JP2004033532A

JP2004033532A - Connection structure of tracheotomy tube

Info

Publication number: JP2004033532A
Application number: JP2002195831A
Authority: JP
Inventors: Katsuhiro Kamiya; 神谷　勝弘; Shoichi Tsukagoshi; 塚越　昌一; Shingo Owaki; 大脇　慎吾; Hirokazu Uehara; 植原　洋和
Original assignee: Senko Medical Instrument Manufacturing Co Ltd
Current assignee: Senko Medical Instrument Manufacturing Co Ltd
Priority date: 2002-07-04
Filing date: 2002-07-04
Publication date: 2004-02-05
Anticipated expiration: 2022-07-04
Also published as: JP4119180B2

Abstract

<P>PROBLEM TO BE SOLVED: To provide a safe tracheotomy tube wherein a speech valve can be connected to a tracheotomy tube having a window hole but can not be connected to a tracheotomy tube having no window hole. <P>SOLUTION: A connection structure attaches the speech valve 40 having a check valve to the respective connection wall parts of the tracheotomy tube 20A which contains a connection wall part 22A provided to the outer peripheral part of one end of a curved pipe 21A and a cannula 23A having a ventilation window hole included in the curved pipe, and the tracheotomy tube 20B including a cannula 23B having no window hole. A locking part is provided only to the connection wall part 22A of the tracheotomy tube 20A (provided with the window hole), and a locking part locked with the above locking part but not connected to the connection wall part 22B of the tracheotomy tube 20B (having no window hole) is provided to the connection end part of the speech valve. <P>COPYRIGHT: (C)2004,JPO

Description

【０００１】
【発明の属する技術分野】
本発明は、気管切開術を施した際に使用する気管切開チューブに関し、気管切開チューブの連結壁部に逆止弁を有するスピーチバルブを連結する際に、窓穴を有するものは連結可能とし、窓穴を有さないものは連結不可能とする気管切開チューブの連結構造に関する。
【０００２】
【従来の技術】
気管切開チューブ（「カニューレ」とも呼ばれる）は、呼吸機能の不十分な患者などに用いられ、その取付は、患者に気管切開術を施し、その切開部へ気管切開チューブの先端を挿入することにより行われる。
患者の症状が重い場合などには、この気管切開チューブに人工呼吸器をつなぐことによって、空気が外部から気管を通じて肺に送り込まれるので、患者は喉や鼻から空気を取り込むことなく、呼吸することができるようになる。
また、患者の症状がある程度回復し自発呼吸ができる場合などには、この気管切開チューブから人工呼吸器をはずし、その部分に逆止弁の役割を果たすスピーチバルブを取り付ける。これにより、吸気の場合にはスピーチバルブを通して肺に空気が取り入れられ、呼気の場合にはスピーチバルブを通さず気管の声帯側を通して口または鼻から呼気を吐き出すようにすることにより、患者が発生できるようにしている。
【０００３】
図８は、従来の気管切開チューブの一例を示し、図８（ａ）は正面図、（ｂ）は側面図である。この気管切開チューブ１は、気管に挿入される湾曲管２の一端外周部に連結壁部３が設けられたカニューレ４と、該カニューレ４に揺動可能に支持された左右が折り畳み可能な固定板５と、湾曲管２の気管挿入側端部に設けられたバルーン状のカフ６と、該カフ６内に空気等のガスを送りまたは排出してカフ６を膨張または収縮させるカフ６操作用チューブおよび気管内に溜まった分泌液等を外部に排出する排出用チューブなどのチューブ７とを主な構成要素として備えている。
この気管切開チューブ１の連結壁部３には、図８（ｂ）に示すようにスピーチバルブ１０が着脱可能に連結される。このスピーチバルブ１０は、連結壁部３に嵌合される筒状体からなる本体に図示しない逆止弁を設けたものである。この逆止弁は、吸気の場合空気の通過を許容し、呼気の場合空気の通過を遮断する。
【０００４】
なお、気管切開チューブとしては、図８に示す単管式の気管切開チューブ１の他に、この気管切開チューブ１の湾曲管をアウターカニューレとし、該アウターカニューレ内にやや細い湾曲管からなるインナーカニューレを挿通、連結した二重管方式のものも提供されている。
また単管式の気管切開チューブについても、図８（ｂ）に示すように湾曲管２に通気用の窓穴８を有するもの、窓穴無しのもの、カフ６が設けられているもの、カフ無しのものなど各種のタイプがある。これらは患者の容体に応じて適宜適切なものが使用される。
【０００５】
【発明が解決しようとする課題】
上述した通り、図８に示す単管式の気管切開チューブ１においては、湾曲管２に窓穴８を有するタイプ（図８（ｂ）参照）と、窓穴のないタイプとが提供されており、患者の容態に応じて、それぞれの連結壁部３にスピーチバルブ１０を連結したり、あるいは人工呼吸器に接続する連結チューブを接続する場合に対応可能となっている。
スピーチバルブ１０は逆止弁を有していることから、前記窓穴８を有する気管切開チューブにのみ使用することができ、窓穴８のない気管切開チューブには使用できない。窓穴８のない気管切開チューブにスピーチバルブ１０を誤連結するのを防止するために、各気管切開チューブの使用説明書等には、該チューブの使用方法とともに、窓穴のない気管切開チューブにスピーチバルブ１０を連結しないように注意書きがなされている。しかしながら、従来の気管切開チューブ１は、窓穴８を有するものと、窓穴のないものとが同等の連結壁部３を用いて作製されていたため、窓穴のない気管切開チューブにスピーチバルブ１０を連結するミスを物理的手段によって防止することはできなかった。
