Visual multi-functional bronchus plugging device of intelligence
Technical Field
The utility model relates to the technical field of medical instruments, in particular to an intelligent visual multifunctional bronchus blocking device.
Background
The thoracic surgery needs an anesthesiologist to implement a lung isolation technology, namely, a technology of separating ventilation paths of a left lung and a right lung at the level of a trachea bulge or a bronchus and ventilating one lung, mainly has the effect of enabling the operated side lung to be unventilated and gradually collapsed, so that a space for surgical operation is generated in a thoracic cavity, the technology is particularly suitable for the thoracoscope operation, is a key core technology of thoracic anesthesia, and is implemented in a national amount of not less than 30 ten thousand cases/year. The current lung isolation technology mainly comprises two types of double-cavity tubes and a bronchus stopper, wherein the application of the double-cavity tubes accounts for 70 percent, the application range is wide, the method is a traditional classic method, and a visual product is provided at present, but due to the double-cavity tube design, the diameter is thick, the occurrence rate of airway injury is relatively high, the air passage injury can not be used for difficult air passages sometimes, and the double-cavity tubes can be exchanged for patients with the existing trachea cannula through special auxiliary tools; the bronchus stopper is thin in pipe diameter, one side of the bronchus can be blocked by the saccule to cause that one side of the lung is not ventilated, the same lung isolation effect as the double-cavity pipe is realized, the flexibility is high, the application accounts for 30 percent at present, but the double-cavity pipe is gradually increased and replaced in the field of thoracoscope minimally invasive surgery. With the development of thoracic surgery technology, minimally invasive surgery is gradually becoming the mainstream and the front direction, and the advantage of minimally invasive bronchial occluders is more prominent; in addition, in recent years, development of partial difficult operations brings new requirements on lung isolation technology, such as chest operation of patients with difficult air passages, and the first choice is the bronchus blocking device; in partial complicated tracheal surgery, the problem of insufficient oxygenation due to special high-frequency ventilation through a catheter is also considered while lung isolation is considered; the anesthesia of part of the fast channel thoracoscopic surgery adopts the laryngeal mask technology to assist ventilation, the lung isolation is realized by the aid of the bronchial occluder (occasionally, the high-frequency ventilation is connected), the clinical changes have higher requirements and challenges for the existing lung isolation technology and device, and the development of a novel bronchial occluder is helpful to adapt to the changes.
One type of the existing common bronchus occluder can complete the catheterization only under the visual guidance of a fiberoptic bronchoscope. During the operation, if the bronchus stopper is displaced, the position also needs to be adjusted under the assistance of the fiberbronchoscope. This requires the operator to be skilled in the bronchofiberscope technology and to disinfect and maintain the bronchofiberscope, which adds virtually to the cost of use. In addition, assistant is needed in the operation process, the bronchial occluder cannot realize whole-process visualization, and the application of the device is limited due to the defects that the bronchofiberscope is used for observation and positioning, and the like.
The second type is a visual bronchial occluder. Chinese utility model patent (grant publication No. CN 206166970U) discloses a visual bronchus stopper, including hollow single cavity pipe, the one end periphery side that the single cavity pipe stretched into the bronchus is equipped with the gasbag, and the outer tip that the single cavity pipe passed the gasbag and outwards extended is equipped with visual device, is equipped with the cleaning device that can get rid of the fender thing of looking in one side of visual device. The visual bronchus stopper is combined with a visual single-cavity tube to realize visualization, but the visual single-cavity tube has thicker and harder tube diameter than the common single-cavity tube due to the additional arrangement of a visual camera, and simultaneously has limitation in clinical application of occupying more airway space and other problems, and the visual single-cavity tube cannot be used independently without the camera.
The utility model patent of China (application publication No. CN 109009309A) discloses a visual bronchus stopper, which comprises a bronchus stopper catheter, a micro camera, a video transmission line, an image switching jack, a display, an inflation indicating air bag, an inflation connecting pipe, a stopper air bag, a breathing machine connecting part, a vent hole and a plastic guide steel wire. The occlusion device integrates the micro camera at the far end of the cuff of the head of the bronchial occlusion catheter, and the far end of the cuff is also provided with a section of ventilation function lumen, but because the far end of the occlusion cuff is provided with the length of a section of catheter, the visual occlusion tube can not be applied to the occlusion of the lung lobe resection, which causes troubles to surgical operation, and in addition, the relative position relationship between the balloon and the trachea bulge can not be seen, and whether the depth of the bronchial occlusion device is proper or not can not be judged, so that the clinical application of part of the bronchial occlusion device is also limited.
