CN208551884U - Tracheae, ring first film mention and cut drag hook - Google Patents

Abstract

The utility model discloses a kind of tracheae, ring first films to mention and cut drag hook, it is as tracheae or ring first film cutting operation special equipment, accelerate tracheae or ring first film surgical procedure speed, it releases rapidly and suffocates caused by patient respiration road obstruction, the life to give emergency treatment to a patient reduces the generation of tracheae or intercricothyrotomy complication.A kind of tracheae, ring first film mention and cut drag hook, including shank, gib head is fixedly connected in the lower end of shank, gib head is stretched out to the side of shank, the end of gib head is in bullet-shaped or coniform, the through-hole extended along gib head length direction is equipped on gib head, through-hole runs through gib head on the length direction of gib head, the top of through-hole is equipped with opening, the clearing end of opening and the end of gib head have a distance, be additionally provided with fluting in shank, fluting also radially runs through shank in shank, and the lower end slotted also with through-hole, opening in communication.

Description

Tracheae, ring first film mention and cut drag hook

Technical field

The medical equipment technical field that the utility model belongs to quick tracheae, ring first film is cut, concretely relates to one Kind handles urgent difficult airway, the quick cutting operation instrument of used tracheae, ring first film in intubation and general anaesthesia.

Background technique

Cervical trachea cuts in tracheotomy (tracheotomy) system, metal (plastics) air pipe sleeve (leading) pipe is put into, with solution Except laryngeal dyspnea, respiratory function is not normal, lower respiratory tract ischesis or prevent accidentally is inhaled, to rescue critical illness life A kind of emergency operation of life.Usual Anesthetist when intubation and general anaesthesia encounters urgent difficult airway, implement tracheae or Intercricothyrotomy is the dying situation of asphyxia caused by order to release supraglottic air flue Severe blockage, with emergency surgical operation patient Life.

The operation of tracheae or intercricothyrotomy can be correctly and promptly carried out in time, it often can be sick in being saved in short several minutes The life of people's preciousness.Therefore it is required that the operation of tracheotomy can be implemented rapidly to complete.

The tracheotomy clinically implemented at present has following several:

One, surgical tracheotomy (open tracheostomy, OT): it is divided into (1) conventional tracheottomy；(2) Emergency tracheotomy；(3) intercricothyrotomy；(4) thyrocricocentesis.

Conventional surgical tracheotomy needs biggish skin incision, separation throat tissue and tracheostomize antetheca due to existing Equal operations cause damage is big, postoperative hemorrhage in art, pneumoderm, pneumothorax, infection of incisional wound, tracheostenosis, sudden arrest of heart beat and with operation The disadvantages of related complication etc. causes the death rate high, while longer there is also surgical procedure required time.Nonetheless, conventional surgical Tracheotomy is existing still to carry out as clinically common tracheotomy formula extensively.

Two, since ring first film incision cannula is more than that should all be changed to tracheotomy in 24 hours, otherwise permanent larynx can be caused narrow Narrow disadvantage, (especially Anesthetist is in trachea cannula for use when intercricothyrotomy being made only in case of emergency to give emergency treatment to a patient It is used when encountering urgent difficult airway).

Three, percutaneous puncture dilatational tracheotomy (percutaneous dilational tracheostomy, PDT) Have become clinical the most commonly used Tracheostoma tracheotomy method at present, advantage are as follows: minimally invasive, simple；Quickly；Few intercurrent disease, safety, but Its disadvantage and complication are as follows: if position of trachea deviation can lead to operative failure in art, routine tracheal incision need to be changed to；It is grasping simultaneously Thyroid gland, tracheae, esophagus etc. may be damaged in work；Once and Massive Bleeding in art, anthemorrhagic difficulty.

For a long time, the method that people are exploring always new, quick tracheotomy.

If difficult airway association, Britain (DAS) is in November, 2015, " 2015 delivered on " Britain's anesthesiology magazine " Difficult tracheal intubation guide that DAS adult does not expect is interpreted " in, about in " urgent throat ring first film is cut " in its PlanD, The scalpel ring first film incision technology for being easier normalized training and execution is advocated, this technical requirements scalpel and bougie have combined Cheng Jinghuan first film cuts and sets pipe, and the requirement to tool is lower, and success rate is high.Department of anesthesia, Beijing Hospital Zuo Mingzhang is taught with PPT Form refer in " difficult tracheal intubation guide that DAS adult in 2015 does not expect interpret " of interpretation and " entering throat After first aid air flue ", Anesthetist answer " enabling urgent surgery air flue ", " selection scalpel ring first film incision technology ", " ring first film is worn Pierce tube placing operation ".