【０００６】
本発明は上記事情に鑑みてなされたもので、窓穴を有する気管切開チューブにはスピーチバルブが連結でき、窓穴のない気管切開チューブには連結できない物理的な誤連結防止手段を有し、安全性を高めた気管切開チューブの提供を目的としている。
【０００７】
【課題を解決するための手段】
前記目的を達成するために、本発明は、湾曲管の一端外周部に連結壁部が設けられ、該湾曲管に通気用の窓穴を有するカニューレを含む気管切開チューブ（Ａ）と、該窓穴を有さないカニューレを含む気管切開チューブ（Ｂ）とのそれぞれの連結壁部に、逆止弁を有するスピーチバルブを取り付ける連結構造であって、前記気管切開チューブ（Ａ）、（Ｂ）のうち窓穴を有するカニューレを含む気管切開チューブ（Ａ）の連結壁部にのみ係合部を設けるとともに、前記スピーチバルブの連結端部に前記係合部に係合するが、窓穴を有さないカニューレを含む気管切開チューブ（Ｂ）の連結壁部には係合しない係止部を設けたことを特徴とする気管切開チューブの連結構造を提供する。
本発明の気管切開チューブの連結構造において、前記スピーチバルブの連結端部に、前記係止部として、長さ方向に突出する係止片と該係止片の前記連結壁部と接する面側から突出する係止突起とを設け、気管切開チューブ（Ａ）の連結壁部に、前記係合部として、前記スピーチバルブの連結時に前記係止片が収容される係合凹部と、該係合凹部内に、前記係止突起が嵌入される溝を設けた構成としてよい。
また、前記スピーチバルブの連結端部に、該スピーチバルブを前記気管切開チューブ（Ａ）の連結壁部に連結した時には該連結壁部により塞がれ、該スピーチバルブを前記気管切開チューブ（Ｂ）の連結壁部に連結した時には該連結壁部に接しない通気口を設けた構成としてよい。
さらに、前記スピーチバルブの連結端部の内壁側と、前記気管切開チューブ（Ａ）の連結壁部のいずれか一方にネジ部を設け、いずれか他方に該ネジ部に螺着嵌合される突起を設けた構成としてよい。
また、前記気管切開チューブ（Ａ）の連結壁部の先端部に、前記スピーチバルブの連結端部に嵌入可能な縮径部を係合部として設け、係止部としてスピーチバルブの連結端部を、気管切開チューブ（Ａ）の連結壁部とは嵌合するが前記縮径部を持たない気管切開チューブ（Ｂ）の連結壁部とは嵌合しない口径とするかまたは前記縮径部に嵌合する突部を設けた構成としてよい。
さらに、前記スピーチバルブの係止部として連結端部が内管と外管からなる二重管構造とされ、気管切開チューブ（Ａ）の係合部として連結壁部が前記連結端部の二重管の間に嵌合する管径または管肉厚を有し、前記気管切開チューブ（Ｂ）の連結壁部はこの連結端部の二重管の隙間に嵌合されない管径または管肉厚とした構成としてよい。
【０００８】
【発明の実施の形態】
（第１実施形態）
図１は本発明に係る気管切開チューブの連結構造の第１実施形態を示す図である。この気管切開チューブ２０Ａは、通気用の窓穴（図示略）を有する湾曲管２１の一端外周部に連結壁部２２Ａを有するカニューレ２３Ａを備えている。なお、該気管切開チューブ２０Ａには、図示は略しているが、図７に示すようなカニューレ２３に揺動可能に支持された左右が折り畳み可能な固定板と、湾曲管２の気管挿入側端部に設けられたバルーン状のカフ６と、該カフ６内に空気等のガスを送りまたは排出してカフ６を膨張または収縮させるカフ６操作用および気管内に溜まった分泌液等を外部に排出する排出用のチューブ７とが設けられている。また、気管切開チューブ２０Ａの隣に図示した気管切開チューブ２０Ｂは、窓穴のない湾曲管２１Ｂを有するカニューレ２３Ｂを備え、また連結壁部２２Ａに後述する係合部を有さない連結壁部２２Ｂを有していること以外は上記気管切開チューブ２０Ａと同じ構成とし得る気管切開チューブ２０Ｂを示している。
以下、窓穴を有するカニューレ２３Ａを備えた気管切開チューブ２０Ａは「気管切開チューブ２０Ａ（窓穴有り）」と記し、窓穴のないカニューレ２３Ｂを備えた気管切開チューブ２０Ｂは「気管切開チューブ２０Ｂ（窓穴なし）」と記載する。
【０００９】
この気管切開チューブ２０Ａ（窓穴有り）の連結壁部２２Ａにはスピーチバルブ４０の連結端部４１が着脱可能に連結される。このスピーチバルブ４０は、連結壁部２２に嵌合される筒状体からなる本体に図示しない逆止弁を設けたものである。この逆止弁は、吸気の場合空気の通過を許容し、呼気の場合空気の通過を遮断する。このスピーチバルブ４０の連結端部４１は、気管切開チューブ２０Ａ（窓穴有り）の連結壁部２２Ａに十分な気密性（シール性）をもって連結される一方、気管切開チューブ２０Ｂ（窓穴なし）の連結壁部２２Ｂには十分な気密性をもった連結が不可能な構造になっている。この選択的な連結を可能とするために、スピーチバルブ４０の連結端部４１に係止部を設けるとともに、気管切開チューブ２０Ａ（窓穴有り）の連結壁部２２Ａのみに該係止部に係合する係合部を設けている。
【００１０】
上記気管切開チューブ２０Ａ（窓穴有り）側の係合部とスピーチバルブ４０側の係止部の具体例として、本実施形態にあっては、スピーチバルブ４０の連結端部４１に、長さ方向に向けて突出する２枚の係止片４２（係止部）を対向配置し、これらの係止片４２の連結壁部２２Ａと接する面側から突出する係止突起４３を設けるとともに、気管切開チューブ２０Ａ（窓穴有り）の連結壁部２２Ａに、スピーチバルブ４０の連結時に各係止片４２が収容される２つの係合凹部２４（係合部）と、これらの係合凹部２４内に、前記係止突起４３が嵌入される溝２５を設けた構成になっている。一方、気管切開チューブ２０Ｂ（窓穴なし）の連結壁部２２Ｂには、係合凹部２４や溝２５は設けられていない。連結壁部２２Ａは先窄まりのテーパになっており、またスピーチバルブ４０の連結端部４１の内壁にはそれに対応するテーパ部が形成されており、連結壁部２２Ａに連結端部４１が十分な連結深さで連結される時、両者は十分な気密性（シール性）をもって連結されるようになっている。
【００１１】
この気管切開チューブ２０Ａ（窓穴有り）は、患者の気管に達する切開部分からカニューレ２３Ａの湾曲管２１Ａを気管内に挿入し、固定板５（図７参照）を広げて患者に密着させ、該固定板５を紐や粘着テープ等で患者に固定するとともに、カフ６に接続されたチューブ７からカフ６内に空気を送って膨らませ、カフ６を患者の気管内壁に密着させることによって患者に固定される。
人工呼吸器使用時には、連結壁部２２Ａに図示しない人工呼吸器に接続されたチューブを取り付け、カニューレ２３Ａを通して人工呼吸を行うことができる。
患者の容態に応じて、人工呼吸器を外し、連結壁部２２Ａにスピーチバルブ４０を連結する場合、スピーチバルブ４０の連結端部４１を気管切開チューブ２０Ａ（窓穴有り）の連結壁部２２に嵌入し、２つの係止片４２をそれぞれ係合凹部２４に向けて押し込む。それぞれの係止片４２の係止突起４３は、係合凹部２４の溝２５に嵌合し、それによって気管切開チューブ２０Ａ（窓穴有り）の連結壁部２２Ａにスピーチバルブ４０が十分な気密性をもって連結される。この状態で使用すれば、吸気はスピーチバルブ４０を通して行われ、呼気は患者の声帯、鼻、口を通して行われるので、患者自身の発声が可能となる。
【００１２】
