CN212281303U - Painless scope is diagnose with uniting oropharynx breather - Google Patents

Painless scope is diagnose with uniting oropharynx breather Download PDF

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Publication number
CN212281303U
CN212281303U CN202020450970.2U CN202020450970U CN212281303U CN 212281303 U CN212281303 U CN 212281303U CN 202020450970 U CN202020450970 U CN 202020450970U CN 212281303 U CN212281303 U CN 212281303U
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oxygen supply
integrated
oropharynx
painless
combined
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CN202020450970.2U
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张丽娟
王郜
姜爱华
张庆凤
刘晓飞
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Yantai Kaifu Medical Technology Co ltd
Yantai Yuhuangding Hospital
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Yantai Kaifu Medical Technology Co ltd
Yantai Yuhuangding Hospital
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Abstract

A combined oropharynx ventilation device for painless endoscope diagnosis and treatment is characterized in that a soft lens through hole is formed on the end face of a lip part, and an oxygen supply and suction integrated interface and an oxygen supply and monitoring integrated interface are formed on two sides of the soft lens through hole; the front end of the tooth part is connected with the mouth lip part, the rear end of the tooth part is connected with the oropharynx integrated part, the upper end of the tooth part is provided with an upper biting groove, and the lower end of the tooth part is provided with a lower biting groove; a C-shaped groove tubular opening is formed at the top end of the oropharynx integral part; an oxygen supply and suction integrated channel which is communicated with each other is formed at one side of the tooth part and the oropharynx integrated body part, and an oxygen supply and suction integrated interface is communicated with the oxygen supply and suction integrated channel; the other side of the tooth part and the oropharynx integrated body part is provided with an oxygen supply monitoring integrated channel which is communicated with each other, and an oxygen supply monitoring integrated interface is communicated with the oxygen supply monitoring integrated channel. The utility model discloses no matter be through oral cavity or nasal cavity, can all put into patient upper and lower respiratory tract and last alimentary canal with soft mirror, when painless comfortable soft mirror diagnoses for the patient under the anesthesia state, prevent effectively that the tongue from weighing down behind, keep the air flue unobstructed.

Description

Painless scope is diagnose with uniting oropharynx breather
Technical Field
The utility model relates to a joint oropharynx air vent, concretely relates to painless scope is diagnose with joint oropharynx air vent.
Background
At present, in the process of examination and treatment, a patient with pathological changes of digestive tract, respiratory system and the like sometimes needs to insert a fiber or an electronic soft lens into the body through mouth or nose, a tooth part of the patient needs to contain a bite block during oral operation, the soft lens is convenient to pass, the soft lens is prevented from being damaged by occlusion of the patient's teeth in the process of microscopic examination and treatment, and meanwhile, the interference of the soft lens on examination and treatment is also avoided. However, when the patient feels discomfort, the patient often uses the tongue to push out the bite block unconsciously, and then the teeth are buckled to bite the soft lens, which is not convenient for the doctor to carry out normal examination and treatment, but also may damage expensive diagnosis and treatment equipment.
In addition, painless endoscopy is often performed on patients in order to improve patient comfort and successfully complete microscopy and treatment. In the examination of painless gastroscopes and painless bronchoscopes, patients enter a sleep state when intravenous anesthesia works, and respiratory depression caused by falling of the tongue body of the patients often occurs. Patients who are under microscopic examination and treated for obesity, sleep apnea syndrome, cardiopulmonary insufficiency, old, weak, and sensitive to anesthetic will suddenly suffer from respiratory distress, cyanosis of lips, and sharp decrease of blood oxygen saturation, and if the treatment is not timely, the patients will suddenly die.
Clinically, a technical scheme is needed to keep the patients in the anesthesia of the painless endoscope diagnosis and treatmentThe mouth of the patient is opened to avoid occlusion, the phenomenon that the tongue body falls backward to cause the obstruction of the air passage and the respiratory inhibition can be avoided, and simultaneously, the end-tidal CO can be conveniently and effectively inhaled through the mouth and conveniently and accurately measured2The painless endoscope treatment respiratory tract management tool has the advantages that the gas concentration is equal, the suction of oral secretion is convenient, the breathing bag can be connected or the breathing circuit can be connected with an anesthesia machine for auxiliary breathing if necessary, and the safety coefficient is improved.