It is all first to cut skin to do notch, so from the point of view of the above existing tracheae, ring first film cut (or puncture) modus operandi Successively cut or expand afterwards subcutaneous tissue, finally cut (or expanding) tracheal rings and enter tracheae it is intracavitary.It is this by The intraluminal operation method of skin of neck extroversion gas has the disadvantage that:

1, surgical operation step it is many and diverse take it is longer: either OT method or PDT method require first to cut skin, then by Layer incised tissue appears tracheae, finally tracheostomize again, and the art formula operating procedure of this tracheotomy is more, and service speed is slower, It is more time-consuming due to also needing often to detect the position of tracheae in surgical procedure, it cannot reach and release patient's death by suffocation rapidly Danger, thus the death rate is higher.

, squeeze tracheae in surgical procedure and be allowed to shift or collapse: due to the tracheae top-operation covered in skin of neck, nothing By being cutting skin histology or puncture needle Needle localization or tracheostomize cartilaginous ring, inevitably squeezing tracheae in art makes tracheae Displacement；Or cause tracheal collapse due to using surgical instrument to press on tracheae, the damage of tracheae rear wall is caused, and occur serious The complication such as esophageal intubation fistula.

Summary of the invention

The purpose of the utility model is to provide a kind of tracheae, ring first films to mention and cut drag hook, cuts as tracheae or ring first film Operation special equipment, keeps the operating procedure of tracheae or intercricothyrotomy simpler, can release patient respiration road obstruction rapidly The dying danger that suffocates is caused, the life of patient is saved, reduces the generation of tracheae or intercricothyrotomy complication.

In order to solve the above technical problems, purpose of the utility model is realized as follows:

A kind of tracheae, ring first film mention and cut drag hook, including shank, are fixedly connected with gib head in the lower end of shank, and gib head is to handle The side of bar is stretched out, and the end of gib head is in bullet shape or cone shape, is equipped on gib head and is prolonged along gib head length direction The through-hole stretched, through-hole run through gib head on the length direction of gib head, and the top of through-hole is equipped with opening, the clearing end and gib head of opening End there is a distance, be additionally provided with fluting in shank, fluting is in shank radially through shank, and under fluting End also with through-hole, opening in communication.

Preferred embodiment on the basis of above scheme and as above scheme: the shank includes upper section and lower section, on Section diameter is 6.0mm, and lower section diameter is 3.0mm, and the fluting of the shank is located on lower section.

Preferred embodiment on the basis of above scheme and as above scheme: the diameter of gib head is 2.0 ~ 3.0mm.

Preferred embodiment on the basis of above scheme and as above scheme: on upper section be equipped with decorative pattern, the decorative pattern by Annular knurl is suppressed.

Preferred embodiment on the basis of above scheme and as above scheme: the diameter of through-hole is 1.6 ~ 2.0mm, through-hole Length be 8.0 ~ 10.0mm.

Preferred embodiment on the basis of above scheme and as above scheme: the clearing end of the opening and the end of gib head The distance between portion is 3.0mm.

Preferred embodiment on the basis of above scheme and as above scheme: the width of fluting is 1.6 ~ 2.0mm.

Preferred embodiment on the basis of above scheme and as above scheme: shank is perpendicular with gib head.

Compared with the prior art, the utility model has prominent and beneficial technical effects that:

The tracheae, ring first film of the utility model mention and cut drag hook, by using the structure of shank and gib head, and in shank Equipped with fluting, the structure of through-hole, opening is set on gib head, open airway can not only alleviate the shape of patient's perinatal asphyxia rapidly Condition, but also change over it is traditional by the isolated operation method of the intraluminal layer-by-layer cutting of skin of neck extroversion gas, Become lifting intratracheal wallflow holostrome tissue cutting (more traditional tracheotomy service speed is faster), cutting operation method is simple With multiplicity (scalpel can be cut holostrome from inside to outside, can also the cutting of ecto-entad holostrome), when cutting limit scalpel into The tracheotomy operating method of knife depth (to prevent stopping loss pipe rear wall of feeling frustrated), reduces the complication of bronchotomu.

Detailed description of the invention

Fig. 1 is the overall structure diagram of the utility model.

Fig. 2 is the schematic cross-sectional view of the utility model.

Specific embodiment

The utility model is further described with specific embodiment with reference to the accompanying drawing, referring to Fig. 1-Fig. 2；

This gives a kind of tracheae, ring first films to mention and cut drag hook, including shank 1 and gib head 2, in one embodiment, Gib head 2 is fixed on the lower end of shank 1, it is preferable that shank is structure as a whole with gib head.Gib head 2 is stretched out to the side of shank 1.It is logical Often, shank 1 is vertical setting with gib head 2.

In general, the long 120.0mm of shank.Shank is divided into upper section and lower section.Upper segment length 50.0mm, diameter 6.0mm；Under Segment length 70.0mm, diameter 3.0mm.

