camera 10 to change angles, and thus the direction of the camera 10 can be adjusted, so that the image of the throat and the glottis can be clearly observed, and the tracheal catheter can accurately enter the glottis in the pushing process.
The connecting handle 28 is sleeved on the surface of the display screen seat rod 27 and is fast fixed through the fixed locking mechanism 37, the cable male connector 25 is spliced in the cable female connector 36, then the display screen 31 is started through the power switch 33, and pictures or videos are captured by pressing the shooting key 32, so that the device can be conveniently used, images can be stored as medical records, and videos can also be applied to teaching.
Embodiment III: the tunnel-type tracheal catheter forward direction guiding airway method of the invention can be independently implemented without the equipment based on the scheme.
The camera 10 can be positioned below the distal end of the guide rail or can be positioned elsewhere on the distal end of the device; the angle adjusting mode of the camera 10 is not limited to the method of applying the V-shaped elastic sheet and the traction wire, as long as all modes capable of realizing the angle changing of the camera 10 in the device are within the protection implementation scope of the patent.
The embodiments of the present invention have been shown and described for the purpose of illustration and description, it being understood that the above embodiments are illustrative and not to be construed as limiting the invention, and that variations, modifications, alternatives and variations may be made therein by one of ordinary skill in the art without departing from the scope of the invention.
Claims (10)
1. A method for guiding a tunnel-type tracheal catheter into an airway in a forward direction, comprising the steps of:
s1: the guide rail (8), the arc-shaped guide shell (2), the inner surface of the arc-shaped reverse folding shell (3) and the front end of the tracheal catheter are rubbed by sterile lubricating oil, the tracheal catheter is put into the device from the inlet (40) of the guide shell (1), and the tracheal catheter is pushed forward in the tunnel along the guide rail (8);
s2: the distal end of the tracheal catheter exceeds the arc-shaped reverse folding shell (3) and is exposed out by about 5 mm, and the checking pin (13) is distributed into the pin hole (11);
s3: the foldable handle (26) is unfolded, the connecting handle (28) of the display screen (31) is inserted into the display screen seat rod (27) and locked by the fixed locking mechanism (37), the cable male connector (25) is in butt joint with the cable female connector (36), the power switch (33) is turned on, and the video monitoring state is achieved;
s4: opening the oral cavity of a patient, laterally placing the front end of the device into the oral cavity until the middle part of the oral cavity is turned over, enabling the bottom surface of the pull-type tongue plate (6) to be close to the tongue body, simultaneously pushing the bottom surface of the pull-type tongue plate into the back wall of the pharyngeal cavity, observing the image of the pharyngeal part in the display screen (31), and directly pushing the distal end of the tracheal catheter into the airway if the distal end of the tracheal catheter is opposite to the glottis of the pharyngeal part;
s5: if the angle of the glottis observed by the display screen (31) is not good at this moment, the fine adjustment adjusting bolt (23) can be used for pushing the angle adjusting rod (19) to tighten the traction wire (16) so as to reduce the angle of the V-shaped elastic sheet (9), the visual angle of the camera (10) is driven to change, the images of the tracheal catheter and the glottis are seen clearly, and then the tracheal catheter is pushed into the glottis and the air flue forward to a certain depth;
s6: if the emergency happens and the power supply is in short supply or the monitored line fails, the blind cannula can be implemented without tension: at this time, a display screen is not needed, a foldable handle (26) of the device is held, the device (figure 3) with the tracheal catheter placed in is propped against the back wall of the pharynx and the distal end of the catheter is slightly tilted forwards, the tracheal catheter is gently pushed, if no resistance exists, the catheter is pushed forward in a proper state, if the resistance exists, the catheter is gently pushed inwards by one hand, the handle end of the device is adjusted by swinging forwards and backwards by the other hand, the catheter is slid into the airway at the moment when the resistance disappears, and the intubation is successful;
s7: the tracheal catheter can be connected with a ventilator pipeline after entering the airway, the catheter sleeve is inflated, the overhead column (13) is loosened, the pull-out tongue plate (6) is pulled out, the semi-tubular guide shell (1) is withdrawn, the depth of the tracheal catheter is regulated if necessary, and the tracheal catheter implantation process is completed.
2. A tunnel-type endotracheal tube forward-guiding airway device comprising a guiding housing (1), characterized in that: the end of the guide shell (1) is connected with an arc guide shell (2), the starting end of the guide shell (1) is provided with an inlet (40), the arc guide shell (2) is extended with an arc reverse folding shell (3), the side surface of the guide shell (1) is provided with a sliding mechanism, a pull-type tongue plate (6) passes through the middle of the sliding mechanism, the starting part of the pull-type tongue plate (6) is connected with a reverse folded plate (41), a reinforcing angle (39) is connected between the pull-type tongue plate (6) and the reverse folded plate (41), the upper surface of the pull-type tongue plate (6) is connected with a guide rail (8) by virtue of a reinforcing column (7), the lower end of the guide rail (8) is connected with a V-shaped elastic sheet (9), the inner wall of the elastic sheet at the far end of the V-shaped elastic sheet is provided with a camera (10), a fixing mechanism is arranged between the guide shell (1) and the pull-type tongue plate (6), the surface of the V-shaped elastic sheet (9) is provided with a first guide hole (14), the guide hole (6) is provided with a second guide hole (15) near to the guide hole (6), the inside through connection of camera (10) has cable (24), the end connection of cable (24) has cable male joint (25), the upper surface of pull formula hyoid lamina (6) is provided with fixing clip (38), the surface connection of guide shell (1) has collapsible handle (26), the perpendicular of collapsible handle (26) is provided with display screen seat pole (27), display mechanism is installed to the tip of display screen seat pole (27).
