JP2006130015A - Tracheotomy catheter - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a tracheotomy catheter which has a double tube structure of an outer tube and an inner tube, which never damages the inner wall of the tracheae when it is inserted to the tracheae and where airtightness between the outer tube and the inner tube is secured easily. <P>SOLUTION: The tracheotomy catheter 1 which is inserted to the tracheae is provided with: the flexible outer tube 2; the inner tube 3 which is arranged in a state where it can be inserted to and detached from the outer tube; a cuff 6 which is fixed to the outer peripheral surface of the outer tube 2 on the side of the distal end 2b of the outer tube 2; and a cylindrical member 10 fitted to the distal end 2b of the outer tube 2. The cuff 6 has an annular fixed part 7 on a distal end side and an annular fixed part 8 on a proximal end side fixed to the outer peripheral surface of the outer tube 2, and is provided with an annular hollow part 9 between the annular fixed part 7 on the distal end side and the annular fixed part 8 on the proximal end side. The outer side face of the cylindrical member 10 and the outer side face 7a of the annular fixed part 7 on the distal end side are connected so as to be flush. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a tracheostomy catheter having a double-tube structure of an outer tube and an inner tube, and more particularly to a tracheostomy catheter that does not cause any damage to the inner wall of the trachea when inserted into the trachea.

  Conventionally, various tubes or catheters inserted into the trachea have been developed in order to secure an airway during general anesthesia during surgery.

  In long-term respiratory management and respiratory management of patients with impaired consciousness, it is necessary to secure the airway by tracheotomy. For patients who have difficulty breathing, a ventilator is also used, and for patients who no longer need artificial respiration, training for spontaneous breathing and vocalization must be performed.

  In order to enable spontaneous breathing and voice production, a tracheostomy catheter having a double tube structure of an outer tube and an inner tube is used. An example of a tracheostomy catheter having a double tube structure will be described with reference to FIG.

  FIG. 5 is a cross-sectional view schematically showing a state where a conventional tracheostomy catheter is placed in the trachea. The trachea 51 of the patient is incised, and a tracheostomy catheter 52 is inserted from the incised portion. The tracheostomy catheter 52 has a curved outer tube 53 and an inner tube 54 inserted into the outer tube 53.

  A cuff 55 is fixed near the distal end 53 b of the outer tube 53. The cuff 55 is made of a stretchable synthetic resin and forms a sealed space around the outer periphery of the outer tube 53. The sealed space in the cuff 55 is connected to the balloon 56, and the cuff 55 can be inflated using the balloon 56. As a result, the outer peripheral surface of the cuff 55 is pressed against the inner peripheral surface of the trachea 51, and air leakage is prevented.

  In the portion inserted into the trachea 51, the outer tube 53 has a Murphy hole 53a. The Murphy hole 53a is used for vocal training and the like. That is, when the Murphy hole 53a removes the inner tube 54 from the outer tube 53 and closes the outer end of the outer tube 53 with a finger or the like, air can flow from the lungs toward the vocal cords via the Murphy hole 53a. Is provided to do.

  In order to describe the portion where the cuff 55 of the tracheostomy catheter 52 is provided in more detail, the cross-sectional structure of the portion where the cuff 55 is provided is shown in an enlarged manner in FIG.

  As shown in FIG. 6, a cuff 55 is fixed to the outer peripheral surface 53 c of the outer tube 53. The cuff 55 is configured by adhering or fusing a stretchable synthetic resin sheet to the outer peripheral surface 53 c of the outer tube 53. Therefore, in the conventional tracheostomy catheter 52, an edge indicated by an arrow A in FIG. 6 is formed on the distal end 53b side of the outer tube 53 by the outer peripheral surface 53c of the outer tube 53 and the distal end portion 55a of the cuff 55. Therefore, when the tracheostomy catheter 52 is inserted into the trachea 51, the inner wall 51a of the trachea 51 may be damaged by the edge.

