JP2008073060A - Phlegm aspiration tube driving device and phlegm aspirator - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To enhance safety by stabilizing the insertion and removal and by preventing an excessive negative pressure in a trachea in an automatic phlegm aspirator which inserts and removes a phlegm aspiration tube by two rollers. <P>SOLUTION: The insertion and removal operation is stabilized by the following manners: one roller forms a positive acute angle, and the other forms a negative acute angle in the direction of a normal line of a central axis of a phlegm aspiration tube insertion hole to give a feed and a rotation to the phlegm aspiration tube, an external wall surface of the phlegm aspiration tube is made to be rough to reduce the adsorption to a tracheal cannula, a V-shaped groove is engraved on a roller piece to increase drive force, a phlegm aspiration tube protecting tube is directly connected to a connection tube between an attachment part of the phlegm aspiration tube protecting tube of a phlegm aspiration tube driving mechanism and a suction source so that the phlegm aspiration tube freely moves and rotates inside the phlegm aspiration tube protecting tube, and the adsorption of the phlegm aspiration tube protecting tube to the phlegm aspiration tube is prevented by making an internal wall surface of the phlegm aspiration tube protecting tube rough and by providing a washing means for the inside of the phlegm aspiration tube protecting tube. The occurrence of the excessive negative pressure is prevented by providing a control means for opening and closing a check valve which opens when the inside of the trachea is at a negative pressure or a switch valve for the suction device. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

The present invention relates to an aspiration apparatus for aspirating and removing (hereinafter simply aspirating) a patient's sputum that is ventilated by a ventilator through a tracheal cannula attached to the trachea.

In the following description, the end on the patient side of each mechanism element is called the end, and the end on the outside is called the root end.

Ventilation with a ventilator may be performed through a tracheal cannula attached to a tracheostomy in patients with reduced or stopped spontaneous breathing. The suction of sputum during the use of a ventilator has traditionally relied on human hands, but this has been requested automatically by detecting the patient's own commands or changes in the situation, reducing the burden on health care workers and their families. Several suction devices for this purpose have been proposed. Examples of these are Patent Publication No. 2002-219175 “Adapter for both artificial respiration and suction and automatic suction device”, Patent Publication No. 2002-177378 “Aspiration device for sputum in airway”, and Japanese Patent Application No. 2004-369640 “Suction tube drive” The conventional example closest to the present invention is the third Japanese Patent Application No. 2004-369640 “Suction tube driving device and suction device”.

In the above Japanese Patent Application No. 2004-369640 “Suction tube driving device and suction device”, a suction tube is sandwiched between two rotatable rollers and the two rollers are rotated in opposite directions. The suction tube is inserted and removed by the soot feeding mechanism.

In addition, the root side of the suction pipe is directly connected to the connection pipe connected to the suction device.

Also, a suction pipe protective bag surrounding the suction pipe is provided, the root end of the protective bag is connected to the suction pipe, and the end is hermetically connected to the root end of the suction pipe feeding mechanism. The outer wall surface of the part inserted into and extracted from the trachea is isolated from the outside to prevent the secretions from diffusing outside and the entry of external substances into the trachea.

Further, the suction pipe feeding mechanism, the suction pipe protection bag, and the suction pipe are combined to constitute a suction pipe drive assembly, and the connection portion with the external mechanism of the suction pipe drive assembly can be easily attached and detached. It is configured so that it can be manufactured, packaged, supplied, stored and discarded in units of suction tube drive assemblies.

In addition, a gas-liquid separation bottle is provided between the root end of the suction tube and the suction source, and an open / close valve is provided between the gas-liquid separation bottle and the suction source so that the suction tube is inserted as far as the back of the trachea. The on-off valve is opened after being opened, and the on-off valve is closed when the suction pipe is pulled out and stopped.
JP 2002-219175 A JP 2002-177378 A Japanese Patent Application No. 2004-369640 “Suction tube driving device and suction device”

In the prior art Japanese Patent Application No. 2004-369640, when the suction tube passes in the insertion direction in a substantially right angle bent portion of the tracheal cannula, (1) the tip of the suction tube hits the inner wall surface of the bent portion. ) Occasionally, phenomena such as the suction of the outer wall of the suction tube to the inner wall of the tracheal cannula occur. When these phenomena occur, an excessive axial compressive force is applied to the suction pipe, (1) the suction pipe buckles, (2) it cannot slide and drive between the roller and the suction pipe, (3 ) Fluctuation speed of suction tube is fluctuating, (4) Motor stops, (5) Flexible shaft driving roller is kinked, or (6) Tracheal cannula and suction tube drive assembly are disconnected Various problems occur.

Therefore, the first problem to be solved is caused by preventing or reducing the contact of the tip of the suction tube with the inner wall surface of the bent portion of the tracheal cannula and the adsorption between the outer wall surface of the suction tube and the inner wall surface of the tracheal cannula. In order to solve the above-described problems, the suction tube smoothly passes through the bent portion of the tracheal cannula.

The first problem is that, as emphasized in the above-mentioned prior art example Japanese Patent Application No. 2004-369640, it is under the condition of preventing the secretion of secretions from the trachea and the entry of external substances into the trachea. It must be resolved. As a new problem that accompanies the solution of the first problem under this condition, the adsorption of both by the contact between the inner wall surface of the suction tube protection tube surrounding the suction tube and the outer wall surface of the suction tube A problem similar to the first problem occurs.

Therefore, the second problem to be solved is to eliminate the problems caused by the adsorption between the suction tube outer wall surface and the suction tube protection tube inner wall surface, so that the suction tube can be smoothly inserted and removed.

The third problem to be solved is to solve the first and second problems under the condition that the whole including the complicated mechanism part to which the secretion is attached can be discarded.

Furthermore, in the conventional example Japanese Patent Application No. 2004-369640, the intratracheal pressure may become an excessive negative pressure during suction. In the case of manual suction, the suction tube is inserted into the tracheal cannula while the ventilator is stopped or in the state where the ventilation line composed of the ventilator and the tracheal cannula is opened to the atmosphere. The intratracheal pressure does not drop below atmospheric pressure. However, in the aforementioned Japanese Patent Application No. 2004-369640, since the root end of the tracheal cannula and the root end of the suction tube are sealed with a suction tube protective bag, when the ventilator is in the expiration mode during suction, the trachea The internal pressure becomes negative. When the tracheal pressure is excessively negative, it is difficult to distinguish it from the patient's spontaneous breathing.

Therefore, the fourth problem to be solved is to suppress the decrease in intratracheal pressure during suction to a slight decrease that can be distinguished from spontaneous breathing.

The first object of the present invention is to (1) eliminate the abutment when the tip of the suction tube abuts against the inner wall surface of the bent portion of the tracheal cannula and exerts a compressive axial force on the suction tube; When the outer wall of the tube comes into contact with the inner wall of the tracheal cannula and the adsorption is about to occur, the contact is eliminated, (3) the adsorption is reduced or prevented, and (4) the drive necessary for the abutment and contact is eliminated. It is to provide a suction pipe feeding mechanism that can supply force.

The second object of the present invention is to eliminate the problems caused by the adsorption of the suction pipe and the suction pipe protection pipe, which accompany the use of the suction pipe feed mechanism that achieves the first objective. It is to provide a suction tube protection tube that completes the purpose.

The third object of the present invention is to isolate the outside from the outside by surrounding the portion protruding from the suction pipe feeding mechanism of the suction pipe inserted into and extracted from the trachea or inserted into the trachea. In addition to preventing the diffusion of the substance to the outside and the invasion of external substances into the trachea, components that are in contact with secretions and are difficult to clean must be packaged and stored cleanly in advance and safely and easily after short-term use. To provide a suction tube drive assembly that can be disposed and replaced, or can be cleaned and sterilized by heating.

A fourth object of the present invention is to provide a suction tube drive assembly or a suction device capable of suppressing the negative pressure generated in the trachea during suction to a slight negative pressure.

In order to achieve the first object, two rollers for driving the suction pipe are divided into two parallel roller planes sandwiching the central axis of the suction pipe insertion hole and the central axis of the suction pipe insertion hole. The roller rotation axis of one roller surface forms a positive acute angle with respect to the perpendicular to the second suction pipe shaft plane perpendicular to the two roller planes, and the roller rotation of the other roller surface The axis was constructed to form a negative acute angle.

The suction pipe outer wall surface was roughened.

In addition, a V-shaped groove perpendicular to the roller rotation axis is provided on the outer periphery of the portion of the roller facing the suction pipe so that contact with the suction pipe occurs at four points on each side of the V-shaped groove of both rollers. At the same time, the contact force was increased and the driving force was increased by compressing and deforming the suction tube from two directions.

With this configuration, the suction tube is given a rotational movement simultaneously with its axial feed, and the combination of these two movements causes the tip of the suction tube to move to the inner wall of the bent portion of the tracheal cannula. It is now possible to eliminate the abutment when it strikes, and to eliminate the contact when the suction tube outer wall and the inner wall of the tracheal cannula come into contact with each other.

In addition, since the outer wall surface of the suction tube is made rough, adsorption with the inner wall surface of the tracheal cannula can be reduced.

In addition, the contact between the roller surface and the suction tube has increased from 2 points to 4 points, and the deformation force of the suction tube has changed from an elliptical shape to a rectangular shape, compared with a roller without grooves. As a result, it was possible to obtain sufficient driving force to eliminate the contact and contact.

In the conventional Japanese Patent Application No. 2004-369640, a suction pipe is connected directly to a connection pipe connected to a gas-liquid separation bottle of a suction device, and a suction pipe protective bag surrounding the suction pipe is provided. The end of the tube protection bag is connected airtight to the root side connection port of the suction pipe drive mechanism, and the root end is connected airtightly to the suction pipe. On the other hand, in the present invention, in order to achieve the first object, the suction pipe is given two movements of feeding and rotation. Therefore, if the suction pipe is directly connected to the fixed connection pipe of the gas-liquid separation bottle, the suction pipe is rotated. The difficulty of twisting the soot tube occurs. Further, if a rotary valve that allows rotation of the suction pipe is provided between the suction pipe and the connection pipe of the gas-liquid separation bottle, the suction pipe protective bag is difficult to be twisted.

In order to eliminate these difficulties in the present invention, a suction tube protection tube surrounding the suction tube is provided, and the end of the suction tube protection tube is hermetically connected to the root end of the suction tube drive mechanism. The end was airtightly connected to the connection pipe of the gas-liquid separation bottle. The suction pipe inserted and removed from the opening at the base end of the suction pipe drive mechanism can freely rotate and move in the axial direction in the suction pipe protection pipe.

With this construction, the suction tube is isolated from the outside to prevent the diffusion of secretions to the outside and the entry of external substances into the trachea, while at the same time feeding and rotating the suction tube in the axial direction Can now be tolerated. The suction of secretions in the trachea can be performed as usual by the low pressure in the suction tube protection tube, which is lowered by the operation of the suction device during suction.

On the other hand, since the suction tube protection tube is provided, (1) when starting the suction tube in the insertion direction, the suction tube outer wall surface is adsorbed on the inner wall surface of the curved portion inside the suction tube protection tube. When the suction pipe is pulled out, the adsorption phenomenon occurs between the suction pipe and the suction pipe protection pipe, for example, the outer wall surface of the suction pipe is adsorbed to the inner wall surface of the suction pipe protection pipe. When these phenomena occur, an excessive axial force is applied to the suction pipe, (1) it cannot slide and drive between the roller and the suction pipe, and (2) the rotational speed of the motor that drives the roller decreases. As a new problem, such as it takes time to insert and remove, these problems caused by adsorption between the suction tube and the suction tube protection tube are solved, and the suction tube is inserted and removed. Need to be able to perform smoothly.

In order to achieve the second object, in the present invention, the suction tube outer wall surface and the suction tube protection tube inner wall surface are further roughened.

With this configuration, the suction on the inner wall of the suction tube protection tube and the outer wall of the suction tube has been eliminated, enabling smooth insertion and removal of the suction tube.

Also, sucking tube protection tube cleaning liquid or its mist is supplied from the cleaning agent blowing hole at the center of the suction tube protection tube, and connected to the root end of the suction tube drive mechanism near the end of the suction tube protection tube Wash slightly closer to the root end of the suction tube protection tube than the connected end, or to the end side of the suction tube insertion hole of the suction tube drive mechanism or the sensor installation part of the suction tube drive mechanism An agent suction hole was provided, and the cleaning agent was sucked out from the hole.

As a result, the suction pipe insertion hole of the suction pipe drive mechanism through which the suction pipe protection pipe or the suction pipe passes or the inner surface of the sensor installation section can be cleaned with the cleaning agent. While keeping clean, the adsorption of the suction tube and the suction tube protection tube due to high-viscosity secretions attached to the inner surface of the suction tube protection tube, the suction tube insertion hole, or the sensor installation part is reduced, and the suction tube Can be inserted and removed smoothly.

In order to achieve the third object, the suction pipe drive mechanism, the suction pipe protection pipe, and the suction pipe are configured as a suction pipe drive assembly, and an external mechanism of the suction pipe drive assembly is provided. The connection part was removed, and it was easy to install, making it possible to manufacture, package, supply, store, and dispose of the suction pipe drive assembly unit.

In this way, the suction tube is isolated from the outside to prevent the secretions from diffusing to the outside and the entry of external substances into the trachea. Now it is cleanly manufactured, packaged, supplied and stored, and can be safely and easily discarded and replaced after a short period of use.

In order to achieve the fourth object, there is provided a check valve which is opened when the internal pressure of the suction pipe driving mechanism is lower than the external pressure and closed when the internal pressure is higher than the external pressure. It was provided on the side wall of the suction tube drive mechanism.

By doing in this way, it was possible to prevent the pressure in the trachea from becoming excessively negative, and discrimination from spontaneous breathing became possible.

As a second means for achieving the fourth object, a pressure sensor for detecting the pressure inside the suction pipe drive mechanism is provided in the suction pipe drive mechanism, and during the period when the tracheal pressure is negative during suction. The on-off valve connected to the suction device was closed to interrupt the suction.

By doing so, the endotracheal pressure is not excessively negative except for spontaneous breathing.

According to claim 1, since the suction tube can be inserted / removed while rotating, the contact between the suction tube and the inner wall surface of the bent portion of the tracheal cannula is eliminated, and the outer wall surface and the trachea of the suction tube When the inner wall surface of the cannula comes into contact and adsorption is about to occur, the contact can be removed by the suction tube drive mechanism having the same size and weight as the conventional patent application 2004-369640.

According to the second aspect, the suction between the outer wall surface of the suction tube and the inner wall surface of the tracheal cannula is reduced, and there is a problem such as buckling of the suction tube that occurs when an excessive axial compressive force is applied to the suction tube. It became possible to prevent.

According to the third aspect, the contact force between the roller piece and the suction pipe can be increased without reducing the cross-sectional area of the suction pipe, so that the rotational force of the suction pipe can be increased, and the suction pipe and the trachea Cannula adsorption and suction tube and suction tube protection tube adsorption can be eliminated more reliably than before.

According to the fourth aspect of the present invention, the suction tube can be allowed to rotate while preventing secretions from the trachea from being scattered outside and intrusion of external substances into the trachea.

According to claim 5, it is possible to prevent the suction pipe and the suction pipe protection pipe from being adsorbed.

According to the sixth aspect, the suction pipe and the suction pipe protection pipe can be prevented from being adsorbed.

According to the seventh aspect, it is possible to prevent the secretions from the trachea from scattering to the outside and the intrusion of an external substance into the trachea and to insert / remove the suction tube while rotating.

According to claim 8, the secretion of the secretions from the trachea and the entry of external substances into the trachea are prevented, and the suction pipe and the tracheal cannula are reduced while rotating the suction pipe. However, it became possible to insert and remove while being more stable than in the seventh aspect.

According to the ninth aspect, the tracheal pressure can be prevented from becoming an excessive negative pressure during the suction.

According to the tenth aspect of the present invention, it is possible to prevent the generation of excessive negative pressure during suction, and to allow the generation of negative pressure due to spontaneous breathing during other standby and insertion of a suction tube.

According to the eleventh aspect, suction between the suction pipe insertion hole or the inner surface of the sensor installation portion and the suction pipe can be prevented.

According to claim 12, a clean automatic sucking operation can be realized easily and reliably.

Several examples are shown below.

FIG. 1 shows a first embodiment of a suction tube driving device and suction device according to the present invention.

The distal side attachment portion 411 of the multi-branch tube portion 410 of the suction tube driving mechanism 500 is connected to the root end 202 of the tracheal cannula 200 attached to the trachea 2 of the patient 1. A ventilator 400 (not shown) is connected to the ventilation branch 412 of the multi-branch pipe section 410 via a ventilation hose 413. Further, the ventilation branch 412 is provided with a check valve 570 and a check valve vent 571 that are opened when the inside of the trachea 2 becomes negative pressure.

The suction branch 414 of the multi-branch pipe part 410 is connected to the suction pipe feed mechanism part 510, and the multi-branch pipe part 410 and the suction pipe feed mechanism part 510 are integrally formed.

Since the details of the suction pipe feeding mechanism 510 will be described later, only the central cross section is shown in FIG.

The rollers 520A and 520B of the suction tube feed mechanism 510 are connected to and driven by the roller driving device 600 via shaft joints 625A and 625B and flexible shafts 620A and 620B, and the suction tube 300 is inserted and removed. Furthermore, the roller driving device 600 is controlled by the controller 800 to start / stop and forward / reverse rotation. The configuration of this roller drive system can be realized by a known example technique disclosed in Japanese Patent Application No. 2004-369640.

The outer wall surface of the suction pipe 300 is finished to a roughness of about 50S with sandpaper.

It should be noted that spring stoppers 626A and 626B are provided to prevent the rollers 520A and 520B and the shaft joints 625A and 625B from being unintentionally disconnected.

A sensor installation unit 700 is provided at the base side of the suction pipe feed mechanism unit 510, and an insertion limit mark 320 and an extraction limit mark 321 of the suction pipe 300 passing through the sensor installation part 700 are detected, and the detection signal is detected. The controller 800 controls the start / stop of the suction pipe 300, the start / stop of the suction source 1010, and the opening / closing of the on-off valve 1002.

A suction tube protection tube mounting portion 558 is provided on the further base side of the sensor installation portion 700, and the end 581 of the suction tube protection tube is airtightly connected. The suction pipe 300 is inserted into the suction pipe insertion hole 551 of the suction pipe protection pipe attachment portion 558 from the end 301 thereof, and the root end 302 side of the suction pipe is not restrained in the suction pipe protection pipe 580. Inserted in. The root end 582 of the suction tube protection tube is airtightly connected to the connection tube 591 of the relay tube 590 communicating with the gas-liquid separation bottle 900. That is, the suction tube protection tube 580 surrounds the suction tube 300 so that the suction tube 300 is airtight, rotatable inside, and further movable in the axial direction.

Further, the inner inner wall surface 583 of the suction tube protection tube bend and the outer inner wall surface 584 of the suction tube protection tube bend are finished to have a uniform roughness with a height difference of about 0.1 mm and a pitch of about 0.3 mm. The roughness shown in FIG. 1 is exaggerated.

The gas-liquid separation bottle 900 is further connected to a suction source 1010 via a suction pipe 1000 and an on-off valve 1002 provided in the middle of the suction pipe 1000. Known as 369640.

FIG. 2 shows a housing 550 of the suction pipe drive mechanism 500, and the suction pipe feed mechanism section housing 530, the sensor installation section 700, and the suction pipe protection from the lowermost multi-branch pipe section 410 to the upper part. A tube attachment portion 558 is provided in order, and these are integrally molded.

Further, the suction tube protective tube attachment portion 558 has the suction tube insertion hole 551 opened, from which the suction tube 300 is inserted and through the multi-branch tube portion 410 to the tracheal cannula 200. Can be reached.

Also, the suction pipe feed mechanism section housing 530 is provided with roller installation holes 531A and 531B at the following angles. Now, the suction pipe shaft plane 553 including the central axis 552 of the suction pipe insertion hole is separated by 1.1 times the outer diameter of the suction pipe 300 on both sides and parallel to the suction pipe shaft plane 553. Hypothetical roller planes 554A and 554B, and hypothetical second suction pipe axis plane 555 that is perpendicular to the suction pipe axis plane 553 and includes the central axis 552 of the suction pipe insertion hole, Intersection lines between the second suction pipe axis plane 555 and the roller planes 554A and 554B are assumed to be virtual axis lines 556A and 556B. The central axis 532A of the roller installation hole 531A is inclined by -20 degrees with respect to the perpendicular 557A of the virtual axis 556A in the roller plane 554A, while the central axis 532B of the roller installation hole 531B is an virtual axis in the roller plane 554B. Roller installation holes 531A and 531B are provided so as to be inclined +20 degrees with respect to the perpendicular line 557B of 556B.

Rollers 520A and 520B described later are attached to the roller installation holes 531A and 531B, respectively. Therefore, in the installed state, the center axes 532A and 532B of the roller installation holes coincide with the roller rotation shafts 522A and 522B, which are the center lines of the roller shafts 521A and 521B, respectively.

3 is a cross-sectional view of the suction pipe drive mechanism housing 550 at the roller plane 554A as viewed in the AA direction of FIG. As described above, the central axis 532A of the roller installation hole is inclined by -20 degrees with respect to the perpendicular 557A of the virtual axis. The front end side bearing hole 533A of the roller installation hole is a stepped portion for fitting a front end roller bearing 523A described later, the large diameter portion 534A is a space for storing a later-described roller top 524A, and the bush fitting portion 535A is described later. Is a stepped portion for fitting the bushing 540A. The center axis 532B of the other roller installation hole is inclined +20 degrees with respect to the perpendicular 557B of the virtual axis in the roller plane 554B, but the other structure is the same as the roller installation hole 531A, and is not shown in the figure.

4 is a cross-sectional view of the suction pipe drive mechanism housing 550 in the suction pipe axis plane 553 as seen from the direction AA of FIG. The suction tube 300 is inserted, and a light emitting diode 701 and a light receiving phototransistor 705 are attached to the sensor installation unit 700 with the suction tube 300 interposed therebetween, and an insertion limit mark 320 printed on the suction tube 300 is shown. And the passage of the extraction limit mark 321 is detected.

The light emitting diode 701 and the light receiving phototransistor 705 are separated from the suction tube insertion hole 551 by a partition wall A703 and a partition wall B704.

FIG. 5 is a side view of the roller 520. Since the structures of the rollers 520A and 520B are the same, the rollers 520A and 520B are referred to as rollers 520 without distinction. A front end roller bearing 523, a roller top 524, and a joint side roller bearing 525 are attached to the roller shaft 521. Further, a semicircular shaft portion 526 for fitting with the shaft joint 625 and a shaft joint 625 described later are prevented from coming off. A slit 527 that meshes with the stopper 626 is provided. The bush penetrating portion 529 is a portion facing a roller shaft through hole 543 described later.

The roller piece 524 is fixed to the roller shaft 521 so as not to rotate.

A V-shaped groove 528 having an opening angle of 90 degrees orthogonal to the roller rotation shaft 522 is provided on the circumference of the roller piece 524.

FIG. 6 shows a roller top 524A in a state where two rollers 520A and 520B are mounted opposite to each other in the above-described virtual roller planes 554A and 554B parallel to each other at angles of −20 degrees and +20 degrees, respectively. And 524B are opposed to each other with the suction pipe 300 interposed therebetween. In the portion where the V-shaped grooves 528A and 528B of the two rollers are opposed to each other, a square space having an inter-surface distance a of 75% of the outer diameter of the suction tube shown in FIG. 6 is formed. 300 is crushed and pinched, and is driven by rotating the two rollers in opposite directions. If the distance between the surfaces is too wide, the driving force becomes small, and if it is too narrow, the driving power becomes too large, and the flow passage area of the suction pipe 300 becomes narrow. A suitable value is about 60 to 80% of the outer diameter of the suction pipe.

FIG. 7 is a cross-sectional view of the bush 540. Since the shapes of the bushes 540A and 540B and their related parts are the same, A and B are omitted. The bush 540 is inserted into the bush fitting portion 535 so that the inclined outer surface 541 of the bush 540 coincides with the lid mounting surface 537 of the suction pipe drive mechanism housing 550 shown in FIGS.

The joint-side roller bearing 525 is fitted to the bush step 542. The roller shaft through hole 543 is a portion through which the bush penetrating portion 529 of the roller shaft 521 passes.

FIG. 8 shows a pressing lid 560 which is attached to the lid mounting surface 537 and fixes the bush 540. The presser lid slits 561A and 561B are passages through which the roller shafts 521A and 521B pass when the presser lid 560 is attached to the lid attachment surface 537.

In the first embodiment described above, as shown in FIG. 9, the suction pipe 300, the suction pipe protection pipe 580, and the suction pipe drive mechanism 500 (the suction pipe protection pipe mounting portion 558, the sensor installation portion 700 ( Light-emitting diode 701, including light-receiving phototransistor 705), suction tube feed mechanism portion 510 (suction tube feed mechanism portion housing 530, rollers 520A, 520B, bush (not shown in the cross-section, not shown in FIG. 9) No) (including 540A, 540B and presser lid 560)) and the multi-branch tube section 410 are manufactured as a unitary assembly, sealed and supplied after sterilization. Hereinafter, the integrated assembly will be referred to as a suction tube drive assembly 1100.

Next, the operation of this embodiment will be described.

In FIG. 1, when the patient 1 is in the attached state of the tracheal cannula 200, the suction tube drive assembly 1100 is removed from the sealed bag and the distal attachment 411 is connected to the root end 202 of the tracheal cannula. Further, the root end 582 of the suction tube protection tube is connected to the connection tube 591.

Next, the ventilation hose 413 of the ventilator 400 is connected to the ventilation branch 412 of the multi-branch pipe section 410 to perform ventilation by the ventilator 400.

In this state, since the on-off valve 1002 is closed, ventilation from the ventilator 400 is not sucked into the suction source 1010, and normal ventilation is started and continued.

Further, shaft joints 625A and 625B are connected to rollers 520A and 520B, and stoppers 626A and 626B are set in slits 527A and 527B, respectively. The controller 800 is connected to the light emitting diode 701 and the light receiving phototransistor 705 through a sensor electric signal line 710. Further, the controller 800 and the roller driving device 600 are turned on, and the suction pipe 300 is set in a standby state.

In the standby state, the extraction limit mark 321 of the suction pipe 300 is located on the end side with respect to the sensor installation part 700, and the end 301 of the suction pipe is set in a desirable position set in advance, that is, the ventilation amount of the multi-branch pipe part 410. The ventilator 400 is set at a position where ventilation by the ventilator 400 at the base side of the branch 412 is not hindered.

After patient 1 or the caregiver gives a command to start the suction operation to the automatic suction device, or after the monitor of patient 1 detects the need for suction and instructs the start of the automatic suction operation, or after the previous automatic suction The operation of the automatic suction device after a predetermined time has elapsed since the end of the dredging operation is as follows. (1) First, the suction pipe 300 is driven in the insertion direction. (2) When the insertion limit mark 320 passes the sensor installation unit 700, the roller driving device 600 is immediately stopped, and (3) the suction source 1010 is activated. Next, (4) the roller driving device 600 is activated in the reverse direction, and the suction pipe 300 is driven in the extraction direction. At the same time, (5) open the on-off valve 1002 and start suction. (6) When the insertion limit mark 320 passes through the sensor installation unit 700, the roller driving device 600 is stopped. That is, suction is performed with the suction tube 300 stopped. (7) When about 1 second has elapsed, the roller driving device 600 is started in the reverse direction, and the suction pipe 300 is driven in the extracting direction. (8) When the extraction limit mark 321 passes through the sensor installation unit 700, the on-off valve 1002 is closed, and at the same time, (9) the roller driving device is stopped and the extraction of the suction pipe 300 is completed. (10) Further, the suction pipe 300 is driven again in the insertion direction, and when the extraction limit mark 321 passes through the sensor installation part 700, the roller driving device 600 is stopped and returned to the standby state.

The above operations (1) to (10) may be completed only once, but in many cases, the operation is repeated two to three times at intervals of several seconds, and one automatic sucking operation is completed. Then, it waits until the next automatic sucking start command in the waiting state at the end of (10).

In the above operation, the two rollers 520A and 520B are inclined at −20 degrees and +20 degrees with respect to the direction perpendicular to the central axis 552 of the suction tube insertion hole, as shown in FIG. Since the scissor tube 300 is sandwiched between the roller tops 524A and 524B as shown in FIG. 6, when the rollers 520A and 520B rotate in opposite directions, the suction tube 300 rotates as soon as it is fed in its axial direction. That is, in this embodiment, the suction tube 300 is inserted and removed while rotating.

At this time, the suction pipe 300 moves while freely rotating inside the suction pipe protection pipe 580.

In the above operation, when the insertion limit mark 320 and the extraction limit mark 321 of the suction pipe 300 pass through the sensor installation part 700, the two kinds of marks block the infrared rays emitted from the light emitting diode 701 shown in FIG. Then, it is detected by preventing the light reception phototransistor 705 from receiving the infrared light.

In the sucking operation, when the sucking tube 300 passes through the sensor installation part 700, the secretions attached to the sucking tube 300 also adhere between the light emitting diode 701 and the light receiving phototransistor 705. At this time, the partition wall A 703 and the partition wall B 704 prevent these secretions from directly adhering to the light emitting diode 701 and the lens portion of the light receiving phototransistor 705 to change the optical performance of both.

When the tracheal pressure is about to become negative during suction, the check valve 570 is opened, and air flows from the check valve vent 571 to prevent the tracheal pressure from becoming negative. The endotracheal pressure tends to become negative when the on-off valve 1002 is opened and the secretion is sucked, and the ventilation by the ventilator 400 is in the expiration mode.

Remove the automated suction cup as follows. (1) Confirm that the suction pipe 300 is in the standby position and the on-off valve 1002 is closed. (2) Remove the stoppers 626A and 626B and the shaft joints 625A and 625B from the rollers 520A and 520B. (3) The sensor electric signal line 710 is removed from the sensor installation part 700. (4) Remove the ventilation hose 413 from the ventilation branch 412. (5) Connect the ventilation hose 413 to the new multi-branch pipe. (6) Remove the distal side attachment portion 411 of the multi-branch tube portion 410 from the root end 202 of the tracheal cannula. (7) Connect a new multi-branch tube to the root end 202 of the tracheal cannula and begin ventilation. (8) Remove the root end 582 of the suction tube protection tube from the connection tube 591. (9) Discard the suction tube drive assembly 1100 from which all connections have been removed, or seal and store it for the next use after cleaning and sterilization.

In the first embodiment described above, when the tracheal pressure is about to become negative during suction, the check valve 570 is opened to introduce the atmosphere. However, if the check valve 570 is always operated, even if the spontaneous breathing function of the patient 1 recovers at a time other than during suction and the tracheal pressure becomes negative, the function recovery cannot be detected and artificial respiration is performed. There is a risk of continuing.

Therefore, in the second embodiment, as shown in FIG. 10, a pressure sensor 575 is provided in the ventilation branch 412, and the output is read by the controller 800. If the output shows a pressure lower than the first negative pressure set in advance, if it is suctioning, the on-off valve 1002 is closed, and after a certain time has elapsed or set in advance When the pressure rises above the second pressure, the on-off valve 1002 is opened. If it was time other than suction, it was left and left to the treatment by the ventilator 400.

In the first and second embodiments described above, when the high-viscosity secretion is aspirated, the secretion that adheres to the suction pipe 300 is installed in the suction pipe drive mechanism 500 as the suction pipe 300 is pulled out. It was observed that the adhering and accumulating on the inner wall of the part 700, the suction tube insertion hole 551, and the suction tube protection tube 580, and that the adhering secretion was dried and concentrated over time, and the viscosity was further increased. As a result, the movement of the suction pipe 300 is slowed, and the insertion limit mark 320 and the extraction limit mark 321 are erroneously detected, or the suction pipe 300 and the sensor installation part 700, the suction pipe insertion hole 551 or the suction pipe protection pipe. Adsorption with 580 may occur, or the inner surface of the suction tube protection tube 580 may become dirty.

Therefore, in the third embodiment, as shown in FIG. 11, the supply pipe connection port 1210 for connecting the cleaning agent supply pipe 1201 from the cleaning agent blowing apparatus 1200 for manufacturing and supplying the mist-like liquid and the cleaning agent blowing for jetting the cleaning agent. A hole 1211 is provided at the center of the suction tube protection tube 580 so that the inner surface of the suction tube protection tube 580 can be cleaned by mist from the cleaning agent blowing hole 1211.

Further, a cleaning agent suction hole 1231 and a suction pipe connection port 1230 are provided at the base end side of the connection portion of the end 581 of the suction pipe protection tube with the suction pipe protection tube mounting portion 558, and the suction pipe connection port 1230 is provided. The cleaning agent suction pipe 1221 connected to the suction source is connected to the suction source 1010 through the cleaning agent separation bottle 225, the suction source connection pipe 1227 and the cleaning agent suction opening / closing valve 1226 provided in the middle thereof, and the cleaning agent is sucked and collected. .

After the series of suction operations of about 1 to 3 times are completed, the cleaning agent blowing device 1200 is operated, and the cleaning agent is ejected from the cleaning agent blowing hole 1211 to clean the inner surface of the suction tube protective tube 580. At the same time, the suction source 1010 and the cleaning agent suction on / off valve 1226 are operated to suck out the liquefied cleaning agent mist.

As a result, accumulation of secretions inside the suction tube protection tube 580 can be prevented, and the inside of the suction tube protection tube 580 can be kept clean.

In the fourth embodiment, as shown in FIG. 12, the cleaning agent suction hole 1231 and the suction pipe connection port 1230 are provided on the end side of the suction pipe protection pipe attachment portion 558. By attaching to this position, the suction pipe insertion hole 551 can be cleaned, and the suction pipe 300 is not adsorbed to the suction pipe insertion hole 551 during a pause period between the suction work and the suction work.

In the fifth embodiment, as shown in FIG. 13, the cleaning agent suction hole 1231 and the suction pipe connection port 1230 are provided on the terminal side of the sensor installation portion 700. By attaching to this position, the suction pipe insertion hole 551 and the inner surface of the sensor installation unit 700 can be cleaned, and the suction pipe 300 is connected to the suction pipe insertion hole 551 and the suction pipe during a pause period between the suction work and the suction work. It is no longer adsorbed to the sensor installation unit 700.

These are elevation views showing the overall configuration of the suction device of the first embodiment of the present invention. FIG. 3 is a bird's-eye view of a suction pipe drive mechanism housing 550 in FIG. 1. FIG. 4 is a cross-sectional view of the suction pipe drive mechanism housing 550 in a roller plane 554A as viewed from the direction AA of FIG. FIG. 6 is a cross-sectional view of the suction pipe drive mechanism housing 550 taken along the suction pipe axis plane 553 as viewed from the AA direction in FIG. 2. FIG. 6 is a side view of the roller 520. FIG. 5 is an explanatory view showing a cross section of a suction pipe 300 sandwiched between square spaces formed by two roller pieces 524A and 524B arranged to face each other. FIG. 6 is a sectional view of the bush 540. FIG. 6 is a bird's-eye view of the presser lid 560. FIG. 6 is a cross-sectional view of a suction tube drive assembly 1100. Fig. 4 is an elevation view showing the overall configuration of the suction device of the second embodiment. These are explanatory drawings which show the structure of the washing | cleaning apparatuses of the suction pipe protective tube 580 inner surface of 3rd Example. These are explanatory drawings explaining the structure of the washing | cleaning apparatus inside the suction pipe protective tube 580 of a 4th Example, especially the position of the washing | cleaning agent suction hole 1231. FIG. These are explanatory drawings explaining the structure of the washing | cleaning apparatuses of the inner surface of the suction pipe protective tube 580 of 5th Example, especially the position of the washing | cleaning agent suction hole 1231. FIG.

Explanation of symbols

1 patient
2 trachea
200 Tracheal cannula
202 Root end of tracheal cannula 300 Suction tube 301 Suction tube end 302 Suction tube root end 320 Insertion limit mark 321 Extraction limit mark 400 Ventilator 410 Multi-branch pipe part 411 End side attachment part 412 Ventilation branch 413 Ventilation hose 414 Suction branch 500 Suction tube drive mechanism 510 Suction tube feed mechanism 520A, 520B Roller 521A, 521B Roller shaft 522A, 522B Roller rotation shaft 523A, 523B End roller bearing 524A, 524B Roller top 525A, 525B Joint side roller Bearings 526A, 526B Semicircular shaft portions 527A, 527B Slits 528A, 528B V-shaped grooves 529A, 529B Bushing through portion 530 Suction tube feed mechanism housing 531A, 531B Roller installation hole 532A, 532B Roller installation hole central axis 533 533B Roller installation hole tip side bearing hole 534A, 534B Large diameter portion 535A, 535B Bush fitting portion 537A, 537B Lid mounting surface 540A, 540B Bush 541A, 541B Bush outer surface 542A, 542B Bush step 543A, 543B Roller shaft Through hole 550 Suction tube drive mechanism housing 551 Suction tube insertion hole 552 Suction tube insertion hole central axis 553 Suction tube axis plane 554A, 554B Roller plane 555 Second suction tube axis plane 556A, 556B Virtual axis 557A, 557B Virtual axis perpendicular line 558 Suction tube protection tube mounting portion 560 Presser lid 561A, 561B Presser lid slit 570 Check valve 571 Check valve vent 575 Pressure sensor 580 Suction tube protection tube 581 Suction tube protection tube 581 End 582 Suction tube protective tube root end 583 Suction tube protection Inner inner wall surface 584 of the bent tube Outer inner wall surface 590 of the suction tube protection tube bent Relay tube 591 Connection tube 600 Roller driving device 620A, 620B Flexible shaft 625A, 625B Shaft joint 626A, 626B Stopper 700 Sensor installation portion 701 Light emitting diode 703 Bulkhead A
704 Bulkhead B
705 Light-receiving phototransistor 710 Sensor electric signal line 800 Controller 900 Gas-liquid separation bottle 1000 Suction pipe 1002 On-off valve 1010 Suction source
DESCRIPTION OF SYMBOLS 1100 Suction pipe drive assembly 1200 Cleaning agent blowing apparatus 1201 Cleaning agent supply pipe 1210 Supply pipe connection port 1211 Cleaning agent blowing hole 1220 Cleaning agent suction apparatus 1221 Cleaning agent suction pipe 1225 Cleaning agent suction opening / closing valve 1226 Suction source Connection pipe 1230 Suction pipe connection port 1231 Cleaning agent suction hole

Claims (12)

A suction pipe feeding mechanism of a suction pipe drive mechanism of a suction apparatus that performs suction by inserting a suction pipe into a trachea, wherein the suction pipe is passed between two rollers, and the two rollers In the suction pipe feeding mechanism of the type in which the suction pipe is inserted into the trachea and removed from the trachea by rotating in the opposite directions, two parallel roller planes sandwiching the central axis of the suction pipe insertion hole and the The roller rotation axis of one roller surface forms a positive acute angle with respect to the perpendicular of the line of intersection with the suction pipe axis plane that includes the central axis of the suction pipe insertion hole and is orthogonal to the two roller planes, and the other A suction pipe feeding mechanism characterized in that the roller rotation shaft of the roller surface forms a negative acute angle. A suction tube of a suction tube drive mechanism of a suction device that performs suction by inserting the suction tube into the trachea, and has a rough outer wall surface 2. The suction pipe feeding mechanism according to claim 1, wherein the roller of the suction pipe feeding mechanism is a roller having a V-shaped groove perpendicular to the roller rotation axis on the outer periphery of the roller piece portion facing the suction pipe. Suction tube feed mechanism characterized by being One end of the suction pipe drive mechanism having the suction pipe through hole is hermetically connected to the base side connection port, and the other end is hermetically and easily connected to the connection pipe connected to the suction device. A suction tube protection tube characterized in that the suction tube is surrounded so that the suction tube can freely rotate and move inside the tube. The suction tube protective tube according to claim 4, wherein the inner wall surface is a rough surface. In the suction tube protective tube according to item 4, the cleaning agent suction hole is provided at the base end side of the portion used for connection with the suction tube mounting portion of the suction tube drive mechanism at the end of the suction tube protection tube, and A suction pipe having a suction pipe connection port, or further having a cleaning agent blowing hole and a supply pipe connection port in the vicinity of the middle between the end of the suction pipe protection pipe and the root end of the suction pipe protection pipe Tube protection tube In a suction tube drive assembly of a suction device that performs suction by inserting a suction tube into a trachea, the suction tube feed mechanism according to the first term or the third term and the fourth term, the fifth term, or the sixth term. Suction tube drive assembly characterized by having a suction tube protection tube as described The suction pipe drive assembly according to claim 7, wherein the suction pipe according to claim 2 is used. In a suction tube drive assembly of a suction device that performs suction by inserting a suction tube into the trachea, the pressure is released between the inside of the suction tube drive assembly and the outside air when the internal pressure is negative. Suction tube drive assembly having a check valve that closes when pressure is applied A suction device for a suction device that performs suction by inserting a suction tube into a trachea, wherein the open / close valve is provided between the root end of the suction tube protection tube and the suction source. Under the condition that the suction pipe feeding mechanism of the suction device drives the suction pipe in the pulling direction, when the tracheal pressure falls below the first preset pressure, the on-off valve is closed and the pressure is A suction device that opens the on-off valve when it rises above a set second set pressure In the suction pipe drive mechanism of the suction apparatus for sucking by inserting the suction pipe into the trachea and having a suction pipe protective pipe mounting portion having a suction pipe insertion hole, the suction pipe drive mechanism is provided. A suction tube driving mechanism having a cleaning agent suction hole and a suction tube connection port on the tracheal cannula side of the distal end of the soot tube attachment portion A suction device that is attached to a tracheal cannula together with a ventilator and sucks and removes sputum, the suction tube feeding mechanism according to claim 1, the suction tube according to claim 2, and the suction suction according to claim 3. A suction feed tube, a suction tube protection tube according to claim 4, a suction tube protection tube according to claim 5, a suction tube protection tube according to claim 6, a suction tube drive assembly according to claim 7, A suction pipe drive assembly according to claim 9, a suction pipe drive assembly according to claim 9, a suction device according to claim 10, and a suction pipe drive mechanism according to claim 11. Sucking device.

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