JP2016137030A

JP2016137030A - Medical stopcock and injection method of impregnating agent

Info

Publication number: JP2016137030A
Application number: JP2015012909A
Authority: JP
Inventors: 貴幸宮崎; Takayuki Miyazaki
Original assignee: Koyo Sangyo Co Ltd
Current assignee: Koyo Sangyo Co Ltd
Priority date: 2015-01-27
Filing date: 2015-01-27
Publication date: 2016-08-04
Anticipated expiration: 2035-01-27
Also published as: JP6499457B2

Abstract

PROBLEM TO BE SOLVED: To provide a medical stopcock that is capable of efficiently performing air vent.SOLUTION: A medical stopcock comprises a three-way cock, and has a body 10 and a cock member 20 turnably stored in a storage space 11a of this body. The body has a first inlet port and a second inlet port 13a where an impregnating agent is made to flow from a syringe, respectively, and an outlet port ranging to the patient's side. The cock member has a main passage 22 and an air vent passage 23, and the second inlet port is cut off from the main passage and is ranged in the upstream end 23a of the air vent passage when the cock member is present in a first turning position. In this state, when the impregnating agent is pushed out from the syringe connected to the second inlet port 13a, the air vent of the second inlet port 13a can be performed. Next, the cock member 20 is set in a second turning position and the second inlet port 13a is ranged to the main passage 22. In this state, when the impregnating agent is pushed out from the syringe, the impregnating agent is configured to be injected into a patient via the second inlet port 13a, the main passage 22 and the outlet port.SELECTED DRAWING: Figure 4C

Description

本発明は、医療用活栓およびこの医療用活栓を用いた患者への注入剤の注入方法に関する。 The present invention relates to a medical stopcock and a method for injecting an injection into a patient using the medical stopcock.

血管造影のために、造影剤を患者の血管に注入することは周知である。特許文献１に開示された造影剤注入装置は、三方活栓を備えている。この三方活栓は、ボデイと、このボデイ内に２つの回動位置の間で回動可能に収容された栓部材とを備えている。このボデイは、流入ポートと流出ポートと検圧ポートとを有している。栓部材は主通路を有している。上記ボデイの流入ポートには造影剤を充填したシリンジが接続され、流出ポートには患者側注入ラインが接続され、検圧ポートには血圧モニタリングラインが接続されている。 It is well known to inject contrast agents into a patient's blood vessels for angiography. The contrast medium injection device disclosed in Patent Document 1 includes a three-way cock. The three-way cock includes a body and a plug member accommodated in the body so as to be rotatable between two rotational positions. This body has an inflow port, an outflow port, and a pressure detection port. The plug member has a main passage. A syringe filled with a contrast agent is connected to the inflow port of the body, a patient-side injection line is connected to the outflow port, and a blood pressure monitoring line is connected to the pressure detection port.

上記栓部材が１つの回動位置にある時、上記主通路を介して流入ポートと流出ポートが接続され、上記シリンジから患者へ造影剤が注入される。この回動位置では、検圧ポートが主通路を介して流出ポートに接続されており、血圧モニタリングラインで患者の血圧を検出することができる。なお、検圧ポートには弁が設けられている。この弁は、造影剤を注入中の高圧時には閉じ、注入が中断しているときには開いて血圧を検出できるようになっている。 When the plug member is in one rotational position, the inflow port and the outflow port are connected via the main passage, and the contrast medium is injected from the syringe into the patient. In this rotational position, the pressure detection port is connected to the outflow port via the main passage, and the blood pressure of the patient can be detected by the blood pressure monitoring line. A valve is provided in the pressure detection port. This valve is closed at high pressure during injection of the contrast agent, and opened when the injection is interrupted to detect blood pressure.

上記栓部材が他の回動位置にある時、上記流出ポートは上記流入ポートから遮断され、検圧ポートにのみ連なる。上記三方活栓がこの回動位置にある時、生理食塩水を患者に注入することができるようになっている。詳述すると、上記栓部材には補助通路が形成されている。この補助通路の一端は上記主通路に連なり、他端は栓部材の軸線方向の端面に開口している。この他端開口には弁が設けられている。この弁はシリンジのノズルを挿入した時に開き、ノズルを外した時に閉じるようになっている。 When the plug member is in another rotational position, the outflow port is blocked from the inflow port and is connected only to the pressure detection port. When the three-way stopcock is in this rotational position, physiological saline can be injected into the patient. More specifically, an auxiliary passage is formed in the plug member. One end of the auxiliary passage is connected to the main passage, and the other end is opened on the end face in the axial direction of the plug member. A valve is provided at the other end opening. This valve opens when the syringe nozzle is inserted, and closes when the nozzle is removed.

上記補助通路の他端開口およびこの他端開口に設けられた弁を上に向け、生理食塩水を充填したシリンジを垂直に立てて、そのノズルを上記弁に差し込む。これにより、弁が開いてシリンジが上記補助通路を介して主通路に連なる。この状態でシリンジを吸引操作すると、補助通路内のエアがシリンジ内の生理食塩水を通り、生理食塩水の上方に至る。このエア抜き後に、シリンジから生理食塩水を押し出すと、生理食塩水は補助通路、主通路、流出ポートおよび患者側注入ラインを経て患者に注入される。 The other end opening of the auxiliary passage and the valve provided at the other end opening are faced up, the syringe filled with physiological saline is set up vertically, and the nozzle is inserted into the valve. Thereby, the valve is opened and the syringe is connected to the main passage through the auxiliary passage. When the syringe is suctioned in this state, the air in the auxiliary passage passes through the physiological saline in the syringe and reaches above the physiological saline. When the physiological saline is pushed out from the syringe after the air is released, the physiological saline is injected into the patient through the auxiliary passage, the main passage, the outflow port, and the patient side injection line.

特許文献２に開示された造影剤注入装置に用いられる三方活栓は特許文献１と同様に、ボデイと、このボデイ内に２つの回動位置の間で回動可能に収容された栓部材とを有している。ボデイは３つのポート、すなわちシリンジに接続される流入ポートと、造影剤供給ラインに接続される供給ポートと、患者側注入ラインに接続される流出ポートを有している。 The three-way cock used in the contrast medium injecting device disclosed in Patent Document 2 includes a body and a plug member accommodated in the body so as to be rotatable between two rotational positions, as in Patent Document 1. Have. The body has three ports: an inflow port connected to the syringe, a supply port connected to the contrast agent supply line, and an outflow port connected to the patient side injection line.

上記栓部材が１つの回動位置にある時、流入ポートが主通路を介して流出ポートに連なり、供給ポートは主通路と遮断される。この状態で、シリンジに充填された造影剤を患者に注入することができる。
栓部材が他の回動位置にある時、流入ポートが主通路を介して供給ポートに連なり、流出ポートは主通路と遮断される。この状態でシリンジを吸引操作することにより、造影剤供給ラインからの造影剤を供給ポート、主通路、流入ポートを経てシリンジに補充することができる。 When the plug member is in one rotational position, the inflow port is connected to the outflow port via the main passage, and the supply port is blocked from the main passage. In this state, the contrast medium filled in the syringe can be injected into the patient.
When the plug member is in another rotational position, the inflow port is connected to the supply port via the main passage, and the outflow port is blocked from the main passage. By aspirating the syringe in this state, the contrast agent from the contrast agent supply line can be replenished to the syringe through the supply port, the main passage, and the inflow port.

上記特許文献２の三方活栓はさらに、栓部材に形成された補助通路を有している。この補助通路の一端は栓部材の周面において主通路の開口端から離れた位置に開口しており、他端は栓部材の回転軸線方向の端面に開口している。この補助通路の他端には、血圧モニタリングラインが接続されている。 The three-way cock of Patent Document 2 further has an auxiliary passage formed in the stopper member. One end of the auxiliary passage opens at a position away from the opening end of the main passage on the peripheral surface of the plug member, and the other end opens on an end surface in the rotation axis direction of the plug member. A blood pressure monitoring line is connected to the other end of the auxiliary passage.

上記栓部材が最初に述べた回動位置にありシリンジから患者に造影剤が注入されている時には、上記補助通路の一端は供給ポートに連なっているため血圧モニタリングラインは血圧を検出しない。上記栓部材が他の回動位置にありシリンジへの造影剤の補充がなされている時には、上記補助通路の一端が流出ポートに連なり、その結果、血圧モニタリングラインが補助通路、流出ポートを介して患者側注入ラインに連なり、患者の血圧を検出することができる。 When the plug member is in the first described rotational position and the contrast medium is being injected from the syringe into the patient, the blood pressure monitoring line does not detect blood pressure because one end of the auxiliary passage is connected to the supply port. When the stopper member is in another rotational position and the contrast medium is replenished to the syringe, one end of the auxiliary passage is connected to the outflow port, and as a result, the blood pressure monitoring line passes through the auxiliary passage and the outflow port. The patient's blood pressure can be detected by connecting to the patient side infusion line.