3. A tunnel-type endotracheal tube according to claim 2, being directed downstream into an airway device, wherein: the sliding mechanism comprises a connecting plate (4) and a tongue plate sliding groove (5), the connecting plate (4) extends from the side surface of the guide shell (1), the tongue plate sliding groove (5) is formed in the inner side wall of the connecting plate (4), and the guide rail (8) is semi-annular bending arch-shaped.
4. A tunnel-type endotracheal tube according to claim 3, being directed downstream into an airway device, wherein: the two sides of the connecting plate (4) are respectively provided with a tongue plate chute (5) which penetrates through the middle of the connecting plate (4), and the pull tongue plate (6) is in sliding connection with the connecting plate (4) through the tongue plate chute (5).
5. A tunnel-type endotracheal tube according to claim 2, being directed downstream into an airway device, wherein: the fixing mechanism comprises a pin hole (11), pin lugs (12) and pin posts (13), the pin hole (11) is formed in the surface of the pull-out type tongue plate (6), the pin lugs (12) are arranged on the door edge of the inlet (40) of the guide shell (1), the pin posts (13) penetrate through the pin lugs (12), the pin holes (11) and the pin lugs (12) are arranged in two groups, the pin posts (13) are U-shaped, two separated thin columns are arranged, the pin posts (13) are in sliding connection with the pin lugs (12), the pin posts (13) are connected with the pin holes (11) in a clamping mode, and the pin posts (13) are used for locking the pull-out type tongue plate (6) after being inserted into the pin holes (11).
6. A tunnel-type endotracheal tube according to claim 2, being directed downstream into an airway device, wherein: the traction mechanism comprises a traction wire (16), a shaft rod (17), a rotary table (18), an angle adjusting rod (19), a fixing bolt (20) and an outer cover (21), wherein the traction wire (16) sequentially penetrates through a first guiding-out hole (14) and a second guiding-out hole (15) and is connected to the whole of the camera (10) and the elastic blade at the far end of the V-shaped elastic piece (9).
7. The tunneled endotracheal tube according to claim 6, wherein the airway device is adapted to be introduced in a forward direction: the surface of the tail end of the drawing type tongue plate (6) is provided with a protruding shaft lever (17), a middle hole of the rotary table (18) is inserted into the shaft lever (17), an angle adjusting rod (19) is arranged on the side surface of the rotary table (18), a fixing bolt (20) is connected to the side surface of the rotary table (18), a traction wire (16) is connected to the fixing bolt (20), an outer cover (21) is connected to the top of the shaft lever (17), and the outer cover (21) is semicircular.
8. A tunnel-type endotracheal tube according to claim 2, being directed downstream into an airway device, wherein: the adjusting mechanism comprises a fixing nut (22) and an adjusting bolt (23), wherein the fixing nut (22) is connected to the surface of the pull-out type tongue plate (6), the adjusting bolt (23) penetrates through the fixing nut (22), the adjusting bolt (23) is in threaded connection with the fixing nut (22), a cable (24) is fixed to the surface of the pull-out type tongue plate (6) through a fixing clamp (38), and the cable (24) is arranged on the outer side of the outer cover (21).
9. A tunnel-type endotracheal tube according to claim 2, being directed downstream into an airway device, wherein: the display mechanism comprises a connecting handle (28), an element part (29), a joint part (30), a display screen (31), a shooting key (32), a power switch (33), a charging port (34), a storage bayonet (35), a cable female connector (36) and a fixed locking mechanism (37), wherein the connecting handle (28) is sleeved on the surface of a display screen seat rod (27), the top of the connecting handle (28) is connected with the element part (29), the top of the element part (29) is provided with the joint part (30), the top of the joint part (30) is connected with the display screen (31), and an elevation angle can be adjusted between the joint part (30) and the display screen (31).
10. The tunneled endotracheal tube according to claim 9, being directed downstream into an airway device, wherein: the camera key (32) and the switch (33) are installed at the top of display screen (31), the side surface of display screen (31) is provided with charge mouth (34) and stores bayonet socket (35), the lower surface of display screen (31) is provided with the jack of cable female joint (36), fixed latch mechanism (37) are installed to the bottom side surface of connective handle (28).
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202310066788.5A CN116271383B (en) | 2023-01-30 | 2023-01-30 | Method and device for guiding tunnel type tracheal catheter forward direction into airway |
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| CN202310066788.5A CN116271383B (en) | 2023-01-30 | 2023-01-30 | Method and device for guiding tunnel type tracheal catheter forward direction into airway |
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| CN116271383B (en) | 2024-02-09 |
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