CN203494044U

CN203494044U - Percutaneous trachea dilator with sheathing canal

Info

Publication number: CN203494044U
Application number: CN201320404140.6U
Authority: CN
Inventors: 冯清亮
Original assignee: Individual
Current assignee: Individual
Priority date: 2013-07-08
Filing date: 2013-07-08
Publication date: 2014-03-26
Anticipated expiration: 2023-07-08

Abstract

The utility model provides a percutaneous trachea dilator with a sheathing canal, which is provided with a dilating pipe. The dilating pipe is formed by connecting a tapered cone end part and a tubular body part; an inner cavity of the dilating pipe is hollow; the dilating pipe is also sleeved with the sheathing canal; the sheathing canal is provided with a front end and a rear end; the front end coats the cone end part; the rear end coats the tubular body part; and the rear end is connected with the tubular body part in a detachable manner. The percutaneous trachea dilator not only can implement the operation of rapidly dilating a wound on the trachea to a suitable size in one step so as to place a tracheal tube into the trachea, but also can avoid an airbag on the trachea being broken by squeezing after the tracheal tube is inserted into the trachea, and enables an operation to be rapid and safe.

Description

A kind of percutaneous trachea dilator with sheath pipe

Technical field

This utility model belongs to medical instruments field, particularly, relates to a kind of percutaneous trachea dilator with sheath pipe.

Background technology

Tracheotomy object is that (1) removes the lower respiratory tract block of secretion that a variety of causes causes.(2) remove the laryngemphraxis that a variety of causes causes, improve and breathe.(3) a variety of causes causes respiratory failure or respiratory arrest, needs pedestrian's work mechanical respiration.Some head neck operation, because oral intubation affects operation technique, needs row tracheotomy.Tracheotomy usually needs emergency treatment clinically, needs row tracheotomy or intubation and not processing in time, directly causes death.Tracheotomy has Direct Surgery to cut and two kinds of percutaneous tracheotomies, and the tracheotomy of domestic and international various report percutaneous has that Wicresoft, complication are little, simple operation and other advantages, and current, multiple percutaneous tracheotomy technology is widely applied clinical.

Several main percutaneous tracheotomy technology comparison of clinical practice at present

Since 1985, the method of relevant percutaneous tracheotomy that had many research report open debates, because these technology in the literature all have common feature, all to have used and entered endotracheal puncture needle and guide wire, all tracheotomy technology are all preced with in " percutaneous " tracheotomy.What percutaneous tracheotomy technology was the most often used is Griggs GWDF and Ciaglia PDT technology, and recently release through laryngotracheotomy and spiral-expanding device expansion technique.They are in device design thinking, and the aspects such as technological innovation and thinking model exist different difference.

1.1 Ciaglia percutaneous expansion tracheotomy technology

1985, a Cardiac surgeon Pasquale Ciaglia of USA New York Elizabethan hospital, be subject to Brantigan and Grow to encircle the enlightenment of first film incision technology and percutaneous renal puncture art apparatus, 7 multistage dilators have been developed, the rig that provides of application Cook company, in 26 routine patient's successful implementations Ciaglia percutaneous dilatational tracheotomy.Within 1999, Ciaglia has done again further improvement to his original sequence expansion apparatus, makes it become single step Blue Rhino expansion apparatus, and dilator is made into the tapered hydrophilic dilator of a bending as blue Cornu rhinocerotis.The more original dilator of this dilator has plurality of advantages, comprising: on single step dilator surface, scribble and have more elastic hydrophilic material, can implement single step expansion etc.Yet curved because of dilator, inconvenience is exerted all one's strength in practical operation, cause puncture difficulty.

1.2 Griggas percutaneous expansion tracheotomy technology

Nineteen ninety, Griggs has described a kind of percutaneous tracheaectasy technology of stretching pliers expansion.Griggs percutaneous dilatational tracheotomy, use one the Howard Kelly curved forceps of improvement, after seal wire passes via the aperture on Howard Kelly expansion curved forceps top, stretching pliers is pushed ahead, until enter in trachea, two handss are opened stretching pliers to close and expanded, divide single step or the operation of two steps, first expand soft tissue, then expand trachea, or the operation of two steps once completes.