As shown in the figure, shank 1 includes upper section 11 and lower section 12.Upper section 11 is mutually held in the mouth with lower section 12 by a changeover portion 13 It connects, changeover portion is tapered from top to bottom, and formation upper section in this way is coarser than lower section.In general, the diameter of lower section 12 is 3.0mm.Upper section It is held for hand, decorative pattern is equipped on upper section, which is suppressed by annular knurl, by the structure of decorative pattern, can be played anti-skidding Effect makes to mention and cuts drag hook hand will not skid when in use.Certainly, shank can also can also be positive using other structures, upper section Hexagonal rod or flat rod.

Lower section 12, lower end are connected with gib head 2.Lower section 12 is in round bar shape, relatively thin relative to upper section.In general, The diameter of gib head is 2.0 ~ 3.0mm.Fluting 3 is additionally provided on lower section 12.As shown in Figure 2, fluting 3 is also in the radial direction of shank It is upper to run through shank 1.In general, the width of fluting is about 1.6 ~ 2.0mm in the diametrical direction of lower section.Pass through the knot of setting fluting Structure, so that the tracheae, ring first film mention and cut drag hook and have several advantages that fluting can play first is that after gib head enters tracheae The ventilation of open airway acts on, and communicates respiratory tract with atmosphere rapidly, releases the anoxia asphyxia situation of patient, especially using When mechanical respiration, this fluting can breathe out convenient for intrapulmonary gas；Second is that fluting can indicate that the direction of gib head (is slotted towards gib head side To), prevent tracheae in cutting process to be displaced, and damage tracheae annular cartilage etc.；Third is that the feed that fluting is scalpel is cut The section start for cutting tissue, limits depth of cut and Cutting Length.

The through-hole 4 extended along gib head length direction is equipped on gib head 2.In general, the diameter of through-hole is 1.6 ~ 2.0mm, The length of through-hole is 8.0 ~ 10.0mm.Through-hole 4 runs through gib head on the length direction of gib head.The top of through-hole 4 is equipped with opening 5. As shown in the figure, be open 5 clearing end 51 and gib head 2 end 21 have a distance.In this way, part of the opening only along gib head Length setting.In general, the distance between the clearing end 51 of opening and the end 21 of gib head d1 are 3mm.It is open by setting, in this way On gib head formed at the top of the closed semipermeable groove-like structure of open lower, for limitation scalpel feed depth of cut and Design.When with mention cut drag hook and lift air flue inner wall when, there is groove-like structure depth between air flue inner wall and half penetrating fluting Gap, scalpel can be made to carry out cutting tissue in slot, simultaneously because the point of a knife of scalpel is hindered by the bottom of groove-like structure Gear, therefore scalpel will not damage the rear wall of tracheae, reach the generation for preventing esophageal intubation fistula complication.As shown in the figure, hook First 2 21 petition cone cell of end.After through-hole 4 is arranged, the wall of through-hole 4 intersects with the conical surface on gib head.In cooperation venous indwelling The syringe needle of trochar or disposable 20ml syringe is in use, the gib head has good puncture resistance.In use, by vein The syringe needle of indwelling trocar or disposable 20ml syringe reveals syringe needle from the through-hole for being inserted into gib head from the fluting in shank 5.0 ~ 10.0mm of end or so of gib head out, the Needle localization operation of air flue cutting section convenient to carry out.End shape as gib head Another embodiment of shape structure, the end of gib head are in bullet-shaped or coniform.

As shown in the figure, slot 3 lower end also 5 is connected with through-hole 4, opening.

This tracheae, ring first film, which mention, to be cut drag hook and should be the sterile product of sterilization before use；To adapt to different age group Crowd use, tracheae, ring first film, which mention, to be cut drag hook can be divided into three kinds of adult type, child form, infant's type models (described herein Model adult shape parameter).And surgical procedure must implement (except emergency) under skin degerming.Tracheae, ring first film are mentioned and being cut The application method of drag hook is as follows:

1, it before being mentioned using the tracheae, ring first film and cutting drag hook promoting the circulation of qi pipe (or ring first film) cutting operation, is aspirated with syringe The syringe needle of vein lien cannula needle head (18G, 20G) or disposable 20ml syringe is connected after local anaesthetics 2-3ml (for pink Needle stand), and will be in through-hole of the syringe needle by shank fluting insertion gib head.

, will be by the gib head of good puncture needle and syringe, the selected incision position of vertical (or sternal direction angle at 45 °) alignment The skin (at such as ring first film or tracheae) is set, (is stayed when puncture using syringe needle or the puncture of vein lien cannula needle promoting the circulation of qi road Set needle or syringe needle should not inserting needle it is too deep, the sense that falls through of syringe needle when paying attention to puncturing, in order to avoid piercing needle inserting needle is too deep and damages air flue Rear wall), after pumpback has bubble to be confirmed as air flue, after local anaesthetics is injected in air flue, puncture needle is exited a little, at this time rapidly Patient can choke, and (cough of choking can be such that local anaesthetics is uniformly distributed on the mucous membrane in air flue to cough, lift air flue when reducing surgical procedure Air flue stress reaction when inner wall).

, surgical operation step below selected according to patient's condition:

(1) operation (can use or omit according to patient's condition) of mechanical ventilation is implemented in selection immediately:

Venous detaining needle is used when if injecting local anaesthetics, needle core is extracted at this time and lays down syringe, by gib head along indwelling The casing of needle is pressed into or is inserted into air flue, by row mechanical ventilation after the casing connection of respirator and remaining needle.If injecting local anaesthetics When use disposable 20ml syringe (its syringe needle for pink needle stand), gib head is pressed into or is inserted at this time air flue along shank It is interior, and syringe needle is exited into the through-hole of gib head, and lay down syringe, with the hand steered syringe needle and fixed needle depth held (to prevent needle Head damage air flue rear wall), respirator is then connect row mechanical ventilation with syringe needle.

After row mechanical ventilation, the anoxia asphyxia state to patient is alleviated or is not alleviated, and extracts casing or the puncture of remaining needle After syringe needle, gib head is gently lifted to rapidly air flue inner wall, into the operation of air flue otomy.

(2) tracheae or intercricothyrotomy operation are directly selected:

After local anaesthetics injection, directly gib head can be pressed into (or insertion) air flue at shank (or casing), extract needle Head and syringe lift air flue inner wall with gib head rapidly, implement air flue otomy.

, tracheotomy in patients: will enter it is endotracheal mention cutting drag hook gib head and lifting inner surface of trachea (make to mention and cut drag hook gib head court Nest direction on sternal, can also be to cephalad direction, should be according to the cut direction of the position selection gib head of selection tracheotomy, and protects It is tracheae center position at tenaculum head lifting), in the fluting at 11 trumpeter's art sharp knife pieces insertion shank, skin is cut (by outer Inwardly) or cutting tracheal rings (from inside to outside) carry out tracheotomy routine operation.The length of tracheotomy should basis It is ready for insertion into the model specification determination that air pipe sleeve (leads) pipe.Finally incision of trachea is separated with haemostatic clamp, tracheal catheter is inserted into In tracheae and tracheal catheter is fixed, completes the operation of tracheotomy.It should be noted that the processing to bleeding in operation, and use aspirator Attract the blood and/or secretion in air flue, keeps the unobstructed of respiratory tract.

, row intercricothyrotomy: first will enter ring first film the leftward or rightward either side standing ring first film of gib head inner wall It is cut, cleavable skin (ecto-entad) or cut ring first film (from inside to outside) carry out the conventional of intercricothyrotomy and grasp Make, the inner wall for then rotating gib head to other side standing ring first film is cut.It is careful not to by gib head sternal and to head Direction lifting, in order to avoid damage thyroid cartilage and damage tracheae annular cartilage, and serious complication occurs.Remaining operation is the same as ring first The routine operation of film otomy or tracheotomy.

Above-described embodiment is only the preferred embodiment of the utility model, not limits the protection model of the utility model according to this It encloses, therefore: the equivalence changes that all structures, shape, principle according to the utility model are done should all be covered by the protection of the utility model Within the scope of.

Claims (7)

1. a kind of tracheae, ring first film mention and cut drag hook, it is characterised in that: including shank, it is fixedly connected with gib head in the lower end of shank, Gib head is stretched out to the side of shank, and the end of gib head is in bullet-shaped or coniform, is equipped on gib head along gib head length side To the through-hole of extension, through-hole runs through gib head on the length direction of gib head, and the top of through-hole is equipped with opening, the clearing end of opening with The end of gib head has a distance, fluting is additionally provided in shank, fluting also radially runs through shank in shank, and slots Lower end also with through-hole, opening in communication.

2. tracheae according to claim 1, ring first film mention and cut drag hook, it is characterised in that: the shank includes upper section under Section, upper diameter 6.0mm, lower section diameter are 3.0mm, and the fluting is located on lower section.

3. tracheae according to claim 1, ring first film mention and cut drag hook, it is characterised in that: the diameter of gib head be 2.0 ~ 3.0mm。

4. tracheae according to claim 1, ring first film mention and cut drag hook, it is characterised in that: the diameter of through-hole be 1.6 ~ 2.0mm, the length of through-hole are 8.0 ~ 10.0mm.

5. tracheae according to claim 1, ring first film mention and cut drag hook, it is characterised in that: the clearing end and hook of the opening The distance between end of head is 3.0mm.

6. tracheae according to claim 1, ring first film mention and cut drag hook, it is characterised in that: the width of fluting be 1.6 ~ 2.0mm。

7. tracheae according to claim 1, ring first film mention and cut drag hook, it is characterised in that: shank is perpendicular with gib head.