SUMMERY OF THE UTILITY MODEL
Therefore, the utility model provides a painless scope is diagnose with uniting oropharynx breather, no matter be through oral cavity or nasal cavity, can all put into patient's last alimentary canal or lower respiratory tract with the soft mirror to help the soft mirror faster more smooth and easy putting into and operation.
In order to achieve the above object, the present invention provides the following technical solutions: a combined oropharynx air breather for painless endoscope diagnosis and treatment comprises a mouth lip part, a tooth part and an oropharynx integrated part; a soft lens through hole is formed on the end face of the mouth lip part, an oxygen supply and suction integrated interface is formed on one side of the soft lens through hole, and an oxygen supply and monitoring integrated interface is formed on the other side of the soft lens through hole; the front end of the tooth part is connected with the mouth lip part, the rear end of the tooth part is connected with the oropharynx integrated body part, an upper biting groove is formed at the upper end of the tooth part, and a lower biting groove is formed at the lower end of the tooth part; the oropharynx integral body is in an arc-shaped bent shape, and a C-shaped groove tubular opening is formed at the top end of the oropharynx integral body;
an oxygen supply and suction integrated channel which is communicated with each other is formed on one side of the tooth part and the oropharynx integrated body part, and the oxygen supply and suction integrated interface is communicated with the oxygen supply and suction integrated channel; the other side of tooth portion and oropharynx integrative body is formed with the integrative passageway of oxygen suppliment monitoring that communicates each other, integrative interface intercommunication of oxygen suppliment monitoring integrative passageway.
As a preferred scheme of the combined oropharyngeal airway device for painless endoscopic diagnosis and treatment, a first arc-shaped opening is formed on the upper end surface of the mouth lip part, and a second arc-shaped opening is formed on the lower end surface of the mouth lip part; the two sides of the mouth lip part are curved in an arc shape.
In a preferred embodiment of the combined oropharyngeal airway device for painless endoscopic surgery, the upper bite-holding groove is curved toward an upper side near the lip portion of the mouth, and the lower bite-holding groove is curved toward a lower side near the lip portion of the mouth.
As a preferable scheme of the combined oropharyngeal airway device for painless endoscopy, the bottom end of the oropharyngeal integral body extends outwards and bends downwards.
As a preferable scheme of the combined oropharyngeal airway device for painless endoscopic diagnosis and treatment, the oxygen supply and suction integrated channel is provided with a second port in the area of the pharyngeal portion.
As a preferable scheme of the combined oropharynx air breather for painless endoscopic diagnosis and treatment, the distance between the tail end of the oxygen supply and suction integrated channel and the tail end of the oropharynx integrated body accounts for 1/4-1/3 of the length of the oropharynx integrated body.
As a preferred scheme of the combined oropharynx air breather for painless endoscopic diagnosis and treatment, the oxygen supply and monitoring integrated channel extends to the tail end of the oropharynx integrated body, and a second through opening is formed in the tail end of the oropharynx integrated body through the oxygen supply and monitoring integrated channel.
As a preferable scheme of the combined oropharyngeal airway device for painless endoscopic diagnosis and treatment, the tooth part is made of silicon rubber.
As a preferable scheme of the combined oropharyngeal ventilation device for painless endoscopic diagnosis and treatment, the soft lens port is inserted or sleeved into a standard connector of a breathing circuit to be connected with a breathing bag or an anesthesia machine.
As a preferable scheme of the combined oropharyngeal airway device for painless endoscopic diagnosis and treatment, the upper ends of the lip and the teeth are provided with precuts.