1.3 Fantoni are through larynx tracheotomy technology

1997, Fantoni described through laryngotracheotomy.This is a kind of new percutaneous tracheotomy technology, and catheter for tracheostomy is by involving outside trachea in trachea, and the expansion and insert catheter for tracheostomy of falling back.Because its extroversion is ostomy, annulus trachealis is easy to separation, so wound is less, complication still less, has solved the many problems that affect in traditional tracheotomy technology and other percutaneous tracheotomy use procedure.What use at present is Mallinckrodt TLT tool set and hard tracheascope guiding.Improvement Fantoni technology, is to change hard tracheascope into application bronchoscope, inserts J-shaped seal wire, uses small size endotracheal tube to be placed in former air flue, during inserting catheter for tracheostomy, gives patient ventilating.This technology is useful to severe hypoxia mass formed by blood stasis patient and the patient that predicts difficult difficult intubation or have neck to push away damage.

1.4 single step rotation expansion tracheotomy technology

2002, by R üsch company, designed the up-to-date improved percutaneous trachea incision and dilation device tool of a kind of PercuTwist.The percutaneous rotating dilator of design, is similar to an automatic puncturing screw, on dilator puncture line, has a hydrophilic coated, need not enter trachea by tracheal wall extension fixture, can good trachea is expanded.It is different from stretching pliers expansion trachea,

dilator, along otch, can, at any time under endoscope's direct-view, be expanded the trachea of above lifting simultaneously.That conventional is Rusch in the market

tool set.At present, this technology has been introduced China, and using it as a kind of safe, effective, simply and tracheotomy technology fast, for critical patient's Percutaneous Tracheotomy.

1.5 balloon percutaneous dilatational tracheotomies

2003, Zgoda and Berger reported a kind of new percutaneous dilatational tracheotomy: balloon percutaneous dilatational tracheotomy.And zoopery and clinical verification have in succession been carried out; Within 2007, passed through FDA authentication, by Cook (Cook Inc., Bloomington, IN, USA) company has released Ciaglia Blue Dolphin balloon percutaneous expansion emergency airway kit (comprise that a head is with intubation catheter and the dilator device of sacculus, Cook fills device, seal wire, implanting needle, TFE sheath catheter needle, cushion, 14Fr. dilator) for commodity.Design a kind of sacculus that can be used for expansion, implemented single step mode expansion.Must the full pressure of working pressure table monitoring during expansion.

Above percutaneous Tracheostoma tracheotomy method and material are external utility model, respectively have its advantage, are suitable for use in row intubation, and conventional tracheotomies, has advantages of Wicresoft, few intercurrent disease relatively.Its weak point has: (1) operation relative complex, in not row tracheotomy, and the unsuccessful patient of tracheal intubation operation, cause the possibility of suffocating, and should not need row emergent tracheotomy patient for circulation of qi promoting cannula not.(2) can not accomplish quick tracheostomize.(3) the above-mentioned percutaneous incision method having needs bronchoscope to carry out under auxiliary.(4) endotracheal tube only has air bag of front end, plays pre-anti-error suction effect, and rear end is without air bag, and as thyroid, to cover trachea bad upper, may cause puncture position hemorrhage and need operations research.(5) import consumptive material price, is difficult to promote at home.

In order to solve the problems of the technologies described above, the improvement of the applicant to Ciaglia percutaneous expansion tracheotomy technology, at application number 201320092347.4, utility model name is called in a kind of Chinese patent literature of percutaneous trachea dilator and discloses a kind of percutaneous trachea dilator, this dilator can be implemented disposable expansion, easy to use during operation, can fast the wound dilator on trachea be expanded to the size of adaptation, thereby endotracheal tube is put into trachea, and operation fast and safely.

