CN1440820A - 一种帮助呼吸装置 - Google Patents
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Abstract
一种帮助呼吸装置,包括导管(4),在转向机构(14b)的下游,导管(4)包括至少一个分配孔(20D),该孔在主通道(5)上相对椭圆形压力区(18)的位置与主通道连通,可提供药物流体(35)。
Description
发明领域
本发明涉及一种帮助呼吸装置,可高效地向濒临死亡的病人提供紧急治疗。
背景技术
已经知道,在病人心搏动停止、试图通过按摩使病人复苏的情况下,为了增加按摩的效率,要向所述病人输入引起血管收缩的药物,比如肾上腺素。这种药物或是通过静脉注射或是通过气管导管输入。在前一种情况下,输入的药物到达肺部比较慢,而在第二种情况下,药物会消散,不能必然地到达肺部。
此外,文献EP-0 390 684已经公开了一种帮助呼吸装置,该装置具有导管的形式,可以引入病人口中或鼻孔中,除了导管构成的主通道,还包括至少一个辅助通道,例如可在所述导管壁中形成,以注入帮助呼吸的气流(氧气、空气、或氧气和空气的混合气),以期帮助病人换气。这些辅助通道在主通道的远端附近连通主通道。
考虑到气体具有动能,为了保证帮助呼吸气流不会直接冲击正在换气的病人的黏膜,带来损坏黏膜的风险,采取了相应的措施,在该现有装置中,通向主通道的辅助通道至少远端是平行于主通道,相对于各辅助通道的远端孔处设置有转向机构,可使所述呼吸换气流转向所述主通道的内部。
因此,通过所述辅助通道的呼吸气流当进入主通道时转向所述主通道的轴线方向。测试结果显示,在所述转向机构的下游,所述主通道内形成椭圆形压力区,压力区从所述辅助通道连通主通道的位置开始,沿所述主通道的轴线朝轴向延续,其截面逐渐减小,只是占据了所述主通道的中间部分,但是所述吸收气流的压力在所述高压区的下游降低,低压气流通过导管的远端孔。实践经验还显示出,在导管的远端出口的下游,压力低并在全部呼吸空间内保持恒定。该压力取决于辅助通道中呼吸气体的流动速率。结果是,根据上述文件的帮助呼吸装置,可以直接向病人肺部的气管隆凸提供氧气,或空气与氧气的混合气,因此可以减少其他已知探子(Probes)存在的死腔(dead space),成人的死腔要占到呼吸容量的大约三分之一,新生婴儿要占到大约二分之一。减少死腔等于将全体病人可实现的呼吸周期增加了25%以上,在某些情况下增加了几乎50%。
文献EP-0 390 684中的装置因此非常有优越性。
发明内容
本发明的目的是改进这种已知装置,使其更有效地输入药物,不仅可以解决如上所述的心搏停止的紧急情况下输入血管收缩药物的问题,还可以用于所有适合的场合。
最后,根据本发明的帮助呼吸装置包括:构成主通道的导管,可通过其远端连接到病人的导气管,所述主通道将所述病人的呼吸系统连通到外面;所述装置还包括至少一个辅助通道,其近端连接到呼吸气体源,以便能够使呼吸气流输入所述呼吸系统;其远端通向所述远端附近的所述主通道,可使所述呼吸气体流转向所述主通道轴线方向的转向机构设置在与所述辅助通道远端孔相对的位置,在所述转向机构的下游,所述主通道内形成椭圆形压力区,压力区从所述辅助通道远端孔开始,然后沿所述主通道的轴线朝远端方向延续,随离开所述主通道的内壁,其截面逐渐减少,仅占据所述主通道的中间部分,其特征在于,所述导管包括至少一个在所述转向机构下游(相对于所述呼吸气流)的分配孔,所述孔开在所述主通道上与所述椭圆形压力区相对的位置,所述孔可提供药物流体。
因此,通过本发明,可以是气体或液体的药物流体成为雾状,然后如同呼吸换气气体在换气过程中直接输送到病人的肺部,同时所述肺部通过换气而充气膨胀。从而输入的药物流体作用到所述肺部的全部表面,所以,所述流体可以具有最好的效果。
供应药物流的孔最好是通过设置在所述导管壁中的通道连接到所述导管的近端,通过所述孔提供药物流。
在避免使用高压呼吸气体源的情况下,根据本发明的装置包括,如文献US09/387 790中所介绍的,设置在所述主通道内所述转向机构下游(相对所述呼吸气体流)并围绕所述椭圆形压力区的环,其至少部分密封所述主通道内壁和所述椭圆形压力区之间圆周向空间,所述环最好设置在所述分配孔和所述转向机构之间。
此外,为了进一步提高根据本发明的装置的效果,供应到所述分配孔的药物流体最好在病人呼气时是中断的,所以,药物流体只是在吸气时输入到所述病人肺部。
附图说明
通过附图,将清楚地显示本发明是如何实现的。在这些附图中,相同的标记代表同一元件。
图1是本发明的装置一个实施例的示意性的部分视图,带有放大的轴向部分;和
图2和图3是沿分别沿图1中线II-II和III-III的横向剖视图。
具体实施方式
附图1示意性显示了放大的根据本发明装置的实施例1的近端2和远端3。该实施例可构成带有气囊或不带的口鼻气管探子、小儿口鼻气管探子、气体监控探子、支气管内探子、鼻咽探子、婴儿解剖学插管法的探子、新生儿Cole探子、Gedel插管探子、氧气治疗的鼻探子、用于治疗睡觉呼吸暂停的鼻或颊面罩或鼻气囊。