The end surface of the mouth lip part of the utility model is provided with a soft lens through hole, one side of the soft lens through hole is provided with an oxygen supply and suction integrated interface, and the other side of the soft lens through hole is provided with an oxygen supply and monitoring integrated interface; the front end of the tooth part is connected with the mouth lip part, the rear end of the tooth part is connected with the oropharynx integral body part, an upper biting groove is formed at the upper end of the tooth part, and a lower biting groove is formed at the lower end of the tooth part; the oropharynx integral body is in an arc bending shape, and a C-shaped groove tubular opening is formed at the top end of the oropharynx integral body; an oxygen supply and suction integrated channel which is communicated with each other is formed at one side of the tooth part and the oropharynx integrated body part, and an oxygen supply and suction integrated interface is communicated with the oxygen supply and suction integrated channel; the other side of the tooth part and the oropharynx integrated body part is provided with an oxygen supply monitoring integrated channel which is communicated with each other, and an oxygen supply monitoring integrated interface is communicated with the oxygen supply monitoring integrated channel. The utility model discloses no matter be through oral cavity or nasal cavity, can all put into patient's upper and lower respiratory tract or last alimentary canal with soft mirror, C shape groove tubulose opening helps the faster more smooth and easy of putting into of soft mirror and operates, guarantees that putting into of gastroscope, bronchoscope is smooth and easy and operate the facility, with the help of the utility model discloses it is smooth and easy like in the operation of intranasal approach bronchoscope, electronic laryngoscope and vocal cords sound gate under them, and the effectual tongue that prevents weighs down keeps the air flue unobstructed, and overall structure is simple, convenient to carry out, safe and reliable.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below. It should be apparent that the drawings in the following description are merely exemplary, and that other embodiments can be derived from the drawings provided by those of ordinary skill in the art without inventive effort.
The structure, ratio, size and the like shown in the present specification are only used for matching with the content disclosed in the specification, so as to be known and read by people familiar with the technology, and are not used for limiting the limit conditions which can be implemented by the present invention, so that the present invention has no technical essential significance, and any structure modification, ratio relationship change or size adjustment should still fall within the scope which can be covered by the technical content disclosed by the present invention without affecting the efficacy and the achievable purpose of the present invention.
Fig. 1 is a schematic structural view of a combined oropharyngeal airway device for painless endoscopic diagnosis and treatment provided in the embodiment of the present invention.
In the figure: 1. a mouth lip portion; 2. a tooth portion; 3. an oropharyngeal integration; 4. a soft lens port; 5. an oxygen supply and suction integrated interface; 6. an oxygen supply and monitoring integrated interface; 7. an upper bite groove; 8. an upper bite groove; 9. a C-shaped groove tubular opening; 10. an oxygen supply and suction integrated channel; 11. an oxygen supply and monitoring integrated channel; 12. a first arcuate port; 13. a second arcuate mouth; 14. a first port; 15. a second port; 16. and pre-cutting the opening.
Detailed Description
The present invention is described in terms of specific embodiments, and other advantages and benefits of the present invention will become apparent to those skilled in the art from the following disclosure. Based on the embodiments in the present invention, all other embodiments obtained by a person skilled in the art without creative work belong to the protection scope of the present invention.
It is known that, in the embodiment of the present invention, "an integrated" in "an oxygen supply monitoring integrated interface" and "an oxygen supply attracting integrated interface" refers to that the action a can be performed, and the action B can also be performed, for example, "an oxygen supply monitoring integrated interface" can be used for supplying oxygen, and also can be used for monitoring, and the purpose of use has replaceability. The meaning of "integrative" in "oropharynx integrative portion" in the embodiment of the utility model refers to that structure one and structure two are together the shaping during design.
Referring to fig. 1, a combined oropharyngeal airway device for painless endoscopic diagnosis and treatment is provided, which comprises a lip part 1, a tooth part 2 and an oropharyngeal integral part 3; a soft lens through hole 4 is formed on the end face of the mouth lip part 1, an oxygen supply and suction integrated interface 5 is formed on one side of the soft lens through hole 4, and an oxygen supply and monitoring integrated interface 6 is formed on the other side of the soft lens through hole 4; the front end of the tooth part 2 is connected with the mouth lip part 1, the rear end of the tooth part 2 is connected with the oropharynx integral body part 3, an upper biting groove 7 is formed at the upper end of the tooth part 2, and a lower biting groove 8 is formed at the lower end of the tooth part 2; the oropharynx integral body part 3 is in an arc bending shape, and a C-shaped groove tubular opening 9 is formed at the top end of the oropharynx integral body part 3.
An oxygen supply and suction integrated channel 10 which is communicated with each other is formed at one side of the tooth part 2 and the oropharynx integrated body 3, and the oxygen supply and suction integrated interface 5 is communicated with the oxygen supply and suction integrated channel 10; the other side of the tooth part 2 and the oropharynx integral body 3 is provided with an oxygen supply monitoring integral channel 11 which is communicated with each other, and the oxygen supply monitoring integral interface 6 is communicated with the oxygen supply monitoring integral channel 11.