The utility model discloses a china utility model patent (No. CN 209595824U) discloses an adjustable bronchus plugging device, including outer pipe, the one end of outer pipe is provided with air inlet joint, and the middle part of outer pipe is provided with Y shape and connects, and air inlet joint's one end is kept away from to outer pipe is connected with multi-functional crossover sub, and the one end that outer pipe was kept away from to multi-functional crossover sub is connected with the sleeve pipe, and sheathed tube inside is provided with the pipe of ventilating, and the one end that multi-functional crossover sub was kept away from to the sleeve pipe is provided with miniature camera head, and the one end that multi-functional crossover sub was kept away from to the sleeve pipe is provided with the hose, and the sheathed tube one end is kept away from to the hose is connected with the shutoff gasbag. The catheter is designed by an inner sleeve and an outer sleeve and has the following defects: (1) the effective ventilation cavity is small, so that the ventilation resistance is increased, (2) the camera is positioned on the outer sleeve, and once the camera is polluted by secretions, the suction catheter is difficult to insert to clean the air passage and the camera, so that the use effect is affected; (3) the visual angle of the camera is small, the balloon of the occluder cannot be shot completely, and the device has single function and cannot meet various requirements in the operation.
In addition, for patients with higher risk of cross infection, if the operation needs to be performed, the disposable video catheter is suitable, for example, when a respiratory system operation is performed on a new coronary pneumonia patient, if the bronchofiberscope is used for assisting positioning every time, the risk of cross infection is obviously increased, and the operation is not suitable; furthermore, it is possible that some patients may have advanced tracheal intubation due to respiratory failure and then have to be replaced by a tube exchanger to double lumen also increasing the risk of cross-infection. For a patient with high risk of pathogenic virus infection like new coronary pneumonia, if lung isolation is required to be implemented and a patient with cross infection is required to be avoided, a lung isolation device with convenient, multifunctional and simple operation process is required. Guidelines for intubation of new coronary patients with pneumonia recommend rapid sequential intubation, avoid positive pressure ventilation, and reduce exhalation of aerosols from new coronary patients during intubation. Therefore, the ideal choice for such patients to perform lung isolation is to insert the single lumen tube or laryngeal mask first and then place the visible bronchial stopper, and preferably simultaneously achieve a series of ancillary functions such as temperature monitoring, adequate suction drainage and high frequency ventilation by one device.
Disclosure of Invention
In view of the defects in the prior art, the utility model designs the intelligent visual multifunctional bronchial occluder which can realize visualization, and can realize the functions of considering body temperature monitoring in operation, catheter balloon position monitoring, adjustment under whole-process visualization, independent of fiberbronchoscope guidance and the like. The device provided by the utility model can simplify the tubing process of the occluder, reduce the operation difficulty, reduce the airway injury, help to find catheter displacement at early stage, help to timely and accurately clear airway secretions, and can use the high-frequency ventilation function.
In order to solve the technical problems, the utility model provides the following technical scheme:
a novel intelligent visual multifunctional bronchus plugging device comprises a bronchus plugging catheter, a cuff, a miniature camera, a video transmission line, a multifunctional conversion head and an instrument connecting part, wherein the instrument connecting part is arranged at one end of the bronchus plugging catheter, and the cuff is arranged at the other end of the bronchus plugging catheter which penetrates through the multifunctional conversion head; one end of the video transmission line is connected with the miniature camera, and the other end of the video transmission line penetrates through the multifunctional converter and is connected with external equipment; the miniature camera is arranged on the bronchus blocking catheter close to the cuff and above the cuff.