特開平７−１００２１２号公報Japanese Patent Laid-Open No. 7-100212 特開平９−２３９０２８号公報Japanese Patent Laid-Open No. 9-239028

特許文献１の三方活栓では、生理食塩水の注入に先立ち、生理食塩水を充填したシリンジを垂直にして吸引動作することによりエア抜きを行う。このエア抜き作業は煩雑であるとともに長い時間を必要とする。 In the three-way cock of Patent Document 1, prior to the injection of physiological saline, air is ventilated by performing a suction operation with a syringe filled with physiological saline being vertical. This air bleeding operation is complicated and requires a long time.

特許文献２の三方活栓は本発明の医療用活栓と似た通路構成を有するが、生理食塩水等の注入、それに先立つエア抜きについては開示していない。特許文献２の三方活栓の補助通路はエア抜きとして用いられず、栓部材の２つの回動位置のいずれにおいても、シリンジからの注入剤が流入する流入ポートに、補助通路が連なることはない。 The three-way cock of Patent Document 2 has a passage configuration similar to that of the medical cock of the present invention, but does not disclose injection of physiological saline or the like and venting prior to that. The auxiliary passage of the three-way cock of Patent Document 2 is not used as an air vent, and the auxiliary passage does not continue to the inflow port into which the injection from the syringe flows in any of the two rotation positions of the plug member.

本発明は上記課題を解決するためになされたものであり、
収容空間と、シリンジからの注入剤が流入される１つまたは複数の流入ポートと、患者側に連なる流出ポートを有するボデイと、
主通路を有し、上記ボデイの収容空間内に第１回動位置と第２回動位置との間で回動可能に収容される栓部材と、
を備えた医療用活栓において、
上記栓部材はさらにエア抜き通路を有し、このエア抜き通路の上流端は、上記栓部材の周面において上記主通路の開口端から周方向に離れた位置で開口し、その下流端は外部に連なり、
上記１つの流入ポートまたは上記複数の流入ポートのうちの１つは、上記栓部材が第１回動位置にある時に、上記主通路と遮断されて上記エア抜き通路の上流端に連なり、上記栓部材が第２回動位置にある時に、上記主通路を介して上記流出ポートに連なることを特徴とする。 The present invention has been made to solve the above problems,
A body having an accommodation space, one or more inflow ports into which the infusate from the syringe flows, and an outflow port connected to the patient side;
A plug member that has a main passage and is rotatably accommodated between the first rotation position and the second rotation position in the housing space of the body;
In the medical stopcock with
The plug member further has an air vent passage, and an upstream end of the air vent passage opens at a position away from the opening end of the main passage in the circumferential direction on the peripheral surface of the plug member, and a downstream end thereof is an external portion. Connected to
The one inflow port or one of the plurality of inflow ports is disconnected from the main passage and connected to the upstream end of the air vent passage when the plug member is in the first rotation position, When the member is in the second rotation position, it is connected to the outflow port through the main passage.

上記構成によれば、栓部材が第１回動位置にある時に、シリンジから注入剤を流入ポートエア抜き通路を経て漏出させることにより、流入ポートのエアも排出し、この後で、栓部材を第２回動位置に切り替えてシリンジからの注入剤を流入ポート、主通路、流出ポートを経て患者へ注入することができる。このように、エア抜き作業においてシリンジの吸引動作を必要とせずシリンジの姿勢に制約が無いため、エア抜き作業を短時間で効率良く行うことができる。 According to the above configuration, when the plug member is in the first rotation position, the infusate is leaked from the syringe through the inflow port air vent passage, whereby the air in the inflow port is also discharged. The injection from the syringe can be injected into the patient via the inflow port, the main passage, and the outflow port by switching to the two rotation positions. Thus, since the suction operation of the syringe is not required in the air bleeding operation and there is no restriction on the posture of the syringe, the air bleeding operation can be performed efficiently in a short time.

好ましくは、上記医療用活栓が三方活栓であり、上記複数の流入ポートが、第１、第２の流入ポートからなり、上記主通路が上記栓部材の周面において周方向に離れて配置された３つの開口端を有し、上記栓部材が第１回動位置にある時、上記第１流入ポートが上記主通路を介して上記流出ポートに連なり、上記第２流入ポートが上記主通路と遮断されて上記エア抜き通路の上流端に連なり、上記栓部材が第２回動位置にある時、上記第２流入ポートが上記主通路を介して上記流出ポートに連なり、上記第１流入ポートが上記主通路と遮断されて上記エア抜き通路の上流端に連なる。
この構成により、三方活栓において、エア抜き通路を用いて第１、第２の２つのポートでのエア抜きを行うことができる、 Preferably, the medical stopcock is a three-way stopcock, the plurality of inflow ports are composed of first and second inflow ports, and the main passage is disposed in a circumferential direction on the peripheral surface of the plug member. When the plug member is in the first rotation position, the first inflow port is connected to the outflow port through the main passage, and the second inflow port is disconnected from the main passage. When the plug member is in the second rotational position, the second inflow port is connected to the outflow port through the main passage, and the first inflow port is connected to the upstream end of the air vent passage. It is cut off from the main passage and continues to the upstream end of the air vent passage.
With this configuration, in the three-way stopcock, air can be vented at the first and second two ports using the air vent passage.

本発明は、上記医療用活栓が二方活栓の場合にも適用できる。この場合、上記ボデイが上記１つの流入ポートを有し、上記主通路が上記栓部材の周面において周方向に離れて配置された２つの開口端を有し、上記栓部材が第１回動位置にある時、上記流入ポートが上記主通路と遮断されて上記エア抜き通路の上流端に連なり、上記栓部材が第２回動位置にある時、上記流入ポートが上記主通路を介して上記流出ポートに連なり、上記エア抜き通路の上流端が上記ボデイの収容空間の内周面によって塞がれる。 The present invention is also applicable when the medical stopcock is a two-way stopcock. In this case, the body has the one inflow port, the main passage has two open ends that are spaced apart in the circumferential direction on the peripheral surface of the plug member, and the plug member rotates in the first direction. When in the position, the inflow port is disconnected from the main passage and is connected to the upstream end of the air vent passage. When the plug member is in the second rotation position, the inflow port is connected to the main passage through the main passage. Continuing to the outflow port, the upstream end of the air vent passage is blocked by the inner peripheral surface of the housing space of the body.

好ましくは、さらに、上記エア抜き通路の下流端を覆うエア逆流防止構造を備え、このエア逆流防止構造は、上記エア抜き通路から外部へのエアの排出を許容し、外部からエア抜き通路へのエアの逆流を防止する。 Preferably, an air backflow prevention structure is provided that covers the downstream end of the air vent passage, and the air backflow prevention structure allows discharge of air from the air vent passage to the outside, and from the outside to the air vent passage. Prevent backflow of air.

上記三方活栓を用いて患者に注入剤を注入する方法において、
上記活栓の第１流入ポートに直接または間接的に第１シリンジを接続し、上記流出ポートを患者側注入ラインを介して患者に接続し、上記栓部材を上記第１回動位置に位置させた状態で、上記第１シリンジに充填された注入剤を、上記第１流入ポート、上記主通路、上記流出ポート、上記患者側注入ラインを経て患者に注入する第１注入工程と、
上記栓部材を上記第１回動位置に位置させ、上記第２流入ポートに第２シリンジを直接または間接的に接続した状態で、この第２シリンジに充填された注入剤を押し出すことにより、この注入剤を第２流入ポートおよび上記エア抜き通路を介して漏出させ、これと同時に上記第２流入ポート内のエアを排出するエア抜き工程と、
上記エア抜き工程の後で、上記栓部材を上記第２回動位置まで回動させ、上記第２シリンジに充填された注入剤を、上記第２流入ポート、上記主通路、上記流出ポート、上記患者側注入ラインを経て患者に注入する第２注入工程と、
を備えたことを特徴とする。 In the method of injecting an infusion to a patient using the three-way stopcock,
The first syringe is connected directly or indirectly to the first inflow port of the stopcock, the outflow port is connected to the patient via the patient side injection line, and the plug member is positioned at the first rotation position. A first injection step of injecting the filling agent filled in the first syringe into the patient through the first inflow port, the main passage, the outflow port, and the patient side injection line;
The plug member is positioned at the first rotation position, and the second syringe is directly or indirectly connected to the second inflow port to push out the injection filled in the second syringe. An air venting process for allowing the infusate to leak through the second inflow port and the air vent passage, and simultaneously discharging the air in the second inflow port;
After the air venting step, the plug member is rotated to the second rotation position, and the injection filled in the second syringe is transferred to the second inflow port, the main passage, the outflow port, the A second injection step of injecting into the patient via the patient side injection line;
It is provided with.