Specifically, oropharynx an organic whole body 3 removes "top", has "bottom" and "both sides" combination to become big opening "C" shape transverse section and extends to the distal end, guarantees that putting into of gastroscope, bronchoscope is smooth and easy and the operation is convenient to can guarantee that transnasal entry bronchoscope is equally smooth and easy, effectually prevents the tongue tenesmus, keeps the air flue unobstructed.
Specifically, the upper ends of the mouth lip part 1 and the tooth part 2 are provided with pre-cutting openings 16, and when trachea intubation is carried out in an emergency, the soft lens is used for guiding the trachea intubation to pass through the soft lens through opening, the pre-cutting openings 16 are broken off, and the ventilation device can be withdrawn, so that the tracheal catheter is reserved.
Particularly, the inside and outside surfaces of the C-shaped structure are subjected to ultra-smooth treatment, so that the C-shaped structure is convenient to place and a soft lens can pass through. Ultra-slip processing is a technique known to those skilled in the art.
Specifically, the oropharynx integral part 3 can be configured with different models from children to adults, such as No. 1 to No. n, and from children to adults, especially fat giant, No. 1 corresponds to the specification of the children, and a standard connector of a breathing circuit can be sleeved outside a soft lens port of the oropharynx integral part; numbers 2 to n correspond to the adult specifications, and a standard connector of a breathing circuit can be inserted into the soft lens opening.
Specifically, the oxygen supply and suction integrated interface 5 and the oxygen supply and suction integrated channel 10 can be directly connected with a suction tube or inserted into a sputum suction tube, adults can be inserted into No. F12 or No. F14 sputum suction tubes, children can be inserted into No. F10 sputum suction tubes, and suction is performed through the sputum suction tubes, so that secretion in the oral cavity and the like can be sucked out conveniently.
In one embodiment of the combined oropharyngeal airway device for painless endoscopy, a first arc-shaped opening 12 which is concave downwards is formed on the upper end surface of the mouth lip part 1, and a second arc-shaped opening 13 which is concave upwards is formed on the lower end surface of the mouth lip part 1; both sides of the mouth lip portion 1 are curved in an arc shape. The design of first arc mouth 12 makes user's upper lip and the good laminating of lip portion 1, and the design of second arc mouth 13 makes user's lower lip and the good laminating of lip portion 1 to the both sides of lip portion 1 are arcuately curved, increase the use comfort level of lip portion 1.
In one embodiment of the combined oropharyngeal airway device for painless endoscopy, the upper gripping groove 7 is curved towards the upper side near the lip portion 1, and the lower gripping groove 8 is curved towards the lower side near the lip portion 1. The upper biting groove 7 and the lower biting groove 8 are provided with certain curvatures, the curvatures are matched with the tooth arrangement arcs of a normal oral cavity, and the details of the front incisors, the side incisors and the canines can be optimized.
Specifically, the upper biting groove 7 and the lower biting groove 8 are used for biting upper and lower dentitions of a patient, and the upper teeth exert downward and backward force and the lower teeth exert upward and forward force by the biting action limited by the upper biting groove 7 and the lower biting groove 8, and the lower jaw is passively extended forwards to form a flat or inverted jaw relation (the principle of a special ground covering tooth structure is opposite), so that the front end (far end) of the whole oropharyngeal airway is tilted towards the root of the epiglottis, the epiglottis is favorably lifted to expose the glottis and open the large pharyngeal airway.
In one embodiment of the combined oropharyngeal airway device for painless endoscopy, the distal base of the oropharyngeal body 3 extends outwards and curves downwards. The end cross-sectional shape of the oropharyngeal integral body 3 is similar to the shape of the tongue, thereby facilitating the oropharyngeal integral body 3 insertion.
In one embodiment of the combined oropharyngeal airway device for painless endoscopy, the soft lens port 4 is inserted or sleeved into a standard connector of a breathing circuit for connecting a breathing bag or an anesthesia machine. The oxygen supply and suction integrated channel 10 is provided with a first through hole 14 in the pharyngeal area, and the first through hole 14 is convenient for sucking secretion in the pharyngeal area and can supply oxygen to the pharyngeal area. The distance between the tail end of the oxygen supply and suction integrated channel 10 and the tail end of the oropharynx integrated body 3 is 1/4-1/3 of the length of the oropharynx integrated body 3, and the distance is better matched with the physiological structure of the oropharynx of a human body.
Specifically, the oxygen supply monitoring integrated channel 11 extends to the tail end of the oropharynx integrated body 3, and the second port 15 is formed in the tail end of the oropharynx integrated body 3 through the oxygen supply monitoring integrated channel 11. The second port 15 may be supplied with oxygen or may be checked for gas sampling, such as end-tidal CO2Concentration, end-tidal sevofluraneMAC value, etc., which not only ensures that oxygen is effectively inhaled into the lung, but also ensures that the end-tidal CO is relatively accurately measured2Concentration, end-tidal sevoflurane MAC value, etc., may be screwed down for connection and sealing.
The application scene of the combined oropharynx air breather for painless endoscope diagnosis and treatment is as follows: generally, when a patient takes a left side lying position for painless gastroscopy, the oxygen supply monitoring integrated channel 11 is used for supplying oxygen, and the oxygen supply suction integrated channel 10 is used for sucking secretion. When the painless bronchoscope is made, the patient takes the supine position, the integrative passageway 10 oxygen suppliment of oxygen suppliment attraction is interrupted and is carried out the secretion attraction, and the integrative passageway 11 of oxygen suppliment monitoring is used for gaseous sampling detection.
In an embodiment of the combined oropharyngeal airway device for painless endoscopic surgery, the dental part 2 is made of silicon rubber. The non-toxic silicon rubber material is adopted, the hardness is moderate, and the use comfort level is increased.
In one embodiment of the combined oropharyngeal airway device for painless endoscopic diagnosis and treatment, the odontopathy part 2 can be designed individually for the elderly with complete tooth loss, and is more suitable for the patients without odontopathy.
The end surface of the mouth lip part 1 of the utility model is provided with a soft lens through hole 4, one side of the soft lens through hole 4 is provided with an oxygen supply and suction integrated interface 5, and the other side of the soft lens through hole 4 is provided with an oxygen supply and monitoring integrated interface 6; the front end of the tooth part 2 is connected with the mouth lip part 1, the rear end of the tooth part 2 is connected with the oropharynx integral body part 3, the upper end of the tooth part 2 is provided with an upper clamping groove 7, and the lower end of the tooth part 2 is provided with a lower clamping groove 8; the oropharynx integral body 3 is in an arc bending shape, and a C-shaped groove tubular opening 9 is formed at the top end of the oropharynx integral body 3; an oxygen supply and suction integrated channel 10 which is communicated with each other is formed at one side of the tooth part 2 and the oropharynx integrated body 3, and an oxygen supply and suction integrated interface 5 is communicated with the oxygen supply and suction integrated channel 10; the other side of the tooth part 2 and the oropharynx integral body 3 is provided with an oxygen supply monitoring integral channel 11 which is communicated with each other, and the oxygen supply monitoring integral interface 6 is communicated with the oxygen supply monitoring integral channel 11. The utility model provides an oropharynx integrative portion 3 removes "top", has "bottom" and "both sides" combination to become big opening "C" shape transverse cutting and extends towards the distal end, guarantees that putting into of gastroscope, bronchoscope is smooth and easy and the operation is convenient to can guarantee that intranasal admission bronchoscope, electronic laryngoscope and vocal cords audio gate department operation under them is the same smooth and easy, effectually prevents tongue tenesmus, keeps the air flue unobstructed. The utility model discloses no matter be through oral cavity or nasal cavity, can all put into patient's upper and lower respiratory tract or last alimentary canal with soft mirror, C shape groove tubulose opening 9 helps putting into and operate that soft mirror is more smooth and easy, guarantees that putting into of gastroscope, bronchoscope is smooth and easy and operate the facility, with the help of the utility model discloses it is smooth and easy like the operation of intranasal admission bronchoscope, electronic laryngoscope and vocal cords audio gate under them, and the effectual tongue that prevents weighs down keeps the air flue unobstructed, and overall structure is simple, convenient to carry out, safe and reliable.
Although the invention has been described in detail with respect to the general description and the specific embodiments, it will be apparent to those skilled in the art that modifications and improvements can be made based on the invention. Therefore, such modifications and improvements are intended to be within the scope of the invention as claimed.

Claims (10)

1. A combined oropharynx air breather for painless endoscope diagnosis and treatment is characterized by comprising a mouth lip part (1), a tooth part (2) and an oropharynx integrated part (3); a soft lens through hole (4) is formed on the end face of the mouth lip portion (1), an oxygen supply and suction integrated interface (5) is formed on one side of the soft lens through hole (4), and an oxygen supply and monitoring integrated interface (6) is formed on the other side of the soft lens through hole (4); the front end of the tooth part (2) is connected with the mouth lip part (1), the rear end of the tooth part (2) is connected with the oropharynx integrated body part (3), an upper biting groove (7) is formed at the upper end of the tooth part (2), and a lower biting groove (8) is formed at the lower end of the tooth part (2); the oropharynx integral body part (3) is in an arc-shaped bent shape, and a C-shaped groove tubular opening (9) is formed at the top end of the oropharynx integral body part (3);
an oxygen supply and suction integrated channel (10) which is communicated with each other is formed on one side of the odontoid part (2) and the oropharynx integrated body part (3), and the oxygen supply and suction integrated interface (5) is communicated with the oxygen supply and suction integrated channel (10); the other sides of the dental part (2) and the oropharynx integral body part (3) are provided with oxygen supply monitoring integral channels (11) which are communicated with each other, and the oxygen supply monitoring integral interface (6) is communicated with the oxygen supply monitoring integral channels (11).
2. The combined oropharyngeal airway device for painless endoscopic surgery according to claim 1, characterized in that a first arc-shaped opening (12) is formed on the upper end surface of the mouth lip portion (1), and a second arc-shaped opening (13) is formed on the lower end surface of the mouth lip portion (1); both sides of the mouth lip part (1) are curved in an arc shape.
3. A combined oropharyngeal airway device for painless endoscopy according to claim 1, characterised in that the upper bite-block groove (7) is curved towards the upper side near the lip (1) and the lower bite-block groove (8) is curved towards the lower side near the lip (1).
4. A combined oropharyngeal airway device for painless endoscopy according to claim 1, characterised in that the bottom of the extremity of the oropharyngeal body (3) extends outwards and bends downwards.
5. The combined oropharyngeal airway device for painless endoscopic surgery according to claim 1, characterized in that the oxygen supply and suction integrated channel (10) is provided with a first opening (14) in the area of the pharynx.
6. The combined oropharyngeal airway device for painless endoscopic surgery of claim 5, wherein the distance between the end of the oxygen supply and suction integrated channel (10) and the end of the oropharyngeal integrated body (3) is 1/4-1/3 of the length of the oropharyngeal integrated body (3).
7. The combined oropharyngeal airway device for painless endoscopic diagnosis and treatment according to claim 1, characterized in that the integrated oxygen supply and monitoring channel (11) extends to the end of the oropharyngeal integrated body (3), and the integrated oxygen supply and monitoring channel (11) is provided with a second opening (15) at the end of the oropharyngeal integrated body (3).
8. The combined oropharyngeal airway device for painless endoscopic surgery according to claim 1, characterized in that the dental part (2) is made of silicon rubber.
9. The combined oropharyngeal airway device for painless endoscopic surgery according to claim 1, characterized in that the soft-lens opening (4) is inserted or sleeved into a standard connector of a breathing circuit for connecting a breathing bag or an anesthesia machine.
10. A combined oropharyngeal airway device for painless endoscopic surgery according to claim 1, characterized in that the mouth lip (1) and the upper end of the dental part (2) are provided with pre-cut openings (16).
CN202020450970.2U 2020-03-31 2020-03-31 Painless scope is diagnose with uniting oropharynx breather Active CN212281303U (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112691273A (en) * 2021-03-25 2021-04-23 上海埃立孚医疗科技有限公司 Special oropharynx channel for endoscope

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112691273A (en) * 2021-03-25 2021-04-23 上海埃立孚医疗科技有限公司 Special oropharynx channel for endoscope

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