The novel intelligent visual multifunctional bronchus plugging device is characterized in that the miniature camera is arranged at the position 3cm above the cuff. The position that can fine observation cover bag in this position and whether have secretion etc. link to each other with the display through video transmission line, image switching jack to need not just to realize with the help of fiberbronchoscope that bronchus occluder is putting the pipe and the whole visual of intraoperative continuous air flue monitoring, pipe position adjustment, simplified and put a tub operating procedure, reduce the operation degree of difficulty, reduce the damage of air flue simultaneously.
The novel intelligent visual multifunctional bronchus stopper is characterized in that the miniature camera is connected with the Bluetooth device or the small-sized electronic monitor with the Bluetooth device through a video transmission line. The bluetooth is opened after the circular telegram, can pair the back with arbitrary cell-phone and open the APP, accessible mobile screen looks at the camera image often, and can be with data sharing to cell-phone APP, realize distal end expert consultation and teaching, be convenient for simultaneously preserve video data to formulating the server, be convenient for clinical research data acquisition's storage, reserve data analysis access function, so that in the future through multi-functional intelligent analytic system, produce through machine learning and assist based on clinical big data's intelligent decision.
Foretell visual multi-functional bronchus plugging device of novel intelligence, multi-functional conversion head in be provided with drainage and suction device, drainage and suction device attract with the camera and be connected with the drainage tube, this pipe one end is located multi-functional conversion head department, other end opening is located miniature camera department. The device can wash the camera on the one hand, also can accomplish on the one hand and attract and administer the function.
Foretell visual multi-functional bronchus plugging device of novel intelligence, bronchus shutoff pipe be close to instrument connecting portion department and be provided with Y shape and connect, Y shape connect one side and be provided with cuff pressure indication gasbag. The cuff pressure indicating air bag is provided with pressure indicating strips of three colors and scales, wherein the scales are 25-30mmHg, and the pressure indicating strips are green; the scale mark is less than 25mmHg, and the pressure indicating strip is yellow; the scale mark is larger than 30mmHg, and the pressure indication strip is red. The yellow indicating bar indicates that the capacity is insufficient; the red indicator bar indicates that the volume is too large, and a doctor can inflate and deflate according to the indicator bar when inflating the balloon, so that the injury of the cuff pressure to the mucosa is ensured to be minimum.
According to the novel intelligent visual multifunctional bronchial occluder, the body temperature monitoring guide wire is arranged on the surface of the cuff, and the port of the body temperature monitoring guide wire is connected with a body temperature monitoring data line; the body temperature monitoring data line passes through the multifunctional conversion head and is connected with an external monitor. Perioperative heat preservation is closely related to patient prognosis, and particularly, the body temperature monitoring of critically ill patients is more important. After the cuff of the bronchial occluder is inflated, the surface of the cuff is in contact with the tracheal mucosa, so that a guide wire sensitive to monitoring temperature is arranged on the surface of the cuff, the monitored body temperature data can be connected with a body temperature monitoring data line of a monitor, and the body temperature data can be displayed in a body temperature module of the monitor.
The novel intelligent visual multifunctional bronchial plugging device is characterized in that the cuff is of a spiral structure when not inflated, and spirally and rotatably wraps and attaches to the wall of the bronchial plugging catheter. Conventional cuffs appear to be chevron-shaped when uninflated, or crimped together, and must occupy a portion of the lumen during placement, which places a demand on the inner diameter of the endotracheal tube, increasing resistance to placement. The cuff with the spiral structure, which is designed by the utility model, is completely attached to the wall of the blocking tube in a spiral manner when not inflated, does not occupy extra space, reduces the difficulty of intubation, and provides convenient conditions for being used as a high-frequency ventilation catheter.
The novel intelligent visual multifunctional bronchial stopper is characterized in that a worm wheel and a worm are arranged on the Y-shaped joint, the worm is connected with a bronchial blocking catheter, the position of the bronchial blocking catheter above the cuff is provided with an angle-adjustable worm, and the angle adjustment range of the angle-adjustable worm is 0-60 degrees. The device use is more simple and convenient to can adjust to the individual. Mainly through worm wheel and worm function control connection, the angle of the cover bag (shutoff gasbag promptly) of adjustment connecting pipe one end, the angle control range is 0-60, makes the cover bag (shutoff gasbag promptly) more conveniently get into the bronchus. Meanwhile, when the device is used as a high-frequency ventilation pipeline and an exchange pipeline, the device can be adjusted to be 0 degree, and the conversion of multiple functions is realized.