上記方法において、次の工程を追加することもできる。
上記栓部材が第２回動位置にある状態で、上記第１シリンジを上記第１流入ポートから取り外し、注入剤を再充填した上記第１シリンジまたは注入剤を充填した他のシリンジを、上記第１流入ポートに接続する再接続工程と、
上記再接続工程の後で、上記栓部材を第２回動位置に維持したまま、上記第１シリンジまたは他のシリンジから注入剤を押し出し、この注入剤を第１流入ポートおよび上記エア抜き通路を介して漏出させ、これと同時に上記第１流入ポート内のエアを排出するエア抜き工程と、
上記エア抜き工程の後で、上記栓部材を上記第１回動位置まで回動させ、上記第1シリンジまたは他のシリンジに充填された注入剤を、上記第１流入ポート、上記主通路、上記流出ポート、上記患者側注入ラインを経て患者に注入する第３注入工程。 In the above method, the following steps may be added.
With the plug member in the second rotation position, the first syringe is removed from the first inflow port, and the first syringe refilled with the infusate or another syringe filled with the infusate is replaced with the first syringe. 1 reconnection process to connect to the inflow port;
After the reconnecting step, the injection member is pushed out from the first syringe or another syringe while the stopper member is maintained at the second rotation position, and the injection agent is passed through the first inflow port and the air vent passage. And an air venting process for discharging air in the first inflow port at the same time,
After the air venting step, the plug member is rotated to the first rotation position, and an injection filled in the first syringe or another syringe is supplied to the first inflow port, the main passage, the A third injection step for injecting the patient through the outflow port, the patient side injection line;

上記二方活栓を用いて患者に注入剤を注入する方法において、
上記流入ポートに直接または間接的にシリンジを接続し、上記流出ポートを患者側注入ラインを介して患者側に接続し、上記栓部材を上記第２回動位置にした状態で、上記シリンジに充填された注入剤を上記流入ポート、上記主通路、上記流出ポート、上記患者側注入ラインを経て患者に注入する第１注入工程と、
上記栓部材を上記第１回動位置まで回動することにより、上記流入ポートと上記主通路を遮断した後で、上記流入ポートからシリンジを取り外し、上記流入ポートに、注入剤を再充填した上記シリンジまたは注入剤を充填した他のシリンジを接続する再接続工程と、
上記再接続工程の後で、上記シリンジから注入剤を押し出すことにより、注入剤を上記流入ポートおよび上記エア抜き通路を介して漏出させ、これと同時に上記流入ポート内のエアを排出するエア抜き工程と、
上記エア抜き工程の後で、上記栓部材を上記第２回動位置まで回動させ、上記シリンジから注入剤を、上記流入ポート、上記主通路、上記流出ポート、上記患者側注入ラインを経て患者に注入する第２注入工程と、
を備えたことを特徴とする。 In the method of injecting an injectant into a patient using the two-way stopcock,
Connect the syringe directly or indirectly to the inflow port, connect the outflow port to the patient side via the patient side injection line, and fill the syringe with the plug member in the second rotational position A first injection step of injecting the injected infusate into the patient via the inflow port, the main passage, the outflow port, and the patient side injection line;
By rotating the plug member to the first rotation position, the syringe is removed from the inflow port after the inflow port and the main passage are blocked, and the infusion port is refilled with the injection agent. A reconnection step of connecting a syringe or other syringe filled with infusate;
After the reconnecting step, by extruding the infusate from the syringe, the infusate leaks through the inflow port and the air vent passage, and at the same time, the air venting step of discharging the air in the inflow port When,
After the air venting step, the stopper member is rotated to the second rotation position, and the injection agent is injected from the syringe through the inflow port, the main passage, the outflow port, and the patient side injection line. A second injection step of injecting into
It is provided with.

本発明によれば、医療用活栓においてエア抜き作業を効率良く行うことができる。 According to the present invention, the air venting operation can be efficiently performed in the medical stopcock.

本発明の第１実施形態に係る三方活栓を備えた造影剤注入装置の平面図であり、造影剤シリンジにより造影剤を患者に注入している状態を示す。It is a top view of the contrast agent injection device provided with the three-way cock according to the first embodiment of the present invention, and shows a state in which a contrast agent is injected into a patient by a contrast agent syringe. 上記造影剤注入装置の平面図であり、生理食塩水シリンジを接続してエア抜きを行っている状態を示す。It is a top view of the said contrast agent injection | pouring apparatus, and shows the state which has connected the physiological saline syringe and is bleeding. 上記造影剤注入装置の平面図であり、生理食塩水シリンジにより生理食塩水を患者に注入している状態を示す。It is a top view of the above-mentioned contrast agent injection device, and shows the state where physiological saline is injecting into a patient with a physiological saline syringe. 図２の状態での上記三方活栓を示す拡大平面図である。It is an enlarged plan view which shows the said three-way cock in the state of FIG. 図４ＡにおけるＢ−Ｂ矢視断面図である。It is BB arrow sectional drawing in FIG. 4A. 図４ＡにおけるＣ−Ｃ矢視断面図である。It is CC sectional view taken on the line in FIG. 4A. 上記三方活栓の栓部材を示す拡大斜視図である。It is an expansion perspective view which shows the plug member of the said three-way cock. 上記三方活栓のボデイに形成された３つのポートと上記栓部材の通路を概略的に示す斜視図である。It is a perspective view which shows roughly the three ports formed in the body of the said three-way cock, and the channel | path of the said plug member. 図３の状態での上記三方活栓を示す平面図である。It is a top view which shows the said three-way cock in the state of FIG. 図７（Ａ）の三方活栓の平断面図である。It is a plane sectional view of the three-way cock of FIG. 7 (A). 図７ＡにおけるＣ−Ｃ矢視断面図である。It is CC sectional view taken on the line in FIG. 7A. 上記三方活栓の異なる使用例を説明する平面図である。It is a top view explaining the usage example from which the said three-way stopcock differs. 図８Ａの三方活栓の平断面図である。It is a plane sectional view of the three-way cock of FIG. 8A. 本発明の第２実施形態に係る逆止弁構造付き三方活栓の断面図である。It is sectional drawing of the three-way cock with a non-return valve structure concerning 2nd Embodiment of this invention. 本発明の第３実施形態に係る逆流防止構造付き三方活栓の断面図である。It is sectional drawing of the three-way cock with a backflow prevention structure which concerns on 3rd Embodiment of this invention. 本発明の第４実施形態に係る逆流防止構造付き三方活栓の断面図である。It is sectional drawing of the three-way cock with a backflow prevention structure which concerns on 4th Embodiment of this invention. 本発明の第５実施形態に係る逆流防止構造付き三方活栓の要部断面図であり、エア抜き通路を閉じた状態で示す。It is principal part sectional drawing of the three-way cock with a backflow prevention structure which concerns on 5th Embodiment of this invention, and shows it in the state which closed the air vent path. 上記第５実施形態に係る三方活栓の要部断面図であり、エア抜き通路を開いた状態で示す。It is principal part sectional drawing of the three-way cock concerning the said 5th Embodiment, and shows it in the state which opened the air vent passage. 本発明の第６実施形態に係る逆流防止構造付き三方活栓の要部断面図であり、エア抜き通路を閉じた状態で示す。It is principal part sectional drawing of the three-way cock with a backflow prevention structure which concerns on 6th Embodiment of this invention, and shows it in the state which closed the air vent path. 上記第６実施形態に係る三方活栓の要部断面図であり、エア抜き通路を開いた状態で示す。It is principal part sectional drawing of the three-way cock concerning the said 6th Embodiment, and shows it in the state which opened the air vent passage. 図１３ＡにおいてＣ方向から見た拡大底面図である。It is the expanded bottom view seen from the C direction in FIG. 13A. 本発明の第７実施形態に係る二方活栓の平面図であり、造影剤シリンジにより造影剤を患者に注入している状態を示す。It is a top view of the two-way stopcock which concerns on 7th Embodiment of this invention, and shows the state which has inject | poured the contrast agent to the patient with the contrast agent syringe. 図１４Ａの二方活栓の平断面図である。It is a plane sectional view of the two-way cock of FIG. 14A. 上記二方活栓の平面図であり、造影剤シリンジを再接続してエア抜きを行っている状態を示す。It is a top view of the said two-way stopcock, and shows the state which is reconnecting a contrast medium syringe and performing air bleeding. 図１５ＡにおけるＢ−Ｂ線矢視断面図である。It is a BB arrow directional cross-sectional view in FIG. 15A.