Patent Document 1 listed below discloses a tracheotomy catheter having a structure that prevents damage to the inner wall of the trachea due to an edge or the like when inserted into the trachea. FIG. 7 shows a cross-sectional structure of a portion where the cuff is provided in the tracheostomy catheter described in Patent Document 1. In addition, the place which has the same structure as the said tracheostomy catheter 52 attaches | subjects the same code | symbol, and abbreviate | omits the description.

In the tracheostomy catheter described in Patent Document 1, as shown in FIG. 7, the tip portion 55a of the cuff 55 is fused to the outer peripheral surface 53c of the outer tube 53, and the fused portion 57 is curved. It is linked to. Therefore, it is said that there is little risk of damaging the inner wall of the trachea 51 when inserted into the trachea 51.
JP-A-8-47537

  In the tracheotomy catheter described in Patent Document 1, the distal end portion 55a of the cuff 55 is fused and integrated with the outer peripheral surface 53c of the outer tube 53 in a subsequent step. However, when fusing in the subsequent process, the shape of the fused portion 57 may not be a beautiful curved surface. Moreover, even if it fuse | melts in a curved surface shape, the surface area | region which rose with respect to the outer peripheral surface 53c of the outer tube | pipe 53 in the melt | fusion part 57 is formed. Therefore, the inner wall 51a of the trachea 51 may be damaged by the fused portion 57 when inserted into the trachea 51.

  By the way, in the tracheostomy catheter having a double tube structure of the outer tube 53 and the inner tube 54, it is necessary to ensure airtightness between the outer tube 53 and the inner tube 54. Conventionally, in order to ensure the airtightness between the outer tube 53 and the inner tube 54, a process for deforming the distal end portion 53d of the outer tube 53 by heating or the like has been performed. That is, as shown in FIG. 8, post-processing is performed to reduce the inner diameter by curving the distal end portion 53d inward so that the inner diameter of the distal end portion 53d of the outer tube 53 is approximately the same as the outer diameter of the inner tube 54. It had been. However, the degree of freedom of post-processing of the outer tube 53 is small, and it may be difficult to make the shape of the distal end portion 53d of the outer tube 53 close to the inner tube 54. In addition, it takes time for processing and the processing cost is also expensive.

  An object of the present invention is to have a double tube structure of an outer tube and an inner tube in view of the state of the prior art described above, and there is no risk of damaging the inner wall of the trachea when inserted into the trachea. It is an object of the present invention to provide a tracheostomy catheter capable of easily ensuring the airtightness of the tracheotomy.

  The present invention relates to a tracheostomy catheter that is inserted into a trachea, and includes a flexible outer tube, an inner tube that can be inserted into and removed from the outer tube, and an outer tube at the distal end side of the outer tube. A cuff fixed to the outer peripheral surface of the tube and a cylindrical member attached to the distal end portion of the outer tube, and the cuff is fixed to the outer peripheral surface of the outer tube. An annular hollow portion is provided between the front end side annular fixing portion and the rear end side annular fixing portion, and the outer surface of the tubular member and the front end side annular fixing portion. It is characterized in that the outer surface of each of the two is connected to the same surface.

  In another specific aspect of the tracheostomy catheter according to the present invention, the cylindrical member has an insertion portion that is inserted into the outer tube from the distal end of the outer tube.

  In still another specific aspect of the tracheostomy catheter according to the present invention, the inner peripheral surface of the tubular member and the outer peripheral surface of the inner tube can be tightly sealed.

  In a limited aspect of the tracheostomy catheter according to the present invention, the shape of the outer surface of the cylindrical member connected to the outer surface of the annular fixing portion on the distal end side is tapered into a substantially truncated cone shape. It is said that.

  In a tracheostomy catheter comprising a cuff fixed to the outer peripheral surface of the outer tube and a cylindrical member attached to the distal end portion of the outer tube, the outer surface of the cylindrical member and the outer surface of the annular fixing portion on the distal end side of the cuff Are connected to each other, there is no possibility that the inner wall of the trachea is damaged by the annular fixing portion on the distal end side when inserted into the trachea.

  When the cylindrical member has an insertion portion inserted into the outer tube from the distal end of the outer tube, the cylindrical member can be easily fixed to the outer tube.

  When the inner peripheral surface of the tubular member and the outer peripheral surface of the inner tube can be tightly sealed, air leakage from the inner tube during artificial respiration can be prevented. Furthermore, by allowing the inner peripheral surface of the insertion portion of the cylindrical member and the outer peripheral surface of the inner tube to be in close contact with each other, the airtightness between the insertion portion of the cylindrical member and the inner tube is maintained, and when the artificial respiration is worn Air leakage from the inner pipe can be prevented more reliably.

  When the shape of the outer surface of the tubular member is a tapered shape substantially in the shape of a truncated cone, the tracheostomy catheter can be easily inserted into the trachea, and the inner wall of the trachea by the tubular member can be easily inserted. Damage is prevented.

  Hereinafter, the present invention will be clarified by describing specific embodiments of the present invention with reference to the drawings.

  FIG. 1 is a schematic configuration diagram showing a tracheostomy catheter according to an embodiment of the present invention. As shown in FIG. 1, the tracheostomy catheter 1 has a double tube structure of an outer tube 2 and an inner tube 3.

  The outer tube 2 is made of flexible synthetic resin, rubber, or elastomer material. More preferably, the outer tube 2 is made of a flexible synthetic resin material such as a soft resin. Since the outer tube 2 has flexibility, it is easy to form a curved shape, and the degree of curvature can be freely changed. Therefore, when the tracheostomy catheter 1 is inserted into the patient's trachea, the outer tube 2 can be easily deformed according to the trachea size, the shape and size of the incision portion, and the like. Accordingly, it is difficult to cause pain when the tracheostomy catheter 1 is inserted into the trachea of the patient.

  In the portion inserted into the trachea, a Murphy hole 2a as a through hole is formed near the center of the outer peripheral surface of the outer tube 2 although it is not always essential. The Murphy hole 2a is used for patient utterance training and the like. That is, when the Murphy hole 2a removes the inner tube 3 from the outer tube 2 and closes the proximal end 2c portion of the outer tube 2 opposite to the distal end 2b side with a finger or the like, the vocal cords from the lungs through the Murphy hole 2a It is provided to allow air to flow toward.

  On the other hand, a connector 4 is fixed in the vicinity of the base end 2 c of the outer tube 2. But the connector 4 does not necessarily need to be provided.

  FIG. 2 is a front view showing the inner tube 3 of the tracheostomy catheter 1 according to one embodiment of the present invention. As shown in FIG. 2, the inner tube 3 is a curved tubular member. The inner tube 3 is not particularly limited, but is made of a synthetic resin material having excellent flexibility such as soft vinyl chloride resin, silicon resin, or polyethylene. In order to facilitate insertion of the inner tube 3 into the outer tube 2, the inner tube 3 is preferably made of a synthetic resin material having a higher hardness than the outer tube 2. The outer diameter of the inner tube 3 is made smaller than the inner diameter of the outer tube 2 so that it can be inserted into and removed from the outer tube 2. The inner tube 3 also functions to supplement the strength of the flexible outer tube 2 when the tracheostomy catheter 1 is inserted into the trachea.

  An inner pipe connection adapter 5 is fixed in the vicinity of the base end 3b opposite to the distal end 3a side of the inner pipe 3. The inner pipe connection adapter 5 has a main body part 5a and a connection part 5b whose diameter is relatively smaller than the diameter of the main body part 5a on the insertion side to the outer pipe 2. The outer diameter of the connecting portion 5b is selected so as to substantially match the inner diameter of the outer tube 2. That is, when the inner tube 3 is inserted into the outer tube 2 in the direction indicated by the arrow B in FIG. 4, the connecting portion 5 b is brought into close contact with the inner peripheral surface of the outer tube 2, and the inner tube 3 is fixed to the outer tube 2. Is possible. On the other hand, the outer diameter of the main body 5 a is set larger than the inner diameter of the outer tube 2 so that the inner tube 3 does not fit into the outer tube 2. But the inner pipe | tube connection adapter 5 does not necessarily need to be provided.

  As shown in FIG. 1, in the tracheostomy catheter 1 of the present embodiment, a cuff 6 is fixed to the outer peripheral surface of the outer tube 2 on the distal end 2 b side of the outer tube 2.

  FIG. 3 is an enlarged front sectional view of a portion of the tracheostomy catheter 1 where the cuff 6 is provided. As shown in FIG. 3, the cuff 6 has an annular fixing portion 7 on the front end side and an annular fixing portion 8 on the rear end side, and an annular shape is provided between the annular fixing portion 7 and the annular fixing portion 8. A hollow portion 9 is provided. The annular fixing portions 7 and 8 are fixed to the outer peripheral side surface of the outer tube 2. An inner surface of the cuff portion 6 a between the annular fixing portions 7 and 8 is not fixed to the outer peripheral surface of the outer tube 2. A space between the cuff portion 6 a and the outer peripheral surface of the outer tube 2 constitutes the annular hollow portion 9. In the present embodiment, the distal end 7 b of the annular fixing portion 7 is aligned with the distal end 2 b of the outer tube 2. The cuff 6 is not particularly limited, but is preferably made of a soft vinyl chloride resin material.

  On the other hand, an indicator cuff 13 is connected to the connector 4 of the outer tube 2. The indicator cuff 13 is composed of a balloon. The indicator cuff 13 is connected to the annular hollow portion 9 of the cuff 6 through the tube 14. The indicator cuff 13 is provided for inflating the cuff 6. When the cuff 6 is inflated, the outer surface of the cuff portion 6a is brought into close contact with the inner wall of the trachea, and air leakage can be prevented. In addition, it is also possible to confirm the state where the cuff 6 is inflated by the indicator cuff 13.

  As shown in FIG. 3, a cylindrical member 10 is attached to the distal end 2 b portion of the outer tube 2. Although it does not specifically limit as a material which comprises the cylindrical member 10, Synthetic resins, such as soft resin, are used suitably. The cylindrical member 10 can be formed by a conventionally known molding method such as injection molding. The cylindrical member 10 includes a main body portion 11 and an insertion portion 12 that is inserted into the outer tube 2 from the distal end 2b of the outer tube 2.

  The main body 11 is configured such that the outer diameter decreases from the rear end 11c toward the front end 11b. That is, the shape of the outer surface 11a is a tapered shape substantially in a truncated cone shape. When the shape of the outer surface 11a of the main body part 11 is tapered in a substantially truncated cone shape, the tracheostomy catheter 1 can be easily inserted into the trachea, and damage to the inner wall of the trachea can be prevented during the insertion. .

  The outer diameter of the rear end 11 c of the main body 11 is the same as the outer diameter of the tip 7 b of the annular fixing part 7. On the other hand, the outer diameter of the insertion portion 12 is equal to or slightly smaller than the inner diameter of the outer tube 2. That is, the outer diameter of the insertion portion 12 is smaller than the outer diameter of the main body portion 11. Therefore, at the rear end 11c of the main body 11, the tubular member 10 has a step, and a locking surface 11d extending in the cross-sectional direction is formed at the step.

  On the other hand, the inner diameter of the main body portion 11 and the inner diameter of the insertion portion 12 are the same. That is, the inner surface of the main body portion 11 and the inner surface of the insertion portion 12 are continuous with each other.

When the cylindrical member 10 is inserted into the outer tube 2, the locking surface 11 d is brought into contact with the distal end 2 b of the outer tube 2 and the distal end 7 b surface of the annular fixing portion 7 of the cuff 6 to stop the insertion.

  As described above, the insertion portion 12 of the tubular member 10 is inserted into the outer tube 2. Further, the cylindrical member 10 is configured to be in close contact with the distal end 2 b of the outer tube 2 and the distal end 7 b of the annular fixing portion 7 of the cuff 6 at the locking surface 11 d of the main body portion 11. In the present embodiment, the tubular member 10 is joined to the outer tube 2 and the cuff 6 by fixing so that the tubular member 10 is not easily detached from the trachea.

  Since the outer diameter of the rear end 11c of the main body part 11 is the same as the outer diameter of the tip 7b of the annular fixing part 7, the outer surface 11a of the main body part 11 of the tubular member 10 and the annular fixing part of the cuff 6 7 is continuous with the outer surface 7a. Therefore, when the tracheostomy catheter 1 is inserted into the trachea, damage to the inner wall of the trachea due to the annular fixing portion 7 of the cuff 6 is prevented.

  The cylindrical member 10 described above may be integrated with the outer tube 2 or the cuff 6.

  Next, FIG. 4A shows a state where the inner tube 3 is inserted into the outer tube 2 in a front sectional view in a portion where the cuff 6 of the tracheostomy catheter 1 is provided.

  As shown in FIG. 4 (a), in the tracheostomy catheter 1 according to this embodiment, the tubular member 10 has an insertion portion 12, and the inner peripheral surface of the insertion portion 12 and the inner tube 3 is in close contact with the outer peripheral surface, and the airtightness between the insertion portion 12 and the inner tube 3 is maintained. Therefore, the tracheostomy catheter 1 can reliably prevent air leakage from the inner tube 3 during artificial respiration.

  As described above, the tracheostomy catheter 1 according to this embodiment has a double tube structure of the outer tube 2 and the inner tube 3. Therefore, when the inner surface of the tracheostomy catheter 1 becomes dirty, only the inner tube 3 can be removed from the outer tube 2 and cleaned. Further, since the tracheostomy catheter 1 has a double tube structure of the outer tube 2 and the inner tube 3, it is possible to provide a Murphy hole 2a in the outer tube 2 and perform generation training or the like.

  In the tracheostomy catheter 1 according to this embodiment, as shown in FIG. 1, the outer tube 2 in the vicinity of the cuff 6 is provided with a vocalette hole 2d. The vocalette hole 2d communicates with a path (not shown) extending in the longitudinal direction in the tube wall of the outer tube 2, and this path is formed to reach the base end 2c. A vocalette hole adapter 15 is connected to this path via a tube 16. Therefore, saliva and secretions can be sucked and removed from the vocabulary hole adapter 15.

  FIG. 4B shows a modification of the tracheostomy catheter 1 according to this embodiment.

  In the tracheostomy catheter 21 shown in FIG. 4B, the distal end 23 b of the annular fixing portion 23 on the distal end side of the cuff 22 is located in the vicinity of the distal end 2 b of the outer tube 2. In other words, the distal end 23b of the annular fixing portion 23 is spaced a certain distance d from the distal end 2b of the outer tube 2 and is positioned slightly closer to the proximal end 2b.

  On the other hand, the cylindrical member 24 has a distance d extended from the locking surface 25a of the main body 25 at the outer end in addition to the insertion portion 26 extended from the locking surface 25a of the main body 25 at the inner end. A convex portion 27 is provided.

The insertion portion 26 of the cylindrical member 24 is inserted into the outer tube 2. Further, the end surface 27 b of the convex portion 27 and the tip 23 b surface of the annular fixing portion 23, the inner peripheral surface of the convex portion 27 and the outer peripheral surface of the outer tube 2, and the front end 2 a surface of the outer tube 2 and the locking surface 25 a of the main body portion 25. Are configured to be in close contact with each other. Here, the outer surface 27 a of the convex portion 27 is continuous with the outer surface 23 a of the annular fixing portion 23.

  As described above, when the outer surface 24a of the tubular member 24 and the outer surface 23a of the annular fixing portion 23 of the cuff 22 are configured to be flush with each other, the annular member 21 is inserted into the trachea when the tracheostomy catheter 21 is inserted into the trachea. Damage to the inner wall of the trachea due to the fixing portion 23 can be prevented.

  FIG. 4C further shows a modification of the tracheostomy catheter 21 shown in FIG.

  In the tracheostomy catheter 31 shown in FIG. 4 (c), the tubular member 32 is provided with a convex portion 34 extending at a distance d from the locking surface 33 a of the main body portion 33 at the outer end. The inner end is not provided with an insertion portion. When the insertion portion is not provided, the inner diameter of the main body 33 is made smaller than the inner diameter of the outer tube 2, and is equal to or slightly smaller than the outer diameter of the inner tube 3. Can be brought into close contact with the outer peripheral surface of the inner tube 3. Therefore, the airtightness between the main body 33 and the inner tube 3 can be maintained, and air leakage from the inner tube 3 during the artificial respiration can be surely prevented.

1 is a schematic configuration diagram showing a tracheostomy catheter according to an embodiment of the present invention. The front view which shows the inner tube | pipe of the tracheostomy catheter which concerns on one Embodiment of this invention. The partial notch front sectional drawing which expands and shows the part in which the cuff of the tracheostomy catheter which concerns on one Embodiment of this invention is provided. (A) is the partial notch front sectional drawing which shows the state by which the inner tube was closely_contact | adhered to the cylindrical member in the tracheostomy catheter which concerns on one Embodiment of this invention. (B) And (c) is a partial notch front sectional drawing which shows the modification of the tracheotomy catheter concerning this invention. Sectional drawing which shows typically the state which detained the conventional tracheotomy catheter in the trachea. The partial notch front sectional drawing which expands and shows the part in which the cuff of the conventional tracheostomy catheter is provided. The partial notch sectional view which shows the state by which the outer peripheral surface of the outer tube | pipe and the front-end | tip part of the cuff were melt | fused in the curved surface form. The partial notch sectional view which shows the state by which the front-end | tip part of the outer tube was processed and the inner tube was closely_contact | adhered to this processed part of the outer tube.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Tracheostomy catheter 2 ... Outer tube 2a ... Murphy hole 2b ... Tip 2c ... Base end 2d ... Vocalet hole 3 ... Inner tube 3a ... Tip 3b ... Base end 4 ... Connector 5 ... Inner tube connection adapter 5a ... Main-body part 5b ... Connection part 6 ... Cuff 6a ... Cuff part 7 ... Ring fixing part 7a ... Outer side surface 7b ... Tip 8 ... Ring fixing part 9 ... Ring hollow part 10 ... Cylindrical member 11 ... Body part 11a ... Outer side face 11b ... Tip 11c ... Rear End 11d ... Locking surface 12 ... Insertion part 13 ... Indicator cuff 14 ... Tube 15 ... Vocaret hole adapter 16 ... Tube 21 ... Tracheostomy catheter 22 ... Cuff 23 ... Annular fixing part 23a ... Outer surface 23b ... Tip 24 ... Cylindrical member 24a ... outer surface 25 ... main body portion 25a ... locking surface 26 ... insertion portion 27 ... convex portion 27a ... outer surface 27b ... end surface 31 ... tracheostomy catheter 32 ... Jo member 33 ... main body 33a ... locking surface 34 ... protrusion

Claims (4)

A tracheostomy catheter inserted into the trachea,
A flexible outer tube;
An inner tube disposed so as to be freely inserted into and removed from the outer tube;
A cuff fixed to the outer peripheral surface of the outer tube at the distal end side of the outer tube;
A cylindrical member attached to the tip of the outer tube,
The cuff has a front-end-side annular fixing portion and a rear-end-side annular fixing portion that are fixed to the outer peripheral surface of the outer tube, and the front-end-side annular fixing portion and the rear-end-side annular fixing portion. An annular hollow portion is provided between
The tracheostomy catheter is characterized in that an outer surface of the tubular member and an outer surface of the annular fixing portion on the distal end side are continuous with each other.   The tracheostomy catheter according to claim 1, wherein the tubular member has an insertion portion that is inserted into the outer tube from a distal end of the outer tube.   The tracheostomy catheter according to claim 1 or 2, wherein an inner peripheral surface of the tubular member and an outer peripheral surface of the inner tube can be tightly sealed. The shape of the outer surface of the cylindrical member that is continuous with the outer surface of the annular fixing portion on the tip side is a shape that is tapered in a substantially truncated cone shape. 2. A tracheostomy catheter according to item 1.

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