JP4930057B2 - Valve body and nutrition catheter having the valve body - Google Patents

Description

  The present invention relates to a valve body and a feeding catheter having the valve body.

  As a management method of nutrition catheters, particularly PEG (gastrostomy) catheters, by filling the lumen of the catheter with acetic acid water (those diluted with 10 times water of common edible vinegar, for example) except when administering nutrients, Methods have been used to keep the gastrostomy catheter clean for an extended period of time, for example, until it is next reused. In the operation of filling the feeding catheter lumen with the acetic acid water, it is necessary to cap the catheter nutrient solution administration port in order to prevent the acetate water from flowing out after filling the catheter lumen with the acetic acid water. Needs to be bent and kinked by hand. These operations are troublesome per se, and are repeated over a long period of time, so that a load is applied to the catheter, in particular, the bent portion of the catheter, thereby promoting the obstruction and aging of the lumen of the catheter. Making it difficult to use. In addition, vinegar that has been filled in a PEG (gastric fistula) catheter immediately before reuse after entering vinegar will enter the body, especially the stomach, duodenum, etc., but the filled vinegar is put into the body. The safety of this is not proven.

JP 2002-28224 JP2003-190274A JP 2002-200145 A Special table 2004-516116

  The problem to be solved is that, as described above, when a feeding catheter such as a PEG (gastrostomy) catheter is filled with a drug or nutrient, and the cap is capped, the bending operation is performed on the conduit. In addition, nutrition catheters such as PEG (gastric fistula) catheters can be used without being put into the body when reusing the vinegar that was previously placed in the catheter to keep it clean. A valve body that is used by being attached to the catheter to enable reuse, and a nutritional catheter having the valve body.

The present invention relates to a container-shaped portion, a slit as a hollow-shaped insert insertion port capable of maintaining airtightness even when the hollow insert mounted in the container-shaped portion is inserted or not inserted, and / or An elastic plug body having a small hole, and a central part standing upright from the elastic plug body on the outlet side of the container-shaped portion and inclined from the container-shaped inner wall surface to the outlet side of the container-shaped portion with respect to the inner wall surface A hollow tube comprising a head side and a foot side through which the liquid can pass through, wherein the hollow insertion body fixing member has a hollow insertion body formed therein. The above problem could be solved by a valve body having a shape (for example, valve body A in FIG. 1).
The said container shape part can be formed in the head side and / or side wall part side of a hollow tube shape.

  When the valve body is inserted and held in the slit and / or hole portion 6 as shown in FIG. 3, a male luer portion 5 of a needleless port of a liquid, for example, a nutrient solution or a chemical solution is inserted or held. By having the fixing member 2 in addition to the hole 6, the hollow insert inserted without any leakage can be stably held.

Since the fixing member of the hollow insertion body is more rigid than the elastic plug body and is inclined to the outlet end side of the container with respect to the side wall surface of the container-shaped portion, the fixing member is The effects a) to (b) can be achieved.
(A) Due to the fact that the fixing member is more rigid than the elastic plug body, the male luer part of the needleless port used for injecting nutrients in particular is used compared with the male luer part used for injecting chemicals. Due to the large size, it is difficult to hold and fix the elastic plug body alone. However, the valve can easily hold and fix the male luer part by providing the fixing member. This fixing member may be formed integrally or separately with the container-shaped portion formed of synthetic resin.
(B) Since the fixing member is provided so as to be inclined and provided on the outlet side of the container with respect to the side wall surface of the container-shaped part, it is easy even with a hollow insert, for example, a male luer part of a large needless port. It can be smoothly inserted into the insertion port of the fixing member.

  In particular, as the fixing member, when the hollow insert is inserted into the insertion port, the fixing member is bent, and the hollow insert is used by utilizing the repulsive force (elasticity) of the fixing member generated thereby. A structure that can be fixed is preferable because not only can the hollow insert be more easily inserted into the insertion port, but also the inserted hollow insert can be more firmly fixed and held. As the structure of the fixing member 2 causing the bending as described above, an inverted conical shape having an insertion port at the top and a thinned thickness, or a plurality of strips so as to form an insertion port The thing etc. which stood and comprised the thing etc. are mentioned.

  As a modified example of the fixing member of the hollow insertion body, the fixing member is present as a fixing member on the inlet end side of the container from the elastic stopper, and has an opening on a side wall between the fixing member and the elastic stopper. (See FIG. 4). The fixing member of this aspect also preferably has the same configuration and function as the fixing member provided in the container-shaped part, but the fixing member of this aspect is visible and hollow-inserted unlike the fixing member provided in the container-shaped part. Since the body can be inserted into the insertion port more easily, it is not necessary to be inclined to the outlet side with respect to the side wall surface of the container like the fixing member provided in the container-shaped part, for example, a horizontal shape It may be. Further, as described above, the valve body according to this aspect has the opening in the side wall between the fixing member and the elastic plug body, so that the cleaning operation by washing before and / or after use of the valve body can be easily performed. It can be carried out.

As a modification of the valve body, instead of a fixing member formed in the container-shaped portion, the container-shaped inner wall surface is reduced in diameter from the inlet side having the insertion port of the hollow insert body toward the outlet side, and is hollow in the center. A conical surface having an insertion port into which the insert is inserted is formed integrally or separately from the container-shaped inner wall surface (for example, FIGS. 7 and 8).
As a modification of the valve body, when the fixing member is formed on the inlet side of the container-shaped part (for example, in the case of FIG. 5), the inside of the container-shaped part may be a passage-shaped (for example, FIG. 9).

  Each of the valve bodies can be used as a cap by being separably connected to the head side and / or the side wall side of the hollow tubular body cap and capable of passing liquid (for example, FIGS. 1, 10, and 11). In this case, the valve body is connected to the head side and / or the side wall portion of the hollow tubular body cap so as to be separable by screwing or fitting, so that the valve body has a longer foot portion than the one formed longer. And the cleaning operation in the valve body can be easily performed. In addition, the foot portion of each valve body may be formed in a structure for enhancing the joining force with a member joined to the foot portion, for example, a catheter, for example, a bamboo cuboid shape having stepped nodes on the outer periphery thereof.

  A medical conduit such as a catheter or a tube, a mixed injection port used attached to the medical conduit, for example, a Y-shaped mixed injection, is provided on the foot of the valve body or the foot of the hollow tubular body cap portion to which the valve body is joined. A port or connector, such as a connector for a nutritional drip set, is attached. An example of the medical conduit connected to the hollow tubular body cap or the foot of the hollow tubular body cap portion is a feeding catheter. The nutritional catheter connected to the valve body includes not only the catheter portion but also a catheter equipped with or formed with the above-described mixed injection port, connector, balloon, bumper and the like. In the present specification, the upstream side refers to, for example, a nutritional drip set side in a nutritional catheter equipped with a nutritional drip set, and the downstream side refers to the human body side where the nutritional catheter is inserted or installed.

  Examples of the nutritional catheter include a nasal (oral) nutritional catheter, an ED tube, a gastrostomy catheter, and a transgastric enema catheter. In addition, the gastrostomy catheter includes a gastric indwelling device of a bumper type and a balloon type, and a tube connection type and a button type of a connection portion with a nutrition drip set. In addition, as a female connector for attaching a nutrition drip set, a medicine mixed injection syringe (or injector), an air injection syringe (or injector), a washing syringe (or injector), etc. to the nutrition catheter, the nutrition catheter And having a taper of 125 ± 25/1000 that conforms to the Ministry of Health and Welfare Medicinal Product No. 888 (August 31, 2000) attached to or formed on the upstream end portion of the above. Some types have a 6/100 taper conforming to international standards ISO594-1 and ISO594-2.

  As the mixed injection port of the nutrition catheter, for example, a Y-shaped tube composed of two ports, a nutrient solution port and a balloon port, can be mentioned. The balloon-type and bumper-type co-injection ports are 2 ports and 1 port, respectively. However, these can also be applied to the 3-port and 2-port types in which a drug co-infusion port is added to them. The type is not particularly limited. Each branch connection port of the mixed injection port has, for example, a nutritional drip set, a medicine mixed injection syringe (or injector), an air injection syringe (or injector), and a cleaning syringe (or injector) as in the case of the female connector. A balloon expansion syringe or the like is connected, but the connection part of the nutritional drip set or syringe (or injector) connected to each branch connection port of the mixed injection port is the same as the female connector of the nutrition catheter The thing which has a taper is mentioned.

  As the mixed injection valve portion of the present invention, it is difficult (or insufficiently fitted) to insert a hollow insert other than the type used for injecting acetic acid, for example, a hollow insert other than a 125 ± 25/1000 taper. In particular, it is preferable not to fit well with a 6/100 taper hollow insert from the viewpoint of preventing erroneous connection. Further, the hollow insert inserted into the mixed injection valve portion is not particularly limited as long as it is a hollow body that can be inserted into the mixed injection valve portion and has a liquid injection function. And an injector having a tip diameter of 6.0 ± 0.5 mm, a length of 15 mm or more, and a 125 ± 25/1000 taper suitable for August 31, 2000).

Hereinafter, usage examples of the cap of the present invention will be shown as embodiments.
Embodiment 1
1. Embodiment 1
The Y-shaped co-infusion port 12 of the balloon-type gastrostomy catheter 13 is fitted and connected to the foot 4 side of the cap B in FIG. 1 (FIG. 12).
2. Embodiment 2
A Y-shaped co-infusion port 12 of a balloon-type gastrostomy catheter 13 is fitted to the foot 4 side of the cap B in FIG. 11, and a connector 16 with a lid 20 is attached to the head side 3 of the cap B (see FIG. 13).

3. Embodiment 3
A female connector 18 of a feeding catheter (nasal gastric tube feeding catheter) 17 is fitted and connected to the foot 4 side of the cap B in FIG. 1 (FIG. 14).
4). Embodiment 4
A female connector 18 of a nutritional catheter (nasal gastric tube feeding catheter) 17 is fitted to the foot 4 side of the cap B in FIG. 11, and a connector 16 having a lid 20 is attached to the head side of the cap. Catheter (nasogastric feeding catheter) (FIG. 15).

5. Embodiment 5
A female connector 18A of an extension tube 21 of a nutritional catheter (nasal gastric tube feeding catheter) 17 is attached to the foot 4 side of the cap B of FIG. 1 (FIG. 16).
6). Embodiment 6
A female connector 18A of an extension tube 21 of a feeding catheter (nasal gastric tube feeding catheter) is attached to the foot 4 side of the cap B in FIG. 11 (FIG. 17).

7). Embodiment 7
A female connector 18B of an ED tube 23 is mounted on the foot 4 side of the cap B in FIG. 1 (FIG. 18).
8). Embodiment 8
A female connector 18B of the ED tube 23 is attached to the foot 4 side of the cap B of FIG. 11 (FIG. 19).

9. Embodiment 9
1 connected to the valve body A of FIG. 1 provided on the side surface of the Y-shaped co-infusion port 12 connected to the balloon-type gastrostomy catheter 13 or a cap connected to the valve body A of FIG. A balloon-type gastrostomy catheter equipped with a valve body A and a connector 16 having a lid 20 on the head side of the mixed injection port Y-shaped mixed injection port 12 (FIG. 20).
10. Embodiment 10
The cap or valve body A of FIG. 1 is attached to the connection portion of the cap or valve body A of FIG. 1 provided on the side surface of the Y-shaped co-infusion port 12 connected to the bumper type gastrostomy catheter 25, and the co-infusion port Y A bumper-type gastrostomy catheter (FIG. 21) in which a connector 16 having a lid 20 is attached to the head side of the letter-shaped mixed injection port 12.

11. Embodiment 11
A cap or valve body connected to the valve body A in FIG. 1 is connected to a cap or valve body A connected to the valve body A in FIG. 1 provided on the side of the female connector 18 member of the nasogastric feeding catheter 17. A nasogastric feeding catheter equipped with A (FIG. 22).
12 Embodiment 12
An ED having the cap or valve body A connected to the valve body A in FIG. 1 attached to the cap or valve body A connecting portion of the valve body A in FIG. 1 provided on the side surface of the female connector 18B of the ED tube 23. Tube (Figure 23).

13. Embodiment 13
1 to the female connector 18C of the extension tube 25 connected to the button type balloon type bumper for PEG (gastric fistula) having the connection part (external fixation plate) 14 connected to the nutrient port of the button type catheter for PEG. A medical extension tube (FIG. 24).
14 Embodiment 14
A valve body A shown in FIG. 1 is connected to an extension tube 27 of a feeding catheter having a male connector 28 (FIG. 25).

15. Embodiment 15
26, except for the nutrition container 29, the drip tube 30, the male connector 34 connected to the clamp 32 and the nutrition catheter, and the nutrition container 29 of the nutrition drip set having the tube 31 connecting the respective members. As shown in FIG. 24, a nutrient infusion set to which a cap B to which the valve body A of FIG. 1 is connected is connected (FIG. 27).

It is explanatory drawing which attached the valve body A to the hollow tubular cap. It is explanatory drawing of valve body A2. It is explanatory drawing which hold | maintained the male luer part on the fixed holding | maintenance board. It is explanatory drawing of the modification of the valve body of FIG. It is explanatory drawing of the modification of the valve body of FIG.

It is explanatory drawing of the structure which hold | maintained the male luer part in valve body A1. It is explanatory drawing which mounted | wore the hollow tubular cap with the valve body in which the fixing member formed the conical surface in the inner wall surface of the container. It is explanatory drawing of the valve body in which the inner wall face of the container shape part formed the conical surface. It is explanatory drawing of another aspect of the valve body in which the container-shaped inner wall surface formed the conical surface. It is explanatory drawing which attached the valve body A to the hollow tubular cap. It is explanatory drawing which mounted | wore the valve body A to the head and side wall part of a hollow tubular cap. It is explanatory drawing which mounted | wore the cap B of FIG. 1 with the Y-shaped co-infusion port 12 of the balloon type gastrostomy catheter 13. FIG. FIG. 12 is an explanatory diagram in which the Y-shaped co-infusion port 12 of the balloon-type gastrostomy catheter 13 is attached to the cap B of FIG. 11.

FIG. 3 is an explanatory diagram in which the cap B of FIG. 1 is attached to the female connector 18 of the nutrition catheter (nasal gastric tube nutrition catheter) 17. FIG. 12 is an explanatory diagram in which the cap B of FIG. 11 is attached to the female connector 18 of the nutrition catheter (nasal gastric tube nutrition catheter) 17. It is explanatory drawing which attached the cap B of FIG. 1 to the female connector 18A of the extension tube 21 of a nutrition catheter. It is explanatory drawing which attached the cap B of FIG. 11 to the female connector of the extension tube 21 of a nutrition catheter.

FIG. 2 is an explanatory diagram in which the cap B of FIG. 1 is attached to the female connector 18B of the ED tube 23. FIG. 12 is an explanatory diagram in which the cap B of FIG. 11 is attached to the female connector of the ED tube 23. It is explanatory drawing which attached the cap B of FIG. 1 to the mixed injection port side surface 12 connected with the balloon type gastrostomy catheter 13. FIG. FIG. 2 is an explanatory diagram in which the cap B of FIG. 1 is attached to the side surface of a Y-shaped mixed injection port connected to a bumper-type gastrostomy catheter 131.

FIG. 3 is an explanatory diagram in which the cap B of FIG. 1 is attached to the side surface of the female connector member 18 of the nasogastric feeding catheter 17. It is explanatory drawing which mounted | wore the side surface of the connector member 18B of the ED tube 23 with the cap B of FIG. FIG. 3 is an explanatory diagram in which the cap B of FIG. 1 is attached to an extension tube 25 female connector 18C connected to a button type balloon type bumper for PEG (gastrostomy). It is explanatory drawing which attached the cap B of FIG. 1 to the extension tube 27 of the nutrition catheter which has the male connector 28 which connects a nutrition catheter. It is explanatory drawing which showed an example of the nutrition drip set. It is explanatory drawing which showed the nutrient infusion set which attached | subjected the cap which equip | installed the valve body of FIG. 1 to this part except the nutrient container shown in FIG.

Explanation of symbols

A valve body A1 valve body A2 valve body part A3 valve body part B cap C elastic plug body 2 fixing part of the hollow insertion member 2A fixing part of the hollow insertion member 2B fixing part of the hollow insertion member 2C of the hollow insertion member Fixing part 2 'Fixing member of conical shaped hollow insertion member 2''Fixing member of conical shaped hollow insertion member 3 Cap head 4 Cap foot 4A Hollow tubular body cap part 5 Male luer part

6 Slit and / or hole part 7 Side wall part of valve body container 7 Side wall part of valve body container (upper part)
7 'Side wall portion of valve body container 7A Side wall portion of valve body container 7A' Side wall portion of valve body container (upper part)
7B Side wall part of the container part of the valve body 7B 'Side wall part (upper part) of the container part of the valve body
7C Side wall part of the container part of the valve body 7C 'Side wall part (upper part) of the container part of the valve body
8 Insertion port of hollow insertion member of fixing member 9 Inlet end of container-like part 10 Outlet end of container-like part

DESCRIPTION OF SYMBOLS 11 Opening part 12 Y-shaped mixed injection port 13 Balloon type gastrostomy catheter 14 Extracorporeal fixation board 15 Balloon 16 Male connector 17 Nutrition catheter (nasal gastric tube feeding catheter)
18 Female connector of feeding catheter (nasal gastric tube feeding catheter) 17 A Female connector of extension tube 21 of feeding catheter (nasal tube feeding catheter) 17 B Female connector of ED tube 23 Female connector of extension tube 25 Type connector 19 side hole 20 lid 21 extension tube of feeding catheter (nasal gastric tube feeding catheter) 17 male connector for connecting the feeding catheter

23 ED Tube 24 Weight 25 Extension Tube Connected to Button Type Balloon Type Bumbar for PEG (Gastrostomy) 26 Cap Button Type Balloon Type Bumbar Cover for PEG (Gastrostoma) 27 Nutritional Catheter Extension Tube 28 Male Type to Connect Nutritional Catheter Connector 29 Nutritional container 30 Drip tube 31 Tube 32 Clamp 33 Male connector to connect to the feeding catheter 34 Mixed injection valve

  The usage example of the valve body of this invention and the cap which this valve body connected is shown.

As Example 1, an operation of putting acetic acid water into a conventional feeding catheter and an operation of putting acetic acid water into a feeding catheter using the valve body of the present invention and a cap connected to the valve body will be described.
Conventional Example (1) A needleless syringe is filled with an appropriate amount of acetic acid water in consideration of the inner diameter, length, etc. of the feeding catheter and feeding set. (2) A cap is attached to the nutrient supply port portion of the Y-shaped mixture injection port of the nutrition catheter to which the nutrition drip set is attached, and the port portion different from the port portion, for example, the medicine mixture injection port portion, from the syringe 1 The appropriate amount of acetic acid water is injected. (3) After injecting the acetic acid water, the syringe is removed from the Y-shaped mixed injection port in a state where the vicinity of the downstream side of the Y-shaped mixed injection port is kinked by hand so that the injected acetic acid water does not flow out of the catheter. The cap is attached to the port from which the syringe is removed while keeping the kinked state, and then the kinked state is released and the catheter is reused.

Example 1
This will be described with reference to FIG.
(1) An appropriate amount of acetic acid water is filled in a needleless syringe having a male luer part in consideration of the inner diameter and length of the feeding catheter. (2) A cap B connected to the valve A of FIG. 1 was connected to a Y-shaped co-infusion port 12 to which a nutrition drip set (not shown) coupled to the balloon-type gastrostomy catheter 13 was mounted. (3) The male luer part of the syringe is inserted into the slit and / or the hole part 6 of the elastic stopper part C of the cap B, and the appropriate amount of acetic acid water in the syringe is injected into the nutrition catheter. When the syringe is removed after injecting the acetic acid water, the mixed injection valve is in a “closed” state. Therefore, the acetic acid water injected into the catheter does not flow out of the catheter due to pressure. As can be understood from the comparison between the conventional example and the embodiment, by using the cap with the mixed injection valve of the present invention, a feeding catheter, for example, a gastrostomy catheter, remains attached and does not form a kinked state. Since acetic acid water can be filled in the inside, the labor of managing these catheters and the load on the catheter accompanying the formation of a kink state are eliminated.

  Further, the feeding catheter equipped with a cap or valve body connected to the valve body of the present invention, as in the conventional example, the acetic acid water stored in the catheter upon reuse is used in the body, for example, the stomach and / or Rather than discharging into the duodenum, etc., the male luer part of the needleless syringe is inserted into the slit and / or hole 6 of the valve body of the cap B, and the acetic acid water filled in the feeding catheter can be taken out by the syringe. Since it is possible, it is not necessary to discharge the acetic acid water into the body. Thus, since the acetic acid water filled in the nutritional catheter does not need to be discharged into the stomach and / or duodenum at the time of reuse, the human body is not adversely affected. In this embodiment, acetic acid water is used to keep the nutritional catheter clean. However, as long as the inside of the nutritional catheter can be kept clean, not only acetic acid water but also other drugs can be used. It is possible to use. In addition, the male luer part used for injecting the acetic acid water into the feeding catheter usually has a large capacity, a large size, and its holding is unstable only with the plug member, but the valve body used in this example Since A has a holding and fixing member for the male luer part of the needleless syringe in addition to the stopper member as shown in FIG. 1, the male luer part can be firmly held.

As another aspect of the present invention, an example in which the cap of the present invention is used for a nutritional drip set attached to the nutritional catheter instead of the nutritional catheter as in Example 1 will be described.
After using the nutritional infusion set shown in FIG. 23, the container 29 containing the nutrient is removed, and the cap connected to the valve body A of FIG. 1 is connected thereto to prevent erroneous connection for enteral nutrition from the valve body A Using a 125 ± 25/1000 taper injector with mechanism, acetic acid is added to fill the feeding catheter and feeding set or feeding catheter. The nutrient set is reused by maintaining the tube feeding until the next tube feeding with the above acetic acid water.

  In the management method for filling the lumen of the feeding catheter with acetic acid water, which has been adopted as a management method for feeding catheters, particularly PEG (gastric fistula) catheters, the labor required for filling the catheter lumen with the acetate water In addition, it is possible to eliminate the need for the operation of capping the catheter by manually bending and kinking the catheter which applies the load to the bent portion of the catheter and promotes the aging of the catheter itself. In addition, since the acetic acid water filled in the feeding catheter lumen can be sucked by the vinegar syringe in the catheter through the valve body of the cap when the feeding catheter is reused, the vinegar left in the catheter for several hours can be removed. No more worries about the effects of getting into the body.

Claims (9)

A container-shaped portion having an inlet end and an outlet end, and a slit as a hollow-shaped insert insertion port capable of maintaining airtightness even when the hollow insert mounted in the container-shaped portion is inserted or not inserted And / or an elastic plug body having a small hole, and a container shape with respect to the inner wall surface from the inner wall surface of the container-shaped portion, which is present in the container shape portion below the elastic plug body and spaced apart from the elastic plug body A hollow tube-shaped valve body characterized by having a hollow insert fixing member that is inclined to stand on the outlet end side of the part and has a hollow insert insert port formed at the center thereof . The hollow tube-shaped valve body according to claim 1 , wherein the fixing member of the hollow insertion body is an inner wall surface of the container-shaped portion . In which the fixing member of the hollow insert forms a conical inner wall surface of the container-shaped portion is reduced in diameter toward the outlet end side of the inlet end side, it has an insertion opening of the hollow insert in its central part The hollow tube-shaped valve body according to claim 2 . The fixing member of the hollow insert is erected from the inner wall surface of the container-shaped portion inclined toward the outlet end side of the container-shaped portion from the inner wall surface of the container-shaped portion, and is inserted hollowly into the center portion thereof The hollow tube-shaped valve body according to claim 1 or 2, wherein a body insertion port is formed . A container-shaped portion having an inlet end and an outlet end, and a hollow insert insertion port mounted inside the container-shaped portion and capable of maintaining airtightness even when the hollow insert is inserted or not inserted An elastic plug having a slit and / or a small hole, and a container from the inner wall surface of the container-shaped portion that is separated from the elastic plug body in the container-shaped portion above the elastic plug body to the inner wall surface A hollow tube-shaped valve body characterized by having a hollow insertion body fixing member that is inclined to stand on the outlet end side of the shape section and has a hollow insertion body insertion port formed in the center thereof . The valve body according to any one of claims 1 to 5 , wherein the fixing member is configured to generate a repulsive force (elasticity) when a hollow insert is inserted into the elastic plug. A catheter cap in which the valve body according to any one of claims 1 to 6 is detachably connected to a head side and / or a side wall side of a hollow tubular body cap of the catheter . A nutritional catheter having the cap according to claim 7 attached thereto . The nutrition catheter according to claim 8, wherein the catheter is filled with a medicine for maintaining a clean state.