以下、本発明の第１実施形態を、図１〜図７Ｃを参照しながら説明する。図１〜図３に示すように、造影剤注入装置は、三方活栓１（医療用活栓）と、第１シリンジ２と、患者側注入ライン３とを備え、さらに必要に応じて追加される第２シリンジ４とを備えている。第１シリンジ２には造影剤（注入剤）が充填されている。第２シリンジ４には生理食塩水（注入剤）が充填されている。患者側注入ライン３は、例えばエクステンションチューブ３ａと針３ｂを有している。 Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. 1 to 7C. As shown in FIGS. 1 to 3, the contrast medium injector includes a three-way stopcock 1 (medical stopcock), a first syringe 2, and a patient-side injection line 3, and is added as necessary. 2 syringes 4. The first syringe 2 is filled with a contrast agent (injection agent). The second syringe 4 is filled with physiological saline (injection agent). The patient side injection line 3 includes, for example, an extension tube 3a and a needle 3b.

図４Ａ〜図４Ｃに示すように、上記三方活栓１は、ボデイ１０と、栓部材２０とを備えている。
ボデイ１０は樹脂製であり、主筒部１１と、この主筒部１１から直交する方向に突出する第１流入側筒部１２（第1シリンジ接続筒部）、第２流入側筒部１３（第２シリンジ接続筒部）および流出側筒部１４とを一体に有している。これら筒部１２〜１４の軸線は主筒部１１の軸線と直交する平面上にあり、第２流入側筒部１３は第１流入側筒部１２と直交し、流出側筒部１４は第１流入側筒部１２と一直線上に配置されている。 As shown in FIGS. 4A to 4C, the three-way cock 1 includes a body 10 and a plug member 20.
The body 10 is made of resin, and includes a main cylinder part 11, a first inflow side cylinder part 12 (first syringe connection cylinder part) and a second inflow side cylinder part 13 (projected in a direction orthogonal to the main cylinder part 11). The second syringe connecting cylinder part) and the outflow side cylinder part 14 are integrally provided. The axis of these cylinder parts 12-14 is on a plane orthogonal to the axis of the main cylinder part 11, the second inflow side cylinder part 13 is orthogonal to the first inflow side cylinder part 12, and the outflow side cylinder part 14 is the first. It is arranged in line with the inflow side cylinder portion 12.

上記主筒部１１は、主筒部１１を軸線方向に貫通する収容空間１１ａを有している。上記第１流入側筒部１２はその軸線方向に延びる第１流入ポート１２ａ（第１シリンジ接続ポート）を有し、同様にして第２流入側筒部１３は第２流入ポート１３ａ（第２シリンジ接続ポート）を有し、流出側筒部１４は流出ポート１４ａを有している。 The main cylinder part 11 has an accommodation space 11a that penetrates the main cylinder part 11 in the axial direction. The first inflow side cylinder part 12 has a first inflow port 12a (first syringe connection port) extending in the axial direction, and the second inflow side cylinder part 13 similarly has a second inflow port 13a (second syringe). And the outflow side cylinder portion 14 has an outflow port 14a.

上記第１流入側筒部１２に第１シリンジ２が着脱可能に接続され、上記第２流入側筒部１３に第２シリンジ４が着脱可能に接続されるようになっている。 The first syringe 2 is detachably connected to the first inflow side cylinder 12, and the second syringe 4 is detachably connected to the second inflow side cylinder 13.

上記流出側筒部１４の先端部には、接続部１９が一体に設けられている。この接続部１９には雌ねじ１９ａが形成されており、この雌ねじ１９ａに，エクステンションチューブ３ａの基端の雄ねじ（図示しない）が螺合されるようになっている。なお、上記接続部１９の代わりに、流出側筒部１４の外周に回転可能に取り付けられたアダプタを用いてもよい、このアダプタは雌ねじを有し、この雌ねじにエクステンションチューブ３ａの基端の雄ねじが螺合された状態で、アダプタを回して締め付けることにより、エクステンションチューブ３ａが流出側筒部１４に接続される。 A connecting portion 19 is integrally provided at the distal end portion of the outflow side cylindrical portion 14. A female screw 19a is formed in the connecting portion 19, and a male screw (not shown) at the base end of the extension tube 3a is screwed into the female screw 19a. Instead of the connecting portion 19, an adapter that is rotatably attached to the outer periphery of the outflow side cylinder portion 14 may be used. This adapter has a female screw, and this female screw has a male screw at the base end of the extension tube 3a. When the adapter is screwed, the extension tube 3a is connected to the outflow side cylindrical portion 14 by turning and tightening the adapter.

上記栓部材２０は樹脂製であり、図４、図５に示すように、上記ボデイ１０の収容空間１１ａに回動可能に収容される挿入部２１と、この挿入部２１の一端に形成された操作部２５とを一体に有している。挿入部２１は、その回動軸線と直交する平面上に主通路２２を有している。 The plug member 20 is made of resin. As shown in FIGS. 4 and 5, the plug member 20 is formed at an insertion portion 21 rotatably accommodated in the accommodation space 11 a of the body 10 and at one end of the insertion portion 21. The operation unit 25 is integrally provided. The insertion portion 21 has a main passage 22 on a plane orthogonal to the rotation axis.

上記主通路２２は、挿入部２１を径方向に貫通する直線状の第１通路部分と、第１通路部分の中央から直角をなして延びる直線状の第２通路部分とを有してＴ字形をなしている。主通路２２は、この第１通路部分の両端に位置して挿入部２１の周面に開口する開口端２２ａ、２２ｂを有するとともに、上記第２通路部分の端に位置して挿入部２１の周面に開口する開口端２２ｃを有している。開口端２２ｃは開口端２２ａ，２２ｂに対して周方向に９０°離れている。 The main passage 22 has a straight first passage portion that penetrates the insertion portion 21 in the radial direction and a straight second passage portion that extends at a right angle from the center of the first passage portion, and is T-shaped. I am doing. The main passage 22 has opening ends 22a and 22b that are located at both ends of the first passage portion and open to the circumferential surface of the insertion portion 21, and is located at the end of the second passage portion and is surrounded by the periphery of the insertion portion 21. It has an open end 22c that opens to the surface. The opening end 22c is separated from the opening ends 22a and 22b by 90 ° in the circumferential direction.

図４、図５に示すように、上記挿入部２１はさらに、エア抜き通路２３を有している。このエア抜き通路２３の上流端２３ａは挿入部２１の周面に開口し、下流端２３ｂは、挿入部２１の回動軸線方向の端面（操作部２５の反対側の端面）に開口している。エア抜き通路２３の上流端２３ａは、主通路２２の開口端２２ａ，２２ｂから周方向に９０°離れ、開口端２２ｃから１８０°離れている。なお、エア抜き通路２３は主通路２２より小径で流通断面積が小さい。 As shown in FIGS. 4 and 5, the insertion portion 21 further has an air vent passage 23. The upstream end 23a of the air vent passage 23 opens to the circumferential surface of the insertion portion 21, and the downstream end 23b opens to the end surface in the rotational axis direction of the insertion portion 21 (the end surface opposite to the operation portion 25). . The upstream end 23a of the air vent passage 23 is 90 ° away from the opening ends 22a and 22b of the main passage 22 in the circumferential direction and 180 ° away from the opening end 22c. The air vent passage 23 has a smaller diameter and a smaller cross-sectional area than the main passage 22.

上記操作部２５は、レバー２５ａを有している。図５に示すように、このレバー２５ａの角度位置（周方向の位置）は、上記エア抜き通路２３の上流端２３ａと一致している。これにより、エア抜き通路２３の角度位置を確認することができる。操作部２５はさらに突起および矢印からなる３つの位置確認部２５ｂを９０°間隔で有している。この位置確認部２５ｂの角度位置は、上記主通路２２の開口端２２ａ〜２２ｃに一致している。 The operation unit 25 has a lever 25a. As shown in FIG. 5, the angular position (circumferential position) of the lever 25 a coincides with the upstream end 23 a of the air vent passage 23. Thereby, the angular position of the air bleeding passage 23 can be confirmed. The operation unit 25 further includes three position confirmation units 25b made of protrusions and arrows at 90 ° intervals. The angular position of the position confirmation portion 25b coincides with the opening ends 22a to 22c of the main passage 22.

上記構成をなす造影剤注入装置の基本的な作用について説明する。図１、図４Ａ〜４Ｃ、図６に示すように、三方活栓１において栓部材２０の回動位置を、レバー２５ａが第２流入側筒部１３に一致する位置（第１回動位置）にする。これにより、栓部材２０の主通路２２の開口端２２ａが第１流入ポート１２ａに連なり、開口端２２ｂが流出ポート１４ａに連なる。 The basic operation of the contrast medium injecting apparatus having the above configuration will be described. As shown in FIGS. 1, 4 </ b> A to 4 </ b> C, and FIG. 6, in the three-way cock 1, the turning position of the plug member 20 is set to the position where the lever 25 a coincides with the second inflow side cylinder portion 13 To do. Thereby, the open end 22a of the main passage 22 of the plug member 20 is connected to the first inflow port 12a, and the open end 22b is connected to the outflow port 14a.

造影剤を充填した第１シリンジ２を第１流入側筒部１２に接続し、第１シリンジ２から造影剤を押し出す。すると造影剤は、図１、図４Ｂに矢印Ｄ１で示すように第１流入ポート１２ａ，主通路２２、流出ポート１４ａを通り、さらに患者側注入ライン３を通り針３ｂから漏れ出る。これにより、造影剤の注入経路からエアを抜くことができる。その後で、針３ｂを患者の血管に刺し、第１シリンジ２から患者の血管に造影剤を注入する。 The first syringe 2 filled with the contrast agent is connected to the first inflow side cylinder 12 and the contrast agent is pushed out from the first syringe 2. Then, the contrast agent leaks from the needle 3b through the first inflow port 12a, the main passage 22, and the outflow port 14a as shown by an arrow D1 in FIGS. 1 and 4B, and further through the patient side injection line 3. Thereby, air can be extracted from the contrast agent injection path. Thereafter, the needle 3b is inserted into the patient's blood vessel, and the contrast medium is injected from the first syringe 2 into the patient's blood vessel.

図４Ｃ、図６に示すように、上記造影剤の注入工程において、第２流入ポート１３ａは主通路２２から遮断され、エア抜き通路２３の上流端２３ａに連通している。 As shown in FIGS. 4C and 6, in the contrast agent injection step, the second inflow port 13 a is blocked from the main passage 22 and communicates with the upstream end 23 a of the air vent passage 23.

上記造影剤注入工程の途中に、生理食塩水の注入が求められることがある。その場合には、三方活栓１の栓部材２０の回動位置を図４Ａ〜図４Ｃ、図６に示す位置に維持した状態で、図２に示すように、第２流入側筒部１３に第２シリンジ４を接続し、第２シリンジ４から生理食塩水を押し出す。すると生理食塩水は、図４Ｃに矢印Ｄ２で示すように、第２流入ポート１３ａを通り、エア抜き通路２３を通って外部に漏れる。これにより、第２流入ポート１３ａのエア抜きがなされる。 Saline injection may be required during the contrast agent injection step. In that case, the second inflow side cylinder portion 13 is moved to the second inflow side cylinder portion 13 as shown in FIG. 2 in a state where the pivot position of the plug member 20 of the three-way stopcock 1 is maintained at the position shown in FIGS. Two syringes 4 are connected, and physiological saline is pushed out from the second syringe 4. Then, as shown by the arrow D2 in FIG. 4C, the physiological saline passes through the second inflow port 13a and leaks to the outside through the air vent passage 23. Thereby, the air removal of the 2nd inflow port 13a is made.

上記エア抜き後に、図３、図７Ａ〜図７Ｃに示すように、栓部材２０を９０°回し、栓部材２０を、レバー２５ａが第１流入側筒部１２に一致する位置（第２回動位置）にする。すると、栓部材２０の主通路２２の開口端２２ｂが第２流入ポート１３ａに連なり、開口端２２ｃが流出ポート１４ａに連なる。この状態で第２シリンジ４から生理食塩水を押し出すと、図３、図７Ｂに矢印Ｄ３で示すように、生理食塩水は第２流入ポート１３ａ、主通路２２、流出ポート１４ａを通り、さらに患者側注入ライン３を通って患者に注入される。 3 and FIG. 7A to FIG. 7C, the plug member 20 is rotated by 90 degrees, and the plug member 20 is moved to the position where the lever 25a coincides with the first inflow side cylinder portion 12 (second rotation). Position). Then, the open end 22b of the main passage 22 of the plug member 20 is connected to the second inflow port 13a, and the open end 22c is connected to the outflow port 14a. When the physiological saline is pushed out from the second syringe 4 in this state, the physiological saline passes through the second inflow port 13a, the main passage 22, and the outflow port 14a as shown by an arrow D3 in FIGS. The patient is injected through the side injection line 3.

上記生理食塩水の注入工程において、第１流入ポート１２Ａは主通路２２から遮断され、エア抜き通路２３の上流端２３ａに連なっている。そのため、造影剤が充填された第１シリンジ２および第１流入ポート１２ａはエア抜き通路２３を介して外部に連なっている。しかし、エア抜き通路２３は小径であるので、比較的粘性抵抗の高い造影剤は外部に漏れ出るのを抑制できる。 In the physiological saline injection step, the first inflow port 12A is blocked from the main passage 22 and continues to the upstream end 23a of the air vent passage 23. Therefore, the first syringe 2 filled with the contrast agent and the first inflow port 12 a are connected to the outside through the air vent passage 23. However, since the air vent passage 23 has a small diameter, the contrast agent having a relatively high viscosity resistance can be prevented from leaking outside.

上記生理食塩水を所望量注入した後、造影剤の注入を再開することができる。
生理食塩水の注入工程の際に外気がエア通路２３から第１流入ポート１２に入り込む可能性がある場合には、生理食塩水の注入工程が終了した後、造影剤の注入再開に先立って、エア抜きを行う。すなわち、栓部材２０の角度位置を生理食塩水注入工程のまま変えずに（図７Ａ〜図７Ｃの位置）、第１シリンジ２を操作して造影剤を押し出す。すると、造影剤は図７Ｃの矢印Ｄ４で示すように、第１流入ポート１２ａ、エア抜き通路２３を経て外部に漏れ出る。これにより、第１流入ポート１２ａのエア抜きを行うことができる。 After injecting a desired amount of the physiological saline, the injection of the contrast medium can be resumed.
When there is a possibility that outside air may enter the first inflow port 12 from the air passage 23 during the physiological saline injection process, after the physiological saline injection process is completed, prior to the resumption of contrast medium injection, Remove air. That is, the contrast agent is pushed out by operating the first syringe 2 without changing the angular position of the plug member 20 as it is in the physiological saline injection process (the positions in FIGS. 7A to 7C). Then, the contrast agent leaks to the outside through the first inflow port 12a and the air vent passage 23 as shown by an arrow D4 in FIG. 7C. Thereby, the 1st inflow port 12a can be air-bleeded.

上記エア抜きの後で、栓部材２０を９０°回してレバー２５ａの角度位置を第２流入筒部１３ａに一致させ（図４Ａ〜図４Ｃの位置）、第１シリンジ２から造影剤を押し出して、患者に注入する。 After the air bleed, the plug member 20 is turned 90 ° so that the angular position of the lever 25a coincides with the second inflow cylinder 13a (the position shown in FIGS. 4A to 4C), and the contrast medium is pushed out from the first syringe 2. Inject into the patient.

第１シリンジ２、第２シリンジ４を接続したままで造影剤の注入と生理食塩水の注入を交互に繰り返し行うことができる。この注入切り替えの度に、上述と同様にしてエア抜きを行なうのが好ましい。 While the first syringe 2 and the second syringe 4 are connected, the contrast medium and the physiological saline can be alternately and repeatedly injected. It is preferable to vent the air in the same manner as described above each time this injection is switched.

第１シリンジ２の造影剤の充填量が必要量に満たない場合には、栓部材２０を図７Ａ〜図７Ｃに示す回動位置にし、第１シリンジ２を第１流入ポート１２ａから外し、図示しない造影剤パックから第１シリンジ２へ造影剤を再充填する。
次に、第１シリンジ２を第１流入ポート１２ａに再接続し、上述と同様にして第１流入ポート１２ａのエア抜きを行った後で、栓部材２０を回動させて図４Ａ〜図４Ｃの位置に戻し、造影剤の再注入を行う。
なお、第１シリンジ２を再接続する代わりに、造影剤を充填した他の新しいシリンジを第１流入ポート１２ａに再接続してもよい。 When the filling amount of the contrast medium in the first syringe 2 is less than the required amount, the plug member 20 is set to the rotational position shown in FIGS. 7A to 7C, and the first syringe 2 is removed from the first inflow port 12a. The first syringe 2 is refilled with the contrast agent from the contrast agent pack that is not.
Next, after reconnecting the 1st syringe 2 to the 1st inflow port 12a and performing air bleeding of the 1st inflow port 12a like the above-mentioned, the plug member 20 is rotated and FIGS. 4A-4C Return to the position and re-inject the contrast medium.
Instead of reconnecting the first syringe 2, another new syringe filled with a contrast agent may be reconnected to the first inflow port 12a.

上記造影剤、生理食塩水の注入工程の間、または注入工程が終了した後で、たとえば患者の病状に対応した薬剤を充填した他のシリンジを第１、第２流入側筒部１２，１３のいずれかに接続して、上記と同様にしてエア抜きと薬剤注入を行なってもよい。 For example, another syringe filled with a medicine corresponding to a patient's medical condition is inserted into the first and second inflow side cylinders 12 and 13 during or after the injection of the contrast medium and physiological saline. It may be connected to either of them, and air bleeding and drug injection may be performed in the same manner as described above.

上記実施形態では栓部材２０を２つの回動位置、すなわち図４Ａ〜図４Ｃに示す回動位置と図７Ａ〜図７Ｃに示す回動位置との間で回動操作したが、さらに第３の回動位置をも選択できるようにしてもよい。例えば、第１シリンジ２の造影剤の充填量が必要量に満たない場合には、第２流入側筒部１３に造影剤補充用のシリンジ（図示しない）を接続する。次に、図４Ａ〜図４Ｃに示す状態でこのシリンジから造影剤を押し出して第２流入ポート１３ａのエア抜きを行った後で、図８Ａ、図８Ｄで示すように、栓部材２０を第３の回動位置まで回動してレバー２５ａの角度位置を流出側筒部１４に一致させる。これにより、栓部材２０の主通路２２を介して流入ポート１２ａ、１３ａが連なり、流出ポート１４ａが流入ポート１２ａ，１３ａから遮断される。 In the above embodiment, the stopper member 20 is rotated between two rotation positions, that is, between the rotation position shown in FIGS. 4A to 4C and the rotation position shown in FIGS. 7A to 7C. You may enable it to also select a rotation position. For example, when the filling amount of the contrast agent in the first syringe 2 is less than the required amount, a contrast agent refilling syringe (not shown) is connected to the second inflow side cylinder 13. Next, after extruding the contrast medium from the syringe in the state shown in FIGS. 4A to 4C and releasing the air from the second inflow port 13a, the plug member 20 is moved to the third position as shown in FIGS. 8A and 8D. And the angular position of the lever 25a is made to coincide with the outflow side cylinder portion 14. Thereby, the inflow ports 12a and 13a are connected via the main passage 22 of the plug member 20, and the outflow port 14a is blocked from the inflow ports 12a and 13a.

次に、上記補充用のシリンジから造影剤を押し出すと、造影剤は、図８Ｂの矢印Ｄ５に示すように、第２流入ポート１３ａ，主通路２２，第１流入ポート１２ａを経て第１シリンジ２へ補充される。次に、三方活栓１の栓部材２０を図４Ａ〜図４Ｃに示す位置に戻し、第１シリンジ２からの造影剤を流入ポート１２ａ、主通路２２、流出ポート１４ａを経て患者に注入する。 Next, when the contrast medium is pushed out from the refilling syringe, the contrast medium passes through the second inflow port 13a, the main passage 22, and the first inflow port 12a as shown by an arrow D5 in FIG. 8B. To be replenished. Next, the stopper member 20 of the three-way stopcock 1 is returned to the position shown in FIGS. 4A to 4C, and the contrast medium from the first syringe 2 is injected into the patient through the inflow port 12a, the main passage 22, and the outflow port 14a.

次に、本発明の他の実施形態について図面を参照しながら説明する。これら実施形態において、先行する実施形態に対応する構成部には同番号を付してその詳細な説明を省略する。 Next, another embodiment of the present invention will be described with reference to the drawings. In these embodiments, components corresponding to the preceding embodiments are assigned the same reference numerals and detailed description thereof is omitted.

図９に示す第２実施形態では、ボデイ１０の主筒部１１の一端（操作部２５の反対側の端）に、エア抜き通路２３の下流端２３ｂを覆う逆流防止構造４０が設けられている。この逆流防止構造４０は、一般的な逆止弁構造であり、主筒部１１に固定された穴４１ａを有するハウジング４１と、ハウジング４１内に配置された環状の弁座部材４２と、この弁座部材４２に対して着座したり離れたりする弁部材４３と、弁部材４３を弁座部材４２に向かって付勢するバネ４４とを有している。弁部材４３にはバネ４４を受ける鍔４３ａが形成されている。この鍔４３ａの周縁とハウジング４１内周との間には、流通を許容する環状の隙間が形成されている。 In the second embodiment shown in FIG. 9, a backflow prevention structure 40 that covers the downstream end 23 b of the air vent passage 23 is provided at one end of the main cylinder portion 11 of the body 10 (the end opposite to the operation portion 25). . The backflow prevention structure 40 is a general check valve structure, and includes a housing 41 having a hole 41 a fixed to the main cylinder portion 11, an annular valve seat member 42 disposed in the housing 41, and the valve It has a valve member 43 that is seated on and away from the seat member 42, and a spring 44 that biases the valve member 43 toward the valve seat member 42. The valve member 43 is formed with a flange 43 a that receives the spring 44. An annular gap is formed between the peripheral edge of the flange 43a and the inner periphery of the housing 41 to allow circulation.

上記第２実施形態では、エア抜き通路２３を介して第１流入ポート１２ａまたは第２流入ポート１３ａのエア抜きを行う場合、弁部材４３がエアおよび生理食塩水（または造影剤）の圧力を受けて開き、エア抜きおよび生理食塩水（または造影剤）の漏出を許容する。 In the second embodiment, when the first inflow port 12a or the second inflow port 13a is vented through the air vent passage 23, the valve member 43 receives the pressure of air and physiological saline (or contrast medium). Open and allow air bleed and leakage of saline (or contrast agent).

他方、例えば第２流入ポート１３ａと流出ポート１４ａが連通した状態で、第１シリンジ２を誤って吸引操作した場合には、弁部材４３が弁座部材４２に着座し、エア抜き通路２３および第１流入ポート１２ａへのエアの入り込みを防ぐ。同様に、第１流入ポート１２ａと流出ポート１４ａが連通した状態で、第２シリンジ４を誤って吸引操作した場合には、弁部材４３が閉じ、エア抜き通路２３および第２流入ポート１３ａへのエアの入り込みを防ぐ。 On the other hand, for example, when the first syringe 2 is accidentally suctioned with the second inflow port 13a and the outflow port 14a communicating, the valve member 43 is seated on the valve seat member 42, and the air vent passage 23 and the second 1 Prevents air from entering the inflow port 12a. Similarly, when the second syringe 4 is accidentally suctioned with the first inflow port 12a and the outflow port 14a communicating with each other, the valve member 43 is closed, and the air vent passage 23 and the second inflow port 13a are connected. Prevent ingress of air.

また、弁部材４３はバネ４４の力で着座しているので、造影剤や生理食塩水がエア抜き通路２３から自然に漏出したりこの漏出に伴ってエアが外部から入り込むのも防止することができる。 Further, since the valve member 43 is seated by the force of the spring 44, it is possible to prevent the contrast medium and the physiological saline from naturally leaking out from the air vent passage 23 and preventing air from entering from the outside due to this leakage. it can.

図１０に示す第３実施形態では、逆流防止構造がダックビル５０により構成されている。このダックビル５０の基端は、栓部材２０の回転軸線方向の端部に固定され、その先端には一対の口唇部５１を有している。一対の口唇部５１は自然状態で所定接触圧で閉じている。エア抜きの場合に開き、シリンジ吸引時には互いに強く接して閉じる。その基本的な作用は第２実施形態と同様であるので詳細な説明を省略する。なお、本実施形態では、主筒部１１が延長部１１ｘを有し、この延長部１１ｘがダックビル５０を囲っている。 In the third embodiment shown in FIG. 10, the backflow prevention structure is constituted by a duckbill 50. The base end of the duckbill 50 is fixed to the end of the plug member 20 in the rotation axis direction, and has a pair of lip portions 51 at the tip thereof. The pair of lip portions 51 are closed with a predetermined contact pressure in a natural state. Open when bleeding, close close to each other during syringe suction. Since the basic operation is the same as that of the second embodiment, detailed description thereof is omitted. In the present embodiment, the main cylinder portion 11 has an extension portion 11x, and the extension portion 11x surrounds the duckbill 50.

図１１に示す第４実施形態では、逆流防止構造がキャップ６０により構成されている。このキャップ６０はゴム製または樹脂製であり、筒部１２〜１４のいずれかに装着された環状の取付部６１と、ボデイ１０の主筒部１１の端部に着脱可能な閉塞部６２と、これら取付部６１と閉塞部６２とを連ねる連結部６３とを一体に有している。エア抜きの際には閉塞部６２を主筒部１１から外しておき、それ以外の時には閉塞部６２を主筒部１１に装着し、エアの入り込みを防止する。 In the fourth embodiment shown in FIG. 11, the backflow prevention structure is constituted by a cap 60. The cap 60 is made of rubber or resin, and has an annular mounting portion 61 attached to any of the cylindrical portions 12 to 14, a closing portion 62 that can be attached to and detached from the end of the main cylindrical portion 11 of the body 10, The attachment part 61 and the connection part 63 which connects the obstruction | occlusion part 62 are integrally provided. When the air is released, the blocking portion 62 is removed from the main cylinder portion 11, and at other times, the blocking portion 62 is attached to the main cylinder portion 11 to prevent air from entering.

