JP6393056B2 - Urine catheter insertion model - Google Patents

Description

  The present invention relates to a urinary catheter insertion model simulating a local part of a human body used for practice of inserting a urinary catheter in nursing practice, medical practice, or the like.

  For example, when urination cannot be performed by oneself due to benign prostatic hyperplasia or spinal cord injury, or when general anesthesia is performed, a urinary catheter is inserted from the urethral orifice to the bladder and the urine is discharged directly from the bladder. Action is being taken.

  There are two types of urinary catheters: one that is removed from the urethra for each urination and the other that is maintained for a while after being inserted into the urethra.

  As shown in FIG. 6 (a), the balloon catheter can be inflated with the tip portion inserted into the bladder, and the inserted catheter can be kept long so that the catheter does not come off the bladder and urethra. It is configured to be maintained over a period of time.

  By the way, males have a longer urethra than women and have male-specific illnesses such as stenosis of the urethra due to benign prostatic hyperplasia, so it is more difficult to perform a maneuver to insert a balloon catheter into the bladder.

  For example, if the urethra is stenotic due to benign prostatic hypertrophy as shown in FIG. 7B, there is strong resistance at the stenosis when the catheter is inserted. As shown in (b), the distal end may not be successfully inserted into the bladder. If the balloon is inflated in such a state, the urethra will be damaged.

  For this reason, it has been conventionally considered that doctors should perform male urination, but due to the recent shortage of doctors, male urine is also within the scope of nurses. However, the teacher class nurses have never experienced male urination, and there are many reports on urethral damage as described above. In particular, for urination to men with urethral stricture due to benign prostatic hyperplasia, the frequency of urethral damage is high due to the high difficulty of urination. For this reason, a urinary catheter insertion model capable of performing training related to male urination is being sought.

  For example, there is a model shown in Patent Document 1 as a model for conducting urine training.

  However, this is to insert a catheter into the simulated urethra on a roughly straight tube and experience the drainage of water from the simulated bladder via the catheter. The feeling of resistance at the time of insertion cannot be reproduced. Therefore, even if training is performed with this model, training in line with actual clinical practice is not performed, and it is difficult to reduce urethral damage as described above.

Japanese Patent Laid-Open No. 11-15370

  The present invention has been made in view of the above-described problems. In particular, urinary catheter insertion that can faithfully reproduce urethral strictures that are problematic in male urination and that can be expected to have a sufficient training effect on catheter insertion. The purpose is to provide a model.

  That is, the present invention is a model for inserting a urinary catheter used to practice inserting a urinary catheter into the urethra, simulating the local part of the human body, and simulates the urethra from the urethral orifice to the bladder. The present invention is characterized by comprising a simulated urethra, and a stenosis part forming mechanism in which a stenosis part is formed in a part of the simulated urethra and the degree of the stenosis is adjustable.

  With such a configuration, various stenosis states of the urethra can be reproduced by the stenosis formation mechanism, so that urinary guidance training can be performed while experiencing the urethra differences among individuals.

  For example, the stenosis formation mechanism of the present invention can be used to perform a training to recognize the difference in resistance when inserting a urinary catheter between a state where there is little urethral stenosis and a state where there is urethral stricture. . In clinical settings, when the urethra is constricted, instead of using a urinary catheter with a small French size (diameter), the urinary tract has a larger French size and a lower back than the current one. It is known that a catheter may be used. Therefore, if it becomes possible to sense the presence or absence of stenosis or the catheter not reaching the bladder due to resistance, etc., select a French-sized urinary catheter according to the state of the urethra and It becomes possible.

  Therefore, if the model for inserting a urinary catheter of the present invention is used, it is possible to perform training that is more clinical than before, and an effect of reducing the frequency of occurrence of urethral damage can be expected.

  If the simulated urethra is completely occluded, it will not be possible to pass the catheter at all, so the urinary catheter insertion model is defective from the user's perspective, or the human body cannot be imitated properly, It seems that it is not useful for urine training. In order to prevent the occurrence of such a problem and to provide an appropriate urethral stricture state that is always effective for urinary tract training, and to ensure the training effect, the stenosis formation mechanism is used. What is necessary is just to further provide the obstruction | occlusion prevention structure which prevents that a simulation urethra is obstruct | occluded. In this specification, “obstruct” means a state in which the simulated urethra is blocked to such an extent that the catheter cannot be passed through even if the French size of the catheter is changed.

  Although it is simple, it can simulate urethral stenosis due to benign prostatic hyperplasia, and it is easy to adjust the degree of stenosis, and it can also prevent the simulated urethra from becoming completely occluded when a stenosis is created. As a specific configuration example, at least a part of the simulated urethra is formed in a tube shape with a silicone resin imitating the hardness of a human body, and the stenosis formation mechanism is configured to be the simulated urethra. A tube that sandwiches the tube-shaped portion in the radial direction, and the occlusion prevention structure is provided so as to cover the outside of the simulated urethra, and is a silicon tube configured to be sandwiched by the clamp together with the simulated urethra, The silicone tube is formed of a silicone resin having a hardness higher than that of the silicone resin forming the simulated urethra. And the like of it. In such a case, since the silicone tube covering the outside of the simulated urethra is harder, the simulated urethra inside the silicone tube deforms and escapes and is crushed even when the clamping is too strong. It is difficult to become blocked.

  In order to realize the difficulty in inserting a catheter peculiar to male urination in a form close to clinical practice, the stenosis formation mechanism is narrowed in a portion corresponding to a portion of the simulated urethra on the bladder side and adjacent to the prostate. What is necessary is just to be comprised so that a part may be formed.

  As described above, according to the urinary catheter insertion model of the present invention, various degrees of stenosis can be freely formed in the simulated urethra by the stenosis portion forming mechanism. It is possible to faithfully reproduce the resistance feeling at the time of insertion. Therefore, the user can obtain a sense in a clinical form even during urinary training, such as selecting an appropriate French-sized catheter according to the thickness of the urethra and the degree of stenosis, so that urine can be conducted. Become. This can be expected to reduce the frequency of urethral damage in the clinical setting.

The typical perspective view which shows the use condition of the model for urinary catheter insertion which concerns on one Embodiment of this invention. The typical perspective view which shows the urinary catheter insertion model in the same embodiment. The typical sectional view of the model for urinary catheter insertion in the embodiment. The schematic diagram which shows the simulated urethra and stenosis part formation mechanism in the embodiment. The schematic diagram which shows the difference by the presence or absence of the obstruction | occlusion prevention structure in the embodiment. The schematic diagram shown about the urethra damage example by inadequate insertion of a balloon catheter. The schematic diagram shown about the narrowing of the urethra by prostatic hypertrophy.

  A urinary catheter insertion model 100 according to an embodiment of the present invention will be described with reference to the drawings.

  The urinary catheter insertion model 100 according to the present embodiment is used for training urination before a nurse, a nursing student, or a doctor stands at a clinical site as shown in FIG. This urinary catheter insertion model 100 imitates the periphery of a male part, and at least the periphery of the genital part is formed of a silicon resin having a hardness similar to that of the human body, so that it can move freely. It is configured. For this reason, as shown in FIG. 1, the orientation and bending of the simulated urethra can be freely adjusted, and the urinary catheter is adjusted so that it can be easily inserted in the same manner as in clinical practice. You can also do that.

  As shown in FIGS. 2 and 3, the urinary catheter insertion model 100 includes a genital cassette 1 formed of a soft silicone resin, and a hard resin that holds the genital cassette 1 and holds it in a predetermined posture and position. And a simulated bladder 3 that is held by the holder 2 and simulates the bladder. The genital cassette 1 is configured to be detachable from the holding body 2. Note that FIG. 3 shows a state in which a knob portion 44 described later is not exposed to the outside.

  The genital cassette 1 includes an outer surface portion 11 simulating the circumference of the crotch and a foreskin as shown in FIGS. 2 and 3, and a glans portion and a urethral orifice as shown in FIG. A simulated urethra 12 that simulates the urethra, a stenosis formation mechanism 4 that forms a stenosis portion in the simulation urethra 12, and an occlusion prevention structure 5 that prevents the simulation urethra 12 from being blocked by the stenosis formation mechanism 4 It is. Further, as shown in FIG. 4A, the simulated urethra 12 is configured to be detachable from the outer surface portion 11.

  Next, each part related to urinary tract training will be described in detail.

  As shown in FIG. 4A, the simulated urethra 12 faithfully simulates the length and thickness of a male urethra, and is formed of a silicone resin having a hardness and a sliding degree comparable to those of a human body. It is. The simulated urethra 12 is formed in a tube shape except for the glans portion, and one end of the tube-shaped portion is connected to the simulated bladder 3. Since the simulated urethra 12 can be bent freely, the actual male urethra shape and bending condition can be simulated when attached to the outer surface portion 11 and the simulated bladder 3.

  The narrowed portion forming mechanism 4 is attached to the tube-like portion of the simulated urethra 12 as shown in FIG. 4B, and the narrowed portion of the simulated urethra 12 is narrowed by sandwiching the tube-like portion in the radial direction. A part is formed. The attachment position of the stenosis forming mechanism 4 corresponds to the position of the prostate with respect to the urethra. In other words, the stenosis formation mechanism 4 can faithfully reproduce the stenosis in the actual human body as shown in FIG. 7 due to the enlargement of the two prostates and the urethra being sandwiched between them. In addition, the stenosis forming mechanism 4 is configured as a clamp 4 that can adjust the amount of pinching so that the degree of stenosis can be freely adjusted. As shown in FIG. 4, the clamp 4 has a pressing plate 42 configured to be advanced and retracted by a feed screw 43, a receiving member 41 to which the simulated urethra 12 is pressed, and a protruding amount of the feed screw 43 manually. It is comprised from the knob part 44 for adjusting. As shown in FIGS. 1 and 2, the knob portion 44 is configured to be attachable so as to be exposed to the outside from a portion corresponding to the perineum of the human body. Therefore, the degree of stenosis in the simulated urethra 12 can be freely adjusted without removing the simulated urethra 12 and the stenosis forming mechanism 4 from the outer surface portion 11.

  The blocking prevention structure 5 prevents the simulated urethra 12 from being crushed when the stenosis formation mechanism 4 sandwiches the simulated urethra 12 to block the inside. In the present embodiment, as shown in FIG. 4, the silicon tube 5 is provided so as to cover the outside of the tubular portion of the simulated urethra 12. The silicon tube 5 is formed so as to be harder than the simulated urethra 12 by changing the blending ratio of the silicone resin forming the simulated urethra 12. Then, as shown in FIGS. 4B and 5A, the blocking prevention structure 5 is sandwiched simultaneously with the tube-shaped portion of the simulated urethra 12 by the stenosis portion forming mechanism 4. In the present embodiment, the inner diameter of the silicon tube 5 is set to be slightly larger than the outer diameter of the tube-shaped portion of the simulated urethra 12, ensuring the bendability of the simulated urethra 12 and preventing the blockage. The function as the structure 5 can be realized.

  Here, “preventing that the simulated urethra 12 is crushed and the inside is blocked” means at least the simulated urethra as compared to the case where there is no blocking prevention structure 5 and only the simulated urethra 12 is present. 12 does not indicate that the simulated urethra 12 is not blocked in any case. In the present embodiment, if the occlusion prevention structure 5 is provided, the operation amount of the knob part 44 that completely occludes the simulated urethra 12 becomes larger.

  The difference in the closed state depending on the presence or absence of the blocking prevention structure 5 will be described with reference to FIG.

  If the silicon tube 5 is provided outside the simulated urethra 12 as shown in FIG. 5A, the silicon tube 5 is Since it is harder than the simulated urethra 12, the simulated urethra 12 can be prevented from being crushed. More specifically, even if the silicon tube 5 on the outside is deformed, there is a predetermined hardness so that a gap can be left in the interior, and the simulated urethra 12 can be caused by the softness of the gap. Even if it is sandwiched, a part can escape, so that the inside of the simulated urethra 12 is prevented from being completely blocked as shown in FIG. Moreover, since it becomes very difficult to turn the knob 44 depending on the hardness and thickness of the silicon tube 5, it is possible to prevent the gap between the clamps 4 from becoming too small.

  If the knob portion 44 is turned too much with only the simulated urethra 12 sandwiched between the clamps 4 without providing the silicon tube 5, it may be completely blocked as shown in FIG. 5B. is there.

  From these facts, it can be seen that according to the urinary catheter insertion model 100 of the present embodiment, the silicon tube 5 can always provide an appropriate stenosis state suitable for urinary training.

  In addition, since various stenosis levels can be created by the stenosis forming mechanism 4, the difference in urethra between individuals can be simulated, or the resistance feeling at the time of catheter insertion due to the presence or absence of stenosis can be given to those who receive training. You can make a difference. From these facts, those who have been trained in the catheter insertion sensation when the catheter does not reach the bladder due to stenosis can gain knowledge and can take measures such as changing the French size of the catheter. It becomes possible to perform proper male urination. Further, as shown in FIGS. 1 and 2, etc., the stenosis can be adjusted by turning the knob portion 44 exposed in the perineum, so that each time the adjustment is made, the simulated urethra 12 and the stenosis formation mechanism 4 are adjusted. There is no need to remove the battery, and it can be used in the assembled state. For this reason, it is very easy to adjust the stenosis.

  Furthermore, in the urinary catheter insertion model 100 of this embodiment, the simulated urethra 12 is not completely occluded, so that it is possible to ensure that the catheter can always be inserted up to the simulated bladder 3. Therefore, the reason why the person who has undergone urinary training cannot insert the catheter into the simulated bladder 3 is that it is difficult to make an excuse that the model is different from the human body, and it is easy to seriously engage in urinary training. .

  As described above, according to the urinary catheter insertion model 100 of the present embodiment, a state close to clinical practice can be faithfully reproduced, and a state in which the catheter can always be inserted up to the simulated bladder 3 can be maintained. Can be expected. It can also be expected to reduce the frequency of urethral damage due to the failure to insert a balloon catheter in the clinic.

  Other embodiments will be described.

  In the embodiment, the urinary catheter insertion model 100 is a male type, but the present invention may be configured as a female type. In the female model urinary catheter insertion model 100, urinary training may be performed by simulating a case where stenosis occurs in the urethra. In addition, the urinary catheter inserted into the simulated urethra 12 in the above embodiment may be a disposable catheter or a balloon catheter. In short, any catheter can be used as long as it is used for guiding urine.

  The narrowed portion forming mechanism 4 is not limited to the clamp 4 of the embodiment. For example, the stenosis portion forming mechanism 4 may be configured such that the simulated urethra 12 can be squeezed with a string, thread, wire, or the like, and the squeezing amount is variable. In short, any stenosis part may be formed in the simulated urethra 12 and the degree of the stenosis can be adjusted. In addition, as a method of attaching the stenosis portion forming mechanism 4, the knob portion 44 does not necessarily have to be exposed to the outside, and the attachment method and the attachment direction are appropriately adjusted in consideration of ease of attachment and the bending state of the simulated urethra 12. You can set it.

  The blocking prevention structure 5 is not limited to the silicon tube 5. For example, the occlusion prevention structure 5 may be a limiter that limits the amount of clamping of the clamp 4, and the material of the part where the stenosis is created in the simulated urethra 12 by the stenosis part forming mechanism 4 may be another part. It may be made higher in hardness. Moreover, in the said embodiment, although the internal diameter of the said silicon tube 5 was set larger than the outer diameter of the said simulated urethra 12, the internal diameter of the said silicon tube 5 and the outer diameter of the said simulated urethra 12 are made into the substantially same dimension. , It may be closely fitted. If it does in this way, the thickness of the silicon tube 5 can be secured, and the simulated urethra 12 can be made more difficult to block by making it more difficult to collapse.

  In addition, various modifications and combinations of embodiments may be performed without departing from the spirit of the present invention.

DESCRIPTION OF SYMBOLS 100 ... Model for urinary catheter insertion 1 ... Genital cassette 11 ... Outer surface part 12 ... Simulated urethra 2 ... Holding body 3 ... Simulated bladder 4 ... Constriction part formation mechanism ( Clamp)
41 ・ ・ ・ Receiving member 42 ・ ・ ・ Pressing plate 43 ・ ・ ・ Feed screw 44 ・ ・ ・ Knob portion 5 ・ ・ ・ Blocking prevention structure

Claims (2)

A model for inserting a urinary catheter that is used to practice inserting a urinary catheter from the urethral orifice to the bladder,
A simulated urethra that simulates the urethra from the urethral orifice to the bladder;
Forming a stenosis in a part of the simulated urethra, and a stenosis formation mechanism capable of adjusting the degree of the stenosis;
An occlusion prevention structure that prevents the simulated urethra from being occluded by the stenosis formation mechanism,
At least a part of the simulated urethra is formed in a tube shape with a silicone resin imitating the hardness of a human body,
The stenosis part forming mechanism is a clamp that sandwiches the tubular part of the simulated urethra in the radial direction,
The occlusion prevention structure is provided so as to cover the outside of the simulated urethra, and is a silicon tube configured to be sandwiched by the clamp together with the simulated urethra,
A urinary catheter insertion model , wherein the silicone tube is made of a silicone resin having a hardness higher than that of a silicone resin forming the simulated urethra .   The urinary catheter insertion model according to claim 1, wherein the stenosis part forming mechanism is configured to form a stenosis part at a portion corresponding to a portion of the simulated urethra on the bladder side and adjacent to the prostate.