図２は、気管切開チューブ２０Ａ（窓穴有り）にスピーチバルブ４０を連結した状態（ａ）と、気管切開チューブ２０Ｂ（窓穴なし）にスピーチバルブ４０が連結不可能な状態（ｂ）を示す概略図である。気管切開チューブ２０Ａ（窓穴有り）にスピーチバルブ４０を連結した状態（ａ）では、スピーチバルブ４０の係止片４２先端部が連結壁部２２Ａの係合凹部２４に収容されることから、連結壁部２２に対して連結端部４１が十分に深く嵌合される。このように連結深さが十分に得られる場合（ａ）には、係止突起４３が溝２５に嵌合してスピーチバルブ４０が気管切開チューブ２０Ａ（窓穴有り）に固定されるとともに、連結壁部２２Ａ外壁面と連結端部４１の内壁面との少なくとも一部（図２（ａ）中のシール部Ｓ）が密接し、両者の隙間から空気が漏れることなく、十分な気密性をもって連結される。
一方、スピーチバルブ４０を連結できない気管切開チューブ２０Ｂ（窓穴なし）は、図２（ｂ）に示すように、連結壁部２２Ｂに嵌合凹部２４が設けられていないため、係止片４２が連結壁部２２Ｂの基部に当接し、十分な連結深さとならない。その結果、スピーチバルブ４０は連結壁部２２Ｂに連結されず、連結壁部２２Ｂと連結端部４１間には隙間があり、何ら抵抗無くスピーチバルブが抜け落ちる非連結状態となる。したがって気管切開チューブ２０Ｂ（窓穴なし）にスピーチバルブ４０を誤って連結しようとしても連結できず、また連結壁部２２Ｂと連結端部４１間に隙間が生じることから、万一誤連結が行われたとしても、誤連結が容易に判り、且つ該隙間を通って空気がカニューレ２３Ｂから流出し、空気流出停止状態となることがない。
【００１３】
本実施形態では、スピーチバルブ４０の連結端部４１に、長さ方向に向けて突出する２枚の係止片４２を対向配置し、これらの係止片４２の連結壁部２２と接する面側から突出する係止突起４３を設けるとともに、気管切開チューブ２０Ａ（窓穴有り）の連結壁部２２Ａに、スピーチバルブ４０の連結時に各係止片４２が収容される２つの係合凹部２４と、これらの係合凹部２４内に、前記係止突起４３が嵌入される溝２５を設ける一方、気管切開チューブ２０Ｂ（窓穴なし）には上記係合凹部２４と溝２５を設けない構成としたので、スピーチバルブ４０が気管切開チューブ２０Ａ（窓穴有り）の連結壁部２２Ａのみに連結可能であり、気管切開チューブ２０Ｂ（窓穴なし）には十分な気密性をもって連結されないので、スピーチバルブ４０を気管切開チューブ２０Ｂ（窓穴なし）に誤連結するミスを確実に防止できる。
【００１４】
（第２実施形態）
図３は本発明に係る気管切開チューブの連結構造の第２実施形態を示す図である。本実施形態において、気管切開チューブ２０Ａ（窓穴有り）と気管切開チューブ２０Ｂ（窓穴なし）は、上記第１実施例でのそれらと同じであり、またスピーチバルブ４０もほぼ同様の構成要素を備えて構成され、同一構成要素には同一符号を付してある。
本実施形態では、スピーチバルブ４０の連結端部４１に、スピーチバルブ４０を気管切開チューブ２０Ａ（窓穴有り）の連結壁部２２Ａに連結した時には該連結壁部２２Ａにより塞がれ、該スピーチバルブを前記気管切開チューブ２０Ｂ（窓穴なし）の連結壁部２２Ｂに誤連結した時には該連結壁部２２Ｂに接しない通気口４４を設けた構成になっている。
【００１５】
図４は気管切開チューブ２０Ａ（窓穴有り）にスピーチバルブ４０を連結した状態（ａ）と、気管切開チューブ２０Ｂ（窓穴なし）にスピーチバルブ４０が連結不可能な状態（ｂ）を示す概略図である。気管切開チューブ２０Ａ（窓穴有り）にスピーチバルブ４０を連結した状態（ａ）では、スピーチバルブ４０の係止片４２先端部が連結壁部２２Ａの係合凹部２４に収容されることから、連結壁部２２Ａに対して連結端部４１が十分に深く嵌合される。このように連結深さが十分に得られる場合（ａ）には、係止突起４３が溝２５に嵌合してスピーチバルブ４０が気管切開チューブ２０Ａ（窓穴有り）に固定されるとともに、連結壁部２２Ａ外壁面と連結端部４１の内壁面との少なくとも一部が密接し、両者の隙間から空気が漏れることなく、十分な気密性をもって連結される。さらに、スピーチバルブ４０に設けた通気口４４は連結壁部２２Ａにより塞がれて、通気口４４から空気が入り込むことがない。
一方、スピーチバルブ４０を連結できない気管切開チューブ２０Ｂ（窓穴なし）は、図４（ｂ）に示すように、連結壁部２２Ｂに嵌合凹部２４が設けられていないため、係止片４２が連結壁部２２Ｂの基部に当接し、十分な連結深さとならない。その結果、スピーチバルブ４０の通気口４４は連結壁部２２Ｂに到達せず、開口状態となることから、空気がこの通気口４４を通ってカニューレ２３Ｂ内に流入し得る。したがって気管切開チューブ２０Ｂ（窓穴なし）にスピーチバルブ４０を誤って連結しようとしても、その誤連結が容易に判り、且つ通気口４４を通して空気がカニューレ２３Ｂから流出するので空気流出停止状態となることがない。
【００１６】
本実施形態の気管切開チューブの連結構造によれば、上述した第１実施形態と同様の効果が得られ、さらにスピーチバルブ４０に気管切開チューブ２０Ａ（窓穴有り）の連結壁部２２Ａに連結した時には該連結壁部２２Ａにより塞がれ、該スピーチバルブ４０を気管切開チューブ２０Ｂ（窓穴なし）の連結壁部２２Ｂに連結した時には該連結壁部２２Ｂに接しない通気口４４を設けた構成としたので、万一誤連結が行われたとしても誤連結が容易に判り、且つ通気口４４を通して空気がカニューレ２３Ｂから流出するので空気流出停止状態となるのを防止でき、より安全性を高めることができる。
【００１７】
（第３実施形態）
図５は本発明に係る気管切開チューブの連結構造の第３実施形態を示す図である。本実施形態において、気管切開チューブ２６Ａ（窓穴有り）は、連結壁部２７Ａの係合部構造の相異を除いて、上記第１実施形態における気管切開チューブ２０Ａ（窓穴有り）と同様の構成要素を備えて構成されている。
本実施形態による気管切開チューブ２６Ａ（窓穴有り）の係合部構造は、先窄まりのテーパ状に形成された連結壁部２７Ａの基部に、周方向外方側に向けて突出する係合突起２８を設けた構成になっている。なお、図５に示した例示において、該係合突起２８は、連結壁部２７Ａの基部を階段状に太径化した台座状部分に突出形成している。この係合突起２８は、連結壁部２７Ａにスピーチバルブ４０以外の連結部材、例えば人工呼吸器のチューブ連結部を取り付ける場合に連結に影響を与えない位置に形成されている。
一方、気管切開チューブ２０Ｂ（窓穴なし）には、該係合突起２８は設けていない。
【００１８】
本実施形態において用いるスピーチバルブ４０は、連結端部４１の連結側先端部に、上記連結壁部２７Ａの係合突起２８が挿入される拡径部４６を設け、且つ該拡径部４６の内壁面に、上記係合突起２８が螺着嵌合されるネジ部４５を設けた構成になっている。
【００１９】
このスピーチバルブ４０を気管切開チューブ２６Ａ（窓穴有り）の連結壁部２７Ａに連結する場合、スピーチバルブ４０の拡径部４６が連結壁部２７Ａの基部に達し、それからスピーチバルブ４０を時計方向（ネジ部４５が逆ネジの場合は反時計方向）に回し、係合突起２８をネジ部４５に対して螺着嵌合させる。この螺着嵌合が終了した時点で、スピーチバルブ４０の連結端部４１内壁面と気管切開チューブ２６Ａ（窓穴有り）の連結壁部２７Ａ外壁面とが密接状態で連結される。一方、連結壁部２２Ｂに係合突起２８を設けていない気管切開チューブ２０Ｂ（窓穴なし）にスピーチバルブ４０を誤って連結しようとしても、螺着嵌合されないためにスピーチバルブ４０は連結されない。
【００２０】