装置1包括柔性的预成型(以适合病人的形态)的导管4,其形成了主通道5,主通道通过近端2的孔6和远端3的孔7进行连通。
因此,主通道5可保证孔6和7之间的通道,一个孔(远端孔7)可位于病人的导气管中,另一个孔(近端孔6)可定位在所述病人的外部。该近端孔6可连通周围的空气。在这种情况下,病人可以通过主通道5吸入新鲜空气和呼出污浊气体。如下面所解释的,还可以将孔6连接到带压的呼吸气体源并设置单向阀系统,使病人可以通过所述主通道5从所述气源吸入呼吸气体,还是通过该主通道将污浊之气呼出到周围的大气中。
主通道5的直径在数个毫米的量级。对于直径3毫米、7毫米、8毫米和12毫米已经进行了另人满意的测试。
此外,在导管4壁厚中形成的辅助通道8沿主通道5的几乎全长延伸,并可以连接到带压的呼吸气体源,如下面所介绍的。
与带压的呼吸气体源的连接可以受到环9的影响。环9在近端2以密封的方式围绕导管4,形成了与所述导管4密封的环形腔10。辅助通道8通过导管4壁上的局部切口11与腔10连通。所述腔10通过管路12连接到所述呼吸气体源。当然,通道8的近端是堵住的,例如可采用从导管4的近端面4P插入的插塞13。
辅助通道8具有比主通道5直径稍小的直径。辅助通道8的直径可以小于1毫米,最好是在400到800微米的量级。在远端,辅助通道8通到导管4内壁15的缩进部分14。缩进部分14是环形的,其中心位于远端3的轴线16上。缩进部分包括基本上横向的或稍微倾斜的面14a,其形成了对主通道5的展宽,所述辅助通道8通过孔17连通所述主通道;还包括与面14a相连的面14b,其沿轴线16的方向收敛。
因此,当辅助通道8通过元件9到12提供带压的呼吸气体时,相应的气流冲击倾斜面14b,气流通过倾斜面转向到轴线16的方向(图1中的箭头F)。在主通道5的远端3的内部产生椭圆形压力区18,压力区从所述远端孔17开始,沿所述远端3的轴线16朝远端孔7的方向延续。压力区18的截面从缩进部分14朝远端孔7逐渐减小。所述压力区18逐渐离开导管4的内壁15,只是占据导管4的远端3的中心部分。在压力区18的下游,已经转向的呼吸气流在轴线16的附近产生低压区19,推动气体在主通道5中从近端孔朝远端孔流动,因此促进了病人的呼吸。
至少一个补充通道20设置在导管4的壁厚中。该补充通道20包括近端孔20P,该孔开在所述导管4的近端面4P上;远端孔20D在所述导管4的内壁15上形成,并在相对压力区18的位置通到主通道5。所述补充通道20可通过其近端孔20P和连接流体源(未显示)的管路24供应带压的药物流,气体流或液体流。管路24上固定有可控制阀41。
出于安全原因,校准的安全阀21可设置在导管4的近端2。因此,在主通道5出现偶然过压的情况下,气体通过导管4的管壁溢出到病人外部,以及时消除这种过压。
如图2和3所示,辅助通道8围绕导管4的轴线均匀地设置。其数量可根据使用情况(成人或儿童使用)来变化,但是通常在3个到9个之间。
根据本发明的装置的导管4可以采用现有呼吸探子的材料来制造,例如带有硅树脂涂层的聚氯乙烯,或允许进行高压注射的钢。
当然,根据本发明的装置的尺寸可以有很大的变化,这主要根据导管安装的方式和病人尺寸的大小,病人可以是成人、儿童、新生婴儿或早产的婴儿。
装置1另外还包括供应和控制装置22,其通过连接23连接到导管4的近端孔6,该装置可通过连接34由压力传感器(未显示)进行控制。压力传感器的压力导出点可设置在远端面4D。
可向供应和控制装置22提供来自气体源25的带压的呼吸气体,通过管路26连接到气体源,管路26上设置了可控减压器/流量表27。
减压器/流量表27的出口通过支路28连接到管路12,第一可控阀29、第二可控阀30和湿度调节器31以串联方式固定在管路12。
可控阀29通过连接32受到供应和控制装置22的控制。
可控阀30通过连接33受到压力传感器(未显示)的控制。压力传感器可检测到病人呼吸中吸气和呼气的变换。该压力传感器的测量点可位于远端孔7的附近。连接33也控制该可控阀41以提供药物流体。
在远端3可以围绕中心压力区18设置环36,其至少占据位于所述中心压力区18和通道5的远端3的内壁15之间的环形圆周空间37的一部分。
通过设置这样的环36,来自呼吸气体源25的形成压力区18的压力可以降低。
作为通用原则,环36和倾斜的转向面14b之间的距离d接近于主通道5的远端部分的直径。
为了使所希望的流体源25的最大压力降低成为可能,可以对该距离d进行调节,如双箭头38所表示。出于相同的目的,环36的中心孔39的直径最好也可以调节,如双箭头40所表示。这两种调节可以通过一组多个可互相调换的环36来实现,按照需要,环36可滑动地固定在主通道5的远端。或者,环36由可膨胀的环来构成,这种环的内径可以通过膨胀来变化。
根据本发明的装置1的操作模式如下。