Foretell visual multi-functional bronchus plugging device of novel intelligence, instrument connecting portion tail end for compatible high frequency jet ventilation respirator connector's drainage and attract the port, the port department be provided with one-way steering valve, connect the high frequency interface of ventilating on one side, the another side is connected and is inhaled phlegm pipe or administer the pipe for medicine. The device tail end designs into the interface of compatible high frequency jet ventilation breathing machine connector, can the lug connection high frequency ventilate when needing, can observe the inside condition of air flue often simultaneously, has the sputum secretion can in time clear up the attraction.
Compared with the prior art, the utility model has the following technical effects:
when the novel intelligent visual multifunctional bronchial occluder is used, the functions of placing a bronchus occluder, continuously monitoring an airway in an operation, performing whole-course visualization of catheter position adjustment and the like can be realized without a fiber bronchoscope, the operation steps of placing the bronchus occluder are simplified, the operation difficulty is reduced, the damage of the airway is reduced, and the whole-course visual monitoring in the airway is beneficial to early finding of catheter displacement and timely and accurate clearing of airway secretions, so that the novel intelligent visual multifunctional bronchial occluder has important significance on airway safety. Through connecting intelligent bluetooth device, can realize distal end expert consultation and teaching, be convenient for simultaneously preserve video data to making the server, the clinical research data acquisition's of being convenient for storage, reserve data analysis access function to in the future through multi-functional intelligent analytic system, produce through machine learning and decide based on clinical big data and assist. The device can also detect the pressure of the cuff in real time to inflate and deflate in the operation process, thereby ensuring the minimum damage to the mucosa. Perioperative heat preservation is closely related to patient prognosis, and the device can detect the body temperature of a patient through a monitor in real time. The cuff of the spiral structure of the device, namely the cuff when the device is not inflated, is spirally and completely attached to the wall of the blocking tube, does not occupy extra space, reduces the difficulty of intubation, and provides convenient conditions for being used as a high-frequency ventilation catheter. The angle of the cuff can be adjusted within a certain range by the aid of the cuff adjusting device, so that the cuff can enter a bronchus more conveniently. Meanwhile, when the device is used as a high-frequency ventilation pipeline and an exchange pipeline, the device can be adjusted to be 0 degree, and the conversion of multiple functions is realized. The device can realize the function of high-frequency ventilation and is suitable for patients with severe tracheal tumors. The device can also realize the functions of cleaning the camera, sucking secretion, dosing and the like through the drainage port.
The multifunctional postoperative rehabilitation nursing bed has multiple functions, is convenient to use, has low operation difficulty, can reduce the pain of a patient, and is beneficial to postoperative recovery of the patient.
Compared with the Chinese utility model (No. CN 209595824U), the intelligent catheter is designed as a single tube, an external camera which is designed 3cm away from the saccule has a large visual angle, can see all saccules and the movement of the saccules, is easy to clean, has the functions of temperature measurement, data recording and the like, and has obvious advantages.
Drawings
The conception, the specific structure and the technical effects of the present invention will be further described with reference to the accompanying drawings to fully understand the objects, the features and the effects of the present invention.
FIG. 1 is a schematic structural diagram of an intelligent visual multifunctional bronchial occluder;
fig. 2 is a partial schematic view of the cuff-evacuated state of an intelligent visual multifunctional bronchial occluder.
Wherein the reference numbers are as follows:
the device comprises a bronchial occlusion catheter 1, a cuff 2, a miniature camera 3, a video transmission line 31, a multifunctional converter 4, a Y-shaped joint 5, a worm wheel 51, a worm 52, a cuff pressure indication air bag 6, a pressure indication strip 61, a scale mark 62, an instrument connecting part 7, a drainage and suction port 71, a one-way steering valve 72, a body temperature monitoring guide wire 8, a body temperature monitoring data line 81, an angle-adjustable worm 9, a suction and drainage device 10 and a camera suction and drainage tube 101.