本実施形態の気管切開チューブの連結構造によれば、上述した第１実施形態と同様に、スピーチバルブ４０を気管切開チューブ２０Ｂ（窓穴なし）に誤連結するミスを確実に防止できる効果が得られ、さらにスピーチバルブ４０の連結端部４１を気管切開チューブ２６Ａ（窓穴有り）の連結壁部２７Ａに螺着嵌合する構成としたので、十分な連結強度が得られ、したがって連結壁部２７Ａにスピーチバルブ４０を連結した状態でスピーチバルブ４０が外れ難くなる。
【００２１】
（第４実施形態）
図６は本発明に係る気管切開チューブの連結構造の第４実施形態を示す図である。本実施形態において、気管切開チューブ２９Ａ（窓穴有り）は、連結壁部３０Ａの係合部構造の相異を除いて、上記第１実施形態における気管切開チューブ２０Ａ（窓穴有り）と同様の構成要素を備えて構成されている。
本実施形態による気管切開チューブ２９Ａ（窓穴有り）の係合部構造は、先窄まりのテーパ状の連結壁部３０Ａの先端部に、所定長さの係合縮径部３１を設けたことを特徴としている。一方、気管切開チューブ２０Ｂ（窓穴なし）の連結壁部２２Ｂには、この係合縮径部３１を設けていない。なお、この係合縮径部３１は、この連結壁部３０Ａにスピーチバルブ４０以外の連結部材、例えば人工呼吸器のチューブ連結部を取り付ける場合に連結に影響を与えないように形成されている。
【００２２】
スピーチバルブ４０の連結端部４１の内壁には、図示されないが上記係合縮径部３１が嵌合する径方向内側に向けて突出する係止突部が設けられている。この係止突部は、連結端部４１の内壁全周にわたる突状であってもよいし、島状あるいはドット状の断続的な突起であってもよい。
【００２３】
このスピーチバルブ４０を気管切開チューブ２９Ａ（窓穴有り）の連結壁部３０Ａに連結する場合、連結壁部３０Ａの先端には、スピーチバルブ４０の連結端部４１内壁に設けられた図示しない係止突部に嵌合する係合縮径部３１を設けたことにより、この係合縮径部３１に係合突部が嵌合してスピーチバルブ４０が連結壁部３０Ａに深く押し込まれ、テーパ面同士が接して連結される。
一方、スピーチバルブ４０を気管切開チューブ２０Ｂ（窓穴なし）の連結壁部２２Ｂに誤って連結しようとしても、連結壁部２２Ｂ先端部がスピーチバルブ４０の連結端部４１内壁に設けられた図示しない係止突部に引っ掛かって、それ以上の進行が阻止されるので、スピーチバルブ４０は連結壁部２２Ｂに連結できない。
【００２４】
本実施形態の気管切開チューブの連結構造によれば、上述した第１実施形態と同様に、スピーチバルブ４０を気管切開チューブ２０Ｂ（窓穴なし）に誤連結するミスを確実に防止できる効果が得られ、さらに係合縮径部３１と係止突起を設ける簡単な構造で選択的な連結（窓穴有りには連結でき、窓穴なしには連結不可能）が可能であり、製造コストを増加させずに上記選択的な連結が可能な構造を提供できる。
【００２５】
（第５実施形態）
図７は本発明に係る気管切開チューブの連結構造の第５実施形態を示す図である。本実施形態では、スピーチバルブ４０の係止部として連結端部４９が内管４７と外管４８からなる二重管構造とされ、気管切開チューブ３２Ａ（窓穴有り）の係合部として、連結壁部３３Ａが連結端部４９の二重管の間に嵌合する管径または管肉厚を有している（図７（ａ））。一方、気管切開チューブ２０Ｂ（窓穴なし）の連結壁部２２Ｂは、この連結端部２９の二重管の隙間に嵌合されない管径または管肉厚とされている（図７（ｂ））。図７（ａ）の例示では、気管切開チューブ３２Ａ（窓穴有り）の連結壁部３３Ａの先端部３４（係合部）を薄肉化して連結端部２９の二重管の隙間に嵌合できるようにし、一方、気管切開チューブ２０Ｂ（窓穴なし）の連結壁部２２Ｂの先端部には薄肉部を形成せず、スピーチバルブ４０の内管４７が挿入できないために、この連結端部２９の二重管の隙間に嵌合されないようになっている。
【００２６】
本実施形態の気管切開チューブの連結構造によれば、上述した第１実施形態と同様に、スピーチバルブ４０を気管切開チューブ２０Ｂ（窓穴なし）に誤連結するミスを確実に防止できる効果が得られ、さらに、スピーチバルブ４０の連結端部４９を内管４７と外管４８とからなる二重管構造とし、気管切開チューブ３２Ａ（窓穴有り）の連結壁部３３Ａがこの二重管の間に嵌合するように構成したので、係合壁部３３ａと連結端部４９とを連結した際に、係合壁部３３ａの先端部の内外面が二重管と接触して接触面積を大きくできるので、双方の連結長さが比較的短くても大きな接触面積をもって連結でき、気管切開チューブ３２Ａ（窓穴有り）の連結壁部３３Ａにスピーチバルブ４０を強固に連結できる。
【００２７】
なお、スピーチバルブ４０は、フィルム上の弁５０が外れないように内部空間のいずれかに弁の吸い込み防止用の弁保持部を設けることができる。この弁保持部は、例えば連結端部４９とスピーチバルブ本体との境界部分に放射状、柵状、格子状として設けることができる。
また、このような弁保持部を形成した際、この弁保持部により通気面積が減少するのを補償するために、内管４７の周方向に沿って複数の垂直な切れ込みを設け、この切れ込みによって通気面積を増加することで、上記弁保持部による通気面積の減少分を補償することもできる。
【００２８】
【発明の効果】
本発明の気管切開チューブの連結構造によれば、窓穴を有する気管切開チューブにはスピーチバルブが連結でき、窓穴のない気管切開チューブには連結できない誤連結防止手段を有し、安全性を高めた気管切開チューブを提供することができる。
【図面の簡単な説明】
【図１】本発明の気管切開チューブの連結構造の第１実施形態を示す要部斜視図である。
【図２】図１の連結構造の要部概略断面図である。
【図３】本発明の気管切開チューブの連結構造の第２実施形態を示す要部斜視図である。
【図４】図３の連結構造の要部概略断面図である。
【図５】本発明の気管切開チューブの連結構造の第３実施形態を示す要部斜視図である。
【図６】本発明の気管切開チューブの連結構造の第４実施形態を示す要部斜視図である。
【図７】本発明の気管切開チューブの連結構造の第５実施形態を示す要部斜視図である。
【図８】従来の気管切開チューブを例示する図である。
【符号の説明】
２０Ａ，２０Ｂ，２６Ａ，２９Ａ，３２Ａ　　気管切開チューブ
２１Ａ，２１Ｂ　　湾曲外管
２２Ａ，２２Ｂ，２７Ａ，３０Ａ，３３Ａ　　連結壁部
２３Ａ，２３Ｂ　　カニューレ
２４　　嵌合凹部（係合部）
２５　　溝（係合部）
２８　　係合突起（係合部）
３１　　係合縮径部（係合部）
３４　　先端部（係合部）
４０　　スピーチバルブ
４１　　連結端部
４２　　係止片（係止部）
４３　　係止突起（係止部）
４４　　通気口
４５　　ネジ部（係止部）
４７　　内管
４８　　外管
４９　　連結端部（係止部）[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a tracheostomy tube used when performing a tracheostomy, when connecting a speech valve having a check valve to the connection wall portion of the tracheostomy tube, those having a window hole can be connected, The present invention relates to a connection structure of a tracheostomy tube that cannot be connected if it has no window hole.
