JP2010012174A - Folding tracheal tube utilizing expansion tube - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a tracheal tube capable of securing a visual field from the oral cavity into the pharynx of a patient when inserted into the trachea by improving the operability in inserting the tube into the trachea, capable of preventing the tube from being inserted into the esophagus side by mistake, and capable of sufficiently securing the air passage for the patient. <P>SOLUTION: The tracheal tube includes an inner tube 11 for making a gas flow accompanying the respiration of the patient; a thin-walled outer tube 12 having a larger tube diameter than the outer diameter of the inner tube 11; a first fluid storage space part 15 formed via a prescribed connection part; a cuff part 14 to be expanded when the fluid flows to abut to the inner wall of the trachea of the patient; a thin-walled outermost tube 13 disposed along the outer surface of the outer tube; a second fluid storage space part 16 formed via a prescribed connection part; and a fluid inflow/outflow mechanism for making the fluid flow into/out of the first fluid storage space part 15 and/or the second fluid storage space part 16. The inner tube, outer tube and outermost tube of the trachea tube are folded flat. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a tracheal tube used at the time of tracheal intubation.

  Tracheal intubation is a method of securing an airway that is performed on a patient to ensure sufficient breathing (airway) for a patient with severe respiratory failure and to prevent aspiration. In recent years, tracheal intubation has become formally recognized as an indispensable medical technique in various medical situations due to its high effectiveness, and in recent years, not only doctors but also paramedics have been officially recognized.

  In such tracheal intubation, for example, a tracheal tube 100 having a configuration shown in FIG. 7 is frequently used. A tracheal tube 100 shown in FIG. 7 includes a shaft 101 made of a bendable material such as vinyl chloride and having a diameter of about 10 mm and a thickness t of about 2 mm, and a connector attached to the rear end side opening of the shaft 101. 106, an inflatable cuff 102 provided at one end of the shaft 101, and a fluid supply / discharge unit for forcibly supplying fluid to the cuff 102 and forcibly discharging fluid from the cuff 102 105. The fluid supply / discharge unit 105 includes a connection pipe 103 connected at one end to the cuff 102 and disposed along the shaft 101, and an expansion indicator 104 connected to the other end of the connection pipe 103. Yes (see, for example, Patent Document 1).

  At the time of tracheal intubation, the practitioner inserts the tracheal tube 100 from the patient's oral cavity into the larynx, passes through the epiglottis, and expands so that the cuff 102 provided at one end on the distal end side of the shaft 101 contacts a part of the inner wall of the trachea. Let Then, the tracheal tube 100 is indwelled at a predetermined intratracheal indwelling position. Then, by connecting the tracheal tube 100 and an appropriate ventilator via the connector 106 attached to the opening on the rear end side of the shaft 101, respiration is ensured for a patient with severe respiratory failure. .

  By the way, the applicant of the present application can easily perform an operation until it is placed at a target position in a body lumen such as a blood vessel, trachea, or digestive tract, and can increase the area of the duct. A patent application was filed for an insertion tube capable of reducing the load on the wall surface (see Patent Document 2).

  The insertion tube described in Patent Document 2 includes a thin inner tube, a thin outer tube disposed along the outer peripheral surface of the inner tube and having a tube diameter larger than the outer diameter of the inner tube, and an inner tube of the outer tube. A fluid storage space provided between a peripheral surface and the outer peripheral surface of the inner tube and storing a fluid; and a fluid input / output mechanism for allowing the fluid to flow into and out of the fluid storage space via a connection tube. The fluid storage space includes an end connecting portion that continuously connects a front end and a rear end of the outer tube in a circumferential direction of the inner tube, an outer peripheral surface of the inner tube, and an inner periphery of the outer tube. It is formed through intermittent connection portions that connect the surfaces intermittently.

JP 2000-167060 A JP 2005-253804 A

  The conventional tracheal tube 100 as shown in Patent Document 1 has a configuration in which an inflatable cuff 102 is provided at one end of the distal end side of the shaft 101 having a certain thickness as described above. Therefore, when the practitioner inserts the tracheal tube 100 from the opened oral cavity into the larynx, the visibility inside the oral cavity is blocked by the shaft 101 or the contracted cuff 102, and the operability during tracheal intubation is poor. There was a risk that the tracheal tube 100 was intubated by mistake to the esophagus side.

  The present invention has been made in view of such circumstances, and it is an object of the present invention to improve the operability of tracheal intubation and to secure a field of view from the oral cavity to the larynx during tracheal intubation. An object of the present invention is to provide a tracheal tube capable of preventing intubation to the side and sufficiently securing an airway.

  As a result of earnest research, the inventors of the present invention applied the insertion tube which is the invention disclosed in Patent Document 2, and examined the structure, manufacturing method, folding type, etc. of the insertion tube. The foldable tracheal tube of the invention has been completed.

  That is, the folding tracheal tube according to the present invention includes a thin inner tube having an inner diameter for circulating a gas accompanying breathing of a patient, and a tube that is disposed along the outer peripheral surface of the inner tube and is larger than the outer diameter of the inner tube. A thin outer tube having a diameter, and a first outer tube disposed between the inner peripheral surface of the outer tube and the outer peripheral surface of the inner tube, and continuously connecting the front end and the rear end of the outer tube in the circumferential direction of the inner tube. The fluid flows into the first fluid storage space formed through the end connection portion of 1 and the intermittent connection portion that intermittently connects the outer peripheral surface of the inner tube and the inner peripheral surface of the outer tube. A cuff that extends and contacts the inner wall of the patient's trachea and has a thin outermost tube disposed along the outer peripheral surface of the outer tube, and between the inner peripheral surface of the outermost tube and the outer peripheral surface of the outer tube A second fluid storage space formed through a second end connection portion that is continuously connected in the circumferential direction of the outer tube with the front end and the rear end of the outermost tube; Fluid collection Space and / or flowing fluid to the second fluid storage space, and a fluid input and mechanism for outflow, the inner tube, the outer tube, and the outermost tube are configured folded into a flat shape.

  The folding tracheal tube of the present invention is inserted into the oral cavity with the inner tube, the outer tube, and the outermost tube folded in a flat shape. In other words, during tracheal intubation, it is possible to minimize the obstruction of the visual field in the oral cavity and facilitate the passage of a narrow part from the oral cavity to the larynx of the folding tracheal tube, and the operability of tracheal intubation Can be increased. When the cuff passes through the epiglottis and the glottis and reaches a predetermined intratracheal indwelling position, for example, a fluid such as air is forcibly sent from the fluid inlet / outlet mechanism to the second fluid storage space. Then, the outermost tube in the folded state is expanded to form a circular tube, and at the same time, the cuff provided in the outermost tube expands until it comes into contact with the inner wall of the trachea with a predetermined pressure. . When the cuff portion comes into contact with the inner wall of the trachea gently pressed, the folding tracheal tube is placed at a predetermined placement position in the trachea. Next, the inner pipe is expanded by forcibly feeding the fluid from the fluid inflow mechanism into the first fluid storage space. When the inner tube is expanded, the rigidity of the circular tube formed by the expansion of the outermost tube is increased and the shape thereof is maintained, and a flow path is formed to circulate the gas accompanying the patient's breathing. Can be secured.

  In the folding tracheal tube according to the present invention, the inner tube, the outer tube, and the outermost tube are folded flat with respect to the center side of the tube.

  Since the inner tube, outer tube, and outermost tube of the folding tracheal tube are folded into a flat shape by being folded toward the center of the tube, the outermost tube is expanded along with the expansion of the outermost tube. The outer peripheral surfaces facing each other at the periphery of the folding position of the tube are pressed against each other. Due to the repulsive force generated against this pressing force, the folding tracheal tube can be expanded more reliably than when the inner tube, the outer tube, and the outermost tube are simply folded flat.

  Furthermore, in the folding tracheal tube according to the present invention, the outer peripheral surface of the outermost tube when folded is allowed to flow out fluid from the first fluid storage space and / or the second fluid storage space, It is good also as a structure temporarily fixed through the adhesive means which has biocompatibility. By configuring in this way, the folding shape of the folding tracheal tube can be reliably maintained, and at the time of tracheal intubation, the visibility in the oral cavity can be minimized, and the folding trachea The narrow portion from the mouth of the tube to the larynx can be easily passed, and the operability of tracheal intubation can be improved.

  Furthermore, in the folding tracheal tube according to the present invention, the first end connection portion, the second end connection portion, and the intermittent connection portion are formed by welding. By comprising in this way, in manufacture of a folding type tracheal tube, it is not necessary to intervene a new member in a connection part, and can reduce a number of parts.

  Further, in the folding tracheal tube according to the present invention, the intermittent connection portion is configured to have at least six welding points in the circumferential direction of the inner tube. With this configuration, it is possible to suppress the narrowing of the flow path accompanying the expansion of the inner tube, and the diameter of the folding tracheal tube can be reduced.

  According to the foldable tracheal tube of the present invention, the operability of tracheal intubation can be improved, and visibility from the oral cavity to the larynx during tracheal intubation can be secured, and accidental intubation to the esophagus side can be prevented. It is possible to provide a tracheal tube capable of sufficiently securing an airway.

  The best mode for carrying out the present invention will be described below with reference to the drawings. In addition, this invention is not limited to the following description, In the range which does not deviate from the summary of this invention, it can change suitably.

  FIG. 1A is a schematic external view illustrating a state before expansion of the folding tracheal tube 10 according to the present invention, and FIG. 1B illustrates a state after expansion of the folding tracheal tube 10. FIG. FIG. 2 is a perspective view schematically showing a part of the folding tracheal tube 10 with a part thereof broken.

  As shown in FIGS. 1 and 2, the foldable tracheal tube 10 is made up of an inner tube 11, an outer tube 12, and an inner tube 11 and an outer tube 12 that are made of biocompatible synthetic resin and are thinly formed. The first fluid storage space 15 formed through the intermittent connection portion 20 and the first end connection portions 21 and 21 'in between, and the fluid expands to contact the inner wall of the patient's trachea. An outermost tube 13 having a cuff portion 14 and made of a biocompatible synthetic resin and having a thin wall like the inner tube 11 and the outer tube 12, and between the outer tube 12 and the outermost tube 13. The second fluid storage space 16 formed via the two end connection portions 22, 22 ′, the first fluid storage space 15, and / or the second fluid storage space 16 is forcibly supplied with fluid. Are provided with fluid input / output mechanisms 17 and 17 'for supplying and discharging.

  The thin inner tube 11, outer tube 12, outermost tube 13, and cuff part 14 have a material strength that can withstand the filling pressure of air as a fluid, a heat welding property that does not have holes during welding, and a foldable flexibility. A material showing biocompatibility applicable to clinical application is selected. In particular, the cuff portion 14 is made of a material having higher flexibility than the inner tube 11, the outer tube 12, and the outermost tube 13 because it directly contacts the trachea. In this embodiment, in order to form the thin inner tube 11, the outer tube 12, and the outermost tube 13, a synthetic resin sheet is used as an example, except for the inner tube 11, the outer tube 12, and the cuff part 14. An outermost tube 13 was formed to form a folding tracheal tube 10. On the other hand, the cuff part 14 formed in a part of the outermost tube 13 uses a synthetic resin sheet having higher flexibility than the synthetic resin sheet used to form the inner tube 11, the outer tube 12, and the outermost tube 13. is doing. In the production of these tubes, a film thinner than the sheet may be used as a film, and the film may be laminated to form a sheet. Furthermore, thin tubes formed in a cylindrical shape in advance may be used as the inner tube 11, the outer tube 12, and the outermost tube 13. Moreover, the inner tube 11, the outer tube 12, and the outermost tube 13 do not have to be cylindrical, and the outer shape and the inner shape are not limited. Here, the inner tube 11, the outer tube 12, and the outermost tube 13 have thicknesses in the range of 10 μm to 1 mm, for example.

  The inner tube 11 is formed in a cylindrical shape having a preset inner diameter. For example, a nylon (polyamide), a polyester, a polyolefin, or at least one of them laminated with a thickness of several tens of μm is laminated. It is made of a known material that has little influence when used in a trachea such as a laminated film.

  The outer tube 12 is formed in a cylindrical shape having an inner diameter formed larger than a preset outer diameter of the inner tube 11, and is similar to the inner tube 11 in a nylon system (polyamide system) having a thickness of several tens of μm. ), Polyester-based, polyolefin-based, or a laminate film obtained by laminating at least one of them. The outer tube 12 is not necessarily made of the same material as the inner tube 11, but has a predetermined connection strength by connecting the outer peripheral surface of the inner tube 11 and the inner peripheral surface of the outer tube 12 by heat welding. A material is preferred. The outer tube 12 and the inner tube 11 have the same length in the longitudinal direction, or are formed so that the outer tube 12 is shortened, and the two tubes have a space at which the first fluid storage space 15 can be formed. It is arranged to be. Further, a connection port 12a is formed between both the pipes so that the connection pipe 18 constituting the fluid input / output mechanism 17 can be connected. The connection port 12a is connected to the outer periphery on one end side of the connection pipe 18 so as to be airtight, and is configured so that the supplied fluid does not leak.

  The first fluid storage space 15 has a plurality of intermittent connection portions 20 that intermittently connect the outer peripheral surface of the inner tube 11 and the inner peripheral surface of the outer tube 12, and opposite ends of the inner tube 11 and the outer tube 12. It is formed between the inner tube 11 and the outer tube 12 via first end connection parts 21 and 21 ', which will be described later, which connect the parts continuously in the circumferential direction, and the supplied fluid is It is formed so as not to leak.

  For example, when the thickness of the synthetic resin sheet used for the inner tube 11 and the outer tube 12 is 45 μm and the sheet size when expanded is 60 mm × 270 mm, the intermittent connection portion 20 is installed in the inner tube 11 and the outer tube 12. Are set so as to have an inner tube 11: 6 mm and an outer tube 12: 9 mm, respectively. Furthermore, the installation interval of the intermittent connection part 20 is preferably as the installation interval becomes narrower, preferably the inner tube 4 mm and the outer tube 6 mm. The number of installation points in the circumferential direction of the inner tube 11 and the outer tube 12 is set to be at least 6 points, preferably 8 points or more. As described above, by appropriately setting the installation interval and the number of installation points of the intermittent connection portion 20, when the fluid is supplied to the first fluid storage space portion 15, the flow of the inner pipe 11 is appropriately expanded. A path is secured, and the outer tube 12 can be appropriately expanded radially from the center. Furthermore, by narrowing the installation interval of the intermittent connection part 20 and increasing the number of installation points in the circumferential direction of the pipe, the narrowing of the flow path of the inner pipe 11 can be suppressed, and the diameter of the folding tracheal tube 10 can be reduced. Can be planned.

  Further, the intermittent connection portion 20 differs depending on whether it is thermally welded or adhered using an adhesive, but here, ultrasonic welding is performed so that the shape of the connection surface is, for example, a square, a circle, an ellipse, or the like. A vessel was used. The intermittent connection portion 20 is not particularly leaked even when a predetermined load is applied to the fluid stored in the first fluid storage space 15 at a predetermined temperature. It is not limited about. Further, in the case of using an adhesive in the folding tracheal tube 10, a medical material having excellent biocompatibility can be used. For example, a high molecular weight polyester adhesive (Byron (registered trademark), commodity Name, manufactured by Toyobo Co., Ltd., main component: polybutylene terephthalate, solvent: mixed solution of toluene and methyl ethyl ketone), epoxy resin, cyanoacrylate adhesive (solvent) and the like can be used.

  For example, when the lengths of both end portions of the inner tube 11 and the outer tube 12 are the same, the first end connection portions 21 and 21 ′ are connected by continuously connecting predetermined width intervals in the circumferential direction. Even if the fluid that is formed and stored in the first fluid storage space 15 is applied with a predetermined load at a predetermined temperature, it may be anything that does not leak. Therefore, the connection means of the first end connection portions 21 and 21 'may be adhesion or welding with an adhesive that does not adversely affect the human body. In addition, you may form the connection port 12a for connecting the connection pipe 18 of the fluid in / out mechanism 17 in the 1st edge part connection part 20 'side used as the back.

  By forming the intermittent connection portion 20 and the first end connection portions 21 and 21 ′ as described above, the first fluid storage space portion 15 is in a state where a predetermined load is applied at a predetermined temperature. Even when the fluid is forcibly supplied by the fluid inlet / outlet mechanism 17, the stored fluid does not leak out, and the reduction rate when expanded is a predetermined value (for example, 85%) or more. Configured.

  The outermost tube 13 is formed in a cylindrical shape having an inner diameter that is larger than the preset outer diameter of the outer tube 12, and is similar to the outer tube 12 in a nylon system (polyamide) having a thickness of several tens of μm. Type), polyester type, polyolefin type, or a laminate film obtained by laminating at least one of them. The outermost tube 13 is not necessarily made of the same material as the outer tube 12, but the outer peripheral surface of the outer tube 12 and the inner peripheral surface of the outermost tube 13 are connected by heat welding to have a predetermined connection strength. It is preferable that the material has And since the cuff part 14 is formed in the outermost pipe | tube 13 via the cuff edge part connection parts 14a and 14b, the dimension is determined in consideration of the dimension of the cuff part 14. Further, the outermost tube 13 and the outer tube 12 are arranged so as to have a space at which the second fluid storage space 16 can be formed. Further, a connection port 13a is formed between both the pipes so that the connection pipe 18 'constituting the fluid input / output mechanism 17' can be connected. The connection port 13a is connected to the outer periphery on one end side of the connection pipe 18 'so as to be airtight, and is configured so that the supplied fluid does not leak.

  The cuff part 14 is formed in a cylindrical shape having a preset inner diameter, for example, a polyethylene film, a PVC film, a silicon film having a thickness of several tens of μm, or a laminate film obtained by laminating at least one of them. The inner tube 11, the outer tube 12, and the cuff portion 14 other than the outermost tube 13 are made of a known material that has higher flexibility and less influence when used in the trachea. Further, the cuff part 14 is continuously connected in the circumferential direction of the outermost tube 13 at a predetermined width interval via the cuff end connection parts 14a and 14b. The connection means of the cuff end connection parts 14a and 14b is not particularly limited, but may be adhesion or welding with an adhesive that does not adversely affect the human body.

  The second fluid storage space 16 is connected to both end portions facing each other between the outer tube 12 and the outermost tube 13 through second end connection portions 22 and 22 'that are continuously connected in the circumferential direction. It is formed between the outer tube 12 and the outermost tube 13 so that the supplied fluid does not leak.

  The fluid inlet / outlet mechanisms 17, 17 ′ are connecting pipes 18, 18 provided so as to provide an opening at one end between the outer pipe 12 and the inner pipe 11 and between the outermost pipe 13 and the outer pipe 12. And supply / discharge port portions 19 and 19 ′ for supplying and discharging a fluid provided at the other end of the connection pipes 18 and 18 ′. The supply / discharge ports 19 and 19 ′ of the fluid input / output mechanisms 17 and 17 ′ allow the fluid such as air to be supplied to the first fluid storage space 15 and the second fluid storage space through the supply / discharge means A1 and A1 ′. When the fluid is forcibly supplied to 16 and discharged, a check valve (not shown) or the like is provided so that the fluid can be controlled at the positions of the supply / discharge ports 19 and 19 '.

  Next, with reference to FIG. 3, an example of the manufacturing process of the folding tracheal tube 10 according to the present invention will be described. FIGS. 3A to 3E are perspective views schematically showing the manufacturing process of the folding tracheal tube 10.

  As shown in FIG. 3 (A), in the first step, the inner tube 11 and the outer tube 12 are laminated sheets of nylon and polyethylene of predetermined dimensions (trade name, manufactured by Unitika Ltd., registered trademark, ON −15 / FCS-30, thickness: 45 μm), and a predetermined width in the longitudinal direction of each sheet is linearly welded by welding means such as an ultrasonic mini-welder to produce an inner tube 11 and an outer tube 12, respectively. (FIG. 3B). In addition, the dimension of the sheet | seat used as the outer tube | pipe 12 is set so that the circumference may become longer than the circumference | surroundings of the inner tube | pipe 11 when it makes it tubular rather than the sheet | seat used as the inner tube | pipe 11. FIG. The length in the longitudinal direction of the sheet serving as the outer tube 12 is set to be equal to or longer than the length in the longitudinal direction of the sheet serving as the inner tube 11.

  Next, as in the second step shown in FIG. 3C, the inner tube 11 is inserted into the outer tube 12, and is intermittently adhered by welding means such as an ultrasonic welding machine to form a plurality of intermittent connection portions 20. To do. The welding interval and the number of welding points in the intermittent connection portion 20 can be arbitrarily set based on the diameter of the circular tube F including the inner tube 11 and the outer tube 12 of the folding tracheal tube 10 to be manufactured. For example, an ultrasonic welder horn having a welding width of 1 mm (welding horn shape: 1 mm × 2 mm rectangular shape) is used, and the welding interval is set to the inner tube 11: 6 mm and the outer tube 12: 9 mm with respect to the longitudinal direction of the circular tube. When the number of welding points is 6 with respect to the circumferential direction of the circular tube, a circular tube F having an inner diameter of 10 mm and an outer diameter of 15 mm can be created. Similarly, when the welding interval is 11: 4 mm for the inner tube and 12: 6 mm for the outer tube and the number of welding points is 6 with respect to the circumferential direction of the circular tube, a circular tube F having an inner diameter of 10 mm and an outer diameter of 13 m can be created. Further, when the welding interval is 11: 4 mm for the inner tube and 12: 6 mm for the outer tube and the number of welding points is 8 with respect to the circumferential direction of the circular tube, the circular tube F having an inner diameter of 6.5 mm and an outer diameter of 10.5 mm is provided. Can be created.

  Then, the circumferential position in the predetermined width of the front end portion (tip portion) of the inner tube 11 and the circumferential position in the predetermined width of the front end portion (tip portion) of the outer tube 12 are continuously circumferential. The first end connection portion 21 is formed by being welded and connected to each other, and similarly, the circumferential position of the rear side end portion (rear end portion) of the inner tube 11 in a predetermined width, and the outer tube An end connection portion 21 ′ is formed by continuously welding and connecting the circumferential position of the rear end portion (rear end portion) of the rear end portion 12 with a predetermined width in the circumferential direction. At the same time, the supply / discharge port 19 of the connection pipe 18 is formed by, for example, mounting a silicon tube in an airtight manner.

  Next, in the third step shown in FIG. 3D, a polyethylene sheet having a predetermined dimension is formed into a tubular shape as the cuff portion 14, and a predetermined width in the longitudinal direction of the sheet is linearly welded by welding means such as an ultrasonic miniwelder. . Then, using the heat shrinkability of polyethylene, for example, the outer diameter of the end portion of the cuff portion 14 is shrunk by the heat supply means such as a hot air gun until the outer diameter of the outermost tube 13 is reached. And by welding the outermost tubes 13b and 13c formed of a sheet of the same material as the inner tube 11 or the outer tube 12 and the cuff portion 14 whose ends are contracted by thermal contraction in the circumferential direction. Cuff end connection portions 14a and 14b are formed. At this time, the inner diameter of the outermost tube 13 is set to be larger than the diameter of the circular tube F composed of the inner tube 11 and the outer tube 12.

  Then, as in the fourth step shown in FIG. 3 (E), the circular tube F is inserted into the outermost tube 13, and the circumferential position of the front end portion (tip portion) of the circular tube F in a predetermined width and The second end connection portion 22 is formed by continuously welding and connecting the circumferential position in the predetermined width of the front end portion (tip portion) of the outer tube 13 in the circumferential direction. Thus, the circumferential position in the predetermined width of the rear end (rear end) of the circular tube F and the circumferential position in the predetermined width of the rear end (rear end) of the outermost tube 13 are continuous. Then, the second end connection portion 22 'is formed by being welded and connected in the circumferential direction. At the same time, the supply / discharge port 19 ′ of the connection pipe 18 ′ is formed by, for example, mounting a silicon tube in an airtight manner.

  Next, the case where the folding tracheal tube 10 having the above-described configuration is inserted into the trachea will be described. When inserting the folding tracheal tube 10 into the trachea, as shown in FIG. 4 (A), the folding tracheal tube 10 is folded flat, or as shown in FIG. 4 (B), The tube can be inserted into the trachea by folding in the direction of the center of the tube and folding it into a flat shape. As described above, according to the folding form shown in FIG. 4 (B), the outer peripheral surfaces facing each other at the folding position of the outermost tube 13 are pressed against each other as the outermost tube 13 is expanded. Become. Due to the repulsive force generated against this pressing force, the folding tracheal tube can be expanded more reliably than the inner tube 11, the outer tube 12, and the outermost tube 13 are simply folded flat. . At the time of folding, the fluid in the first fluid storage space 15 and the second fluid storage space 16 is forcibly extracted by the negative pressure by the fluid input / output mechanisms 17 and 17 ′, and the thickness of the folding tracheal tube 10 is minimized. By doing so, it is possible to flatten. At this time, in order to maintain the folded state, the outer peripheral surfaces facing each other at the fold position of the outermost tube 13 are temporarily fixed with a biocompatible adhesive (for example, fibrin or the like). It may be left.

  And the insertion method to the trachea of the folding-type tracheal tube 10 folded by either type shown in FIG. 4 is demonstrated using FIG.5 and FIG.6. As shown in FIG. 5, for example, when a foldable tracheal tube 10 folded into a flat shape is inserted into a trachea, first, the inside of the folded tracheal tube 10 folded into a flat shape (inside the inner tube 11) ) Is inserted with a stylet 23 having a sharp shape at one end. In the previous stage of tracheal intubation, since the fluid is not supplied from the fluid inlet / outlet mechanisms 17 and 17 ', the folding tracheal tube 10 is in a contracted state and does not have rigidity. In this state, in order to insert the foldable tracheal tube 10 into the trachea, it is necessary to insert the stylet 23 into the foldable tracheal tube 10 to give a certain degree of rigidity. In addition, since the one end side of the stylet 23 in the trachea insertion direction is formed in a sharp shape, the folding tracheal tube 10 can be inserted through the gap of the glottis.

  First, as shown in FIG. 6A, the practitioner inserts and feeds the folding tracheal tube 10 containing the stylet 23 from the patient's mouth to the larynx.

  Then, the practitioner carefully feeds the folding tracheal tube 10 to the trachea side with care so that the tip of the folding tracheal tube 10 does not enter the esophagus side at the position of the epiglottis G (FIG. 6 ( B)). At this time, since the foldable tracheal tube 10 is folded in a flat shape, the insertion operation can be performed in a minimum state that does not obstruct the field of view when operated by the practitioner, and is excellent in safety. In addition, it is excellent in operability.

  As shown in FIG. 6 (C), when the distal end of the folding tracheal tube 10 passes through the glottis H and reaches a predetermined indwelling position, the practitioner can supply and discharge means A1, Air, which is a fluid, is forcibly injected through a syringe that is A1 ′. At this time, first, air is injected from the syringe which is the supply / discharge means A1 '. Then, the outermost tube 13 in the folded state is expanded to form a circular tube, and at the same time, the cuff portion 14 provided in the outermost tube 13 contacts the inner wall of the trachea with a predetermined pressure. Extend to. When the cuff part 14 comes into contact with the inner wall of the trachea gently pressed, the folding tracheal tube 10 is placed at a predetermined placement position in the trachea. Next, when air is injected from the syringe which is the supply / discharge means A1, the inner tube 11 is expanded. When the inner tube 11 is expanded, the rigidity of the circular tube formed by the expansion of the outermost tube 13 is increased and the shape thereof is maintained, and a flow path for circulating gas accompanying the patient's breathing is formed. The airway can be secured.

  Further, the above-described folding tracheal tube 10 can be inserted into the trachea, for example, using a laryngoscope 30 having a blade provided with a guide groove for the folding tracheal tube 10 (FIG. 6D). )). At this time, the glottis H can be easily confirmed by inserting the blade of the laryngoscope 30 into the epiglottis G and lifting the grip formed on the grip of the laryngoscope 30 by the practitioner. Then, the folding tracheal tube 10 can be placed at a predetermined placement position based on the operation procedure described above.

  As described above, according to the foldable tracheal tube according to the embodiment of the present invention, the operability of tracheal intubation can be improved, and visibility from the oral cavity to the larynx during tracheal intubation can be ensured. It is possible to provide a tracheal tube capable of preventing intubation and ensuring a sufficient airway.

1 is a schematic external view for explaining a folding tracheal tube 10. FIG. It is the figure which fractured | ruptured a part of folding type tracheal tube 10, and was shown typically. It is a figure explaining an example of the manufacturing process of the folding type tracheal tube. It is a figure explaining the folding system of the folding type tracheal tube. It is a figure explaining the insertion method to the trachea of the folding tracheal tube. It is a figure explaining the insertion method to the trachea of the folding tracheal tube. It is a figure explaining the conventional tracheal tube.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Folding type tracheal tube 11 Inner tube 12 Outer tube 12a Connection port 13 Outermost tube 13a Connection port 14 Cuff part 14a, 14b Cuff part connection part 15 1st fluid storage space 16 2nd fluid storage space 17, 17 ' Fluid inlet / outlet mechanism 18, 18 'Connection pipe 19, 19' Supply / discharge port portion 20 Intermittent connection portion 21, 21 'First cut portion connection portion 22, 22' Second end portion connection portion 23 Stylet 30 Laryngoscope F Round tube G epiglottis H glottis

Claims (5)

A thin-walled inner tube having an inner diameter through which the gas accompanying the patient's breathing flows;
A thin outer tube disposed along the outer peripheral surface of the inner tube and having a tube diameter larger than the outer diameter of the inner tube;
A first end connection that is disposed between the inner peripheral surface of the outer tube and the outer peripheral surface of the inner tube and continuously connects the front end and the rear end of the outer tube in the circumferential direction of the inner tube. A first fluid storage space formed through an intermittent connection portion that intermittently connects the outer peripheral surface of the inner portion and the inner tube and the inner peripheral surface of the outer tube;
A thin-walled outermost tube disposed along the outer peripheral surface of the outer tube, having a cuff portion that expands by inflow of fluid and contacts the inner wall of the patient's trachea,
A second end disposed between an inner peripheral surface of the outermost tube and an outer peripheral surface of the outer tube, and continuously connecting a front end and a rear end of the outermost tube in a circumferential direction of the outer tube; A second fluid storage space formed through the connection part;
A fluid input / output mechanism for allowing the fluid to flow into and out of the first fluid storage space and / or the second fluid storage space;
The foldable tracheal tube, wherein the inner tube, the outer tube, and the outermost tube are folded flat.   The foldable tracheal tube according to claim 1, wherein the inner tube, the outer tube, and the outermost tube are folded into a flat shape by being folded with respect to a central direction side of the tube.   The outer peripheral surface of the outermost pipe when folded is allowed to flow out of the fluid from the first fluid storage space and / or the second fluid storage space or via biocompatible adhesive means. The folding tracheal tube according to claim 1 or 2, wherein the folding tracheal tube is temporarily fixed.   The foldable tracheal tube according to any one of claims 1 to 3, wherein the first end connection part, the second end connection part, and the intermittent connection part are formed by welding. .   The foldable tracheal tube according to claim 4, wherein the intermittent connection portion has at least six welding points in the circumferential direction of the inner tube.