CN2865589Y - Medical apparatus for auxiliary detecting ultrasonic cardiogram blind zone via esophagus - Google Patents

Abstract

It is a medical appliance for assisting the inspection of the blind area of ultrasonic cardiogram through the oesophagus, and it is mainly composed of a water sac, and a push rod for the water sac, openings for affusing and discharging water, and a manometric opening. The water sac is made of emulsion, silica gel or any other materials harmless to people's health, and it is at the front section of its push rod. The push rod, supporting and pushing the water sac, can be bent and is equipped with marks of length scale outside and pervious water sac inside, on the front section of which, there are many openings for affusing and discharging water, and measuring pressure. The openings for affusing and discharging water and the manometric opening are all interfaces of medical injectors with a valve, linking with the inner part of the water sac through the lumen of the push rod for the water sac. TEE trans-tracheal acoustic window, established through the aforesaid devices, may detect what the current TEE may not detect, such as the distal segment of the ascending aorta, the proximal segment of the aortic arch, anonyma, the left subclavian artery, the left common carotid artery, and the left pulmonary artery, making up the deficiency of the detectable range of the current TEE.

Description

The medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone

Technical field

This utility model belongs to the medical equipment field, is specifically related to a kind ofly to the tracheal intubation patient, and auxiliary transesophageal echocardiography (TEE) is checked, a kind of medical checkout facility or the device of the monitoring preceding blood vessel structure of trachea (comprising bronchus) and blood flow information.

Background technology

TEE is a monitoring technology conventional in the present operation on vessels of heart, is usually used in checking the position etc. of development trend, atherosclerotic plaque and thrombosis of coverage, the trunk wound of artery dissection.But because trachea is between esophagus and aortic arch, conventional TEE can not check or monitor the part trunk before the trachea and bronchus, comprise ascending aorta section far away, the nearly section of aortic arch, innominate artery, left pulmonary artery etc., part patient's left subclavian artery, left common carotid artery can not detect.These positions be called as TEE's " blind area " gas causes in the trachea because ultrasound wave can not pass.The method of checking the TEE blind area at present can be divided into ultrasonic method and other iconography method two classes.Ultrasonic method mainly contains transthoracic echocardiography, blood vessel surface is ultrasonic and three kinds of intravascular ultrasounds.Transthoracic echocardiography is generally passed through the suprasternal fossa inspection, and the method can't obtain satisfied image to obesity, emphysema and the thicker patient of thoracic wall; Because the requirement of operation sterilization scope can not detect as in the operation on heart.Blood vessel surface is ultrasonic to be that less sterilization probe is placed on the body structure surface inspection that needs inspection.This method must be opened the thoracic cavity and expose blood vessel, and testing process is disturbed operation technique, expends operating time.Intravascular ultrasound needs special probe puncture is put into blood vessel, and examination scope is limited, and the visual field is less, is unsuitable for doing to detect in the art.

Other iconography methods have angiography, computed tomography (CT) and nuclear magnetic resonance, NMR (MRI) etc.These class methods not only price are high, need special technique personnel and instrument and equipment, and can only obtain the instant static blood-vessel image, can not carry out dynamic blood flow monitoring, can't use in operating room.Angiography, reinforcement computed tomography (CT) also need may cause complication such as allergy to the special contrast agent of injection in the patient's blood vessel.In addition, patient need transport between each section office of hospital, is unsuitable for the emergency case of trunk wound.

Summary of the invention

In order to overcome the defective of using in above-mentioned prior art cost height, interference operation technique, the inconvenience operation, at the development of emergency treatment macroangiopathy rapidly, the characteristics that the state of an illness is critical, this utility model provides a kind of medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone, on the basis of tracheal intubation, set up interim TEE through trachea sound window, enlarged the range of application of TEE, so that check monitoring TEE blind area blood vessel and blood flow information in clinicist's art.

The technical scheme that its technical problem that solves this utility model adopts is: the described medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone mainly is made of water pocket, water pocket pushing ram, water filling discharge outlet and pressure tap.Water pocket can be positioned at water pocket pushing ram leading portion by latex, silica gel or any harmless material, can insert trachea and taking-up by the tracheal intubation mouth of per nasal or per os any kind during emptying.Be close to tracheal wall behind the full of liquid, intracapsular pressure is no more than 30cmH ₂O.Available normal saline or any venoclysis liquid in the water pocket.

In the such scheme, the water pocket pushing ram is that the support of water pocket pushes thing, flexible, its crooked radian and tracheal intubation match at the intravital radian of people during use, length enough arrives the bronchus far-end from front tooth, but in tube chamber water flowing capsule is arranged, the part leading portion has a plurality of openings in the water pocket, use for water filling, draining and pressure measurement, as shown in Figure 3.Pushing ram has the length scale mark outward.Water filling discharge outlet, pressure tap are that (connecing syringe can inject or extraction liquid endotracheal water pocket valve-type injector for medical purpose interface, automatically close after taking off syringe), tube chamber by the water pocket pushing ram communicates with water pocket inside, water filling discharge outlet, pressure tap function unanimity all can be used as water filling, draw water or pressure measurement.Described water pocket and water pocket pushing ram can have different model (diameter and length), can be selected to use according to patient body weight height and check point by the examiner.

In the such scheme, water filling discharge outlet, the pressure tap of water pocket pushing ram end generally place outside the tracheal intubation, by a pressure sensitive sensing system, as hydraulic pressure water pocket pressure inside in the trachea is spread out of, and link to each other by water filling discharge outlet or the anastomosing external piezometer of pressure tap or pressure transducer.Also can have only the water filling discharge outlet, the pipeline that does not have pressure tap and continue mutually with the water pocket pushing ram gets final product at water filling discharge outlet terminal connection one medical three-way cock and pressure tester.

Utilize tracheal intubation and TEE checkout equipment, the water pocket of medical apparatus described in the utility model is inserted trachea by the tracheal intubation mouth, fill with the air (needing pressure measurement simultaneously) of respective regions in the fluid removal trachea with the antisitic defect trachea, make the ultrasound wave that the TEE probe sends in the esophagus can pass through water pocket, temporarily set up a new TEE through trachea sound window, the blind area of TEE be can eliminate, trachea, preceding trunk structure and the blood flow information of bronchus detected.Inspection finishes and takes out behind the emptied of water capsule.(use the patient of pure oxygen mechanical ventilation, the body oxygen reserve allows to stop to ventilate 3 minutes.) also can use twoport tracheal intubation joint, in the checking process partially or completely emptying be placed on endotracheal water pocket, do not influence ventilation, full once more in case of necessity the inspection is in case major structure becomes patient's anoxia.Do not need mechanical ventilation in the operation on vessels of heart extracorporeal circulation process, sustainable full water pocket is observed trachea, the preceding blood vessel of bronchus and blood flow incessantly.

The beneficial effects of the utility model are, use " TEE is through trachea sound window " available TEE that device described in the utility model sets up to the tracheal intubation patient at any time, noinvasive, trunk structure and the blood flow before detecting trachea, bronchus dynamically, can be used in the operating room, do not disturb operation technique; Also can get a distinct image to obesity, emphysema, patient that thoracic wall is thicker; Can select for use normal saline as the sound wave medium, cheap, can not cause allergy; To the inspection of trunk emergency treatment pathological changes (for example the Marfan's syndrome inner membrance is torn, large aneurysm or atherosclerotic plaque suspiciously break, thrombosis etc.), can carry out simultaneously with surgical procedures, do not prolong the waiting time before the art; This utility model is specially adapted to the operation on vessels of heart patient, can continue trunk and blood flow thereof before the observation trachea in the extracorporeal circulation process, for the operation technique of relevant range in time provides information.The TEE that sets up with this utility model is through trachea sound window, can check the not measurable ascending aorta of present TEE section far away, the nearly section of aortic arch, innominate artery, left subclavian artery, left common carotid artery and left pulmonary artery, replenished the deficiency of the scope of present TEE inspection, can be for surgical procedures provide reliable imaging information, for the anesthesia monitoring in the art and Hemodynamics Study provide the new visual field.

Description of drawings

Fig. 1 is the basic structure sketch map that is used for the medical apparatus of assistant check of via esophagus ultrasound cardiogram blind zone described in the utility model.

Fig. 2 is the cross-sectional configuration sketch map at this utility model water pocket pushing ram (A place).

Fig. 3 is the vertical section organigram of the inner leading portion of this utility model water pocket pushing ram water pocket.

Fig. 4 is the vertical section sketch map of this utility model embodiment.

Among the figure, 1. water pocket, 2. water pocket pushing ram, 3. water filling discharge outlet, 4. pressure tap, 5. water pocket pushing ram front opening, 6. trachea, 7. tracheal intubation, 8. esophagus, 9. transesophagel echocardiography probe, 10. innominate artery, 11. left common carotid artery, 12. left subclavian arteries, 13. aortic arch.

The specific embodiment

Below in conjunction with drawings and Examples this utility model is further specified.This utility model is not limited to described embodiment.

Shown in Fig. 4 embodiment, this utility model water pocket 1 is placed in the trachea 6 by tracheal intubation 7, got rid of the endotracheal air of respective regions after filling with normal saline, made the TEE probe 9 in its rear esophagus 8 check the nearly section of the pretracheal aortic arch of monitoring, innominate artery 10, left common carotid artery 11 and left subclavian artery 12 by water pocket 1.During use, can water pocket be put to the appropriate location, and can need to change the water pocket position, with the water pocket emptying, take out after inspection finishes through tracheal intubation with checking by methods such as blind spy, auscultation, calculating, branchofiberoscope or X lines.

Claims (6)

1, a kind of medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone, it is characterized in that mainly being made of water pocket (1), water pocket pushing ram (2), the water filling discharge outlet (3) and the pressure tap (4) that communicate with water pocket by the water pocket pushing ram, water pocket is positioned at water pocket pushing ram leading portion.

2, the medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone according to claim 1 is characterized in that the intracapsular pressure behind water pocket (1) full of liquid is no more than 30cmH ₂O.

3, the medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone according to claim 1 is characterized in that water pocket pushing ram (2) is flexible.

4, the medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone according to claim 1 is characterized in that the length scale mark is arranged outside the water pocket pushing ram (2).

5, the medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone according to claim 1 is characterized in that water pocket pushing ram (2) part leading portion in water pocket has a plurality of openings (5) for water filling, draining and pressure measurement use.

6, the medical apparatus that is used for assistant check of via esophagus ultrasound cardiogram blind zone according to claim 1 is characterized in that water filling discharge outlet (3) and pressure tap (4) are valve-type injector for medical purpose interface.

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