JP5420469B2 - Check valve device and gastrostomy catheter - Google Patents

Description

  The present invention relates to a backflow prevention valve device and a gastrostomy catheter, and more particularly, to a technique for improving the closing function of a so-called duckbill valve that is a medical catheter such as a gastrostomy catheter, for example, used for a gastrostomy feeding button. It is concerned.

  After gastrostomy, gastrostomy is performed to supply nutrients into the body using the gastrostomy button placed in the body. To prevent backflow of nutrients after supply, a check valve is provided on a part of the button. (See, for example, Patent Document 1).

  The backflow prevention valve disclosed in Patent Document 1 is a slit valve in which a cut line (slit) is provided in a circular silicon thin plate, and is usually pushed open by the tip of the nutrient supply adapter when supplying nutrients, Sometimes it is blocked to prevent backflow from the stomach interior. However, in this slit valve, the slits are gradually attached to the slit due to the insertion of the tip of the adapter by repeated use, and the slit valve may not be normally closed.

  Therefore, a duck bill valve in which a portion provided with a slit is shaped like a duck's ridge has been newly considered to be easily closed during normal times (see, for example, Patent Document 2). This duckbill valve has a structure in which the slit closing performance is higher than that of the slit valve in a normal state, and a corresponding effect can be expected.

  By the way, recently, not only supplying nutrients but also increasing the opportunities to use PEG endoscopes that are inserted into gastrostomy catheters and look directly into the stomach. It is necessary. Therefore, since the slit becomes longer, even the duckbill valve disclosed in Patent Document 2 is liable to cause a poor closing of the slit due to the influence of the distortion of the slit caused by the passage of the PEG endoscope. There was a problem that the reverse flow would occur.

JP 2003-38655 A JP-T-2001-510272

  Therefore, in view of the conventional problems as described above, an object of the present invention is to provide a backflow prevention valve device and a gastrostomy catheter that can improve the slit closing function and prevent backflow. And

In order to solve the above-mentioned problem, the invention according to claim 1 is a backflow prevention valve device used for a medical catheter having a tubular catheter body, wherein a valve housing recess is formed at the rear end of the catheter body. The valve housing recess is entirely made of an elastomer such as silicone rubber, and has a base portion formed in an annular flat plate and both side wall portions inclined opposite to each other downward from the base portion so as to be narrowed. A backflow prevention valve having a slit formed at the lower end of the main body portion, and at the middle part in the vertical direction of both side walls of the backflow prevention valve. A rectangular elastic convex portion that acts to press the intermediate position in the longitudinal direction of the slit from the horizontal direction so that the slit is always closed is a lower portion of the valve housing concave portion that faces both side walls when the backflow prevention valve is mounted. inner wall And being provided integrally extends vertically at a position opposed.

The invention according to claim 2 is the backflow prevention valve device according to claim 1, wherein the medical catheter is a gastrostomy catheter.

The invention according to claim 3 is a gastrostomy catheter comprising the check valve device according to claim 1 or 2 .

This invention is as described above, and according to the invention described in claim 1 or 2, there is provided a pressure applying member that acts to apply a pressing force to both side walls of the backflow prevention valve so that the slit is always closed. , provided at a position facing the inner wall of the side walls portion opposite to the valve housing recess, a vertical intermediate portion of both side walls of the check valve, pressing a longitudinal middle position of the slit from the horizontal direction In addition, a rectangular elastic projection that acts so that the slit is always closed extends vertically to the opposite position of the lower inner wall of the valve storage recess that faces both side walls when the backflow prevention valve is mounted, and is provided integrally Therefore, even if the above-mentioned backflow prevention valve is used for a medical catheter such as a gastrostomy catheter, the closing function can be improved so that the slit cannot be closed poorly, and the backflow phenomenon can be prevented. can do. Moreover, there is an excellent effect that the pressing action by the elastic convex portion can be performed well and the slit can be opened and closed smoothly.

According to the third aspect of the present invention, the above-described anti-reflux valve device is used for the gastrostomy catheter. Therefore, in the supply of various agents such as nutrients performed using the gastrostomy catheter, the counter-flow phenomenon is appropriately observed. Can be prevented.

1 shows a gastrostomy feeding button with a backflow prevention valve device according to an embodiment of the present invention, and FIG. B) is a longitudinal cross-sectional front view of a main part with a part omitted after the adapter is mounted. The backflow prevention valve used for the above is shown, (A) is a plan view, (B) is a sectional view, (C) is a front view, (D) is a side view, and (E) is a bottom view. It is a principal part enlarged view of the valve storage recess formed in the rear-end part of the gastrostoma nutrition button, (A) is a top view, (B) is a front sectional view, (C) is a sectional side view. It is a front sectional view of the principal part expansion which shows the state which inserted the backflow prevention valve in the valve storage recess. It is the principal part longitudinal cross-section front view which abbreviate | omitted one part which shows the state which mounted | wore the gastrostomy nutrition button and inserted the endoscope for PEG through this adapter. It is a principal part enlarged view which shows the modification of a valve storage recess, (A) is a top view, (B) is a front sectional view, (C) is a sectional side view. It is a principal part enlarged view which shows another modification of a valve storage recess, (A) is a top view, (B) is a front sectional view, (C) is a sectional side view.

  Hereinafter, a gastrostomy feeding button as a medical catheter with a backflow prevention valve (gastrostomy catheter) according to an embodiment of the present invention will be described with reference to the drawings.

  In FIG. 1, reference numeral 1 denotes a gastrostomy feeding button. The gastrostomy feeding button 1 is detachably attached to a tube-shaped button main body 2 made of an elastomer (elastic body) such as silicone rubber and a rear end portion of the main body. And an adapter 3 made of synthetic resin.

  The button body 2 has a length of about 5 to 6 cm, and the front end side is omitted, but has a balloon (not shown) on the outer periphery of the front end portion. A large-diameter valve storage recess 5 is provided at the rear end of the button main body 2 so as to communicate with the main body lumen 4, and a backflow prevention valve 10 is stored in the storage recess. In FIG. 1, a cap for attaching a gastrostomy nutrient supply port, an adapter for inflating a balloon, and the like provided at the rear end of the button body 2 are not shown.

  As shown in detail in FIG. 2, the backflow prevention valve 10 is entirely made of an elastomer (elastic body) such as silicone rubber, and has a base portion 11 formed on an annular flat plate and a bottom end that extends downward from the base portion. And a main body 12 formed in an elongated rectangular shape. The main body portion 12 is inclined inward so that the interval gradually decreases toward the lower end toward the opposite side in contact with the lower end of the cylindrical portion 13 and the cylindrical portion 13 in contact with the lower surface on the inner peripheral side of the base portion 11. The both side wall portions 14 and the elongated rectangular lower end wall 15 in contact with the lower ends of the both side wall portions are integrated, and the inside is hollow. The upper ends of the side wall portions 14 that are in contact with the lower ends of the cylindrical portions 13 are formed so as to draw an arc-shaped parabola as shown in FIG. A single slit 16 is formed in the closed lower end wall 15 so as to be openable and closable along the length direction thereof. The slit 16 is formed over a length that allows a distal end portion of an adapter to be described later to pass therethrough.

  As shown in FIG. 2A, the lumen 18 of the check valve 10 formed in a hollow shape by the cylindrical portion 13 and both side wall portions 14 has a relatively wide cross-sectional area when viewed from the base 11 side. It has a tapered shape that extends integrally from the proximal end toward the distal end, which has a relatively narrow cross-sectional area. In FIG. 2 (B), 19 is an annular protrusion formed on the inner peripheral surface of the base 11, and it fits into an annular recess, which will be described later, of the adapter 3 and serves to prevent its positioning and nutrient leakage. .

  The backflow prevention valve 10 is mounted and stored in the valve storage recess 5 with its base 11 engaged with the annular groove 6 as described above. At the time of mounting, an adhesive may be applied in advance to the lower surface of the base 11 and bonded to the upper surface of the annular groove 6 via the adhesive. By adhering in this way, the storage of the backflow prevention valve 10 is stabilized and the position is not shifted after the storage. Further, a valve presser member 21 formed in a ring shape from above the backflow prevention valve 10 has its lower end leg portion 22 placed on the upper surface of the base portion 11 of the backflow prevention valve 10 and engaged with the annular groove 6. The flange 23 is brought into contact with the rear end surface of the button main body 2 and is mounted in the fitting recess 8 and accommodated. The inner diameter of the annular groove 6 is larger than the inner diameter of the valve housing recess 5, and the inner diameter of the fitting recess 8 is smaller than the inner diameter of the annular groove 6.

  FIG. 3 is a detailed view of the valve housing recess 5. The valve housing recess 5 is a circular space having a size that fits the cylindrical portion 13 of the backflow prevention valve 10 when viewed from above, and the lower portion of the valve housing recess 5 is a tapered portion 7 that is open behind the button body 2. It is connected to the end side. A rectangular elastic convex portion 17 as a pressure applying member extending in the vertical direction is integrally provided at a position facing the lower inner peripheral wall (inner wall) of the valve housing recess 5 that is located immediately above the tapered portion 7. Yes. The elastic convex portion 17 is made of an elastomer that is the same material as the backflow prevention valve 10, and when the backflow prevention valve 10 is mounted in the valve housing recess 5, the main body portion 12 of the valve becomes narrowed. While being pressed and compressed by the vertical middle portion of both side wall portions 14, a pressing force is applied to both side wall portions 14 in this compressed state to act in a direction in which the slit 16 is always closed, while the mounting is released. When it is in a broken state, it can be restored to its original state. The elastic convex portion 17 is the middle portion in the vertical direction of the both side wall portions 14 and presses the middle position in the longitudinal direction of the slit from the horizontal direction without always reducing the closing function of the slit 16. This is to keep the opening / closing operation good. That is, the pressing position of the elastic convex portion 17 against the both side wall portions 14 of the backflow prevention valve 10 is not particularly limited as long as it is the both side wall portions 14. Since it has been found that the middle position in the length direction of 16 is most effective, this position is shown here as a preferred example. In the above description, the elastic convex portion 17 is integrally provided in the valve housing recess 5, but a separately manufactured one may be fixed to the valve housing recess 5 by bonding or the like.

  In order to mount the backflow prevention valve 10 in the valve housing recess 5, as shown in FIG. 4, the opening 11 on the rear end side of the button body 2 is engaged so that the base 11 of the backflow prevention valve 10 is engaged with the annular groove 6. I'll put it in. In this inserted state, both side wall portions 14 of the backflow prevention valve 10 are brought into contact with the elastic convex portion 17 and receive a slight pressing force, so that the base portion 11 is biased to the upper side of the annular groove 6. ing. Thereafter, the valve pressing member 21 is inserted so that the lower end leg portion 22 thereof is placed on the upper surface of the base portion 11 of the check valve 10, and the lower end leg portion 22 is engaged with the annular groove 6 together with the base portion 11 of the check valve 10. When combined, the upper end flange 23 comes into contact with the rear end surface of the button main body 2, thereby completing the mounting. In the state where the backflow prevention valve 10 is mounted in the valve housing recess 5, the force with which the side wall portions 14 of the backflow prevention valve 10 are in contact with the elastic convex portion 17 becomes stronger than that in the inserted state, and the compression is caused by the force. Since the reaction force from the elastic convex portion 17 is also increased, a force in the closing direction acts on the slit 16 that receives the pressing force of the reaction force, and the occlusion of the slit 16 during normal operation is improved.

  When supplying the nutrient solution, as shown in FIG. 1, the small-diameter distal end portion 25 of the nutrient solution supply adapter 3 is inserted and attached to the button body 2 after the backflow prevention valve 10 and the valve pressing member 21 are accommodated. For mounting, the distal end portion 25 is inserted through an opening 26 provided in the valve pressing member 21, and the adapter 3 is rotated by a predetermined angle after the distal end surface of the large-diameter base portion 27 contacts the upper end flange 23 of the valve pressing member 21. The lock (not shown) is applied and the mounting is completed. At this time, the annular recess 29 provided in the intermediate portion of the distal end portion 25 is fitted with the annular protrusion 19 formed in the base portion 11. As is clear from FIG. 1B, the distal end portion 25 of the inserted adapter 3 opens the slit 16 so as to push the side wall portions 14 through the lumen 18 of the check valve 10. As the both side wall portions 14 are spread out, the outward surface comes into contact with the elastic convex portion 17 of the valve housing recess 5 to be pressed and compressed. The locking mechanism is a well-known technique and will not be described in detail.

  When using the gastrostomy nutrition button 1 for supplying nutrients, the gastrostomy nutrient to be supplied to the connecting portion 28 connected to the large-diameter base portion 27 of the adapter 3 attached to the button body 2 in the direction opposite to the distal end portion 25. For example, a nutrient supply tube (not shown) is connected as the supply member. Then, the gastrostomy nutrient is supplied from the nutrient supply tube through the adapter 3, and the supplied gastrostomy nutrient is supplied from the lumen 18 of the check valve 10 into the button body 2. It passes through the cavity 4 and is supplied into the stomach from its distal opening. After the supply is completed, the adapter 3 is unlocked and removed by taking the reverse procedure. When the adapter 3 is pulled out from the button main body 2 during this removal, the elastic convex portion 17 of the valve housing recess 5 kept in the compressed state is elastically restored. Even in this state of use, the slits 16 are closed without being opened for a moment by the both side wall portions 14 pressed from the elastic convex portions 17 as described above, and the closed state is maintained.

  In this embodiment, since the elastic convex part 17 presses the vertical intermediate part of the both side wall parts 14 of the backflow prevention valve 10, the slit 16 does not have a conventional opening flaw and the slit 16 is closed. It goes smoothly and there is no concern that the slit 16 will not close normally. The same applies to the mounting and dismounting by reinsertion, so that the opening and closing of the slit 16 is always kept good. When the gastrostomy feeding button 1 is not used, the cap (not shown) is attached to the button body 2 after the adapter 3 is removed.

  As described above, when the backflow prevention valve 10 is mounted in the valve storage recess 5, both side wall portions 14 of the backflow prevention valve 10 receive a pressing force from the elastic convex portion 17 of the valve storage recess 5. The slit 16 does not become poorly closed as in the prior art, and the closing function can be kept good. Therefore, even when the backflow prevention valve 10 is used for the gastrostoma feeding button 1, the slit 16 can be always opened and closed smoothly, and the backflow phenomenon can be prevented.

  According to the experiment of the present inventor, when the backflow prevention valve 10 is mounted on the valve housing recess 5 without the elastic convex portion 17, when the adapter 3 is pulled out, a gap is momentarily opened in the slit 16. Although it is visible and does not close sufficiently, when the backflow prevention valve 10 is attached to the valve housing recess 5 having the elastic convex portion 17, the opening of the slit 16 cannot be confirmed even if the adapter 3 is pulled out. , It turned out to be fully closed. In addition, regarding the durability of the valve housing recess 5 having the elastic convex portion 17, the adapter 3 was repeatedly inserted and removed 100 times a day continuously for 5 days, a total of 1500 times, but the opening of the slit 16 can be confirmed. There was not (the number of times of 100 times a day in a row is a severeness that cannot be actually used, and a test with a severeness in consideration of frictional resistance, verification).

  In the above description, the attachment of the adapter 3 in the normal supply of gastrostomy nutrient has been described. However, the same applies to the insertion of the PEG endoscope 30 as shown in FIG. That is, when the endoscope 30 is inserted into the adapter 3 and the gastrostomy button 2, the side walls 14 are pushed by the distal end portion 25 of the adapter 3 through the lumen 18 of the check valve 10. It is inserted through the slit 16 which is widened and opened. In such a case as well, due to the expansion of the side wall portions 14, the outward surfaces of the side wall portions 14 abut against the elastic convex portions 17 of the valve housing recess 5 and are compressed by receiving a pressing force. As described above. However, in this case, although the diameter of the endoscope 30 is smaller than 2.2φ and 4.0φ of the diameter of the distal end portion 25 of the adapter 3, the elastic convex portion 17 is still compressed, and this is the endoscope 30. It is possible to keep the slit 16 open and closed by restoring the elasticity by removing the. Further, the slit 16 is not distorted as in the prior art.

Various modifications of the pressure applying member provided in the valve housing recess 5 are shown in FIG.
Up to the above, elastic convex portions 17 are provided on the opposing inner peripheral walls of the valve housing recess 5, and both side wall portions 14 of the backflow prevention valve 10 accommodated by the convex portions are pressed, so that the slit 16 can be opened and subtracted appropriately. In FIG. 6, instead of the elastic convex portion 17, a spiral spring 17 a is provided as a pressure applying member, and both side wall portions 14 of the backflow prevention valve 10 accommodated by the spiral spring are provided. By pressing, the slit 16 is kept open and adjusted well. Note that the spiral spring 17a is usually manufactured as a separate body of a metal or a material with some degree of rigidity, and one end in the axial direction thereof is connected to the inner peripheral wall of the valve housing recess 5. Since the other configuration is the same as that of the above-described embodiment, the same reference numeral is given to the same configuration, and the detailed description is omitted.

  In FIG. 7, a leaf spring 17 b is provided as a pressure applying member, and both side wall portions 14 of the backflow prevention valve 10 accommodated by the leaf spring are pressed to keep the slit 16 open and subtracted. The leaf spring 17b is also usually manufactured as a separate member of a metal or a material with a certain degree of rigidity, similar to the spiral spring 17a, and one end in the axial direction thereof is connected to the inner peripheral wall of the valve housing recess 5. Since the other configuration is the same as that of the above-described embodiment, the same reference numeral is given to the same configuration, and the detailed description is omitted.

  In the above embodiment, the gastrostomy feeding button 1 is shown as an example of a gastrostomy catheter that is a medical catheter. However, instead of this gastrostomy feeding button 1, other gastrostomy catheters may be used. It can also be used for other medical catheters. Moreover, the elastic convex part 17 shown as a pressure-applying member, and the spiral spring 17a and the leaf spring 17b shown as modifications thereof are merely representative examples, and details of design matters are claimed. Needless to say, it can be arbitrarily changed and modified within the range described in the range.

1 Gastrostomy button (gastrostomy catheter)
2 Button body (catheter body)
3 Nutrient supply adapter 4 Body cavity 5 Valve housing recess 6 Annular recess 8 Fitting recess 10 Backflow prevention valve 11 Base 12 Body 13 Cylindrical portion 14 Side wall 15 Closed lower end wall 16 Slit 17 Elastic convex (pressure) Granting member)
17a Tsurumaki spring (pressure applying member)
17b Leaf spring (pressure applying member)
18 Lumen 21 Valve pressing member 22 Lower end leg portion 23 Upper end flange 25 Small diameter distal end portion 26 Open hole 27 Large diameter base portion 28 Connection portion 29 Annular recess 30 Endoscope for PEG

Claims (3)

A backflow prevention valve device used for a medical catheter having a tubular catheter body, wherein a valve housing recess is formed at the rear end of the catheter body, and the entire valve housing recess is made of an elastomer such as silicone rubber, A base portion formed on an annular flat plate, and a main body portion formed in an elongated rectangular shape extending in a narrowed shape and having a flat bottom end by opposite side wall portions inclined downwardly from the base portion. A backflow prevention valve having a slit formed at the lower end of the main body, and a vertical middle portion of both side walls of the backflow prevention valve, pressing the longitudinal middle position of the slit from the horizontal direction. elastic projections of rectangular shape which slit acts to close constantly, provided integrally extends vertically at a position opposing the lower inner wall of the valve housing recess which faces the two side wall portions when mounting the check valve Check valve device according to claim Rukoto.   2. The check valve device according to claim 1, wherein the medical catheter is a gastrostomy catheter. A gastrostomy catheter comprising the check valve device according to claim 1 or 2 .

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