Utility model content

On this basis, the applicant further expands the improvement of tracheotomy technology for Ciaglia percutaneous, a kind of percutaneous trachea dilator with sheath pipe are provided, can implement the disposable size that fast wound on trachea is expanded to adaptation, thereby endotracheal tube is put into trachea, can avoid again endotracheal tube to insert after trachea, the air bag on trachea is squeezed and breaks, and operation fast and safely.

The technical solution of the utility model is as follows: a kind of percutaneous trachea dilator with sheath pipe, there is convergent divergent channel, and this convergent divergent channel is formed by connecting by conical end and the tubular body of convergent, convergent divergent channel inner chamber hollow, described convergent divergent channel outside is also arranged with sheath pipe; This sheath pipe has front-end and back-end, and described front end is coated described conical end, and described rear end is coated described tubular body; And described rear end part and described tubular body removably connect.

Further, described rear end part and described tubular body removably connect by internal and external screw thread.

The front end of the conical end of described convergent divergent channel and described sheath pipe is all curved.

The percutaneous trachea dilator preferably, with sheath pipe also comprise puncture needle, seal wire and endotracheal tube;

The inner chamber hollow of described puncture needle, apical head taper, afterbody connects syringe tube, from trachea antetheca interannular carries out puncture after connecting water in syringe tube, and pumpback is shown in that bubble confirms that piercing needle portion is positioned at trachea;

Seal wire; The inner chamber of this seal wire and puncture needle matches, and seal wire enters puncture needle inner chamber from the afterbody of puncture needle, and before be advanced into trachea inside, along seal wire, extract puncture needle, trachea is kept somewhere in seal wire one end inner, the other end is kept somewhere outside trachea;

Described seal wire also matches with described convergent divergent channel inner chamber, seal wire enters convergent divergent channel inner chamber from the conical end of convergent divergent channel, and guide convergent divergent channel to expand the puncture mouth on trachea outer wall, thereby enter trachea inside, when wound is expanded to pre-sizing, being connected between dismounting sheath pipe and convergent divergent channel, extracts convergent divergent channel and seal wire, sheath pipe one end is retained in to trachea inside, and the other end is kept somewhere outside trachea;

Endotracheal tube, described endotracheal tube comprises tracheal intubation, is attached to the air bag of described tracheal intubation outer wall and is placed in the interior bolt in described tracheal intubation inner chamber; Endotracheal tube enters sheath tube cavity from sheath pipe rear end, and before be advanced into trachea inside, extract sheath pipe, complete puncture.

Described endotracheal tube is curved, and equates with the radian of the conical end of described convergent divergent channel and the front end of described sheath pipe.

Preferably, the described percutaneous trachea dilator with sheath pipe, also comprise syringe, seal wire and endotracheal tube with the trocar;

With the syringe of the trocar, comprise syringe needle and be placed on sleeve pipe and the syringe tube outside syringe needle, to carry out carrying out puncture from trachea antetheca interannular after connecting water in syringe tube, pumpback is shown in that bubble confirms that syringe needle is positioned at trachea, transfers to syringe needle, indwelling casing tube;

Seal wire; The inner chamber of this seal wire and sleeve pipe matches, and seal wire enters needle guard inner chamber from the afterbody of sleeve pipe, and before be advanced into trachea inside, along seal wire, extract sleeve pipe, trachea is kept somewhere in seal wire one end inner, the other end is kept somewhere outside trachea;

Endotracheal tube, described endotracheal tube comprises tracheal intubation, is attached to the air bag of described tracheal intubation outer wall and is placed in the interior bolt in described tracheal intubation inner chamber; Endotracheal tube enters sheath tube cavity from sheath pipe rear end, and before be advanced into trachea inside, pulled sheathing canal, completes puncture.

The AL of the conical end of described convergent divergent channel is 3 to 10cm.

Described conical end is one-body molded with described tubular body or be connected by internal and external screw thread.

Described seal wire is J type head seal wire.