図１２Ａ，図１２Ｂに示す第５実施形態では、逆流防止構造７０はパージボルト７１を有している。ボデイ１０の主筒部１１の中心軸線方向の端部は拡径されており、その内周には雌ねじ１１ｙが形成されている。栓部材２０の回転軸線方向の端面には、エア抜き通路２３の下流端として拡径された円形の凹部２３ｂ’が形成されている。上記パージボルト７１は、上記雌ねじ１１ｙに螺合される大径の雄ねじ７２と、上記凹部２３ｂ’に挿入される小径の閉塞部７３とを有している。閉塞部７３の外周にはＯリング７５が装着されている。 In the fifth embodiment shown in FIGS. 12A and 12B, the backflow prevention structure 70 has a purge bolt 71. The end of the main cylinder portion 11 of the body 10 in the central axis direction is enlarged in diameter, and a female screw 11y is formed on the inner periphery thereof. On the end surface of the plug member 20 in the rotation axis direction, a circular concave portion 23 b ′ whose diameter is increased as a downstream end of the air vent passage 23 is formed. The purge bolt 71 has a large-diameter male screw 72 screwed into the female screw 11y, and a small-diameter blocking portion 73 inserted into the recess 23b '. An O-ring 75 is attached to the outer periphery of the closing part 73.

上記実施形態では、エア抜きの際には、図１２Ｂに示すようにパージボルト７１を緩めて閉塞部７３を凹部２３ｂ’から離すことにより、エアおよび生理食塩水（または造影剤）の漏出を許容し、それ以外の時にはパージボルト７０の螺合を進めて、閉塞部７２を凹部２３ｂ’に圧入しエア通路２３を閉じる。 In the above embodiment, when bleeding the air, the purge bolt 71 is loosened to separate the blocking portion 73 from the recess 23b ′ as shown in FIG. 12B, thereby allowing leakage of air and physiological saline (or contrast agent). In other cases, the purge bolt 70 is screwed, and the closing portion 72 is press-fitted into the recess 23b ′ to close the air passage 23.

図１３Ａ〜図１３Ｃに示す第６実施形態では、逆流防止構造８０は２つの部材８１，８２からなる。第１部材８１は、ボデイ１０の主筒部１１の端部内に収容され、径方向外方向に突出するキー８１ｚを主筒部１１の内周に形成されたキー溝１１ｚに嵌めることにより回り止めされている。第２部材８２は、主筒部１１の端部外周に回動可能に装着されている。ただし、第２部材８２は主筒部１１との間に働く摩擦により、外力が働かない限りその回動位置を維持される。第１部材８１には、その中心から外れた位置に例えば２つの穴８１ａが形成されている。第２部材８２にも同様にして穴８２ａが形成されている。 In the sixth embodiment shown in FIGS. 13A to 13C, the backflow prevention structure 80 includes two members 81 and 82. The first member 81 is housed in the end portion of the main tube portion 11 of the body 10 and is prevented from rotating by fitting a key 81z protruding outward in the radial direction into a key groove 11z formed on the inner periphery of the main tube portion 11. Has been. The second member 82 is rotatably mounted on the outer periphery of the end portion of the main cylinder portion 11. However, the rotation position of the second member 82 is maintained as long as no external force is applied due to the friction between the second member 82 and the main cylinder portion 11. For example, two holes 81a are formed in the first member 81 at a position deviated from the center thereof. Similarly, the second member 82 has a hole 82a.

エア抜きの際には、図１３Ｂに示すように第２部材８２を、その穴８２ａが第１部材８１の穴８１ａに合致させるように位置決めすることにより、エアおよび生理食塩水（または造影剤）の漏出を許容する。それ以外の時には、図１３Ａ，図１３Ｃに示すように第２部材８２を、その穴８２ａが第１部材８１の穴８１ａと合致しないように位置決めすることにより、エアの逆流を防止する。 At the time of air bleeding, as shown in FIG. 13B, the second member 82 is positioned so that its hole 82a matches the hole 81a of the first member 81, so that air and physiological saline (or contrast medium) are obtained. Allow leakage. At other times, as shown in FIGS. 13A and 13C, the second member 82 is positioned so that its hole 82a does not coincide with the hole 81a of the first member 81, thereby preventing backflow of air.

図１４Ａ〜図１５Ｂに示す第７実施形態では、二方活栓１’（医療用活栓）を用いる。この二方活栓１’のボデイ１０は主筒部１１と、単一の流入側筒部１２と、流出側筒部１４を有している。栓部材２０の挿入部２１は一直線をなす主通路２２と前記実施形態と同様のエア抜き通路２３を有している。エア抜き通路２３の上流端２３ａは、主通路２２の一対の開口端２２ａ，２２ｂから周方向に９０°離れている。 In the seventh embodiment shown in FIGS. 14A to 15B, a two-way stopcock 1 '(medical stopcock) is used. The body 10 of this two-way cock 1 'has a main cylinder part 11, a single inflow side cylinder part 12, and an outflow side cylinder part 14. The insertion portion 21 of the plug member 20 has a straight main passage 22 and an air vent passage 23 similar to the above-described embodiment. The upstream end 23 a of the air vent passage 23 is separated from the pair of open ends 22 a and 22 b of the main passage 22 by 90 ° in the circumferential direction.

上記栓部材２０の操作部２５は一対のレバー２５ａを有している。これらレバー２５ａの角度位置は、主通路２２の一対の開口端２２ａ，２２ｂと一致している。
栓部材２０は、図１４Ａ，図１４Ｂに示す連通位置（第２回動位置）と、図１５Ａ、図１５Ｂに示す遮断位置（第１回動位置）との間で回動可能である。 The operation portion 25 of the plug member 20 has a pair of levers 25a. The angular positions of these levers 25a coincide with the pair of open ends 22a, 22b of the main passage 22.
The plug member 20 is rotatable between a communication position (second rotation position) shown in FIGS. 14A and 14B and a blocking position (first rotation position) shown in FIGS. 15A and 15B.

栓部材２０を図１４Ａ，図１４Ｂに示す連通位置にし、流入ポート１２ａと流出ポート１４ａを主通路２２を介して連通させた状態で、流入側筒部１２に接続された第１シリンジから造影剤を押し出す。すると、造影剤は流入ポート１２ａ、主通路２２、流出ポート１４ａ、患者側注入ラインを経て先端の針から漏れ出る。これにより造影剤の流路のエア抜きを行う。
なお、この連通位置では、エア抜き通路２３の上流端２３ａはボデイ１０の収容空間１１ａの内周面によって塞がれている。 14A and 14B, the inflow port 12a and the outflow port 14a are in communication with each other through the main passage 22, and the contrast agent is connected to the inflow side cylinder portion 12 from the first syringe. Extrude Then, the contrast agent leaks from the needle at the tip through the inflow port 12a, the main passage 22, the outflow port 14a, and the patient side injection line. As a result, air is removed from the flow path of the contrast agent.
In this communication position, the upstream end 23 a of the air vent passage 23 is closed by the inner peripheral surface of the housing space 11 a of the body 10.

次に、患者側注入ラインの針を患者の血管に刺して、第１シリンジから造影剤を押し出し、患者に注入する。
生理食塩水の注入が求められる場合には、栓部材２０を図１５Ａ，図１５Ｂに示す遮断位置にし、流入ポート１２ａを主通路２２から遮断し、エア抜き通路２３の上流端２３ａに連ねる。この状態で第１シリンジを流入側筒部１２から外し、この流入側筒部１２に第２シリンジを接続する。この状態で第２シリンジから生理食塩水を押し出す。すると、生理食塩水は、図１５Ｂの矢印Ｄ６に示すように、流入ポート１２ａおよびエア抜き通路２３を通って外部に漏れ出る。この時、流入ポート１２ａのエア抜きが行われる。 Next, the needle of the patient side injection line is inserted into the patient's blood vessel, and the contrast medium is pushed out from the first syringe and injected into the patient.
When injection of physiological saline is required, the plug member 20 is set to the blocking position shown in FIGS. 15A and 15B, the inlet port 12 a is blocked from the main passage 22, and is connected to the upstream end 23 a of the air bleeding passage 23. In this state, the first syringe is removed from the inflow side cylinder 12 and the second syringe is connected to the inflow side cylinder 12. In this state, physiological saline is pushed out from the second syringe. Then, the physiological saline leaks outside through the inflow port 12a and the air vent passage 23 as shown by an arrow D6 in FIG. 15B. At this time, air is removed from the inflow port 12a.

次に、栓部材２０を連通位置に戻し、その後で第２シリンジから生理食塩水を押し出す。すると、生理食塩水は流入ポート１２ａ，主通路２２、流出ポート１４ａを通り、さらに患者側注入ラインを通って患者に注入される。 Next, the stopper member 20 is returned to the communication position, and then physiological saline is pushed out from the second syringe. Then, the physiological saline passes through the inflow port 12a, the main passage 22, and the outflow port 14a, and is further injected into the patient through the patient side injection line.

第１シリンジの造影剤の充填量が必要量に満たない場合には、栓部材２０を一旦遮断位置にして第１シリンジを流入側筒部１２から外し、造影剤パックから第１シリンジへ造影剤を再充填する。
次に、第１シリンジを流入ポート１２ａに再接続し、上述と同様にして流入ポート１２ａのエア抜きを行った後で、栓部材２０を回動させて連通位置に戻し、造影剤の再注入を行う。なお、第１シリンジを再接続する代わりに、造影剤を充填した他の新しいシリンジを流入ポート１２ａに再接続してもよい。 When the filling amount of the contrast agent in the first syringe is less than the required amount, the stopper member 20 is temporarily shut off, the first syringe is removed from the inflow side cylinder portion 12, and the contrast agent is transferred from the contrast agent pack to the first syringe. Refill.
Next, after reconnecting the first syringe to the inflow port 12a and releasing the air from the inflow port 12a in the same manner as described above, the plug member 20 is rotated back to the communication position, and the contrast medium is reinjected. I do. Instead of reconnecting the first syringe, another new syringe filled with contrast medium may be reconnected to the inflow port 12a.

本発明は上記実施形態に制約されず、種々の態様が可能である。例えば、２方活栓にも、第２〜第６実施形態の逆流防止構造を設けてもよい。
患者に注入される注入剤は造影剤、生理食塩水以外の薬剤であってもよい。
血圧モニタリングラインを三方活栓等を介して上記実施形態の医療用活栓の上流側または下流側に接続してもよい。上流側に接続する場合には、医療用活栓の流入ポートにはシリンジがチューブ等を介して間接的に接続される。
患者側注入ラインは例えば冠動脈まで延びるカテーテルであってもよい。 The present invention is not limited to the above-described embodiments, and various aspects are possible. For example, the two-way stopcock may be provided with the backflow prevention structure of the second to sixth embodiments.
The infusion to be injected into the patient may be an agent other than a contrast agent or physiological saline.
The blood pressure monitoring line may be connected to the upstream side or the downstream side of the medical stopcock of the above embodiment via a three-way stopcock. When connecting to the upstream side, a syringe is indirectly connected to the inflow port of the medical stopcock via a tube or the like.
The patient side infusion line may be, for example, a catheter that extends to the coronary artery.

本発明は、造影剤注入装置等の医療用活栓に適用することができる。 The present invention can be applied to a medical stopcock such as a contrast medium injection device.

１三方活栓（医療用活栓）
１’ 二方活栓（医療用活栓）
２第１シリンジ
３患者側注入ライン
４第２シリンジ
１０ボデイ
１２ａ第１流入ポート（流入ポート）
１３ａ第２流入ポート
１４ａ流出ポート
２０栓部材
２２主通路
２２ａ〜２２ｃ主通路の開口端
２３エア抜き通路
２３ａエア抜き通路の上流端
２３ｂ、２３ｂ’ エア抜き通路の下流端
４０、５０、６０、７０、８０逆流防止構造 1 Three-way stopcock (medical stopcock)
1 'Two-way stopcock (medical stopcock)
2 1st syringe 3 patient side injection line 4 2nd syringe 10 body 12a 1st inflow port (inflow port)
13a 2nd inflow port 14a Outflow port 20 Plug member 22 Main passage 22a-22c Open end 23 of main passage Air vent passage 23a Upstream end 23b of air vent passage, 23b 'Downstream end 40, 50, 60, 70 of air vent passage , 80 Backflow prevention structure

Claims

A body having an accommodation space, one or more inflow ports into which the infusate from the syringe flows, and an outflow port connected to the patient side;
A plug member that has a main passage and is rotatably accommodated between the first rotation position and the second rotation position in the housing space of the body;
In the medical stopcock with
The plug member further has an air vent passage, and an upstream end of the air vent passage opens at a position away from the opening end of the main passage in the circumferential direction on the peripheral surface of the plug member, and a downstream end thereof is an external portion. Connected to
The one inflow port or one of the plurality of inflow ports is disconnected from the main passage and connected to the upstream end of the air vent passage when the plug member is in the first rotation position, A medical stopcock, wherein the stopcock is connected to the outflow port through the main passage when the member is in the second rotation position.

The medical stopcock is a three-way stopcock, the plurality of inflow ports are composed of first and second inflow ports, and the three main passages are spaced apart in the circumferential direction on the peripheral surface of the plug member. Has an edge,
When the plug member is in the first rotation position, the first inflow port is connected to the outflow port via the main passage, and the second inflow port is blocked from the main passage, so that the upstream of the air vent passage. Connected to the end,
When the plug member is in the second rotation position, the second inflow port is connected to the outflow port through the main passage, and the first inflow port is disconnected from the main passage, so that the upstream of the air vent passage. The medical stopcock according to claim 1, wherein the stopcock is continuous with an end.

The medical stopcock is a two-way stopcock, the body has the one inflow port, the main passage has two open ends arranged in the circumferential direction on the peripheral surface of the plug member,
When the plug member is in the first rotation position, the inflow port is blocked from the main passage and is connected to the upstream end of the air vent passage,
When the plug member is in the second rotation position, the inflow port is connected to the outflow port via the main passage, and the upstream end of the air vent passage is blocked by the inner peripheral surface of the housing space of the body. The medical stopcock according to claim 1, wherein:

Furthermore, an air backflow prevention structure is provided to cover the downstream end of the air vent passage, and this air backflow prevention structure allows the air to be discharged from the air vent passage to the outside, and the air backflow from the outside to the air vent passage is provided. The medical stopcock according to any one of claims 1 to 3, wherein the medical stopcock is prevented.

The first syringe is connected directly or indirectly to the first inflow port of the medical stopcock according to claim 2, the outflow port is connected to the patient via a patient-side injection line, and the plug member is connected to the first inflow port. A first injection for injecting the infusion filled in the first syringe into the patient through the first inflow port, the main passage, the outflow port, and the patient side injection line in a state where the first syringe is placed in the rotational position. Process,
The plug member is positioned at the first rotation position, and the second syringe is directly or indirectly connected to the second inflow port to push out the injection filled in the second syringe. An air venting process for allowing the infusate to leak through the second inflow port and the air vent passage, and simultaneously discharging the air in the second inflow port;
After the air venting step, the plug member is rotated to the second rotation position, and the injection filled in the second syringe is transferred to the second inflow port, the main passage, the outflow port, the A second injection step of injecting into the patient via the patient side injection line;
An injection method comprising:

With the plug member in the second rotation position, the first syringe is removed from the first inflow port, and the first syringe refilled with the infusate or another syringe filled with the infusate is replaced with the first syringe. 1 reconnection process to connect to the inflow port;
After the reconnecting step, the injection member is pushed out from the first syringe or another syringe while the stopper member is maintained at the second rotation position, and the injection agent is passed through the first inflow port and the air vent passage. And an air venting process for discharging air in the first inflow port at the same time,
After the air venting step, the plug member is rotated to the first rotation position, and an injection filled in the first syringe or another syringe is supplied to the first inflow port, the main passage, the An outflow port, a third injection step for injecting into the patient via the patient side injection line;
The injection method according to claim 5, further comprising:

A syringe is directly or indirectly connected to the inflow port of the medical stopcock according to claim 3, the outflow port is connected to the patient side via a patient side infusion line, and the plug member is rotated in the second direction. A first injection step of injecting the filling agent filled in the syringe into the patient through the inflow port, the main passage, the outflow port, and the patient-side injection line in a position,
By rotating the plug member to the first rotation position, the syringe is removed from the inflow port after the inflow port and the main passage are blocked, and the infusion port is refilled with the injection agent. A reconnection step of connecting a syringe or other syringe filled with infusate;
After the reconnecting step, by extruding the infusate from the syringe, the infusate leaks through the inflow port and the air vent passage, and at the same time, the air venting step of discharging the air in the inflow port When,
After the air venting step, the stopper member is rotated to the second rotation position, and the injection agent is injected from the syringe through the inflow port, the main passage, the outflow port, and the patient side injection line. A second injection step of injecting into
A method for injecting an injection, comprising: