JP2011156246A - Trachea tube for non-invasively sucking phlegm in trachea - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a tracheal tube which prevents mucosal damage caused by the tracheal mucosa being continuously adsorbed to the suction port during suction of sputum.
[Configuration] A tracheal tube that can be intubated through the mouth or nostril to secure the airway or a tracheostomy tube that can be intubated through the tracheostomy opening. A tracheal tube or a tracheostomy tube, which is an installed tracheal tube or tracheostomy tube, wherein a suction port of the sputum suction path opens only inside the tube.
[Selection] Figure 2

Description

  The present invention relates to a tracheal tube inserted into the trachea from the mouth or nostril or a tracheostomy tube inserted into the trachea from the tracheostomy opening (hereinafter referred to as “tracheal tube”). To eliminate the possibility of mucosal damage and bleeding due to the tracheal mucosa being continuously adsorbed by the suction port when sucking the sputum continuously using the sputum suction path provided in parallel with It relates to the intended tracheal tube.

  Patients with a tracheal tube inserted into the trachea often have difficulty in breathing due to obstruction of the airways due to traps in the trachea and bronchi. To prevent this, respiratory physiotherapy such as postural drainage and respiratory assistance techniques, collecting peripheral bronchial sputum into the main bronchus and trachea, and inserting a suction catheter through the respiratory tract of the tracheal tube to the trachea and main bronchus The sputum collected by the method must be removed from the trachea by aspiration. Saliva and the like flowing into the trachea from the oral cavity are also subject to suction removal, as is the case with sputum. Hereinafter, the sputum generated on the bronchial side and the saliva flowing into the trachea from the oral cavity are collectively referred to simply as “spider”.

Usually, the caregiver performs insertion of the suction catheter, and suction is performed by a suction pump connected to the suction catheter. For patients using ventilators, it is necessary to temporarily disconnect the ventilator when inserting the suction catheter, and the caregiver is operating the suction catheter. The operation needs to be completed in a short time. For this purpose, an electric suction pump having a suction speed of several liters to several tens of liters per minute is used. This method is referred to as “manual suction method”.
However, this manual suction method is an operation that causes great pain to the patient because the tip of the suction catheter contacts the tracheal mucosa when the suction catheter is inserted to cause the patient's cough reflex. However, if the tip of the suction catheter is kept in the tracheal tube so that it does not hit the tracheal mucosa, the stored sputum cannot often be sufficiently sucked.

In Patent Document 1, a suction catheter (indicated as “suction tube” in Patent Document 1) whose distal end is placed in the trachea and a tube pump having a lower suction speed than an electric suction pump used in a manual suction method are used. It has been shown that, when used in combination, the tube pump is operated continuously to suction and remove sputum in the patient's trachea and improve airway obstruction due to sputum. Hereinafter, this method is referred to as “continuous suction method”. In this continuous suction method, since the ventilator takes only a minimum amount of air sent to the patient, continuous sputum suction is possible while using the ventilator. Further, since the caregiver does not need to perform the suction operation frequently as in the manual suction method, the burden on the caregiver is greatly reduced.
In the manual suction method, the caregiver manually inserts the suction catheter into the trachea and sucks the sputum while moving the suction catheter. Therefore, the suction port at the tip of the suction catheter does not continue to hit one place of the mucous membrane. However, in the continuous suction method, the position of the suction port is a fixed position with respect to the trachea, so the tracheal mucosa is adsorbed to the suction port by some momentum, causing mucosal damage and bleeding due to continuous suction for a long time There was a possibility. Patent Document 1 describes that even if the suction port contacts the tracheal mucosa because the suction speed of the suction pump is low, mucosal damage due to suction is unlikely to occur, but further research needs to improve safety. I know that there is.
For this reason, in Patent Literature 2, a tracheal tube in which the suction path of the sputum is provided in parallel with the axis of the tracheal tube, and the suction port of the sputum is provided inside and outside the tube at the distal end of the tracheal tube. A tracheal tube similar to that of Patent Document 2 is shown in which a suction port on the outer side of the tube is located on the distal end side of the tracheal tube from a suction port on the inner side of the tube.
However, even if the invention of Patent Document 2 or 3 is used, there are cases in which the tracheal mucosa is sucked from the outer suction port and adsorbed to the sputum suction path for a long time depending on the conditions, which may cause mucosal damage. It was discovered and the need for further safety was confirmed.

WO2006 / 009283 WO2006 / 035769 JP 2008-23105 A

  An object of the present invention is to provide a tracheal tube that prevents mucosal damage due to the tracheal mucosa being continuously adsorbed to the sputum suction port of the tracheal tube in the suction of sputum in the trachea by the continuous suction method.

The gist of the present invention is a tracheal tube provided with a sputum suction path having a mouth for sucking sputum in the trachea, wherein the sputum suction path is provided parallel to the axis of the tracheal tube, and the sputum suction port is the trachea The tracheal tube is characterized by opening only inside the tube.

In the present invention, since the suction port for sucking sputum is opened only inside the tracheal tube, the possibility that the tracheal mucosa contacts the suction port disappears. It is possible to prevent a mucous membrane damage accident caused by touching and adsorbing as it is.

The perspective view which shows the whole tracheal tube which concerns on this invention Sectional drawing which showed the state by which the tracheal tube which concerns on this invention product was intubated and detained in the trachea (The lumen | lumen and tube for inflating a cuff are abbreviate | omitted). Sectional drawing of suction port vicinity of the sputum shown in Example 1 Sectional drawing of suction port vicinity of the sputum shown in Example 2

The present invention will be described in detail below.
The overall structure of the tracheal tube according to the present invention is the same as that of the existing tracheal tube as shown in FIG. 1, and the material is the same as that of the currently used tracheal tube, such as polyvinyl chloride, polyurethane and silicone rubber. Etc. are used. The tracheal tube is provided with a soot suction path parallel to its axis. Some existing tracheal tubes have a sputum suction path, but the only one that is available on the market is a sputum suction port that is provided only outside the tracheal tube. Documents 2 and 3 only show that the suction ports are provided on both the inside and outside of the tracheal tube. When such an existing tracheal tube is used, instead of using a suction catheter, the sputum suction path is used to operate the sputum suction for a short time using an electric suction pump or the like as in the manual suction method. Is done in In this case, there is a possibility that the suction port of the sputum may come into contact with the tracheal mucosa, but there is no particular problem because the suction is performed in a short time.

In the present invention, the sputum suction port is opened only inside the tracheal tube, and the suction port may be located at any position in the tracheal tube. Is preferably near the tip of the tracheal tube, that is, near the end to be inserted into the trachea. The number of sputum suction ports is not limited to one, and a plurality of sputum suction ports may be opened along the sputum suction path. Even though the sputum suction port is open only inside the tracheal tube and it does not open outside, the sputum suction can be performed without any problems in the continuous suction method. It was thought like.
In the continuous suction method, a constant amount of air is always sucked from the suction port. In addition, sputum stored near the tip of the tracheal tube in the trachea repeatedly enters and exits the tracheal tube with the flow of air by breathing. At this time, the soot that accidentally contacts the suction port of the suction path is drawn into the suction path and removed by suction. Even if the amount sucked at a time is small, since suction is always performed, soot in the trachea is sufficiently removed by suction over a long time span. Even in the continuous suction method, it is preferable to collect peripheral bronchial sputum in the main bronchus and trachea by respiratory physical therapy such as posture drainage and assistive breathing as necessary so that the sputum can be easily guided to the suction port.

  It is also useful in some cases to use the tracheal tube according to the present invention to aspirate and remove wrinkles in the trachea by a technique close to the manual suction method rather than the continuous suction method. In this case, instead of a pump having a low suction speed used in the continuous suction method, a pump having a high suction speed used in the manual suction method is used, or suction is performed using a syringe. When it is recognized that the sputum is stored in the trachea, the sputum in the trachea is removed by suction by performing a suction operation for a short time using this pump or syringe. Compared with the usual manual suction method, this method eliminates the need for preparation, insertion, and clean-up of the suction catheter, and there is no pain for the patient due to the suction catheter coming into contact with the tracheal mucosa. Even if you are doing it, there is a merit that you do not need to disconnect from the ventilator. Furthermore, in the normal manual suction method, it is necessary to insert a suction catheter into the trachea from the outside. However, in this method, since it is not necessary to insert anything from the outside, the risk of infection can be reduced.

Conventionally, a method of fixing an existing suction catheter to an existing tracheal tube is known. In this case, if the suction catheter is fixed outside the tracheal tube, the tracheal mucosa is adsorbed to the suction port of the suction catheter. There is a possibility that. In addition, even when fixed inside the tracheal tube, if the suction port of the suction catheter is in the same position as the tip of the tracheal tube, or if it protrudes from the tip of the tracheal tube, the tracheal mucosa may be adsorbed to the suction port of the suction catheter There is. If the suction port of the suction catheter stays inside the tracheal tube, there is no risk of adsorbing the tracheal mucosa. The problem of how to place the suction port of the suction catheter so that it stays in the tracheal tube, and when using a ventilator, the effective cross-sectional area of the respiratory tract changes as the suction catheter is inserted and removed, so the ventilator However, in the tracheal tube according to the present invention, since the sputum suction port that is opened only inside the tracheal tube is provided integrally with the tracheal tube, The above problems do not occur.

Next, the tracheal tube according to the present invention will be described in detail as an example with reference to the drawings. However, the present invention is not limited to these examples.
Example 1
FIG. 1 shows an overall view of the product of the present invention, FIG. 2 shows a state where the product of the present invention is intubated and placed in the trachea from the tracheostomy opening, and FIG. 3 shows a sectional view of the vicinity of the suction port of the tracheal tube.
The tracheal tube (1) has a cuff (5) in the vicinity of the end (8) (hereinafter referred to as the tip) on the side to be inserted into the trachea, and a ventilator on the end opposite to the tip if necessary. JIS standard 15 mm male connector (9) is provided so that it can be connected. The 15 mm male connector (9) is exposed outside the body even during tracheal intubation. The lumen of the tracheal tube itself becomes the respiratory path (2). The cuff (5) is a balloon that blocks between the tracheal tube (1) and the tracheal mucosa (11), and a lumen (in FIGS. 1 and 2) provided in the tube wall that forms a respiratory path leading to the cuff (5). It is possible to inflate and deflate by taking air in and out through the tube (10) which is omitted) and the tube (10) connected thereto. By inflating the cuff (5), it is possible to prevent the air sent from the ventilator from leaking to the larynx side, or to some extent prevent saliva etc. flowing from the larynx side from entering the lung side. .
A sputum suction path (3) is installed in the tube wall forming the respiratory path of the tracheal tube (1) in parallel with the respiratory path. The soot suction path (3) is rectangular or semi-elliptical in cross section, and has a width of about 3 mm and a height of about 1 mm. A larger cross-sectional area of the sputum suction path (3) is more convenient for suction of sputum, but for that purpose, the tube wall must be thickened, and the breathing path (2) becomes narrower accordingly. However, the above-mentioned size is practical.
A tube (6) connected to the soot suction path extends from the base of the 15 mm male connector (9), and a connector (7 that can be connected to a suction pump or the like for sucking soot is attached to the end of this tube. ) Is provided.
As shown in FIG. 3, the sputum suction port (4) is open near the tip of the tracheal tube (1) toward the breathing path (2), and its diameter is the same as the width of the sputum suction path. Or it is an ellipse.
Example 2

10mm from the tracheal tube tip when the vaginal suction route passes to the tracheal tube tip for manufacturing reasons, such as when the tube part constituting the respiratory tract and sputum suction route of the tracheal tube is made by extrusion molding with vinyl chloride. Remove the partition that separates the breathing path and the sputum suction path over a range, and the sputum suction port is the same as the sputum suction path with a width of about 10 mm from the tip as shown in FIG. You may make it an opening part of a shape.
Example 3
The sputum suction path does not necessarily have to exist in the tube wall forming the respiratory path. The thing of the structure which adhere | attached the thin tube about 1-2 mm in internal diameter on the inner surface of the tube which forms a respiratory path may be used. The tip of this thin tube becomes the suction port for the sputum. In order to eliminate the risk of adsorbing the tracheal mucosa, the tip of this thin tube should be retracted about a few millimeters from the tip of the tracheal tube.

  INDUSTRIAL APPLICABILITY The present invention is used to perform suction removal of a tracheostomy of a patient who uses an endotracheal tube or a tracheostomy tube without causing pain to the patient and by a simpler method than the conventional method. By increasing safety, you can use it with peace of mind.

DESCRIPTION OF SYMBOLS 1 Tracheal tube 2 Breathing path 3 痰 suction path 4 Suction port 5 Cuff 6 痰 Suction tube 7 Suction pump connector 8 End of tracheal tube 9 15 mm male connector 10 Tube for inflating cuff 11 Tracheal mucosa 12 Tracheal incision 13 Skin surface

Claims (2)

A tracheal tube provided with a sputum suction path having a mouth for sucking sputum in the trachea, wherein the sputum suction path is provided in parallel to the axis of the tracheal tube, and the sputum suction opening opens only inside the tracheal tube. A tracheal tube characterized by The tracheal tube according to claim 1, wherein the sputum suction path is provided as a lumen in the tube wall of the tracheal tube.

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