JP2010110588A - Anal and enteral feeding tube - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an anal and enteral feeding tube for avoiding a complication occurring when performing enteral feeding by using nasotracheal tube or gastrostoma. <P>SOLUTION: The anal and enteral tube 1 is 9m long, where a rear balloon 2 having a diameter of 4 cm is arranged at the mouth side end, a tube 1 of 8.85m is arranged on an anal side and continued from the rear balloon 2, and a front balloon 3 having a diameter of 2 cm to be expanded in the intestine is arranged at an anal side end. The nasally inserted tube 1 is made to reach the duodenum through the use of a guide wire, and then, the anal side of the tube 1 is made to reach the anal by way of a small intestine and a large intestine by the peristalsis of the intestines by expanding the front balloon 3. When the tube 1 is pulled from the anal side, the mouth side of the tube 1 is drawn into a stomach so as to expand the rear balloon 2 inside the stomach. An enteral feeding product is put in from a front distal end hole 12, discharged from side holes a8, b9, and rear distal end hole 10, and then, injected to the stomach and the duodenum from the anal side. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

The present invention relates to the form of a tube used for enteral nutrition.
Patent Publication 2003-164517 Patent publication 5005-512669 Edited by Japanese Society for Parenteral and Enteral Nutrition Manual of Intravenous and Enteral Nutrition for Comedy Nanedo 2003

  The elderly population is increasing rapidly, and the frequency of enteral nutrition is increasing to improve nutritional disorders caused by dysphagia. The tube used for conventional enteral nutrition is a nasal tube or a tube inserted through a percutaneous gastrostomy constructed surgically or endoscopically. A conventional nasal enteral tube has a length of about 80 cm, for example, as shown in Patent Publication 2003-164517, and has a hole for injecting enteral nutrients into the mouth side and the stomach end of the tube. This hole is also a hole for the guide wire to guide the insertion of the tube from the nose into the esophagus-stomach. Insert the nasal enteral tube into the nasal cavity, pass through the nasal cavity-pharynx-esophagus, and insert the tip of the nasal enteral tube into the stomach. After confirming the position by abdominal radiograph, the oral side of the nasal enteral tube Enteral nutrients are injected from the end hole, and enteral nutrients enter the stomach. Nasal enteral methods have complications such as misinsertion of the tube into the trachea, aspiration pneumonia, ulceration of the nose, pharynx and esophagus.

Although percutaneous endoscopic gastrostomy, which is a method of performing enteral nutrition from the gastrostomy, is described in detail in the background of the invention of Patent Publication 5005-512669, percutaneous endoscopic gastrostomy. The outline of the Pull method is described. The upper gastrointestinal endoscope is inserted into the patient through the mouth, air is sent from the endoscope, the stomach is inflated, the puncture site is specified from the stomach, and the puncture is performed from the abdominal wall skin side to the stomach. A needle is punctured and a loop wire is inserted into the stomach through the puncture needle. Grasp the wire with the forceps inserted through the endoscope, take the mouth end of the wire out of the body, connect the catheter tube to the loop of the wire, pull the wire on the abdominal wall, and pull the catheter tube from the mouth into the stomach Pull the wire until the mouth end of the retractable tube is in close contact with the stomach wall. The catheter tube is fixed and gastrostomy is completed. Percutaneous endoscopic gastrostomy, when the patient's general condition is reduced, when there is an infection, ascites retention, extreme obesity, or when the large intestine is located between the stomach wall and the abdominal wall It cannot be enforced. There are also complications such as gastrointestinal perforation, peritonitis, gastrostomy skin folds and ulceration.

  According to anatomy, the length of the entire digestive tract is about 8 m. (Esophagus 0.25m + stomach 0.2m + duodenum 0.25m + (jejunum + ileum) 6m + large intestine 1.5m)

  According to the prior art, severe aspiration pneumonia due to misinsertion or aspiration in case of nasal tube, sputum of nasal part, throat head or esophageal mucosa, peritonitis at the time of gastrostomy construction in case of gastrostomy tube Complications such as ulceration of the gastrostomy skin are often seen. Therefore, an object of the present invention is to provide an enteral feeding tube that does not require a surgical procedure and that can avoid the adverse effects caused by inserting a nasal tube over a long period of time.

  In order to solve the above problems, in the first embodiment of the present invention, the length of the enteral feeding tube is increased to 9 m so that it can be inserted from the nasal cavity and reach the outside of the anus via the stomach, small intestine and large intestine. Featuring a posterior balloon that can enter enteral nutrients injected from the anal side of the tube into the stomach and prevents the tip of the tube from falling out of the stomach with a balloon inflated in the stomach Provide enteral feeding tube. In a second embodiment of the present invention, an insertion tube connectable with the tube is provided for pushing the mouth end of the tube into the stomach. In the third embodiment, this tube is inserted from the anal side to the stomach using a lower digestive tract endoscope. According to these embodiments, a patient receiving enteral nutrition can receive nutrition nasally without undergoing surgical invasion.

Next, the transanal enteral feeding tube in the first embodiment of the present invention will be described with reference to FIGS. 1, 2, and 3. FIG.
The tube 1 main body is shown in FIG. The material constituting the tube 1 is silicon, soft vinyl chloride, polyethylene or the like used in conventional enteral feeding tubes.
There is a rear balloon 2 having a diameter of 4 cm to be inflated in the stomach on the rear side (oral end) of the tube 1, and a tube of 8.85 m continues to the anal side from the rear balloon 2, and the diameter to be inflated in the intestine on the front side. There is a 2 cm forward balloon 3. In other words, the total length of the tube 1 is 9 m, and the balloon 2 is located at a portion 6 to 10 cm from the mouth side end of the tube 1 and the balloon 3 is located at a portion 3 to 5 cm from the anal side end. A cross-sectional view of the tube 1 is shown in FIG. The tube 1 has an outer diameter of 8 mm, an inner diameter of 6 mm, and two inner wall tubes (inner wall tube a4 and inner wall tube b5) with a diameter of 0.4 mm for inflating the balloon are incorporated in the side wall of the tube. The intramural tube a4 continues from the front balloon expansion hole 6 on the mouth side to the balloon 3, and the intramural tube b5 continues from the rear balloon expansion hole 7 on the anal side to the balloon 2. The mouth tube 1 in the vicinity of the balloon 2 has six side holes a8 with a diameter of 3 mm and four side holes b9 with a diameter of 3 mm on the anus side of the balloon 2. When the pyloric ring is closed, gastric juice is discharged into the duodenum.

According to the first embodiment, a guide wire 11 of 11 m from the rear end hole 10 of the tube 1 is put into the tube 1 and inserted to 1 cm before the front end hole 12. This is because the living body may be damaged by taking out the guide wire from the front end hole 12. Thereafter, the tube 1 is inserted into the nasal cavity as shown in FIG. Next, the tube 1 is advanced to the esophagus and stomach, and the tube 1 is advanced into the duodenum while being guided by the guide wire 11. As shown in FIG. 4, the front balloon 3 is inflated by injecting air from the front balloon expansion hole 6. When the front balloon 3 is inflated, the tube 1 reaches the anus via the stomach-small intestine (jejunum + ileum) -large intestine by peristalsis of the intestine. Grasping the anal side of the tube 1 and slowly pulling the tube 1 to the anus side, and when the position of the balloon 2 reaches the stomach, as shown in FIG. 5 and FIG. The mixed distilled water is injected using the syringe 13, and the balloon 2 is inflated in the stomach. It is confirmed that the balloon 2 is properly placed in the stomach under fluoroscopy with X-rays. Thereafter, enteral nutrients are injected from the front tip hole 12, and enteral nutrients are supplied into the stomach or duodenum.

In the first embodiment, the tube 1 is grasped on the anal side, and the mouth side end of the tube 1 is drawn into the stomach. However, in the second embodiment, as shown in FIG. 7, the mouth side portion of the tube 1 is pushed into the stomach using the insertion tube 14 connected to the mouth side end. The insertion tube 14 has a total length of 1 m and is made of vinyl chloride. The connecting portion with the tube 1 is a 5 cm overtube 15, and the inner diameter of the overtube is set to 8.1 mm so that the mouth side of the tube 1 enters the insertion tube 14. The tube 1 is pushed out by the water flow 18 discharged from the injection hole 16 on the mouth side of the insertion tube 14 to the discharge hole 17, and the tube 1 is separated in the stomach. Then, the rear balloon 2 is inflated in the stomach. The risk of the mouth end of the tube 1 blocking the larynx by the operation of pushing the mouth side of the tube 1 can be avoided.

In the third embodiment, as shown in FIG. 8, the lower digestive tract endoscope 19 is inserted from the anus, and the tip thereof reaches the cecum. Here, the guide wire 11 is retrogradely inserted into the ileum. The lower digestive tract endoscope 19 is removed leaving only the guide wire 11. The anus side of the guide wire 11 is inserted into the rear end hole 10 of the tube 1, and the tube 1 is inserted retrogradely from the anus to the large intestine, small intestine, and stomach along the guide wire 11 as shown in FIG. 9. When the posterior balloon 2 reaches the stomach, distilled water mixed with a contrast medium is injected from the posterior balloon expansion hole 7 using the syringe 13 to inflate the balloon 2 in the stomach. It is confirmed that the balloon 2 is properly placed in the stomach under fluoroscopy with X-rays. Thereafter, enteral nutrients are injected from the front tip hole 12, and enteral nutrients are supplied into the stomach or duodenum.

The top view of a transanal enteral feeding tube. Sectional drawing of a transanal enteral feeding tube. The figure which inserts a transanal enteral feeding tube in a nasal cavity in 1st embodiment. The figure which inflated the front balloon of the transanal enteral feeding tube in the duodenum in 1st embodiment. The figure which inflated the back balloon of the transanal enteral feeding tube in 1st embodiment. The figure which inflated the back balloon of the transanal enteral feeding tube in the stomach in 1st embodiment. The form figure of the insertion tube in 2nd embodiment. The figure which inserted the lower gastrointestinal endoscope in 3rd embodiment. The figure which inserts a transanal enteral feeding tube retrogradely in 3rd embodiment.

Explanation of symbols

1 Tube body 2 Rear balloon 3 Front balloon 4 In-wall tube a
5 Inner wall b 6 Front balloon expansion hole 7 Rear balloon expansion hole 8 Side hole a
9 Side hole b 10 Rear tip hole 11 Guide wire 12 Front tip hole 13 Syringe 14 Insertion tube 15 Overtube 16 Injection hole 17 Discharge hole 18 Water flow 19 Lower digestive tract endoscope

Claims (4)

This is a transanal enteral feeding tube that is long enough to reach the stomach from the anus to the stomach through the large intestine-small intestine to enter the patient. A posterior balloon which is provided at the mouth end, which is the side, and which is inflated in the stomach; an anterior balloon which is inflated in the intestine and which is inflated in the intestine; An intra-wall tube a for supplying fluid for expansion by communicating from the front balloon expansion hole on the mouth side to the front balloon, and communication from the rear balloon expansion hole on the anal side of the tube to the rear balloon An inner wall tube b for supplying a fluid for expansion, a side hole a and a side hole b for opening the tube in the vicinity of the rear balloon and discharging enteral nutrients; Transanal enteral feeding tube to the tube and front front end hole and a rear distal end hole for inserting a guide wire for guiding the insertion nasally, characterized in that it has a. The transanal cavity that allows the enteral nutrient to be injected into the stomach and the small intestine by injecting the enteral nutrient from the front end hole of the anal side end of the transanal enteral feeding tube according to claim 1. Intestinal nutrition tube. The transanal enteral feeding tube according to claim 1, in order to push the mouth side of the tube into the stomach, an overtube portion that is a connection portion with the tube and a fluid for releasing the connection are injected. An insertion tube comprising an injection hole and a discharge hole. The transanal enteral feeding tube according to claim 1 is not inserted nasally or orally, but this tube is inserted retrogradely from the anal side using a lower digestive tract endoscope and a guide wire. An enteral enteral feeding tube that allows administration of enteral nutrients by reaching the stomach.

Images