[0002]
[Prior art]
Tracheostomy tubes (also called "cannulas") are used in patients with inadequate respiratory function, such as by performing a tracheostomy on the patient and inserting the tip of the tracheostomy tube into the incision. Done.
In cases such as when the patient's condition is severe, connecting the ventilator to the tracheostomy tube allows air to be sent from the outside to the lungs through the trachea, so that the patient can breathe without taking in air from the throat or nose. Will be able to
When the patient's symptoms recover to some extent and spontaneous breathing is possible, the ventilator is removed from the tracheostomy tube, and a speech valve serving as a check valve is attached to that part. This allows the patient to develop by inhaling air into the lungs through a speech valve in the case of inhalation and exhaling through the mouth or nose through the vocal cord side of the trachea without exhaling in the case of exhalation. Like that.
[0003]
FIG. 8 shows an example of a conventional tracheostomy tube. FIG. 8 (a) is a front view, and FIG. 8 (b) is a side view. The tracheostomy tube 1 includes a cannula 4 having a connecting wall 3 provided at an outer periphery of one end of a curved tube 2 inserted into the trachea, and a fixed plate that is swingably supported by the cannula 4 and that can be folded left and right. 5, a balloon-shaped cuff 6 provided at the end of the curved tube 2 on the tracheal insertion side, and a cuff 6 operation tube for inflating or deflating the cuff 6 by sending or discharging gas such as air into the cuff 6 And a tube 7 such as a discharge tube for discharging secretion fluid or the like accumulated in the trachea to the outside as main components.
As shown in FIG. 8B, a speech valve 10 is detachably connected to the connection wall 3 of the tracheostomy tube 1. The speech valve 10 is provided with a check valve (not shown) on a main body formed of a tubular body fitted into the connection wall 3. This check valve permits the passage of air in the case of inhalation and shuts off the passage of air in the case of exhalation.
[0004]
As the tracheostomy tube, in addition to the single-tube tracheostomy tube 1 shown in FIG. 8, a curved tube of the tracheostomy tube 1 is used as an outer cannula, and an inner cannula made of a slightly thinner curved tube is provided in the outer cannula. Are also provided.
As shown in FIG. 8 (b), a single tube type tracheostomy tube having a window hole 8 for ventilation in a curved tube 2 as shown in FIG. 8 (b), a tube having no window hole, a tube provided with a cuff 6, a cuff 6 There are various types such as those without. These are appropriately used depending on the condition of the patient.
[0005]
[Problems to be solved by the invention]
As described above, in the single tube type tracheostomy tube 1 shown in FIG. 8, a type having the window 8 in the curved tube 2 (see FIG. 8B) and a type without the window are provided. Depending on the condition of the patient, it is possible to cope with the case where the speech valve 10 is connected to each connection wall 3 or the connection tube connected to the artificial respirator is connected.
Since the speech valve 10 has the check valve, it can be used only for the tracheostomy tube having the window 8 and cannot be used for the tracheostomy tube without the window 8. In order to prevent the speech valve 10 from being erroneously connected to the tracheostomy tube without the window 8, the instruction manual for each tracheostomy tube and the method of using the tubes should be included in the tracheostomy tube without the windows. Precautions have been taken not to connect the speech valve 10. However, since the conventional tracheostomy tube 1 has a window hole 8 and a windowless holeless tube using the same connecting wall 3, the speech valve 10 has a tracheostomy tube without a window hole. Could not be prevented by physical means.
[0006]
The present invention has been made in view of the above circumstances, a speech valve can be connected to a tracheostomy tube having a window, and a means for preventing physical misconnection that cannot be connected to a tracheostomy tube without a window, The purpose is to provide a tracheostomy tube with improved safety.
[0007]
[Means for Solving the Problems]
In order to achieve the above object, the present invention provides a tracheostomy tube (A) including a cannula provided with a connecting wall portion at one end outer peripheral portion of a curved tube and having a window hole for ventilation in the curved tube; A connection structure in which a speech valve having a check valve is attached to each connection wall with a tracheostomy tube (B) including a cannula having no hole, wherein the tracheostomy tubes (A) and (B) are connected to each other. An engaging portion is provided only on a connecting wall portion of the tracheostomy tube (A) including a cannula having a window hole, and the engaging portion is engaged with a connecting end portion of the speech valve, but has a window hole. A coupling structure for a tracheostomy tube, wherein a locking portion that does not engage with the tracheostomy tube (B) including a cannula is provided.
In the connection structure of the tracheostomy tube of the present invention, the connection end of the speech valve is provided with a locking piece projecting in a longitudinal direction as the locking portion, and a locking piece protruding in a length direction and a surface side of the locking piece contacting the connection wall portion. An engaging recess that is provided on the connecting wall portion of the tracheostomy tube (A) as the engaging portion, wherein the engaging piece is housed when the speech valve is connected; The inside may be provided with a groove into which the locking projection is fitted.
Also, when the speech valve is connected to the connection wall of the tracheostomy tube (A) at the connection end of the speech valve, the speech valve is closed by the connection wall, and the speech valve is connected to the tracheostomy tube (B). It is good also as a structure provided with the vent which does not contact the said connection wall part when connected to the said connection wall part.
Further, a screw portion is provided on one of the inner wall side of the connection end portion of the speech valve and the connection wall portion of the tracheostomy tube (A), and a protrusion which is screwed and fitted to the screw portion is provided on one of the other. May be provided.
In addition, a reduced diameter portion that can be fitted into the connection end portion of the speech valve is provided as an engagement portion at a distal end portion of the connection wall portion of the tracheostomy tube (A), and the connection end portion of the speech valve is provided as a locking portion. The diameter of the tracheostomy tube (A) fits with the connecting wall of the tracheostomy tube (A) but does not fit with the connecting wall of the tracheostomy tube (B) having no reduced diameter portion, or fits into the reduced diameter portion. It is good also as a structure provided with the projection part which matches.
Further, the connecting end of the speech valve has a double tube structure including an inner tube and an outer tube, and the connecting wall portion has a double wall of the connecting end as an engaging portion of the tracheostomy tube (A). The connecting wall of the tracheostomy tube (B) has a pipe diameter or wall thickness that does not fit into the gap between the double pipes at the connection end. The configuration may be as follows.
[0008]
BEST MODE FOR CARRYING OUT THE INVENTION
(1st Embodiment)
FIG. 1 is a view showing a first embodiment of a connection structure for a tracheostomy tube according to the present invention. The tracheostomy tube 20A is provided with a cannula 23A having a connecting wall 22A at one end outer peripheral portion of a curved tube 21 having a ventilation hole (not shown). Although not shown in the figure, the tracheostomy tube 20A is provided with a left and right foldable fixed plate supported swingably by a cannula 23 as shown in FIG. A balloon-shaped cuff 6 provided in the section, and a cuff 6 for inflating or deflating the cuff 6 by sending or discharging gas such as air into the cuff 6 and secretion fluid accumulated in the trachea to the outside. A discharge tube 7 for discharging is provided. Further, the tracheostomy tube 20B illustrated next to the tracheostomy tube 20A includes a cannula 23B having a curved tube 21B without a window hole, and a connecting wall portion 22B having no engaging portion described later on the connecting wall portion 22A. A tracheostomy tube 20B that can have the same configuration as the tracheostomy tube 20A except that the tracheostomy tube 20A is shown.
Hereinafter, the tracheostomy tube 20A provided with the cannula 23A having the window hole is referred to as "tracheostomy tube 20A (with a window hole)", and the tracheostomy tube 20B provided with the cannula 23B without the window hole is referred to as "tracheostomy tube 20B ( No window hole) ".
[0009]
The connection end 41 of the speech valve 40 is detachably connected to the connection wall 22A of the tracheostomy tube 20A (with a window hole). The speech valve 40 has a non-illustrated check valve provided on a main body formed of a cylindrical body fitted into the connecting wall portion 22. This check valve permits the passage of air in the case of inhalation and shuts off the passage of air in the case of exhalation. The connection end 41 of the speech valve 40 is connected to the connection wall 22A of the tracheostomy tube 20A (with a window) with sufficient airtightness (sealability), while the connection end 41 of the tracheostomy tube 20B (without a window) is provided. The connection wall portion 22B has a structure that cannot be connected with sufficient airtightness. In order to enable this selective connection, a locking portion is provided at the connecting end 41 of the speech valve 40, and the locking portion is connected to only the connecting wall portion 22A of the tracheostomy tube 20A (with a window hole). A mating engaging portion is provided.
[0010]
As a specific example of the engagement portion on the tracheostomy tube 20A (with a window hole) side and the locking portion on the speech valve 40 side, in the present embodiment, the connection end 41 of the speech valve 40 is provided in the length direction. The two locking pieces 42 (locking portions) protruding toward the upper surface are arranged to face each other, and the locking projections 43 protruding from the surface of the locking pieces 42 that come into contact with the connecting wall 22A are provided, and the tracheostomy is performed. Two engaging recesses 24 (engaging portions) for accommodating the respective locking pieces 42 when the speech valve 40 is connected to the connecting wall portion 22A of the tube 20A (with a window hole). And a groove 25 into which the locking projection 43 is fitted. On the other hand, the engaging recess 24 and the groove 25 are not provided on the connecting wall 22B of the tracheostomy tube 20B (without a window hole). The connecting wall portion 22A is tapered so as to be tapered, and the inner wall of the connecting end portion 41 of the speech valve 40 is formed with a corresponding tapered portion, so that the connecting wall portion 22A has a sufficient connecting end portion 41. When they are connected at a proper connection depth, they are connected with a sufficient airtightness (sealing property).
[0011]
In this tracheostomy tube 20A (with a window hole), the curved tube 21A of the cannula 23A is inserted into the trachea from the incision reaching the trachea of the patient, the fixing plate 5 (see FIG. 7) is spread, and the tracheostomy tube is brought into close contact with the patient. The fixing plate 5 is fixed to the patient with a cord or an adhesive tape or the like, and air is sent from the tube 7 connected to the cuff 6 into the cuff 6 so that the cuff 6 is inflated to the patient's tracheal inner wall, thereby fixing the patient to the patient. Is done.
When the artificial respirator is used, a tube connected to an artificial respirator (not shown) is attached to the connection wall 22A, and artificial respiration can be performed through the cannula 23A.
When the ventilator is removed and the speech valve 40 is connected to the connection wall 22A according to the condition of the patient, the connection end 41 of the speech valve 40 is connected to the connection wall 22 of the tracheostomy tube 20A (with a window hole). Then, the two locking pieces 42 are pushed into the engagement recesses 24, respectively. The locking projection 43 of each locking piece 42 fits into the groove 25 of the engaging concave portion 24, so that the speech valve 40 has sufficient airtightness on the connecting wall 22A of the tracheostomy tube 20A (with a window hole). Are linked. When used in this state, inhalation is performed through the speech valve 40 and exhalation is performed through the vocal cords, nose, and mouth of the patient, so that the patient can utter himself.
[0012]
FIG. 2 shows a state (a) in which the speech valve 40 is connected to the tracheostomy tube 20A (with a window hole) and a state (b) in which the speech valve 40 cannot be connected to the tracheostomy tube 20B (without a window hole). It is a schematic diagram. In the state (a) in which the speech valve 40 is connected to the tracheostomy tube 20A (with a window hole), the distal end of the locking piece 42 of the speech valve 40 is accommodated in the engagement recess 24 of the connection wall 22A. The connection end 41 is fitted into the wall 22 sufficiently deep. When the connection depth is sufficiently obtained as described above (a), the locking protrusion 43 is fitted into the groove 25, and the speech valve 40 is fixed to the tracheostomy tube 20A (with a window hole), and the connection is established. At least a part of the outer wall surface of the wall portion 22A and the inner wall surface of the connection end portion 41 (seal portion S in FIG. 2A) are in close contact, and air is not leaked from a gap between the two, and the connection is performed with sufficient airtightness. Is done.
On the other hand, in the tracheostomy tube 20B (without a window hole) to which the speech valve 40 cannot be connected, as shown in FIG. 2B, since the fitting recess 24 is not provided in the connecting wall portion 22B, the locking piece 42 is not provided. It abuts against the base of the connecting wall 22B and does not have a sufficient connecting depth. As a result, the speech valve 40 is not connected to the connection wall 22B, and there is a gap between the connection wall 22B and the connection end 41, so that the speech valve is disconnected without any resistance. Therefore, even if the speech valve 40 is erroneously connected to the tracheostomy tube 20B (without a window hole), it cannot be connected, and a gap is formed between the connection wall portion 22B and the connection end portion 41. Even if the misconnection is easily recognized, the air does not flow out of the cannula 23B through the gap, and the air outflow is not stopped.
[0013]
In the present embodiment, two engaging pieces 42 protruding in the length direction are arranged opposite to the connecting end 41 of the speech valve 40, and the surface of the engaging piece 42 that is in contact with the connecting wall 22. Are provided on the connecting wall 22A of the tracheostomy tube 20A (with a window hole), and two engaging recesses 24 for accommodating the respective locking pieces 42 when the speech valve 40 is connected. The grooves 25 into which the locking projections 43 are fitted are provided in the engagement recesses 24, while the engagement recesses 24 and the grooves 25 are not provided in the tracheostomy tube 20B (no window hole). Since the speech valve 40 can be connected only to the connection wall 22A of the tracheostomy tube 20A (with a window hole) and is not connected to the tracheostomy tube 20B (without a window hole) with sufficient airtightness, the speech valve 4 The can be reliably prevented miss connecting erroneously tracheostomy tube 20B (without a window hole).
[0014]
(2nd Embodiment)
FIG. 3 is a view showing a second embodiment of the connection structure of the tracheostomy tube according to the present invention. In the present embodiment, the tracheostomy tube 20A (with a window hole) and the tracheostomy tube 20B (without a window hole) are the same as those in the first embodiment, and the speech valve 40 has substantially the same components. The same components are denoted by the same reference numerals.
In the present embodiment, when the speech valve 40 is connected to the connection end portion 41 of the speech valve 40 and the connection wall portion 22A of the tracheostomy tube 20A (with a window hole), the speech valve 40 is closed by the connection wall portion 22A. When the erroneous connection is made to the connecting wall portion 22B of the tracheostomy tube 20B (without a window hole), a ventilation port 44 that does not contact the connecting wall portion 22B is provided.
[0015]
FIG. 4 is a schematic diagram showing a state in which the speech valve 40 is connected to the tracheostomy tube 20A (with a window hole) (a) and a state in which the speech valve 40 is not connectable to the tracheostomy tube 20B (without a window hole) (b). FIG. In the state (a) in which the speech valve 40 is connected to the tracheostomy tube 20A (with a window hole), the distal end of the locking piece 42 of the speech valve 40 is accommodated in the engagement recess 24 of the connection wall 22A. The connection end 41 is fitted sufficiently deep into the wall 22A. When the connection depth is sufficiently obtained as described above (a), the locking protrusion 43 is fitted into the groove 25, and the speech valve 40 is fixed to the tracheostomy tube 20A (with a window hole), and the connection is established. At least a portion of the outer wall surface of the wall portion 22A and the inner wall surface of the connection end portion 41 are in close contact with each other, and air is not leaked from a gap between the two and the connection is performed with sufficient airtightness. Further, the ventilation port 44 provided in the speech valve 40 is closed by the connecting wall 22A, so that air does not enter through the ventilation port 44.
On the other hand, in the tracheostomy tube 20B (without window hole) to which the speech valve 40 cannot be connected, as shown in FIG. 4B, since the fitting recess 24 is not provided in the connecting wall portion 22B, the locking piece 42 is not provided. It abuts against the base of the connecting wall 22B and does not have a sufficient connecting depth. As a result, the ventilation port 44 of the speech valve 40 does not reach the connecting wall 22B and is opened, so that air can flow into the cannula 23B through the ventilation port 44. Therefore, even if the speech valve 40 is erroneously connected to the tracheostomy tube 20B (without a window hole), the erroneous connection is easily recognized, and the air flows out of the cannula 23B through the ventilation port 44, so that the air outflow is stopped. There is no.
[0016]
According to the connection structure of the tracheostomy tube of the present embodiment, the same effect as that of the above-described first embodiment is obtained, and the speech valve 40 is further connected to the connection wall portion 22A of the tracheostomy tube 20A (with a window hole). A structure in which a ventilation port 44 which is sometimes closed by the connecting wall portion 22A and which does not contact the connecting wall portion 22B when the speech valve 40 is connected to the connecting wall portion 22B of the tracheostomy tube 20B (no window hole) is provided. Therefore, even if an erroneous connection is made, the erroneous connection can be easily recognized, and since the air flows out of the cannula 23B through the ventilation port 44, it is possible to prevent the air outflow from being stopped, thereby improving safety. Can be.
[0017]
(Third embodiment)
FIG. 5 is a view showing a third embodiment of the connection structure of the tracheostomy tube according to the present invention. In the present embodiment, the tracheostomy tube 26A (with a window hole) is the same as the tracheostomy tube 20A (with a window hole) in the first embodiment, except for the difference in the structure of the engaging portion of the connecting wall 27A. It is configured with components.
The engagement portion structure of the tracheostomy tube 26A (with a window hole) according to the present embodiment is configured to engage with the base of the connecting wall portion 27A formed in a tapered tapered shape so as to protrude outward in the circumferential direction. The configuration is such that a projection 28 is provided. In the example shown in FIG. 5, the engagement protrusion 28 is formed so as to protrude from a pedestal-shaped portion in which the base of the connection wall 27A is increased in diameter in a stepwise manner. The engagement protrusion 28 is formed at a position where it does not affect the connection when a connecting member other than the speech valve 40, for example, a tube connecting portion of a respirator is attached to the connecting wall 27A.
On the other hand, the tracheostomy tube 20B (without a window hole) is not provided with the engaging projection 28.
[0018]
The speech valve 40 used in the present embodiment is provided with a large-diameter portion 46 at the front end of the connection end portion 41 on the connection side where the engagement projection 28 of the connection wall portion 27A is inserted. A screw portion 45 into which the engagement protrusion 28 is screwed and fitted is provided on a wall surface.
[0019]
When connecting the speech valve 40 to the connection wall 27A of the tracheostomy tube 26A (with a window hole), the enlarged diameter portion 46 of the speech valve 40 reaches the base of the connection wall 27A, and then moves the speech valve 40 clockwise ( (If the screw portion 45 is a reverse screw, it is turned counterclockwise.) The engagement protrusion 28 is screwed and fitted to the screw portion 45. When the screw fitting is completed, the inner wall surface of the connection end 41 of the speech valve 40 and the outer wall surface of the connection wall 27A of the tracheostomy tube 26A (with a window hole) are connected in a tight state. On the other hand, even if the speech valve 40 is erroneously connected to the tracheostomy tube 20B (no window hole) in which the engagement projection 28 is not provided on the connection wall portion 22B, the speech valve 40 is not connected because it is not screw-fitted.
[0020]
According to the connection structure of the tracheostomy tube of the present embodiment, similarly to the above-described first embodiment, an effect of reliably preventing a mistake in incorrectly connecting the speech valve 40 to the tracheostomy tube 20B (no window hole) is obtained. Further, since the connection end 41 of the speech valve 40 is screwed into the connection wall 27A of the tracheostomy tube 26A (with a window hole), a sufficient connection strength is obtained, and therefore the connection wall 27A is provided. It is difficult for the speech valve 40 to come off in a state where the speech valve 40 is connected.
[0021]
(Fourth embodiment)
FIG. 6 is a view showing a fourth embodiment of the connection structure of the tracheostomy tube according to the present invention. In the present embodiment, the tracheostomy tube 29A (with a window hole) is the same as the tracheostomy tube 20A (with a window hole) in the first embodiment, except for the structure of the engaging portion of the connecting wall 30A. It is configured with components.
The engagement portion structure of the tracheostomy tube 29A (with a window hole) according to the present embodiment is such that a tapered engagement wall portion 31 having a predetermined length is provided at the distal end of a tapered connecting wall portion 30A. It is characterized by. On the other hand, the connecting reduced diameter portion 31 is not provided on the connecting wall portion 22B of the tracheostomy tube 20B (without a window hole). The engagement reduced diameter portion 31 is formed so as not to affect the connection when a connecting member other than the speech valve 40, for example, a tube connecting portion of a respirator is attached to the connecting wall portion 30A.
[0022]
On the inner wall of the connection end 41 of the speech valve 40, a locking projection (not shown) is provided which protrudes radially inward and into which the engagement reduced diameter portion 31 is fitted. The locking protrusion may be a protrusion over the entire inner wall of the connection end 41, or may be an intermittent protrusion in the shape of an island or dot.
[0023]
When the speech valve 40 is connected to the connection wall 30A of the tracheostomy tube 29A (with a window hole), a not-shown lock provided on the inner wall of the connection end 41 of the speech valve 40 is provided at the tip of the connection wall 30A. By providing the engagement reduced diameter portion 31 fitted to the projection, the engagement projection is fitted to the engagement reduced diameter portion 31, and the speech valve 40 is pushed deep into the connecting wall portion 30A, and the tapered surface is formed. They are connected to each other.
On the other hand, even if the speech valve 40 is erroneously connected to the connection wall 22B of the tracheostomy tube 20B (no window hole), the distal end of the connection wall 22B is provided on the inner wall of the connection end 41 of the speech valve 40 (not shown). The speech valve 40 cannot be connected to the connection wall portion 22B because it is caught by the locking projection and further progress is prevented.
[0024]
According to the connection structure of the tracheostomy tube of the present embodiment, similarly to the above-described first embodiment, an effect of reliably preventing a mistake in incorrectly connecting the speech valve 40 to the tracheostomy tube 20B (no window hole) is obtained. In addition, selective connection (connection is possible with a window hole, and connection is impossible without a window hole) is possible with a simple structure in which the engagement reduced diameter portion 31 and the locking projection are provided, thereby increasing the manufacturing cost. A structure capable of the above-described selective connection can be provided without performing the above.
[0025]
(Fifth embodiment)
FIG. 7 is a view showing a fifth embodiment of the connection structure of the tracheostomy tube according to the present invention. In the present embodiment, the connection end portion 49 has a double tube structure including an inner tube 47 and an outer tube 48 as an engagement portion of the speech valve 40, and is connected as an engagement portion of the tracheostomy tube 32A (with a window hole). The wall portion 33A has a pipe diameter or a pipe wall thickness that fits between the double pipes at the connection end 49 (FIG. 7A). On the other hand, the connecting wall 22B of the tracheostomy tube 20B (without a window hole) has a tube diameter or a wall thickness that does not fit into the gap between the double tubes at the connecting end 29 (FIG. 7B). . In the example of FIG. 7A, the distal end portion 34 (engaging portion) of the connecting wall portion 33A of the tracheostomy tube 32A (with a window hole) is made thinner and can be fitted into the gap between the double tubes at the connecting end portion 29. On the other hand, a thin-walled portion is not formed at the distal end of the connecting wall portion 22B of the tracheostomy tube 20B (without a window hole), and the inner tube 47 of the speech valve 40 cannot be inserted. It is designed not to fit in the gap between the double pipes.
[0026]
According to the connection structure of the tracheostomy tube of the present embodiment, similarly to the above-described first embodiment, an effect of reliably preventing a mistake in incorrectly connecting the speech valve 40 to the tracheostomy tube 20B (no window hole) is obtained. Further, the connection end 49 of the speech valve 40 has a double tube structure including the inner tube 47 and the outer tube 48, and the connection wall portion 33A of the tracheostomy tube 32A (with a window hole) is provided between the double tube. When the engagement wall portion 33a and the connection end portion 49 are connected, the inner and outer surfaces of the distal end portion of the engagement wall portion 33a come into contact with the double pipe to increase the contact area. Since it is possible, even if both connection lengths are relatively short, connection can be made with a large contact area, and the speech valve 40 can be firmly connected to the connection wall 33A of the tracheostomy tube 32A (with a window hole).
[0027]
The speech valve 40 may be provided with a valve holding portion for preventing the valve from being sucked in any of the internal spaces so that the valve 50 on the film does not come off. This valve holding portion can be provided, for example, in a radial shape, a fence shape, or a grid shape at a boundary portion between the connection end portion 49 and the speech valve body.
Also, when such a valve holding portion is formed, a plurality of vertical cuts are provided along the circumferential direction of the inner tube 47 in order to compensate for a reduction in the ventilation area due to the valve holding portion. By increasing the ventilation area, it is possible to compensate for the decrease in the ventilation area due to the valve holding portion.
[0028]
【The invention's effect】
According to the connection structure of the tracheostomy tube of the present invention, a speech valve can be connected to the tracheostomy tube having a window, and there is an erroneous connection preventing means that cannot be connected to the tracheostomy tube without a window, thereby ensuring safety. An enhanced tracheostomy tube can be provided.
[Brief description of the drawings]
FIG. 1 is a perspective view of a main part showing a first embodiment of a connection structure for a tracheostomy tube of the present invention.
FIG. 2 is a schematic sectional view of a main part of the connection structure of FIG.
FIG. 3 is a perspective view of a main part showing a second embodiment of the connecting structure of the tracheostomy tube of the present invention.
FIG. 4 is a schematic sectional view of a main part of the connection structure of FIG. 3;
FIG. 5 is a perspective view of a main part showing a third embodiment of the connection structure of the tracheostomy tube of the present invention.
FIG. 6 is a perspective view of a main part showing a fourth embodiment of the connection structure of the tracheostomy tube of the present invention.
FIG. 7 is a perspective view of a main part showing a fifth embodiment of the connection structure of the tracheostomy tube of the present invention.
FIG. 8 is a diagram illustrating a conventional tracheostomy tube.
[Explanation of symbols]
20A, 20B, 26A, 29A, 32A Tracheostomy tube
21A, 21B Curved outer tube
22A, 22B, 27A, 30A, 33A Connecting wall
23A, 23B cannula
24 Fitting recess (engaging part)
25 groove (engagement part)
28 Engagement protrusion (engagement part)
31 Engagement reduced diameter part (engagement part)
34 Tip (engagement part)
40 speech valve
41 Connection end
42 Locking piece (locking part)
43 Locking projection (locking part)
44 Vent
45 Screw part (locking part)
47 Inner tube
48 outer tube
49 Connecting end (locking part)

Claims

A tracheostomy tube (A) including a cannula having a window hole for ventilation provided with a connecting wall portion at one end outer peripheral portion of the bending tube, and a tracheostomy tube (A) including a cannula having no window hole in the bending tube ( B) a connecting structure for attaching a speech valve having a check valve to each connecting wall with B).
An engaging portion is provided only on a connecting wall of the tracheostomy tube (A) including a cannula having a window hole among the tracheostomy tubes (A) and (B), and the engaging portion is provided on a connecting end of the speech valve. A coupling structure for a tracheostomy tube, wherein a locking portion is provided which engages with a portion of the tracheostomy tube (B) and includes a cannula having no window hole, the locking portion not engaging with the coupling wall portion.

At the connection end of the speech valve, a locking piece protruding in a length direction and a locking protrusion protruding from a surface of the locking piece that comes into contact with the connection wall are provided as the locking portion, and the tracheostomy is performed. An engaging recess for accommodating the engaging piece when the speech valve is connected to the connecting wall of the tube (A) as the engaging portion, and the engaging protrusion is fitted into the engaging concave. The connection structure for a tracheostomy tube according to claim 1, wherein a groove is provided.

When the speech valve is connected to the connection wall of the tracheostomy tube (A) at the connection end of the speech valve, the speech valve is closed by the connection wall, and the speech valve is connected to the tracheostomy tube (B). 3. The connection structure for a tracheostomy tube according to claim 2, wherein an air vent that does not contact the connection wall when connected to the wall is provided.

A thread portion is provided on one of the inner wall side of the connection end of the speech valve and the connection wall portion of the tracheostomy tube (A), and a projection which is screw-fitted to the thread portion is provided on one of the other. The connection structure for a tracheostomy tube according to claim 1, wherein:

At the distal end of the connecting wall of the tracheostomy tube (A), a reduced diameter portion that can be fitted into the connecting end of the speech valve is provided as an engaging portion, and the connecting end of the speech valve is used as an engaging portion. The diameter of the tracheostomy tube (B) that fits with the connecting wall portion of the incision tube (A) but does not fit with the connecting wall portion of the tracheostomy tube (B) that does not have the reduced diameter portion, or fits into the reduced diameter portion. The connection structure for a tracheostomy tube according to claim 1, wherein a projection is provided.

The connection end of the speech valve has a double tube structure including an inner tube and an outer tube, and a connection wall portion of the double tube of the connection end serves as an engagement portion of the tracheostomy tube (A). The tracheostomy tube (B) has a pipe diameter or wall thickness that does not fit into the gap between the double pipes at the connection end. The connection structure for a tracheostomy tube according to claim 1, wherein: