JP2020000451A - catheter - Google Patents

Abstract

To provide a reinforcement body for catheters, spirally buried in a peripheral wall of a catheter such as an endotracheal tube to reinforce the catheter, and capable of preventing kink thereof.SOLUTION: A reinforcement body 1 includes: a first reinforcement part 2 spirally buried in a peripheral wall of a catheter across a prescribed length for reinforcing the catheter; and a second reinforcement part 3 connected to the first reinforcement body part continuously in the axial direction. The first reinforcement body part, in an end position thereof on an opposite side of the connection part of the second reinforcement body part, is so formed that a lateral shape viewed from an intersection of a line orthogonally crossing the axial center line is a true circular shape, while the second reinforcement body part, in an end position thereof on an opposite side of the connection part of the first reinforcement body part, is so formed that a lateral shape viewed from an intersection of a line orthogonally crossing the axial center line is a substantially semicircular shape.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a reinforcing member for a catheter, and more particularly, to a reinforcing member having a winding shape changed around the peripheral wall of a catheter such as a double-lumen endotracheal tube used for anesthesia and respiratory management in thoracic surgery over a predetermined length. The present invention relates to a technology that enables the catheter to be reinforced by embedding the catheter in the hole to prevent the kink.

  In surgery for lung cancer, surgery cannot be performed if the operating lung is inflated or contracted, so the patient's lung is degassed and collapsed, and the other lung is used to manage the patient's breathing. Need to be done. In this case, a double-lumen endotracheal tube is mainly inserted into the left or right bronchus for use. In lung cancer surgery and the like, since the lungs on the operation side are pulled to move the lungs, it is desirable to soften the double-lumen endotracheal tube so that the distal end of the tube does not contact the bronchus and is damaged. However, with a soft tube, there is a risk that the tube will break (kink) if the bronchi are curved when the lungs are pulled. If the tube is kinked during use, respiratory management cannot be performed. For this purpose, measures such as spirally burying a reinforcing body on the peripheral wall of the tube body have been taken for the purpose of preventing kinking. Patent Literature 1 is an example of this, in which a striated body as a reinforcing body is elastically deformed on a peripheral wall of a long-end portion of both end portions of a double-lumen type endotracheal tube around a lumen thereof as a reinforcing member. It is configured to be buried as possible (claim 1, paragraph 0010).

  However, since one of the lumens of the tube body is made to protrude, the bronchial tube is substantially semicircular, and the inner cavity of the tube is also similar, and the buried reinforcement is also substantially semicircular. . Therefore, it can be bent in the left-right direction without resistance, but in the up-down direction, the corners (circled portions) of the semicircle become resistance and need to be bent with strong force. Therefore, when the lung to be operated on is pulled up and down with respect to the tube body, it is necessary to bend it with a strong force, the cuff indwelled and fixed in the bronchial lumen will be displaced, and it will be impossible to manage the patient's respiration, etc. There was a problem.

Registered Utility Model No. 2568048

  Therefore, the present invention solves the problems of the prior art, including the technique disclosed in Patent Document 1, and helically embedded in the peripheral wall of a catheter such as a double-lumen endotracheal tube to reinforce the catheter. It is an object of the present invention to provide a catheter reinforcing body capable of preventing the kink.

  In order to solve the above-mentioned problem, the invention according to claim 1 is a spiral reinforcing member embedded in a peripheral wall of the catheter over a predetermined length to reinforce the catheter, wherein the first reinforcing member portion is provided. And a second reinforcing member connected to the first reinforcing member in the axial direction. The first reinforcing member is connected to the second reinforcing member on the side opposite to the connecting portion. At the end position, the side shape seen from the intersection of the line orthogonal to the axial center line is formed in a perfect circular shape, and the second reinforcement portion is connected to the connection portion with the first reinforcement portion. At an opposite end position, a side surface shape viewed from an intersection of a line orthogonal to the axial center line is substantially semicircular.

  According to a second aspect of the present invention, in the first aspect, the connecting portion between the first reinforcing member portion and the second reinforcing member portion has a side surface shape that changes gradually from a substantially semicircular shape to a perfect circular shape. Shape.

  According to a third aspect of the present invention, in the first or second aspect, the winding pitch of the first reinforcing member is larger than the winding pitch of the second reinforcing member.

  The invention described in claim 4 is characterized in that the catheter reinforcing body according to any one of claims 1 to 3 is a catheter embedded in a peripheral wall of a catheter body.

  According to a fifth aspect of the present invention, in the fourth aspect, the catheter is a double-lumen endotracheal tube, and the endotracheal tube has a first distal end portion having a first bronchial lumen on the distal end side; It is branched to a second distal end portion having a second bronchial lumen extending longer than the distal end portion, and the first bronchial lumen at the first distal end portion has a substantially semicircular cross section. The cross section of the second bronchial lumen at the second distal end is formed in a perfect circle. According to a sixth aspect of the present invention, in the fifth aspect, the reinforcing member is located on the peripheral wall of the second distal end at one end near the distal opening of the distal end, and the other end is near the proximal end of the distal end. It is buried to be located at. According to a seventh aspect of the present invention, in any one of the first to sixth aspects, the first reinforcing portion and the second reinforcing portion have the same area on the inner side when viewed from the side.

  The present invention is as described above, and according to the first to third aspects of the present invention, the first reinforcing member portion and the first reinforcing member portion continuously connected in the axial direction to the first reinforcing member portion. 2, the first reinforcing member portion is located at an end position opposite to the connection portion with the second reinforcing member portion, as viewed from the intersection of a line orthogonal to the axial center line. The side surface shape is formed in a perfect circular shape, and the second reinforcing member portion is located at an end position opposite to the connection portion with the first reinforcing member portion, at the intersection of a line orthogonal to the axial center line at the end position. Since the side shape viewed from the side is formed in a substantially semicircular shape, the catheter is reinforced by the second reinforcing portion formed in a substantially semicircular shape by changing the winding method from the first reinforcing portion, and Kink can be prevented.

  According to the invention described in claim 4, it is possible to provide a catheter in which the catheter reinforcing body as described in claims 1 to 3 is embedded in the peripheral wall of the catheter body. According to the fifth or sixth aspect of the present invention, the second distal end portion of the endotracheal tube is reinforced by applying the double lumen type endotracheal tube and embedding the reinforcing member in the peripheral wall of the second distal end portion. However, kink of the second bronchial lumen can be effectively prevented. According to the invention described in claim 7, it is possible to prevent the air supply resistance from changing.

Fig. 2 shows a catheter reinforcement according to an embodiment of the present invention, wherein (A) is a front view thereof, (B) is a plan view, (C) is a left side view, (D) is a right side view, and (E). FIG. 4 is a right side view of a wound shape deformed portion of the reinforcing member. It is a figure which shows the shape deformation from the right side to the left side of the catheter reinforcement body. It is a figure for demonstrating the intensity | strength of the left side part same as the above. It is a figure for demonstrating the intensity | strength of the right side part same as the above. It is an overall perspective view showing the example used for the double lumen type endotracheal tube. It is an expanded sectional view of the front-end | tip part of the same endotracheal tube. FIG. 7 is a sectional view taken along line AA in FIG. 6. It is explanatory drawing which shows a usage example. (A), (B) is explanatory drawing which shows the example of an attempt which makes the shape of the front-end | tip part of a tracheal tube circular. The other embodiment of the reinforcement body for catheters is shown, (A) is the front view, (B) is a top view, (C) is a left view, (D) is a right view. It is a figure which shows the shape deformation from the right side to the left side of the catheter reinforcement body.

  Hereinafter, an embodiment of the present invention will be described with reference to the drawings.

  In FIG. 1, reference numeral 1 denotes a reinforcing member for a catheter. The reinforcing body (wire) 1 has a cross section not shown, but is formed in a perfect circular shape, and its entire shape is formed in a spiral shape. The material is titanium or nickel titanium alloy used for medical use. Made of non-magnetic material, stainless steel, resin and the like. The reinforcing member 1 is configured as a single member including a first reinforcing member portion 2 and a second reinforcing member portion 3 that is connected to the first reinforcing member portion 2 continuously in the axial direction. The first reinforcing member portion 2 and the second reinforcing member portion 3 are wound differently at the connection portion. The first reinforcing portion 2 is orthogonal to the axial center line XX at an end position opposite to the connection portion with the second reinforcing portion 3 as shown in FIG. The side surface shape seen from the intersection of the line Y-Y is formed in a perfect circular shape. Further, as shown in FIG. 4D, the second reinforcing member 3 has an axial center line XX at an end position opposite to the connection with the first reinforcing member 2. The side surface shape seen from the intersection of the orthogonal line Y-Y is formed in a substantially semicircular shape. Further, the connecting portion between the first reinforcing member portion 2 and the second reinforcing member portion 3 has a side surface shape gradually continuous from a substantially semicircular shape to a perfect circular shape as shown in FIG. It has a changed shape. The area inside the side view (the area of the space surrounded by the reinforcing member) does not change in any of these portions having different side shapes. This is because, when buried in the peripheral wall of the endotracheal tube, as will be described later, the cross-sectional area of the lumen does not change and the air supply amount does not decrease.

  FIGS. 3 and 4 show the resistance and the like of the first reinforcing member portion (true circular reinforcing member portion) 2 and the second reinforcing member portion 3 (substantially semi-circular reinforcing member portion) of the reinforcing member 1 as described above. It is a drawing explaining strength. The first reinforcing member 2 shown in FIG. 3 is bent without any resistance in any direction because its side shape is a perfect circle. On the other hand, since the second reinforcing member 3 shown in FIG. 4 has a substantially semicircular side shape, it can be bent without resistance in the left-right direction, but has a semicircular corner (circled in the vertical direction). Part) becomes a resistance and must be bent with strong force. Therefore, the second reinforcing portion 3 is stronger than the first reinforcing portion 2 due to the resistance due to the corners, and has no kink.

  5 to 7 show a double-lumen endotracheal tube in which the reinforcing body 1 is embedded. The endotracheal tube 11 is made of silicone rubber or the like, and includes a tube main body 15 in which lumens 12 and 13 are formed in parallel in the axial direction. The lumens 12 and 13 each have a substantially semicircular cross section, and are arranged with their linear back surfaces in contact with each other. A tracheal cuff 16 is attached to the distal end of the tube main body 15, and the distal end side of the cuff is branched into two long and short distal ends 17 and 18. Of the two distal ends 17, 18, the distal end 17 having the lumen 12 for ventilation of the right bronchus has a length slightly protruding from the front end of the cuff 16.

  On the other hand, the distal end portion 18 having the lumen 13 for left bronchial ventilation is longer than the distal end portion 17, and the lumen 13 a communicating with the lumen 13 is formed to have a perfect circular cross section. I have. The reinforcing body 1 is helically embedded in the peripheral wall of the distal end portion 18 so as to be elastically deformable. That is, in the reinforcing body 1 embedded in the peripheral wall of the distal end portion 18, the side surface is formed in a perfect circular shape, one end is located near the distal end opening of the distal end portion 18, and the side surface is formed in a substantially semicircular shape. It is embedded so as to surround the lumen 13 a so that the other end is located near the base end of the distal end portion 18 near the cuff 16.

  The open end surface of the distal end portion 17 is formed in a tapered shape obliquely inclined toward the open end surface side of the distal end portion 18. The reinforcing body 1 is not embedded in the peripheral wall other than the peripheral wall of the distal end portion 18, that is, the peripheral wall of the tube body 15 and the peripheral wall of the distal end portion 17. A bronchial cuff 20 is mounted near the distal end opening of the distal end portion 18. At the time of intubation, the bifurcations of the distal ends 17, 18 may hit the trachea and the bronchus bifurcation (carina) and damage the bifurcation. Therefore, a soft silicone rubber or silicone gel is attached to the abutment as a pad. It is preferable to keep it.

  Reference numeral 21 denotes a tracheal-side branch tube connected to the lumen 12 of the tube body 15, and reference numeral 22 denotes a bronchial-side branch tube connected to the lumen 13 of the tube body 15. Reference numeral 24 denotes a pilot balloon for the tracheal cuff 16, reference numeral 26 denotes a pilot balloon for the bronchial cuff 20, and reference numerals 25 and 27 (see FIG. 7) denote the tube main body 15 so that the pilot balloons 24 and 26 communicate with the cuffs 16 and 20. This is the caf ー lumen formed on the surrounding wall. Reference numeral 28 denotes a scale provided on the outer circumferential surface of the tube body 15 in the axial direction, for grasping the insertion amount of the endotracheal tube 11 into the trachea. For example, the first numeral 22 shown in FIG. 5 indicates that the length from the tip of the tube body 15 is 22 cm.

  Next, a method of using the endotracheal tube 11 in which the reinforcing body 1 is embedded in the peripheral wall of the tube main body 15 will be described with reference to FIG. When intubating, the bent distal end portion 18 is straightened with a stylet (not shown), and then inserted into the patient's trachea from the distal end side. The tube main body 15 is advanced while checking the bifurcations of the tips 17 and 18 on the scale 28, and when the tip 18 is inserted into the right bronchus from the trachea, the stylet is gently pulled out, and the tips 17 and 18 are removed. The intubation is completed by locating the bifurcation of the trachea and the bronchial carina so that they do not directly hit the carina. At the time of intubation, a tube holder may be inserted and fixed. In this case, the tube holder is placed so as to be in contact with the surface of the throat. As a result, further insertion is prevented and the tube is intubated.

  After intubation, the cuffs 16 and 20 are inflated to firmly fix the distal end portion 18 of the tube body 15. Thus, the endotracheal tube 11 is in an intubation fixed state at an appropriate position, and various operations are performed in this state.

  Even if the distal end 18 inserted into the left bronchus of the tube main body 15 is likely to be bent due to this operation or body position change, the reinforcing body 1 is buried in the distal end. The cavity 13 is not closed.

  Further, the reinforcing body 1 is embedded in the peripheral wall of the distal end portion 18 of the tube main body 15, and the second reinforcing portion 3 of the reinforcing body 1 is located at the branch portion of both the distal end portions 17 and 18, so that it can withstand a strong bending force. Therefore, the kink does not occur in the lumen 13a of the distal end portion 18 and the kink can be prevented. Therefore, even when the tube holder is used outside the body, it can be securely fixed.

  The fact that the manner of winding the reinforcing member 1 is changed at the connection between the first reinforcing member portion 2 and the second reinforcing member portion 3 will be described below. The endotracheal tube 11 is inserted into the trachea. Wide lumens 12 and 13 are required so that the outer diameter is small and a large amount of air is supplied. Therefore, the shape of both the lumens is made semicircular (kamaboko shape), and the tube cross section is used efficiently. It has a configuration that can be used. Further, the distal end portion 18 having the lumen 13a is longer than the distal end portion 17 having the lumen 12 so as to be inserted into the bronchus. Since the lungs are moved during the operation, it is necessary to soften the tube 11 so that the bronchi are not damaged during the operation. However, if it is soft, the tube 11 will bend (kink). Therefore, a reinforcing body is required to improve kink resistance.

  By the way, it was not possible to fabricate a reinforcing body that has been used conventionally as one having a changed winding shape. For this reason, the distal end of the tracheal tube in which the reinforcing member is embedded has a semicircular shape in which the lumen is simply extended. Attempts were made to make the shape of the distal end portion of the tracheal tube circular. However, as shown in FIG. 9A, when the width of the semicircular tube and that of the circular tube were the same, the circular tube had a larger lumen area. As shown in FIG. 9 (B), the width becomes wider when trying to have the same lumen area. For this reason, there are problems such as a decrease in the amount of air supply, making breathing management difficult, and a step formed at a branch portion of the tube, thereby damaging the trachea and the inner circumference of the bronchi. However, the above-described problem can be solved by adopting a configuration in which the side shape changes from a substantially semicircular shape to a perfect circular shape as in the above-described reinforcing body 1. .

  10 and 11 show another embodiment of the reinforcing member. The basic structure of the reinforcing member 51 is different from that of the reinforcing member in that a winding pitch of a first reinforcing member portion 52 having a side surface formed in a perfect circular shape is larger than that of a second reinforcing member portion 53. Other configurations are the same as those of the reinforcing body. That is, the first reinforcing member portion 52 is formed in a perfect circular shape as shown in FIG. (C), and the second reinforcing member portion 53 is formed as shown in FIG. The side surface shape is formed in a substantially semicircular shape, and the connecting portion between the first reinforcing member portion 52 and the second reinforcing member portion 53 has a side surface shape gradually and continuously changed from a substantially semicircular shape to a perfect circular shape. It has a shape.

  By embedding the reinforcing member 51 in the peripheral wall of the tube body of the endotracheal tube, the kink of the distal end portion 18 of the tube body 15 can be prevented, and the same operation and effect as the reinforcing member 1 can be expected. .

  The substantially semicircular shape (kamaboko shape) of the second reinforcing member portion in the reinforcing member described in the above embodiment is merely a preferable example, and other shapes are not excluded. As long as the kink of the catheter (tube) can be prevented, it is a matter of course that another equivalent shape may be used. Further, in the above description, the cross-sectional shape of the reinforcing body 1 is formed in a perfect circular shape, but it is not necessarily required to be a perfect circular shape, and may be a polygonal shape such as a rectangular shape. In addition, it goes without saying that the design of each part of the configuration can be appropriately changed within the scope of the claims.

Reference Signs List 1,51 Reinforcement 2,52 First Reinforcement Part 3,53 Second Reinforcement Part 11 Double-lumen endotracheal tube 12,13 Lumen 15 Tube body 16 Tracheal cuff 17,18 Tip 20 Bronchial cuff 21 Tracheal branch tube 22 Bronchial branch tube 24 Pilot balloon 25 for tracheal cuff Caflumen 26 for tracheal cuff Pilot balloon 27 for bronchial cuff Cufflumen 28 for bronchial cuff Scale

The present invention relates to a catheter , and more specifically, embeds a reinforcing member having a different winding manner around a peripheral wall of a catheter such as a double-lumen type endotracheal tube used for anesthesia and respiratory management in thoracic surgery in a spiral shape over a predetermined length. The present invention relates to a technique that makes it possible to reinforce a catheter and prevent kink thereof.

  In surgery for lung cancer, surgery cannot be performed if the operating lung is inflated or contracted, so the patient's lung is degassed and collapsed, and the other lung is used to manage the patient's breathing. Need to be done. In this case, a double-lumen endotracheal tube is mainly inserted into the left or right bronchus for use. In lung cancer surgery and the like, since the lungs on the operation side are pulled to move the lungs, it is desirable to soften the double-lumen endotracheal tube so that the distal end of the tube does not contact the bronchus and is damaged. However, with a soft tube, there is a risk that the tube will break (kink) if the bronchi are curved when the lungs are pulled. If the tube is kinked during use, respiratory management cannot be performed. For this purpose, measures such as spirally burying a reinforcing body on the peripheral wall of the tube body have been taken for the purpose of preventing kinking. Patent Literature 1 is an example of this, in which a striated body as a reinforcing body is elastically deformed on a peripheral wall of a long-end portion of both end portions of a double-lumen type endotracheal tube around a lumen thereof as a reinforcing member. It is configured to be buried as possible (claim 1, paragraph 0010).

  However, since one of the lumens of the tube body is made to protrude, the bronchial tube is substantially semicircular, and the inner cavity of the tube is also similar, and the buried reinforcement is also substantially semicircular. . Therefore, it can be bent in the left-right direction without resistance, but in the up-down direction, the corners (circled portions) of the semicircle become resistance and need to be bent with strong force. Therefore, when the lung to be operated on is pulled up and down with respect to the tube body, it is necessary to bend it with a strong force, the cuff indwelled and fixed in the bronchial lumen will be displaced, and it will be impossible to manage the patient's respiration, etc. There was a problem.

Registered Utility Model No. 2568048

Therefore, the present invention solves the problems of the prior art, including the technique disclosed in Patent Document 1, and helically embedded in the peripheral wall of a catheter such as a double-lumen endotracheal tube to reinforce the catheter. It is an object of the present invention to provide a catheter having a catheter reinforcing member capable of preventing the kink.

In order to solve the above-mentioned problem, the invention according to claim 1 includes a first reinforcing member and a second reinforcing member connected to the first reinforcing member in the axial direction. The first reinforcing member portion has a perfect circular side shape at an end position opposite to the connection portion with the second reinforcing member portion, as viewed from the intersection of a line orthogonal to the axial center line thereof. The second reinforcing portion has a side surface shape viewed from an intersection of a line orthogonal to the axial center line at an end position opposite to the connection portion with the first reinforcing portion. It is formed in a substantially semicircular shape, and a connecting portion between the first reinforcing member portion and the second reinforcing member portion has a shape in which a side surface shape is gradually and continuously changed from a substantially semicircular shape to a perfect circular shape. Catheter stiffener, a first distal end with a first bronchial lumen on the distal end side, longer than the distal end The catheter body comprises a double lumen endotracheal tube branched to a second distal end having an elongated second bronchial lumen, wherein the first bronchial lumen at the first distal end of the catheter body has a cross section. A second main body having a substantially semicircular shape, wherein the second bronchial lumen at the second distal end includes a catheter body having a cross-sectional shape of a perfect circle; On the peripheral wall, the reinforcing member for a catheter has a distal end of a first reinforcing portion positioned near a distal end opening of a second distal end portion, and a connecting portion with the second reinforcing portion positioned at a second distal end. A catheter positioned near the proximal end of the portion and embedded such that the second stiffener portion is not located at the second distal end.

According to a second aspect of the present invention, in the first aspect, the winding pitch of the first reinforcing portion is larger than the winding pitch of the second reinforcing portion.

According to a third aspect of the present invention, in the first or second aspect, the first reinforcing portion and the second reinforcing portion have the same area on the inner side in a side view.

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The present invention is as described above, and according to the first and second aspects of the invention, it is possible to provide a catheter in which the catheter reinforcing body is embedded in the peripheral wall of the catheter body. Moreover, the catheter reinforcement includes a first reinforcement and a second reinforcement connected to the first reinforcement in the axial direction, and the first reinforcement is At an end position opposite to the connection portion with the second reinforcing member, the side shape viewed from the intersection of a line orthogonal to the axial center line is formed in a perfect circle, and the second reinforcing member Since the side shape viewed from the intersection of the line orthogonal to the axial center line is formed in a substantially semicircular shape at an end position opposite to the connection portion with the first reinforcing member portion, The catheter is reinforced by the second reinforcing portion formed into a substantially semicircular shape by changing the winding manner from the first reinforcing portion, and the kink can be prevented. In addition, the second distal end portion of the endotracheal tube is reinforced by embedding the reinforcing member in the peripheral wall of the second distal end portion by applying the double lumen type endotracheal tube to the kink of the second bronchial lumen. Prevention can be effectively achieved.

According to the third aspect of the invention, the air supply resistance can be prevented from changing.

Fig. 2 shows a catheter reinforcement according to an embodiment of the present invention, wherein (A) is a front view thereof, (B) is a plan view, (C) is a left side view, (D) is a right side view, and (E). FIG. 4 is a right side view of a wound shape deformed portion of the reinforcing member. It is a figure which shows the shape deformation from the right side to the left side of the catheter reinforcement body. It is a figure for demonstrating the intensity | strength of the left side part same as the above. It is a figure for demonstrating the intensity | strength of the right side part same as the above. It is an overall perspective view showing the example used for the double lumen type endotracheal tube. It is an expanded sectional view of the front-end | tip part of the same endotracheal tube. FIG. 7 is a sectional view taken along line AA in FIG. 6. It is explanatory drawing which shows a usage example. (A), (B) is explanatory drawing which shows the example of an attempt which makes the shape of the front-end | tip part of a tracheal tube circular. The other embodiment of the reinforcement body for catheters is shown, (A) is the front view, (B) is a top view, (C) is a left view, (D) is a right view. It is a figure which shows the shape deformation from the right side to the left side of the catheter reinforcement body.

  Hereinafter, an embodiment of the present invention will be described with reference to the drawings.

  In FIG. 1, reference numeral 1 denotes a reinforcing member for a catheter. The reinforcing body (wire) 1 has a cross section, not shown, and is formed in a perfect circle shape, and its entire shape is formed in a spiral shape. The material is titanium or nickel titanium alloy used for medical use. Made of non-magnetic material, stainless steel, resin and the like. The reinforcing member 1 is configured as a single member including a first reinforcing member portion 2 and a second reinforcing member portion 3 that is connected to the first reinforcing member portion 2 continuously in the axial direction. The first reinforcing member portion 2 and the second reinforcing member portion 3 are wound differently at the connection portion. The first reinforcing portion 2 is orthogonal to the axial center line XX at an end portion opposite to the connection portion with the second reinforcing portion 3 as shown in FIG. The side surface shape seen from the intersection of the line Y-Y is formed in a perfect circular shape. In addition, as shown in FIG. 3D, the second reinforcing member 3 has an axial center line XX at an end position opposite to the connection with the first reinforcing member 2. The side surface shape seen from the intersection of the orthogonal line Y-Y is formed in a substantially semicircular shape. Further, the connecting portion between the first reinforcing portion 2 and the second reinforcing portion 3 has a side surface gradually continuous from a substantially semicircular shape to a perfect circular shape as shown in FIG. It has a changed shape. The area inside the side view (the area of the space surrounded by the reinforcing member) does not change in any of these portions having different side shapes. This is because, when embedded in the peripheral wall of the endotracheal tube, as will be described later, the cross-sectional area of the lumen does not change, and a decrease in the amount of air supply does not occur.

  FIGS. 3 and 4 show the resistance and the like of the first reinforcing member portion (true circular reinforcing member portion) 2 and the second reinforcing member portion 3 (substantially semi-circular reinforcing member portion) of the reinforcing member 1 as described above. It is a drawing explaining strength. The first reinforcing member 2 shown in FIG. 3 is bent without any resistance in any direction because its side shape is a perfect circle. On the other hand, since the second reinforcing member 3 shown in FIG. 4 has a substantially semicircular side shape, it can be bent without resistance in the left-right direction, but has a semicircular corner (circled in the vertical direction). Part) becomes a resistance and must be bent with strong force. Therefore, the second reinforcing portion 3 is stronger than the first reinforcing portion 2 due to the resistance due to the corners, and has no kink.

  5 to 7 show a double-lumen endotracheal tube in which the reinforcing body 1 is embedded. The endotracheal tube 11 is made of silicone rubber or the like, and includes a tube main body 15 in which lumens 12 and 13 are formed in parallel in the axial direction. The lumens 12 and 13 each have a substantially semicircular cross section, and are arranged with their linear back surfaces in contact with each other. A tracheal cuff 16 is attached to the distal end of the tube main body 15, and the distal end side of the cuff is branched into two long and short distal ends 17 and 18. Of the two distal ends 17, 18, the distal end 17 having the lumen 12 for ventilation of the right bronchus has a length slightly protruding from the front end of the cuff 16.

  On the other hand, the distal end portion 18 having the lumen 13 for left bronchial ventilation is longer than the distal end portion 17, and the lumen 13 a communicating with the lumen 13 is formed to have a perfect circular cross section. I have. The reinforcing body 1 is helically embedded in the peripheral wall of the distal end portion 18 so as to be elastically deformable. That is, in the reinforcing body 1 embedded in the peripheral wall of the distal end portion 18, the side surface is formed in a perfect circular shape, one end is located near the distal end opening of the distal end portion 18, and the side surface is formed in a substantially semicircular shape. It is embedded so as to surround the lumen 13 a so that the other end is located near the base end of the distal end portion 18 near the cuff 16.

  The open end surface of the distal end portion 17 is formed in a tapered shape obliquely inclined toward the open end surface side of the distal end portion 18. The reinforcing body 1 is not embedded in the peripheral wall other than the peripheral wall of the distal end portion 18, that is, the peripheral wall of the tube body 15 and the peripheral wall of the distal end portion 17. A bronchial cuff 20 is mounted near the distal end opening of the distal end portion 18. At the time of intubation, the bifurcations of the distal ends 17, 18 may hit the trachea and the bronchus bifurcation (carina) and damage the bifurcation. Therefore, a soft silicone rubber or silicone gel is attached to the abutment as a pad. It is preferable to keep it.

  Reference numeral 21 denotes a tracheal-side branch tube connected to the lumen 12 of the tube body 15, and reference numeral 22 denotes a bronchial-side branch tube connected to the lumen 13 of the tube body 15. Reference numeral 24 denotes a pilot balloon for the tracheal cuff 16, reference numeral 26 denotes a pilot balloon for the bronchial cuff 20, and reference numerals 25 and 27 (see FIG. 7) denote the tube main body 15 so that the pilot balloons 24 and 26 communicate with the cuffs 16 and 20. This is the caf ー lumen formed on the surrounding wall. Reference numeral 28 denotes a scale provided on the outer circumferential surface of the tube body 15 in the axial direction, for grasping the insertion amount of the endotracheal tube 11 into the trachea. For example, the first numeral 22 shown in FIG. 5 indicates that the length from the tip of the tube body 15 is 22 cm.

  Next, a method of using the endotracheal tube 11 in which the reinforcing body 1 is embedded in the peripheral wall of the tube main body 15 will be described with reference to FIG. When intubating, the bent distal end portion 18 is straightened with a stylet (not shown), and then inserted into the patient's trachea from the distal end side. The tube main body 15 is advanced while checking the bifurcations of the tips 17 and 18 on the scale 28, and when the tip 18 is inserted into the right bronchus from the trachea, the stylet is gently pulled out, and the tips 17 and 18 are removed. The intubation is completed by locating the bifurcation of the trachea and the bronchial carina so that they do not directly hit the carina. At the time of intubation, a tube holder may be inserted and fixed. In this case, the tube holder is placed so as to be in contact with the surface of the throat. As a result, further insertion is prevented and the tube is intubated.

  After intubation, the cuffs 16 and 20 are inflated to firmly fix the distal end portion 18 of the tube body 15. Thus, the endotracheal tube 11 is in an intubation fixed state at an appropriate position, and various operations are performed in this state.

  Even if the distal end 18 inserted into the left bronchus of the tube main body 15 is likely to be bent due to this operation or body position change, the reinforcing body 1 is buried in the distal end. The cavity 13 is not closed.

  Further, the reinforcing body 1 is embedded in the peripheral wall of the distal end portion 18 of the tube main body 15, and the second reinforcing portion 3 of the reinforcing body 1 is located at the branch portion of both the distal end portions 17 and 18, so that it can withstand a strong bending force. Therefore, the kink does not occur in the lumen 13a of the distal end portion 18 and the kink can be prevented. Therefore, even when the tube holder is used outside the body, it can be securely fixed.

  The fact that the manner of winding the reinforcing member 1 is changed at the connection between the first reinforcing member portion 2 and the second reinforcing member portion 3 will be described below. The endotracheal tube 11 is inserted into the trachea. Wide lumens 12 and 13 are required so that the outer diameter is small and a large amount of air is supplied. Therefore, the shape of both the lumens is made semicircular (kamaboko shape), and the tube cross section is used efficiently. It has a configuration that can be used. Further, the distal end portion 18 having the lumen 13a is longer than the distal end portion 17 having the lumen 12 so as to be inserted into the bronchus. Since the lungs are moved during the operation, it is necessary to soften the tube 11 so that the bronchi are not damaged during the operation. However, if it is soft, the tube 11 will bend (kink). Therefore, a reinforcing body is required to improve kink resistance.

  By the way, it was not possible to fabricate a reinforcing body that has been used conventionally as one having a changed winding shape. For this reason, the distal end of the tracheal tube in which the reinforcing member is embedded has a semicircular shape in which the lumen is simply extended. Attempts were made to make the shape of the distal end portion of the tracheal tube circular. However, as shown in FIG. 9A, when the width of the semicircular tube and that of the circular tube were the same, the circular tube had a larger lumen area. As shown in FIG. 9 (B), the width becomes wider when trying to have the same lumen area. For this reason, there are problems such as a decrease in the amount of air supply, making breathing management difficult, and a step formed at a branch portion of the tube, thereby damaging the trachea and the inner circumference of the bronchi. However, the above-described problem can be solved by adopting a configuration in which the side shape changes from a substantially semicircular shape to a perfect circular shape as in the above-described reinforcing body 1. .

  10 and 11 show another embodiment of the reinforcing member. The basic structure of the reinforcing member 51 is different from that of the reinforcing member in that a winding pitch of a first reinforcing member portion 52 having a side surface formed in a perfect circular shape is larger than that of a second reinforcing member portion 53. Other configurations are the same as those of the reinforcing body. That is, the first reinforcing member portion 52 is formed in a perfect circular shape as shown in FIG. (C), and the second reinforcing member portion 53 is formed as shown in FIG. The side surface shape is formed in a substantially semicircular shape, and the connecting portion between the first reinforcing member portion 52 and the second reinforcing member portion 53 has a side surface shape gradually and continuously changed from a substantially semicircular shape to a perfect circular shape. It has a shape.

  By embedding the reinforcing member 51 in the peripheral wall of the tube body of the endotracheal tube, the kink of the distal end portion 18 of the tube body 15 can be prevented, and the same operation and effect as the reinforcing member 1 can be expected. .

  The substantially semicircular shape (kamaboko shape) of the second reinforcing member portion in the reinforcing member described in the above embodiment is merely a preferable example, and other shapes are not excluded. As long as the kink of the catheter (tube) can be prevented, it is a matter of course that another equivalent shape may be used. Further, in the above description, the cross-sectional shape of the reinforcing body 1 is formed in a perfect circular shape, but it is not necessarily required to be a perfect circular shape, and may be a polygonal shape such as a rectangular shape. In addition, it goes without saying that the design of each part of the configuration can be appropriately changed within the scope of the claims.

Reference Signs List 1,51 Reinforcement 2,52 First Reinforcement Part 3,53 Second Reinforcement Part 11 Double-lumen endotracheal tube 12,13 Lumen 15 Tube body 16 Tracheal cuff 17,18 Tip 20 Bronchial cuff 21 Tracheal branch tube 22 Bronchial branch tube 24 Pilot balloon 25 for tracheal cuff Caflumen 26 for tracheal cuff Pilot balloon 27 for bronchial cuff Cufflumen 28 for bronchial cuff Scale

Claims (7)

A spiral reinforcing body embedded in the peripheral wall of the catheter over a predetermined length to reinforce the catheter,
A first reinforcing member portion; and a second reinforcing member portion continuously connected to the first reinforcing member portion in the axial direction, wherein the first reinforcing member portion is connected to the second reinforcing member portion. In the end position opposite to the connecting portion, the side shape viewed from the intersection of the line orthogonal to the axial center line is formed in a perfect circle shape, and the second reinforcing member portion is formed by the first reinforcing member. A reinforcing member for a catheter, wherein a side surface shape viewed from an intersection of a line orthogonal to the axial center line is formed in a substantially semicircular shape at an end position opposite to a connection portion with the portion. .   2. The catheter according to claim 1, wherein the connecting portion between the first reinforcing member portion and the second reinforcing member portion has a shape in which a side surface shape is gradually and continuously changed from a substantially semicircular shape to a perfect circular shape. Reinforcement.   The catheter reinforcement according to claim 1 or 2, wherein the winding pitch of the first reinforcement is larger than the winding pitch of the second reinforcement.   A catheter, wherein the catheter reinforcement according to any one of claims 1 to 3 is embedded in a peripheral wall of the catheter body.   The catheter is a double-lumen endotracheal tube, the endotracheal tube having a first distal end having a first bronchial lumen at the distal end and a second bronchial lumen extending longer than the distal end. The first bronchial lumen at the first distal end is branched into a certain second distal end, and the first bronchial lumen at the first distal end is formed in a substantially semicircular cross section, and the second bronchial lumen at the second distal end is formed. 5. The catheter according to claim 4, wherein the cross section is formed in a perfect circular shape.   The reinforcing body is embedded in the peripheral wall of the second distal end so that one end is located near the distal opening of the distal end and the other end is located near the proximal end of the distal end. Catheter.   The catheter reinforcing member according to any one of claims 1 to 6, wherein the first reinforcing member portion and the second reinforcing member portion have the same area on the inner side in a side view.

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