Preferably, convergent divergent channel and sheath pipe be coated with water wetted material outward, be convenient to expansion and can alleviate damage again.

The beneficial effects of the utility model are: the percutaneous trachea dilator with sheath pipe described in the utility model, both can easily the wound at gas official outer wall place be expanded to suitable size, can avoid again endotracheal tube to insert after trachea, air bag on trachea is squeezed and breaks, simple to operate, safety, surgery cost are lower, are suitable for applying.

Accompanying drawing explanation

Fig. 1 a, the structural representation of an embodiment of convergent divergent channel described in the utility model;

Fig. 1 b, the structural representation of another embodiment of convergent divergent channel described in the utility model;

Fig. 1 c, the described syringe with the trocar of this utility model the first embodiment;

Fig. 1 d, the described puncture needle of this utility model the second embodiment;

Fig. 1 e, seal wire described in the utility model;

Fig. 1 f, endotracheal tube described in the utility model;

Fig. 2 a-2h has shown the use procedure with an enforcement of percutaneous trachea dilator of sheath pipe described in the utility model, has used the syringe with the trocar shown in convergent divergent channel shown in Fig. 1 a and Fig. 1 c in this enforcement.Wherein

Fig. 2 a is that the syringe with the trocar described in the utility model punctures trachea forearm and enters in trachea;

Fig. 2 b is that keep somewhere in trachea sleeve pipe described in the utility model one end, and stretch out outside trachea one end;

Fig. 2 c sleeve pipe described in the utility model guides described seal wire to enter in trachea;

Fig. 2 d is that keep somewhere in trachea seal wire described in the utility model one end, and extratracheal state diagram is stretched out in one end;

Fig. 2 e is that seal wire shown in Fig. 2 d guides the opening on described convergent divergent channel expansion tracheal wall, and convergent divergent channel and sheath pipe one end enter in trachea;

Fig. 2 f, after convergent divergent channel in Fig. 2 e and seal wire are extracted, keeps somewhere sheath pipe one end in trachea, and extratracheal state diagram is stretched out in one end;

Fig. 2 g is that endotracheal tube described in the utility model enters described sheath pipe and moves ahead, and one end passes described sheath pipe and enters in trachea;

Fig. 2 h is that Fig. 2 g tears described sheath pipe, and a described endotracheal tube part is retained in trachea, and another part stretches out extratracheal state diagram.

Fig. 3 a-3d shown when the percutaneous trachea dilator with sheath pipe described in the utility model only use puncture needle 11, from pass pin 11 start puncture to described seal wire 20 enter trachea use procedure.Wherein,

Fig. 3 a is that puncture needle dispelling the stagnated QI pipe forearm described in the utility model enters in trachea;

Fig. 3 b is puncture needle position view in trachea described in detection Fig. 3 a;

Fig. 3 c is that puncture needle described in the utility model guides described seal wire to enter in trachea;

Fig. 3 d is that keep somewhere in trachea seal wire described in the utility model one end, and extratracheal state diagram is stretched out in one end.

Fig. 4 is described sheath pipe and described endotracheal tube while being arc, and the described endotracheal tube of arc enters the described sheath pipe of arc and moves ahead, and one end passes described sheath pipe and enters endotracheal view.

The specific embodiment

With reference to Fig. 1 a to 1e, a kind of percutaneous trachea dilator with sheath pipe, comprise convergent divergent channel 30.With reference to Fig. 1 a and Fig. 1 b, conical end 31 and tubular body 32 that described convergent divergent channel 30 has convergent are formed by connecting, convergent divergent channel inner chamber 33 hollows, and described convergent divergent channel outside is also arranged with sheath pipe 34.This sheath pipe 34 has front end 35 and rear end 36, the coated described conical end 31 of described front end 35, and the coated described tubular body 32 in described rear end 36, a part for described rear end 36 and described tubular body 32 removably connect.As preferred embodiment a kind of, described rear end 36 is respectively equipped with internal and external screw thread with described tubular body 32, and the two removably connects by internal and external screw thread.Or, a part for a part for described rear end 36 and described tubular body 32 bonds by binding agent, when user is fixed one of them, and while granting the strength that another moves, can destroy the bonding between the two, and described convergent divergent channel 30 can be extracted from described sheath pipe 34.

With reference to Fig. 1 b, preferably, the conical end 31 of described convergent divergent channel 30 and the front end 35 of described sheath pipe 34 are all curved, and the two radian equates.

With reference to Fig. 1 c, described percutaneous trachea dilator also comprise the syringe 10 with the trocar, comprise puncture needle 11 and are placed on sleeve pipe 12 and the syringe tube 13 outside puncture needle 11.

As another optional embodiment of the present invention, with reference to Fig. 1 d, described percutaneous trachea dilator guide hereinafter described seal wire to enter in trachea after also can only completing puncture with puncture needle 11.Inner chamber 111 hollows of described puncture needle 11, head 112 top tapers, afterbody 113 can connect syringe tube.

With reference to Fig. 1 e, described percutaneous trachea dilator also comprise seal wire 20.The internal diameter of the internal diameter of the external diameter of seal wire 20 and described sleeve pipe 12 or described puncture needle 11 matches.The external diameter of described seal wire 20 also matches with the inner chamber of described convergent divergent channel 30.Described seal wire 20 is J type head seal wire.

With reference to Fig. 1 f, described percutaneous trachea dilator also comprise endotracheal tube 40.Described endotracheal tube 40 comprises tracheal intubation 41, is attached to the air bag 42 of described tracheal intubation 41 outer walls and is placed in the interior bolt 43 in described tracheal intubation inner chamber.

Fig. 2 a-2h has shown the use procedure with the percutaneous trachea dilator of sheath pipe described in the utility model, has used the syringe with the trocar shown in Fig. 1 a and Fig. 1 c in this enforcement.

With reference to Fig. 2 a and 2b, after connecting water in the syringe tube 13 of described syringe 10, carry out carrying out puncture from trachea antetheca interannular, pumpback is shown in that bubble confirms that puncture needle 11 is positioned at trachea, remove syringe tube 13, transfer to puncture needle 11, indwelling casing tube 12, makes sleeve pipe 12 one end be positioned at trachea, and the other end stretches out outside trachea.

Then, with reference to Fig. 2 c and Fig. 2 d, described seal wire 20 one end along the afterbody of described sleeve pipe 12 enter sleeve pipe 12 inner chambers and before be advanced in trachea, along seal wire 20, extract sleeve pipe 12, seal wire 20 one end are kept somewhere in trachea, the other end stretches out outside trachea.

With reference to Fig. 2 e and 2f, seal wire 20 stretches out extratracheal one end and from the taper shape front portion 31 of described convergent divergent channel 30, enters the inner chamber 33 of described convergent divergent channel 30, and convergent divergent channel 30 proceeds to puncture needle 10 and punctures trachea outer wall place under the guiding of seal wire, and this place is expanded.Because the anterior AL of the taper shape of described convergent divergent channel 30 is 4cm, only need once to expand and opening can be expanded to suitable size, convergent divergent channel 30 conical anterior 31 is entered in trachea.Now, the front end 35 of described sheath pipe 34 also enters in trachea, and then, being connected between the rear end 36 of dismounting sheath pipe 34 and convergent divergent channel 30, extracts convergent divergent channel 30 and seal wire 20, and sheath pipe 34 front ends 35 are kept somewhere in trachea, and stretch out outside trachea rear end 36.

With reference to Fig. 2 g and 2h, endotracheal tube 40 enters the inner chamber of sheath pipe 34 from the rear end 36 of sheath pipe 34, and before be advanced into trachea inside, pulled sheathing canal 34, completes puncture.

When the described percutaneous trachea dilator with sheath pipe only use puncture needle 11, with reference to Fig. 3 a-3d, shown from passing pin 11 and started the process that puncture to described seal wire 20 enters trachea.