Detailed Description
In order to make the technical means, the characteristics, the purposes and the functions of the utility model easy to understand, the utility model is further described with reference to the specific drawings. However, the present invention is not limited to the following embodiments.
It should be understood that the structures, ratios, sizes, and the like shown in the drawings and described in the specification are only used for matching with the disclosure of the specification, so as to be understood and read by those skilled in the art, and are not used to limit the conditions under which the present invention can be implemented, so that the present invention has no technical significance, and any structural modification, ratio relationship change, or size adjustment should still fall within the scope of the present invention without affecting the efficacy and the achievable purpose of the present invention.
The utility model provides a novel visual multifunctional bronchial occluder in a preferred embodiment.
As shown in fig. 1, a novel intelligent visual multifunctional bronchus plugging device comprises a bronchus plugging catheter 1, a cuff 2, a micro-camera 3, a video transmission line 31, a multifunctional conversion head 4 and an instrument connecting part 7, wherein the instrument connecting part 7 is arranged at one end of the bronchus plugging catheter 1, and the cuff 2 is arranged at the other end of the bronchus plugging catheter which passes through the multifunctional conversion head 4; one end of the video transmission line 31 is connected with the miniature camera 3, and the other end of the video transmission line passes through the multifunctional converter 4 and is connected with external equipment; the miniature camera 3 is arranged on the bronchus blocking catheter 1 close to the cuff 2 and above the cuff 2. The micro camera 3 is arranged at the position 3cm above the cuff 2 and is connected with a Bluetooth device or a small electronic monitor with the Bluetooth device through a video transmission line 31.
The multifunctional conversion head 4 is internally provided with a drainage and suction device 10 which is connected with a camera drainage and suction tube 101, one end of the multifunctional conversion head is positioned at the multifunctional conversion head 4, and the opening at the other end is positioned at the micro camera 3.
The bronchial occlusion catheter 1 is provided with a Y-shaped joint 5 near an instrument connecting part 7, and one side of the Y-shaped joint 5 is provided with a cuff pressure indicating air bag 6. The cuff pressure indicating air bag 6 is provided with three colors of pressure indicating strips 61 and scale marks 62, wherein the scale marks are 25-30mmHg, and the pressure indicating strips 61 are green; the scale mark is less than 25mmHg, and the pressure indicating bar 61 is yellow; the scale is larger than the portion of 30mmHg, and the pressure indication bar 61 is red.
The surface of the cuff 2 is provided with a body temperature monitoring guide wire 8, and the port of the body temperature monitoring guide wire is connected with a body temperature monitoring data line 81; the body temperature monitoring data line 81 passes through the multifunctional conversion head 4 and is connected with an external device (such as a monitor).
The cuff 2 is of a spiral structure when not inflated, and spirally and rotatably wraps and is attached to the wall of the bronchial occlusion catheter 1.
The Y-shaped joint 5 is provided with a worm wheel 51 and a worm 52, the worm 52 is connected with the bronchial occlusion catheter 1, the bronchial occlusion catheter 1 is provided with an angle-adjustable worm 9 at the position above the cuff 3, and the angle adjustment range is 0-60 degrees. By rotating the worm wheel 51, the worm 52 is driven by the worm wheel 51, the worm 52 is in transmission connection with the angle-adjustable worm 9 (the transmission connection is through a transmission rod which is equivalent to a thin wire embedded in the bronchial occlusion catheter 1, one end of the transmission rod is connected with the worm 52, the other end of the transmission rod is connected with the angle-adjustable worm 9, the thin wire can be tightened when the worm 52 is screwed, the angle-adjustable worm 9 is bent to drive the cuff 2 to be bent, the angle of the angle-adjustable worm 9 is controlled to change, the change range is 0-60 degrees, so that the angle (the angle adjustment range is 0-60 degrees) of the cuff 2 (namely the occlusion balloon) is adjusted, and the cuff 2 (namely the occlusion balloon) can enter the bronchial tube more conveniently. Meanwhile, when the device is used as a high-frequency ventilation pipeline and an exchange pipeline, the device can be adjusted to be 0 degree, and the conversion of multiple functions is realized.
The tail end of the instrument connecting part 7 is a drainage and suction port 71 compatible with a high-frequency jet ventilation respirator connector, a one-way steering valve 72 is arranged at the port 71, one side of the port is connected with a high-frequency ventilation interface, and the other side of the port is connected with a sputum suction pipe or a drug delivery pipe.
As shown in figure 2, the cuff 2 of the novel intelligent visual multifunctional bronchial occlusion device is in an evacuated state and is spirally sleeved on the tube wall of a bronchial occlusion catheter 1. Conventional cuffs appear to be chevron-shaped when uninflated, or crimped together, and must occupy a portion of the lumen during placement, which places a demand on the inner diameter of the endotracheal tube, increasing resistance to placement. In the embodiment, the cuff 2 is spirally and completely attached to the wall of the bronchial occlusion catheter 1 when the cuff is not inflated, so that extra space is not occupied, the difficulty of intubation is reduced, and convenient conditions are provided when the cuff is used as a high-frequency ventilation catheter.
The use method of the device comprises the following steps: in the process of inserting the bronchial occluder into a patient, the cuff 2 is in an evacuation state, the miniature camera 3 is started, the bronchial occlusion catheter 1 is used for conveying the cuff 2 to a proper position, the miniature camera 3 is connected with an external display or a Bluetooth device through a video transmission line 31 in the process, the angle of the angle-adjustable worm 9 can be adjusted in real time through the worm wheel 51 and the worm 52, the bronchial occluder is convenient to use, and the pain of the patient can be reduced. In the use, but video transmission line lug connection display, or connect intelligent bluetooth device, the bluetooth is opened after the circular telegram, can pair the back with arbitrary cell-phone and open APP, and the accessible cell-phone screen observes the camera image often to can be with data sharing to cell-phone APP, whole can observe the state in the operation in real time.
After reaching the proper position in the body of the patient, the cuff 2 is in an inflated state, the body temperature monitoring guide wire 8 on the surface of the cuff 2 is in contact with the organ of the patient, the body temperature monitoring data wire 81 is connected with a monitoring instrument, and the body temperature data is transmitted to the monitoring instrument through the body temperature monitoring data wire 81, so that the body temperature state of the patient can be detected in real time. The miniature camera 3 is provided with a drainage and suction tube 101 port, and the camera can be cleaned when the camera is shielded by secretions and the like; when the secretion is excessive, the secretion can be sucked away; when administration is required, administration may be performed.
In the using process, the pressure range of the bronchus stopper cuff 2 is generally 25-30mmHg, and the local tracheal mucosa can be pressed by overhigh pressure to cause ischemic necrosis of the mucosa, so that the trachea is deformed, and the breathing is influenced. The device detects the cuff pressure in real time by using the pressure indication strip 61 and the scale mark 62 with three colors arranged on the cuff pressure indication air bag 6. When the pressure is in the range of 25-30mmHg, a green indicating strip is displayed, when the pressure is smaller than the range, a yellow indicating strip is displayed, the volume is indicated to be insufficient, when the pressure is larger than the range, a red indicating strip is displayed, and when a cuff is inflated by a doctor, the doctor can inflate and deflate according to the pressure indicating strip 61, so that the cuff pressure can be guaranteed to damage the mucosa to the minimum.
This device can use the high frequency function of ventilating, at critical patient, perhaps when tracheal tumour patient needs the high frequency to ventilate, this novel visual multi-functional bronchus of intelligence blocks the pipe, and high frequency jet ventilation respirator connector's interface 71 is connected to instrument connecting portion 7, is 0 degree with angle of adjustment worm 9 angular adjustment, can the lug connection high frequency ventilate when needs, can observe the inside condition of air flue in real time through miniature camera 3 simultaneously, has sputum secretion can in time attract, clear up.
The foregoing detailed description of the preferred embodiments of the utility model has been presented. It should be understood that numerous modifications and variations could be devised by those skilled in the art in light of the present teachings without departing from the inventive concepts. Therefore, the technical solutions available to those skilled in the art through logic analysis, reasoning and limited experiments based on the prior art according to the concept of the present invention should be within the scope of protection defined by the claims.