在人工呼吸的模式下,供应和控制装置22一方面通过连接32使阀29关闭,使管路12不供应气体;另一方面,通过连接23输送呼吸气体进入导管4。该装置22包括可调节呼吸气体的压力和流速的器件(未显示),呼吸气体来自管路26并送到导管4。如果病人的导气管中出现过压,检测到的过压通过连接34传递到装置22,装置停止操作。此外,如果过压超过校准的阀21的校准门槛值,阀21打开使附近的通道5与大气连通。
在帮助呼吸的模式下,供应和控制装置22切断连接23,以便使近端孔6与大气连通,通过连接32对阀29进行控制,使该阀通过阀30、湿度调节器31和辅助通道8输送连续的或脉冲的呼吸气流给病人。
所形成的压力区18和低压区19,使得病人可以容易地换气。所述病人可以自由地和深深地吸气。此时,阀41打开,药物流体通过管路24、通道20和孔20D进入病人的肺部。
吸气后,当病人开始呼气时,检测到呼气开始,阀30和41通过连接33关闭。呼吸气流、压力区18、低压区19、和药物流体的供应消失,病人可以通过主通道5自由呼气。
如果在换气的过程中,病人的导气管出现过压,如上面所介绍的,检测到过压,通过补充通道20传递,使装置22关闭阀29,换气停止。
从上面所进行的说明,可以看出,通过本发明,使用中压的气源,可以得到有效的、可靠的、润湿的并伴随药物流体的帮助呼吸,使得已知探子所固有的死腔全部消失。此外,应当指出,帮助呼吸装置可以设计成轻便和便携的,使之能够用于医院或诊所以外的紧急情况。
Claims (3)
1.一种帮助呼吸装置,包括:构成主通道的导管,可通过其远端连接病人的导气管,所述主通道将所述病人的呼吸系统连通到外面;所述装置还包括至少一个辅助通道,其近端连接到呼吸气体源,以便能够使呼吸气流输入所述呼吸系统;其远端通向所述远端附近的所述主通道,可使所述呼吸气流转向所述主通道轴线方向的转向机构设置在与所述辅助通道远端孔相对的位置,在所述转向机构的下游,所述主通道内形成椭圆形压力区,所述压力区从所述辅助通道远端孔开始,然后沿所述主通道的轴线朝远端方向延续,随离开所述主通道内壁,其截面逐渐减少,仅占据所述主通道的中间部分,其特征在于,所述导管包括至少一个在所述转向机构下游的分配孔,所述孔开在所述主通道上与所述椭圆形压力区相对的位置,所述孔可提供药物流体。
2.根据权利要求1所述的装置,其特征在于,所述分配孔通过设置在所述导管壁厚内的通道连接到所述导管的近端,并通过所述通道提供药物流体。
3.根据权利要求1所述的装置,其特征在于,所述装置包括设置在所述主通道中所述转向机构下游并围绕所述椭圆形压力区的环,至少部分密封所述主通道内壁和所述椭圆形压力区之间的圆周向空间,所述环设置在所述分配孔和所述转向机构之间。
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FR0202468A FR2836384B1 (fr) | 2002-02-27 | 2002-02-27 | Dispositif d'assistance respiratoire |
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CN03107029A Pending CN1440820A (zh) | 2002-02-27 | 2003-02-27 | 一种帮助呼吸装置 |
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JP (1) | JP4621413B2 (zh) |
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2002
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EP1340515A1 (fr) | 2003-09-03 |
ATE372803T1 (de) | 2007-09-15 |
PT1340515E (pt) | 2007-11-28 |
JP4621413B2 (ja) | 2011-01-26 |
FR2836384A1 (fr) | 2003-08-29 |
FR2836384B1 (fr) | 2004-12-10 |
CA2418447A1 (fr) | 2003-08-27 |
JP2003250893A (ja) | 2003-09-09 |
ES2292915T3 (es) | 2008-03-16 |
DE60316211D1 (de) | 2007-10-25 |
US20030159696A1 (en) | 2003-08-28 |
EP1340515B1 (fr) | 2007-09-12 |
DE60316211T2 (de) | 2008-06-05 |
DK1340515T3 (da) | 2007-10-22 |
CA2418447C (fr) | 2010-08-10 |
US6761172B2 (en) | 2004-07-13 |
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