With reference to Fig. 3 a and 3b, described puncture needle 11 connects syringe, after connecting water in syringe tube 13, carry out carrying out puncture from trachea antetheca interannular, pumpback is shown in that bubble confirms that puncture needle 11 is positioned at trachea, remove syringe tube 13, keep somewhere puncture needle 11, make puncture needle 11 one end be positioned at trachea, the other end stretches out outside trachea.

Then, with reference to Fig. 3 c and Fig. 3 d, described seal wire 20 one end along the afterbody of described puncture needle 11 enter puncture needle 11 inner chambers and before be advanced in trachea, along seal wire 20, extract puncture needle 11, seal wire 20 one end are kept somewhere in trachea, the other end stretches out outside trachea.

In this embodiment, the process that the described convergent divergent channel 30 of described seal wire 20 guiding, described sheath pipe 34 and described endotracheal tube 40 enter trachea, as shown in Fig. 2 e to Fig. 2 h, does not repeat one by one at this.

When described convergent divergent channel 30 is convergent divergent channel shown in Fig. 1 b, described sheath pipe 34, described endotracheal tube 40 all has the crooked radian identical with described convergent divergent channel 30, similar process shown in its puncture and intubation process and Fig. 2 a-Fig. 2 h.What deserves to be explained is, with reference to Fig. 4, the endotracheal tube 40 of arc, under sheath pipe 34 guiding of arc, enters in trachea, and then pulled sheathing canal 34, and endotracheal tube 40 is kept somewhere in trachea.Obviously, the radian of described convergent divergent channel 30, described sheath pipe 34 and described endotracheal tube 40 approaches physiologic radian, is more conducive to puncture and intubation.

Above content is in conjunction with concrete preferred implementation further detailed description of the utility model, can not assert that concrete enforcement of the present utility model is confined to these explanations.For this utility model person of an ordinary skill in the technical field, without departing from the concept of the premise utility, its framework form can be flexible and changeable, can subseries product.Just make some simple deduction or replace, all should be considered as belonging to this utility model by the definite scope of patent protection of submitted to claims.

Claims

1. percutaneous trachea dilator with sheath pipe, described dilator has convergent divergent channel, and this convergent divergent channel is formed by connecting by conical end and the tubular body of convergent, and convergent divergent channel inner chamber hollow, is characterized in that, and described convergent divergent channel outside is also arranged with sheath pipe; This sheath pipe has front-end and back-end, and described front end is coated described conical end, and described rear end is coated described tubular body; And described rear end part and described tubular body removably connect.

2. the percutaneous trachea dilator with sheath pipe as claimed in claim 1, is characterized in that, described rear end part and described tubular body removably connect by internal and external screw thread.

3. the percutaneous trachea dilator with sheath pipe as claimed in claim 1, is characterized in that, the front end of the conical end of described convergent divergent channel and described sheath pipe is all curved.

4. the percutaneous trachea dilator with sheath pipe as described in claim 1-3 any one, is characterized in that, also comprise puncture needle, seal wire and endotracheal tube;

5. percutaneous trachea dilator as claimed in claim 4, is characterized in that, described endotracheal tube is curved, and equate with the radian of the conical end of described convergent divergent channel and the front end of described sheath pipe.

6. the percutaneous trachea dilator with sheath pipe as described in claim 1-3 any one, is characterized in that, also comprise syringe, seal wire and endotracheal tube with the trocar;

7. the percutaneous trachea dilator as described in claim 1-3 any one, is characterized in that, the AL of the conical end of described convergent divergent channel is 3 to 10cm.

8. the percutaneous trachea dilator as described in claim 1-3 any one, is characterized in that, described conical end is one-body molded with described tubular body or be connected by internal and external screw thread.

9. the percutaneous trachea dilator as described in claim 1-3 any one, is characterized in that, the outer and sheath pipe of described convergent divergent channel all scribbles water wetted material outward.

10. percutaneous trachea dilator as claimed in claim 4, is characterized in that, described seal wire is J type head seal wire.